oru.sePublikationer
Ändra sökning
Avgränsa sökresultatet
123456 51 - 100 av 272
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 51.
    Carbajal, Ricardo
    et al.
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Eriksson, Mats
    Centre for health care sciences, Örebro University Hospital, Örebro, Sweden.
    Courtois, Emilie
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Andersen, Randi Dovland
    Telemark Hospital, Skien, Norway.
    Avila-Alvarez,, A.
    Complexo Hospitalario Universitario de a Coruña, a Coruña, Spain.
    Boyle, Elaine
    University of Leicester, Leicester, UK.
    Lago, Paola
    University of Padova, Padova, Italy.
    Sarafidis, K.
    Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Simons, Sinno
    Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands.
    Pölkki, Tarja
    Institute of Health Sciences, University of Oulu, Oulu, Finland.
    Ilmoja, M.L.
    Tallinn Children’s Hospital, Tallinn, Estonia.
    Van Overmeire, Bart
    Erasme Hospital, Bruxelles, Belgium.
    Berger, A.
    Univ. Klinik F. Kinder and Jugendheilkunde, Vienna, Austria.
    Papadouri, T.
    Arch. Makarios Hospital, Nicosia, Cyprus.
    Schroth, M.
    Cnopf’sche Kinderklinik, Nuremberg, Germany.
    Tameliene, R.
    Perinatal Center, Kaunas, Lithuania.
    Attard Montalto, S.
    Mater Dei Hospital, Msida, Malta.
    Dobrzanska, A.
    Children’s Memorial Health Institute, Warsaw, Poland.
    Matos, C.
    Maternidade Dr Alfredo Da Costa, Lisboa, Portugal.
    Europain Study group, Group author
    Europain Study Group, Europain Study Group, Paris, France.
    Bergqvist, Lena
    Karolinska University Hospital, Stockholm, Sweden.
    Lagercrantz, Hugo
    Karolinska University Hospital, Stockholm, Sweden.
    Anand, K.J.S.
    Department of Pediatrics Critical Care Medecine Division, University of Tennessee Health Science Center, Memphis, USA.
    Pain Assessment In Ventilated And Non-ventilated Neonates In Nicus Across Europe: European Pain Audit In Neonates (europain Survey)2014Ingår i: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 99, s. A68-A68Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Neonates undergo many painful procedures during their NICU stay. These may include tracheal intubation/ventilation, skin-breaking procedures, drainage/suctioning of body orifices or cavities. Inherent subjectivity and difficulties of neonatal pain assessment contribute to a wide variety of assessment tools and clinical practices. To date, these practices have been not studied at a large scale.

    Objective: To determine current clinical practices for neonatal pain assessment in NICUs across Europe.

    Methods: An epidemiological observational study on bedside pain assessment practices collected data for all neonates in participating NICUs until infants left the unit (discharge, death, transfer to another hospital) or for 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to a gestational age of 44 weeks were included.

    Results: From October 2012 to June 2013, 243 NICUs from 18 European countries collected pain assessment data in 6680 neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, 58.5% of TV neonates, 45.0% of NIV neonates and 30.4% of SV neonates received bedside pain assessments (p < 0.001). Fig. shows pain assessments by country.

    Conclusions: Over half (58.5%) of TV neonates and less than half (45.0%) of NIV neonates had pain assessments performed in European NICUs. Wide variations in the rates of pain assessment exist among countries and an important improvement seems necessary.

  • 52.
    Carbajal, Ricardo
    et al.
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Eriksson, Mats
    Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Courtois, Emilie
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Avila-Alvarez,, A.
    Complexo Hospitalario Universitario de a Coruña, a Coruña, Spain.
    Berger, A.
    Univ. Klinik F. Kinder and Jugendheilkunde, Vienna, Austria.
    Lago, Paola
    University of Padova, Padova, Italy.
    Van Overmeire, Bart
    Erasme Hospital, Bruxelles, Belgium.
    Papadouri, T.
    Arch. Makarios Hospital, Nicosia, Cyprus.
    Ilmoja, M.L.
    Tallinn Children’s Hospital, Tallinn, Estonia.
    Pölkki, Tarja
    Institute of Health Sciences, University of Oulu, Oulu, Finland.
    Schroth, M.
    Cnopf’sche Kinderklinik, Nuremberg, Germany.
    Sarafidis, K.
    Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Tameliene, R.
    Perinatal Center, Kaunas, Lithuania.
    Attard Montalto, S.
    Mater Dei Hospital, Msida, Malta.
    Simons, Sinno
    Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands.
    Andersen, Randi Dovland
    Telemark Hospital, Skien, Norway.
    Dobrzanska, A.
    Children’s Memorial Health Institute, Warsaw, Poland.
    Matos, C.
    Maternidade Dr Alfredo Da Costa, Lisboa, Portugal.
    Boyle, Elaine
    University of Leicester, Leicester, UK.
    E Europain Study group, Group author
    Europain Study Group, Europain Study Group, Paris, France.
    Lagercrantz, Hugo
    Karoliniska institutet, Stocholm, Sweden.
    Bergqvist, Lena
    Karolinska institutet.
    Anand, K.J.S.
    Department of Pediatrics Critical Care Medecine Division, University of Tennessee Health Science Center, Memphis, USA.
    Sedation And Analgesia For Neonates In Nicus Across Europe: The Europain Survey2014Ingår i: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 99, s. A64-A64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Pain and stress induced by mechanical ventilation, invasive procedures, or painful diseases supports the use of sedation/analgesia (S/A) in newborns admitted to Neonatal Intensive Care Units (NICUs). To date, these practices have not been studied at a large scale.

    Objective: To determine current clinical practices regarding the use of S/A drugs in NICUs across Europe.

    Methods: This epidemiological observational study on bedside clinical practices regarding S/A collected data for all neonates in participating NICUs until the infant left the unit (discharge, death, transfer) or for up to 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to 44 weeks gestation were included.

    Results: From October 2012 to June 2013, 243 NICUs from 18 European countries collected data on 6680 eligible neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, more TV neonates [81.5% (n = 1746)] received S/A drugs than NIV neonates [17.8% (n = 266)] and SV neonates [9.3% (n = 282)]; p < 0.001. Fig. shows the rate of S/A use by country; table shows S/A drugs used.

    Conclusions: Most ventilated but few non-ventilated neonates (NIV and SV) receive S/A therapy in European NICUs. Wide variations in S/A use, drugs used, and mode of administration (continuous, bolus, or both) exist among countries.

  • 53.
    Carbajal, Ricardo
    et al.
    Service des Urgences Pédiatriques, Faculté de Médecine, Hôpital Armand Trousseau, Paris, France; INSERM U1153, Faculté de Médecine, Paris, France; Faculté de Médecine, Université Pierre et Marie Curie, Paris, France.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Courtois, Emilie
    Service des Urgences Pédiatriques, Faculté de Médecine, Hôpital Armand Trousseau, Paris, France; INSERM U1153, Faculté de Médecine, Paris, France.
    Boyle, Elaine
    University of Leicester, Leicester, United Kingdom.
    Avila-Alvarez, Alejandro
    Complexo Hospitalario Universitario de A Coruña, Coruña, Spain.
    Dovland-Andersen, Randi
    Telemark Hospital, Skien, Norway.
    Sarafidis, Kosmas
    Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Pölkki, Tarja
    University of Oulu, Oulu, Finland.
    Matos, Cristina
    Maternidade Dr Alfredo da Costa, Lisbon, Portugal.
    Lago, Paola
    University of Padua, Padua, Italy.
    Papadouri, Thalia
    Archbishop Makarios Hospital, Nicosia, Cyprus.
    Attard Montalto, Simon
    Mater Dei Hospital, Msida, Malta.
    Ilmoja, Mari-Liis
    Tallinn Children's Hospital, Tallin, Estonia.
    Simons, Sinno
    Erasmus MC–Sophia Kinderziekenhuis, Rotterdam, Netherlands.
    Tameliene, Rasa
    Kaunas Perinatal Center, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    van Overmeire, Bart
    Erasme Hospital, Brussels, Belgium.
    Berger, Angelika
    Medical University of Vienna, Vienna, Austria.
    Dobrzanska, Anna
    Children's Memorial Health Institute, Warsaw, Poland.
    Schroth, Michael
    Cnopf'sche Kinderklinik, Nürnberg, Germany.
    Bergqvist, Lena
    Karolinska Institute, Stockholm, Sweden.
    Lagercrantz, Hugo
    Karolinska Institute, Stockholm, Sweden.
    Anand, Kanvaljeet J. S.
    University of Tennessee, Memphis TN, USA.
    Sedation and analgesia practices in neonatal intensive care units (EUROPAIN): results from a prospective cohort study2015Ingår i: The Lancet Respiratory Medicine, ISSN 2213-2600, E-ISSN 2213-2619, Vol. 3, nr 10, s. 796-812Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Neonates who are in pain or are stressed during care in the intensive care unit (ICU) are often given sedation or analgesia. We investigated the current use of sedation or analgesia in neonatal ICUs (NICUs) in European countries.                                         

    Methods: EUROPAIN (EUROpean Pain Audit In Neonates) was a prospective cohort study of the management of sedation and analgesia in patients in NICUs. All neonates admitted to NICUs during 1 month were included in this study. Data on demographics, methods of respiration, use of continuous or intermittent sedation, analgesia, or neuromuscular blockers, pain assessments, and drug withdrawal syndromes were gathered during the first 28 days of admission to NICUs. Multivariable linear regression models and propensity scores were used to assess the association between duration of tracheal ventilation (TV) and exposure to opioids, sedatives-hypnotics, or general anaesthetics in neonates (O-SH-GA). This study is registered with ClinicalTrials.gov, number NCT01694745.                                         

    Findings: From Oct 1, 2012, to June 30, 2013, 6680 neonates were enrolled in 243 NICUs in 18 European countries. Mean gestational age of these neonates was 35∙0 weeks (SD 4∙6) and birthweight was 2384 g (1007). 2142 (32%) neonates were given TV, 1496 (22%) non-invasive ventilation (NIV), and 3042 (46%) were kept on spontaneous ventilation (SV). 1746 (82%), 266 (18%), and 282 (9%) neonates in the TV, NIV, and SV groups, respectively, were given sedation or analgesia as a continuous infusion, intermittent doses, or both (p<0∙0001). In the participating NICUs, the median use of sedation or analgesia was 89∙3% (70∙0–100) for neonates in the TV group. Opioids were given to 1764 (26%) of 6680 neonates and to 1589 (74%) of 2142 neonates in the TV group. Midazolam was given to 576 (9%) of 6680 neonates and 536 (25%) neonates of 2142 neonates in the TV group. 542 (25%) neonates in the TV group were given neuromuscular blockers, which were administered as continuous infusions to 146 (7%) of these neonates. Pain assessments were recorded in 1250 (58%) of 2138, 672 (45%) of 1493, and 916 (30%) of 3017 neonates in the TV, NIV, and SV groups, respectively (p<0∙0001). In the univariate analysis, neonates given O-SH-GA in the TV group needed a longer duration of TV than did those who were not given O-SH-GA (mean 136∙2 h [SD 173∙1] vs 39∙8 h [94∙7] h; p<0∙0001). Multivariable and propensity score analyses confirmed this association (p<0∙0001).                        

    Interpretation: Wide variations in sedation and analgesia practices occur between NICUs and countries. Widespread use of O-SH-GA in intubated neonates might prolong their need for mechanical ventilation, but further research is needed to investigate the therapeutic and adverse effects of O-SH-GA in neonates, and to develop new and safe approaches for sedation and analgesia. 

