| 1. |
- Albinsson, Eva, et al.
(författare)
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Unpredictable supplementation of vitamin D to infants in the neonatal intensive care unit : An experimental study.
- 2024
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227.
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Extremely premature infants receive nutrition and medication through nasogastric tubes. Breastmilk given accordingly is subject to fat loss. This study aimed to investigate whether this could also apply to vitamin D.METHODS: A questionnaire investigated vitamin D administration at a level III neonatal intensive care unit in Sweden in 2021. Feeding simulations with breastmilk and various vitamin D mixtures were done accordingly. After administration, vitamin D3 concentration was analysed using chromatography with mass spectrometry, followed by repeated simulations with vitamin D mixtures without breastmilk in 2023.RESULTS: The questionnaire was completed by 10 persons. Vitamin D was administered as drops using an enteral syringe and a nasogastric tube in conjunction with a breastmilk meal. In the feeding simulations, vitamin D3 concentration after administration was significantly higher using a syringe alone compared to standard administration. When vitamins were administered according to standard but without breastmilk, 100% of the vitamin D and 40% of the multivitamins were lost. The vitamins adhered to the material, mainly in the nasogastric tube.CONCLUSION: Our findings indicate that standard vitamin D supplementation in the neonatal intensive care unit may be unpredictable when administered by enteral syringe and nasogastric tube. We suggest using direct oral administration whenever possible.
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| 2. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Study protocol for a randomized controlled trial with rituximab for psychotic disorder in adults (RCT-Rits)
- 2023
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Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The role of inflammation in the aetiology of schizophrenia has gained wide attention and research on the association shows an exponential growth in the last 15 years. Autoimmune diseases and severe infections are risk factors for the later development of schizophrenia, elevated inflammatory markers in childhood or adolescence are associated with a greater risk of schizophrenia in adulthood, individuals with schizophrenia have increased levels of pro-inflammatory cytokines compared to healthy controls, and autoimmune diseases are overrepresented in schizophrenia. However, treatments with anti-inflammatory agents are so far of doubtful clinical relevance. The primary objective of this study is to test whether the monoclonal antibody rituximab, directed against the B-cell antigen CD20 ameliorates psychotic symptoms in adults with schizophrenia or schizoaffective disorder and to examine potential mechanisms. A secondary objective is to examine characteristics of inflammation-associated psychosis and to identify pre-treatment biochemical characteristics of rituximab responders. A third objective is to interview a subset of patients and informants on their experiences of the trial to obtain insights that rating scales may not capture.METHODS: A proof-of-concept study employing a randomised, parallel-group, double-blind, placebo-controlled design testing the effect of B-cell depletion in patients with psychosis. 120 participants with a diagnosis of schizophrenia spectrum disorders (SSD) (ICD-10 codes F20, F25) will receive either one intravenous infusion of rituximab (1000 mg) or saline. Psychiatric measures and blood samples will be collected at baseline, week 12, and week 24 post-infusion. Brief assessments will also be made in weeks 2 and 7. Neuroimaging and lumbar puncture, both optional, will be performed at baseline and endpoints. Approximately 40 of the patients and their informants will be interviewed for qualitative analyses on the perceived changes in well-being and emotional qualities, in addition to their views on the research.DISCUSSION: This is the first RCT investigating add-on treatment with rituximab in unselected SSD patients. If the treatment is helpful, it may transform the treatment of patients with psychotic disorders. It may also heighten the awareness of immune-psychiatric disorders and reduce stigma.TRIAL REGISTRATION: NCT05622201, EudraCT-nr 2022-000220-37 version 2.1. registered 14th of October 2022.
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| 3. |
- Bornehag, Carl-Gustav, 1957-, et al.
