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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Pediatrik) > Luleå tekniska universitet

  • Resultat 1-10 av 19
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1.
  • Socher, Michaela, et al. (författare)
  • Comparing the semantic networks of children with cochlear implants and children with typical hearing: Effects of length of language access
  • 2022
  • Ingår i: Journal of Communication Disorders. - : Elsevier. - 0021-9924 .- 1873-7994. ; 99
  • Tidskriftsartikel (refereegranskat)abstract
    • PurposeKenett et al. (2013) report that the sematic networks, measured by using an oral semantic fluency task, of children with cochlear implants (CI) are less structured compared to the sematic networks of children with typical hearing (TH). This study aims to evaluate if such differences are only evident if children with CI are compared to children with TH matched on chronological age, or also if they are compared to children with TH matched on hearing age.MethodThe performance of a group of children with CI on a verbal fluency task was compared to the performance of a group of chronological-age matched children with TH. Subsequently, computational network analysis was used to compare the semantic network structure of the groups. The same procedure was applied to compare a group of children with CI to a group of hearing-age matched children with TH.ResultsThe children with CI perform on the same level on an oral semantic verbal fluency task as the children with TH matched on hearing age. There are significant differences in terms of the structure of the semantic network between the groups. The magnitude of these differences is very small and they are non-significant for a proportion of nodes included in the bootstrap analysis. This indicates that there is no true difference between the networks. Hearing age, but not age at implantation was found to be significantly positively correlated with semantic verbal fluency performance for the children with CI.ConclusionsThe results from the current study indicate that length of language exposure is an important factor for the structure of the semantic network and the performance on a semantic verbal fluency task for children with CI. Further studies are needed to explore the role of the accessibility of the language input for the development of semantic networks of children with CI.
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2.
  • Razzaghy-Azar, Maryam, et al. (författare)
  • Investigating Genetic Mutations in a Large Cohort of Iranian Patients with Congenital Hyperinsulinism
  • 2022
  • Ingår i: Journal of Clinical Research in Pediatric Endocrinology. - : Galenos Yayinevi. - 1308-5727 .- 1308-5735. ; 14:1, s. 87-95
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Congenital hyperinsulinism (CHI) is the most frequent cause of severe and persistent hypoglycaemia from birth. Understanding the pathophysiology and genetic defects behind hyperinsulinism and its complications provides clues to timely diagnosis and management. The aim of this study was to evaluate the underlying genetic aetiology of a specific Iranian pediatric cohort with CHI.Methods: A total of 44 unrelated children, 20 girls and 24 boys, with an initial diagnosis or history of CHI from all regions of Iran were recruited between 2016 and 2019. Targeted next generation sequencing (tNGS) was performed for the genes found in about half of CHI patients.Results: Mutations were identified in 24 cases (55%). Patients with a confirmed genetic cause were mainly diagnosed below age of one year old (p=0.01), had fewer other syndromic features, excluding seizure, (p=0.03), were less diazoxide responsive (p=0.04) and were more diazoxide unresponsive leading to pancreatectomy (p=0.007) compared to those with no identified mutations. Among 24 patients with identified genetic mutations, 17 (71%) had a mutation in ABCC8, 3 (12%) in KCNJ11, 3 (12%) in HADH, and 1 patient had a mutation in KMT2D. These included five novel mutations in ABCC8, KCNJ11, and KMT2D.Conclusion: This is the biggest genetic study of CHI in Iran. A high frequency of recessive forms of CHI, especially HADH mutations, in our study could be due to a high rate of consanguineous marriage. We recommend tNGS to screen for all the CHI genes.
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3.
  • Bromfalk, Åsa, 1967-, et al. (författare)
  • Postoperative recovery in preschool‐aged children: A secondary analysis of a randomized controlled trial comparing premedication with midazolam, clonidine, and dexmedetomidine
  • 2023
  • Ingår i: Pediatric Anaesthesia. - : John Wiley & Sons. - 1155-5645 .- 1460-9592. ; 33:11, s. 962-972
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPreoperative anxiety in pediatric patients can worsen postoperative outcomes and delay discharge. Drugs aimed at reducing preoperative anxiety and facilitating postoperative recovery are available; however, their effects on postoperative recovery from propofol-remifentanil anesthesia have not been studied in preschool-aged children. Thus, we aimed to investigate the effects of three sedative premedications on postoperative recovery from total intravenous anesthesia in children aged 2–6 years.MethodsIn this prespecified secondary analysis of a double-blinded randomized trial, 90 children scheduled for ear, nose, and throat surgery were randomized (1:1:1) to receive sedative premedication: oral midazolam 0.5 mg/kg, oral clonidine 4 μg/kg, or intranasal dexmedetomidine 2 μg/kg. Using validated instruments, outcome measures including time for readiness to discharge from the postoperative care unit, postoperative sedation, emergence delirium, anxiety, pain, and nausea/vomiting were measured.ResultsAfter excluding eight children due to drug refusal or deviation from the protocol, 82 children were included in this study. No differences were found between the groups in terms of median time [interquartile range] to readiness for discharge (midazolam, 90 min [48]; clonidine, 80 min [46]; dexmedetomidine 100.5 min [42]). Compared to the midazolam group, logistic regression with a mixed model and repeated measures approach found no differences in sedation, less emergence delirium, and less pain in the dexmedetomidine group, and less anxiety in both clonidine and dexmedetomidine groups.ConclusionsNo statistical difference was observed in the postoperative recovery times between the premedication regimens. Compared with midazolam, dexmedetomidine was favorable in reducing both emergence delirium and pain in the postoperative care unit, and both clonidine and dexmedetomidine reduced anxiety in the postoperative care unit. Our results indicated that premedication with α2-agonists had a better recovery profile than short-acting benzodiazepines; although the overall recovery time in the postoperative care unit was not affected.
