Issue Highlights

A study by Carpén et al. [1] found significant differences in gene expression when they compared newborn infants after Caesarean and vaginal births. They report that 95 genes were significantly upregulated in the infants in the vaginal group, compared with those in the Caesarean group, including those related to immune and stress responses. Lagercrantz discusses whether the benefits of vaginal births are being lost due to rising Caesarean deliveries [2]. A narrative review by Broomé and Mathiesen discusses how evaluating consciousness in intensive care is pivotal to prognoses and diagnoses and relieving suffering with analgesic or sedative drugs. Consciousness in clinical care is usually equated with patients' responsiveness, assumed functional motor responses and sympathetic activity. Clinically diagnosed comas may be incorrect in more than 15% of cases and are particularly challenging in neonates and paediatric patients [3]. The review includes monitoring techniques, possible treatments and the ethical implications of disorders of consciousness. It also describes models for understanding the origin of consciousness, based on functional neuroanatomy and information processing theory. Bray et al. [4] report that 3.1% of Danish children aged 0–5 years were switched to amoxicillin 3 days after they were initially prescribed oral forms of phenoxymethylpenicillin between 1997 and 2023. The proportion that switched varied with the children's age, birth order and their parents' economic and immigration status. The authors concluded that the unpleasant flavour of phenoxymethylpenicillin may have played a role. Meanwhile, Kitsos et al. [5] share the result from a 5-year follow-up study of children who had undergone antibiotic allergy evaluations at a tertiary paediatric allergy centre and conclude that delabelling was safe. An Australian survey has revealed inconsistencies in forensic and coroner care processes and policies following sudden unexpected child deaths [6]. Tiemensma et al. concluded that this may have led to variations in standards of care and advocacy for the affected families. Such discrepancies make it challenging for families to understand the coroners' processes, access bereavement support, and participate in much-needed research to prevent future cases. Delays may have posed health risks to relatives in the rare instance when genetic causes were associated with sudden arrhythmias. Scorpion stings are a worldwide public health concern, as more than 1 million cases are reported each year. Children are particularly vulnerable and exhibit higher morbidity and mortality. Kestenbom et al. studied 287 children with mild (83%) and more severe (17%) stings and found that a risk-stratified approach could safely reduce emergency department observation stays. Factors considered included age, time since the attack, a history of allergies, and symptom severity. The authors concluded that children with mild symptoms from scorpion venom had a low risk of developing significant delayed complications [7]. Figures: 1, 3–5: istockphoto, 2: M Karlén.