Acta Paediatrica

AIM: The effect of ventilator modes on regional tissue oxygenation in premature neonates with respiratory distress syndrome (RDS) has yet to be delineated. Previous studies have looked at global oxygen delivery and have not assessed the effects on regional tissue oxygenation. Our aim in this study was to assess such tissue oxygenation in premature babies with RDS in relation to differing modes of ventilation using near infrared spectroscopy (NIRS). METHODS: In 24 stable preterm infants with RDS, undergoing elective wean in ventilator mode, cerebral and muscle tissue oxygenation were assessed using NIRS...

Current guidelines suggest that clinicians may not administer supplemental oxygen to infants with bronchiolitis if their peripheral capillary oxygen saturation of haemoglobin (SpO2 ) exceeds 90%. It has been argued that oxygen administration to achieve an SpO2 of more than 90% does not improve physiological function or clinical outcomes (1). Nevertheless, the pathophysiological and subclinical consequences of mild hypoxaemia in infants during sleep have not been studied.

AIM: To describe neurodevelopmental outcomes during early childhood among infants born very preterm and define the relationships between neurobehavior of very preterm infants and neurodevelopmental outcomes at 4 years. METHODS: Forty-eight infants born ≤32 weeks gestation had neurobehavior assessed at term equivalent age using the NICU Network Neurobehavioral Scale (NNNS). Outcomes at 4 years were assessed with the Ages and Stages Questionnaire (ASQ-3), the Sensory Profile - Short Form (SF), and the Behavior Rating Inventory of Executive Function - Preschool version (BRIEF-P)...

AIM: We aimed to describe changes in invasive pneumococcal disease (IPD) hospitalizations after introduction of the pneumococcal conjugate vaccine (PCV13). METHODS: This was a retrospective analysis of the Pediatric Health Information System (PHIS) database, including children with IPD pre-PCV13 (2004-2009) and post-PCV13 (2012-2017). Healthy children and those with chronic conditions were analyzed separately. The primary outcome was IPD incidence. Secondary outcomes included length of stay, intensive care unit (ICU) admission, mechanical ventilation, and mortality...

AIM: We investigated whether birth order is an influencing factor for birth weight independent from maternal factors. METHODS: Data were obtained from the longitudinal cohort study LIFE Child and included 1864 children, of which 526 were only children. The 1338 siblings were ranked into first-borns (n=570), second-borns (n=606) and third-or-later-borns (n=162). Children born prematurely, suffering from chronic or syndromic diseases were excluded. We performed intra-family comparisons to reduce bias and assessed the impact of perinatal parameters, such as birth order on birth weight, using mixed models...

We read with interest the study by Nayeb et al which investigated the accuracy of screening models for language disorders in bilingual children (1). While an engaging and interesting study, it does have areas for improvement. Children that were born prematurely as well as those with known disabilities were excluded from this study. Disabilities is a broad term, with a spectrum shifting between intellectual and physical disabilities.

The rising prevalence in allergies over the last few decades appears to be a global epidemic. Although we still lack a concise, robust model to adequately interpret this phenomenon, the available evidence points to the role of an increasingly urban and westernised lifestyle. This includes vitamin D deficiency, which is due to staying indoors most of the time without adequate exposure to sunlight and has been identified as one of the contributing risk factors in rising allergy rates. Indeed, a growing body of evidence has suggested that vitamin D deficiency is implicated in the pathogenesis of allergic disorders, although its role is not clear and is open to debate...

AIM: Little attention has been paid to breastfeeding late preterm (LPT) infants. This study compared breastfeeding, worries, depression and stress in mothers of LPT and term-born infants throughout the first year. We also described factors associated with shorter breastfeeding duration of LPT infants. METHODS: This longitudinal cohort study of the mothers of singleton infants - 129 born LPT and 277 born at term - was conducted at Landspitali - The National University Hospital of Iceland, which has the country's only neonatal intensive care unit...

AIM: To evaluate whether a very low glycated haemoglobin A (HbA1c) (<48 mmol/mol, 6.5 %) during childhood compared to higher HbA1c values further decreases the risk for microvascular complications. METHODS: Data was included from the 5116 patients with type 1 diabetes transferred from the Swedish paediatric diabetes quality registry to the Swedish National Diabetes Register (NDR), until 2014. All HbA1c values ever registered in the paediatric registry were used to divide patients into six groups based on the mean HbA1c...

