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| 2. |
- Myléus, Anna, 1978-, et al.
(författare)
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Celiac disease revealed in 3% of Swedish 12-year-olds born during an epidemic
- 2009
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Ingår i: Journal of Pediatric Gastroenterology and Nutrition - JPGN. - New York : Raven P. - 0277-2116 .- 1536-4801. ; 49:2, s. 170-176
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Tidskriftsartikel (refereegranskat)abstract
- Objetive: Sweden experienced a marked epidemic of celiac disease between 1984 and 1996 in children younger than 2 years of age, partly explained by changes in infant feeding. The objective of this study was to determine the prevalence of celiac disease in 12-year-olds born during the epidemic (1993), including both symptomatic and screening detected cases.Patients and methods: All sixth-grade children in participating schools were invited (n = 10,041). Symptomatic and, therefore, previously diagnosed celiac disease cases were ascertained through the National Swedish Childhood Celiac Disease Register and/or medical records. All serum samples were analyzed for antihuman tissue transglutaminase (tTG)-IgA (Celikey), and serum-IgA, and some for tTG-IgG and endomysial antibodies. A small intestinal biopsy was recommended for all children with suspected undiagnosed celiac disease.Results: Participation was accepted by 7567 families (75%). Previously diagnosed celiac disease was found in 67 children; 8.9/1000 (95% confidence interval [CI] 6.7-11). In another 192 children, a small intestinal biopsy was recommended and was performed in 180. Celiac disease was verified in 145 children, 20/1000 (95% CI 17-23). The total prevalence was 29/1000 (95% CI 25-33).Conclusions: The celiac disease prevalence of 29/1000 (3%)-with two thirds of cases undiagnosed before screening-is 3-fold higher than the usually suggested prevalence of 1%. When these 12-year-olds were infants, the prevailing feeding practice was to introduce gluten abruptly, often without ongoing breast-feeding, which might have contributed to this unexpectedly high prevalence.
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| 3. |
- Skolin, Inger, et al.
(författare)
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Altered food intake and taste perception in children with cancer after start of chemotherapy : perspectives of children, parents and nurses.
- 2006
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 14:4, s. 369-378
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Tidskriftsartikel (refereegranskat)abstract
- GOALS OF WORK: The purpose of this study was to better understand various variables related to food intake and eating problems in children with cancer during their chemotherapy. PATIENTS AND METHODS: Twenty-two consecutively admitted children, diagnosed with cancer and undergoing chemotherapy, participated in this study. Twenty-one of them, their parents and attending nurses participated in semi-structured interviews. Ten of the children underwent a taste acuity test, and recognition thresholds for the four basic tastes were determined. MAIN RESULTS: The shared view of both children and parents was that altered taste was the predominant cause of the eating problems. In contrast, the nurses perceived that nausea was the most important cause of the children's eating problems. In addition, psychological aspects such as learned food aversions and negative attitudes towards hospital food were regarded as important by children, parents and nurses. The taste test showed that the patients had higher thresholds for bitter taste and made more taste recognition errors compared to controls. CONCLUSIONS: Changes seem to exist both in the primary gustatory sense as well as in food perception in paediatric cancer patients undergoing chemotherapy. Single solutions, such as efforts to serve "tasty food", do not suffice alone. A more effective solution may be to combine different strategies and combinations of oral, enteral and parenteral nutrition should be considered to prevent malnutrition.
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| 4. |
- West, Christina E, et al.
(författare)
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Effects of feeding probiotics during weaning on infections and antibody responses to diphtheria, tetanus and Hib vaccines.
