Nirsevimab and maternal respiratory syncytial virus (RSV) vaccination are delivering real-world important reductions in RSV-bronchiolitis hospitalisations, a landmark achievement in paediatric preventive medicine. We argue, however, that these successes should not be mistaken for the resolution of severe bronchiolitis as a clinical and public health problem. First, RSV’s epidemiological dominance may partly reflect its transmission efficiency rather than a unique pathogenic superiority: rhinovirus, human metapneumovirus, adenovirus, and bocavirus already cause substantial disease, and genetic variants in CDHR3, GSDMB, and innate immune genes indicate that host susceptibility, not pathogen identity, is a key driver of severity. Second, although current evidence does not support viral replacement, the possibility that other respiratory viruses could expand into the ecological niche vacated by suppressed RSV transmission warrants close monitoring, alongside the theoretical, fitness-limited risk of nirsevimab-resistant RSV escape variants. Third, important gaps remain in long-term virological surveillance, cost-effectiveness evaluation, and equitable global access, particularly for the low- and middle-income countries that bear over 97
The purpose of this study is to characterize clinical features, treatment patterns, and outcomes of rare and/or high damage-burden joints in juvenile idiopathic arthritis (JIA). Patients diagnosed with JIA between January 2008 and June 2025 were included in this retrospective study. Joints involved in less than 10
Neurofibromatosis type 1 (NF1) is associated with an increased risk of epilepsy, but the clinical spectrum and associated factors of epilepsy in paediatric NF1 remain incompletely characterized. We aimed to describe frequency and features of epilepsy in paediatric NF1 and to compare the characteristics of NF1 patients with and without epilepsy. We retrospectively reviewed 253 paediatric NF1 patients followed up between January 2020 and December 2025. Demographic, clinical, electroencephalographic, and radiological data were collected. Categorical comparisons between patients with and without epilepsy were performed using χ2 or Fisher’s exact tests. Of 253 patients (53.8
To evaluate the integrity and maturation of the auditory pathway in infants exposed to congenital infections by comparing them with infants without risk indicators for hearing loss. This prospective longitudinal study included 55 infants exposed to congenital TORCH infections (study group—SG) and 38 infants without risk indicators for hearing loss (control group—CG) enrolled in a Neonatal Hearing Screening program at a public hospital in São Paulo, Brazil. Infants exposed to congenital TORCH infections and a control group without risk indicators for hearing loss were evaluated. Participants underwent three assessments: before 3 months of age (T1), 3 months after the first assessment (T2), and 6 months after the first assessment (T3). Auditory Brainstem Response (ABR) and Long-Latency Auditory Evoked Potentials (LLAEP) were recorded. Absolute latencies and interpeak intervals of the ABR, as well as the P1 component latency of the LLAEP, were analyzed. Infants exposed to congenital infections showed a higher frequency of ABR abnormalities involving waves III and V, interpeak intervals I–III and I–V, and the overall ABR outcome, particularly at the initial assessments. Progressive reductions in ABR wave and interpeak latencies, as well as in LLAEP P1 latency, were observed over time in both groups. No significant between-group differences were found in P1 latency. Conclusion: Infants exposed to congenital infections exhibit alterations in brainstem auditory pathway maturation, suggesting a slower or distinct maturational trajectory than infants without risk indicators for hearing loss. Longitudinal audiological follow-up is essential for the early identification of auditory pathway abnormalities in this population.
Professionals in healthcare, social services and the education system are confronted with a growing number of children with chronic conditions. Complex treatment plans, care coordination and cross-system care needs result in additional demands on professionals. This study aimed to explore professionals’ perspectives on the patient journeys of children with chronic conditions in Germany and identify opportunities to improve care. This qualitative study used semi-structured interviews conducted from May 2023 to February 2024. A purposive sample of professionals working with children with chronic conditions (attention-deficit/hyperactivity disorder, autism spectrum disorder, developmental disorders, cerebral palsy, bronchial asthma, type 1 diabetes) was recruited from the health, social care, and education systems in Germany. Sampling was guided by an assessment of thematic saturation. Data were analysed using structuring qualitative content analysis. Twenty-two professionals participated, including physicians (n = 7), therapists (n = 8) and social workers and counsellors (n = 7). Care was perceived as fragmented, difficult to navigate, and poorly coordinated across health, social care, and education systems. Key barriers included long waiting times, unclear care pathways, and limited interprofessional communication. Greater difficulties in navigating care and support were perceived among families facing socioeconomic disadvantage or language barriers. Professionals perceived current care structures as insufficiently meeting the needs of children with chronic conditions, particularly where families face greater barriers to navigating services. Strengthening cross-system coordination and accessibility may improve patient journeys. Future research should examine how barriers vary according to socioeconomic circumstances and across stages of the patient journey and evaluate condition-independent approaches to improving care. Trial registration: This study was registered in the German Clinical Trials Register, ID: DRKS00032139, on 07 November 2023.
