| 1. |
- Ahlin, Kristina, et al.
(författare)
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Antecedents and neuroimaging patterns in cerebral palsy with epilepsy and cognitive impairment: a population-based study in children born at term
- 2017
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 96:7, s. 828-836
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Antecedents of accompanying impairments in cerebral palsy and their relation to neuroimaging patterns need to be explored. Material and methods. A population-based study of 309 children with cerebral palsy born at term between 1983 and 1994. Prepartum, intrapartum, and postpartum variables previously studied as antecedents of cerebral palsy type and motor severity were analyzed in children with cerebral palsy and cognitive impairment and/or epilepsy, and in children with cerebral palsy without these accompanying impairments. Neuroimaging patterns and their relation to identified antecedents were analyzed. Data were retrieved from the cerebral palsy register of western Sweden, and from obstetric and neonatal records. Results. Children with cerebral palsy and accompanying impairments more often had low birthweight (kg) (odds ratio 0.5, 95% confidence interval 0.3-0.8), brain maldevelopment known at birth (p = 0.007, odds ratio infinity) and neonatal infection (odds ratio 5.4, 95% confidence interval 1.04-28.4). Moreover, neuroimaging patterns of maldevelopment (odds ratio 7.2, 95% confidence interval 2.9-17.2), cortical/subcortical lesions (odds ratio 5.3, 95% confidence interval 2.3-12.2) and basal ganglia lesions (odds ratio 7.6, 95% confidence interval 1.4-41.3) were more common, wheras white matter injury was found significantly less often (odds ratio 0.2, 95% confidence interval 0.1-0.5). In most children with maldevelopment, the intrapartum and postpartum periods were uneventful (p
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| 2. |
- Ahlin, Kristina, et al.
(författare)
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Antecedents of cerebral palsy according to severity of motor impairment.
- 2016
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 95:7, s. 793-802
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to determine whether antecedents and neuroimaging patterns vary according to the severity of motor impairment in children with cerebral palsy. Material and methods. A population-based study in which all 309 term-born children with spastic and dyskinetic cerebral palsy born between 1983 and 1994 and 618 matched controls were studied. Antecedents were retrieved from obstetric records. Information on neuroimaging was retrieved from the cerebral palsy Register of Western Sweden. Cases were grouped by severity of motor impairment: mild (walks without aids), moderate (walks with aids) or severe (dependent on wheelchair). Binary logistic regression, the Cochran-Armitage test for trends, interaction analyses and interrelationship analyses were performed. Results. Antecedents associated with mild motor impairment were antepartum (placental weight, maternal weight and antibiotic therapy) or intrapartum and postpartum adverse events (meconium-stained amniotic fluid, low Apgar score, admission to neonatal intensive care unit and neonatal encephalopathy). Antecedents associated with severe motor impairment were antepartum (congenital infection, small head circumference and brain maldevelopment) or intrapartum and postpartum (emergency cesarean section and maternal antibiotic therapy). Comparisons between mild and severe motor impairment revealed congenital infection, maldevelopment, neonatal encephalopathy and meconium aspiration syndrome significantly more often in the group with severe motor impairment (p
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| 3. |
- Ahlin, Kristina
(författare)
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Antecedents of Cerebral Palsy in children born at term - according to subtype, motor severity and accompanying impairments
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: To explore antecedents of cerebral palsy (CP) according to subtype, severity of motor impairment and accompanying impairments (epilepsy and/or cognitive impairments) in relation to neuroimaging patterns. Material and methods: Case control studies were performed in a population-based serie of children with CP born at term (n=309), matched with a control group (n=618). The cases and the matched controls were divided into CP subtype; spastic hemiplegia, spastic diplegia or tetraplegia and dyskinetic CP and into severity of motor impairment; mild, moderate or severe. Obstetric records and the CP register of western Sweden were reviewed and 88 antecedents to CP were analyzed for their associations to different subtypes, severity of motor impairment, associated impairments in CP as well as to neuroimaging pattern. Binary logistic regression, the Cochran-Armitage Chi-squared test for trends, interaction analyses and interrelationship analyses were used. Both univariable and adjusted analyzes were performed. Results: Paper I: The antecedent pattern differed by CP subtype. All subtypes shared a mix of prepartal, intrapartal and postpartal antecedents, except for dyskinetic CP, for which intra- and postpartal events played a major role. Paper II: Maternal infections were associated only with the subgroup spastic hemiplegia whereas neonatal infection was associated with the subgroups of spastic diplegia or tetraplegia. Paper III: The antecedent pattern differed by severity of motor impairment in CP. Timing of antecedents corresponded to identified neuroimaging patterns. Paper IV: The accompanying impairments epilepsy and cognitive impairment in CP were associated with poor intrauterine growth, maldevelopment, and neonatal infections. Accompanying impairments in CP are more often associated with abnormal neuroimaging than motor impairment alone. Conclusions: The antecedent pattern differed by CP subtype, severity of motor impairment and by presence of accompanying impairments in CP. Our results might illustrate some of the causal pathways to CP, namely hypoxia, malformations and infection.
