Acta Paediatrica最新文献

{"title":"Issue highlights","authors":"Anna Käll, Hugo Lagercrantz","doi":"10.1111/apa.17520","DOIUrl":"https://doi.org/10.1111/apa.17520","url":null,"abstract":"<p>Dahlén and Kimland analysed nearly 4.6 million prescriptions dispensed to more than 2 million children aged 0–17 years in Sweden.<span><sup>1</sup></span> Just under half of the children (47%) received at least one drug in 2019 and 34% received three or more different drugs. The most common drugs were for respiratory tract issues, followed by psychoanaleptics and melatonin for the nervous system and dermatologicals. The average number of prescriptions almost doubled from 2.3 in 2007 to 4.5 in 2019. Garnemark and Kindblom comment on the findings in an editorial.<span><sup>2</sup></span> https://doi.org/10.1111/apa.17425.</p><p>Height velocity is a key tool for monitoring growth and detecting serious health conditions early. Scherdel et al. have produced new annual and biannual height velocity charts for French children up to 15 years of age, using values routinely collected in primary care settings.<span><sup>3</sup></span> The median curves were close to the 1979 French and 2009 World Health Organization values, but there were important differences in the standard deviation curves. An editorial by Van Dommelen states that the same data collection method could be used by other countries to produce velocity charts with minimal extra effort.<span><sup>4</sup></span> https://doi.org/10.1111/apa.17454.</p><p>Cholestasis is highly prevalent in very low birth weight infants. It is predominantly caused by parenteral nutrition, and Oh et al. found that this condition developed at about 1 month of age.<span><sup>5</sup></span> They report that it took approximately 2 months for direct bilirubin to normalise, even when parenteral nutrition ceased and full enteral feeding was established. More time was required to normalise aspartate transferase and alanine aminotransferase levels. An editorial by Teng et al. states that understanding the dynamics of biochemical liver markers in pre-term infants with parenteral nutrition-associated cholestasis may prevent unnecessary invasive examinations.<span><sup>6</sup></span> https://doi.org/10.1111/apa.17427.</p><p>Tracheomalacia causes considerable morbidity in children and the best treatment options are still being debated. Møller et al. present a case series of seven Danish children who underwent surgical interventions, including tracheopexy and aortopexy, to reduce the respiratory symptoms caused by tracheal collapse. They report favourable clinical outcomes, particularly when there was an early intervention, and discuss the indications, timing and potential benefits of this surgery.<span><sup>7</sup></span> https://doi.org/10.1111/apa.17452.</p><p>Neonatal intensive care has improved for infants born extremely preterm, but it has not been matched by similar progress in post-discharge interventions. Baraldi et al. conducted a randomised clinical trial of 130 children born extremely preterm, to evaluate an interaction-based home-visiting programme during the first year after discharge.<span><sup>8</sup></span> Th","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"114 1","pages":"6-7"},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.17520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thresholds for conjugated hyperbilirubinaemia and hepatobiliary scintigraphy in biliary atresia: A 12-year national follow-up.","authors":"Anna Kajsa G Jessen, Thora W Helt, Lars S Johansen, Rasmus N Gaardskær, Christian Heiring, Helene Kvistgaard, Michael A Madsen, Jane A Simonsen, Søren Møller, Vibeke B Christensen, Lise Borgwardt","doi":"10.1111/apa.17536","DOIUrl":"https://doi.org/10.1111/apa.17536","url":null,"abstract":"<p><strong>Aim: </strong>To investigate liver biochemistry in infants screened for biliary atresia (BA) at the time of hepatobiliary scintigraphy (HS) and to evaluate the effect of change in threshold for HS.</p><p><strong>Methods: </strong>Infants born from 2010 to 2021, who underwent HS <6 months postpartum for BA, were included and data sourced from electronic medical records. The change in threshold in 2018 from ≥20 (and/or if conjugated bilirubin exceeds 20% of total bilirubin) to ≥17 μM (regardless of total bilirubin) was evaluated.</p><p><strong>Results: </strong>In the cohort of 635 infants, 48 had BA, 247 had AATD, and the remaining 343 were categorised as 'other'. After the threshold adjustment, HS timing was unaffected (p = 0.27), but the annual HS rate rose from 39 to 87, yet evaluations following the new guideline only accounted for 12%. All liver parameters were elevated in the BA group compared with the additional groups (p < 0.001). Amongst the 104 patients with non-excretory HS, gamma-glutamyl transferase (p < 0.001) and alanine aminotransferase (p = 0.002) remained elevated for BA. The lowest conjugated bilirubin measured in BA children was 36 μM.</p><p><strong>Conclusion: </strong>After threshold change, HS use increased without earlier BA diagnostics, but most were not due to the new guideline. Alanine aminotransferase and gamma-glutamyl transferase should be considered in BA diagnostics.