  • 54.
    Carbajal, Ricardo
    et al.
    Emergency Department, Trousseau Hospital, Paris, France.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Courtois, Emilie
    Trousseau Hospital, Paris, France.
    Dovland Andersen, Randi
    Telemark Hospital, Skien, Norway.
    Avila-Alvarez, A
    Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
    Boyle, Elaine
    University of Leicester, Leicester, United Kingdom.
    Lago, Paola
    University of Padova, Padova, Italy.
    Sarafidis, K
    Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Simons, Sinno
    Erasmus MC – Sophia Kinderziekenhuis, Rotterdam, Netherlands.
    Pölkki, Tarja
    Institute of Health Sciences University of Oulu, Oulu, Finland.
    Ilmoja, ML
    Tallinn Children's Hospital, Tallinn, Estonia.
    Van Overmeire, Bart
    Erasme Hospital, Bruxelles, Belgium.
    Berger, A
    Univ. Klinik f. Kinder und Jugendheilkunde, Vienna, Austria.
    Papadouri, T
    Arch. Makarios Hospital, Nicosia, Cyprus.
    Schroth, Michael
    Cnopf'sche Kinderklinik, Nuremberg, Germany.
    Tameliene, R
    Perinatal Center, Kaunas, Lithuania.
    Attard-Montalto, S
    Mater Dei Hospital, Msida, Malta.
    Dobrzanska, A
    Children's' Memorial Health Institute, Warsaw, Poland .
    Matos, C
    Maternidade Dr Alfredo da Costa, Lisboa, Portugal.
    Bergqvist, Lena
    Karolinska University Hospital, Stockholm, Sweden.
    Lagercrantz, Hugo
    Karolinska University Hospital, Stockholm, Sweden.
    Anand, KJS
    Department of Pediatrics, University of Tennessee Health Science Center, Memphis TN, USA.
    Pain Assessment in Ventilated and Non-Ventilated Neonates in NICUs across Europe: EUROpean Pain Audit in Neonates (EUROPAIN Survey)2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Neonates undergo many painful procedures during their NICU stay. These may include tracheal intubation/ventilation, skin-breaking procedures, drainage/suctioning of body orifices or cavities. Inherent subjectivity and difficulties of neonatal pain assessment contribute to a wide variety of assessment tools and clinical practices. To date, these practices have been not studied at a large scale. OBJECTIVE: To determine current clinical practices for neonatal pain assessment in NICUs across Europe. DESIGN/METHODS: An epidemiological observational study on bedside pain assessment practices collected data for all neonates in participating NICUs until infants left the unit (discharge, death, transfer to another hospital) or for 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to a gestational age of 44 weeks were included. RESULTS: From October 2012 to June 2013, 243 NICUs from 18 European countries collected pain assessment data in 6680 neonates. Of these, 2142 received tracheal ventilation (ventilated) and 4538 had spontaneous breathing or non- invasive ventilation (non-ventilated). The median (IQR) gestational age of ventilated neonates [32.1 (28.1-37.4)] was less than non-ventilated neonates [36.6 (33.6-39.1), p<0.001]. Overall, 58.5% of ventilated neonates and 35.2%% of non-ventilated neonates received bedside pain assessments (p<0.001). CONCLUSIONS: Over half (58.5%) of ventilated neonates and about one third (35.2%) of non-ventilated neonates had pain assessments performed in European NICUs. Wide variations in the methods used and rates of pain assessment exist among countries 

  • 55.
    Cario, Holger
    et al.
    University Medical Center, Ulm, Germany.
    McMullin, Mary Frances
    Queens university, Belfast, Northern Ireland.
    Bento, Celeste
    University Hospital, Coimbra, Portugal.
    Pospisilova, Dagmar
    Palacky University, Olomouc, Czech Republic.
    Percy, Melanie J.
    Belfast City Hospital, Belfast, Northern Ireland.
    Hussein, Kais
    Hannover Medical School, Hannover, Germany.
    Schwarz, Jiri
    Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
    Åström, Maria
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Hermouet, Sylvie
    Université de Nantes, Nantes, France.
    Erythrocytosis in Children and Adolescents: Classification, Characterization, and Consensus Recommendations for the Diagnostic Approach2013Ingår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, nr 11, s. 1734-1738Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    During recent years, the increasing knowledge of genetic and physiological changes in polycythemia vera (PV) and of different types of congenital erythrocytosis has led to fundamental changes in recommendations for the diagnostic approach to patients with erythrocytosis. Although widely accepted for adult patients this approach may not be appropriate with regard to children and adolescents affected by erythrocytosis. The congenital erythrocytosis working group established within the framework of the MPN&MPNr-EuroNet (COST action BM0902) addressed this question in a consensus finding process and developed a specific algorithm for the diagnosis of erythrocytosis in childhood and adolescence which is presented here. Pediatr Blood Cancer 2013;60:1734-1738. (c) 2013 Wiley Periodicals, Inc.

  • 56.
    Chen, Ruoqing
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Regodón Wallin, Amanda
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sjölander, Arvid
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Valdimarsdóttir, Unnur
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
    Ye, Weimin
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Tiemeier, Henning
    Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Almqvist, Catarina
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Lung and Allergy Unit, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Czene, Kamila
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fang, Fang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Childhood injury after a parental cancer diagnosis2015Ingår i: eLIFE, E-ISSN 2050-084X, Vol. 4, artikel-id e08500Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A parental cancer diagnosis is psychologically straining for the whole family. We investigated whether a parental cancer diagnosis is associated with a higher-than-expected risk of injury among children by using a Swedish nationwide register-based cohort study. Compared to children without parental cancer, children with parental cancer had a higher rate of hospital contact for injury during the first year after parental cancer diagnosis (hazard ratio [HR]=1.27, 95% confidence interval [CI]=1.22-1.33), especially when the parent had a comorbid psychiatric disorder after cancer diagnosis (HR=1.41, 95% CI=1.08-1.85). The rate increment declined during the second and third year after parental cancer diagnosis (HR=1.10, 95% CI=1.07-1.14) and became null afterwards (HR=1.01, 95% CI=0.99-1.03). Children with parental cancer also had a higher rate of repeated injuries than the other children (HR=1.13, 95% CI= 1.12-1.15). Given the high rate of injury among children in the general population, our findings may have important public health implications.

  • 57.
    Colins, Olivier F.
    et al.
    Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden, The Netherlands; Center for Criminological and Psychosocial Research, Örebro University, Örebro, Sweden.
    Van Damme, Lore
    Department of Special Education, Ghent University, Ghent, Belgium.
    Fanti, Kostas A.
    Department of Psychology, University of Cyprus, Nicosia, Cyprus.
    Andershed, Henrik
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    The prospective usefulness of callous-unemotional traits and conduct disorder in predicting treatment engagement among detained girls2017Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 26, nr 1, s. 75-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although treatment engagement (TE) is crucial for treatment success it is not well known how likely detained girls are to engage in treatment and what features may impede them from doing so. This study is the first to examine the prognostic usefulness of two features of potential interest, being callous-unemotional (CU) traits and conduct disorder (CD), in relation to TE. Detained girls and their parents (n = 75) were interviewed with the Diagnostic Interview Schedule for Children to assess CD, and completed the Antisocial Process Screening Device to assess CU traits dimensionally and categorically as in the new diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) CU-based specifier. One to two months later, the girls reported how much they engaged in treatment. At the zero-order level, self-, but not parent-reported CU traits and CD were predictive of lower levels of TE. The incorporation of CU traits into a diagnosis of CD identified girls with lower levels of future TE, a finding that held across different informants. Of note, the aforementioned findings only became apparent when using a dimensional measure of CU traits, and not when using the categorical measure of CU traits currently included in DSM-5. This study showed that CU traits can help developing an understanding of what factors hinder TE among detained girls. Our findings also support recommendations to incorporate CU traits into the CD diagnosis, and suggest that dimensional approaches to do so may yield relevant information about future levels of TE.

  • 58.
    Dalal, Koustuv
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Lao, Zhinqin
    Gifford, Mervyn
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Wang, Shu-Mei
    School of Public Health, Key Laboratory of Public Health Safety Ministry of Education, Fudan University, Shanghai, China .
    Knowledge and attitudes towards childhood injury prevention: a study of parents in Shanghai, China2012Ingår i: HealthMed, ISSN 1840-2291, E-ISSN 1986-8103, Vol. 6, nr 11, s. 3783-3789Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Childhood injuries are a major problem worldwide. The study explored the parents' knowledge and attitudes towards childhood injury prevention in relation to theirsocioeconomic status. The study also tried to compare parents' perceptions of cause and place of child injury with actual cause and place of injury. This was a cross sectional study of 986 randomly selected parents whose children (3-6 years old) were enrolled at selected kindergartens in a 'Safe Community' in Shanghai, China. Chi-square tests and bar diagrams were used. Almost all parents (97%) thought that injury was a serious problem for their children. Around half of the parents thought that child injuries could be prevented while almost one-third (29%) of parents indicated that there were risk factors in the living environment of their children. Parental perceptions of cause of injuries and place of injuries significantly differed from that of the reality. Parents identified the most common barriers of childhood injury prevention: lack of parental attention (41.6%), environment (35.6%) and children's risky behavior (22.7%). The difference between parental opinions and reality illustrated that parents had incorrect knowledge of childhood injuries, which might lead to incorrect foci of prevention programs.

    Before tackling environmental modifications to prevent child injuries, policy makers should focus on rectifying parents' incorrect perceptions and on modifying their attitudes as key players. It is important to first raise awareness about childhood injury prevention among the parents for appropriate intervention strategies.

  • 59.
    de Beaufort, Carine E.
    et al.
    Pediat Clin, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg.
    Lange, Karin
    Dept Med Psychol, Hannover Medical School, Hannover, Germany.
    Swift, Peter G. F.
    Childrens Hosp, Leicester Royal Infirmary, Leicester, England..
    Åman, Jan
    Region Örebro län. Dept Pediat, Örebro University Hospital, Örebro, Sweden.
    Cameron, Fergus
    Dept Endocrinol & Diabet, Royal Childrens Hosp, Parkville Vic, Australia.
    Castano, Luis
    Endocrinol & Diabet Res Grp, Hosp Cruces, Univ Basque Country, Baracaldo, Spain.
    Dorchy, Harry
    Diabetol Clin, Univ Hosp Reine Fabiola, Brussels, Belgium.
    Fisher, Lynda K.
    Dept Endocrinol & Diabet, Childrens Hosp Los Angeles, Los Angeles CA, USA..
    Hoey, Hilary
    Natl Childrens Hosp, Univ Dublin Trinity Coll, Dublin, Ireland.
    Kaprio, Eero
    Dept Paediat, Peijas Hosp, Helsinki, Finland.
    Kocova, Mirjana
    Dept Endocrinol & Genet, Univ Pediat Clin, Skopje, Macedonia.
    Neu, Andreas
    Clin Children & Adolescence, Univ Tubingen, Tubingen, Germany.
    Njolstad, Pal R.
    Dept Clin Med, Univ Bergen, Bergen, Norway; Dept Pediat, Haukeland Hosp, Bergen, Norway.
    Phillip, Moshe
    Natl Ctr Childhood Diabet, Schneiders Med Ctr Israel, Petah Tiqwa, Israel.
    Schoenle, Eugen
    Dept Diabet & Endocrinol, Univ Childrens Hosp, Zurich, Switzerland.
    Robert, Jean J.
    Dept Childhood & Adolescent Diabet, Hop Necker Enfants Malad, Paris, France.
    Urukami, Tatsuhiko
    Sch Med, Nihon Univ, Tokyo, Japan.
    Vanelli, Maurizio
    Pediat Clin, Ctr Diabetol, Parma, Italy.
    Danne, Thomas
    Krankenhaus Bult, Hannover, Germany.
    Barrett, Tim
    Inst Child Hlth, Univ Birmingham, Birmingham, England; Birmingham Childrens Hosp, Univ Birmingham, Birmingham, England.
    Chiarelli, Franco
    Pediat Clin, Osped Policlin, Chieti, Italy.
    Aanstoot, Henk J.
    Ctr Pediat & Adolescent Diabet Care & Res, Rotterdam, Netherlands.
    Mortensen, Henrik B.
    Herlev Hosp, Dept Pediat, Herlev, Denmark; Fac Hlth Sci, Univ Copenhagen, Copenhagen, Denmark.
    Metabolic outcomes in young children with type 1 diabetes differ between treatment centers: the Hvidoere Study in Young Children 20092013Ingår i: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 14, nr 6, s. 422-428Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate whether center differences in glycemic control are present in prepubertal children <11yr with type 1 diabetes mellitus. Research Design and Methods: This cross-sectional study involved 18 pediatric centers worldwide. All children, <11 y with a diabetes duration 12months were invited to participate. Case Record Forms included information on clinical characteristics, insulin regimens, diabetic ketoacidosis (DKA), severe hypoglycemia, language difficulties, and comorbidities. Hemoglobin A1c (HbA1c) was measured centrally by liquid chromatography (DCCT aligned, range: 4.4-6.3%; IFFC: 25-45mmol/mol). Results: A total of 1133 children participated (mean age: 8.0 +/- 2.1 y; females: 47.5%, mean diabetes duration: 3.8 +/- 2.1 y). HbA1c (overall mean: 8.0 +/- 1.0%; range: 7.3-8.9%) and severe hypoglycemia frequency (mean 21.7 events per 100 patient-years), but not DKA, differed significantly between centers (p<0.001 resp. p=0.179). Language difficulties showed a negative relationship with HbA1c (8.3 +/- 1.2% vs. 8.0 +/- 1.0%; p = 0.036). Frequency of blood glucose monitoring demonstrated a significant but weak association with HbA1c (r=-0.17; p<0.0001). Although significant different HbA1c levels were obtained with diverse insulin regimens (range: 7.3-8.5%; p<0.001), center differences remained after adjusting for insulin regimen (p<0.001). Differences between insulin regimens were no longer significant after adjusting for center effect (p=0.199). Conclusions: Center differences in metabolic outcomes are present in children <11yr, irrespective of diabetes duration, age, or gender. The incidence of severe hypoglycemia is lower than in adolescents despite achieving better glycemic control. Insulin regimens show a significant relationship with HbA1c but do not explain center differences. Each center's effectiveness in using specific treatment strategies remains the key factor for outcome.

