Acta Paediatrica

Publisher: Blackwell Publishing

Description

  • Impact factor
    1.97
  • 5-year impact
    2.06
  • Cited half-life
    8.70
  • Immediacy index
    0.41
  • Eigenfactor
    0.02
  • Article influence
    0.67
  • Other titles
    Acta pædiatrica (Oslo, Norway: 1992: Online), Acta paediatrica
  • ISSN
    1651-2227
  • OCLC
    37664034
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

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    • Author can archive a pre-print version
  • Post-print
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    • See Wiley-Blackwell entry for articles after February 2007
    • Publisher's version/PDF cannot be used
    • On author's server, institutional server or subject-based server
    • Server must be non-commercial
    • Publisher copyright and source must be acknowledged with set statement ("The definitive version is available at www.blackwell-synergy.com")
    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • Acta Paediatrica 12/2014; 103(12).
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    ABSTRACT: We read with great interest the article by Brødsgaard et al (1) that reported the effectiveness of topical clobetasol propionate for treating umbilical granuloma in infants. The authors concluded that topical application of clobetasol propionate cream (0.05%) was as effective as topical silver nitrate (99%) for treating umbilical granuloma, with self-limiting mild side effects. They said that the advantage of this approach was that it could be applied by the parents at home, compared to silver nitrate, which needed to be applied in the clinic setting.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: Hospitalised children are at increased risk of malnutrition and preterm infants, in particular, often experience poor growth (1) This may be partly attributed to variability in nutritional care and a failure to meet nutritional targets, with the extent of nutritional deficits related to the degree of postnatal growth failure seen (2). One strategy to address this is the provision of specialist nutritional support while the infant is in the neonatal intensive care unit (NICU) (3) and, in relation to this, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommends the implementation of specialist paediatric nutrition support teams in hospital, with their role including nutritional screening (4).This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThe rate of paediatric occult bacteraemia after the introduction of the 13-valent pneumococcal conjugated vaccine is relatively unknown. We determined the rate, and identified isolated pathogens, in children aged three to 36 months who presented to a paediatric emergency department with fever, but otherwise appeared well. We also analysed the yield of laboratory parameters traditionally considered risk factors for occult bacteraemia.Methods Children aged three to 36 months who were febrile, but otherwise appeared well, were included if they had blood tests in the paediatric emergency department between April 2010 and September 2012.ResultsOf the 591 patients, only six (1.0%) had a true bacterial pathogen and three of those were Streptococcus pneumoniae (0.5%). None of the children with pneumococcal bacteraemia had been immunised. The contaminant rate was 2.7% and an elevated band count was the best predictor of occult bacteraemia, with positive and negative likelihood ratios of 10 and 0.4, respectively. The yield of the other laboratory parameters was very limited.Conclusions In the era of the 13-valent pneumococcal conjugated vaccine, occult bacteraemia is an uncommon event in febrile children aged three to 36 who otherwise appear well and close follow-up should replace blood analysis in such cases.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimAsthma is one of the most common chronic paediatric diseases worldwide and affects different dimensions of health-related quality of life. This study tested the feasibility and convergent validity of using EQ-5D-Y instrument on children and adolescents with asthma.MethodsA cross-sectional design was chosen and children with asthma, aged from eight to 16-years-of-age, were recruited from clinics in Stockholm, Sweden. To test convergent validity, the EQ-5D-Y instrument was combined with the Paediatric Quality of Life Questionnaire.ResultsThe EQ-5D-Y proved feasible as nearly 96% of the 94 respondents completed all items on the questionnaire. High and moderate correlations between the two instruments were found for the dimensions of ‘doing usual activities’ and ‘activity limitations’ and for ‘having pain or discomfort’ and ‘symptoms’. The visual analogue scale of the ED-5D-Y correlated with the Paediatric Quality of Life Questionnaire total score and the self-rated health question. The dimensions on the EQ-5D-Y with most reported problems were ‘usual activities’, ‘pain or discomfort’ and ‘worried, sad or unhappy’.Conclusion The EQ-5D-Y instrument seemed to provide feasiblity and convergent validity for measuring health-related quality of life in children and adolescents with asthma.