Acta Paediatrica最新文献_第6页

Development and Validation of Multivariable Machine-Learning Models for the Prediction of Multisystemic Inflammatory Syndrome Outcomes in Latin American Children. 拉丁美洲儿童多系统炎症综合征结局预测的多变量机器学习模型的开发和验证。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-09-01 DOI: 10.1111/apa.70290

Danilo Buonsenso, Luca Mastrantoni, Rolando Ulloa-Gutierrez, Jimena García-Silva, Gabriela Ivankovich-Escoto, Marco A Yamazaki-Nakashimada, Enrique Faugier-Fuentes, Olguita Del Águila, German Camacho-Moreno, Dora Estripeaut, Iván F Gutiérrez-Tobar, Adriana H Tremoulet

{"title":"Development and Validation of Multivariable Machine-Learning Models for the Prediction of Multisystemic Inflammatory Syndrome Outcomes in Latin American Children.","authors":"Danilo Buonsenso, Luca Mastrantoni, Rolando Ulloa-Gutierrez, Jimena García-Silva, Gabriela Ivankovich-Escoto, Marco A Yamazaki-Nakashimada, Enrique Faugier-Fuentes, Olguita Del Águila, German Camacho-Moreno, Dora Estripeaut, Iván F Gutiérrez-Tobar, Adriana H Tremoulet","doi":"10.1111/apa.70290","DOIUrl":"https://doi.org/10.1111/apa.70290","url":null,"abstract":"Aim: We aimed to develop and test machine learning algorithms for the prediction of severe outcomes associated with MIS-C.Method: An observational ambispective cohort study was conducted including children aged from 1 month to 18 years old in 84 hospitals from the REKAMLATINA (Red de la Enfermedad de Kawasaki en America Latina) network diagnosed with MIS-C from 1st January 2020 to 31st June 2022. Multiple models were developed to predict four main outcomes: paediatric intensive care unit (PICU) admission, need for inotropes, need for mechanical ventilation, and death. Performance measures were accuracy for PICU admission, inotropes use and mechanical ventilation, and the area under the receiver operating characteristic curve (AUROC) for death. Variable contribution was analysed using Shapley Additive Explanations (SHAP) values.Results: We included 1303 children with a diagnosis of MIS-C. The model for the prediction of PICU admission (random forest [RF]) reached an accuracy of 0.80 (95% CI: 0.76-0.84), the model for inotrope use (RF) an accuracy of 0.86 (95% CI: 0.82-0.90), the model for mechanical ventilation (histogram-based gradient boosting [HBGB]) an accuracy of 0.84 (95% CI 0.80-0.88), and the model for death (RF) reached an AUROC of 0.85 (95% CI 0.77-0.93).Conclusions: We developed and validated machine learning models for the prediction of MIS-C related outcomes that can help clinicians risk stratify patients to identify those most likely to have a severe outcome from MIS-C.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979669","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}

引用次数: 0

Electrolyte Imbalance in Infants Younger Than 90 Days of Age With Febrile Urinary Tract Infection. 未满90天婴幼儿伴发热性尿路感染的电解质失衡。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-29 DOI: 10.1111/apa.70291

M Serrano Oarbeaskoa, M Camarero Pagonabarraga, I Iriarte Uribeecheverria, I Gangoiti, B Gomez, D Jimenez-Gonzalez, S Mintegi

