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Acta Paediatrica

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Acta Paediatrica last won the day on October 26 2016

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About Acta Paediatrica

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    Acta Paediatrica
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    Stockholm, Sweden
  1. Highlights in Acta Paediatrica's March 2017 issue Evidence-based neonatology commentaries In this month's issue, we are delighted to announce a new feature, the Evidence-Based Neonatology Commentary. This represents a unique collaboration between Acta Paediatrica and the International Society for Evidence-Based Neonatology (EBNEO). Readers will find objective appraisals of trials related to the care of neonates. The commentaries will be published in Acta Paediatrica and displayed in more detail on the EBNEO website. The goal of this initiative was to reduce the time it takes to implement evidence-based research. See the editorial by Wright et al for more details. Moderate drinking during pregnancy also affects offspring Heavy maternal alcohol consumption is well known to cause foetal alcohol spectrum disorders, but there is some controversy about whether low-to-moderate drinking during pregnancy can affect offspring. Sundelin-Wahlsten et al examined the effects of mothers’ self-reported alcohol consumption and reported negative effects on their children's growth, development and behaviour after moderate drinking. In the accompanying editorial, Landgren discusses the implications of recognising alcohol as a teratogen. Swiss end-of-life decisions in the French, German or Italian way Hendriks et al conducted a nationwide telephone survey of the general population in the French-, German- and Italian-speaking regions of Switzerland, to explore attitudes and values with regard to extreme prematurity. The majority of the 1210 respondents, almost 78%, showed a strong preference for shared decision-making, although this was lower in the Italian region (66%) than in the German (78%) and French (80%) regions. In the accompanying editorial, Bührer asks whether end-of-life decisions about extremely preterm infants are influenced by language, gender and education. Large differences between the Nordic countries in the use of less invasive surfactant administration Less invasive surfactant administration (LISA) – which is surfactant instillation administered through a thin catheter in the trachea during spontaneous breathing – is increasingly used for premature infants. Heiring et al surveyed Nordic neonatal units in autumn 2015 and of the 73 units who responded, 32% said that they used LISA. However, it was more common in Iceland (100%) and Norway (82%) than in Denmark (11%) and Sweden (9%), with Finland falling in between (60%). Premedication was used by 78%, which is more often than previously reported. Readers may also be interested to read the survey by Mukerji et al, who evaluated practice variations in noninvasive respiratory support use across Canadian neonatal intensive care units. Forty years of childhood encephalitis in Sweden In this paper, Wickström et al describe childhood encephalitis in Stockholm, Sweden, from 1970 to 2009, covering the diagnostics, aetiology and outcomes. The incidence was similar over the 40-year period and, although mortality markedly decreased and aetiologies shifted during that time, no clear long-term improvements in outcome were seen. The need for intensive care was relatively unchanged (18%–20%) for each of the study intervals, possibly indicating that the severity of cases remained unaltered.
  2. The rights of the newborn at the edge of viability and other NICU related highlights in Acta Paediatrica's November issue The recent fall in postperinatal mortality in New Zealand and the Safe Sleep programme Free Article The decline in postneonatal mortality in New Zealand plateaued in 2000. Recognition of the fact that more than 50% of sudden unexpected deaths in infancy were associated with unsafe sleeping, especially bed sharing, led to various safe sleep initiatives. The most important of these was the introduction of the Wahakura, a portable infant safe sleeping device that can be placed in the adult bed to improve the safety of bed sharing. Māori midwives issued the Wahakura, and the similar Pēpi-Pod device, to families together with advice on safe sleep. The successful programme, described in detail in Edvin A Mitchell et al’s paper, resulted in a 29% decrease in postperinatal mortality in New Zealand from 2009 to 2015. Göran Wennergren comments on the paper in: No bed sharing or safer bed sharing? Free article Why does nobody like preemies? Ola Saugstad writes about the rights of the newborn at the edge of viability Free Article Countries and institutions that define a lower gestational age limit for offering treatment to extremely preterm infants, such as 23 or 24 weeks, may be violating the United Nations Convention on the Rights of the Child says Ola Saugstad in this editorial. He states that each child has the right to an individual assessment. Over two-thirds of the adolescents who received active perinatal care after extremely preterm birth only had mild disabilities or none at all Active perinatal care increases the survival of extremely preterm infants, but may increase the rate of disabilities. Antti Holsti et al examined the outcomes of 132 adolescents aged 10–15 years who were born at gestational ages of 23–25 weeks and received active perinatal care, and compared them with term-born controls. Over two-thirds of the adolescents born extremely preterm only had mild disabilities or none at all. Is a delivery room hospice approach for periviable infants a feasible alternative? Garbi et al present the case of a periviable infant born at 23 weeks of gestation, whose mother suffered distress while watching her child struggle to breathe. At first, the mother opted to defer resuscitation, based on the belief that it was in the best interests of her child. However, she later changed her mind and requested resuscitation, as she could not bear to watch her infant struggle. The case led the authors to question the limitations of the current ethical rationale for the care of periviable infants. They propose an alternative model that uses a delivery room hospice care approach involving the administration of opioids. Brian S Carter discusses the paper in an editorial. Free article Emergency transport by a specialist paediatric transport team Centralisation of paediatric intensive care increases the need to transport critically ill children. Tova Hanneard-Hamrin et al looked at 221 children who were transported to a paediatric intensive care unit by a specialist paediatric transport team. The transported patients were sicker, younger, stayed longer in intensive care and needed more specific therapies than other patients admitted to the same unit. Despite the higher severity of illness in the transport cohort, the standardised mortality ratio was similar in both groups and survival rates were not affected by the mode of transport or the distance. Michael T Bigham and Brent McSharry comment on the paper.
  3. This article is now free online! Fast food versus slow food in very and extremely low-birthweight infants: speed of feeds is a little more than a gut feeling by Sascha Meyer et al.
  4. Thank you Ruth! That's a very good point! The Editorials by Dirk Wackernagel, Frans J Walther and David Askenazi are already open. I'll check if we can open some of the other articles too. For the regular articles and reviews the abstracts are open access. The paper by Sasha Meyer et al about fast vs slow food is an "a different view paper" an this article type doesn't have an abstract. Kind regards, Anna, Acta Paediatrica Editorial Office
  5. Infant feeding and other NICU related content in Acta Paediatrica's October issue! Fast food versus slow food in very and extremely low-birthweight infants: speed of feeds is a little more than a gut feeling. Sascha Meyer et al present their local feeding strategies and explain how a more careful feeding regime, based on a slow increment, resulted in a remarkably low incidence of NEC in their neonatal intensive care unit. Dirk Wackernagel comments on the paper and discusses the current evidence on how to feed preterm infants. Children born preterm and full term have similar rates of feeding problems at three years of age, by Tjitske Nieuwenhuis et al, with accompanying commentaries by Frans J Walther and Roberta G Pineda Review of the clinical significance of respiratory virus infections in newborn infants, by Raakel Luoto et al Positioning newborns on their back or right side for umbilical venous catheter insertion, by Emily A Kieran et al Treating perinatal asphyxia with theophylline at birth helps to reduce the severity of renal dysfunction in term neonates, A randomized controlled trial by Alok Raina et al, with David Askenazi commenting on the finding. See also a summary of the Highlights in the October 2016 issue!