| 1. |
- Moraes Holst, Luiza, et al.
(författare)
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Fecal Luminal Factors from Patients with Gastrointestinal Diseases Alter Gene Expression Profiles in Caco-2 Cells and Colonoids
- 2022
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Ingår i: International Journal of Molecular Sciences. - : MDPI AG. - 1422-0067 .- 1661-6596. ; 23:24
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Tidskriftsartikel (refereegranskat)abstract
- Previous in vitro studies have shown that the intestinal luminal content, including metabolites, possibly regulates epithelial layer responses to harmful stimuli and promotes disease. Therefore, we aimed to test the hypothesis that fecal supernatants from patients with colon cancer (CC), ulcerative colitis (UC) and irritable bowel syndrome (IBS) contain distinct metabolite profiles and establish their effects on Caco-2 cells and human-derived colon organoids (colonoids). The metabolite profiles of fecal supernatants were analyzed by liquid chromatography-mass spectrometry and distinguished patients with CC (n = 6), UC (n = 6), IBS (n = 6) and healthy subjects (n = 6). Caco-2 monolayers and human apical-out colonoids underwent stimulation with fecal supernatants from different patient groups and healthy subjects. Their addition did not impair monolayer integrity, as measured by transepithelial electrical resistance; however, fecal supernatants from different patient groups and healthy subjects altered the gene expression of Caco-2 monolayers, as well as colonoid cultures. In conclusion, the stimulation of Caco-2 cells and colonoids with fecal supernatants derived from CC, UC and IBS patients altered gene expression profiles, potentially reflecting the luminal microenvironment of the fecal sample donor. This experimental approach allows for investigating the crosstalk at the gut barrier and the effects of the gut microenvironment in the pathogenesis of intestinal diseases.
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| 2. |
- Cetinic, I., et al.
(författare)
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Ultrasound Shear Wave Elastography, Shear Wave Dispersion and Attenuation Imaging of Pediatric Liver Disease with Histological Correlation
- 2022
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Ingår i: Children. - : MDPI AG. - 2227-9067. ; 9:5
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the feasibility of multiple ultrasound markers for the non-invasive characterization of fibrosis, inflammation and steatosis in the liver in pediatric patients. Materials and methods: The quantitative ultrasound measures shear wave elastography (SWE), shear wave dispersion (SWD) and attenuation imaging (ATI) were compared and correlated with percutaneous liver biopsies and corresponding measures in a control cohort. Results: The median age of the 32 patients was 12.1 years (range 0.1-17.9), and that of the 15 controls was 11.8 years (range: 2.6-16.6). Results: There was a significant difference in SWE values between histologic grades of fibrosis (p = 0.003), with a positive correlation according to the grade (r = 0.7; p < 0.0001). Overall, a difference in SWD values between grades of inflammation was found (p = 0.009) but with a lack of correlation (r = 0.1; p = 0.67). Comparing inflammation grades 0-1 (median:13.6 m/s kHz [min; max; 8.4; 17.5]) versus grades 2-3 (16.3 m/s kHz [14.6; 24.2]) showed significant differences between the groups (p = 0.003). In the 30 individuals with a steatosis score of 0, ATI was measured in 23 cases with a median value of 0.56 dB/cm/MHz. Conclusion: Comprehensive ultrasound analysis was feasible to apply in children and has the potential to reflect the various components of liver affection non-invasively. Larger studies are necessary to conclude to what extent these image-based markers can classify the grade of fibrosis, inflammation and steatosis.
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| 3. |
- Simrén, Yvonne, 1966, et al.