- 2008
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 19:1, s. 53-60
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Microbial exposure is necessary for the development of normal immune function, which has driven the idea of using probiotics for treatment and prevention of immune-mediated diseases in infancy and childhood. Mounting evidence indicates that probiotics have immunomodulatory effects. However, the mechanisms are still poorly understood. Specific antibody response is a valuable proxy for immune system maturation status in infancy. We aimed at determining the impact of Lactobacillus F19 (LF19) during weaning on infections and IgG antibody responses to routine vaccines. In a double-blind, placebo-controlled randomized intervention trial, infants were fed cereals with (n = 89) or without LF19 (n = 90) from 4 to 13 months of age. Infants were immunized with DTaP (diphtheria and tetanus toxoid and acellular pertussis), polio and Hib-conjugate vaccines at (3), 5(1/2) and 12 months of age. We assessed the number of days with infections, antibiotic prescriptions and antibody concentrations to Hib capsular polysaccharide (HibPS), diphtheria toxin (D) and tetanus toxoid (T) before and after the second and third doses. Days with infectious symptoms did not differ between the groups. Days with antibiotic prescriptions were fewer in the LF19 group (p = 0.044). LF19 enhanced anti-D concentrations when adjusting for breastfeeding duration and colonization with LF19 (p = 0.024). There was an interaction of the intervention and colonization with LF19 on anti-T concentrations during the course of vaccination (p = 0.035). The anti-HibPS concentrations were higher after the first and second dose of Hib vaccine in infants breastfed <6 months compared with those breastfed > or =6 months (p < 0.05), with no effect by LF19. In conclusion, feeding LF19 did not prevent infections, but increased the capacity to raise immune responses to protein antigens, with more pronounced effects in infants breastfed <6 months.
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| 5. |
- Domellöf, Magnus, et al.
(författare)
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Effects of mode of oral iron administration on serum ferritin and haemoglobin in infants
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:8, s. 1055-1060
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate effects of iron-fortified foods (FFs) and medicinal iron drops (MD) on iron status in infants. Methods: Data from one MD and one FF study were compared. Infants were divided into groups depending on the predominant source and amount of dietary iron during 6–9 months of age: MD: Medicinal iron drops (1 mg/kg/day). FF: iron intake >1.3 mg/kg/day, predominantly from FF and no iron supplements. Low iron (LI) group: iron intake <1.3 mg/kg/day and no iron supplements. Results: Mean iron intake did not differ between MD (n = 30) and FF (n = 35) groups but was lower in the LI (n = 232) group. The FF group had significantly higher mean Hb at 9 months compared to the MD and LI groups (120 vs. 115 g/L and 120 vs. 116 g/L, respectively, p ≤ 0.005). The MD group had significantly higher mean SF at 9 months compared to the FF and the LI groups (46 vs. 23 μg/L and 46 vs. 26 μg/L, respectively, p < 0.001). Conclusions: Our results suggest that, in healthy, term, nonanaemic 6–9-month-old infants, iron given as medicinal iron drops is primarily deposited into iron stores while iron given as iron-fortified foods is primarily utilized for Hb synthesis.
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| 7. |
- Lagerqvist, Carina, et al.
(författare)
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Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age
- 2008
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Ingår i: Journal of Pediatric Gastroenterology and Nutrition - JPGN. - 0277-2116 .- 1536-4801. ; 47:4, s. 428-35
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim was to investigate age-dependent serum levels and occurrence of elevated celiac disease (CD)-related antibodies in young children, to define the optimal serological procedure when selecting for small intestinal biopsy. PATIENTS AND METHODS: Included were 428 children with biopsy verified CD (median age 16 months; range 7.5 months-14 years) and 216 controls (median age 2.7 years; range 8.5 months-14.6 years). Immunoglobulin (Ig) A antibodies against gliadin (AGA-IgA), tissue transglutaminase (tTG-IgA), and endomysium (EMA-IgA) were analysed. RESULTS: Increased serum AGA-IgA levels were found in 411 of 428 CD cases, tTG-IgA in 385 of 428, and EMA-IgA in 383 of 428. In the control group, 11 of 216 had increased levels of AGA-IgA, 5 of 216 of tTG-IgA, and 8 of 216 of EMA-IgA. In CD children younger than 18 months, elevated AGA-IgA occurred in 97% and elevated tTG-IgA and EMA-IgA were found in 83% of the cases. Conversely, in CD children older than 18 months, elevated AGA-IgA occurred in 94%, and elevated tTG-IgA and EMA-IgA were found in 99% of the cases. CONCLUSIONS: In children older than 18 months, both tTG-IgA and EMA-IgA are sufficiently accurate to be used as a single antibody marker, whereas a large proportion of younger children with CD lack these antibodies. Therefore, when selecting children for small intestinal biopsy, the detection of a combination of AGA-IgA and tTG-IgA is optimal for identifying untreated CD in children younger than 18 months.
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| 8. |
- Li, Xiaonan, et al.