(författare)
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Prenatal exposure to bisphenols and cognitive function in children at 7 years of age in the Swedish SELMA study
- 2021
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- Background: Experimental evidence demonstrates that exposure to bisphenol A (BPA), and the recently intro-duced alternatives bisphenol S (BPS) and bisphenol F (BPF) alter normal neurodevelopment. More research is needed to evaluate the associations between exposure to individual BPA alternatives and neurodevelopmental outcomes in humans. Objective: The present study aimed at examining the individual associations between prenatal BPA , BPS and BPF exposure and cognitive outcomes in children at age 7 years. Method: Women were enrolled in the Swedish Environmental Longitudinal Mother and Child, Asthma and Al-lergy (SELMA) study, at gestational median week 10.0, and their children were examined for cognitive function at 7 years of age (N = 803). Maternal urina r y BPA , BPS, and BPF concentrations were measured at enrollment and children?s cognitive function at the age of 7 years was measured using the Wechsler Intelligence Scale for Children IV (WISC-IV). Results: A l l three bisphenols were detected in over 90% of the women, where BPA had the highest geometric mean concentrations (1.55 ng/mL), followed by BPF (0.16 ng/mL) and BPS (0.07 ng/mL). Prenatal BPF exposure was associated with decreased f u l l scale IQ (13 =-1.96, 95%CI;-3.12;-0.80), as we l l as with a decrease in a l l four sub scales covering verbal comprehension, perceptual reasoning, working memor y and processing speed. This association corresponded to a 1.6-point lower IQ score for an inter-quartile-range (IQR) change in prenatal BPF exposure (IQR = 0.054 & ndash;0.350 ng/mL). In sex-stratified analyses, significant associations with f u l l scale IQ were found for boys (13 = - 2.86, 95%CI;-4.54;-1.18), while the associations for girls did not reach significance (13 =-1.38, 95%CI;-2.97; 0.22). No significant associations between BPA nor BPS and cognition were found. Discussion: Prenatal exposure to BPF was significantly associated with children?s cognitive function at 7 years. Since BPF is replacing BPA in numerous consumer products globally, this finding urgently ca l l for further studies.
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| 4. |
- Delvert, Johanna, et al.
(författare)
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Associations between Motor Competence, Physical Activity and Sedentary Behaviour among Early School-Aged Children in the SELMA Cohort Study
- 2024
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Ingår i: Children. - : MDPI. - 2227-9067. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Low motor competence (MC) has been associated with lower physical activity (PA) and long-term health risks in children. Less is known about sex-specific patterns and associations during early school age. The aim of this study was to explore how motor difficulties are associated with PA levels, screen time, and organised sports participation (OSP). Data from 479 children, seven years of age, participating in the Swedish Environmental, Longitudinal, Mother and child, Asthma, and allergy (SELMA) pregnancy cohort study were used. MC and activity-related outcomes were assessed with questionnaires answered by parents. Associations between MC and outcomes were evaluated using logistic regression models adjusted for sex, overweight, and parental education level. Sex differences were investigated with interaction analyses and in stratified models. Children with motor difficulties had the same level of PA as their peers, but more screen time and lower OSP. Compared with children with normal MC, boys with motor difficulties had lower rates of OSP, but girls did not. This indicates that the identification and compensatory support for motor difficulties for boys at an early age, as well as the development of inclusive leisure time activities, are of importance to facilitate health-promoting activities on equal terms.
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| 5. |
- Delvert, Johanna, et al.
(författare)
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Struggling to Enable Physical Activity for Children with Disabilities : A Narrative Model of Parental Roles
- 2022
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Ingår i: Scandinavian Journal of Disability Research. - : Stockholm University Press. - 1501-7419 .- 1745-3011. ; 24:1, s. 196-209
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Tidskriftsartikel (refereegranskat)abstract
- This article presents a narrative model based on in-depth interviews with parents of children 6-12 years old with a variety of disabilities. It is a grounded theory study aiming to explore the parents' experiences of enabling health-promoting physical activity (PA) for their children. The core of the generated theory struggling between roles to facilitate PA describes how the parents, in different contexts and over time, are forced to take on roles as experts, coaches, minesweepers, and activists to facilitate adapted PA for their children. How tiresome this struggle became depended on contextual factors, the extent of effort put into the separate roles, and the interaction between them. The study revealed a complex picture unique for each family but at the same time suitable despite the character of the child's disability. This study adds knowledge to better support parents enabling PA on equal terms for all children.