{"title":"Electrolyte Imbalance in Infants Younger Than 90 Days of Age With Febrile Urinary Tract Infection.","authors":"M Serrano Oarbeaskoa, M Camarero Pagonabarraga, I Iriarte Uribeecheverria, I Gangoiti, B Gomez, D Jimenez-Gonzalez, S Mintegi","doi":"10.1111/apa.70291","DOIUrl":"https://doi.org/10.1111/apa.70291","url":null,"abstract":"Aim: To analyse the prevalence of electrolyte and kidney function alterations in infants ≤ 90 days with febrile urinary tract infection (UTI).Methods: Secondary analysis of a prospective registry including infants ≤ 90 days with fever without a source seen between 2010 and 2022 in an emergency department. We analysed electrolyte and kidney function laboratory parameters in relation to the definitive diagnosis and a group of healthy controls.Results: We registered 2361 episodes: 495 UTI (34 with an associated invasive bacterial infection [IBI]), 43 IBI not related to a UTI, and 1823 without bacterial infection. Further, we included 205 healthy controls. The median duration of fever was 4 h, and 98.5% were well appearing. Among infants with UTI without an associated IBI, blood creatinine levels were abnormal in 0.2%, urea in 1.1% and glomerular filtration rate in 3.2%, similar to infants not diagnosed with bacterial infections and healthy controls, and significantly lower than in those with UTI and an associated IBI (9.4%, 18.1% and 17.2% respectively). No patients had signs or symptoms of acute kidney injury.Conclusions: Electrolyte imbalance and kidney function impairment are rare in well-appearing infants younger than 90 days with febrile UTI and a short duration of fever.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979657","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}

引用次数: 0

Could Escalated Caesarean Sections Be Viewed as Obstetric Mistreatment? 增加剖腹产会被视为产科虐待吗？

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-28 DOI: 10.1111/apa.70289

Ariadne Malamitsi-Puchner, Despina D Briana, Camilla Pickles

引用次数: 0

Atopic Dermatitis and Food Allergy in Children. 儿童特应性皮炎和食物过敏。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-28 DOI: 10.1111/apa.70283

Sonila Borici

{"title":"Atopic Dermatitis and Food Allergy in Children.","authors":"Sonila Borici","doi":"10.1111/apa.70283","DOIUrl":"https://doi.org/10.1111/apa.70283","url":null,"abstract":"Aim: This study investigates current scientific perspectives on the relationship between atopic dermatitis (AD) and food allergy (FA) in children, focusing on shared mechanisms, clinical implications and treatment approaches.Methods: A targeted analysis and synthesis of recent scientific publications was conducted, including studies on diagnostic strategies, immunopathology and clinical guidelines. Selection criteria emphasised thematic relevance to AD-FA interplay and innovations in therapy.Results: Findings indicate that impaired skin barrier function, systemic sensitisation, and Th2-driven inflammation are central to both conditions. Filaggrin deficiency, lipid abnormalities and altered skin microbiota contribute to cutaneous and systemic immune dysregulation. Children with severe AD show a higher prevalence of food sensitisation, suggesting a bidirectional link. Sensitisation via damaged skin may promote gastrointestinal allergic responses. Effective diagnosis requires integrated use of history-taking, laboratory markers and provocation testing. Treatment should aim to restore skin integrity, modulate immune responses and manage dietary allergens.Conclusion: AD and FA share common pathophysiological pathways that warrant coordinated diagnostic and therapeutic strategies. Understanding their interrelation is essential for developing individualised prevention and treatment plans, especially in paediatric populations vulnerable to allergic progression.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979342","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}

引用次数: 0

Mortality and Neurodevelopmental Outcome in an Italian Cohort of Very Low Birth Weight Infants. 意大利极低出生体重儿队列的死亡率和神经发育结局。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-27 DOI: 10.1111/apa.70292

Lugli Licia, Bedetti Luca, Pugliese Marisa, Guidotti Isotta, Ancora Gina, Gargano Giancarlo, Perrone Serafina, Solinas Agostina, Motta Mario, Corvaglia Luigi Tommaso, Sansavini Alessandra, Stella Marcello, Cuoghi Costantini Riccardo, DiCaprio Antonella, Della Casa Muttini Elisa, Roversi Maria Federica, Bertoncelli Natascia, Catenazzi Piero, Ballardini Elisa, Grandi Sara, Moretti Sabrina, Turoli Daniela, Aceti Arianna, Braibanti Silvia, Insalaco Anna, Camilla Migliozzi, Fumagalli Monica, Ferrari Fabrizio, Berardi Alberto

