Lars Gelander, Aimon Niklasson, Anton Holmgren, Aldina Pivodic, Antti Saari, Ulla Sankilampi, Leo Dunkel, Kerstin Albertsson-Wikland
{"title":"Computerised Algorithms Showed Promise in Identifying Swedish Children With Atypical Growth Patterns.","authors":"Lars Gelander, Aimon Niklasson, Anton Holmgren, Aldina Pivodic, Antti Saari, Ulla Sankilampi, Leo Dunkel, Kerstin Albertsson-Wikland","doi":"10.1111/apa.70196","DOIUrl":"https://doi.org/10.1111/apa.70196","url":null,"abstract":"<p><strong>Aim: </strong>We used computerised algorithms comparing the performance of the growth assessment criteria recommended in Sweden with those used in Finland and established by the International Obesity Task Force (IOTF).</p><p><strong>Methods: </strong>Historical data from 3214 Swedish children (51.6% girls) at 4, 6, and 8 years of age were compared with five Finnish screening parameters: the height standard deviation score (height-SDS), body mass index standard deviation score (BMI-SDS), differences in those over time and deviations from target height. In addition, BMI cut-offs in the Swedish, Finnish, and IOTF growth references were compared.</p><p><strong>Results: </strong>The Finnish screening algorithms identified up to 1.8% of Swedish children with low height-SDS or a negative change in height-SDS, and up to 1.5% with high height-SDS or a positive change in height-SDS. They also identified 26.4% more children with BMI corresponding to underweight, overweight or obesity than the IOTF measure. The Swedish cut-off identified a larger proportion than the Finnish algorithms: 17.4% of boys and 13.6% of girls were short at 4 years of age, while 15.5% of boys and 18.6% of girls were tall. Most children with atypical values were identified by this age.</p><p><strong>Conclusion: </strong>Computerised Finnish algorithms could identify Swedish children with atypical growth patterns.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical Cannabis for Paediatric Use: Weighing Promise Against Risks in Light of Emerging Evidence.","authors":"Jyotirmoy Sarker","doi":"10.1111/apa.70211","DOIUrl":"https://doi.org/10.1111/apa.70211","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Aetiology of Elevated Total Serum Immunoglobulin E in Children.","authors":"Aliisa Ärölä, Kaarina Kukkonen, Svetlana Vakkilainen","doi":"10.1111/apa.70205","DOIUrl":"https://doi.org/10.1111/apa.70205","url":null,"abstract":"<p><strong>Aim: </strong>The paucity of real-world data on the aetiology of elevated total serum immunoglobulin E (TS-IgE) in children afflicts families and health care systems with diagnostic uncertainty. We explored a cohort of children with TS-IgE levels over 1000 kU/L, focusing on the prevalence of atopic and non-atopic conditions, the aetiology of extremely elevated TS-IgE and the relevance of TS-IgE levels for the diagnosis of non-atopic diseases.</p><p><strong>Methods: </strong>Data from paediatric patients managed at HUS Group hospitals in Finland between 1998 and 2024 were queried for TS-IgE levels and International Classification of Diseases (ICD)-10 diagnostic codes. A chart review was performed for patients with non-atopic conditions.</p><p><strong>Results: </strong>Our cohort included 2431 children with TS-IgE levels over 1000 kU/L; for 2061 of them, ICD-10 codes were available. Non-atopic conditions rarely caused TS-IgE elevation (45/2061 patients, 2%), even in children with extremely high (> 15 000 kU/L, N = 76) TS-IgE levels. Graft-versus-host disease and inborn errors of immunity were the most common non-atopic aetiologies of TS-IgE elevation. All children with non-atopic conditions manifested distinct clinical symptoms, and TS-IgE level was irrelevant for reaching the diagnosis.</p><p><strong>Conclusion: </strong>Non-atopic conditions were uncommon and clinically obvious in children with elevated TS-IgE; therefore, we question the diagnostic relevance of TS-IgE measurement.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krista Taivassalo, Marita Valkama, Markku Leskinen, Marja Ojaniemi