AIM: To present the first case series of patients with Langerhans cell histiocytosis (LCH) also affected by Crohn's disease (CD), both of which are granulomatous diseases, and in LCH investigate the role of interleukin (IL)-23, which is a well-described disease mediator in CD. METHODS: A case series of three patients with LCH and CD were described; a cohort of LCH patients (n=55) as well as controls (n=55) were analyzed for circulating IL-23 levels; and the relation between the percentage of LCH cells in lesions and circulating IL-23 levels was analyzed in seven LCH patients...

We thank our colleague Monnens to highlight the risk to develop hypomagnesemia as an adverse effect of proton pump inhibitor (PPI) administration.1,2 The duration of PPI administration is indeed directly linked with the risk to develop hypomagnesemia. Muscle cramps, tetany and muscular weakness are symptoms indicating possible hypomagnesemia. Yadiapati et al published an overview of observed and hypothesized adverse effects as well as reported weak associations between chronic PPI use and adverse effects.3 ...

AIM: To evaluate the association between small for gestational age (SGA) and the prevalence of congenital heart disease (CHD) and the association of the SGA status with the outcomes among infants with CHD. METHODS: Echocardiography was performed within the first 5 days of life in 5664 consecutive infants. Infants were classified into four groups according to the presence or absence of SGA and CHD. All CHD infants were followed up until either spontaneous resolution of all cardiac lesions, invasive intervention, or death...

AIM: To measure the prognostic value of C-Reactive Protein (CRP) and its ability to predict pneumonia-associated complications. METHODS: A 3.75-years retrospective cohort analysis of all pediatric emergency department visits with a discharge diagnosis of pneumonia. Visits where CRP was not measured or with a discharge-diagnosis of viral pneumonia were excluded. The following five outcomes were studied: hospitalization, presence of parapneumonic effusion (PPE), placement of a chest-drain, admission to Pediatric Intensive Care Unit (PICU), and bacteremia...

The reliability of Apgar scores and umbilical cord pH for predicting outcomes in very low birth weight (VLBW) neonates is controversial. A few studies have tried to identify the prognostic value of these measurements among VLBW and preterm infants. Forsblad et al. showed that the Apgar score had a prognostic value in preterm infants born at 25 weeks and that a high Apgar score was associated with survival, without neurological morbidity, in the first 180 days of life (1). Locatelli et al reported that the umbilical cord pH can be normal even if the Apgar score is low five minutes after birth (2)...

AIM: To determine if closed loop automated oxygen control resulted in a reduction in the duration and severity of desaturation episodes and the number of blood gases and chest radiographs in preterm, ventilated infants. METHODS: Infants were studied on two consecutive days for 12 hours on each day. They were randomised to receive standard care (standard period) or standard care with a closed loop automated oxygen control system (automated oxygen control period) first...

No abstract text is available yet for this article.

Gluten-related diseases, such as coeliac disease, wheat allergy and non-coeliac gluten sensitivity, are increasingly being diagnosed in children. Non-coeliac gluten sensitivity is an unclear and controversial entity, unlike the other two conditions. The recommended diagnosis is a double-blind, placebo-controlled gluten provocation test. Similarly, the test may be performed on children with suspected gluten-related diseases in very specific circumstances and under medical supervision. One example is patients who have started a gluten-free diet without undergoing a duodenal biopsy...

In the article about the effects of proton inhibitors by Levy et al in Acta Paediatrica the possible effect on serum magnesium is only briefly mentioned1 . Still a vigilant attitude, however, is required to prevent hypomagnesemia. Accurate studies about the frequency of hypomagnesemia including the duration of proton pump inhibitors (PPI`s) in adults are available. Kieboom et al2 studied a population of 9.818 participants. A total of 724 participants used PPI`s. Thirty-six PPI users(5%) had hypomagnesemia (<or= 1...

No abstract text is available yet for this article.

In recent years, the field of infectious diseases has been hit by the overwhelming amount of information generated while the human microbiome is being disentangled. Based on the interaction between the microbiota and the immune system, the implications regarding infectious diseases are probably major and remain a challenge. This review was conceived as a comprehensive tool to provide an overview of the available evidence regarding the influence of the microbiome on infectious diseases in children. We present the main findings aroused from microbiome research in prevention, diagnosis and treatment of infectious disease under a pediatric perspective, to inform clinicians of the potential relevance of microbiome-related knowledge for translation to clinical practice...