  • 60.
    Dickson, Daniel J.
    et al.
    Department of Psychology, Florida Atlantic University, Fort Lauderdale FL, United States.
    Laursen, Brett
    Department of Psychology, Florida Atlantic University, Fort Lauderdale FL, United States.
    Stattin, Håkan
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Kerr, Margaret
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Parental Supervision and Alcohol Abuse Among Adolescent Girls2015Ingår i: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 136, nr 4, s. 617-624Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Inadequate parent supervision during the early adolescent years forecasts a host of conduct problems, including illicit alcohol consumption. Early pubertal maturation may exacerbate problems, because girls alienated from same-age peers seek the company of older, more mature youth. The current study examines overtime associations between parent autonomy granting and adolescent alcohol abuse during a developmental period when alcohol consumption becomes increasingly normative, to determine if early maturing girls are at special risk for problems arising from a lack of parent supervision.

    METHODS: At annual intervals for 4 consecutive years, a community sample of 957 Swedish girls completed surveys beginning in the first year of secondary school (approximate age: 13 years) describing rates of alcohol intoxication and perceptions of parent autonomy granting. Participants also reported age at menarche.

    RESULTS: Multiple-group parallel process growth curve models revealed that early pubertal maturation exacerbated the risk associated with premature autonomy granting: Alcohol intoxication rates increased 3 times faster for early maturing girls with the greatest autonomy than they did for early maturing girls with the least autonomy. Child-driven effects were also found such that higher initial levels of alcohol abuse predicted greater increases in autonomy granting as parent supervision over children engaged in illicit drinking waned.

    CONCLUSIONS: Early maturing girls are at elevated risk for physical and psychological adjustment difficulties. The etiology of escalating problems with alcohol can be traced, in part, to a relative absence of parent supervision during a time when peer interactions assume special significance.

  • 61.
    Dornbusch, Hans Juergen
    et al.
    Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
    Hadjipanayis, Adamos
    Department of Paediatrics, Larnaca General Hospital, Derynia, Cyprus; Medical School, European University of Cyprus, Nicosia, Cyprus .
    Del Torso, Stefano
    Dipartimento della Sanità Pubblica, Padova, Italy.
    Mercier, Jean-Christophe
    Service de Pédiatrie-Urgences, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris & Université Paris Diderot, Paris, France .
    Wyder, Corinne
    Paediatric Primary Care Center Kurwerk, Burgdorf, Switzerland.
    Schrier, Lenneke
    Juliana Children’s Hospital, The Hague, Netherlands.
    Ross-Russell, Robert
    Department of Paediatric Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
    Stiris, Tom
    Department of Neonatology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway .
    Ludvigsson, Jonas F.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    We strongly support childhood immunisation-statement from the European Academy of Paediatrics (EAP)2017Ingår i: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 176, nr 5, s. 679-680Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The eradication of smallpox and the elimination of several other infectious diseases from much of the world has provided convincing evidence that vaccines are among the most effective interventions for promoting health. The current scepticism about immunisation among members of the new US administration carries a risk of decreasing immunisation rates also in Europe. While only a small minority of the population are strongly anti-vaccine, their public activities have significantly influenced an uncertainty among the general population about both the safety of and the necessity for vaccination. Therefore, the EAP calls for greater publically available, scientifically supported information on vaccination, particularly targeted at health care providers, for the further development of electronically based immunisation information systems (IIS). We further call on all European countries to work together both in legislative and public health arenas in order to increase vaccination coverage among the paediatric population. In the interest of children and their parents, the EAP expresses its strong support for childhood immunisation and recommended vaccination schedules. We are prepared to work with governments and media and share the extensive evidence demonstrating the effectiveness and safety of vaccines.

  • 62.
    Du Rietz, Ebba
    et al.
    MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom.
    Kuja-Halkola, Ralf
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Brikell, Isabell
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Jangmo, Andreas
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sariaslan, Amir
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Kuntsi, Jonna
    MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, United Kingdom.
    Larsson, Henrik
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Predictive validity of parent- and self-rated ADHD symptoms in adolescence on adverse socioeconomic and health outcomes2017Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 26, nr 7, s. 857-867Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is scarcity of research investigating the validity of self-report of attention deficit hyperactivity disorder (ADHD) symptoms compared to other informants, such as parents. This study aimed to compare the predictive associations of ADHD symptoms rated by parents and their children across adolescence on a range of adverse socioeconomic and health outcomes in early adulthood. Parent- and self-rated ADHD symptoms were assessed in 2960 individuals in early (13-14 years) and late adolescence (16-17 years). Logistic regression analyses were used to compare the associations between parent- and self-rated ADHD symptoms at both time points and adverse life outcomes in young adulthood obtained from Swedish national registries. Both parent- and self-ratings of ADHD symptoms were associated with increased risk for adverse outcomes, although associations of parent-ratings were more often statistically significant and were generally stronger (OR = 1.12-1.49, p < 0.05) than self-ratings (OR = 1.07-1.17, p < 0.05). After controlling for the other informant, parent-ratings of ADHD symptoms in both early and late adolescence significantly predicted academic and occupational failure, criminal convictions and traffic-related injuries, while self-ratings of ADHD symptoms only in late adolescence predicted substance use disorder and academic failure. Our findings suggest that both parent- and self-ratings of ADHD symptoms in adolescence provides valuable information on risk of future adverse socioeconomic and health outcomes, however, self-ratings are not valuable once parent-ratings have been taken into account in predicting most outcomes. Thus, clinicians and researchers should prioritize parent-ratings over self-ratings.

  • 63.
    Edvinsson, Siv E.
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Prevalence of orofacial dysfunction in cerebral palsy and its association with gross motor function and manual ability2016Ingår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 58, nr 4, s. 385-394Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To investigate the prevalence of orofacial dysfunction (OFD) and explore factors associated with OFD in young individuals with cerebral palsy (CP).

    Method: We conducted a cross-sectional study on a population with CP in a Swedish county (132 individuals, mean age 14y 2mo [SD 4y 5mo], range 5-22y) using the Nordic Orofacial Test - Screening (NOT-S), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification System (MACS). The NOT-S interview was completed by 129 individuals (76 males, 53 females) of whom 52 (30 males, 22 females) also agreed to complete the NOT-S examination.

    Results: OFD occurred in at least one NOT-S domain in about 80% of the individuals and was present in all subdiagnoses, GMFCS levels, and MACS levels. Prevalence of OFD increased with increasing levels of GMFCS and MACS from level I=55% to level V=100%. Within the 12 NOT-S domains, the prevalence of OFD varied between 19% and 69%, wherein seven of them were at least 40%: 'Drooling', 'Nose breathing', 'Chewing and swallowing', 'Face at rest', 'Oral motor function', 'Speech', and 'Facial expression' (in ascending order).

    Interpretation: OFD is common in CP. The use of OFD screening in health service planning would assist detection of areas in need of further evaluation.

  • 64.
    Einberg, Afrodite Psaros
    et al.
    Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden.
    Duberg, Ann-Sofi
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Filipovich, Olga
    North-Western State Medical University of I.I.Mechnikov, Saint Petersburg, Russia.
    Nyström, Jessica
    Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.
    Zhirkov, Anton
    Science Research Institute of Children's Infections, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
    Brenndörfer, Erwin Daniel
    Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.
    Frelin, Lars
    Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.
    Rukoiatkina, Elena
    Maternity Hospital No. 16, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia; Department of Pediatrics, Gynecology and Female Reproductology, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
    Lobzin, Yuriy
    Science Research Institute of Children's Infections, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
    Sällberg, Matti
    Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.
    Fischler, Björn
    Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden.
    Lutckii, Anton
    Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden; Science Research Institute of Children's Infections.
    Lack of association between interleukin 28B polymorphism and vertical transmission of hepatitis C2017Ingår i: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 65, nr 6, s. 608-612Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Single genetic nucleotide polymorphism (rs12979860) near the gene for Interleukin 28B (IL28B), is known to be of importance for frequency of spontaneous clearance and treatment outcome in interferon based therapies in patients with hepatitis C virus (HCV) infection. The aim of this study was to investigate if IL28B polymorphism in children and/or their mothers plays a role in vertical transmission of HCV (HCV-VT).

    METHODS: Plasma samples from 59 infected women, 76 uninfected children born to infected mothers, and 47 children with known vertically transmitted HCV infection, were analysed for IL28B polymorphism and classified by the IL28B genotype (C/C, C/T and T/T) as well as by viral genotype.

    RESULTS: The proportion of children with genotype C/C was the same in the vertically infected (36%, 17/47) and the exposed uninfected children (38%, 29/76). No difference was seen when stratifying for viral genotype. There was no association between mothers' IL28B genotype and the risk of vertical transmission.

    CONCLUSION: Regardless of viral genotype we found no association between IL28B genotype and the risk of HCV-VT. The IL28B genotype CC, which has been shown to be favourable in other settings, was not protective of HCV-VT. Thus, other factors possibly associated with the risk of HCV-VT need to be explored.

  • 65.
    Ekelund, Ulf
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom; Department of Sport Medicine, Norwegian School of Sport Science, Oslo, Norway .
    Luan, Jian'an
    MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom .
    Sherar, Lauren B.
    College of Kinesiology, University of Saskatchewan, Saskatoon, Canada; School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.
    Esliger, Dale W.
    College of Kinesiology, University of Saskatchewan, Saskatoon, Canada; School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.
    Griew, Pippa
    School of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom.
    Cooper, Ashley
    Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom.
    Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents2012Ingår i: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 307, nr 7, s. 704-712Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context: Sparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children.

    Objective: To examine the independent and combined associations between objectively measured time in moderate- to vigorous-intensity physical activity (MVPA) and sedentary time with cardiometabolic risk factors.

    Design, Setting, and Participants: Pooled data from 14 studies between 1998 and 2009 comprising 20 871 children (aged 4-18 years) from the International Children's Accelerometry Database. Time spent in MVPA and sedentary time were measured using accelerometry after reanalyzing raw data. The independent associations between time in MVPA and sedentary time, with outcomes, were examined using meta-analysis. Participants were stratified by tertiles of MVPA and sedentary time.

    Main Outcome Measures: Waist circumference, systolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and insulin.

    Results: Times (mean [SD] min/d) accumulated by children in MVPA and being sedentary were 30 (21) and 354 (96), respectively. Time in MVPA was significantly associated with all cardiometabolic outcomes independent of sex, age, monitor wear time, time spent sedentary, and waist circumference (when not the outcome). Sedentary time was not associated with any outcome independent of time in MVPA. In the combined analyses, higher levels of MVPA were associated with better cardiometabolic risk factors across tertiles of sedentary time. The differences in outcomes between higher and lower MVPA were greater with lower sedentary time. Mean differences in waist circumference between the bottom and top tertiles of MVPA were 5.6 cm (95% CI, 4.8-6.4 cm) for high sedentary time and 3.6 cm (95% CI, 2.8-4.3 cm) for low sedentary time. Mean differences in systolic blood pressure for high and low sedentary time were 0.7 mm Hg (95% CI, -0.07 to 1.6) and 2.5 mmHg (95% CI, 1.7-3.3), and for high-density lipoprotein cholesterol, differences were -2.6 mg/dL(95% CI, -1.4 to -3.9) and -4.5 mg/dL(95% CI, -3.3 to -5.6), respectively. Geometric mean differences for insulin and triglycerides showed similar variation. Those in the top tertile of MVPA accumulated more than 35 minutes per day in this intensity level compared with fewer than 18 minutes per day for those in the bottom tertile. In prospective analyses (N=6413 at 2.1 years' follow-up), MVPA and sedentary time were not associated with waist circumference at follow-up, but a higher waist circumference at baseline was associated with higher amounts of sedentary time at follow-up.

    Conclusion: Higher MVPA time by children and adolescents was associated with better cardiometabolic risk factors regardless of the amount of sedentary time.

  • 66.
    Elfström, Peter
    Örebro universitet, Hälsoakademin.
    Associated disorders in celiac disease2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Celiac disease (CD) is an autoimmune disorder that affects genetically susceptible individuals and is induced by dietary gluten. Treatment consists of a lifelong gluten-free diet. CD is common and affects about 1% of the general population. The classic symptoms include diarrhea and malabsorption, but many patients have only mild symptoms or no symptoms at all. The proportion of individuals presenting with atypical symptoms or discovered only when investigating an associated condition of CD is increasing.

    Aims: The aim of this thesis was to investigate the risk of possible associated disorders through Swedish population-based registers. The objective was to gain more information on the consequences of having CD and to identify high risk groups where screening may be considered.

    Materials and methods: We used the Swedish hospital discharge register to examine the risk of liver disease, autoimmune heart disease, Addison’s disease and thyroid disorders in a cohort of about 14,000 individuals with CD and an age and sex matched reference population of 70,000 individuals. In the last study we used all regional pathology registers and the cancer registry to examine the risk of hematopoietic cancer, including lymphoma in three different cohorts: I) 28,810 individuals with CD; II) 12,681 individuals with small intestinal mucosal inflammation but without villous atrophy; and III) 3552 individuals with latent CD (a positive serology test for CD with a normal small intestinal biopsy).

    Results: CD is statistically significantly associated with an increased risk of liver disease, Addison’s disease, thyroid disease and lymphoma. We also found an increased risk of lymphoma in individuals with small intestinal mucosal inflammation. There was no statistically significant association between autoimmune heart disease or leukemia and CD. Latent CD was not associated with any hematopoietic cancers.

