Acta Paediatrica最新文献

{"title":"Vaccinations During Pregnancy Protect the Mother–Infant Dyad and Are Generally Safe","authors":"Ariadne Malamitsi-Puchner,&nbsp;Despina D. Briana,&nbsp;Gian Carlo Di Renzo","doi":"10.1111/apa.70301","DOIUrl":"10.1111/apa.70301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Vaccination in pregnancy has a critical impact on mothers, foetuses and infants. The aim of this paper was to summarise key points presented by experts attending the 12th Maria Delivoria-Papadopoulos Perinatal Symposium in March 2025 and further expand and update them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We discuss the benefits and potential side effects of vaccines for tetanus-diphtheria-acellular pertussis, influenza, COVID-19, respiratory syncytial virus and monkeypox. The future use of cytomegalovirus and group B streptococcus vaccines is also covered. Vaccine hesitancy, mainly due to fears of harming the foetus, including preterm delivery, is addressed. The use of evidence-based information to allay fears is explored. Ethical issues about the potential side effects of vaccinating mothers, primarily for the good of the infant, are discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The vaccines we looked at were generally effective and safe, with no considerable adverse effects for the mother–infant dyad. Vaccination hesitancy was predominately based on fears about the adverse effects on the foetus. These can mainly be combated by health professionals providing clear information on the impact on both the mother and her offspring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The vaccines discussed in the paper were generally effective and safe for the mother, foetus and infant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2380-2388"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179979","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":"The Paediatric BCG Vaccine Century: From Historical Success to Future Innovations","authors":"Stefan H. E. Kaufmann","doi":"10.1111/apa.70182","DOIUrl":"10.1111/apa.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The tuberculosis (TB) vaccine, Bacille-Calmette-Guérin (BCG), protects infants against severe forms of primary TB. Yet, it does not protect against pulmonary reactivation TB in adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature review was conducted between 1st January and 28th February 2025 using PubMed, Google Scholar and reports of the World Health Organization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Protection against TB includes innate and acquired cellular immunity and infants are more susceptible due to immature immunity. Immunopathology of infant TB is characterised by formation of small granulomas in the lung often followed by dissemination to other organs. Infection in adults is frequently contained until immunity is weakened and TB disease develops. Novel vaccines are being developed mostly for adolescents and adults, but two live attenuated vaccines are currently assessed in infants in Phase III clinical trials. Globally, TB remains a major health threat and countries of the global south bear the major TB burden. Today, Sweden, similar to other high-income countries, has a low incidence. General vaccination has therefore been terminated and targeted BCG vaccination is offered to infants at higher risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Together with short-treatment and rapid diagnosis, novel vaccines profoundly contribute to the fight against TB in all age groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2433-2440"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477957","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":"Update on Vaccinations in Childhood","authors":"Sven Arne Silfverdal","doi":"10.1111/apa.70782","DOIUrl":"10.1111/apa.70782","url":null,"abstract":"&lt;p&gt;This special issue is an attempt to update us on vaccinations in childhood. Although most articles are written from a European perspective, we must keep in mind that we live in a world with inequality and poverty, with consequences also for vaccinations and vaccination coverage globally. In fact, people living in economic restraint situations seem to benefit most from vaccinations. We know from history that peace, nutrition and vaccinations are most important for health and growth in society. A review by Alfvén et al. examines persistent and emerging challenges, inequities, limited manufacturing capacity, vaccination hesitancy, and climate-related disruptions [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Recent research has increased our knowledge about the immune system where trained innate immunity seems to play an important role as reviewed by both Brodin and Kaufmann et al. [&lt;span&gt;2, 3&lt;/span&gt;]. Sällberg presents different vaccine platforms and how genetic vaccines revolutionized the way that the COVID-19 pandemic was handled [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Peltola shows in an informative review that vaccination against measles has been a success but this is challenged by today's antivaxxers [&lt;span&gt;5&lt;/span&gt;]. To meet this, we need communication methods to increase parents' understanding and to help them weigh risks and benefits with vaccination as presented by Diana and Nuccetelli et al. [&lt;span&gt;6, 7&lt;/span&gt;]. In a situation where parents refuse vaccination an ethical dilemma will emerge and this is discussed by Sandlund et al. [&lt;span&gt;8&lt;/span&gt;]. Childhood vaccines are generally safe today, but side-effects exist, mostly mild and quickly transient, as reviewed by Nilsson and Storsaeter [&lt;span&gt;9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Although BCG has been a success in industrial countries, tuberculosis is still a major threat especially in the global south. New vaccines are being developed and are in clinical