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| 6. |
- Jägetoft, Zebulohn, et al.
(författare)
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Anthropometric measures do not explain the 2D : 4D ratio sexual dimorphism in 7-year-old children
- 2022
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Ingår i: American Journal of Human Biology. - : John Wiley & Sons. - 1042-0533 .- 1520-6300. ; 34:9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Digit ratio (2D:4D) might reflect prenatal testosterone exposure and has been used as a putative marker for androgen related outcomes. However, such associations might be inflicted by confounders. Application of 2D:4D in epidemiological research motivate identification of biological background determinants. We examined sex, anthropometric measures, and maternal factors as determinants of 2D:4D in Swedish 7-year-old children.METHODS: The study was embedded in the Swedish Environmental, Longitudinal, Mother and Child, Asthma and Allergy (SELMA) pregnancy cohort. A total of 870 pre-pubertal children, median 7.5 years of age, were studied. A single assessor performed digit measurements from scanned photocopies using computer software. Child anthropometric measurements investigated were hand size, birthweight, recumbent birth length, standing height, weight, BMI, body fat percentage, and waist/hip circumference. Maternal factors included age, pregnancy length, parity, and education.RESULTS: We found a significant sexual dimorphism regarding digit lengths and 2D:4D, boys on average presenting a lower 2D:4D than girls also after adjustment for summed finger lengths and body fatness. In crude analyses, maternal age correlated with 2D:4D across the whole population and in females but not in adjusted models. No other study variables were associated with 2D:4D.CONCLUSION: Digit ratio showed sexual dimorphism at the age of seven and seems to represent a true sex difference rather than an artifact and bias from hand size, body size or body fat content. Among the rest of our investigated variables, we found no determinants constituting important confounders in future research on 2D:4D ratio.
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| 7. |
- Mellstr?m, E., et al.
(författare)
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Methylphenidate and Reduced Overweight in Children With ADHD
- 2020
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Ingår i: Journal of Attention Disorders. - : SAGE Publications. - 1087-0547 .- 1557-1246. ; 24:2, s. 246-254
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of this study was to investigate odds ratios of overweight/obesity in children with ADHD and to compare the change in body mass index (BMI) after initiation of methylphenidate treatment in normal versus overweight/obese children. Method: This population-based study included 724 children (<18 years), of whom 197 were girls. Odds ratios for overweight and obesity were calculated, comparing the study group with a reference group from the same area. After initiation of methylphenidate treatment, changes in BMI were assessed for up to 3 years. Results: Children with ADHD had an odds ratio of 1.87 (95% confidence interval [CI]: [1.60, 2.19]) for overweight/obesity. A decrease in BMI standard deviation score was identified 1 to 3 years into treatment. The decrease was beneficially greater in overweight/obese as compared with normal weight children-mean (SD) -0.64 (0.80) versus -0.39 (0.68); p = .001-and greater in girls. Conclusion: Medication with methylphenidate may facilitate favorable weight development in children with ADHD and overweight/obesity.
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| 8. |
- Preece, Anna-Sofia, et al.
(författare)
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Phthalate levels in indoor dust and associations to croup in the SELMA study
- 2021
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Ingår i: Journal of Exposure Science and Environmental Epidemiology. - : Nature Publishing Group. - 1559-0631 .- 1559-064X. ; 30, s. 257-265
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Tidskriftsartikel (refereegranskat)abstract
- Phthalates are ubiquitous indoor pollutants which have been associated with child airway disease although results are inconclusive. This study examined associations between phthalate levels in residential indoor dust and croup during infancy. Settled indoor dust was collected in 482 homes of 6-month-old infants in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study and analysed for seven phthalates and one phthalate replacement using gas chromatography tandem mass spectrometry. The incidence of parental reported croup at 12 months was 6.4% for girls and 13.4% for boys. Associations between phthalate dust levels and croup were analysed by logistic regression adjusted for potential confounders. We found significant associations between di-ethyl phthalate (DEP) and di-ethyl-hexyl phthalate (DEHP) in residential dust and parental reported croup (adjusted odds ratio (aOR) = 1.71; 95% CI: 1.08-2.73 and 2.07; 1.00-4.30, respectively). Stratified results for boys showed significant associations between DEP and butyl-benzyl phthalate (BBzP) in dust and infant croup (aOR = 1.86; 95% CI: 1.04-3.34 and 2.02; 1.04-3.90, respectively). Results for girls had questionable statistical power due to few cases. Our results suggest that exposure to phthalates in dust is a risk factor for airway inflammatory responses in infant children.