    Conclusion: This thesis found a positive association between CD and a number of autoimmune and inflammatory disorders. Clinicians need to have a high awareness of this association and to test for these conditions when symptoms appear.

    Delarbeten
    1. Celiac disease and risk of liver disease: a general population-based study
    Öppna denna publikation i ny flik eller fönster >>Celiac disease and risk of liver disease: a general population-based study
    Visa övriga...
    2007 (Engelska)Ingår i: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 5, nr 1, s. 63-69Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background & aims: Celiac disease (CD) is an important cause of hypertransaminasemia. CD may also be associated with severe forms of liver disease. We investigated the risk of liver disease in 13,818 patients with CD (1964-2003) and 66,584 age- and sex-matched reference individuals from a general population cohort.Methods: We used Cox regression to estimate hazard ratios (HRs) for later liver disease and conditional logistic regression to estimate the risk of CD in individuals with liver disease prior to study entry.Results: CD was associated with an increased risk of acute hepatitis (HR = 5.21; 95% CI = 1.88-14.40; P = .001), chronic hepatitis (HR = 5.84; 95% CI = 2.89-11.79; P < .001), primary sclerosing cholangitis (PSC)(HR = 4.46; 95% CI = 2.50-7.98; P < .001), fatty liver (HR = 6.06; 95% CI = 1.35-27.16; P = .018), liver failure (HR = 3.30; 95% CI = 2.22-4.88; P < .001), liver cirrhosis or liver fibrosis (HR = 2.23; 95% CI = 1.34-3.72; P < .001) and primary biliary cirrhosis (HR = 10.16; 95% CI = 2.61-39.49; P < .001). There was no increased risk of liver transplantation (HR = 1.07; 95% CI = 0.12-9.62; P = .954). Adjustment for socioeconomic index or diabetes mellitus had no notable effect on the risk estimates.Prior liver disease was associated with a statistically significant 4-6 fold increased risk of later CD.Conclusion: This study suggests that individuals with CD are at increased risk of both prior and subsequent liver disease.

    Ort, förlag, år, upplaga, sidor
    Amsterdam: Elsevier, 2007
    Nyckelord
    autoimmune; celiac; cirrhosis; cohort study; liver and primary sclerosing cholangitis
    Nationell ämneskategori
    Gastroenterologi Pediatrik Medicin och hälsovetenskap
    Forskningsämne
    pediatrik
    Identifikatorer
    urn:nbn:se:oru:diva-5212 (URN)10.1016/j.cgh.2006.09.034 (DOI)
    Anmärkning
    Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223Tillgänglig från: 2009-01-30 Skapad: 2009-01-30 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    2. Cardiomyopathy, pericarditis and myocarditis in a population-based cohort of inpatients with coeliac disease
    Öppna denna publikation i ny flik eller fönster >>Cardiomyopathy, pericarditis and myocarditis in a population-based cohort of inpatients with coeliac disease
    Visa övriga...
    2007 (Engelska)Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 262, nr 5, s. 545-554Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: We investigated the risk of myocarditis, cardiomyopathy, and pericarditis in patients with celiac disease (CD) from a general population cohort.Subjects and methods: Through the Swedish national registers we identified 9363 children and 4969 adults with a diagnosis of CD (1964–2003). These individuals were matched with upto five reference individuals for age, sex, calendar year and county (n = 69 851). Cox regression estimated hazard ratios (HRs) for later heart disease. Main outcome measures: Myocarditis, cardiomyopathy (any or dilated), and pericarditis defined according torelevant international classification of disease codes in the Swedish national inpatient register.Results: Celiac disease diagnosed in childhood was not associated with later myocarditis (HR = 0.2; 95% CI = 0.0–1.5), cardiomyopathy of any type (HR = 0.8; 95% CI = 0.2–3.7), or pericarditis (HR = 0.4; 95% CI = 0.1–1.9). Restricting our analyses to adulthood CD and heart disease diagnosed from 1987 and onwards in departments of cardiology ⁄ internal medicine, we found no association between CD and later myocarditis (HR = 2.1; 95% CI = 0.4–11.7), dilated cardiomyopathy (HR = 1.7; 95% CI = 0.4– 6.5) or pericarditis (HR = 1.5; 95% CI = 0.5–4.0).Conclusion: This study found no association between CD, later myocarditis, cardiomyopathy or pericarditis

    Ort, förlag, år, upplaga, sidor
    Oxford: Blackwell Publishing, 2007
    Nyckelord
    Autoimmunity, cardiology, coeliac disease, pericarditis.
    Nationell ämneskategori
    Pediatrik Gastroenterologi Kardiologi Medicin och hälsovetenskap
    Forskningsämne
    pediatrik; epidemiologi
    Identifikatorer
    urn:nbn:se:oru:diva-5217 (URN)10.1111/j.1365-2796.2007.01843.x (DOI)
    Anmärkning
    Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223Tillgänglig från: 2009-01-30 Skapad: 2009-01-30 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    3. Risk of primary adrenal insufficiency in patients with celiac disease
    Öppna denna publikation i ny flik eller fönster >>Risk of primary adrenal insufficiency in patients with celiac disease
    Visa övriga...
    2007 (Engelska)Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 92, nr 9, s. 3595-3598Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: Earlier research has suggested a positive association between Addison’s disease (AD) and celiac disease (CD).Wehave here investigated the risk of AD in individuals with CD from a general population cohort.Methods: Through the Swedish national registers we identified 14,366 individuals with a diagnosis of CD (1964–2003) and 70,095 reference individuals matched for age, sex, calendar year, and county of residence. We used Cox regression to estimate hazard ratios (HRs) for subsequent AD. Analyses were restricted to individuals with more than 1 yr of follow-up and without AD prior to study entry or within 1 yr after study entry. Conditional logistic regression estimated the odds ratio for CD in individuals with prior AD.Results: There was a statistically significantly positive association between CD and subsequent AD [HR _ 11.4; 95% confidence interval (CI) _ 4.4 –29.6]. This risk increase was seen in both children and adults and did not change with adjustment for diabetes mellitus or socioeconomic status. When we restricted reference individuals to inpatients, the adjusted HR for AD was 4.6 (95% CI _ 1.9 –11.4). Individuals with prior AD were at increased risk of CD (odds ratio _ 8.6; 95% CI _ 3.4 –21.8).Conclusions: This study found a highly increased risk of AD in individuals with CD. This relationship was independent of temporal sequence. We therefore recommend that individuals with AD should be screened for CD. We also suggest an increased awareness of AD in individuals with CD.

    Ort, förlag, år, upplaga, sidor
    Chevy Chase, Md.: Endocrine Society, 2007
    Nyckelord
    adrenocortical insufficiency, autoimmune; celiac; cohort study; Addison disease
    Nationell ämneskategori
    Pediatrik Gastroenterologi Endokrinologi och diabetes Medicin och hälsovetenskap
    Forskningsämne
    pediatrik; epidemiologi
    Identifikatorer
    urn:nbn:se:oru:diva-5218 (URN)17595243 (PubMedID)
    Anmärkning
    Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223Tillgänglig från: 2009-01-30 Skapad: 2009-01-30 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    4. Risk of Thyroid Disease in Individuals with Celiac Disease
    Öppna denna publikation i ny flik eller fönster >>Risk of Thyroid Disease in Individuals with Celiac Disease
    Visa övriga...
    2008 (Engelska)Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 93, nr 10, s. 3915-3921Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: It has been suggested that celiac disease is associated with thyroid disease. Earlier studies, however, have been predominately cross-sectional and have often lacked controls. There is hence a need for further research. In this study, we estimated the risk of thyroid disease in individuals with celiac disease from a general population cohort.Methods: A total of 14,021 individuals with celiac disease (1964–2003) and a matched reference population of 68,068 individuals were identified through the Swedish national registers. Cox regression estimated the risk of thyroid disease in subjects with celiac disease. Analyses were restricted to individuals with a follow-up ofmorethan 1 yr and withnothyroid disease before study entry or within 1 yr after study entry. Conditional logistic regression estimated the odds ratio for subsequent celiac disease in individuals with thyroid disease.Results: Celiac disease was positively associated with hypothyroidism [hazard ratio (HR)_4.4;95% confidence interval (CI) _ 3.4 –5.6; P _ 0.001], thyroiditis (HR _ 3.6; 95% CI _1.9–6.7; P _ 0.001) and hyperthyroidism (HR_2.9;95%CI_2.0–4.2; P_0.001). The highest risk estimates were found in children (hypothyroidism, HR _ 6.0 and 95% CI _ 3.4 –10.6; thyroiditis, HR _ 4.7 and 95% CI _ 2.1–10.5; hyperthyroidism, HR _ 4.8 and 95% CI _ 2.5–9.4). In post hoc analyses, where the reference population was restricted to inpatients, the adjusted HR was 3.4 for hypothyroidism (95% CI_2.7– 4.4; P_0.001), 3.3 for thyroiditis(95%CI_1.5–7.7; P_0.001), and 3.1 for hyperthyroidism (95% CI _ 2.0–4.8; P _ 0.001).Conclusion: Celiac disease is associated with thyroid disease, and these associations were seen regardless of temporal sequence. This indicates shared etiology and that these individuals are more susceptible to autoimmune disease.

    Nyckelord
    autoimmune; celiac; coeliac; child; cohort study; hypothyroidism; hyperthyroidism; thyroiditis.
    Nationell ämneskategori
    Pediatrik Gastroenterologi Endokrinologi och diabetes
    Forskningsämne
    Pediatrik; Epidemiologi
    Identifikatorer
    urn:nbn:se:oru:diva-5219 (URN)10.1210/jc.2008-0798 (DOI)
    Anmärkning
    Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223Tillgänglig från: 2009-01-30 Skapad: 2009-01-30 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    5. Hematopoietic cancer including lymphoma in celiac disease according to Marsh criteria 0-3
    Öppna denna publikation i ny flik eller fönster >>Hematopoietic cancer including lymphoma in celiac disease according to Marsh criteria 0-3
    Visa övriga...
    (Engelska)Manuskript (Övrigt vetenskapligt)
    Abstract [en]

    Background: Celiac disease (CD) is associated with an increased risk of lymphoma, but it is unknown if borderline mucosal damage and latent CD are risk factors for lymphoma.Methods: We examined the risk of hematopoietic cancer in a nationwide population–based cohort of 28,800 individuals with biopsy-verified CD (villous atrophy, Marsh 3), 12,663 individuals with small intestinal inflammation (Marsh 1+2), and 3,551 with latent CD (positive antiendomysial, tissue transglutaminase or antigliadin test but normal mucosa on biopsy). The study participants were identified through all pathology departments (n=28) in Sweden and were biopsied in 1969-2006 (median: 1998). Cox regression estimated the hazard ratio (HR) for hematopoietic malignancies.Results: While biopsy-verified CD and intestinal inflammation were both statistically significantly associated with lymphoma (CD: HR = 3.18; 95% CI = 2.63-3.83; inflammation: 1.66; 1.28-2.17), latent CD was not (1.04; 0.44-2.43). CD was associated with both non-Hodgkin’s (NHL) and Hodgkin’s lymphoma (HL) (4.81; 3.81-6.07 and 4.39; 2.59-7.45 respectively). Risk estimates for NHL and HL were lower in inflammation (1.65; 1.15-2.38 and 1.48; 0.60-3.62 respectively) and latent CD (1.79; 0.74-4.34 and 1.08; 0.13-9.00 respectively). No increased risk of lymphoma was seen in children with a small intestinal biopsy. This study found no association between leukemia and small intestinal pathology.Conclusion: CD is associated with an increased risk of lymphoma. This risk increase was also seen in individuals with small intestinal inflammation. Latent CD is not associated with lymphoma of any kind, and positive CD serology alone cannot be used to predict future risk of lymphoma.