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796386","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":"Treatment trajectories among children and adolescents referred to the Norwegian National Center for Gender Incongruence.","authors":"Cecilie Bjertness Nyquist, Leila Torgersen, Linda W David, Trond Haaken Diseth, Kjersti Gulbrandsen, Anne Waehre","doi":"10.1111/apa.17530","DOIUrl":"https://doi.org/10.1111/apa.17530","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to describe treatment trajectories, detransition and mortality rate among children and adolescents referred to the Norwegian National Center for Gender Incongruence (NCGI).</p><p><strong>Methods: </strong>The cohort included all 1258 persons under 18 years at referral to the NCGI from 2000 to 2020. Trajectories were registered until end of 2023.</p><p><strong>Results: </strong>In total, 861/1258 (68.4%) were assigned female gender at birth (AFAB). Mean age at referral was 14.4 years. Puberty suppression with gonadotropin-releasing hormone agonists (GnRHa) was initiated among 135/1258 (10.7%), significantly more persons assigned male gender at birth (AMAB) than AFAB (p < 0.001). Gender-affirming hormonal treatment (GAHT) was initiated in 783/1258 (62.2%). The continuation rate from GnRHa to GAHT was 97%. Discharge rate from NCGI without gender-affirming medical treatment among those who attended at least one appointment, was 264/1198 (22.0%). Eighteen AFAB detransitioned after initiated GAHT, eleven due to a cessation of transgender identity. Mortality rate in the cohort until end of 2023 was 11/1258 (0.9%).</p><p><strong>Conclusion: </strong>Different trajectories including medical pathways and assessments without gender-affirming treatment were observed. GAHT was initiated in 783/1258 (62.2%), including eighteen AFAB detransitioning after testosterone treatment. There was a high continuation rate from GnRHa to GAHT. Various trajectories highlights the need for long-term follow-up in care.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796390","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":"Complex trajectories are associated with neurological impairment in infants with congenital gastrointestinal malformations aged two.","authors":"Manon Midavaine, Nicolas Vinit, Victor Sartorius, Elsa Kermorvant-Duchemin, Alexandre Lapillonne","doi":"10.1111/apa.17523","DOIUrl":"https://doi.org/10.1111/apa.17523","url":null,"abstract":"<p><strong>Aim: </strong>Our aims were to describe the neurodevelopment of infants with congenital gastrointestinal malformations at 2 years of age and to investigate the association between developmental delay and complex trajectories.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study. Infants operated on for oesophageal atresia, abdominal wall defects, intestinal malformation, congenital diaphragmatic hernia and anorectal malformation were analysed. Neurodevelopment was assessed using the Ages and Stages Questionnaire at 24 months. The primary outcome was the presence of developmental delay, defined as ASQ-24 months of total score ≤ 185.</p><p><strong>Results: </strong>Of 118 patients, 11 (9%) had an ASQ-24 months ≤185. Factors associated with an ASQ-24 months ≤185 were earlier gestational age (p = 0.045), longer invasive ventilation (p = 0.046), longer parenteral nutrition (p = 0.043) and ≥2 hospitalisations in the first 2 years (p = 0.022). They had a significantly longer stay in the neonatal intensive care unit and subsequent hospitalisations (p = 0.007). After adjustment for prematurity and breastfeeding, this association remained statistically significant.</p><p><strong>Conclusion: </strong>Nine per cent of children with a gastrointestinal malformation show a developmental delay at the age of two. A prolonged stay in the neonatal intensive care unit and subsequent hospitalisations are associated with an increased risk of neurodevelopmental disorders, while breastfeeding may have a protective effect.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793078","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":"EBNEO commentary: Dextrose gel prophylaxis for neonatal hypoglycemia and neurocognitive function at an early school age: A randomised dosage trial.","authors":"Ashlee Smith-Patel, Daniela Dinu, Elena Itriago","doi":"10.1111/apa.17528","DOIUrl":"https://doi.org/10.1111/apa.17528","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793079","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":"Growth hormone treatment in children in Israel: A large-scale retrospective database study.","authors":"Yael Reichenberg, Rachel Bello, Bernice Oberman, Moryia Cohen, Avner Herman Cohen, Vered Shkalim Zemer","doi":"10.1111/apa.17535","DOIUrl":"https://doi.org/10.1111/apa.17535","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the indications, population characteristics and latency between short stature diagnosis to treatment with recombinant growth hormone (GH) therapy in a large cohort of children in Israel.</p><p><strong>Methods: </strong>We performed a retrospective medical chart review of all children treated with GH for conditions associated with short stature in three central districts in Israel from 1 January 2010 to 31 December 2021. Data extracted from the medical files included demographics, time to diagnosis, treatment indications and GH therapy duration.