Highlights in this issue

Abstract

Measles is one of the most contagious infectious diseases. Before the introduction of an efficient vaccine, it is estimated that there were 30 million cases and two million deaths each year, mostly among children in low-income countries. During the 1980s, measles was almost eliminated in many European countries. An editorial by Leif Dotevall 1 discusses the paradoxical and painful resurgence of measles in Europe in the last few years and highlights the need to regain confidence in immunisation. In a double-blind randomised study, Wejryd et al. gave 134 extremely low-birthweight infant oil drops containing the probiotic Lactobacillus reuteri DSM 17938 or a placebo. They did this once a day until the infants reached 36 weeks of gestation 2. The authors found that the probiotic did not reduce the time it took the infants to reach full enteral feeds. However, the infants who received the probiotic supplements had a better head growth rate during the first month of life. Claris 3 comments on the findings. This issue includes three reviews on paediatric hypertension. Wühl 4 shows that hypertension in childhood obesity was associated with significantly increased cardiovascular morbidity and mortality and states that early diagnosis and treatment for blood pressure control and weight reduction are essential. Meanwhile, Krmar 5 reviewed the prevalence of white-coat hypertension from a paediatric perspective and reports that this condition was best diagnosed in children by using ambulatory blood pressure monitoring over a 24-hour period. Carlström 6 studied hydronephrosis, and the risk of later hypertension, and points out that today's nonoperative management of hydronephrosis should be reconsidered to reduce the risk of developing elevated blood pressure or hypertension later in life. In 2014, an outbreak of group B streptococcus caused severe late-onset septicaemia in five very preterm infants and colonisation in 10 more infants in a neonatal intensive care unit (NICU) in Sweden. Åberg et al. 7 analysed the course of the outbreak, to find tools that stopped it from happening again. Meanwhile, Rønning et al. 8 adopted a similar approach to investigate an outbreak caused by antibiotic-susceptible Klebsiella oxytoca in a Norwegian NICU. The authors concluded that appropriate microbiological molecular screening methods and strict infection control measures are important, in order to control an outbreak. Readers may also be interested in the paper by Özenci and Schubert 9, which evaluated the implementation of an earlier, and more targeted, treatment of neonatal sepsis. The number of child deaths fell in Sweden from 2000 to 2014, but as many as 25% were from badly defined external causes or unknown causes, according to a study by Otterman et al. 10. A sizeable number of deaths were registered without death certificates, especially for infants. The authors conclude that systematic death reviews could yield information that could prevent future deaths. Palusci 11 comments on the findings. Readers may also be interested in the paper by Lykke et al. 12 on child mortality rates in Denmark, which we published in 2018, and the accompanying editorial by Kreicbergs 13, who discussed why and where children die. Figures 1–5. Istockphoto.com.