(författare)
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Adiponectin and peroxisome proliferator-activated receptor gamma expression in subcutaneous and omental adipose tissue in children
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:5, s. 630-5
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare the expression levels of the adiponectin and peroxisome proliferator -activated receptor gamma (PPARgamma) genes in subcutaneous adipose tissue (SC) and omental adipose tissue (OM) in children with relation to age and anthropometric variables. METHODS: Paired biopsies (SC and OM) were obtained from 53 children (age 0.2-14 years, BMI 12.5-25.8 kg/m(2)). Adiponectin and PPARgamma mRNA levels in adipose tissue were measured by real-time PCR. RESULTS: In overweight, but not in normal weight children, the median adiponectin mRNA level was significantly lower in OM [0.51 (0.1-2.17)] compared to SC [1.29 (0.16-5.08)], (p = 0.03). Adiponectin mRNA levels were strongly associated with PPARgamma mRNA levels in both SC (r = 0.73, p < 0.001) and OM (r = 0.78, p < 0.001). CONCLUSIONS: The lower adiponectin expression in OM relative to SC in overweight children indicates that metabolic-endocrine alterations begin already in childhood. The close association between adiponectin and PPARgamma expression supports the hypothesis this transcription factor is involved in adiponectin gene regulation.
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| 9. |
- Li, X., et al.
(författare)
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Depot-specific messenger RNA expression of 11 beta-hydroxysteroid dehydrogenase type 1 and leptin in adipose tissue of children and adults
- 2007
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Ingår i: International Journal of Obesity. - London : Macmillan. - 0307-0565 .- 1476-5497. ; 31:5, s. 820-828
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare expression of messenger RNA (mRNA) coding for the cortisol regenerating enzyme 11-hydroxysteroid dehydrogenase type 1 (11-HSD1), and the adipocytokines leptin and resistin in paired biopsies of subcutaneous adipose tissue (SC) and omental adipose tissue (OM) from children. Design: Paired biopsies (SC and OM) were obtained from 54 children (age 0.17–16 years, body mass index (BMI) 12.5–28.3 kg/m2, BMI standard deviation score (SDS) -2.5–4.5) and 16 adults (age 27–79 years, BMI 19–46 kg/m2) undergoing open abdominal surgery. mRNA levels of 11-HSD1, leptin and resistin were measured using quantitative real-time polymerase chain reaction (PCR). Results: 11-HSD1 mRNA level was higher in OM than in SC (P<0.05), whereas leptin mRNA was higher in SC than in OM (P<0.001). There was no difference in the resistin mRNA level between SC and OM. These results were consistent in children and adults. In children, 11-HSD1 mRNA in SC was positively associated with BMI SDS (P<0.05), whereas in OM it was positively associated with age (P<0.05). The association between 11-HSD1 expression and age remained significant after adjustment for BMI SDS and gender. Leptin mRNA was positively associated with BMI SDS (SC:P<0.001, OM: P<0.001) but not with age in children. In multiple regression analyses, including anthropometric variables and age, BMI SDS was independently associated with mRNA levels of 11-HSD1 (P<0.05) and leptin (P<0.001) in SC. When normal weight and overweight children were analyzed separately, 11-HSD1 mRNA levels were positively associated with leptin in OM in the overweight group (P<0.05). Conclusion: There are depot-specific differences in mRNA levels of 11-HSD1 and leptin in children and adults. The positive association of 11-HSD1 mRNA in OM with age may reflect a causal role in visceral fat accumulation during growth. Increasing 11-HSD1 and leptin mRNA in SC with increasing BMI SDS could suggest that the risk of metabolic consequences of obesity may be established early in life.
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| 10. |
- Rioux, France M, et al.
(författare)
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Does inadequate maternal iron or DHA status have a negative impact on an infant's functional outcomes?
- 2006
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Ingår i: Acta Paediatr. - 0803-5253. ; 95:2, s. 137-44
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Marginal intake of iron and omega-3 long-chain fatty acids (DHA) is prevalent among pregnant women. It is not clear to what extent poor iron or DHA status during pregnancy impacts on an infant's functional outcomes. A few studies suggest that inadequate maternal iron or DHA status may be associated with suboptimal functional outcomes in infants. In addition, there is a lack of prospective studies using randomized, double-blind design or experimental studies with appropriate animal models. Although both nutrients are involved in early brain development and their metabolism is interrelated, no study has examined the interaction between iron and omega-3 fatty acids during pregnancy. CONCLUSION: Long-term studies on large cohorts of pregnant women and their infants are needed to determine whether inadequate iron or DHA status during pregnancy is detrimental to infant neurodevelopment.
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