| 1. |
- Alm, Bernt, 1951, et al.
(författare)
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Breast feeding and the sudden infant death syndrome in Scandinavia, 1992-95.
- 2002
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 86:6, s. 400-2
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Tidskriftsartikel (refereegranskat)abstract
- To assess the effects of breast feeding habits on sudden infant death syndrome (SIDS).The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries between 1 September 1992 and 31 August 1995 were invited to participate, each with parents of four matched controls. The odds ratios presented were computed by conditional logistic regression analysis.After adjustment for smoking during pregnancy, paternal employment, sleeping position, and age of the infant, the adjusted odds ratio (95% CI) was 5.1 (2.3 to 11.2) if the infant was exclusively breast fed for less than four weeks, 3.7 (1.6 to 8.4) for 4-7 weeks, 1.6 (0.7 to 3.6) for 8-11 weeks, and 2.8 (1.2 to 6.8) for 12-15 weeks, with exclusive breast feeding over 16 weeks as the reference. Mixed feeding in the first week post partum did not increase the risk.The study is supportive of a weak relation between breast feeding and SIDS reduction.
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| 2. |
- Alm, Bernt, 1951, et al.
(författare)
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Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996.
- 2001
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Ingår i: Archives of disease in childhood. - 1468-2044. ; 84:1, s. 24-30
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Tidskriftsartikel (refereegranskat)abstract
- From the early 1970s to the early 1990s, there was a significant rise in the incidence of sudden infant death syndrome (SIDS) in Scandinavia. Following the risk reducing campaign, the incidence has fallen to about the same level as in 1973.To identify the changes that have occurred in the epidemiology of SIDS.We compared the Swedish part of the Nordic Epidemiological SIDS Study (NESS), covering the years 1992-1995, with two earlier, descriptive studies during this period. To assess the changing effects of risk factors, we analysed data from the Medical Birth Registry of Sweden, covering the years 1973-1996.There was a predominance of deaths during weekends in the 1970s and 1990s. The seasonal variation was most notable in the 1980s. The proportion of young mothers decreased from 14% to 5%. Cohabitation (living with the biological father) was as frequent in the 1990s as in the 1970s. The prevalence of high parity, admissions to neonatal wards, low birth weight, prematurity, and multiple pregnancies were all increased in the 1990s compared to the 1970s. No significant change in the prevalence of previous apparent life threatening events was found. Deaths occurring in cars diminished from 10% to below 2%. In the data from the Medical Birth Registry of Sweden, there were significantly increased odds ratios after the risk reducing campaign of the risk factors smoking during early pregnancy and preterm birth. We could find no increased effects of maternal age, parity, or being small for gestational age over time. The rate of deaths at weekends remained increased; the median age at death fell from 90 to 60 days. Seasonal variation was less notable in the periods of low incidence.
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| 3. |
- Alm, Bernt, 1951, et al.
(författare)
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Föräldrar har tagit till sig råden för att förebygga plötslig spädbarnsdöd : [Parents have accepted the advice on how to prevent sudden infant death]
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:14, s. 1268-1270
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Tidskriftsartikel (refereegranskat)abstract
- We have compared 430 healthy Swedish infants born between 1991 and 1995 with 599 healthy, six months old infants born in 2002, regarding the prevalence of risk factors for SIDS. Following the introduction of the campaign to reduce the risk of SIDS in Sweden in 1992, we could see a decrease in prone sleeping from 32% to 7% together with an increase in supine sleeping from 35% to 44%. Maternal smoking during pregnancy has gone down from 24% to 10%. The prevalence of breast feeding, already high in Sweden in the 90s, was largely unchanged, 69% at six months of age in 2002. This comparison shows that parents of small infants have accepted the advice on ways to reduce the risk of SIDS, and that information given at infant welfare clinics is still effective ten years later. Further improvements are possible by changing the side sleeping position to supine, and by decreasing tobacco smoking among pregnant mothers.
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| 4. |
- Alm, Bernt, 1951, et al.
(författare)
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Living conditions in early infancy in Denmark, Norway and Sweden 1992-95: results from the Nordic Epidemiological SIDS study.
- 2000
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 89:2, s. 208-14
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to study living conditions of infants and their families in Scandinavia in the 1990s and to assess similarities and differences among the three Scandinavian countries. The emphasis is on health and normality rather than on diseases and other deviations from well-being. The subjects are the 869 controls in the Nordic Epidemiological SIDS study carried out between 1 September 1992 and 31 August 1995 in Norway, Denmark and Sweden. The controls were matched with the 244 SIDS cases for sex, age and maternity hospital. Parents of the SIDS cases and the controls filled in the same questionnaire on family, pregnancy, delivery, the neonatal and the post-perinatal period. The most striking findings were that 99% of the mothers went to regular maternity controls, 97% to well-baby clinics and 84% breastfed exclusively. On the other hand, 11% drank alcohol more than once a month during pregnancy and 29% smoked during pregnancy. Compared to official statistics, to the extent they exist, the differences were small. The material contains valuable information on normal infant care in Scandinavia in the 1990s. Living conditions of infants in Scandinavia are similar in the three countries. Differences exist, but only to a small extent.
