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- Bixo Ottosson, Anna, et al.
(författare)
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Self-care management of type 1 diabetes has improved in Swedish schools according to children and adolescents
- 2017
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 106:12, s. 1987-1993
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Age-appropriate support for diabetes self-care is essential during school time, and we investigated the perceived quality of support children and adolescents received in 2015 and 2008.Methods: This national study was based on questionnaires answered by children and adolescents aged 6–15 years of age with type 1 diabetes attending schools or preschools in 2008 (n = 317) and 2015 (n = 570) and separate parental questionnaires. The subjects were recruited by Swedish paediatric diabetes units, with 41/44 taking part in 2008 and 41/42 in 2015.Results: Fewer participants said they were treated differently in school because of their diabetes in 2015 than 2008. The opportunity to perform insulin boluses and glucose monitoring in privacy increased (80% versus 88%; p < 0.05). Most (83%) adolescents aged 13–15 years were satisfied with the support they received, but levels were lower in girls (p < 0.05). More subjects had hypoglycaemia during school hours (84% versus 70%, p < 0.001), but hypoglycaemia support did not increase and was lower for adolescents than younger children (p < 0.001).Conclusion: Children and adolescents received more support for type 1 diabetes in Swedish schools in 2015 than 2008, but more support is needed by girls and during hypoglycaemia.
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| 6. |
- Karefylakis, Christos, et al.
(författare)
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Effect of Vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men : a randomized controlled trial
- 2018
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Ingår i: Endocrine. - : Humana Press. - 1355-008X .- 1559-0100. ; 61:3, s. 388-397
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Several observational studies have shown an association between vitamin D deficiency and non-skeletal major health issues including impaired cardiorespiratory fitness and adiposity. Only a few studies have examined the impact of vitamin D supplementation on these conditions and the results are ambiguous. The aim of this study was to examine the effect of vitamin D supplementation on body composition and cardiorespiratory fitness in overweight/obese men with vitamin D deficiency.Methods: This study was a prospective, placebo controlled, double blinded, randomized trial with a study period of 6 months. Forty overweight/obese men (BMI > 25 kg/m2) with vitamin D deficiency (25(OH)D ≤ 55 nmol/L) were randomized to receive either 2000 IU Cholecalciferol drops or the equivalent amount of drops of placebo. At baseline and follow up body composition and cardiorespiratory fitness were measured and blood samples were obtained. Body composition was measured using bioelectrical impedance analysis (BIA) and cardiorespiratory fitness using cardiopulmonary exercise test (CPET). The primary outcomes were changes in percentage body fat and in maximum oxygen uptake (VO2max).Results: No statistically significant difference between the placebo and the intervention group regarding changes in percentage body fat (p = 0.54) and VO2max (p = 0.90) was observed. Moreover, there was no statistically significant difference between the groups concerning changes in BMI (p = 0.26), maximum load (p = 0.89) and oxygen uptake at anaerobic threshold (AT) (p = 0.14).Conclusions: We conclude that treatment with 2000 IU/d vitamin D for 6 months does not impact body composition or maximum oxygen uptake in overweight/obese men with vitamin D deficiency.
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| 8. |
- Karefylakis, Christos, 1982-
(författare)
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Vitamin D and its role in obesity and other associated conditions
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Vitamin D has received much attention in recent years due to the re-emergence of vitamin D deficiency as a global health issue along with increasing evidence indicating that 1,25-dihydroxivitamin D, the hormonally active form of vita-min D, not only acts in calcium and bone metabolism but also generates ex-traskeletal biological responses.In this thesis, the role of vitamin D in obesity and other associated condi-tions has been studied.In paper 1, the prevalence of vitamin D deficiency and secondary hyperpara-thyroidism over the long term after Roux-en-Y gastric bypass (RYGB) were evaluated. We found a substantial prevalence of vitamin D deficiency and secondary hyperparathyroidism after RYGB, whereas calcium levels remained within normal range. An expected improvement in vitamin D status after weight loss could have been countered by the malabsorption induced by surgery.In paper 2, the prevalence of anemia and related deficiencies over the long term after RYGB were studied. We found that 27% of the patients had anemia postoperatively, 20% had iron deficiency, 12% had folate deficiency and 2% had vitamin B12 deficiency. Anemia was mainly due to iron deficiency, and its frequency did not seem to progress with time after surgery.In paper 3, the effects of vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men with vitamin D deficiency at baseline were investigated. No statistically significant difference between the placebo and the intervention group regarding changes in percentage body fat, maximum oxygen uptake, BMI and maximum load was found.In paper 4, the prevalence and determinants of 3-epi-25(OH)D3 were exam-ined. 3-epi-25(OH)D3 was detected in 7.7% of the study population and the mean concentration was 8.4 nmol/L. The quantification of 3-epi-25(OH)D3 would not significantly influence the clinical interpretation of vitamin D levels.In conclusion, new knowledge about vitamin D is continuously emerging but there is a discrepancy between cross-sectional studies associating low vitamin D levels to obesity and other related metabolic complications and the lack of effects of vitamin D supplementation in clinical trials. Large RCTs with longer duration in obese subjects with baseline vitamin D deficiency are warranted.