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4.
  • Bromfalk, Åsa, 1967-, et al. (författare)
  • Preoperative anxiety in preschool children : A randomized clinical trial comparing midazolam, clonidine, and dexmedetomidine
  • 2021
  • Ingår i: Pediatric Anaesthesia. - : John Wiley & Sons. - 1155-5645 .- 1460-9592. ; 31:11, s. 1225-1233
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Anxiety in pediatric patients may challenge perioperative anesthesiology management and worsen postoperative outcomes. Sedative drugs aimed to reducing anxiety are available with different pharmacologic profiles, and there is no consensus on their effect or the best option for preschool children. In this study, we aimed to compare the effect of three different premedications on anxiety before anesthesia induction in preschool children aged 2-6 years scheduled for elective surgery. The secondary outcomes comprised distress during peripheral catheter (PVC) insertion, compliance at anesthesia induction, and level of sedation.Patients and methods: In this double-blinded randomized clinical trial, we enrolled 90 participants aged 2-6 years, who were scheduled for elective ear-, nose-and-throat surgery. The participants were randomly assigned to three groups: those who were administered 0.5 mg/kg oral midazolam, 4 µg/kg oral clonidine, or 2 µg/kg intranasal dexmedetomidine. Anxiety, distress during PVC insertion, compliance with mask during preoxygenation, and sedation were measured using the modified Yale Preoperative Anxiety Scale, Behavioral Distress Scale, Induction Compliance Checklist, and Ramsay Sedation Scale, respectively.Results: Six children who refused premedication were excluded, leaving 84 enrolled patients. At baseline, all groups had similar levels of preoperative anxiety and distress. During anesthesia preparation, anxiety was increased in the children who received clonidine and dexmedetomidine; however, it remained unaltered in the midazolam group. There were no differences in distress during PVC insertion or compliance at induction between the groups. The children in the clonidine and dexmedetomidine groups developed higher levels of sedation than those in the midazolam group.Conclusions: In preschool children, midazolam resulted in a more effective anxiolysis and less sedation compared to clonidine and dexmedetomidine.
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5.
  • Nakeva von Mentzer, Cecilia, 1968-, et al. (författare)
  • Computer-assisted training of phoneme-grapheme correspondence for children who are deaf and hard of hearing : Effects on phonological processing skills
  • 2013
  • Ingår i: International Journal of Pediatric Otorhinolaryngology. - Amsterdam, Netherlands : Elsevier. - 0165-5876 .- 1872-8464. ; 77:12, s. 2049-2057
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Examine deaf and hard of hearing (DHH) children's phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme-grapheme correspondence training in the children. Specifically analyze possible effects on DHH children's phonological processing skills.Methods: The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme-grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents.Results: NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme-grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme-grapheme correspondence.Conclusion: For some DHH children phonological processing skills are boosted relatively more by phoneme-grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.
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6.
  • Rönnqvist, Louise, et al. (författare)
  • Effects of twin-births on IQ, handedness, and brain volumes in 8-years-old preterm born twins and matched singletons: a pilot study
  • 2016
  • Ingår i: Developmental Medicine & Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 58:S6, s. 57-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Children born preterm have a high prevalence of long-term cognitive and behavioral disturbances. Still, studies of how preterm-twin-births may effect brain maturation and thus, contribute to long-term effects on brain-behavioral development and functions are rare.Aim: To investigate whether brain volumes differ between twin (TPB) and singleton preterm born (SPB) and full-term born children (FTB) and associate to long-term cognitive and behavioral outcomes as well as to gestational age (GA), birth weight (BW) and head circumference (BHC) at birth.Method: A sample of 22 twin born preterm (Mean GA=32.1, BW=1781), 23 matched singletons preterm (Mean GA=31.8, BW=1751), and 22 full-term singletons were included. All children were investigated by means of their cognition functions (WISC-IV), handedness performance index and brain volumes (3 Tesla MRI) at early school ages (M=7.8y) in 40 children (9 TPB, 10 SPB, 21 FTB).Results: The FTB-children performed better than both TPB and SPB on cognitive performance, and showed higher IQ. Brain volumes, especially Gray matter were stronger associated with IQ in the twins. Furthermore it was found that the SPB singletons had smaller Total Brain volume and less Grey Matter than FTB. The twins showed a higher prevalence of non-right handedness associated to GA, than both SPB and FTB. Independently of birth status, GA, BW and BHC were found to correlate positively with IQ, Total Brain volume, and Gray-and White matter volumes.Conclusion: Discordant handedness in TPB children and associations to lower GA indicate effect of twin-births on early functional laterality. The overall associations found between low GA/BW and smaller BHC at birth in preterm born and associations with lower IQ and smaller brain volumes at 8-y indicate that a very preterm birth are a higher predictor for long-term effects on brain development and cognitive performance than twin-birth per se.