{"title":"Mortality and Neurodevelopmental Outcome in an Italian Cohort of Very Low Birth Weight Infants.","authors":"Lugli Licia, Bedetti Luca, Pugliese Marisa, Guidotti Isotta, Ancora Gina, Gargano Giancarlo, Perrone Serafina, Solinas Agostina, Motta Mario, Corvaglia Luigi Tommaso, Sansavini Alessandra, Stella Marcello, Cuoghi Costantini Riccardo, DiCaprio Antonella, Della Casa Muttini Elisa, Roversi Maria Federica, Bertoncelli Natascia, Catenazzi Piero, Ballardini Elisa, Grandi Sara, Moretti Sabrina, Turoli Daniela, Aceti Arianna, Braibanti Silvia, Insalaco Anna, Camilla Migliozzi, Fumagalli Monica, Ferrari Fabrizio, Berardi Alberto","doi":"10.1111/apa.70292","DOIUrl":"https://doi.org/10.1111/apa.70292","url":null,"abstract":"Aim: Preterm infants face high risks of mortality and neurodevelopmental impairment. We aimed to evaluate the outcomes in an Italian cohort of very low birth weight infants.Methods: This multicenter prospective study included very low birth weight infants born in Italy between 2016 and 2020. Severe functional disability was defined as cognitive impairment, cerebral palsy, blindness or deafness.Results: A total of 1381 patients were enrolled (median gestational age: 29.1 weeks; males: 678) and 136 (9.8%) died. Multivariate analysis identified gestational age (OR 0.65), prenatal steroids (OR 0.36), magnesium sulphate (OR 0.48), advanced resuscitation (OR 4.04) and admission body temperature (OR 0.84) as predictors of mortality. A total of 802 (65.5%) completed the 24-month neurodevelopmental follow-up. Severe functional disability was observed in 71/802 (8.9%) infants, including neuropsychological impairment (59.1%), cerebral palsy (4.2%), deafness (1%) and blindness (0.2%). Multivariate analysis identified male gender (OR 1.84), advanced resuscitation (OR 1.92), periventricular leukomalacia (OR 9.94) and periventricular-intraventricular haemorrhage (OR 1.74) as predictors of severe functional disability.Conclusion: Mortality and neurodevelopmental impairments in very low birth weight infants were associated with gestational age and neonatal complications. Early interventions, including prenatal steroids, magnesium sulphate and improved neonatal care, may enhance survival and outcomes.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979727","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}

引用次数: 0

Caffeine Was Associated With Shorter Continuous Positive Airway Pressure Treatment for Infants up to Eight Weeks Old Hospitalised for Bronchiolitis. 对于8周以下因毛细支气管炎住院的婴儿，咖啡因与较短的持续气道正压治疗相关。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-27 DOI: 10.1111/apa.70279

Manon Casabianca, David Akouka, Linda Maman, Anne-Aurélie Lopes

{"title":"Caffeine Was Associated With Shorter Continuous Positive Airway Pressure Treatment for Infants up to Eight Weeks Old Hospitalised for Bronchiolitis.","authors":"Manon Casabianca, David Akouka, Linda Maman, Anne-Aurélie Lopes","doi":"10.1111/apa.70279","DOIUrl":"https://doi.org/10.1111/apa.70279","url":null,"abstract":"Aim: Bronchiolitis is the leading cause of hospitalisation before 1 year of age, with no treatment available, while caffeine stimulates respiratory function in young infants. This pilot study investigated the impact of caffeine on infants up to 8-week-old hospitalised for bronchiolitis, regardless of apnoea.Method: An observational study was conducted from October 2021 to February 2022 and from October 2022 to February 2023 in two Paris hospitals. The outcomes included adverse events and the need for, and duration of, ventilatory support and nutritional support.Results: We recruited 186 patients (55% boys) at a median age of 4.5 weeks. The 65 patients who received caffeine required nutritional support significantly less often than the no caffeine group (p < 0.001). The duration of continuous positive airway pressure (CPAP) was significantly shorter in patients in the caffeine group (4.1 days) than in the no caffeine group (7.1 days) (p = 0.003). There was a nonsignificant shorter duration of nutritional support in those who required ventilatory support (p = 0.05). Caffeine was well tolerated.Conclusion: Caffeine reduced the duration of CPAP and the need for and duration of nutritional support through a direct effect on the digestive system or overall improvement. These results should be confirmed by randomised trials.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979630","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}