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| 4. |
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| 5. |
- Ahlin, Kristina, et al.
(författare)
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Non-infectious risk factors for different types of cerebral palsy in term-born babies: a population-based, case-control study.
- 2013
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Ingår i: BJOG : an international journal of obstetrics and gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 120:6, s. 724-731
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify non-infectious antenatal and perinatal risk factors for cerebral palsy (CP) and its subtypes in children born at term. DESIGN: A population-based, case-control study. SETTING: The western healthcare region of Sweden. POPULATION: A population-based series of children with CP born at term during 1983-94 (n=309) was matched with a control group (n=618). METHODS: A total of 62 variables, maternal characteristics, and prepartal, intrapartal and postpartal variables were retrieved from obstetric records. Both univariate and multivariate analyses were performed for spastic and dyskinetic CP, and for the total CP group. MAIN OUTCOME MEASURES: Cerebral palsy (CP) and subtypes. RESULTS: Univariate analysis resulted in 26 significant risk factors for CP. Birthweight (OR0.54, 95%CI0.39-0.74), not living with the baby's father (OR2.58, 95%CI 1.11-5.97), admittance to a neonatal intensive care unit (NICU) (OR 4.43, 95% CI 3.03-6.47), maternal weight at 34weeks of gestation (OR1.02, 95%CI 1.00-1.03) and neonatal encephalopathy (OR69.2, 95%CI 9.36-511.89) were found to be risk factors for CP in the totalCP group in our multivariate analysis. Factors during the periods before, during and after delivery were all shown to increase the risk of spastic diplegia and tetraplegia, whereas mostly factors during the period before delivery increased the risk of spastic hemiplegia, and only factors during delivery increased the risk of dyskinetic CP. Admittance to an NICU was a risk factor for all CP subtypes. CONCLUSIONS: The risk factor pattern differed by CP subtype. The presented risk factors may be useful indicators for identifying children at risk of developing CP, and helpful for targeting individuals for early intervention programmes.
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| 6. |
- Ahlin, Sofie, 1985, et al.
(författare)
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Adipose Tissue-Derived Human Serum Amyloid A Does Not Affect Atherosclerotic Lesion Area in hSAA(+/) (-/)ApoE(-/-) Mice
- 2014
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 9:4
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Tidskriftsartikel (refereegranskat)abstract
- Chronically elevated serum levels of serum amyloid A (SAA) are linked to increased risk of cardiovascular disease. However, whether SAA is directly involved in atherosclerosis development is still not known. The aim of this study was to investigate the effects of adipose tissue-derived human SAA on atherosclerosis in mice. hSAA1(+/-) transgenic mice (hSAA1 mice) with a specific expression of human SAA1 in adipose tissue were bred with ApoE-deficient mice. The hSAA1 mice and their wild type (wt) littermates were fed normal chow for 35 weeks. At the end of the experiment, the mice were euthanized and blood, gonadal adipose tissue and aortas were collected. Plasma levels of SAA, cholesterol and triglycerides were measured. Atherosclerotic lesion areas were analyzed in the aortic arch, the thoracic aorta and the abdominal aorta in en face preparations of aorta stained with Sudan IV. The human SAA protein was present in plasma from hSAA1 mice but undetectable in wt mice. Similar plasma levels of cholesterol and triglycerides were observed in hSAA1 mice and their wt controls. There were no differences in atherosclerotic lesion areas in any sections of the aorta in hSAA1 mice compared to wt mice. In conclusion, our data suggest that adipose tissue-derived human SAA does not influence atherosclerosis development in mice.