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7.
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8.
  • Al-Azzawi, Sana Sabah, et al. (författare)
  • HeadUp: A Low-Cost Solution for Tracking Head Movement of Children with Cerebral Palsy Using IMU
  • 2021
  • Ingår i: Sensors. - : MDPI. - 1424-8220. ; 21:23
  • Tidskriftsartikel (refereegranskat)abstract
    • Cerebral palsy (CP) is a common reason for human motor ability limitations caused before birth, through infancy or early childhood. Poor head control is one of the most important problems in children with level IV CP and level V CP, which can affect many aspects of children's lives. The current visual assessment method for measuring head control ability and cervical range of motion (CROM) lacks accuracy and reliability. In this paper, a HeadUp system that is based on a low-cost, 9-axis, inertial measurement unit (IMU) is proposed to capture and evaluate the head control ability for children with CP. The proposed system wirelessly measures CROM in frontal, sagittal, and transverse planes during ordinary life activities. The system is designed to provide real-time, bidirectional communication with an Euler-based, sensor fusion algorithm (SFA) to estimate the head orientation and its control ability tracking. The experimental results for the proposed SFA show high accuracy in noise reduction with faster system response. The system is clinically tested on five typically developing children and five children with CP (age range: 2-5 years). The proposed HeadUp system can be implemented as a head control trainer in an entertaining way to motivate the child with CP to keep their head up.
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9.
  • Domellöf, Erik, et al. (författare)
  • Improved fine motor performance in children born preterm : a longitudinal study of upper-limb kinematics from 4 to 8 years
  • 2015
  • Konferensbidrag (refereegranskat)abstract
    • Introduction:Although children born preterm (PT) are at known risk for impaired neuromotor development, longitudinal studies using detailed measurements of motor performance are rare. This study investigated developmental changes in goal-directed upper-limb kinematics from 4-8 years old in a sample of children born fullterm (FT) and PT without known developmental disabilities.Participants and Methods:3D kinematic recordings of performance with either arm/hand during a goal-directed unimanual precision task were carried out at 4 and 8 years in 37 children (13 very PT, V-PT, < 32 GW; 5 moderately PT, M-PT, 33-35 GW; 19 FT).Results:Repeated measures ANOVA revealed significant main effects for group and occasion, and interaction effects between group and occasion, for distal movement duration (p < .0001) and segmentation in terms of movement units (MUs, p < .0001). From initially having displayed less proficient movement organization at 4 years than both children born FT and M-PT, the children born V-PT showed a marked catch-up at 8 years, where no significant group differences remained. The mean between-occasion difference was substantial for both duration and segmentation in V-PT relative the other groups, although with noticeably higher within-group variability (MSD = 1.2 s/7.8 MUs) than M-PT (MSD = 0.5 s/2.5 MUs) and FT (MSD = 0.5 s/4.2 MUs).Conclusion:The children born PT, V-PT in particular, generally displayed a considerable gain in fine motor performance from preschool to school age. Compared with the FT and M-PT groups, however, the rate of improvement appears more heterogeneous in the V-PT group
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10.
  • Domellöf, Erik, 1970-, et al. (författare)
  • Relations Among Upper-Limb Movement Organization and Cognitive Function at School Age in Children Born Preterm
  • 2013
  • Ingår i: Journal of Developmental and Behavioral Pediatrics. - : Lippincott Williams & Wilkins. - 0196-206X .- 1536-7312. ; 34:5, s. 344-352
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To explore relations between aspects of upper-body spatiotemporal movement organization and intelligence in children born preterm at school age.Methods: Three-dimensional (3D) kinematic recordings of arm and head movements during a unimanual precision task were related to performance on the Wechsler Intelligence Scale for Children, 4th edition, in a sample of 32 children born preterm (gestational age, mean: 31.5 weeks [range: 22-35 weeks]; birth weight, mean: 1699 g [range: 404-2962 g]) at 6 years to 8 years with no diagnosed cognitive, sensory, or motor impairments compared with 40 age-matched control children born fullterm.Results: In the children born preterm, upper-limb movement duration and segmentation of movement trajectories were significantly associated with full-scale intelligence quotient independent of gestational age (GA) and sex. These effects pertained to the preferred side, characterized by more effective movement organization being linked with increased intelligence scores. The same relations were not seen in the controls. Within the children born preterm, a significant effect of GA was also found for some aspects of upper-limb movement organization. Full-scale intelligence quotient was within normal limits for both groups but significantly lower in the preterm (mean: 94.5 [range: 72-120]) compared with the fullterm (mean: 101.7 [range: 76-119]) born children.Conclusions: The findings demonstrate that, independent of GA, the spatiotemporal organization of upper-limb movements is partly associated with cognitive performance in children born preterm.
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