(författare)
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Diffusion tensor imaging based multiparametric characterization of renal lesions in infants with urinary tract infections: an explorative study
- 2021
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Ingår i: Bmc Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Conventional diffusion weighted imaging (DWI) is a promising non-invasive tool in the evaluation of infants with symptomatic urinary tract infections (UTI). The use of multiparametric diffusion tensor imaging (DTI) provides further information on renal pathology by reflecting renal microstructure. However, its potential to characterize and distinguish between renal lesions, such as acute pyelonephritic lesions, permanent renal damages or dysplastic changes has not been shown. This study aimed to evaluate the potential of multiparametric DTI for characterization of renal lesions with purpose to distinguish acute pyelonephritis from other renal lesions in young infants with their first UTI. Methods Nine kidneys in seven infants, age 1.0-5.6 months, with renal lesions i.e. uptake reductions, on acute scintigraphy performed after their first UTI, were included. The DTI examinations were performed during free breathing without sedation. The signal in the lesions and in normal renal tissue was measured in the following images: b0, b700, apparent diffusion coefficient (ADC), and fractional anisotropy (FA). In addition, DTI tractographies were produced for visibility. Results There was a difference between lesions and normal tissue in b700 signal (197 +/- 52 and 164 +/- 53, p = 0.011), ADC (1.22 +/- 0.11 and 1.45 +/- 0.15 mm(2)/s, p = 0.008), and FA (0.18 +/- 0.03 and 0.30 +/- 0.10, p = 0.008) for all nine kidneys. Six kidneys had focal lesions with increased b700 signal, decreased ADC and FA indicating acute inflammation. In three patients, the multiparametric characteristics of the lesions were diverging. Conclusion Multiparametric DTI has the potential to further characterize and distinguish acute pyelonephritis from other renal lesions in infants with symptomatic UTI.
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| 4. |
- Simrén, Yvonne, 1966, et al.
(författare)
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Diffusion weighted imaging is a promising method to detect acute pyelonephritis in non-sedated free breathing infants
- 2020
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Ingår i: Journal of Pediatric Urology. - : Elsevier BV. - 1477-5131. ; 16, s. 320-325
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Urinary tract infection (UTI) is a common disease in infants. The initial evaluation includes imaging to identify risk factors for permanent renal damage, such as malformation and renal parenchymal involvement of the infection i.e. pyelonephritis. 99mTc-Dimercaptosuccinic acid (DMSA) scintigraphy is a well-established method for detection of pyelonephritis and renal damage, but has limitations in availability, spatial resolution, and detection of congenital malformations. Diffusion weighted magnetic resonance imaging (DWI) has been shown to have a high sensitivity for detection of pyelonephritis in children without the use of invasive procedures, contrast agents or ionizing radiation. How this method performs in young infants during non-sedated free breathing remains, however, to be investigated. Objective: To prospectively assess the feasibility and performance of DWI for detection of pyelonephritis in non-sedated free breathing infants. Methods: 32 children <6 months of age with first-time symptomatic UTI were examined with DWI and DMSA scintigraphy. The DWI examination was performed using a free breathing protocol without the use of sedation. Pyelonephritic lesions were registered for both methods by independent observers. Agreement between DWI and DMSA was evaluated. Consensus diagnosis was determined and compared to the DWI findings. Results: The MRI and DMSA examinations were completed in 25 infants, with a median age of 1.7 (0.7–5.5) months. Focal uptake reductions were detected on the DMSA images in 12 (24%) of the 50 kidneys. The DWI method demonstrated a fair to good agreement with DMSA, k = 0.50 (p < 0.0001). The consensus diagnosis was pyelonephritis in eight (16%) of the 50 kidneys. DWI detected seven of the eight kidneys with pyelonephritis. No false positive findings were detected with DWI compared to consensus diagnosis. Discussion: This study has shown an agreement between DWI and DMSA scintigraphy in the detection of pyelonephritis. Further validation of the performance of DWI, using a consensus diagnosis as a reference, confirmed the potential of the method. This feasibility study included a limited number of patients and the results need to be confirmed in a prospective study of a larger cohort. Conclusion: Free breathing DWI is a promising method for detection of pyelonephritic lesions in non-sedated infants.[Formula presented] © 2020 Journal of Pediatric Urology Company
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| 5. |
- Simrén, Yvonne, 1966
(författare)
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New perspectives on imaging of urinary tract infections in infants
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Urinary tract infection (UTI) is a common disease in infants that may lead to renal damage with an increased risk of long term complications. The diagnostic imaging aims to identify risk factors as underlying urinary tract abnormalities and renal involvement of the infection for prevention of long term adverse outcome. There is a need for alternative methods to the ones presently used for investigation and follow-up of this patient group without the use of invasive procedures, contrast agents or ionizing radiation. The aim of this thesis was to evaluate the potential of ultrasound (US), diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) in the initial evaluation of the urinary tract in infants with their first UTI. Methods: Infants with their first symptomatic UTI were included in four prospective studies. The infants were examined with US, magnetic resonance imaging (MRI) including DWI and DTI, and 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy during the acute phase of the infection. Inflammatory parameters, C-reactive protein and body temperature, were registered. Follow-up examinations included US after 1 month and scintigraphy after one year. Results: Renal size measured at early US determined renal swelling in infants with a UTI. The renal swelling correlated with inflammatory parameters and was associated with renal damage at acute and follow-up DMSA scintigraphy. There was an agreement between DWI and DMSA scintigraphy in the detection of pyelonephritis. With the use of DTI, differences were found in quantitative and qualitative parameters in lesions compared to normal tissue and further lesion characterization patterns were recognised. Conclusion: The results show that US, DWI and DTI are valuable non-invasive, nonradiating tools in the initial evaluation of infants with their first UTI. Renal length US measurements adds value to the early US examination by helping to identify patients at risk for renal damage even though it cannot replace DMSA scintigraphy. DWI and DTI have the potential to be advantageous alternatives to DMSA scintigraphy. However, studies of larger cohorts are needed to verify the results.