    Nyckelord
    autoimmune, biopsy, celiac, coeliac, child, cohort study, cancer, hematopoietic, leukemia, lymphoma, pathology
    Nationell ämneskategori
    Pediatrik Gastroenterologi Medicin och hälsovetenskap
    Forskningsämne
    Pediatrik; Epidemiologi; Medicin
    Identifikatorer
    urn:nbn:se:oru:diva-5222 (URN)
    Tillgänglig från: 2009-01-30 Skapad: 2009-01-30 Senast uppdaterad: 2017-10-18Bibliografiskt granskad
  • 67.
    Elfström, Peter
    et al.
    Örebro universitet, Hälsoakademin.
    Granath, Fredrik
    Ekström Smedby, Karin
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Askling, Johan
    Ekbom, Anders
    Ludvigsson, Jonas F.
    Örebro universitet, Hälsoakademin.
    Hematopoietic cancer including lymphoma in celiac disease according to Marsh criteria 0-3Manuskript (Övrigt vetenskapligt)
    Abstract [en]

    Background: Celiac disease (CD) is associated with an increased risk of lymphoma, but it is unknown if borderline mucosal damage and latent CD are risk factors for lymphoma.Methods: We examined the risk of hematopoietic cancer in a nationwide population–based cohort of 28,800 individuals with biopsy-verified CD (villous atrophy, Marsh 3), 12,663 individuals with small intestinal inflammation (Marsh 1+2), and 3,551 with latent CD (positive antiendomysial, tissue transglutaminase or antigliadin test but normal mucosa on biopsy). The study participants were identified through all pathology departments (n=28) in Sweden and were biopsied in 1969-2006 (median: 1998). Cox regression estimated the hazard ratio (HR) for hematopoietic malignancies.Results: While biopsy-verified CD and intestinal inflammation were both statistically significantly associated with lymphoma (CD: HR = 3.18; 95% CI = 2.63-3.83; inflammation: 1.66; 1.28-2.17), latent CD was not (1.04; 0.44-2.43). CD was associated with both non-Hodgkin’s (NHL) and Hodgkin’s lymphoma (HL) (4.81; 3.81-6.07 and 4.39; 2.59-7.45 respectively). Risk estimates for NHL and HL were lower in inflammation (1.65; 1.15-2.38 and 1.48; 0.60-3.62 respectively) and latent CD (1.79; 0.74-4.34 and 1.08; 0.13-9.00 respectively). No increased risk of lymphoma was seen in children with a small intestinal biopsy. This study found no association between leukemia and small intestinal pathology.Conclusion: CD is associated with an increased risk of lymphoma. This risk increase was also seen in individuals with small intestinal inflammation. Latent CD is not associated with lymphoma of any kind, and positive CD serology alone cannot be used to predict future risk of lymphoma.

  • 68.
    Elfström, Peter
    et al.
    Örebro universitet, Hälsoakademin.
    Hamsten, Anders
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Ekbom, Anders
    Ludvigsson, Jonas F.
    Cardiomyopathy, pericarditis and myocarditis in a population-based cohort of inpatients with coeliac disease2007Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 262, nr 5, s. 545-554Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: We investigated the risk of myocarditis, cardiomyopathy, and pericarditis in patients with celiac disease (CD) from a general population cohort.Subjects and methods: Through the Swedish national registers we identified 9363 children and 4969 adults with a diagnosis of CD (1964–2003). These individuals were matched with upto five reference individuals for age, sex, calendar year and county (n = 69 851). Cox regression estimated hazard ratios (HRs) for later heart disease. Main outcome measures: Myocarditis, cardiomyopathy (any or dilated), and pericarditis defined according torelevant international classification of disease codes in the Swedish national inpatient register.Results: Celiac disease diagnosed in childhood was not associated with later myocarditis (HR = 0.2; 95% CI = 0.0–1.5), cardiomyopathy of any type (HR = 0.8; 95% CI = 0.2–3.7), or pericarditis (HR = 0.4; 95% CI = 0.1–1.9). Restricting our analyses to adulthood CD and heart disease diagnosed from 1987 and onwards in departments of cardiology ⁄ internal medicine, we found no association between CD and later myocarditis (HR = 2.1; 95% CI = 0.4–11.7), dilated cardiomyopathy (HR = 1.7; 95% CI = 0.4– 6.5) or pericarditis (HR = 1.5; 95% CI = 0.5–4.0).Conclusion: This study found no association between CD, later myocarditis, cardiomyopathy or pericarditis

  • 69.
    Elfström, Peter
    et al.
    Örebro universitet, Hälsoakademin.
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Kämpe, Olle
    Uppsala Universitet.
    Ekbom, Anders
    Karolinska Institutet.
    Ludvigsson, Jonas F.
    Risk of primary adrenal insufficiency in patients with celiac disease2007Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 92, nr 9, s. 3595-3598Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Earlier research has suggested a positive association between Addison’s disease (AD) and celiac disease (CD).Wehave here investigated the risk of AD in individuals with CD from a general population cohort.Methods: Through the Swedish national registers we identified 14,366 individuals with a diagnosis of CD (1964–2003) and 70,095 reference individuals matched for age, sex, calendar year, and county of residence. We used Cox regression to estimate hazard ratios (HRs) for subsequent AD. Analyses were restricted to individuals with more than 1 yr of follow-up and without AD prior to study entry or within 1 yr after study entry. Conditional logistic regression estimated the odds ratio for CD in individuals with prior AD.Results: There was a statistically significantly positive association between CD and subsequent AD [HR _ 11.4; 95% confidence interval (CI) _ 4.4 –29.6]. This risk increase was seen in both children and adults and did not change with adjustment for diabetes mellitus or socioeconomic status. When we restricted reference individuals to inpatients, the adjusted HR for AD was 4.6 (95% CI _ 1.9 –11.4). Individuals with prior AD were at increased risk of CD (odds ratio _ 8.6; 95% CI _ 3.4 –21.8).Conclusions: This study found a highly increased risk of AD in individuals with CD. This relationship was independent of temporal sequence. We therefore recommend that individuals with AD should be screened for CD. We also suggest an increased awareness of AD in individuals with CD.

  • 70.
    Elfström, Peter
    et al.
    Örebro universitet, Hälsoakademin.
    Montgomery, Scott M.
    Kämpe, Olle
    Ekbom, Anders
    Ludvigsson, Jonas F.
    Risk of Thyroid Disease in Individuals with Celiac Disease2008Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 93, nr 10, s. 3915-3921Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: It has been suggested that celiac disease is associated with thyroid disease. Earlier studies, however, have been predominately cross-sectional and have often lacked controls. There is hence a need for further research. In this study, we estimated the risk of thyroid disease in individuals with celiac disease from a general population cohort.Methods: A total of 14,021 individuals with celiac disease (1964–2003) and a matched reference population of 68,068 individuals were identified through the Swedish national registers. Cox regression estimated the risk of thyroid disease in subjects with celiac disease. Analyses were restricted to individuals with a follow-up ofmorethan 1 yr and withnothyroid disease before study entry or within 1 yr after study entry. Conditional logistic regression estimated the odds ratio for subsequent celiac disease in individuals with thyroid disease.Results: Celiac disease was positively associated with hypothyroidism [hazard ratio (HR)_4.4;95% confidence interval (CI) _ 3.4 –5.6; P _ 0.001], thyroiditis (HR _ 3.6; 95% CI _1.9–6.7; P _ 0.001) and hyperthyroidism (HR_2.9;95%CI_2.0–4.2; P_0.001). The highest risk estimates were found in children (hypothyroidism, HR _ 6.0 and 95% CI _ 3.4 –10.6; thyroiditis, HR _ 4.7 and 95% CI _ 2.1–10.5; hyperthyroidism, HR _ 4.8 and 95% CI _ 2.5–9.4). In post hoc analyses, where the reference population was restricted to inpatients, the adjusted HR was 3.4 for hypothyroidism (95% CI_2.7– 4.4; P_0.001), 3.3 for thyroiditis(95%CI_1.5–7.7; P_0.001), and 3.1 for hyperthyroidism (95% CI _ 2.0–4.8; P _ 0.001).Conclusion: Celiac disease is associated with thyroid disease, and these associations were seen regardless of temporal sequence. This indicates shared etiology and that these individuals are more susceptible to autoimmune disease.

  • 71.
    Elinder, Göran
    et al.
    Department of Pediatrics, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Anders
    Department of Community Medicine and Rehabilitation, Forensic Medicine, Umeå University, Umeå, Sweden; The National Board of Forensic Medicine, Linköping, Sweden.
    Hallberg, Boubou
    Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics and Neonatology, Karolinska University Hospital, Stockholm, Sweden.
    Lynøe, Niels
    Medical Ethics, Karolinska Institutet, Stockholm, Sweden.
    Sundgren, Pia Maly
    Diagnostic Radiology, Lund University, Lund, Sweden; Department of Neuroradiology, Skåne University Hospital, Lund, Sweden.
    Rosén, Måns
    Health Technology Assessment, Karolinska Institutet, Stockholm, Sweden.
    Engström, Ingemar
    Örebro universitet, Institutionen för medicinska vetenskaper. Child and Adolecent Psychiatry, University Health Care Research Center.
    Erlandsson, Björn-Erik
    Medical Technology, Royal Institute of Technology, Stockholm, Sweden.
    Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr S472, s. 3-23Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The Swedish Agency for Health Technology Assessment and Assesment of Social Services (SBU) is an independent national authority, tasked by the government with assessing methods used in health, medical and dental services and social service interventions from a broad perspective, covering medical, economic, ethical and social aspects. The language in SBU's reports are adjusted to a wide audience. SBU's Board of Directors has approved the conclusions in this report. The systematic review showed the following graded results:

    • There is limited scientific evidence that the triad (Three components of a whole. The triad associated with SBS usually comprises subdural haematoma, retinal haemorrhages and encephalopathy.) and therefore, its components can be associated with traumatic shaking (low-quality evidence).
    • There is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low-quality evidence).

    Limited scientific evidence (low-quality evidence) represents a combined assessment of studies of high or moderate quality which disclose factors that markedly weaken the evidence. It is important to note that limited scientific evidence for the reliability of a method or an effect does not imply complete lack of scientific support. Insufficient scientific evidence (very low-quality evidence) represents either a lack of studies or situations when available studies are of low quality or show contradictory results. Evaluation of the evidence was not based on formal grading of the evidence according to GRADE but on an evaluation of the total scientific basis.

  • 72.
    Engström, Ingemar
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Psykiatriskt forskningscentrum, Örebro universitet, Örebro, Sverige.
    Barn- och ungdomspsykiatri2011Ingår i: Pediatrik / [ed] Christian Moëll & Jan Gustavsson, Stockholm: Liber, 2011, 1, s. 537-555Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 73.
    Engström, Ingemar
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Psykiatriskt forskningscentrum, Örebro.
    Diagnostik och differentialdiagnostik2013Ingår i: Från apati till aktivitet: Teori och behandling av flyktingbarn med svår psykisk ohälsa / [ed] Henry Ascher & Anders Hjern, Lund: Studentlitteratur AB, 2013, 1, s. 117-136Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 74.
    Ericson, Jenny
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden; Department of Paediatrics, Falu Hospital, Falun, Sweden.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskaper.
    Hellström-Westas, Lena
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Hoddinott, Pat
    Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, UK.
    Flacking, Renée
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 5, s. 791-798Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim was to evaluate the effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants after discharge from neonatal intensive care units (NICU).

    METHODS: Between March 2013 and December 2015, a randomised controlled trial was conducted at six NICUs across Sweden. At each NICU, a breastfeeding support team recruited, randomised and delivered the support to participating mothers. The intervention group received a daily proactive telephone call up to 14 days after discharge from the support team. The control group could initiate telephone contact themselves. Primary outcome was exclusive breastfeeding eight weeks after discharge. Secondary outcomes were maternal satisfaction with breastfeeding, attachment, quality of life and parental stress.

    RESULTS: In total, 493 mothers were randomised, 231 to intervention group and 262 to control group. There were no differences between the groups for exclusive breastfeeding, odds ratio 0.96, 95% CI 0.66-1.38, nor for maternal satisfaction with breastfeeding, attachment or quality of life. The intervention group reported significantly less parental stress than the controls, t=2.44, 95% CI 0.03-0.23, effect size d=0.26.

    CONCLUSION: In this trial, proactive telephone support was not associated with increased exclusive breastfeeding prevalence eight weeks following discharge. However, intervention group mothers showed significantly lower parental stress.

  • 75.
    Ericson, Jenny
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Clinical Research Dalarna, Falun, Sweden; Department of Paediatrics, Falu Hospital, Falun, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskaper.
    Hoddinot, Pat
    Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, UK.
    Hellström-Westas, Lena
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Flacking, Renée
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Breastfeeding and risk for ceasing in mothers of preterm infants: Long‐term follow‐up2018Ingår i: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 14, nr 4, artikel-id e12618Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU. Six NICUs across Sweden randomised a total of 493 mothers. We used regression and survival analyses to assess the risk factors for ceasing breastfeeding and the long‐term outcomes of the intervention. The results showed that 305 (64%) of the infants were breastfed at 6 months and 49 (21%) at 12 months. Partial breastfeeding at discharge, low maternal educational level, and longer length of stay in the NICU increased the risk for ceasing breastfeeding during the first 12 months. Furthermore, the Kaplan–Meier analysis showed that the proportion of mothers who ceased breastfeeding did not differ between the intervention (n = 231) and controls (n = 262) during the first 12 months (log‐rank test p = .68). No difference was found between groups on method of feeding. More than 85% of the infants were fed directly at the breast. These findings provide important insights for health professionals who are supporting mothers of preterm infants to breastfeed long term. Registered in www.clinicaltrials.gov (NCT01806480).