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| 9. |
- Karefylakis, Christos, 1982-, et al.
(författare)
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Vitamin D C3 epimer in a mid-Swedish region : Analytical measurement and epidemiology
- 2018
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Ingår i: Clinica Chimica Acta. - Amsterdam, Netherlands : Elsevier. - 0009-8981 .- 1873-3492. ; 478, s. 182-187
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Tidskriftsartikel (refereegranskat)abstract
- Background: The discovery of an epimeric form of 25(OH)D3 may complicate the interpretation of vitamin Dstatus. The aim of this study was to examine the prevalence and determinants of 25-hydroxy-3-epi-vitamin D3 (3- epi-25(OH)D3) in a mid-Swedish region and to investigate how the measurement of 3-epi-25(OH)D3 would affect the assessment of vitamin D status using current thresholds.Methods: We conducted a cross-sectional study of 8286 in- and outpatients in primary as well as secondary care settings. Plasma 25(OH)D, 25(OH)D2, 25(OH)D3 and 3-epi-25(OH)D3 were measured using High Pressure Liquid Chromatography – Tandem Mass Spectrometry (HPLC – MS/MS). The relative 3-epi-25(OH)D3 contribution was calculated as a percentage of the total 25(OH)D3. Blood samples were collected between March 2014 and July 2015 providing a seasonal aspect to the results.Results: 3-epi-25(OH)D3was detected in 635 cases (7.7% of all subjects), and the mean concentration was8.4 ± 3.5 nmol/L. 3-epi-25(OH)D3correlated significantly with 25(OH)D3(r =0.38, p < 0.001).A multivariateanalysis among the detected showed that male gender and winter season were independently associatedwith higher 3-epi-25(OH)D3/25(OH)D3percentage ratio (R2=0.044). Infants and children had a significantlyhigher detection rate compared to the reference age category (18–45 years) as well as those who were testedduring the summer season.Conclusions: We report findings from the first epidemiologic study of 3-epi-25(OH)D3 conducted in Sweden, based on a large population sample. 3-epi-25(OH)D3 was detected in 7.7% of the study population and the mean concentration was 8.4 nmol/L. The quantification of 3-epi-25(OH)D3 would not significantly influence the clinical interpretation of vitamin D levels. Additional studies are needed to understand the metabolic pathway and the possible physiological functions of this metabolite.
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| 10. |
- Lemonaki, Myrsini, et al.
(författare)
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Paediatric education in the Curriculum of the School of Medicine in the University of Örebro in Sweden
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: In Sweden there are seven Medical Schools. Some of them have existed in more than 50 years whereas the School of Medicine at Örebro University was established in 2011. The education is built as 5,5 year studies (330 ECTS credits) and the Curriculum is integrated according to the PBL system. The aim is to present our approach to the training in paediatrics.Method: The poster presents the theoretical and clinical studies, as well as the examination and the assessment system concerning the paediatric education. The medical students in Örebro study paediatrics during the study of the theme of Reproduction and Growth. This is formed in three steps during their studies, particularly in terms 2, 6, 9. As an integrated medical curriculum students have both theoretical and practical studies during all the terms. The learning methods are base studies, seminars, lectures, simulation training, and clinic practice.In the second term, the medical students study embryology, genetics, anatomy and have some clinical practice in the paediatric primary health center. In the sixth term, they study about the healthy newborn, child and adolescent as well as normal and retarded growth and normal development and nutrition. Students also start their training in taking medical history and doing clinical examination. In the ninth term students have focus on the sick newborn, child and adolescent. Seminars on child abuse and neglect are given with a specialized pediatrician, a specialized lawyer and social worker as teachers.Conclusion: The theoretical aims of the paediatric curriculum are obtained through clinical practice, team base groups, case seminaria, other seminaria, lectures, and self studies. The clinical skills are obtained through clinical skills training in paediatric units and simulation training. The examination system includes a writing exam after each term as well as an examination of clinical skills and a OSCE examination after the ninth term. The assessment ofthe students in the end of each term is very good.Take-home message: The training in paediatrics in the Medical school of Örebro is formed in three steps in an integrated form.
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