{"title":"Performing Pulse Oximetry Screening in the Delivery Room Identified Newborn Infants Who Required Early Medical Attention.","authors":"Krista Taivassalo, Marita Valkama, Markku Leskinen, Marja Ojaniemi","doi":"10.1111/apa.70202","DOIUrl":"https://doi.org/10.1111/apa.70202","url":null,"abstract":"<p><strong>Aim: </strong>This study assessed whether pulse oximetry screening was associated with maternal and newborn characteristics or predicted the need for early medical attention. Congenital heart defects (CHDs) were also monitored.</p><p><strong>Methods: </strong>Pulse oximetry screening was performed during delivery room discharge on 638/698 (91.4%) consecutive live-born infants at Oulu University Hospital, Finland, in 2006. All 638 had peripheral oxygen saturation (SpO2) measurements and the peripheral perfusion index (PPI) was recorded for 459 infants, 103 ± 29 min after birth. CHDs were followed up until 13 years of age.</p><p><strong>Results: </strong>The infants (51.7% male) were born at 39.8 ± 1.4 gestational weeks. Those admitted to the neonatal intensive care unit (NICU) had lower mean SpO2 values (97.2% vs. 98.4%, p = 0.048). Males had higher mean PPI values than females (1.96 vs. 1.66, p = 0.002). Low mean PPI values were associated with maternal labetalol (1.28 vs. 1.84, p = 0.033) and antimicrobial medication (1.61 vs. 1.86, p = 0.036). CHDs were rare and no surgery was required.</p><p><strong>Conclusion: </strong>PPI values were gender-dependent and associated with maternal medication. Pulse oximetry screening had the potential to identify newborn infants in the delivery room who appeared healthy but required early medical attention.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Håkon Endal, Bjørn Helge Handegård, Katrine Nordeng Mellem, Anita Andrejeva, Inga Maria Rinvoll Johannsdottir, Bendik Lund, Trond Flægstad, Inger P Landsem
{"title":"Early Increase in Weight Is Seen During Treatment for Paediatric Acute Lymphoblastic Leukaemia-A Retrospective Analysis of Medical Records.","authors":"Håkon Endal, Bjørn Helge Handegård, Katrine Nordeng Mellem, Anita Andrejeva, Inga Maria Rinvoll Johannsdottir, Bendik Lund, Trond Flægstad, Inger P Landsem","doi":"10.1111/apa.70194","DOIUrl":"https://doi.org/10.1111/apa.70194","url":null,"abstract":"<p><strong>Aim: </strong>The aim of the study was to assess growth patterns in a national cohort of children aged 0-17.9 years diagnosed with acute lymphoblastic leukaemia (ALL).</p><p><strong>Methods: </strong>Medical records at the four tertiary paediatric oncology hospitals in Norway were used for retrospective data collection. Anthropometrics were collected for patients diagnosed between 1 January 2008 and 31 December 2018, weekly, or as soon after as available, and followed up for 10 years after diagnosis. Z-scores were collected from the growth curve function in the medical record software and compared to the Norwegian reference population. Generalised additive mixed model was used for analysis.</p><p><strong>Results: </strong>The analysis included 375 paediatric ALL patients. Data displayed an initial weight loss (z-score from 0.00 to -0.25) and a stagnation in height growth (z-score from 0.20 to -0.55). Throughout treatment and into remission, weight and body mass index stabilised significantly above the average healthy population (z-score: 0.30 and 0.55 respectively). Height was nonsignificantly different in remission compared to the general population (z-score: -0.15).</p><p><strong>Conclusion: </strong>Weight gain, and BMI increase, occurred earlier than previously reported. Height was negatively affected by treatment. Monitoring of nutritional status, nutritional support efforts and physical activity is important throughout treatment to prevent unwanted and avoidable fluctuations in growth.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina Schreiner, Katharina Goeral, Marlene Hammerl, Katrin Klebermass-Schrehof, Alexander Avian, Vera Neubauer, Ursula Kiechl-Kohlendorfer, Daniel Pfurtscheller, Elke Griesmaier, Gerhard Pichler