</p><p><strong>Results: </strong>The study group comprised 5148 children aged 1 day to 17 years. A total of 64.1% were diagnosed with idiopathic short stature (ISS), 31.1% with GH deficiency (GHD) and 2.5% with small-for-gestational age (SGA). Males were treated more than females (58.9% vs. 41.1%). The mean age at first documentation of short stature was 6.9 ± 3.5 years. GH therapy was initiated at a mean age of 9.8 ± 3.3 years. A total of 51.2% were of high socio-economic status (SES); 78.2% were non-ultraorthodox Jews, 13%, ultraorthodox Jews, and 8.8% were Arabs.</p><p><strong>Conclusion: </strong>Meticulous growth follow-up from early childhood for all children, specifically females, those of low SES, and minorities is important to provide appropriate referral, treatment and final adult height outcomes.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788011","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":"Being born extremely preterm with low-grade intraventricular haemorrhage had no impact on brain volumes or neurodevelopment in later childhood.","authors":"Lina Broström, Lexuri Fernández de Gamarra-Oca, Hedvig Kvanta, Maria Örtqvist, Nelly Padilla, Ulrika Ådén","doi":"10.1111/apa.17517","DOIUrl":"https://doi.org/10.1111/apa.17517","url":null,"abstract":"<p><strong>Aim: </strong>Our aim was to investigate the impact that low-grade intraventricular haemorrhage (IVH) had on neonatal morbidities, brain volumes and neurodevelopmental outcomes in children born extremely preterm (EPT) and compare them with children born EPT without low-grade IVH.</p><p><strong>Methods: </strong>This prospective cohort study was carried out in Stockholm, Sweden. It focused on 103 children born EPT from 2004 to 2007, at less than 27 weeks of gestation, without major brain injuries. The group with low-grade IVH, defined as grades I-II, were compared with children born EPT without IVH. Around half (45%) underwent MRI scans at 10 years of age and 55% had neurodevelopmental assessments at 12 years.</p><p><strong>Results: </strong>The low-grade IVH group was sicker during the neonatal period than the children born EPT without IVH. They had lower gestational ages at birth, more days on mechanical ventilation, a higher incidence of necrotising enterocolitis and were more likely to need surgical ligation of patent ductus arteriosus. However, they did not have significantly smaller brain volumes at 10 years of age or worse neurodevelopmental outcomes at 12 years of age.</p><p><strong>Conclusion: </strong>Brain volumes or neurodevelopment were not affected in children born EPT with low-grade IVH, compared to children born EPT without IVH.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788010","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":"Micrognathia and cleft palate as a cause of obstructive sleep apnoea in infants.","authors":"Turkka Kirjavainen, Pia Vuola, Janne Suominen, Anne Saarikko","doi":"10.1111/apa.17540","DOIUrl":"https://doi.org/10.1111/apa.17540","url":null,"abstract":"<p><strong>Aim: </strong>Obstructive sleep apnoea (OSA) is common in Robin sequence (RS). We investigated the significance of micrognathia, cleft palate and sleep positioning on OSA in infants.</p><p><strong>Methods: </strong>We analysed our 13-year national reference centre polysomnography (PSG) dataset. PSG was performed as daytime recordings (97%) in the supine-, side- and prone sleeping position at the median age of 5 weeks (interquartile range 3-8 weeks).</p><p><strong>Results: </strong>Our study included 113 infants with RS and cleft palate, 10 infants with RS but intact palate and 32 infants with cleft palate without micrognathia. The degree of OSA in infants with cleft palate without micrognathia was less severe than in infants with RS in terms of obstructive events (median OAHI 4 vs. 32 h^-1, respectively), SpO₂ desaturations (ODI_≥3OAH 0.4 vs. 3 h^-1), transcutaneous pCO₂ levels (TcCO₂P₉₅, 41 vs. 46 mmHg) (p < 0.0001) and work of breathing (p = 0.01). In the RS group, OSA was sleep-position dependent, with fewer obstructive events apparent in the side (18 vs. 24 h^-1, p = 0.005) and prone (39 vs. 27 h^-1, p = 0.003) sleeping positions than when supine.</p><p><strong>Conclusions: </strong>The degree of OSA in RS infants is more dependent on micrognathia than on cleft palate.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788012","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":"Understanding the context of injury data is crucial to improving safety and avoiding accidents.","authors":"Isain Zapata","doi":"10.1111/apa.17541","DOIUrl":"https://doi.org/10.1111/apa.17541","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788013","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":"Response to Letter to the Editor: 'New French height velocity growth charts: An innovative big-data approach based on routine measurements'.","authors":"Pauline Scherdel, Martin Chalumeau, Barbara Heude","doi":"10.1111/apa.17516","DOIUrl":"https://doi.org/10.1111/apa.17516","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781956","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}