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| 7. |
- Himmelmann, Kate, 1959, et al.
(författare)
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Risk factors for cerebral palsy in children born at term.
- 2011
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349.
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To provide an overview of current research on risk factors for cerebral palsy (CP) in children born at term and hypothesize how new findings can affect the content of the CP registers worldwide. Data Source. A systematic search in PubMed for original articles, published from 2000 to 2010 regarding risk factors for CP in children born at term was conducted. Methods of study selection. Factors from the prenatal, perinatal and neonatal period considered as possible contributors to the causal pathway to CP in children born at term were regarded as risk factors. Full text review was made of 266 articles. Results. Sixty-two articles met the criteria for an original report on risk factors for CP in children born at term. Perinatal adverse events including stroke were the focus of most publications, followed by genetic studies. Malformations, infections, perinatal adverse events and multiple gestation were risk factors associated with CP. The evidence regarding for example thrombophilic factors and non-CNS abnormalities was inconsistent. Conclusion. Information on maternal and neonatal infections, umbilical cord blood gases at birth, mode of delivery and placental status should be collected in a standardized way in CP registers. Information on social factors such as education level, family income and area of residence is also of importance. More research is needed to understand the risk factors of CP and specifically of how they relate to causal pathways of cerebral palsy.
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| 8. |
- Klintman, Marie, et al.
(författare)
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The Prognostic Value of Mitotic Activity Index (MAI), Phosphohistone H3 (PPH3), Cyclin B1, Cyclin A, and Ki67, Alone and in Combinations, in Node-Negative Premenopausal Breast Cancer
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:12
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Tidskriftsartikel (refereegranskat)abstract
- Proliferation, either as the main common denominator in genetic profiles, or in the form of single factors such as Ki67, is recommended for clinical use especially in estrogen receptor-positive (ER) patients. However, due to high costs of genetic profiles and lack of reproducibility for Ki67, studies on other proliferation factors are warranted. The aim of the present study was to evaluate the prognostic value of the proliferation factors mitotic activity index (MAI), phosphohistone H3 (PPH3), cyclin B1, cyclin A and Ki67, alone and in combinations. In 222 consecutive premenopausal node-negative breast cancer patients (87% without adjuvant medical treatment), MAI was assessed on whole tissue sections (predefined cut-off >= 10 mitoses), and PPH3, cyclin B1, cyclin A, and Ki67 on tissue microarray (predefined cut-offs 7th decile). In univariable analysis (high versus low) the strongest prognostic proliferation factor for 10-year distant disease-free survival was MAI (Hazard Ratio (HR)=3.3, 95% Confidence Interval (CI): 1.8-6.1), followed by PPH3, cyclin A, Ki67, and cyclin B1. A combination variable, with patients with MAI and/or cyclin A high defined as high-risk, had even stronger prognostic value (HR=4.2, 95% CI: 2.2-7). When stratifying for ER-status, MAI was a significant prognostic factor in ER-positive patients only (HR=7.0, 95% CI: 3.1-16). Stratified for histological grade, MAI added prognostic value in grade 2 (HR=7.2, 95% CI: 3.1-38) and grade 1 patients. In multivariable analysis including HER2, age, adjuvant medical treatment, ER, and one proliferation factor at a time, only MAI (HR=2.7, 95% CI: 1.1-6.7), and cyclin A (HR=2.7, 95% CI: 1.2-6.0) remained independently prognostic. In conclusion this study confirms the strong prognostic value of all proliferation factors, especially MAI and cyclin A, in all patients, and more specifically in ER-positive patients, and patients with histological grade 2 and 1. Additionally, by combining two proliferation factors, an even stronger prognostic value may be found.
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| 9. |
- Sjöström, Lars, et al.
(författare)
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Bariatric surgery and long-term cardiovascular events.
- 2012
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Ingår i: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598. ; 307:1, s. 56-65
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Tidskriftsartikel (refereegranskat)abstract
- Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking.
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