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- Johansson, Inger, 1953, et al.
(författare)
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Lower incidence of CMV infection and acute rejections with valganciclovir
- 2013
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Ingår i: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background Cytomegalovirus (CMV) is the most common opportunistic infection following lung transplantation. CMV replication in the lung allograft is described as accelerating the development of bronchiolitis obliterans syndrome (BOS).Finding a strategy to prevent CMV infection is an important issue. Methods We performed a retrospective, single-centre study of 114 lung transplant recipients (LTRs) who underwent lung transplantation from January 2001 to December 2006. In a smaller cohort of 88 CMV seropositive (R+) LTRs, three months of valganciclovir prophylaxis (2004-2006) was compared to three months of oral ganciclovir (2001-2003) with respect to the incidence of CMV infection/disease, the severity of CMV disease, acute rejection, BOS-free 4 year survival and 4 year survival. In the whole group of 114 LTRs the impact of CMV infection on long-term survival (BOS free 4 year survival and 6 year survival) was assessed. Results For the cohort of 88 CMV seropositive LTRs, the incidence of CMV infection/disease at one year was lower in the valganciclovir group compared to the ganciclovir group (24% vs. 54%, p = 0.003). There was a tendency towards reduced CMV disease, from 33% to 20% and a significant lower incidence of asymptomatic CMV infection (22% vs. 4%, p = 0.005). A lower incidence of acute rejection was observed in the valganciclovir group. However, there was no significant difference between the two groups in BOS free 4 year survival and 4 year survival. For the entire group of 114 LTRs, BOS-free 4 year survival for recipients with CMV disease was (32%, p = 0.005) and among those with asymptomatic CMV infection (36%, p = 0.061) as compared with patients without CMV infection (69%). Six year survival was lower among patients with CMV disease, (64%, p = 0.042) and asymptomatic CMV infection (55%, p = 0.018) than patients without CMV infection (84%). Conclusions A lower incidence of CMV infection/disease and acute rejections was observed with valganciclovir (3 months) when compared to oral ganciclovir (3 months). The long-term impact of CMV infection/disease was significant for BOS-free survival and survival.
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- Johnson, Mats, 1956, et al.
(författare)
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Attention-deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children - an open study of collaborative problem solving.
- 2012
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253. ; 101:6, s. 624-630
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate Collaborative Problem Solving (CPS) in Swedish 6-13-year-old children with attention-deficit/hyperactivity disorder and oppositional defiant disorder. Methods: Seventeen families completed 6-10 sessions of CPS training. Primary outcome measures were SNAP-IV (ADHD and ODD scores) and Clinical Global Impression - Improvement (CGI-I) scores at baseline, post-intervention and 6 months later. Secondary outcome measures were the Conners'-10-item scale and the Family Burden of Illness Module (FBIM). Results: All 17 participants completed the intervention. The whole group had significant reductions in SNAP-IV ODD, ADHD, total Conners' and FBIM scores, both post-intervention and at 6-month-follow-up. Eight of the children, although significantly improved on ODD scores and the Conners' emotional lability subscale at post-intervention, had almost no improvement in hyperactivity/impulsivity. Post-intervention, this group received stimulant medication for their ADHD. At post-intervention CGI-I scores of much improved or very much improved were reached by 53% (9/17) of all at post-intervention, and by 81% (13/16) at 6-month follow-up. Conclusion: CPS significantly reduced ODD, ADHD and emotional lability symptoms. A subgroup improved in their ADHD symptoms only after adding stimulant medication.
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- Jonsson, Karin, et al.
(författare)
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Urine bladder catheters in nursing home patients: a one-day point prevalence study in a Swedish county.
- 2010
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Ingår i: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599. ; 44:5, s. 320-3
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to register the use of long-term indwelling catheters in nursing homes in a defined geographical region, and present the indications for and duration of catheterization, catheter material and size, the time between the regular catheter changes and the number of patients with regular catheter rinses.
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- Larsson, Per-Göran, et al.
