| 1. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Dose-dependent effect of growth hormone on final height in children with short stature without growth hormone deficiency
- 2008
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 93:11, s. 4342-4350
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: The effect of GH therapy in short non-GH-deficient children, especially those with idiopathic short stature (ISS), has not been clearly established owing to the lack of controlled trials continuing until final height (FH).OBJECTIVE: The aim of the study was to investigate the effect on growth to FH of two GH doses given to short children, mainly with ISS, compared with untreated controls.DESIGN AND SETTING: A randomized, controlled, long-term multicenter trial was conducted in Sweden.INTERVENTION: Two doses of GH (Genotropin) were administered, 33 or 67 microg/kg.d; control subjects were untreated.SUBJECTS: A total of 177 subjects with short stature were enrolled. Of these, 151 were included in the intent to treat (AllITT) population, and 108 in the per protocol (AllPP) population. Analysis of ISS subjects included 126 children in the ITT (ISSITT) population and 68 subjects in the PP (ISSPP) population.MAIN OUTCOME MEASURES: We measured FH sd score (SDS), difference in SDS to midparenteral height (diff MPHSDS), and gain in heightSDS.RESULTS: After 5.9+/-1.1 yr on GH therapy, the FHSDS in the AllPP population treated with GH vs. controls was -1.5+/-0.81 (33 microg/kg.d, -1.7+/-0.70; and 67 microg/kg.d, -1.4+/-0.86; P<0.032), vs. -2.4+/-0.85 (P<0.001); the diff MPHSDS was -0.2+/-1.0 vs. -1.0+/-0.74 (P<0.001); and the gain in heightSDS was 1.3+/-0.78 vs. 0.2+/-0.69 (P<0.001). GH therapy was safe and had no impact on time to onset of puberty. A dose-response relationship identified after 1 yr remained to FH for all growth outcome variables in all four populations.CONCLUSION: GH treatment significantly increased FH in ISS children in a dose-dependent manner, with a mean gain of 1.3 SDS (8 cm) and a broad range of response from no gain to 3 SDS compared to a mean gain of 0.2 SDS in the untreated controls.
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| 2. |
- van Vught, Anneke J. A. H., et al.
(författare)
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Association between dietary protein and change in body composition among children (EYHS)
- 2009
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Ingår i: Clinical Nutrition. - : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 28:6, s. 684-688
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Growth hormone (GH) affects body composition by a relatively reduced fat mass and increased fat free mass. The intake of protein as well as the specific amino acids arginine and lysine potently stimulate GH secretion. This study investigated associations between intakes of protein, arginine, lysine and subsequent 6-year change in body composition among 8-10-year-old children.METHODS: Data of 364 children were collected from Odense, Denmark, during 1997-1998 and 6-year later as part of the European Youth Heart Study. Body mass index among children was subdivided by fat free mass index (FFMI) and fat mass index (FMI), based on skinfold measurements. Dietary intake was estimated via 24h recall. Associations between intakes of protein as well as arginine, lysine and change in FFMI and FMI were analysed by multiple linear regressions, adjusted for social economic status, puberty stage and physical activity level.RESULTS: Among lean girls inverse associations were found between protein as well as arginine and lysine intake and change in fat mass index (beta=-1.12+/-0.56, p=0.03, beta=-1.10+/-0.53, p=0.04, beta=-1.13+/-0.51, p=0.03 respectively). Furthermore among girls with a body mass index in the 5th quintile, protein intake was associated with DeltaFFMI (p=0.04), and more specific when LYS intake was high, ARG intake was associated with DeltaFFMI (p=0.04).CONCLUSION: Among girls high protein intakes may decrease body fat gain and increase fat free mass gain, depending on the available amounts and combinations of arginine and lysine.
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| 3. |
- Berg, Marie, 1955, et al.
(författare)
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Evidence-based care and childbearing - A critical approach
- 2008
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; :3, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- Developing the best care for clients and patients is a paramount aim of all health care practices, which therefore, should be based on best evidence. This is also crucial for care during the childbearing period here defined as pregnancy, childbirth, and infancy. However, due to dominance of the evidence-based medicine (EBM) model, health care practice has encountered problems especially regarding its relationship to qualitative research. In this article, we analyze and discuss how research based on a lifeworld perspective fits with evidence-based care (EBC), and how a circular model instead of a hierarchy is suitable when attributing value to knowledge for EBC. The article focuses on the history of EBM and EBC, the power of the evidence concept, and EBC from a narrow to a broad view. Further qualitative research and its use for developing EBC is discussed and examples are presented from the authors’ own lifeworld research in the Nordic childbearing context. Finally, an alternative circular model of knowledge for EBC is presented. In order to develop evidence-based care, there is need for multiple types of scientific knowledge with equal strength of evidence, integrated with clinical experience, setting, circumstances and health care resources, and incorporating the experiences and clinical state of the childbearing woman and her family.