trials as reviewed by Kaufmann [&lt;span&gt;10&lt;/span&gt;]. Whooping cough is still a disease of all ages and is a very serious threat in the very young, who can die of apnoea and respiratory failure. The treatment is difficult and prevention has many challenges, but new vaccines are under development, presented by Heininger [&lt;span&gt;11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Invasive meningococcal infection is a very severe disease, and its epidemiology varies over time by country, age and serogroup, and is hard to predict. We have now safe and efficient vaccines that should be considered to be included in national vaccination programmes according to Næss and Watle [&lt;span&gt;12&lt;/span&gt;]. Climate change and travelling have increased our exposure to new contagions, and diseases like Tick Borne Encephalitis need to be included in vaccination programmes as suggested by Hervius Askling and Zavadska [&lt;span&gt;13&lt;/span&gt;]. Human Papillomavirus (HPV) vaccination has been used for more than a decade and the goal is now to eradicate HPV totally according to Dillner [&lt;span&gt;14&lt;/span&gt;]. Many countries have already implemented vaccination against va","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2359-2360"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70782","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169071","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":"Parental Vaccine Refusal in Children With Developmental Risks or Difficulties.","authors":"Funda Akpinar, Begum Yilmaz, Gamze Hayran Turmus, Dilan Yesiloglu, Gulsum Ozturk Emiral, Aysun Kara, Pelin Celik","doi":"10.1111/apa.70798","DOIUrl":"https://doi.org/10.1111/apa.70798","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168013","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":"Rapid Outpatient Tube Weaning Is Effective but Associated With Frequent Adverse Events: A Retrospective Cohort Study.","authors":"Josefine Limnell, Mari Ahlroos, Maisa Keski-Kuha, Päivi Peldan, Jetta Tuokkola, Anna Kaarina Kukkonen, Laura Merras-Salmio","doi":"10.1111/apa.70799","DOIUrl":"https://doi.org/10.1111/apa.70799","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the outcomes and safety of an outpatient tube-weaning programme involving rapid tube feed reduction.</p><p><strong>Methods: </strong>This retrospective patient record-based cohort study included children referred to a multidisciplinary, hunger provocation-based tube-weaning programme from 2016 to 2023 in our tertiary paediatric hospital. The primary outcome was complete tube weaning. Secondary outcomes were changes in oral feeding skills and adverse effects.</p><p><strong>Results: </strong>We traced 49 children with mostly somatic underlying diseases who had taken part in the programme. Of them, 65% achieved complete weaning and oral feeding improved in 92%, by programme completion. At a median follow-up of 2.4 years, 69% remained fully weaned. Patients with neurodevelopmental diseases benefited least. Adverse effects occurred in 49%, most commonly hypoglycaemia (37%) and dehydration (31%). Lower initial oral feeding skill was associated with reduced weaning success and a higher incidence of hypoglycaemic events. Children experiencing adverse effects-particularly hypoglycaemia-were less likely to be fully weaned.</p><p><strong>Conclusions: </strong>Rapid tube feed reduction within an outpatient hunger-provocation programme improved oral feeding but was associated with notable adverse effects. These findings support individualized tube feed reduction, patient monitoring and careful patient selection.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171329","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":"Oral Propranolol Versus Topical Timolol for the Treatment of Infantile Haemangiomas: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Liwen Weng, Hongli Zuo, Min Zhao, Jialin Dong","doi":"10.1111/apa.70789","DOIUrl":"https://doi.org/10.1111/apa.70789","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review and meta-analysis aimed to compare the efficacy and safety of oral propranolol versus topical timolol for the treatment of superficial infantile haemangiomas.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane Library, Embase, Web of Science and China National Knowledge Infrastructure from inception to April 23, 2026. Only randomized controlled trials comparing oral propranolol with topical timolol for superficial infantile haemangiomas were included. Two reviewers independently screened studies, extracted data and assessed risk of bias using the Cochrane risk of bias 2.0 tool. The primary outcomes were overall response rate and incidence of systemic adverse events. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using fixed-effect models.</p><p><strong>Results: </strong>Seven randomized controlled trials comprising 428 infants were included. Topical timolol was comparable to oral propranolol in overall response rate (RR = 1.09, 95% CI 0.97-1.23, p = 0.17; I² = 0%). Topical timolol significantly reduced the risk of systemic adverse events compared with oral propranolol (RR = 0.35, 95% CI 0.20-0.59, p < 0.0001; I² = 9%).</p><p><strong>Conclusions: </strong>Topical timolol demonstrates comparable efficacy to oral propranolol for superficial infantile haemangiomas and has a significantly superior safety profile with a 65% reduction in systemic adverse events.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149781","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":"Interviews With Physicians and Nurses Revealed Inconsistencies in Paediatric Basic Life Support Training for Families of Children With Heart Disease in Sweden.","authors":"Helena Roos, Sepideh Olausson, Anders Nygren, Ewa-Lena Bratt","doi":"10.1111/apa.70794","DOIUrl":"https://doi.org/10.1111/apa.70794","url":null,"abstract":"<p><strong>Aim: </strong>Paediatric basic life support (PBLS) training is strongly recommended for the families of children with elevated risks of cardiac arrest, as their initial survival could rely heavily on bystanders. We explored the perspectives of physicians and nurses on PBLS training and identified perceived barriers and facilitators to implementing family training.