(författare)
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Extended antimicrobial treatment of bacterial vaginosis combined with human lactobacilli to find the best treatment and minimize the risk of relapses
- 2011
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Ingår i: BMC Infectious Diseases. - : BioMed Central. - 1471-2334. ; 11:223
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Tidskriftsartikel (refereegranskat)abstract
- Background: The primary objective of this study was to investigate if extended antibiotic treatment against bacterial vaginosis (BV) together with adjuvant lactobacilli treatment could cure BV and, furthermore, to investigate factors that could cause relapse. less thanbrgreater than less thanbrgreater thanMethods: In all, 63 consecutive women with bacterial vaginosis diagnosed by Amsel criteria were offered a much more aggressive treatment of BV than used in normal clinical practice with repeated antibiotic treatment with clindamycin and metronidazole together with vaginal gelatine capsules containing different strains of lactobacilli both newly characterised and a commercial one (10(9) freeze-dried bacteria per capsule). Oral clindamycin treatment was also given to the patients sexual partner. less thanbrgreater than less thanbrgreater thanResults: The cure rate was 74.6% after 6 months. The patients were then followed as long as possible or until a relapse. The cure rate was 65.1% at 12 months and 55.6% after 24 months. There was no significant difference in cure rate depending on which Lactobacillus strains were given to the women or if the women were colonised by lactobacilli. The most striking factor was a new sex partner during the follow up period where the Odds Ratio of having a relapse was 9.3 (2.8-31.2) if the patients had a new sex partner during the observation period. less thanbrgreater than less thanbrgreater thanConclusions: The study shows that aggressive treatment of the patient with antibiotics combined with specific Lactobacillus strain administration and partner treatment can provide long lasting cure. A striking result of our study is that change of partner is strongly associated with relapse of BV.
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- Lindblad, Ida, et al.
(författare)
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Mild intellectual disability and ADHD; a comparative study of school age children's adaptive abilities
- 2013
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 102:10, s. 1027-1031
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To compare adaptive functioning in children with mild intellectual disability (MID) with that of children with attention-deficit/hyperactivity disorder (ADHD). Methods: Thirty-three children with MID were contrasted with 27 children with ADHD with regard to adaptive functioning as measured by the Adaptive Behaviour Assessment System (ABAS-II). The group with MID was population-based, and the group with ADHD was considered representative of a clinically referred group with that diagnosis. The two groups were subdivided into those <= 11 years and those >= 12 years. Results: The group with ADHD had lower adaptive functioning, but differences were not significant at total group levels. In children 12 years or older, the group with ADHD had significantly lower adaptive functioning. Conclusion: Older children with ADHD had poorer adaptive functioning than those with MID, a finding which should be of interest to school and other authorities mapping out education and intervention plans for children with special needs.
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- Nylander, Charlotte, 1979-, et al.
(författare)
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Children and adolescents with type 1 diabetes and high HbA1c - a neurodevelopmental perspective.
- 2013
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 102:4, s. 410-415
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To examine the association between neurodevelopmental problems and high HbA1c among paediatric patients with type 1 diabetes. METHODS: A population-based study was performed among patients with type 1 diabetes (5-16 years) in two Swedish counties (n=233). The Five to Fifteen (FTF) questionnaire targeted neurodevelopmental qualities. Scores above the 90(th) percentile in the various domains are considered as definitive problems and scores above the 75(th) percentile as mild. FTF-scores were compared with regard to HbA1c ≤73 mmol/mol and >73 mmol/mol (8.0%). RESULTS: The response rate was 190 (82%). Neurodevelopmental problems were not over-represented among patients in general. Memory and learning problems were associated with HbA1c >73 mmol/mol (p = 0.01). This correlation was especially seen in adolescents (12-16 years) where mild executive problems (adjOR 3.1), definite memory problems (adjOR 5.0) and definite learning problems (adjOR 5.0) were associated with HbA1c >73 mmol/mol after adjustment for gender, diabetes duration and age of onset. CONCLUSION: Our findings that high HbA1c are more common in adolescent diabetes patients with neurodevelopmental problems generate the hypothesis that these problems might precede poor metabolic control. If so, early detection of neurodevelopmental problems would allow individually tailored treatment that may improve metabolic control and prevent complications.
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- Wennström, Berith, et al.
(författare)
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Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery
- 2013
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 28:6, s. 361-367
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPerioperative procedures in children can impair their emotional status negatively with stress and/or anxiety. Cortisol concentrations and drawings could be helpful in gaining information about a child's levels of stress and/or anxiety when attending the hospital for surgery.PurposeThe purpose of this study was to determine the degree of anxiety and stress as well as to explore the association between objective measures of stress (cortisol concentration in saliva) and subjective assessment of hospital anxiety (children's drawings) as interpreted by the Swedish version of the Child Drawing: Hospital manual.MethodsA total of 93 children scheduled for day surgery were included. Salivary cortisol was sampled preoperatively on the day of surgery at which time the children were also requested to make a drawing of a person at the hospital.ResultsResults showed no association between salivary cortisol concentration and the CD:H score.ConclusionThe drawings and salivary cortisol concentration preoperatively on the day of surgery reflect different components of the conditions of fear, anxiety, or stress emerging in the situation.
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