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| 4. |
- Dahlgren, Jovanna, 1964, et al.
(författare)
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Models predicting the growth response to growth hormone treatment in short children independent of GH status, birth size and gestational age
- 2007
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Ingår i: BMC Med Inform Decis Mak. - : Springer Science and Business Media LLC. - 1472-6947. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mathematical models can be used to predict individual growth responses to growth hormone (GH) therapy. The aim of this study was to construct and validate high-precision models to predict the growth response to GH treatment of short children, independent of their GH status, birth size and gestational age. As the GH doses are included, these models can be used to individualize treatment. METHODS: Growth data from 415 short prepubertal children were used to construct models for predicting the growth response during the first years of GH therapy. The performance of the models was validated with data from a separate cohort of 112 children using the same inclusion criteria. RESULTS: Using only auxological data, the model had a standard error of the residuals (SDres), of 0.23 SDS. The model was improved when endocrine data (GHmax profile, IGF-I and leptin) collected before starting GH treatment were included. Inclusion of these data resulted in a decrease of the SDres to 0.15 SDS (corresponding to 1.1 cm in a 3-year-old child and 1.6 cm in a 7-year old). Validation of these models with a separate cohort, showed similar SDres for both types of models. Preterm children were not included in the Model group, but predictions for this group were within the expected range. CONCLUSION: These prediction models can with high accuracy be used to identify short children who will benefit from GH treatment. They are clinically useful as they are constructed using data from short children with a broad range of GH secretory status, birth size and gestational age.
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| 5. |
- Jakobsen, Marianne U, et al.
(författare)
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Major types of dietary fat and risk of coronary heart disease : a pooled analysis of 11 cohort studies.
- 2009
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 89:5, s. 1425-1432
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance. OBJECTIVE: We investigated associations between energy intake from monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and carbohydrates and risk of CHD while assessing the potential effect-modifying role of sex and age. Using substitution models, our aim was to clarify whether energy from unsaturated fatty acids or carbohydrates should replace energy from SFAs to prevent CHD. DESIGN: This was a follow-up study in which data from 11 American and European cohort studies were pooled. The outcome measure was incident CHD. RESULTS: During 4-10 y of follow-up, 5249 coronary events and 2155 coronary deaths occurred among 344,696 persons. For a 5% lower energy intake from SFAs and a concomitant higher energy intake from PUFAs, there was a significant inverse association between PUFAs and risk of coronary events (hazard ratio: 0.87; 95% CI: 0.77, 0.97); the hazard ratio for coronary deaths was 0.74 (95% CI: 0.61, 0.89). For a 5% lower energy intake from SFAs and a concomitant higher energy intake from carbohydrates, there was a modest significant direct association between carbohydrates and coronary events (hazard ratio: 1.07; 95% CI: 1.01, 1.14); the hazard ratio for coronary deaths was 0.96 (95% CI: 0.82, 1.13). MUFA intake was not associated with CHD. No effect modification by sex or age was found. CONCLUSION: The associations suggest that replacing SFAs with PUFAs rather than MUFAs or carbohydrates prevents CHD over a wide range of intakes.
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| 6. |
- Jemec, Gregor B. E., et al.
(författare)
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A new scalp formulation of calcipotriene plus betamethasone compared with its active ingredients and the vehicle in the treatment of scalp psoriasis : a randomized, double-blind, controlled trial
- 2008
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Ingår i: The Journal of American Academy of Dermatology. - : Elsevier BV. - 0190-9622 .- 1097-6787. ; 59:3, s. 455-463
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: New topical treatments in scalp psoriasis are needed because many current topical treatments are disliked by patients and associated with poor compliance. OBJECTIVE: To compare the efficacy and safety of once-daily, two-compound scalp formulation containing calcipotriene plus betamethasone dipropionate with the individual components in the same vehicle and the vehicle alone. METHODS: In this 8-week, multicenter, randomized, double-blind study, patients with scalp psoriasis were randomized to treatment with the two-compound scalp formulation (calcipotriene 50 microg/g plus betamethasone 0.5 mg/g, as dipropionate) (n = 541), betamethasone 0.5 mg/g (as dipropionate) in the same vehicle (n = 556), calcipotriene 50 microg/g in the same vehicle (n = 272), or vehicle alone (n = 136). RESULTS: More patients achieved "absent" or "very mild" disease at week 8 with the two-compound scalp formulation (71.2%) compared with betamethasone dipropionate in the same vehicle (64.0%, p = .011), calcipotriene in the same vehicle (36.8%, p < .0001), or the vehicle (22.8%, p < .0001). LIMITATIONS: Efficacy of the active comparators in the study has not been established in relation to calcipotriene and betamethasone formulations available for clinical use. CONCLUSION: Calcipotriene plus betamethasone dipropionate scalp formulation was more effective than either of the individual components or the vehicle alone.
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| 7. |
- Kriström, Berit, et al.
(författare)
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Growth hormone (GH) dosing during catch-up growth guided by individual responsiveness decreases growth response variability in prepubertal children with GH deficiency or idiopathic short stature
- 2009
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 94:2, s. 483-490
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Weight-based GH dosing results in a wide variation in growth response in children with GH deficiency (GHD) or idiopathic short stature (ISS). OBJECTIVE: The hypothesis tested was whether individualized GH doses, based on variation in GH responsiveness estimated by a prediction model, reduced variability in growth response around a set height target compared with a standardized weight-based dose. SETTING: A total of 153 short prepubertal children diagnosed with isolated GHD or ISS (n = 43) and at least 1 SD score (SDS) below midparental height SDS (MPH(SDS)) were included in this 2-yr multicenter study. INTERVENTION: The children were randomized to either a standard (43 microg/kg.d) or individualized (17-100 microg/kg.d) GH dose. MAIN OUTCOME MEASURE: We measured the deviation of height(SDS) from individual MPH(SDS) (diffMPH(SDS)). The primary endpoint was the difference in the range of diffMPH(SDS) between the two groups. RESULTS: The diffMPH(SDS) range was reduced by 32% in the individualized-dose group relative to the standard-dose group (P < 0.003), whereas the mean diffMPH(SDS) was equal: -0.42 +/- 0.46 and -0.48 +/- 0.67, respectively. Gain in height(SDS) 0-2 yr was equal for the GH-deficient and ISS groups: 1.31 +/- 0.47 and 1.36 +/- 0.47, respectively, when ISS was classified on the basis of maximum GH peak on the arginine-insulin tolerance test or 24-h profile. CONCLUSION: Individualized GH doses during catch-up growth significantly reduce the proportion of unexpectedly good and poor responders around a predefined individual growth target and result in equal growth responses in children with GHD and ISS.
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| 8. |
- Merritt, Eleanor A., et al.
(författare)
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Diaryliodonium salts: A journey from obscurity to fame
- 2009
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Ingår i: Angewandte Chemie International Edition. - : Wiley. - 1433-7851 .- 1521-3773. ; 48:48, s. 9052-9070
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Forskningsöversikt (refereegranskat)abstract
- The recent groundbreaking developments in the application of diaryliodonium salts in cross-coupling reactions has brought this class of previously underdeveloped reagents to the forefront of organic chemistry. With the advent of novel, facile, and efficient synthetic routes to these compounds, many more applications can be foreseen. Herein we provide an overview of the historical and recent advances in the synthesis and applications of diaryliodonium salts.
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| 9. |
- Merritt, Eleanor A., et al.
(författare)
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Diaryliodoniumsalze - aus dem Nichts ins Rampenlicht
- 2009
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Ingår i: Angewandte Chemie. - : Wiley. - 1521-3757 .- 0044-8249. ; 121:48, s. 9214-9234
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Forskningsöversikt (refereegranskat)abstract
- Die jüngsten bahnbrechenden Entwicklungen bei der Anwendung von Diaryliodoniumsalzen in Kreuzkupplungsreaktionen haben diese ehemals unterentwickelte Klasse von Reagentien in die vorderste Reihe der organischen Chemie katapultiert. Mit dem Aufkommen neuartiger, einfacher, effizienter Methoden zur Synthese dieser Reagentien lassen sich noch sehr viel mehr Einsatzmöglichkeiten voraussehen. Wir bieten hier einen Überblick über die historischen und neuerlichen Fortschritte bei der Synthese und Anwendung von Diaryliodoniumsalzen.
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| 10. |
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