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThe aim of this study was to investigate whether scrubbing the hub of intravenous catheters with an alcohol wipe for 15 seconds could reduce the incidence of neonatal sepsis in a level-three neonatal intensive care unit.Methods We studied the incidence of neonatal sepsis caused by coagulase negative staphylococci (CoNS) for 16.5 months before the initiative was launched on 15 May 2012 and then for a further 8.5 months after it was introduced. The hub routine was applied to all intravenous catheters.ResultsDuring the control period before the initiative was launched, there were nine cases of CoNS sepsis compared with no cases after it was introduced, resulting in a decrease in sepsis incidence from 1.5% to 0% with a risk reduction of 1.5% (0.53-2.58%) (p=0.06). In the preterm infant population, the incidence of sepsis decreased from 3.6% to 0% (1.1-6%) (p=0.11).Conclusion Scrubbing the hub of intravenous catheters with an alcohol wipe for 15 seconds seemed to be an efficient way of preventing sepsis caused by CoNS in newborn infants. However, the evidence for the benefits will remain weak until a large randomised trial has been completed.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThe two-thumb encircling (TTE) technique often results in suboptimal cardiac compression and does not meet the requirements of current resuscitation guidelines. We compared this technique with the vertical two-thumb (VTT) technique, our novel modification of the TTE technique.Methods This was a prospective randomised crossover simulation study of out-of-hospital infant cardiopulmonary resuscitation (CPR). Participants who had completed a basic life support course performed 10 cycles of cardiac compressions on a manikin for each technique.ResultsWe enrolled 36 medical doctors who had applied for a hospital internship in this study. The VTT generated significantly higher pressure than the TTE and the pressure difference ranged from 26.8-62.9mmHg for each cycle, with a mean difference of 43.5mmHg (95% CI, 37.8-49.2). The difference in pressure showed a tendency to increase with increasing cycles of cardiac compressions. The participants’ heart and respiratory rate was higher with the VTT, but they said that it was easier to perform cardiac compressions with this technique.Conclusion The VTT technique generated more pressure than the TTE technique in a simulated model of infant out-of-hospital CPR. It can provide an alternative compression technique for effective infant CPR, especially for the rescuers with small hands or a weak grip.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: In a previous short communication published in this journal, we reported that pregnant women of Somali origin, living in the county of Stockholm, Sweden, had severe vitamin D deficiency (1). The study group consisted of 20 women, consecutively asked during their first visit to the antenatal clinic if they would participate in a study of vitamin D levels during pregnancy. The vitamin D levels of the 20 women of Somali origin were compared with an ethnic Swedish group of 20 pregnant women residing in the same county. The median level of serum 25-hydroxy-vitamin D (S-25-OHD) was significantly lower in women of Somali origin (11 nmol/L) than ethnic Swedish women (70 nmol/L).This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimMethods to improve the mental development of extremely low birth weight (ELBW) children are currently lacking. We assessed the effects of long-term supplementation of alpha-Tocopherol on the neurological development of 259 school-aged ELBW children.MethodsELBW participants were divided into three groups: group A with no alpha-Tocopherol supplementation (n=121); group B with supplementation for less than six months (n=104) and group C with supplementation for more than six months (n=34). We analysed the participants’ data at birth and between the ages of one-and-a-half to eight years and evaluated potential factors associated with intellectual disabilities.ResultsChildren from group C had the best outcome. The groups’ mean gestational weeks and mean ventilator days were: 27.5 weeks, 16.1 days (group A); 25.7 weeks, 41.7 days (group B), and 25.1 weeks, 75.5 days (group C). Multivariate regression analysis revealed that the odds ratios for impaired mental development at eight years were 1.5 in group B and 0.19 (p=0.017) in group C, compared to 1.0 in group A. The association between duration of alpha-Tocopherol administration and performance intelligence quotient (IQ) was dose dependent (p=0.03).Conclusion Long-term supplementation of alpha-Tocopherol appeared to improve mental development, in particular, performance IQ, in school-aged ELBW children.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimVery little is known about risk predictors for the development of reduced processing speed, which can cause intellectual problems in later life. This study identified risk predictors at five-years-of-age in a population-based cohort of very preterm infants.Methods Between January 2003 and August 2006 all preterm infants born before 32 weeks of gestation in Tyrol were prospectively enrolled (n=223) and 161 underwent a detailed examination at five-years-of-age, including a cognitive assessment using the Wechsler Preschool and Primary Scale of Intelligence, third edition. The processing speed quotient is calculated on the basis of two subtests that assess symbol search and coding. The association between prenatal and postnatal factors and reduced processing speed was analysed by means of logistic regression analysis.ResultsOf 161 children tested, 55 (34.2%) showed reduced processing speed. In 55.6% (n=30) of these children, reduced processing speed was related to full-scale intelligence quotient scores of less than 85. Smoking in pregnancy, steroids for chronic lung disease and intracerebral haemorrhage predicted reduced processing speed at five-years-of-age.Conclusion More than a third of the very preterm children we tested showed reduced processing speed at five-years-of-age and predictors were typical complications of prematurity and smoking in pregnancy.