</p><p><strong>Methods: </strong>An exploratory descriptive design was used, based on semi-structured interviews with 15 physicians and 16 registered nurses working in paediatric cardiology clinics in university and regional hospitals across Sweden.</p><p><strong>Results: </strong>Healthcare professionals were concerned that introducing PBLS training might heighten parental anxiety and were reluctant to raise the subject. Consequently, PBLS training was infrequently discussed or offered. Furthermore, there was uncertainty regarding which families should be prioritised. The absence of structured routines and national guidelines was perceived as frustrating and ethically burdensome. The lack of formal policies emerged as the primary barrier to implementation.</p><p><strong>Conclusion: </strong>This study revealed inconsistencies in PBLS training practices for families of children with heart disease. There is a clear need for consensus on which families should be prioritised for PBLS training and for national guidelines to support healthcare professionals in identifying eligible families.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139526","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":"Postoperative Outcomes After Single or Multiple Visits for Paediatric Appendicitis.","authors":"Ioannis Orfanos, Carl Ekelund, Amadeus Sund, Martin Salö, Jorge Sotoca Fernandez","doi":"10.1111/apa.70801","DOIUrl":"https://doi.org/10.1111/apa.70801","url":null,"abstract":"<p><strong>Aim: </strong>To compare the postoperative outcomes in children with appendicitis diagnosed at the first visit versus after multiple visits overall and among children with complicated appendicitis.</p><p><strong>Methods: </strong>We identified children aged < 15 years diagnosed with appendicitis between 2018 and 2023. Children were classified as having a single visit (SV) or multiple visits (MV) and in those with and without complicated appendicitis.</p><p><strong>Results: </strong>Of 739 children with appendicitis, 614 (83%) were in the SV group versus 125 (17%) in the MV group. Complicated appendicitis occurred in 28% (95% CI, 25-32) and 36% (95% CI, 28-45), respectively (p = 0.074). The median number of operations was 1 in both groups (p = 0.327), and median hospitalization was 2 days in both groups (p = 0.061). Among 217 children with complicated appendicitis, 172 (79%) were in the SV group and 45 (21%) in the MV group. The median number of operations was 1 in both groups (p = 0.586), while median hospitalization was 5 versus 6 days, respectively (p = 0.196).</p><p><strong>Conclusion: </strong>Complicated appendicitis was more frequent after multiple visits, but diagnosis after multiple visits was not associated with more operations or longer hospitalization. For selected children, observation and planned reassessment may be a reasonable alternative to extensive investigations.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139472","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":"Finnish Paramedics' Self-Assessed Competence in Paediatric and Neonatal Care: A Nationwide Survey of Education, Training and Development Needs.","authors":"Mikko Kaartinen, Emilia Laapio-Rapi, Ilari Kuitunen","doi":"10.1111/apa.70791","DOIUrl":"https://doi.org/10.1111/apa.70791","url":null,"abstract":"<p><strong>Aim: </strong>To explore Finnish paramedics' self-assessed competence in paediatric and neonatal care and identify educational and training needs.</p><p><strong>Methods: </strong>This cross-sectional survey included 253 graduates of Finnish bachelor-level paramedic programmes. Data were collected between January and March 2026 using a Webropol questionnaire distributed through social media. The survey assessed self-perceived competence in paediatric and neonatal care, educational experiences, training opportunities and development needs. Data were analysed using descriptive statistics, composite variables and non-parametric methods.</p><p><strong>Results: </strong>Participants reported moderate competence in paediatric care (mean 2.92) and lower competence in neonatal care (mean 2.04). Younger and less experienced paramedics reported higher competence in theoretical and assessment-related domains, whereas more experienced paramedics reported stronger competence in emergency response performance and stress management. Competence in paediatric mental and behavioural health emergencies was consistently rated lowest (mean 1.30). Neonatal assessment and resuscitation skills also received relatively low ratings. Participants reported limited opportunities for simulation-based training and clinical placements, particularly in neonatal care.</p><p><strong>Conclusion: </strong>Paramedics identified important competence gaps in paediatric and neonatal care, especially in mental health emergencies and neonatal practice. Strengthening undergraduate education, simulation-based learning and continuing professional development may improve preparedness for paediatric and neonatal emergencies.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139514","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":"Abstracts of the European Academy of Paediatrics (EAP) Annual Paediatic Forum & Mastercourse, 30 April – 3 May 2026, Tbilisi, Georgia","authors":"","doi":"10.1111/apa.70760","DOIUrl":"https://doi.org/10.1111/apa.70760","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 S476","pages":"S3-S26"},"PeriodicalIF":1.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149100266","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}