{"title":"Cerebral Oxygenation During Transition and Amplitude-Integrated Electroencephalography Signals: An Ancillary Study to the COSGOD-III Trial.","authors":"Christina Schreiner, Katharina Goeral, Marlene Hammerl, Katrin Klebermass-Schrehof, Alexander Avian, Vera Neubauer, Ursula Kiechl-Kohlendorfer, Daniel Pfurtscheller, Elke Griesmaier, Gerhard Pichler","doi":"10.1111/apa.70190","DOIUrl":"https://doi.org/10.1111/apa.70190","url":null,"abstract":"<p><strong>Aim: </strong>The COSGOD III trial was designed to guide oxygen delivery by cerebral near infrared spectroscopy (NIRS) in preterm neonates during the immediate transition after birth and showed a non-significant increase of 4.3% in survival without cerebral injury compared to the control group. This ancillary observational study investigated the effect of cerebral oximetry on electrocortical activity assessed by amplitude-integrated electroencephalography (aEEG).</p><p><strong>Methods: </strong>aEEG from three centres participating in the COSGOD III trial was evaluated for the total maturation score (TMS) and its four individual component scores, the visual background pattern and sleep-wake cycling.</p><p><strong>Results: </strong>We included 147 preterm infants with a mean gestational age of 28.1 weeks and a mean birth weight of 1020 g: 70 in the NIRS group, 77 in the control group. We found significantly higher total maturation scores, more mature sleep-wake cycles, and mature background patterns in the NIRS group compared to the control group.</p><p><strong>Conclusion: </strong>In the present cohort, NIRS-guided oxygen delivery combined with dedicated treatment guidelines during the immediate transition after birth showed an impact on electrocortical activity in the neonatal period. Whether this improvement in maturational aspects of the aEEG is also associated with better outcome needs to be evaluated in the long term.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ebba Nordström Carlsson, Julie Ansorge, Ioannis Orfanos
{"title":"Accuracy of Inflammatory Biomarkers for Ruling out Invasive Bacterial Infections in Young Febrile Infants.","authors":"Ebba Nordström Carlsson, Julie Ansorge, Ioannis Orfanos","doi":"10.1111/apa.70201","DOIUrl":"https://doi.org/10.1111/apa.70201","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the diagnostic accuracy of procalcitonin (PCT), C-reactive protein (CRP) and absolute neutrophil count (ANC) to rule out invasive bacterial infections (IBI) in well-appearing febrile infants aged ≤ 60 days.</p><p><strong>Methods: </strong>Multicentre study of infants ≤ 60 days with fever without source. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ANC, CRP and PCT.</p><p><strong>Results: </strong>We included 2053 well-appearing infants. The sensitivity of PCT > 0.5 ng/mL was 83% (95% CI, 45%-99%), the specificity was 90% (95% CI, 88%-92%), the PPV was 7.4% (95% CI 2.7-15.1) and the NPV was 99.8% (95% CI 99.2-100). The sensitivity of CRP > 20 mg/L was 63% (95% CI, 43%-50%) and of ANC > 4090/μL was 72% (95% CI, 50%-89%). There was 1 IBI with PCT ≤ 0.5 ng/mL and 9 IBIs with CRP ≤ 20 mg/L.</p><p><strong>Conclusions: </strong>Procalcitonin showed the highest accuracy for ruling out IBI in well-appearing febrile infants aged ≤ 60 days. With a PCT cutoff of 0.5 ng/mL, CRP and ANC had no extra value in ruling out IBIs, while ANC had an added value with a CRP cutoff of 20 mg/L. The PPV of PCT > 0.5 ng/mL was low, which can lead to unnecessary investigations, antibiotic treatments and hospitalisations.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Home-Like Setting and a Multidisciplinary Team in the Care of Kidnapped Children: A Retrospective Descriptive Study.","authors":"Efrat Bron-Harlev, Lotem Goldberg, Omer Niv, Shirley Saar, Shlomit Yaron, Noa Ziv, Dana Singer-Harel, Havazelet Yarden-Bilavsky, Yael Mozer-Glassberg, Noa Eliakim-Raz, Silvana Fennig, Gilat Livni","doi":"10.1111/apa.70189","DOIUrl":"https://doi.org/10.1111/apa.70189","url":null,"abstract":"<p><strong>Aim: </strong>In October 2023, Hamas kidnapped 257 Israelis, including 38 children. Most of the children and some of the women were released after 49-54 days. Data or protocols for managing children returning from captivity are scarce. We describe how our hospital prepared for, and assessed children returning from captivity.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study of all returnees hospitalised at Schneider Children's Medical Center of Israel, during 24 November-7 December 2023.</p><p><strong>Results: </strong>Twenty-six returnees were admitted, comprising 11 children, eight adolescents and seven adults. Median hospitalisation period was 4 days. Returnees were hospitalised in a dedicated ward, with two pre-assigned rooms per family and equipped with new clothes and hygiene products in order to create a home-like environment. A multidisciplinary team was established along with a well-equipped educational centre. Examinations and treatments were conducted in a protected area to reduce external exposure. An innovative protocol was prepared in advance for evaluation and guidelines for future treatment. All returnees reported satisfaction with the physical conditions, integrated treatment and education received at our medical centre.