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: Aimhe aim of thisstudy was to examine the overlap between child maltreatment types and theirassociation with quality of life amongschool children.MethodsA national cross-sectional study of 3,202 grade nine Swedish pupils of 15-years-of-agewas carried out in 2011 with an 84% response rate.Data were analysed usingPearson chi-squareandmultiple linear regression analyses.ResultsOf the total sample, 650 children (20%) reported at least one type of maltreatment.There was a large degree of overlap between maltreatment types.In particular,neglect and witnessing intimate partner violence overlapped with most other types of maltreatment.There was a significant relationship between the degree of abuse and multi-type maltreatment. Results showeda linear relationship between the number of types ofmaltreatment and quality of life (p<0.001), indicating a dose-response relationship.Conclusion The results emphasise the negative impact of child maltreatment on children's lives and highlight the importance of taking the broad spectrum of child maltreatment into account in both research and practice. A more comprehensive assessment of the width of maltreatment among professionals may help to identify the most seriously maltreated children and lead to an improved ability to target intervention and prevention atthese children.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimPrematurity is associated with features of metabolic syndrome in young adulthood. We investigated the body composition and blood pressure of children born preterm.MethodsA longitudinal, observational study was conducted with preterm infants who had a birth weight of less than <1500g and a gestational age of less than 32 weeks. Growth and body composition were assessed by air-displacement plethysmography at term equivalent age and at school age and were compared to those of 61 healthy, term breastfed subjects.ResultsA total of 63 preterm infants were enrolled. At term equivalent age, growth and fat free mass were lower in preterm infants than in term newborns, but fat mass was higher. At five-years-of-age, children born preterm were still lighter and shorter than children born at term. When the results were analysed by gender, the fat free mass index was lower in boys born preterm than in their peers (12.1±1.1 versus 13.0±1.0 kg/h2 P<0.005) whereas no difference was detected among girls. Diastolic blood pressure was higher in children born preterm than in children born at term (61.14±7.8 vs 56.69±8.2 mmHg, p=0.009).Conclusion Boys born preterm showed a relative lack of fat free mass at school age compared to their peers.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThe precise role of the influenza virus in the morbidity of hospitalised paediatric pneumonia cases is unknown. We identified how many cases hospitalised during the 2009 pandemic had influenza associated pneumonia and assessed their severity.Methods Children admitted to three Israeli medical centres during the 2009 influenza pandemic with radiologically confirmed pneumonia were prospectively screened for influenza. We compared the clinical, laboratory and radiologic findings for positive and negative cases.ResultsThe pandemic H1N1 virus was detected in 89 (30%) of the 297 patients hospitalised for pneumonia and 55% of the Paediatric Intensive Care Unit admissions for pneumonia. There were no significant differences in the rates of underlying disease between the two groups. Logistic regression analysis revealed that children with pandemic H1N1 virus associated pneumonia had significantly increased disease severity than those without, with a higher incidence of hypoxemia (41.6% versus 24%) with a relative risk (RR) of 2.2, higher rate of Paediatric Intensive Care Unit admission (16.9% versus 5.8%, RR of 2.7) and higher rate of mechanical ventilation (10.1% versus 2.4%, RR:4.4).Conclusion During the 2009 influenza pandemic, 30% of children hospitalised for pneumonia had the influenza infection and these children displayed increased disease severity.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThe Finnish healthcare system will undergo major reform in the near future. This study examined whether post neonatal childhood mortality differed between university and central hospital districts in Finland from 1985-2004 and whether the causes of death were preventable.Methods We analysed post neonatal childhood mortality in Finland during two ten-year periods – 1985 to 1994 and 1995 to 2004 - analysing university and central hospital districts separately, as paediatric intensive care is centralised in university hospitals. The study looked at the main causes of death in each hospital and the mortality rates were adjusted to demonstrate how many children were at risk of dying.ResultsPost neonatal childhood mortality decreased during the study period in university and central hospital districts. We found no significant difference in mortality rates between university hospital districts, but regional differences were notable in central hospital districts, partly because of historical differences in mortality. Accidents were the most common cause of death, with substantial regional differences.Conclusion Regional post neonatal childhood mortality differed across central hospital districts and this should be taken into account in the forthcoming restructuring of the Finnish healthcare system. Special attention is needed to prevent accidental deaths, both nationally and locally.