引用次数: 0

Link Between History of Neonatal Jaundice and Early Childhood Allergic Diseases in South Korea. 韩国新生儿黄疸史与儿童早期过敏性疾病之间的联系

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-27 DOI: 10.1111/apa.70277

Seong Wan Kim, Yoong-A Suh, Seoheui Choi, Moon Sung Park, O Kyu Noh, Jang Hoon Lee

{"title":"Link Between History of Neonatal Jaundice and Early Childhood Allergic Diseases in South Korea.","authors":"Seong Wan Kim, Yoong-A Suh, Seoheui Choi, Moon Sung Park, O Kyu Noh, Jang Hoon Lee","doi":"10.1111/apa.70277","DOIUrl":"https://doi.org/10.1111/apa.70277","url":null,"abstract":"Aim: Allergic diseases, such as asthma, allergic rhinitis (AR), and atopic dermatitis (AD) are prevalent chronic childhood conditions, with a rising incidence globally and in South Korea. Neonatal jaundice is a common perinatal condition. However, its association with the subsequent development of allergic diseases remains unclear.Methods: This retrospective population-based cohort study used data from the Korean Health Insurance Review and Assessment Service database. Participants were categorised according to the history and severity of neonatal jaundice, defined by treatment status. Logistic regression and Cox proportional hazard models were used to estimate the risk of neonatal jaundice.Results: Children with neonatal jaundice showed a moderately increased risk of asthma and AR, particularly those who received treatment. Neonatal jaundice requiring treatment showed significantly elevated odds ratios for asthma and AR.Conclusion: Neonatal jaundice requiring treatment was associated with an increased risk of asthma and AR in early childhood. This suggests that the severity of neonatal jaundice may influence the later development of allergic diseases and highlights the need for closer follow-up of this population.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979691","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}

引用次数: 0

Tick-Borne Encephalitis (TBE) Vaccine in the National Immunisation Programme-For Whom, When and Where? 国家免疫规划中的蜱传脑炎（TBE）疫苗——为谁、何时、何地接种？

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-26 DOI: 10.1111/apa.70280

H H Askling, D Zavadska

{"title":"Tick-Borne Encephalitis (TBE) Vaccine in the National Immunisation Programme-For Whom, When and Where?","authors":"H H Askling, D Zavadska","doi":"10.1111/apa.70280","DOIUrl":"https://doi.org/10.1111/apa.70280","url":null,"abstract":"The incidence of Tick-borne encephalitis (TBE) cases has increased. The presumed location of transmission of Tick-borne encephalitis virus (TBEV) has been expanding increasingly in the western parts of Europe during the past decade. There has also been an increased incidence of surveillance-reported TBE cases in southern Sweden and southern Norway. Additionally, the warmer climate has enabled ticks to be present to a greater extent in the northern part of Scandinavia. In several reports, pre-school children tend to have a lower TBE incidence rate compared to teenagers, whereas both younger children and teenagers may experience severe neurological symptoms such as meningitis and encephalitis. In addition to physical impairments, long-term cognitive and mental impairments have been observed in up to 70% of children with TBEV infection. These may include attention deficits, reduced concentration and impaired memory, which can significantly affect daily life and school performance. Finland, Latvia and Slovenia have already included TBE vaccines in their National Immunisation Program (NIP). TBE vaccines are safe and effective for children from the age of 1, and we propose all countries with endemic areas include TBE vaccines in their future NIP. This is a cost-effective strategy and, even more important, a pivotal equity strategy for all European children.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979698","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}

引用次数: 0

We Have More to Learn About Weight Gain, Pubertal Timing and Treatment for Precocious Puberty. 关于体重增加、青春期时间和性早熟的治疗，我们还有很多要了解。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-26 DOI: 10.1111/apa.70287

Maria Elfving

引用次数: 0

Rigour Is not Opposed to Clinical Utility: A Reply on Transparency and Modelling in Meta-Analysis. 严谨不反对临床应用：对meta分析中透明度和建模的回答。

IF 2.1 4区医学

Acta Paediatrica Pub Date : 2025-08-25 DOI: 10.1111/apa.70272

Javier Arredondo Montero

引用次数: 0