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| 6. |
- Simrén, Yvonne, 1966, et al.
(författare)
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Renal swelling indicates renal damage in infants with their first urinary tract infection
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253. ; 107:11, s. 2004-2010
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Tidskriftsartikel (refereegranskat)abstract
- Aim: We used ultrasound to evaluate renal swelling as a predictor of acute and permanent renal damage in infants with their first urinary tract infection (UTI). Methods: The cohort at the Queen Silvia Children's Hospital, Gothenburg, Sweden, comprised 101 infants with their first UTI at a mean age of 3.9 +/- 3.0 months. Acute and follow-up ultrasounds were carried out a few days and one month after treatment started, and a (99m)technetium dimercaptosuccinic acid (DMSA) scan was carried out after one month and after a year if the first scan was abnormal. Results: The acute ultrasounds showed that renal length and volume, calculated as standard deviation scores (SDS), were 1.39 +/- 1.43 SDS and 1.30 +/- 1.08 SDS. We found that 52% of the one-month DMSA scans and 25% of the one-year DMSA scans were abnormal. Renal length (p = 0.0026) and initial volume (p = 0.0005) on the ultrasound predicted acute renal damage at the one-month DMSA scan and initial renal length (p = 0.030) predicted permanent renal damage at the one-year DMSA scan. Conclusion: Renal swelling was associated with renal damage. Although the diagnostic performance compared with the DMSA scan was weak, renal swelling may help clinicians to make decisions about further investigations and follow-ups of infants with UTIs.
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| 7. |
- Simrén, Yvonne, 1966, et al.
(författare)
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Ultrasound is an effective and noninvasive method of evaluating renal swelling in infants with their first urinary tract infection
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253. ; 106:11, s. 1868-1874
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study evaluated renal swelling in infants with a first urinary tract infection (UTI) by correlating renal length and volume with C-reactive protein (CRP) and body temperature. Methods: Ultrasounds were carried out on 104 infants at The Queen Silvia Children's Hospital, Gothenburg, Sweden - 58 boys (mean age 3.3 months) and 46 girls (mean age 4.8 months) - during the acute phase of their UTI. A second scan was performed on 94 of them 4 weeks later. Renal length and volume were computed to standard deviation scores (SDS). Results: The mean renal length and volume at the first ultrasound were 1.90 SDS (1.54) and 1.67 SDS (+/- 1.13) for the larger kidney and 0.86 SDS (+/- 1.01) and 0.84 SDS (+/- 0.90) for the smaller kidney. There was a significant decrease in renal length and volume between the two ultrasounds, with a mean difference of 0.96 SDS (+/- 1.24) and 1.07 SDS (+/- 1.10) for the larger kidney (p < 0.0001). The length and volume of the larger kidney correlated with CRP (p < 0.001), but only the renal length correlated with fever (p < 0.001). Conclusion: Early ultrasound determined renal swelling in infants with a UTI and may be a valuable noninvasive way of identifying infants with renal parenchymal involvement.
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