  • 76.
    Eriksson, Britt
    Linköping university, Linköping, Sweden.
    Metabolic, methodological and developmental aspects of body composition: Studies in women and children with special reference to early life mechanisms behind childhood obesity2010Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Övervikt och fetma bland barn har under senare år blivit allt vanligare i många delar av världen. Studier av nutrition, metabolism och fysiologi under graviditet och de tidiga barnaåren är av vikt för att förstå vilka faktorer som ligger bakom denna utveckling. Speciellt viktigt är att studera hur kroppssammansättningen förändras tidigt i livet. Den här avhandlingen innehåller tre studier som berör detta ämnesområde. I en studie på gravida analyserades serumprover, insamlade från 23 kvinnor innan, under och efter deras graviditet, med avseende på halter av leptin, adiponektin och resistin. Via serumproverna fastställdes också kvinnornas insulinresistens (HOMA-IR). Dessa resultat relaterades sedan till mängden kroppsfett hos dessa kvinnor. Mängden kroppsfett (%) och leptin visade, före och under graviditet, en signifikant korrelation med HOMA-IR. En regressionsanalys av HOMA-IR (y) och % kroppsfett (x) i graviditetsvecka 32 gav ett k-värde (lutning) på 0,111, vilket i jämförelse med motsvarande k-värde före graviditet 0,046 var signifikant högre (p<0.05). Detta resultat visar att hos friska kvinnor potentierar graviditeten sambandet mellan kroppsfett och insulinresistens. I en studie av hydreringsgrad i fettfri kroppsvikt (HF) fastställdes HF i 12 nyfödda med hjälp av dubbelmärkt vatten och helkroppsplethysmografi (PeaPod). HF uppmättes till 80,9% med en låg biologisk variation (0,81 % av genomsnittlig HF). I en longitudinell studie mättes kroppsdensiteten med PeaPod hos 108 friska fullgångna spädbarn (53 flickor, 55 pojkar) när de var en respektive tolv veckor gamla. Deras kroppssammansättning beräknades med två olika modeller (Fomons och Buttes). Uppgift om mödrarnas pregravida BMI samlades in. Vid 1,5 års ålder mättes kroppssammansättning och total energiomsättning hos 20 av de 108 barnen. Vid detta tillfälle mättes även viloomsättningen med indirekt kalorimetri under sömn. Viloomsättningen predikterades även med en formel. Buttes modell gav signifikant (p<0.05) lägre nivå av kroppsfett (%) jämfört med Fomons modell och i fem fall erhölls inga resultat alls. Beräkningar med Fomons modell visade att vid en veckas ålder innehöll flickorna 13.4 ± 3.7 % och pojkarna 12.5 ± 4.0 % kroppsfett. Motsvarande värden vid 12 veckors ålder var 26.3 ± 4.2 % och 26.4 ± 5.1 %. Mödrarnas BMI innan graviditet korrelerade med kroppsvikt men inte med kroppsfett (g,%) eller fettfri vikt (g) hos deras barn vid en veckas ålder. Vid 1,5 års ålder innehöll flickorna (n=9) 28.0±2.8 % och pojkarna (n=11) 28.3±3.7 % kroppsfett. Mellan en och 12 veckors ålder ökade alla barnen sin kroppsfetthalt. Mellan 12 veckor och 1,5 år ökade kroppsfetthalten hos 13 barn medan den minskade hos 7. Resultat visar att predikterad viloomsättning ökar risken för att få en falsk korrelation mellan kroppsfetthalt och fysisk aktivitetsnivå jämfört med om man använder uppmätt viloomsättning. Den fysiska aktivitetsnivån vid 1,5 års ålder (x), var negativt korrelerad till förändring i kroppsfetthalt [kroppsfett (%) vid 1.5 år minus kroppsfett (%) vid 12 veckor] (y), r=-0.52, p=0.02. Sammanfattningsvis tyder resultaten på att kvinnors kroppsfetthalt har en stimulerande effekt på fostrets på totala tillväxt men inte på dess retention av kroppsfett. Dessutom visar resultaten att Fomons modell är den bästa tillgängliga när det gäller att beräkna kroppssammansättningen hos spädbarn från kroppsdensitet. Slutligen tyder resultaten på att den fysiska aktivitetsnivån vid 1,5 års ålder har betydelse för hur fort den höga kroppsfetthalten, som är typisk för spädbarnsperioden, sjunker under tidig barndom.

    Delarbeten
    1. Body fat, insulin resistance, energy expenditure and serum concentrations of leptin, adiponectin and resistin before, during and after pregnancy in healthy Swedish women
    Öppna denna publikation i ny flik eller fönster >>Body fat, insulin resistance, energy expenditure and serum concentrations of leptin, adiponectin and resistin before, during and after pregnancy in healthy Swedish women
    2010 (Engelska)Ingår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 103, nr 1, s. 50-57Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Healthy human pregnancy is associated with changes in food intake, body fatness, energy expenditure and insulin resistance. However, available knowledge is limited regarding the physiological basis of these changes. Published evidence suggests that so-called adipokines (i.e. leptin, adiponectin and resistin) have significant roles when such changes are established. We explored, throughout a complete pregnancy, relationships between total body fat (TBF), energy expenditure, insulin resistance (homeostasic model of insulin resistance, HOMA-IR) and serum concentrations of leptin, adiponectin and resistin. Such concentrations were assessed before pregnancy in gestational weeks 8, 14, 20, 32 and 35, and 2 weeks postpartum in twenty-three healthy women. TBF, BMR (n 23) and HOMA-IR (n 17) were assessed before pregnancy in gestational weeks 14 and 32 and 2 weeks postpartum. TBF (%) was correlated with HOMA-IR (r 0.68-0.79, P < 0.01) and with serum leptin (r 0.85-0.88, P < 0.001) before and during pregnancy. Serum leptin was correlated with HOMA-IR (r 0.53-0.70, P < 0.05) before and during pregnancy. Serum adiponectin was inversely correlated with HOMA-IR in gestational week 32 (r - 0.52, P < 0.05). When HOMA-IR was regressed on TBF (%), the slope of the regression line was 0.046 before pregnancy, which was significantly (P < 0.05) different from the corresponding value, 0.111, in gestational week 32. The results indicate that pregnancy has an enhancing effect on the relationship between body fatness and insulin resistance. This effect, possibly mediated by leptin, may represent a mechanism by which offspring size is regulated in response to the nutritional situation of the mother.

    Ort, förlag, år, upplaga, sidor
    Cambridge, United Kingdom: Cambridge University Press, 2010
    Nyckelord
    Adipokines, body fat, energy expenditure, insulin resistance, pregnancy
    Nationell ämneskategori
    Medicin och hälsovetenskap Näringslära
    Identifikatorer
    urn:nbn:se:oru:diva-48423 (URN)10.1017/S0007114509991371 (DOI)000274575200008 ()19703326 (PubMedID)2-s2.0-75549089817 (Scopus ID)
    Anmärkning

    Original Publication: Britt Eriksson, Marie Löf, Hanna Olausson and Elisabet Forsum, Body fat, insulin resistance, energy expenditure and serum concentrations of leptin, adiponectin and resistin before, during and after pregnancy in healthy Swedish women., 2010, The British journal of nutrition, (103), 1, 50-57. http://dx.doi.org/10.1017/S0007114509991371 Copyright: Cambridge University Press http://www.cambridge.org/uk/

    Tillgänglig från: 2016-02-23 Skapad: 2016-02-19 Senast uppdaterad: 2017-11-30Bibliografiskt granskad
    2. Fat-free mass hydration in newborns: assessment and implications for body composition studies
    Öppna denna publikation i ny flik eller fönster >>Fat-free mass hydration in newborns: assessment and implications for body composition studies
    Visa övriga...
    2011 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 5, s. 680-686Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Equipment (Pea Pod) for assessing infant body density accurately and conveniently has recently become available. This density can be converted to body composition using the “Fomon” or the “Butte” model. These models differ regarding the water content in fat-free mass (hydration factor, HF). We assessed HF and its biological variability in newborns and compared results calculated using the two models at one and 12 weeks. Body volume and body weight were measured in 12 infants less than 10 days old using Pea Pod. Their total body water was assessed using isotope dilution. Their HF was found to be 80.9% with low biological variability (0.81% of average HF). Further, Pea Pod was used to assess body density of 108 infants at one and 12 weeks of age. Values for body fat (%) calculated using the “Butte” model were significantly lower than when using the “Fomon” model at one week (p<0.05) and 12 weeks (p<0.01). The difference between the two models was particularly large at one week, probably due to their different HF-values. Our HF-value is in agreement with that in the “Fomon” model and our results support the conclusion that this model is preferable when calculating body composition in infants.

    Ort, förlag, år, upplaga, sidor
    Hoboken, USA: Wiley-Blackwell, 2011
    Nationell ämneskategori
    Näringslära Pediatrik
    Identifikatorer
    urn:nbn:se:oru:diva-48422 (URN)10.1111/j.1651-2227.2011.02147.x (DOI)000289250200013 ()21226759 (PubMedID)2-s2.0-79953770829 (Scopus ID)
    Tillgänglig från: 2010-04-26 Skapad: 2016-02-19 Senast uppdaterad: 2017-11-30Bibliografiskt granskad
    3. Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of age
    Öppna denna publikation i ny flik eller fönster >>Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of age
    2010 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 4, s. 563-568Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aim: To use Pea Pod, a device based on air displacement plethysmography, to study body composition of healthy, full-term infants born to well-nourished women with a western life-style. Methods: Body composition was assessed in 53 girls and 55 boys at 1 week (before 10 days of age) and at 12 weeks (between 77 and 91 days of age). Results: At 1 week girls contained 13.4 +/- 3.7% body fat and boys 12.5 +/- 4.0%. At 12 weeks, these figures were 26.3 +/- 4.2% (girls) and 26.4 +/- 5.1% (boys). Body fat (%) did not differ significantly between the genders. Body fat (%) at the two measurements was not correlated. At 1 week, the weight (r = 0.20, p = 0.044) and BMI (r = 0.26, p = 0.007) of the infants, but not their body fat (g, %) or fat free mass (g), correlated with BMI before pregnancy in their mothers. Conclusions: Pea Pod has potential for use in studies investigating the effect of external (i.e. nutritional status) and internal (i.e. age, gender, gestational age at birth) factors on infant body composition. This may be of value when studying relationships between the nutritional situation during early life and adult health.

    Ort, förlag, år, upplaga, sidor
    Malden, USA: Wiley-Blackwell, 2010
    Nyckelord
    Air displacement plethysmography, Body composition, Infants, Longitudinal study, Pea Pod
    Nationell ämneskategori
    Medicin och hälsovetenskap Pediatrik
    Identifikatorer
    urn:nbn:se:oru:diva-48421 (URN)10.1111/j.1651-2227.2009.01665.x (DOI)000274951200022 ()20064135 (PubMedID)2-s2.0-77649223288 (Scopus ID)
    Tillgänglig från: 2010-03-12 Skapad: 2016-02-19 Senast uppdaterad: 2017-11-30Bibliografiskt granskad
    4. Body composition and energy expenditure in response to physical activity in 1.5-year-old children studied by means of the doubly labeled water method
    Öppna denna publikation i ny flik eller fönster >>Body composition and energy expenditure in response to physical activity in 1.5-year-old children studied by means of the doubly labeled water method
    Visa övriga...
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    During recent decades the prevalence of overweight and obesity in childhood has increased and studies of the mechanisms involved are motivated. Previous research has shown a correlation between total body fat (TBF) (%) and physical activity level (PAL) but the assessment of PAL has often involved a risk for spurious correlations. Thus we compared PAL calculated using basal metabolic rate (BMR) predicted from equations, based on body weight (PALBMR) and associated with a risk for spurious correlations, with PAL calculated using sleeping metabolic rate (SMR) assessed using indirect calorimetry (PALSMR) in 20 healthy children aged 1.5 years. Total energy expenditure and body fatness were assessed using the doubly labelled water method. Body fatness of these children was also assessed at one week and three months of age. PALBMR was significantly (r=-0.48, p=0.03) correlated with TBF (%) while PALSMR was not. Furthermore, the increase in body fatness between three months and 1.5 years was significantly (r=-0.52, p=0.02) correlated with PALSMR at the age of 1.5 years. Our results indicate complex relationships between body fatness and physical activity in early life. When conducting studies in this area, resting energy metabolism should be measured rather than predicted using equations based on body weight.

    Nationell ämneskategori
    Medicin och hälsovetenskap Näringslära
    Identifikatorer
    urn:nbn:se:oru:diva-48428 (URN)
    Tillgänglig från: 2010-04-26 Skapad: 2016-02-19 Senast uppdaterad: 2017-10-17Bibliografiskt granskad
  • 77.
    Eriksson, Britt
    et al.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Löf, Marie
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Eriksson, Olle
    Department of Computer and Information Science, Linköping University, Linköping, Sweden.
    Hannestad, Ulf
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Forsum, Elisabet
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Fat-free mass hydration in newborns: assessment and implications for body composition studies2011Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 5, s. 680-686Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Equipment (Pea Pod) for assessing infant body density accurately and conveniently has recently become available. This density can be converted to body composition using the “Fomon” or the “Butte” model. These models differ regarding the water content in fat-free mass (hydration factor, HF). We assessed HF and its biological variability in newborns and compared results calculated using the two models at one and 12 weeks. Body volume and body weight were measured in 12 infants less than 10 days old using Pea Pod. Their total body water was assessed using isotope dilution. Their HF was found to be 80.9% with low biological variability (0.81% of average HF). Further, Pea Pod was used to assess body density of 108 infants at one and 12 weeks of age. Values for body fat (%) calculated using the “Butte” model were significantly lower than when using the “Fomon” model at one week (p<0.05) and 12 weeks (p<0.01). The difference between the two models was particularly large at one week, probably due to their different HF-values. Our HF-value is in agreement with that in the “Fomon” model and our results support the conclusion that this model is preferable when calculating body composition in infants.