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| 5. |
- Alm, Bernt, 1951, et al.
(författare)
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Vitamin A and sudden infant death syndrome in Scandinavia 1992-1995.
- 2003
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253. ; 92:2, s. 162-4
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Tidskriftsartikel (refereegranskat)abstract
- To assess the effect of vitamin supplementation on the risk of sudden infant death syndrome (SIDS).The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries were invited to participate together with parents of four matched controls between 1 September 1992 and 31 August 1995. The odds ratios presented are computed by conditional logistic regression analysis.The crude odds ratio in Scandinavia for not giving vitamin substitution was 2.8 (95% CI (1.9, 4.3)). This effect was statistically significant in Norway and Sweden, which use A and D vitamin supplementation, but not in Denmark, where only vitamin D supplementation is given. The odds ratios remained significant in Sweden when an adjustment was made for confounding factors (OR 28.4, 95% CI (4.7, 171.3)).We found an association between increased risk of sudden infant death syndrome and infants not being given vitamin supplementation during their first year of life. This was highly significant in Sweden, and the effect is possibly connected with vitamin A deficiency. This effect persisted when an adjustment was made for potential confounders, includingsocioeconomic factors.
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| 6. |
- Benson, Mikael, 1954, et al.
(författare)
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Altered levels of the soluble IL-1, IL-4 and TNF receptors, as well as the IL-1 receptor antagonist, in intermittent allergic rhinitis
- 2004
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Ingår i: Int Arch Allergy Immunol. - : S. Karger AG. - 1018-2438 .- 1423-0097. ; 134:3, s. 227-32
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The effects of cytokines are modulated by soluble cytokine receptors (SCR) and receptor antagonists. Therefore, allergic disease may depend on altered proportions between cytokines, their SCR and receptor antagonists, rather than absolute changes in cytokine levels. Little is known about SCR in intermittent allergic rhinitis (IAR). OBJECTIVE: To examine the concentrations of SCR, i.e. sIL-1R2, sIL-4R, sIL-6R and sTNFR1, as well as the interleukin-1 receptor antagonist (IL-1Ra) in nasal fluids from allergen-challenged patients with IAR and healthy controls. METHODS: 30 patients with birch- or grass-pollen-induced IAR and 30 healthy controls were studied. In the patients nasal fluids were obtained before as well as 1 and 6 h after allergen provocation. RESULTS: Both symptom scores and rhinoscopic signs of rhinitis increased in the patients after allergen challenge. Comparisons between patients and controls showed that sIL-4R was lower in patients before and 1 and 6 h after provocation. IL-1Ra was lower before and 1 h after provocation. In addition, lower concentrations of sTNFR1 were found in patients after 1 h, while sIL-1R2 concentrations were higher after 1 h. Comparisons of patients before and after challenge showed that IL-1Ra and sTNFR1 decreased after 1 h, while sIL-1R2 increased. No significant differences were found compared to 6 h. sIL-6R did not significantly differ between the study groups. CONCLUSIONS: After allergen challenge, significant changes in the nasal fluid levels of IL-1Ra, sIL-1R2 and sTNFR1 were found. By contrast, sIL-4R remained at lower levels than in controls both before and after challenge. Since sIL-4R modulates IgE synthesis, this may play a role in the pathogenesis of IAR.
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| 7. |
- Benson, Mikael, 1954, et al.
(författare)
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Increase of the soluble IL-4 receptor (IL-4sR) and positive correlation between IL-4sR and IgE in nasal fluids from school children with allergic rhinitis.
- 2000
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Ingår i: Allergy and asthma proceedings. - : OceanSide Publications. - 1088-5412 .- 1539-6304. ; 21:2, s. 89-95
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Tidskriftsartikel (refereegranskat)abstract
- Soluble cytokine receptors (SCR) can either act as inhibitors, by competitively inhibiting cytokines from binding to their membrane-bound receptors, or as enhancers, by serving as cytokine carriers. We have previously found that the levels of the Th2 cytokines interleukin (IL)-4, IL-5, IL-6, and IL-10 were positively correlated to eosinophils and IgE in nasal fluids from 60 children with seasonal allergic rhinitis. In this study, nasal fluids were reexamined to analyze IL-4sR, IL-6sR, IL-1 beta, TNF-alpha, IL-1sR2, TNF-sR1, and TNFsR2 in relation to eosinophils, neutrophils, ECP, and IgE. In allergic patients IL-4sR increased significantly during the pollen season, and weak, but positive correlations with IgE and eosinophils were found (r = 0.45, P < 0.001 and r = 0.4, P < 0.001 respectively). By contrast, none of the other SCR showed increases or correlations with IgE. However, positive correlations between IL1 beta, TNF-alpha, IL-6sR, IL-1sR2, TNF-sR1, TNF-sR2, and either neutrophils or ECP were found. Also, in healthy controls, these cytokines and their receptors were positively correlated to neutrophils or ECP. Thus, increased levels of the soluble IL-4 receptor, as well as IgE, were specifically associated with allergic rhinitis, whereas all other SCR correlated with either inflammatory cells or their products, in both allergic and healthy subjects. These results may suggest that SCR in vivo act as cytokine enhancers, rather than inhibitors.
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| 8. |
- Benson, Mikael, 1954, et al.
(författare)
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Increased expression of Vascular Endothelial Growth Factor-A in seasonal allergic rhinitis.
- 2002
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Ingår i: Cytokine. - : Elsevier BV. - 1043-4666 .- 1096-0023. ; 20:6, s. 268-73
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Tidskriftsartikel (refereegranskat)abstract
- Increased vascular dilatation and permeability characterize allergic rhinitis. In this study oligonucleotide microarrays (Affymetrix HuGe95A) were used to identify differentially expressed vasoactive genes in nasal biopsies from 23 patients with symptomatic seasonal allergic rhinitis (SAR) and 12 healthy controls. RNA was extracted from the biopsies and pooled in three patient and three control pools. Out of 12,626 analysed transcripts, 39 were higher and 81 lower in the patients. Of these transcripts two have vasoactive effects: Vascular Endothelial Growth Factor-A (VEGF-A) and the Beta-1-Adrenergic Receptor. Both were higher in patients than in controls. The mean +/- SEM expression levels in arbitrary units of VEGF-A were 130 +/- 123 in the patients and 59 +/- 53 in the controls. The fold ratio in expression levels between patients/controls was 2.2. The corresponding values for the beta-1-adrenergic receptor were 129 +/- 123 in the patients and 40 +/- 31 in the controls. The fold ratio between patient/controls was 3.2. The role of VEGF-A was assessed by determining VEGF-A concentrations in nasal fluids from another 30 patients with SAR before and after allergen provocation. VEGF-A increased from 124.3 +/- 30.2 to 163.2 +/- 37.8 pg/ml after challenge, P < 0.05. In summary, oligonucleotide microarray analysis of nasal biopsies and protein analyses of nasal fluids indicate that VEGF-A may be an important mediator in SAR.
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| 9. |
- Benson, Mikael, 1954, et al.
(författare)
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Low levels of interferon-gamma in nasal fluid accompany raised levels of T-helper 2 cytokines in children with ongoing allergic rhinitis.
- 2000
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley-Blackwell. - 0905-6157 .- 1399-3038. ; 11:1, s. 20-8
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Tidskriftsartikel (refereegranskat)abstract
- The T-helper 2 (Th2) cytokines interleukin-(IL-) 4, IL-5, IL-6, IL-10 and the Th1 cytokine IFN-gamma and their associations with eosinophil, eosinophil cationic protein (ECP) and immunoglobulin (Ig) E were studied in nasal lavage fluid from 60 school children with allergic seasonal rhinitis and 36 nonatopic healthy controls, before and during the pollen season. Eosinophil differential counts and IgE increased significantly in the patients during the pollen season. The eosinophil differential counts, ECP and IgE were all significantly higher during the season than in specimens simultaneously obtained from the nonatopic controls. Before season, the levels of ECP and IgE, but not eosinophils, were significantly higher in the patients than in the controls. During the season the nasal lavage fluid levels of IFN-gamma were significantly lower and the IL-4/IFN-gamma quotients significantly higher in the allergic than in the control children. In the allergic children, but not in the controls, the nasal fluid levels of the Th2 cytokines IL-4, IL-5 and IL-10 increased during the season, and together with IL-6, were correlated with the differential counts of eosinophils, and with the levels of ECP and IgE. These findings are compatible with the hypothesis that a deficient release of the Th1 cytokine IFN-gamma plays an important role in the pathogenesis of allergic inflammation. Regardless of whether the defective IFN-gamma secretion is primary or a consequence of suppression by other cytokines, it will in the atopic subjects enhance the release of Th2 cytokines, which in turn will facilitate the development of allergic inflammation.
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| 10. |
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