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| 9. |
- Savvidou, Antri, et al.
(författare)
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Drug-induced hyperthermia with rhabdomyolysis in CLN3 disease
- 2022
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Ingår i: European Journal of Paediatric Neurology. - : Elsevier BV. - 1090-3798 .- 1532-2130. ; 39, s. 74-78
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Tidskriftsartikel (refereegranskat)abstract
- CLN3 disease (MIM# 204200), the most prevalent of the neuronal ceroid lipofuscinoses (NCL), is an autosomal recessive disorder with juvenile onset characterized by blindness, epilepsy, dementia, psychiatric manifestations, and motor deterioration. Problems related to behavior, emotions and thought are among the main features. Antidepressant and antipsychotic drugs have been employed with variable results. Neuroleptic malignant syndrome (NMS) has previously been described in two patients with NCL, one with CLN3 disease and one with adult onset NCL of unclear genetic origin. Our aims were to describe the occurrence of drug-induced hyperthermia in pediatric patients with CLN3 disease from West and South Sweden and to delineate the range of associated clinical features. Our study identified four patients presenting with seven episodes of severe drug-induced hyperthermia and either NMS-like or Serotonin syndrome (SS)-like features. Possibly provoking drugs were risperidone, clozapine, olanzapine, haloperidol, quetiapine, and sertraline. The course was atypical, frequently prolonged, associated with rhabdomyolysis and status dystonicus, and resulted in the death of three of the patients. Our study points to a vulnerability to drug-induced hyperthermia in patients with CLN3 disease which we believe could be underreported. Interestingly the proposed pathophysiological mechanisms behind NMS and SS on one hand and CLN3 on the other hand seem to converge in a common mechanism involving dysregulation of the sympathetic nervous system.
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| 10. |
- Svensson, Katherine
(författare)
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Early life environmental exposures and children's growth : A longitudinal study evaluating prenatal exposure for endocrine disrupting chemicals and nutrition in relation to children's growth up to seven years of age
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Endocrine disrupting chemicals (EDCs) have the potential to disrupt the endocrine system in humans and animals with importance for health and development. Additionally, optimal nutrition during pregnancy is critical for fetal growth and pregnancy outcomes. However, further knowledge on the importance of EDC mixtures and nutrition, on birthweight and growth during childhood is needed. The overall aim of this thesis was to evaluate the associations between prenatal exposure to EDC mixtures and nutrition respectively, with birthweight, growth and body composition in early- and mid-childhood, and to determine if these associations differed by sex. Data from mother-child pairs in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study was analyzed, including 26 EDCs in prenatal urine and serum samples, children’s anthropometric and body composition measures up to seven years of age, and sociodemographic data from questionnaires and registers.Results suggest that higher prenatal exposure to EDC mixtures were associated with lower birthweight, and slower weight gain in early childhood, including a later peak growth velocity among girls. At 5.5 and 7 years of age, EDC mixtures were associated with lower BMI, less odds of overweight and less body fat among girls, but more body fat among boys at 7 years of age. Chemicals of concern in the mixtures were e.g., phthalates, bisphenols, perfluorinated alkyl substances (PFASs) and pesticides. Finally, maternal nutrition during pregnancy, i.e., better adherence to nutritional guidelines, was associated with more body fat for boys but less body fat for girls.In conclusion, prenatal exposure to both EDC mixtures and nutrition suggests to have an influence on birthweight, and children´s growth. Several of the found associations also differed by sex.
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