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThe difficulty in assessing pain during the neonatal period is one of the main obstacles for appropriate analgesia in intensive care units. The aim of this study was to develop and validate computer software to monitor neonatal facial movements of pain in real time.Methods The software was developed in the Delphi integrated development environment and provides real-time image analysis during monitoring, based on image recognition of pain-related facial actions. To validate the software performance, facial images were obtained during the monitoring of 30 neonates who were subjected to painful procedures related to daily care management. Of the 5,644 images identified and analysed by the software, 360 images – 12 per infant - were randomly selected and assessed by six healthcare professionals with experience of recognising neonatal pain.ResultsThe agreement between the examiners and the software assessment was excellent (Kappa=0.975). The software exhibited 85% sensitivity and 100% specificity in detecting neutral facial expressions in the resting state and 100% sensitivity and specificity in detecting pain during painful procedures.Conclusion It is possible to assess neonatal procedural pain by using computer software that has good sensitivity and specificity to detect facial movements.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: C F Louis Leipoldt was a man of fascinating complexity and great versatility. He graduated from Guy's hospital in London at the age of 27, and, after focusing on paediatrics, he returned to South Africa to become the first medical inspector for schools in the Transvaal. He later became the editor-in-chief of the South African Medical Journal and the first lecturer in children's diseases at the University of Cape Town Medical Schools. In addition, he was a highly esteemed journalist who wrote novels, plays, cook books and was regarded as a leading Afrikaans poet.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: A letter from Aydin et al (1) on our recently published study (2), states that topical clobetasol propionate should not be routinely used in infants because of the potential local and systemic side effects. We acknowledge that our study lacks information on potential systemic side effects, such as suppression of the hypothalamic-pituitary-adrenal axis, as we did not investigate this. However, the risk of meaningful systemic side effects may be considered negligible, as only a small amount of cream, of between 2-5 mg per application, was applied to a very small surface area.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimEven short periods of hyperoxia may induce prolonged cerebral vasoconstriction in newborn infants and this could theoretically lead to cerebral ischaemia even once normoxia is re-established. This study aimed to investigate the effect of brief hyperoxic exposures on regional cerebral tissue oxygen saturation (rStO2) and to evaluate whether any observed prolonged cerebral vasoconstriction was related to maturity.Methods The study included 30 infants with a postmenstrual age of more than 32 weeks, who were treated with nasal continuous positive airway pressure and a fraction of inspired oxygen of less than 0.3. The INVOS 5100C Oximeter was used to measure rStO2 before, during and after two hyperoxic exposures. If hyperoxia induced a prolonged cerebral vasoconstriction, post-hyperoxic rStO2 would be expected to decrease.ResultsrStO2 increased slightly after the first hyperoxic exposure, with a mean difference of 1.37% (95% CI 0.15, 2.6). After the second oxygen exposure, rStO2 remained unchanged with a mean difference of -0.4% (95% CI -1.6, 0.78). Differences in rStO2 were not related to gestational age in either of the two hyperoxic episodes.Conclusion We found no evidence to support the theory that transient hyperoxia induces prolonged cerebral vasoconstriction in infants with a postmenstrual age above 32 weeks.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 11/2014;
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    ABSTRACT: AimThis study aimed to evaluate the reproducibility of macronutrient measurements of domestic pooled human milk from mothers with preterm infants and to see how the results affected human milk fortifications.Method We asked 28 new mothers to express their breast milk for 24 hours on two consecutive days and repeat the process at weekly intervals. The samples were analysed using mid-infrared technology to calculate the differences between the milk collected on two consecutive days for reproducibility and the total protein supply with standard fortification.ResultsThere was a significant linear correlation between the two consecutive days with regard to protein (r=0.94, p<0.001), lipids (r= 0.86, p<0.001), lactose (r= 0.91, p< 0.001) and 24-hour volume (r=0.96, p<0.001). The percentage of the samples that would provide a protein supply of 3.5 - 4.5 g/kg/d with a fortification of 0.6 and 1.2 g protein/100 ml at a volume of 170 ml/kg, were 28% and 41%, respectively.Conclusion The domestic pooling of 24-hour expressed human milk for macronutrient analysis was a simple and reliable way of obtaining representative data. Standard fortification implies there is a risk of under and over-nutrition and individual fortification may improve the nutrition of preterm infants.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 10/2014;