  • 78.
    Eriksson, Britt
    et al.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Löf, Marie
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Forsum, Elisabet
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of age2010Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 4, s. 563-568Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To use Pea Pod, a device based on air displacement plethysmography, to study body composition of healthy, full-term infants born to well-nourished women with a western life-style. Methods: Body composition was assessed in 53 girls and 55 boys at 1 week (before 10 days of age) and at 12 weeks (between 77 and 91 days of age). Results: At 1 week girls contained 13.4 +/- 3.7% body fat and boys 12.5 +/- 4.0%. At 12 weeks, these figures were 26.3 +/- 4.2% (girls) and 26.4 +/- 5.1% (boys). Body fat (%) did not differ significantly between the genders. Body fat (%) at the two measurements was not correlated. At 1 week, the weight (r = 0.20, p = 0.044) and BMI (r = 0.26, p = 0.007) of the infants, but not their body fat (g, %) or fat free mass (g), correlated with BMI before pregnancy in their mothers. Conclusions: Pea Pod has potential for use in studies investigating the effect of external (i.e. nutritional status) and internal (i.e. age, gender, gestational age at birth) factors on infant body composition. This may be of value when studying relationships between the nutritional situation during early life and adult health.

  • 79.
    Eriksson, Mats
    Örebro universitet, Hälsoakademin.
    Commentary on Arikan D et al. (2008) Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic. Journal of Clinical Nursing 17, 1754-1761.2008Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 21, s. 2945-2947Artikel i tidskrift (Refereegranskat)
  • 80.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Good news for Spanish neonates! [¡Buenas noticias para los neonatos españoles!]2015Ingår i: Anales de Pediatría, ISSN 1695-4033, E-ISSN 1695-9531, Vol. 83, nr 2, s. 73-74Artikel i tidskrift (Övrigt vetenskapligt)
  • 81.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskaper.
    Pediatrisk omvårdnadsforskning – inte bara en ”sjuksköterskegrej”2019Ingår i: Barnläkaren, ISSN 1651-0534, nr 1, s. 14-15Artikel, forskningsöversikt (Övrigt vetenskapligt)
  • 82.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Söta lösningar som smärtlindring till små och nyfödda barn2013Ingår i: Barnbladet, ISSN 0349-1994, Vol. 38, nr 2, s. 38-40Artikel, forskningsöversikt (Övrig (populärvetenskap, debatt, mm))
  • 83.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ahl, Hanna
    Skåne University Hospital, Lund, Sweden.
    Bengtsson, Kevin
    Lund University, Lund, Sweden.
    Bruschettini, Matteo
    Cochrane, Sweden.
    Norman, Elisabeth
    Lund University, Lund, Sweden.
    Olsson, Emma
    Örebro universitet, Institutionen för hälsovetenskaper.
    Naidu Vejayaram, Dhashin
    Lund University, Lund, Sweden.
    Pain scales in clinical trials in newborn infants – a mapping of the evidence2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Numerous clinical studies have aimed at finding a strategy to reduce the pain newborn infants are subjected to by their medical conditions and also by medical and caring procedures. Little is however known about whether the outcome measures in these trials are valid for the specific type of pain or group of infants included in the studies. There are today over 40 published scales, consisting of behavioral or physiological signals or a combination of both. The aim of this study was to evaluate the reporting of pain scales assessments that were most commonly used in all the published trials examining interventions related to neonatal pain.

    Methods: A systematic and broad search up to January 2019 was performed in Embase, PubMed, PsycInfo, Cinahl, Cochrane Library, Scopus and Luxid. Randomized and quasi-randomized clinical trials on neonatal pain were included. Title and abstract screening followed by full text screening were performed by two independent researchers using an online tool for the preparation of systematic reviews (Covidence). Disagreements were resolved by a third researcher or in discussions within the group, as recommended in the Cochrane handbook. Data extraction and quality assessment were also performed by two researchers independently. 

    Results: The systematic search retrieved 3715 scientific articles. Following screening, 342 studies with a total of 16210 infants were included, reporting data from the use of at least one neonatal pain assessment scale. Ninety per cent of the studies concerned procedural pain where the most frequently used pain scales were PIPP or PIPP-R (43%), followed by NIPS (17%). For ongoing or post-operative pain there was a more unclear pattern with COMFORT (24%) and NFCS (10%) as the most reported. We observed a wide variation of pain scales (Fig 1) and found numerous studies where pain scales were used that were not validated for the studied population or type of pain. In 11 papers self-constructed study-specific scales were used. The most frequent sources of procedural pain were heel lance (28% of the studies) followed by venipuncture (10%) and ROP-screening (5%).

    Conclusion: This is the first scoping review reporting systematically how neonatal pain scales are used in clinical trials. There are a few validated pain assessment scales used in most clinical studies. It is crucial to choose an appropriate scale, validated for the type of pain and population of infants included in the study. The inappropriate use of pain scales raises serious concerns on ethical conduct of research and waste of resources.

     

  • 84.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ahl, Hanna
    Lund University, Lund, Sweden.
    Bengtsson, Kevin
    Lund University, Lund, Sweden.
    Bruschettini, Matteo
    Lund University, Lund, Sweden.
    Norman, Elisabeth
    Lund University, Lund, Sweden.
    Olsson, Emma
    Örebro universitet, Institutionen för hälsovetenskaper.
    Vejayaram, Dashini
    Lund University, Lund, Sweden.
    Pain scales in clinical trials in newborn infants – a mapping of the evidence2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    BackgroundNumerous clinical studies have aimed at reducing pain in newborn infants. Little is known about whether the outcome measures are valid for the specific type of pain or group of infants included. 

    Aim: To evaluate the reporting of pain assessments used in published trials.

    MethodsA systematic search up to January 2019 was performed in Embase, PubMed, PsycInfo, Cinahl, Cochrane Library, Scopus and Luxid. Randomized and quasi-randomized clinical trials were included. Title and abstract screening followed by full text screening were performed by two independent researchers. Data extraction and quality assessment were also performed by two researchers independently.

    Results: The search retrieved 3715 articles. 342 studies with a total of 16210 infants were included. 90% of the studies concerned procedural pain where the most frequently used pain scales were PIPP or PIPP-R followed by NIPS For ongoing or post-operative pain COMFORT and NFCS were mostly used. We observed a wide variation of pain scales and found numerous studies where pain scales were used that were not validated for the studied population or type of pain. 

    ConclusionThis is the first scoping review reporting systematically how neonatal pain scales are used in clinical trials. There are a few validated pain assessment scales used in most clinical studies. It is crucial to choose an appropriate scale, validated for the type of pain and population of infants included in the study. The inappropriate use of pain scales raises serious concerns on ethical conduct of research and waste of resources.

  • 85.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Campbell-Yeo, Marsha
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden; School of Nursing, Faculty of Health, Departments of Pediatrics, Psychology & Neuroscience, Dalhousie University, 5850/5890 University Ave, Halifax, NS, Canada; Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada.
    Assessment of pain in newborn infants2019Ingår i: Seminars in Fetal & Neonatal Medicine, ISSN 1744-165X, E-ISSN 1878-0946, Vol. 24, nr 4, artikel-id UNSP 101003Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hospitalized newborn infants experience pain that can have negative short- and long-term consequences and thus should be prevented and treated. National and international guidelines state that adequate pain management requires valid pain assessment. Nociceptive signals cause a cascade of physical and behavioral reactions that alone or in combination can be observed and used to assess the presence and intensity of pain.

    Units that are caring for newborn infants must adopt sufficient pain assessment tools to cover the gestational ages and pain types that occurs in their setting. Pain assessment should be performed on a regular basis and any detection of pain should be acted on. Future research should focus on developing and validating pain assessment tools for specific situations.

  • 86.
    Eriksson, Mats
    et al.
    Örebro universitet, Hälsoakademin.
    Gradin, Maria
    Örebro universitet, Hälsoakademin.
    Pain management in Swedish neonatal units: a national survey2008Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, nr 7, s. 870-874Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim of this study was to investigate the degree to which Swedish neonatal units have adopted the national guidelines for prevention and treatment of pain in newborn infants. METHOD: A survey was sent to all units in Sweden that provide neonatal care. For a list of potentially painful procedures, compiled from the national neonatal pain guidelines, the units were asked if they would use pharmacological and/or behavioural interventions, and in each case to specify the treatment. RESULTS: The response rate was 80.4%. Eighty-eight percent of the units had written guidelines for pain management, and 59% of these had been updated within the last 2 years. For almost every presented case, all units reported that they used either pharmacological or behavioural treatment or both. The survey showed a wide variation in morphine and paracetamol dosing and the absence of a paracetamol loading dose in a fourth of the units. CONCLUSIONS: This study suggests that a majority of Swedish neonatal units have adopted pain management guidelines in concordance with the Swedish national guidelines, and kept them up-to-date. For most painful situations a variety of behavioural and pharmacological interventions are used, often in combination.

  • 87.
    Eriksson, Mats
    et al.
    Örebro universitet, Hälsoakademin.
    Kenner, Carole
    Neonatal nursing research: an international perspective—the Swedish view2008Ingår i: Newborn and Infant Nursing Reviews, ISSN 1527-3369, E-ISSN 1558-352X, Vol. 8, nr 3, s. 120-122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Our world is shrinking because of computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review (NAINR) issue will feature a column that highlights care-related issues from a featured country or region of the world. This article focuses on Sweden. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses NAINR's theme-oriented topic. This month, Sweden will be featured. Our guest author is Dr Mats Eriksson from the Department of Pediatrics and Department of Clinical Research, Örebro University Hospital, Örebro, Sweden, and Contact for the Council of International Neonatal Nurses for Sweden. This month's article focuses on evidence-based care through research.

  • 88.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Nilsson, Ulrica
    Örebro universitet, Institutionen för hälsovetenskaper.
    Bramhagen, Ann-Cathrine
    Fakulty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.
    Idvall, Ewa
    Fakulty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.
    Ericsson, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskaper.
    Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy2017Ingår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 96, s. 47-54Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect.

    Methods: In total, 238 children (4–12 years old) with a history of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil surgery were included. Forty-eight per cent were operated with partial tonsil resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery.

    Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument PRiC, Postoperative Recovery in Children. This includes 23 items covering different aspects of recovery after tonsil surgery. A higher score indicates worse status in the respective items.

    Results: Daily life activities (sleeping, eating and playing), physical symptoms (e.g., headache, stomach ache, sore throat, otalgia, dizziness, nausea, defecation, urination), and emotional aspects (sadness, frightening dreams) were affected during the recovery period.

    The TE-girls showed higher scores than the boys regarding stomach ache, defecation and dizziness.

    Children above 6 years of age reported higher values for the physical comfort variables, while the younger group showed worse emotional states.

    Postoperative recovery improved from day 1–10 in all surgical groups. The TE-group showed lower recovery compared to the TT-group (p < 0.01–0.001) in most items.

    Conclusion: The goal of postoperative management is to minimize or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery, and thus, PRiC seems to be able to serve as a PROM to obtain patient-centered data after tonsil surgery. The recovery process after TT causes less postoperative morbidity and a quicker return to normal activity compared to TE.

  • 89.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Norman, Elisabeth
    Lund University, Lund, Sweden.
    Modernt tänk i neonatal smärtbehandling2019Konferensbidrag (Övrigt vetenskapligt)
  • 90.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Pettersson, Miriam
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Olsson, Emma
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ohlin, Andreas
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Neurophysiological and behavioural measures of pain during neonatal hip examination2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.

    Aim: The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns. 

    Method: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.

    Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex. Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination. GSR analyses showed significant increase in area under small peaks during the hip examination. 

    Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution. 

  • 91.
    Eriksson, Mats
    et al.
    Örebro University Hospital, Örebro, Sweden.
    Rombo, Karl
    Karolinska Institutet, Stockholm, Sweden.
    Mader, Silke
    European Foundation for the Care of Newborn Infants, Munich, Germany.
    Föräldrarollen i neonatalvården behöver anpassas och utvecklas [Need for improvements in neonatal care]2019Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, artikel-id FSR9Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The medical and nursing care of preterm infantshas improved over the last decades, including the involvement of parents in the daily care. Previously parents could only visit a few scheduled hours per day but today most neonatal units in Sweden strive to let the parents be the primary caregivers, with the rightto stay at the unit during the entire hospitalization period. Despite this development, there is still need for a number of improvements, not only in the neonatal care but also during the complicated pregnancy.