</p><p><strong>Conclusion: </strong>Children returning from captivity require specialised care. A multidisciplinary approach and a supportive home-like environment may facilitate their reintegration into daily life.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabeth Fernell, Sara Landberg, Carmela Miniscalco, Rosanna Fagerudd, Jakob Åsberg Johnels, Mats Johnson, Nouchine Hadjikhani, Christopher Gillberg
{"title":"Bumetanide Treatment in 15 Children With Autism: A Randomised Waitlist-Control Study.","authors":"Elisabeth Fernell, Sara Landberg, Carmela Miniscalco, Rosanna Fagerudd, Jakob Åsberg Johnels, Mats Johnson, Nouchine Hadjikhani, Christopher Gillberg","doi":"10.1111/apa.70204","DOIUrl":"https://doi.org/10.1111/apa.70204","url":null,"abstract":"<p><strong>Aim: </strong>Bumetanide, a diuretic, influences neuronal chloride homeostasis and potentially restores GABAergic inhibition and neuronal signalling balance. This mechanism may contribute to improvements in autism-related symptoms. The present study builds on the preclinical research and on previous clinical research on bumetanide treatment for children with autism.</p><p><strong>Methods: </strong>Fifteen children (10 boys, 5 girls), aged 4-12 years with a clinically confirmed autism diagnosis, with and without intellectual disability and with and without ADHD were enrolled in this 9-month randomised waitlist-control study. Participants were randomly assigned to either begin bumetanide treatment immediately or wait 3 months before starting. Parents completed rating scales assessing symptoms, behaviours and functioning at baseline and after 3, 6 and 9 months.</p><p><strong>Results: </strong>Two children had to be excluded in the first treatment period with bumetanide due to emerging behavioural problems. Of the remaining 13, 4 discontinued after the 4-6 months period with bumetanide, and 9 completed the full 9-month study. According to parent reports, 4 of these 9 children experienced significant clinical improvements, leading parents to opt for continued bumetanide treatment for their child after study completion.</p><p><strong>Conclusion: </strong>This small, waitlist-control study provides further support that bumetanide may have beneficial effects for some children with autism.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Closing in on a Consensus in Identifying, Assessing and Diagnosing Children With Cerebral Visual Impairment.","authors":"Barbro Lindquist, Christina Westerberg","doi":"10.1111/apa.70200","DOIUrl":"https://doi.org/10.1111/apa.70200","url":null,"abstract":"<p><strong>Aim: </strong>Lack of global consensus regarding CVI makes assessment and research more difficult. Our aim is to describe current consensus and evident methods for how to identify, assess and diagnose CVI in children.</p><p><strong>Method: </strong>Data-based search on reviews and papers published 2014-2023.</p><p><strong>Result: </strong>The seven reviews and 23 papers reviewed here jointly convey a broad knowledge on CVI including its definition, assessment tools, and evidence-based methods to diagnose this condition. The definition of CVI as a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways, or any potentially co-occurring ocular impairment was confirmed. Assessment tools based on Dutton's CVI questionnaire were identified as being most relevant. A diagnosis of CVI should be assessed and established by a multidisciplinary team, following a cognitive assessment. A magnetic resonance imaging scan in addition to the ophthalmological examination can be valuable but is optional and is not on its own sufficient for diagnosis. The neuropsychological assessment must further include tests of visual and visuospatial perception. All assessments should be in co-operation with caregivers and teachers.</p><p><strong>Conclusion: </strong>This scoping review demonstrates satisfactory evidence and consensus needed in order to proceed with general recommendations for assessment and diagnosis of CVI.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}