  • 92.
    Eriksson, Mats
    et al.
    Örebro universitet, Hälsoakademin.
    Storm, Hanne
    Fremming, Asbjörn
    Schollin, Jens
    Örebro universitet, Hälsoakademin.
    Skin conductance compared to a combined behavioural and physiologicalpain measure in newborn infants2008Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, nr 1, s. 27-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To assess the ability of galvanic skin response (GSR) to differentiate between tactile and painful stimulation in newborn infants, and to compare this with the ability of the premature infant pain profile (PIPP). METHODS: Thirty-two healthy full-term infants undergoing routine blood sampling were recruited. In a randomized order they were subjected to tactile and painful stimulation. The three GSR variables conductance baseline level, number of waves per second and mean amplitude of the waves were recorded together with the behavioural and physiological variables of PIPP. RESULTS: The GSR variables number of waves and amplitude of the waves increased more during painful stimulation than during tactile stimulation, as did also the PIPP score. Receiver operating characteristic curves analysis revealed no significant differences between the studied methods. CONCLUSION: GSR can differentiate painful from tactile stimulation, but more research is needed to achieve a clinically useful application.

  • 93.
    Fadl, Shalan
    et al.
    Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Wåhlander, Håkan
    The Queen Silvia Children`s Hospital, Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sunnegårdh, Jan
    The Queen Silvia Children`s Hospital, Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
    The highest mortality rates in childhood dilated cardiomyopathy occur during the first year after diagnosis2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 4, s. 672-677Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim of the study was to assess the incidence, mortality and morbidity of dilated cardiomyopathy (DCM) and non-compaction of the left ventricle (LVNC) in Swedish children.

    METHODS: We reviewed hospital records of all children with dilated cardiomyopathy (DCM) or left ventricular non-compaction cardiomyopathy (LVNC) up to the age of 18 in the healthcare region of western Sweden from 1991 to 2015.

    RESULTS: In total, 69 cases (61% males) were identified. The combined incidence of DCM and LVNC was 0.77 (95% CI 0.59-0.96) per 100,000 person years. Children were divided into six groups and their outcomes were analysed depending on their aetiology. Idiopathic DCM was reported in 43% and familial dilated and left ventricular non-compaction aetiology was present in 32%. DCM due to various diseases occurred in 8%. DCM associated with neuromuscular diseases was present in 16%. The overall risk of death or receiving transplants in children with idiopathic and familial DCM was 30% over the study period and 21% died in the first year after diagnosis.

    CONCLUSION: The combined incidence of DCM and LVNC was similar to previous reports. Most children with idiopathic DCM presented during infancy and mortality was highest during the first year after diagnosis.

  • 94.
    Fall, Tove
    et al.
    Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Lundholm, Cecilia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Örtqvist, Anne K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Orebro Univ Hosp, Orebro, Sweden.
    Fang, Fang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Hedhammar, Åke
    Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden .
    Kämpe, Olle
    Centre for Molecular Medicine, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden .
    Ingelsson, Erik
    Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Almqvist, Catarina
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children’s Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden.
    Early Exposure to Dogs and Farm Animals and the Risk of Childhood Asthma2015Ingår i: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 169, nr 11, artikel-id e153219Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IMPORTANCE: The association between early exposure to animals and childhood asthma is not clear, and previous studies have yielded contradictory results.

    OBJECTIVE: To determine whether exposure to dogs and farm animals confers a risk of asthma.

    DESIGN, SETTING AND PARTICIPANTS: In a nationwide cohort study, the association between early exposure to dogs and farm animals and the risk of asthma was evaluated and included all children born in Sweden from January 1, 2001, to December 31, 2010 (N = 1 011 051), using registry data on dog and farm registration, asthma medication, diagnosis, and confounders for parents and their children. The association was assessed as the odds ratio (OR) for a current diagnosis of asthma at age 6 years for school-aged children and as the hazard ratio (HR) for incident asthma at ages 1 to 5 years for preschool-aged children. Data were analyzed from January 1, 2007, to September 30, 2012.

    EXPOSURES: Living with a dog or farm animal.

    MAIN OUTCOMES AND MEASURES: Childhood asthma diagnosis and medication used.

    RESULTS: Of the 1 011 051 children born during the study period, 376 638 preschool-aged (53 460 [14.2%] exposed to dogs and 1729 [0.5%] exposed to farm animals) and 276 298 school-aged children (22 629 [8.2%] exposed to dogs and 958 [0.3%] exposed to farm animals) were included in the analyses. Of these, 18 799 children (5.0%) in the preschool-aged children's cohort experienced an asthmatic event before baseline, and 28 511 cases of asthma and 906 071 years at risk were recorded during follow-up (incidence rate, 3.1 cases per 1000 years at risk). In the school-aged children's cohort, 11 585 children (4.2%) experienced an asthmatic event during the seventh year of life. Dog exposure during the first year of life was associated with a decreased risk of asthma in school-aged children (OR, 0.87; 95% CI, 0.81-0.93) and in preschool-aged children 3 years or older (HR, 0.90; 95% CI, 0.83-0.99) but not in children younger than 3 years (HR, 1.03; 95% CI, 1.00-1.07). Results were comparable when analyzing only first-born children. Farm animal exposure was associated with a reduced risk of asthma in both school-aged children and preschool-aged children (OR, 0.48; 95% CI, 0.31-0.76, and HR, 0.69; 95% CI, 0.56-0.84), respectively.

    CONCLUSIONS AND RELEVANCE: In this study, the data support the hypothesis that exposure to dogs and farm animals during the first year of life reduces the risk of asthma in children at age 6 years. This information might be helpful in decision making for families and physicians on the appropriateness and timing of early animal exposure.

  • 95.
    Fang, Xin
    et al.
    Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wang, Lei
    Department of Oral & Maxillofacial-Head & Neck Oncology, the Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
    Wu, Chunhua
    School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
    Shi, Huijing
    School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
    Zhou, Zhijun
    School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sex Hormones, Gonadotropins, and Sex Hormone-binding Globulin in Infants Fed Breast Milk, Cow Milk Formula, or Soy Formula2017Ingår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, artikel-id 4332Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Measurement of endogenous hormones in early life is important to investigate the effects of hormonally active environmental compounds. To assess the possible hormonal effects of different feeding regimens in different sample matrices of infants, 166 infants were enrolled from two U.S hospitals between 2006 and 2009. The children were classified into exclusive soy formula, cow milk formula or breast milk regimens. Urine, saliva and blood samples were collected over the first 12 months of life. Estradiol, estrone, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels were measured in the three matrices. Lower estradiol and LH levels were found in urine and saliva samples of soy formula-fed boys compared to cow formula-fed boys. Higher LH level was found in urine samples of soy formula-fed girls compared to cow formula-fed girls. However, we found neither a neonatal testosterone rise in the boys nor a gender-specific difference in testosterone levels, which suggests that urinary testosterone levels may not accurately reflect blood levels during mini-puberty. Nevertheless, our study shows that blood, urine and saliva samples are readily collectible and suitable for multi-hormone analyses in children and allow examination of hypotheses concerning endocrine effects from dietary compounds.

  • 96.
    Faraone, Stephen V.
    et al.
    State University of New York Upstate Medical University, Syracuse, USA; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.
    Ghirardi, Laura
    Karolinska Institutet, Stockholm, Sweden.
    Kuja-Halkola, Ralf
    Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, Paul
    Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Örebro universitet, Institutionen för medicinska vetenskaper.
    The Familial Co-Aggregation of Attention-Deficit/Hyperactivity Disorder and Intellectual Disability: A Register-Based Family Study2017Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 56, nr 2, s. 167-174.e1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Although many studies document an association between attention-deficit/hyperactivity disorder (ADHD) and intellectual disability (ID), little is known about the etiology of this comorbidity and how it should be addressed in clinical settings. We sought to clarify this issue.

    Method: All individuals born in Sweden between 1987 and 2006 (n = 2,049,587) were identified using the Medical Birth Register (MBR). From this we selected 7 cohorts of relatives: 1,899,654 parent-offspring pairs, 4,180 monozygotic twin pairs, 12,655 dizygotic twin pairs, 914,848 full sibling pairs, 136,962 maternal half-sibling pairs, 134,502 paternal half-sibling pairs, and 2,790,164 full cousin pairs. We used within-individual and within-family analyses to assess the association between ADHD and ID.

    Results: Individuals with ID were at increased risk for ADHD compared to those without ID, and relatives of participants with ID were at increased risk of ADHD compared with relatives of those without ID. The magnitude of this association was positively associated with the fraction of the genome shared by the relative pair and was lower for severe compared with mild and moderate ID. Model-fitting analyses demonstrated that 91% of the correlation between the liabilities of ADHD and ID was attributable to genetic factors.

    Conclusion: These data provide evidence that nearly all of the comorbidity between ADHD and ID can be attributed to genetic factors, which has implications for diagnostic practice.

  • 97.
    Flacking, Renee
    et al.
    School of Education, Health and Social Studies, Dalarna University, Sweden.
    Breili, Christine
    School of Education, Health and Social Studies, Dalarna University, Sweden; Centre for Clinical Research Dalarna, Sweden.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskaper.
    Facilities for presence and provision of support to parents and significant others in neonatal units2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe parental facilities for staying in neonatal units, visiting policies, and access to emotional support during hospitalization.

    Methods: A cross‐sectional design was used in which a survey was presented to all neonatal units in Sweden; 34 out of 38 units participated (89%).

    Results: The findings showed that in 50% of the units, parents could stay 24/7 for the infant's entire hospital stay. In 32% of the units, siblings could stay the night with their parents. Units had policies on restrictions for visits by siblings (80%), grandparents (59%), friends and relatives (71%). All units offered counselling to parents, and some units offered peer‐to‐peer groups (24%), diaries (35%), relaxation techniques (6%) or internet parental forums (6%). All units enabled parents to be at home with their infant and to visit the unit for check‐ups (35%) or to have staff visits at home (65%).

    Conclusion: Facilities for parents to stay with their infant during hospitalization and to have significant others visit are good, but there is room for improvement. During the transitional phase to being at home, parents are facilitated in being at home before the infant is discharged and are supported by the unit, which must be considered beneficial for parents.

  • 98.
    Frölander, Hans-Erik
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. School of Health and Medical Sciences, Örebro; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Research on Hearing and Deafness (HEAD) Graduate School, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden;.
    Möller, Claes
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Department of Audiology, Örebro University Hospital, Örebro, Sweden; The Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping, Sweden.
    Marshall, Jan D.
    The Jackson laboratory, Bar Harbor ME, USA.
    Sundqvist, Annette
    Department of Behavioral Science and Learning, Linköping University, Linköping, Sweden; Linnaeus Ctr HEAD, Linköping, Sweden; The Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Rönnåsen, Berit
    Örebro universitet, Institutionen för hälsovetenskap och medicin. School of Health and Medical Sciences, Örebro; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Research on Hearing and Deafness (HEAD) Graduate School, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Falkensson, Lil
    The Swedish National Expert Team for the Diagnoses of Deafblindness, National Resource Centre, Lund, Sweden.
    Lyxell, Björn
    Department of Behavioral Science and Learning, Linköping University, Linköping, Sweden; The Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Theory-of-mind in adolescents and young adults with Alström Syndrome2014Ingår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 3, s. 530-537Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

    Methods: Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story chraracters´. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

    Results: The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

    Conclusions: The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.

  • 99. Furuman, Anna-Lena
    et al.
    Lilja, Mikael
    Lind, Torbjörn
    Särnblad, Stefan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Samuelsson, Ulf
    A comparison between treatment with continuous insulin infusion and multiple daily injections in children and adolescents with type 1 diabetes in Sweden-data from the Swedish national quality register SWEDIABKIDS2019Konferensbidrag (Refereegranskat)
  • 100.
    Ghanei, M.
    et al.
    Public Dental Service, Gothenburg, Sweden.
    Arnrup, Kristina
    Örebro universitet, Institutionen för hälsovetenskaper. Dental Research Department, Public Dental Service, Örebro, Sweden.
    Robertson, A.
    Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Procedural pain in routine dental care for children: a part of the Swedish BITA study2018Ingår i: European Archives of Paediatric Dentistry, ISSN 1818-6300, E-ISSN 1996-9805, Vol. 19, nr 5, s. 365-372Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To investigate the frequency and reported intensity levels of dental treatment pain and discomfort in children, in conjunction with regular dental visits.

    METHODS: The study included 2363 children in four different age cohorts. Data was collected from structured interviews by dental personnel regarding pain experiences or discomfort after treatments, including analgesia, extractions, operative treatments and radiographic examinations.

    RESULTS: One-third of all treatment occasions were experienced as painful and/or causing discomfort. Treatment sessions including analgesia were assessed as painful in 49.7% of occasions, with injection being the most common given reason for pain. Extraction was painful in 62.4% of occasions, with injection as the main reason for pain. Operative treatments were assessed as painful in 38.8% of occasions, with drilling as the most common reason for pain and discomfort. Pain was reported in approximately 19% of all radiographic examinations.

    CONCLUSIONS: Injection was the major reason for pain during treatment, including injection and extraction, while drilling was the most common cause of pain during restorative treatment. Dentists should try to minimise the experience of pain and discomfort by using all available measures to perform pain-free and effective dental injections.

123456 51 - 100 av 272
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf