| 1. |
- Duan, Rui-Dong, et al.
(författare)
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Human meconium contains significant amounts of alkaline sphingomyelinase, neutral ceramidase, and sphingolipid metabolites.
- 2007
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 1530-0447 .- 0031-3998. ; 61:1, s. 61-66
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Tidskriftsartikel (refereegranskat)abstract
- Intestinal alkaline sphingomyelinase (Alk-SMase) and neutral ceramidase may catalyze the hydrolysis of endogenous sphin-gomyelin (SM) and milk SM in human-milk fed infants. The enzymes generate sphingolipid metabolites that may influence gut maturation. Alk-SMase also inactivates platelet-activating factor (PAF) that is involved in the pathogenesis of necrotizing enterocolitis (NEC). We examined whether the two enzymes are expressed in both preterm and term infants and analyzed Alk-SMase, neutral ceramidase, SM, and sphingolipid metabolites in meconium. Meconium was collected from 46 preterm (gestational ages 23-36 wk) and 38 term infants (gestational ages 37-42 wk) and analyzed for Alk-SMase using C-14-choline-labeled SM and for neutral ceramidase using C-14-octanoyl-sphingosine as substrates. Molecular species of SM, ceramide, and sphingosine were analyzed by high-performance liquid chromatography mass spectroscopy. Meconium contained significant levels of Alk-SMase and ceramidase at all gestational ages. It also contained 16-24 carbon molecular species of SM, palmitoyl-and stearoyl-sphingosine, and sphingosine. There were positive correlations between levels of SM and ceramide and between ceramide and sphingosine levels. In conclusion, Alk-SMase and ceramidase are expressed in the gut of both preterm and term newborn infants and may generate bioactive sphingolipid messengers.
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| 2. |
- Jacobson, Lena, et al.
(författare)
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Visual impairment is common in children born before 25 gestational weeks-boys are more vulnerable than girls.
- 2009
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 98:2, s. 261-5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Children born extremely preterm have high risk of visual impairment due to retinopathy of prematurity (ROP) and cerebral lesions. Objective: The aim of this study was to investigate the frequency of ROP and visual impairment as defined by the World Health Organization (WHO), with respect to gender in two hospital-based groups of children born at the limit of viability. Patients and methods: A retrospective chart review was conducted for all children (n = 114), born before 25 gestational weeks and screened for ROP at Karolinska hospital in Stockholm and Sahlgrenska hospital in Gothenburg between 1990 and 2002. Maximal ROP stages, treatment for ROP and visual acuity (VA), with correction when needed at latest available visit, were recorded. Results: Altogether 97.4% had ROP, 74.6% developed proliferative disease (stage >/= 3) and 63.2% were treated with retinal ablation. Normal VA (>/=0.8) in at least one eye was found in 50.5% of all and in significantly more girls (61.5%) than boys (34.8%) (p = 0.006), while visual impairment (VA < 0.33) was more common in boys (32.6%) than in girls (9.2%) (p = 0.004). Conclusion: A large proportion of children, especially boys, born at the level of viability are visually impaired with low vision or blindness. Development of preventive measures is urgent.
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| 3. |
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| 4. |
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| 5. |
- Andersson Grönlund, Marita, 1959-, et al.
(författare)
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Ophthalmological findings in a sample of Swedish children aged 4-15 years
- 2006
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Ingår i: Acta Ophthalmologica Scandinavica. - : Munksgaard Forlag. - 1395-3907 .- 1600-0420. ; 84:2, s. 169-76
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To characterize ophthalmological findings in a sample of Swedish children aged 4-15 years.METHODS: A prospective cross-sectional comprehensive ophthalmological investigation was performed on a sample of 143 children (67 girls, 76 boys) aged 4-15 years.RESULTS: Visual acuity (VA) in the better eye >or=1.0 (0.3 logMAR). Amblyopia was found in 0.7% of subjects. A total of 68% of the children had no refractive errors. Hyperopia (>or=2.0 dioptres [D] in spherical equivalent [SE]) was found in 9% and myopia (>or=0.5 D SE) in 6% of children. Astigmatism (>or=0.75 D) was recorded in 22% and anisometropia (>or=1.0 D SE) in 3%. A total of 8% were optically corrected. Strabismus was recorded in 3.5%. Signs of visuoperceptual problems were reported in 3% of the children.CONCLUSION: This sample of Swedish children may serve as a comparison group regarding ophthalmological findings in children aged 4-15 years.
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| 6. |
- Andersson, Susann, 1965, et al.
(författare)
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Vision in children with hydrocephalus.
- 2006
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Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 48:10, s. 836-41
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Hydrocephalus in children has many aetiologies, and can cause multiple ophthalmic and visual disorders. This study sets out to detect and quantify visual and visuoperceptual dysfunction in children who have received surgical treatment for hydrocephalus with and without myelomeningocele, and to relate the results to the associated diagnoses and results from a comparison group. Seventy-five school-aged children (41 males, 34 females) with surgically-treated hydrocephalus and 140 comparison children (76 males, 64 females) matched for age and sex underwent comprehensive ophthalmologic examination. Median age at examination was 9 years and 4 months (range 7 y 4 mo-12 y 10 mo). Visual function deficits were identified in 83% (62/75) of the children with hydrocephalus. Visual impairment (binocular visual acuity <0.3) was found in 15% (11/73; comparison group 0%) but in none with myelomeningocele. Strabismus was found in 69% (51/74; comparison group 4% [5/140], p < 0.001), and refractive errors were found in 67% (47/70; comparison group 20% [28/140], p < 0.001). Cognitive visual dysfunction was identified in 59% (38/64; comparison group 3% [4/140], p < 0.001). These disorders were identified in various combinations and comprised impaired ability to plan movement through depth (e.g. going down a stair), impaired simultaneous perception, impaired perception of movement, impaired orientation, and (least frequently) impaired recognition. In this study, children with hydrocephalus associated with myelomeningocele were least commonly affected. Visual disorders were most frequent in those with epilepsy, cerebral palsy, and/or cognitive disability.
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| 7. |
- Aring, Eva, 1959, et al.
(författare)
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Strabismus and binocular functions in a sample of Swedish children aged 4-15 years
- 2005
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Ingår i: Strabismus. - : Taylor & Francis. - 0927-3972 .- 1744-5132. ; 13:2, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate strabismus, head posture, nystagmus, stereoacuity, ocular motility, near point of convergence (NPC) and accommodative convergence to accommodation ratio (AC/A) in a sample of Swedish children. METHODS: A prospective cross-sectional study was carried out on 143 children, 4-15 years of age. RESULTS: Heterotropia was found in five children (3.5%), four with esotropia and one with exotropia. One child with esotropia had a slight overaction of both inferior oblique muscles. Heterophoria was found in 37 children (26%) at near and/or distance fixation and it was four times more common at near than at distance. In 29 children, heterophoria was found at one distance only and orthophoria at the other. Orthophoria at both near and distance fixation was noted in 101 children (70.5%). The near point of convergence was < or =6 cm in 97% of the children and 97% had stereoacuity of 60" or better. In the whole group, the median AC/A ratio calculated with the heterophoria method was 5.6/1 prism diopters/diopters (PD/D) and with the gradient method, 1.3/1 PD/D. No anomalous head postures or nystagmus were observed and all children had normal versions. CONCLUSION: In this study, 143 well-defined children were investigated with a battery of accurately described tests, commonly used in clinical practice. These results are in agreement with those of other studies examining one or few variables in larger populations and the authors therefore conclude that their results may be used for comparisons with different patient groups.
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| 8. |
- Aring, Eva, 1959, et al.
(författare)
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Strabismus, binocular functions and ocular motility in children with hydrocephalus.
- 2007
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Ingår i: Strabismus. - : Informa UK Limited. - 0927-3972 .- 1744-5132. ; 15:2, s. 79-88
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate heterotropia, heterophoria, head posture, nystagmus, stereo acuity, ocular motility and near point of convergence (NPC) in children with hydrocephalus treated surgically before 1 year of age. In addition, the effects of being born with hydrocephalus, the effect of the etiology of hydrocephalus, number of shunt revisions and the size of the ventricles on these variables were studied. METHODS: A population-based study was performed in 75 children and the results were compared with the results of an age- and sex-matched group (comp group) (n = 140). RESULTS: Heterotropia 68.9% (comp group 3.6%; p < 0.001), abnormal head posture 41.3% (comp group 0; p < 0.001), nystagmus 44.0% (comp group 0; p < 0.001), stereo acuity < or =60'' 33.8% (comp group 97.1%; p < 0.001) and ocular motility defects 69.7% (comp group 0.7%; p < 0.001) were more common among children with hydrocephalus than in the comparison group. Children with overt hydrocephalus at birth had significantly more heterotropia (p = 0.0006), esotropia (p = 0.002), abnormal head posture (p = 0.02) and motility defects (p = 0.003) compared to those with hydrocephalus developing during the first year of life. The etiology, number of shunt revisions and the size of the ventricles had no significant effect on any of the investigated variables. CONCLUSIONS: Children with hydrocephalus surgically treated before the age of one year commonly present orthoptic abnormalities. The etiology of hydrocephalus, number of shunt revisions and ventricle size seem to be of minor importance compared with the age of onset of hydrocephalus with regard to the risk for orthoptic abnormalities.
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| 9. |
- Bael, An M, et al.
(författare)
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Self-reported urinary incontinence, voiding frequency, voided volume and pad-test results: variables in a prospective study in children.
- 2007
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Ingår i: BJU international. - 1464-4096. ; 100:3, s. 651-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the congruence between self-reported and objective data on incontinence, voided volume (VV) and voiding frequency (VF), in a prospective study of treatment of functional urinary incontinence (UI) due to urge syndrome or dysfunctional voiding in children. PATIENTS AND METHODS: In all, 202 children, enrolled in the European Bladder Dysfunction Study (EBDS), provided self-reported data on UI, VV and VF, before and after treatment, with validated questionnaires and 72-h voiding diaries. Objective data were obtained with uroflowmetry and a 12-h pad test, also before and after treatment. Questionnaires and diaries were checked and scored by a urotherapist, at scheduled office visits that were combined with uroflowmetry. RESULTS: At entry, parents under-reported UI on the questionnaires in 45% of cases, compared with the urotherapist's scores, and the 12-h pad test sensitivity for UI was only 64% (95% confidence interval 55-73%). The voiding diaries had inconsistent entries on UI and on VV. VF was overestimated in the questionnaires and underestimated in the diaries, compared with the urotherapist's scores. A VF of >7/day decreased significantly after EBDS treatment, but with no correlation with treatment outcome. The mean VV increased significantly after treatment for UI, also with no correlation with treatment outcome. CONCLUSIONS: Voiding diaries and questionnaires are useful tools for charting individual treatment and for screening, but they are ill-suited to documenting outcome variables in urge syndrome or dysfunctional voiding, because of over- and under-reporting. VV and VF lack specificity as outcome variables in children with urge syndrome or dysfunctional voiding. The 12-h pad test is not sensitive enough to complement self-reported symptoms of UI in children with urge syndrome or dysfunctional voiding. Clinical studies on UI rely on complaints and self-reported symptoms, but in children the reporting should be supervised by a trained urotherapist, to provide the necessary checks and balances.
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| 10. |
- Bengtsson, Jörgen, et al.
(författare)
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The influence of age on the distribution of morphine and morphine-3-glucuronide across the blood-brain barrier in sheep
- 2009
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Ingår i: British Journal of Pharmacology. - : Wiley. - 0007-1188 .- 1476-5381. ; 157:6, s. 1085-1096
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The effect of age on the distribution of morphine and morphine-3-glucuronide (M3G) across the blood-brain barrier (BBB) was studied in a sheep model utilizing intracerebral microdialysis. The effect of neonatal asphyxia on brain drug distribution was also studied. Experimental approach Microdialysis probes were inserted into the cortex, striatum and blood of 11 lambs (127 gestation days) and six ewes. Morphine, 1 mg.kg(-1), was intravenously administered as a 10 min constant infusion. Microdialysis and blood samples were collected for up to 360 min and analysed using liquid chromatography-tandem mass spectrometry. The half-life, clearance, volume of distribution, unbound drug brain : blood distribution ratio (K(p,uu)) and unbound drug volume of distribution in brain (V(u,brain)) were estimated. Key results Morphine K(p,uu) was 1.19 and 1.89 for the sheep and premature lambs, respectively, indicating that active influx into the brain decreases with age. Induced asphyxia did not affect transport of morphine or M3G across the BBB. Morphine V(u,brain) measurements were higher in sheep than in premature lambs. The M3G K(p,uu) values were 0.27 and 0.17 in sheep and premature lambs, indicating a net efflux from the brain in both groups. Conclusions and implications The morphine K(p,uu) was above unity, indicating active transport into the brain; influx was significantly higher in premature lambs than in adult sheep. These results in sheep differ from those in humans, rats, mice and pigs where a net efflux of morphine from the brain is observed.
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| 11. |
- Berntsson, Leeni, 1938, et al.
(författare)
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Adolescents' experiences of well-being when living with a long-term illness or disability.
- 2007
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:4, s. 419-25
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Tidskriftsartikel (refereegranskat)abstract
- Present-day society has produced changes in family living patterns and conditions and this has resulted in new stressors and health problems. Most children and adolescents with chronic diseases and disabilities, who were previously cared for at hospitals and institutions for long periods, are now integrated in society and they are expected to live a normal life in the conditions that currently prevail. The number of young people with long-term illnesses/disability has increased worldwide during the last decades. There is lack of studies relating to the way young people regard their daily lives and factors that are important for their well-being. The aim of this study was to describe the meaning of feeling good in daily life in adolescents living with a long-term illness or disability. Eight boys and seven girls, aged between 12 and 19 years, with different conditions of long-term illness or disability, participated in the study. Tape-recorded interviews were conducted between the years 2003-2004 and the data were analysed using content analysis. The results revealed that the adolescents with long-term illness generally experienced well-being like everybody else. Three themes were found to be important in order to feel good: 'a feeling of acceptance of illness/disability as a natural part of life', 'a feeling of support' and 'a feeling of personal growth'. This study concludes that adolescents with long-term illness or disabilities experience well-being when they are allowed to prepare for living a normal life integrated in society.
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| 12. |
- de Vries, LS, et al.
(författare)
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Role of cerebral function monitoring in the newborn
- 2005
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Ingår i: Archives of disease in childhood. Fetal and neonatal edition. - : BMJ. - 1359-2998 .- 1468-2052. ; 90:3, s. 201-207
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Forskningsöversikt (refereegranskat)abstract
- For many years, newborn infants admitted to neonatal intensive care units have had routine electrocardiography and been monitored for respiratory rate, heart rate, oxygen saturation, and blood pressure. Only recently has it also been considered important to monitor brain function using continuous electroencephalography. The role of cerebral function monitoring in sick full term and preterm infants is reviewed.
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| 13. |
- Edwall, Lise-Lotte, et al.
(författare)
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The lived experience of the diabetes nurse specialist regular check-ups, as narrated by patients with type 2 diabetes.
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:6, s. 772-81
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Tidskriftsartikel (refereegranskat)abstract
- The Sahlgrenska Academy, Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden. Lise-lotte.edwall@epost.tidanet.se AIM: The aim was to elucidate the lived experience of regular diabetes nurse specialist check-ups among patients with type 2 diabetes. BACKGROUND: Diabetes care with diabetes nurse-led clinics in primary care has been established in Sweden since the 1980s. Information about patients' lived experience of these regular check-ups is important in the further development of diabetes nursing in primary care. METHODS: Narrative interviews were conducted with 10 women and 10 men with type 2 diabetes regarding their lived experience in everyday life and the regular check-ups by the diabetes nurse specialist. A phenomenological-hermeneutic method inspired by Ricoeur was used in the analysis. RESULTS: Patients'- with type 2 diabetes - lived experience of regular check-ups showed an overall positive influence on the patients' way of living with the disease by underpinning and developing their understanding and management of daily life. This influence was interpreted as an interlinked chain comprising the following elements; being confirmed, being guided within the disease process, becoming confident and independent and being relieved. Every link contained a positive influence from being dependent-independent, autonomous and a feeling of freedom in patients striving for an everyday life with a disease under control. RELEVANCE TO CLINICAL PRACTICE: The development of diabetes-nurse-led clinics from the perspective of the patient must consider the patient's individual need for support and continuity with the diabetes nurse specialist. Consultations with collaborative partnership and specific expertise that is easy to access implied autonomous disease self-management in terms of patients' own control of the disease over time. In view of the increasing number of patients with diabetes, this could positively impact the availability of diabetes nursing care.
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| 14. |
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| 15. |
- Elsmén, Emma, et al.
(författare)
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Fetal gender and gestational-age-related incidence of pre-eclampsia.
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 85:11, s. 1285-1291
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Tidskriftsartikel (refereegranskat)abstract
- Background. Male fetal gender is associated with an overall increased risk of pre-eclampsia. However, it was recently shown that the male: female birth ratio was decreased in pre-eclampsia associated with preterm delivery. The reason for this discrepancy is not known. Objective. To investigate whether the fetal and newborn gender is associated with the incidence of antenatal maternal pregnancy complications, and to investigate if gender-associated risk changes with gestational age at delivery. Methods. Population-based study including 1,158,276 infants born in Sweden 1990-2001. Five maternal diagnosis groups (pre-eclampsia, infection, preterm premature rupture of membranes, abruptio placentae, and polyhydramnios) were explored in relation to newborn infant gender and gestational age at delivery. Results. When all gestational ages were evaluated, male newborn gender was associated with increased odds ratios for all five diagnosis groups, and for preterm birth before 37 weeks gestation, M/F ratio 1.17. In very preterm births (gestational age below 32 weeks), male newborn gender was associated with a significantly lower risk for pre-eclampsia (OR 0.88, 95%CI 0.80-0.97), and a marginally lower risk for polyhydramnios (OR 0.74, 95%CI 0.54-1.01). Conclusion. The fetal gender seems to affect the occurrence of pre-eclampsia, and possibly also polyhydramnios. The finding could be due to an increased risk for spontaneous abortions in pregnancies with male fetuses, but could also be associated with the etiology of these conditions. Evaluation of antenatal pregnancy complications from a fetal/newborn gender perspective may contribute to new insights regarding their pathophysiological mechanisms.
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| 16. |
- Elsmén, Emma, et al.
(författare)
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Umbilical Cord Levels of Interleukin-1 Receptor Antagonist and Neonatal Outcome.
- 2006
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Ingår i: Biology of the Neonate. - : S. Karger AG. - 1421-9727. ; 89:4, s. 220-226
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies indicate that there may be infant gender differences in cytokine expression associated with differences in neonatal morbidity. Objective: We tested the hypothesis that umbilical cord interleukin-1 receptor antagonist (IL-1ra) correlates with infant gender and neonatal outcome in preterm infants. Study Design: IL-1ra was measured in cord blood taken from 58 preterm infants (33 males, 25 females) with gestational age less than 32 weeks. Receiver operating characteristics (ROC) curve were used for identifying IL-1ra values with high sensitivity and specificity for neonatal morbidity and adverse outcome, i.e., death or survival with severe intraventricular hemorrhage or periventricular leukomalacia. Results: In the female infants, but not the male infants, cord IL-1ra values correlated with postnatal depression, expressed as Apgar scores at 1 min (correlation coefficient, r(s); p value: -0.542; 0.005), 5 min (-0.571; 0.018), and 10 min (-0.442; 0.035); and postnatal age at intubation (-0.799; 0.001). The ROC area under the curve (AUC) was 0.735 for adverse outcome (p = 0.013), and 0.683 for bronchopulmonary dysplasia (p = 0.021) when all infants were included. However, there was a significant gender difference in the ROC curve for adverse outcome (p = 0.026), with AUC 0.640 (p = 0.240) in males and AUC 0.929 (p = 0.008) in females. Above a chosen cutoff at 13,500 ng/I for IL-1ra cord the sensitivity and specificity for predicting adverse outcome was 100 and 81%, respectively in females versus 50 and 84% in males. Conclusion: Increased levels of cord IL-1ra levels are associated with neonatal morbidity and adverse outcome in preterm infants. Comparable levels of IL-1ra have different predictive value depending on infant gender. Copyright (c) 2006 S. Karger AG, Basel.
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| 17. |
- Enskär, Karin, et al.
(författare)
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Siblings of children with cancer
- 2006
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Ingår i: NOBOS, Nordic Society of Pediatric Oncology Nurses, 6th meeting 6-9 May 2006 Tampere, Finland.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 18. |
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| 19. |
- Ericsson, Jessica S, 1971, et al.
(författare)
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Periodontal health status in Swedish adolescents: an epidemiological, cross-sectional study
- 2009
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 33:(3), s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this epidemiological survey was to analyze the periodontal conditions of 19-year old individuals in two rural county areas, i.e. Fyrbodal and Skaraborg, Västra Götaland, Sweden, with special reference to gender and socioeconomic grouping. A randomized sample of 506 individuals (Fyrbodal 250 and Skaraborg 256 individuals, respectively) was clinically examined with regard to oral hygiene, gingivitis, periodontal pockets and gingival recession. Bitewing radiographs were used for assessment of alveolar bone level (ABL) and dental calculus. A questionnaire-based interview regarding oral hygiene habits was included. A majority of the subjects (76%) claimed to brush their teeth at least twice a day, while interdental hygiene means were used daily by 4%. The subjects showed a mean plaque score of 47% and a gingivitis score of 56%. Forty-six % of the adolescents had a plaque score of > or = 50%, whereas the corresponding figure for gingivitis was 62%. The subjects had on average 5.5 teeth with facial gingival recession. The mean prevalence of sites with probing depth (PPD) of > or = 4 mm was 8, out of which 99% were located at proximal sites. A radiographic bone level of > 2 mm was observed at on average 0.4 teeth per subject. Logistic regression analyses revealed that gender (males) and county area (Fyrbodal) were significant factors for a high plaque and gingivitis score. There was no significant difference in periodontal conditions in relation to socio-economic grouping. In conclusion, the survey revealed higher prevalence of plaque and gingivitis among male than female adolescents, but no differences between socioeconomic groups.
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| 20. |
- Fellman, Vineta, et al.
(författare)
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One-year survival of extremely preterm infants after active perinatal care in Sweden.
- 2009
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Ingår i: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 301:21, s. 2225-33
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Tidskriftsartikel (refereegranskat)abstract
- Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling.
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| 21. |
- Forsblad, Kristina, et al.
(författare)
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Apgar score predicts short-term outcome in infants born at 25 gestational weeks
- 2007
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Ingår i: Acta paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 96:2, s. 166-171
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify early predictors of outcome in infants born at 25 gestational weeks. Material and Methods: Data from a regional perinatal database (time-period 1995-2001, total n = 108 000 births) were used. Apgar scores were available in 92 preterm infants, born at 25 + 0 to 25 + 6 gestational weeks, and analyzed in relation to short-term outcome (180-day survival with, or without, severe brain damage defined as intraventricular hemorrhage grade 3-4 or cystic periventricular leukomalacia). Based on multiple logistic regression analyses we constructed graphs of the estimated chance of survival. Results: Apgar scores at 1, 5 and 10 min correlated with survival without severe brain damage (p = 0.02, 0.006 and 0.006, respectively). Survival without severe brain damage was higher in singleton than in multiple births (p = 0.03); there was no association with infant gender or mode of delivery. The strongest model for prediction of survival without severe brain damage was based on 5-min Apgar score and the Clinical Risk Index for Babies (CRIB), (p < 0.001). Conclusion: Apgar score predicts short-term outcome in extremely preterm infants at 25 gestational weeks. The precision for prediction of outcome increases when Apgar score is combined with CRIB.
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| 22. |
- Forsblad, Kristina, et al.
(författare)
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Short-term outcome predictors in infants born at 23-24 gestational weeks
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:5, s. 551-556
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Outcome is uncertain in infants born at 23-24 gestational weeks. The aim of the present study was to identify possible early predictors of outcome in these infants. MATERIALS AND METHODS: Data from the Swedish medical birth register (MBR) for live-born infants with gestational ages (GAs) 23 and 24 weeks, born during the time-period 2000-2002, were analysed in relation to short-term outcomes, that is survival and survival without severe brain damage (intraventricular haemorrhage [IVH] grades 3 and 4 and/or periventricular leukomalacia [PVL]). RESULTS: In 57 infants born at 23 gestational weeks, survival was associated with birthweight (BW) (p = 0.018) and 5-min Apgar score (p = 0.020) on univariate analyses. In 99 infants born at 24 weeks of gestation, survival without severe brain damage correlated with BW (p = 0.039), birth type (singleton/multiple) (p = 0.017) and Apgar score at 1, 5 and 10 min (p = 0.028, 0.014 and 0.030, respectively). The best model for predicting survival without severe brain damage in infants born at 24 gestational weeks was based on 5-min Apgar score and birth type. The small number of live-born infants at 23 weeks of gestation did not allow for multiple logistic regression analyses. CONCLUSION: The 5-min Apgar score is associated with short-term outcome in live-born infants at 23-24 gestational weeks. The association is stronger for infants born at 24 weeks of gestation.
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| 23. |
- Frändin, Kerstin, et al.
(författare)
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A Nordic multi-center study on physical and daily activities for residents in nursing home settings : design of a randomized, controlled trial
- 2009
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 21:4-5, s. 314-322
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Nursing home residents constitute a frail, multi-diseased and heterogeneous group. As physical activity is essential for the preservation of function, personalized training and activities are of great importance, The main objective of this study was to describe the influence of an individually tailored intervention program, in a nursing home setting, on physical capacity, degree of dependence in Activities of Daily Living (ADL), long-term participation in physical and/or daily activities, and self-rated wellbeing. The aim of the present work is to describe the overall design of the study. Methods: Nursing homes in Sweden, Norway and Denmark were involved, and 322 residents were randomized to either Intervention or Control groups. The intervention lasted for three months and consisted of physical and daily activities, led by physiotherapists and occupational therapists, and was built on their evaluations and on the goals expressed by each resident. Tests of muscle strength, mobility, balance function and confidence, ADL, level of physical activity, wellbeing and cognitive function were performed at baseline, directly after the intervention period and three months later. Results: They will be presented in articles to follow. Conclusions: Although it is a great challenge to carry out an intervention study directed toward such a frail population, it is of great interest to find out whether individually tailored and enhanced activities can lead to decreased dependence in ADL and increased wellbeing.
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| 24. |
- Grövdal, Michael, et al.
(författare)
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Negative effect of DNA hypermethylation on the outcome of intensive chemotherapy in older patients with high-risk myelodysplastic syndromes and acute myeloid leukemia following myelodysplastic syndrome
- 2007
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Ingår i: Clinical Cancer Research. - 1078-0432 .- 1557-3265. ; 13:23, s. 7107-7112
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Promoter hypermethylation of, for example, tumor-suppressor genes, is considered to be an important step in cancerogenesis and a negative risk factor for survival in patients with myelodysplastic syndromes (MDS); however, its role for response to therapy has not been determined. This study was designed to assess the effect of methylation status on the outcome of conventional induction chemotherapy. EXPERIMENTAL DESIGN: Sixty patients with high-risk MDS or acute myeloid leukemia following MDS were treated with standard doses of daunorubicin and 1-beta-d-arabinofuranosylcytosine. Standard prognostic variables and methylation status of the P15(ink4b) (P15), E-cadherin (CDH), and hypermethylated in cancer 1 (HIC) genes were analyzed before treatment. RESULTS: Forty percent of the patients achieved complete remission (CR). CR rate was lower in patients with high WBC counts (P = 0.03) and high CD34 expression on bone marrow cells (P = 0.02). Whereas P15 status alone was not significantly associated with CR rate (P = 0.25), no patient with hypermethylation of all three genes achieved CR (P = 0.03). Moreover, patients with CDH methylation showed a significantly lower CR rate (P = 0.008), and CDH methylation retained its prognostic value also in the multivariate analysis. Hypermethylation was associated with increased CD34 expression, but not with other known predictive factors for response, such as cytogenetic profile. CONCLUSIONS: We show for the first time a significant effect of methylation status on the outcome of conventional chemotherapy in high-risk MDS and acute myelogenous leukemia following MDS. Provided confirmed in an independent study, our results should be used as a basis for therapeutic decision-making in this patient group.
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| 25. |
- Gunnarsson Mériaux, Benita, 1965, et al.
(författare)
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Identification and follow-up of obesity in ten-year-old school children.
- 2008
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Ingår i: International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity. - : Informa UK Limited. - 1747-7174. ; 3:2, s. 102-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Growth surveillance of children in school health services is a routine in Sweden. We describe the effect at follow-up of an overt identification of obesity in school children. METHODS: Follow-up data were collected in two populations of ten-year-old children with obesity. Children in the study group belonged to a cohort born in 1990. Here the presence of obesity had been identified at the routine growth screening, and intervention activities against obesity had been actively offered. Controls belonged to a cohort born in 1989. RESULTS: Of the 176 children with obesity, 91 were in the study group (41 girls) and 85 (44 girls) in the control group. No differences were found between the groups in age, gender or body mass index at baseline. At follow-up, after one to two years, children in the study group had a modest but significantly more pronounced decrease in the relative body mass index, compared with controls. The mean difference between the populations in body mass index standard deviation score (z-score) after adjustment for baseline body mass index and follow-up time was -0.14 (95% confidence interval: -0.25 to -0.02; P=0.027). Socioeconomic status, gender, follow-up time and group were independent predictors for change in body mass index z-score. CONCLUSIONS: To identify children with obesity in a routine school health survey may be a crucial initial step in the management of childhood obesity.
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| 26. |
- Hagwall, N., et al.
(författare)
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Periventricular leukomalacia and retinopathy in a term infant born to a mother with asthma
- 2006
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Ingår i: Dev Med Child Neurol. ; 48:4, s. 301-3
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Tidskriftsartikel (refereegranskat)abstract
- A male child, born at 37+5 gestational weeks (GWs) (birthweight 2000g) after intrauterine growth retardation (IUG; -3 SD), to a mother treated during pregnancy for asthma, developed periventricular leukomalacia and retinopathy with total retinal detachment in the left eye and partial detachment in the right eye. Apart from basic asthma treatment with terbutalin, budesonid, and fenoterolhydrobromid throughout the pregnancy, she was treated with intravenous or oral cortisone for 6.5 weeks from 28+5 GWs. In addition she developed deep venous thrombosis at 29 GWs and was treated with heparin until delivery. Psychotic symptoms during the 31st GW were treated with diazepam, haloperidol, and levomepromazin. Functional sequelae for the child were visual impairment (visual acuity 5/60), uneven intellectual profile (Wechsler Pre-school and Primary Scale of Intelligence, Verbal IQ 94 and Performance IQ 32 at 8y of age), and autistic-like behaviour. The possibility that pre- and perinatal risk factors (e.g. severe maternal illness, IUGR, and cortisone treatment) in a term infant may create conditions for developing eye and brain pathologies commonly closely related to preterm birth should be considered.
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| 27. |
- Hellström, Ann, 1959, et al.
(författare)
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Early weight gain predicts retinopathy in preterm infants: new, simple, efficient approach to screening
- 2009
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Ingår i: Pediatrics. - 1098-4275. ; 123:4, s. 638-645
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The risk for sight-threatening retinopathy of prematurity is predicted by using gestational age and/or weight at birth. All infants below a threshold undergo serial ophthalmologic examinations for identification of those who would benefit from treatment (approximately 10%). We hypothesized that factoring in postnatal weight gain could identify children at risk for sight-threatening retinopathy of prematurity more specifically and earlier. METHODS: Weekly weights from birth to postmenstrual week 36 were retrospectively entered into a surveillance system that gave an alarm when the rate of weight gain decreased to a certain level. For all children (N = 354) screened and/or treated for retinopathy of prematurity at Sahlgrenska University Hospital in 2004-2007, weekly weights were recorded. One child was excluded because of known nonphysiologic weight gain (hydrocephalus). RESULTS: For 127 (36%) of 353 children, no alarm was given; for 40%, alarm at low risk was given after postmenstrual week 32. None of those children developed retinopathy of prematurity requiring treatment. Of the remaining 24% of children who received alarm at high or low risk before 32 postmenstrual weeks, 41% developed proliferative retinopathy of prematurity and 29% were treated because of sight-threatening disease. The median time from alarm to treatment was 9 weeks. CONCLUSIONS: The weight, insulin-like growth factor, neonatal retinopathy of prematurity algorithm detected early 100% of infants who developed retinopathy of prematurity requiring treatment and correctly predicted the majority who did not require treatment. With this simple postnatal evaluation, costly stressful eye examinations can be markedly reduced (approximately 75% of infants). In addition, early identification of children at risk may lead to the initiation of interventions and possibly prevent sight-threatening retinopathy of prematurity.
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| 28. |
- Hellström, Anna-Lena, 1946
(författare)
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Enures och blåsstörningar
- 2008
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Ingår i: Pediatrisk vård och specifik omvårdnad, Marie Edwinson Månsson & Karin Enskär (red.). - : Studentlitteratur. - 9789144019918
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 29. |
- Hellström, Anna-Lena, 1946, et al.
(författare)
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Feeling good in daily life: from the point of view of boys with posterior urethral valves
- 2006
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Ingår i: J Urol. - 0022-5347. ; 176:4 Pt 2, s. 1742-6
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We determined what is important to feel good in daily life when living with a long-term illness that requires daily treatment routines. MATERIALS AND METHODS: Seven boys between 6 and 16 years old who were born with posterior urethral valves narrated their experiences with daily life. They were on clean intermittent catheterization, had impaired renal function and 2 had undergone transplantation. RESULTS: Being involved in decisions about themselves was important, as was having their own doctor and nurse. Friends were important. Clean intermittent catheterization was something that worried them in relation to friends and made them feel uncertain about how they would react to it. The boys accepted the catheterization procedure as something that had to be done but they needed strategies to be able to comply. A single event, such as no available toilet, was enough to interrupt treatment. CONCLUSIONS: In these boys prescribed treatment was a surprisingly small part of their lives. The clean intermittent catheterization routine was sometimes experienced as an obstacle in company with friends. The new challenge might be to achieve compliance with the treatment routine in daily life in a long-term perspective.
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| 30. |
- Hellström, Ann, 1959, et al.
(författare)
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Synproblem
- 2008
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Ingår i: Neonatologi.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 31. |
- Hellström, J. Gunnar I., et al.
(författare)
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Flow through a hexagonal array of perturbed spheres at low to high Reynolds number
- 2007
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Ingår i: Abstracts of the Second International Conference on Porous Media and its Applications in Science, Engineering and Industry. - : Engineering Conferences International.
-
Konferensbidrag (refereegranskat)abstract
- When performing numerical simulations of fluid flow through porous media it is necessary to know when to switch from a creeping flow formulation to a more elaborate laminar description. In the creeping flow regime the Darcy law is sufficient while when inertia-effects become significant it is necessarily to use the full Navier-Stokes equations or at least add a non-linear term to Darcy's law as done in the empirically derived Ergun equation. The latter equation has also turned out to be valid for turbulent flows. It is however not obvious which equation to use at a certain Reynolds number. In order to solve this problem Computational Fluid Dynamics is used to derive the apparent permeability of a hexagonal packed array of spheres. In addition the forces acting on the spheres are derived when a perturbation in the form of a spherically shaped particle is introduced in the pore space. Then simulations are performed at various Reynolds number ranging from the creeping flow region to moderate Reynolds number flows. The simulations are carried out with the commercially available software, ANSYS CFX 11.0, with a particular effort on grid refinement and numerical iteration in order to secure that the errors are sufficiently small. One result is that inertia effects become important already at Reynolds number about 5 for as well the array as the perturbed geometry. As the particle radius increases the shear and normal forces per unit area decreases. In general, these forces increase with Reynolds number. The simulations however show that for some cases the normal forces per unit area decreases and even change sign as Reynolds number increases.
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| 32. |
- Hellström, J. Gunnar I., et al.
(författare)
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Forces on grains located in model geometry with application to internal erosion in embankment dams
- 2007
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Ingår i: International Symposium on Modern Technology of Dams. ; , s. 375-386
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Konferensbidrag (refereegranskat)abstract
- For a comprehensive understanding of internal erosion in embankment dams it is necessary to elucidate the detailed seepage flow. A neat tool that can be used for this purpose is Computational Fluid Dynamics. With such a tool forces on individual particles can be derived and means to decide when to switch from a creeping flow formulation to a more elaborate laminar description for macroscopic flow simulations can be derived. It can even be decided when the transition from a laminar formulation to a fully turbulent description should take place. In the creeping flow regime a Darcy law formulation is sufficient while when inertia-effects become significant it is necessary to use the Navier-Stokes equations or at least add a non-linear term to Darcy's law as done in the empirically derived Ergun equation. It is, however, not obvious which equation to use at a certain Reynolds number. Hence, Computational Fluid Dynamics is here used to derive the apparent permeability of a hexagonal packed array of spheres. Then, grains are introduced in the pore space between the spheres and forces acting on the grains are derived. It will then be possible to decide at what conditions such particles will start to move, due to flow induced forces, and thereby initiating internal erosion. The simulations are performed at various Reynolds number ranging from the creeping flow region to the transition regime. The software ANSYS CFX 11.0 is applied with particular effort on grid refinement and numerical iteration in order to secure that the numerical errors are sufficiently small. One result is that inertia-effects become important already at a Reynolds number of 10. Another is that the forces acting on the grains can decrease as a function of Reynolds number and can as well be dependent on the geometry of the grains, even though the force per unit area on the array of spheres increases. Interestingly, the direction of the forces on the grains can even be opposite to the main flow direction.
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| 33. |
- Hellström, Lena
(författare)
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Images of places : designing rural identity and hospitality
- 2008
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Ingår i: Culinary arts and sciences VI. - Stavanger : The Worshipful Company of Cooks, University of Stavanger and Norwegian School of Hotel Management. - 8276442943 ; , s. 223-226
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 34. |
- Hellström, Lena
(författare)
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Mjöl, salt, vatten och eld
- 2007
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Ingår i: Den medvetna måltidskunskapen. - Örebro : Örebro universitet. - 9789176685464 ; , s. 99-108
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 35. |
- Hellström, Martin, 1979-
(författare)
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Hyaluronan and the receptor CD 44 in the heart and vessels : a study in normal and pathological conditions
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Tissues are not solely composed of cells. The extracellular matrix is important for the cell well-being and cell-cell communication. The glycosaminoglycan hyaluronan (HYA) is a widely distributed extracellular matrix (ECM) component. The molecule has prominent physicochemical properties, foremost viscoelastic and osmotic, but participates in many biological processes such as cell migration, proliferation, tissue turnover, wound healing and angiogenesis. HYA is synthesised by either of three different hyaluronan-synthesising enzymes, HAS1-3, and its main ligand is the transmembrane receptor CD44. In the heart and vessels the matrix components are of great importance for endurance and elasticity which are prerequisites for a normal function. The aims of the study were to describe the distribution of HYA and its receptor CD44 in normal cardiovascular tissue and to investigate the ECM composition in myocardial hypertrophy. Normal conditions were studied in a rat model. These studies showed that the tunica adventitia in almost all vessels stained strongly for HYA. The expression in the tunica intima and media on the venous side, differed between the vessels and was almost absent on the arterial side. In the adult animals only minute amounts of CD44 were detected. The expression of both HYA and CD44 was increased in newborn rats. In the heart HYA was unevenly distributed in the interstitium. Strong HYA-staining was seen in the valves and in the adventitia of intramyocardial vessels. Almost no CD44-staining was observed. Notably, there was no obvious difference between newborn and adult animals. In an experimental rat model of pressure-induced cardiac hypertrophy the mRNA-levels of HAS1, HAS2, CD44, basic Fibroblast Growth Factor (FGF-2) and Fibroblast Growth Factor Receptor-1 (FGFR-1) were elevated on day 1 after aortic banding. HAS2, CD44 and FGFR-1 were at basal levels on day 42. The HYA-concentration was significally elevated on day 1. HYA was detected in the interstitium by histochemistry and CD44 was detected mainly in and around the intramyocardial vessels. The HYA-staining was increased in myectomi specimens from patients with HCM compared to controls. HYA was detected in the interstitium, in fibrous septas and in the adventitia of intramyocardial vessels. No CD44 was detected in HCM or in control specimens. Our results indicate that HYA and CD44 play an active role in the maturing vessel tree and that the ECM content of HYA is increased in experimental myocardial hypertrophy and human hypertrophic cardiomyopathy.
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| 36. |
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| 37. |
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| 38. |
- Hellström-Westas, Lena, et al.
(författare)
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Continuous brain-function monitoring: State of the art in clinical practice.
- 2006
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Ingår i: Seminars in Fetal & Neonatal Medicine. - : Elsevier BV. - 1878-0946 .- 1744-165X. ; 11, s. 503-511
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Tidskriftsartikel (refereegranskat)abstract
- Continuous electroencephalographic (EEG) monitoring gives direct information on brain function in newborn infants needing intensive care. To improve the possibilities of long-term monitoring, the EEG is time-compressed and recorded with a reduced number of electrodes. A trend measure of the EEG, the amptitude-integrated EEG (aEEG), has proved capable of giving relevant information in newborn infants of differing levels of maturity. The electrocortical background activity gives information on the level of brain activity, which is associated with outcome in both term asphyxiated infants and in preterm infants. However, the background activity is also affected by several medications, and this must be considered when interpreting the aEEG trace. The aEEG also reveals subclinical epileptic seizure activity, and can be used for evaluation of anti-epileptic treatment. The aEEG should be used as a complement to the standard EEG, and close collaboration between neonatologists and clinical neurophysiologists is necessary for optimal performance of EEG monitoring.
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| 39. |
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| 40. |
- Hellström-Westas, Lena, et al.
(författare)
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Earlier Apgar score increase in severely depressed term infants cared for in Swedish level III units with 40% oxygen versus 100% oxygen resuscitation strategies: a population-based register study.
- 2006
-
Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 118:6, s. 1798-1804
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES. The aim of this study was to evaluate whether a resuscitation strategy based on administration of 40% oxygen influences mortality rates and rates of improvement in 5-minute Apgar scores, compared with a strategy based on 100% oxygen administration. METHODS. A population-based study evaluated data from 4 Swedish perinatal level III centers during the period of 1998 to 2003. During this period, the centers used either of 2 resuscitation strategies (initial oxygen administration of 40% or 100%). Live-born, singleton, term infants with 1-minute Apgar scores of < 4, with a birth weight appropriate for gestational age, and without major malformations were included in the study (n = 1223). RESULTS. Infants born in hospitals using a 40% oxygen strategy had a more rapid Apgar score increase than did infants born in hospitals using a 100% oxygen strategy; however, no difference remained at 10 minutes. The mean Apgar score increased from 2.01 at 1 minute to 6.74 at 5 minutes in the 2 hospitals initiating resuscitation with 40% oxygen, compared with 2.01 to 6.38 in the 2 hospitals using 100% oxygen, with a mean difference in Apgar score increases of 0.36. At 5 minutes, 44.3% of infants born in the hospitals using 100% oxygen had an Apgar score of < 7, compared with 34.0% of infants at the hospitals using 40% oxygen. At 10 minutes, the mean Apgar scores were 8.16 at the hospitals using 40% oxygen and 8.07 at the hospitals using 100% oxygen. There were no significant differences in rates of neonatal death, hypoxic ischemic encephalopathy, or seizures in relation to the 2 oxygen strategies. CONCLUSION. Severely depressed term infants born in hospitals initiating resuscitation with 40% oxygen had earlier Apgar score recovery than did infants born in hospitals using a 100% oxygen strategy.
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| 41. |
- Hellström-Westas, Lena, et al.
(författare)
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Electroencephalography and brain damage in preterm infants.
- 2005
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Ingår i: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 81:3, s. 255-261
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Tidskriftsartikel (refereegranskat)abstract
- Electroencephalography (EEG) is a sensitive method for detection of brain injury in preterm infants. Although the acute and chronic EEG changes are mainly non-specific regarding type of injury, they correlate with later neurological and cognitive function. In infants developing periventricular hemorrhagic or ischemic brain injury, acute EEG findings include depression of background activity and presence of epileptic seizure activity. The chronic EEG changes associated with white matter injury and abnormal neurological development include delayed maturation, and presence of abundant rolandic sharp waves. Suboptimal cognitive development in preterm infants has been associated with changes in various sleep measures in EEG’s recorded at full term. Continuous EEG-monitoring during neonatal intensive care shows that cerebral electrical activity during this vulnerable period can be affected by several extracerebral factors, e.g. cerebral blood flow, acidosis and some commonly used medications. For diagnosis of brain injury in preterm infants with neurophysiological methods, a combination of early continuous EEG monitoring during the initial intensive care period and full EEG, performed at later stages, is probably optimal.
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| 42. |
- Hellström-Westas, Lena
(författare)
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Hypotermi efter perinatal asfyxi minskar risken för hjärnskada. Men för tidigt att rekommendera rutinmässig behandling
- 2005
-
Ingår i: Läkartidningen. - 0023-7205. ; 102:42, s. 1-3030
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Tidskriftsartikel (refereegranskat)abstract
- Two randomised controlled trials evaluating intervention with moderate hypothermia after perinatal asphyxia will probably be published this year. The first study, evaluating head cooling with a "cool cap" is already published, and preliminary data from the other study evaluating body cooling earlier have been presented. Both studies indicate that moderate hypothermia, initiated within 6 h after birth, for 72 h reduces mortality and survival with severe brain injury. Several issues must, however, be solved before postasphyctic cooling can be recommended as clinical routine. There are no data on optimal duration, degree of cooling, best method, or if methods and degree of cooling should be adapted to type of brain injury. Continued research with randomised controlled trials is recommended.
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| 43. |
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| 44. |
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| 45. |
- Hernandez-Andrade, Edgar, et al.
(författare)
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Perinatal adaptive response of the adrenal and carotid blood flow in sheep fetuses subjected to total cord occlusion
- 2005
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Ingår i: Journal of Maternal-Fetal & Neonatal Medicine. - 1476-7058. ; 17:2, s. 101-109
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate the perinatal adaptive response of the adrenal blood flow/adrenal fractional moving blood volume (AFMBV) and carotid blood flow (CBF), in sheep fetuses subjected to severe acute intrauterine hypoxia/asphyxia induced by total cord occlusion.Methods. Adrenal blood flow velocity, AFMBV and CBF were measured in 13 exteriorized fetal sheep; eight of them underwent total umbilical cord occlusion to induce severe acute hypoxia/asphyxia. Five lambs were used as sham controls. Middle adrenal artery pulsatility index (MAAPI) and mean velocity (MAAMV) were recorded with pulsed Doppler ultrasound. AFMBV was estimated using power Doppler ultrasound. CBF was recorded with a transonic flowmeter. In the neonatal period, after resuscitation all lambs were followed for a 4-hour period and AFMBV and CBF were recorded. Mean arterial blood pressure (MABP) and fetal heart rate were recorded continuously. Arterial cortisol levels were measured at the beginning and at the end of the fetal and neonatal periods.Results. Following the total cord occlusion, there was a significant reduction in the CBF, MABP, and heart rate and adrenal flow/AFMBV after 2, 4 and 5?min, respectively. Cortisol levels in the asphyctic lambs at the end of the cord occlusion were significantly lower than those in controls. After resuscitation, the asphyctic lambs showed increased AFMBV and cortisol levels, and reduced MABP as compared to control lambs. No differences were found in CBF, MAAPI and MAAMV. Thereafter, no differences were observed between the two groups in any of the studied parameters. At the end of the cord occlusion period, there was a significant correlation between AFMBV and MABP (r?=?0.69), between AFMBV and CBF (r?=?0.65) and between CBF and MABP (r?=?0.89).Conclusion. During severe acute intrauterine hypoxia, the fetal lamb is able to maintain the blood flow to the brain and the adrenal gland for 3-5?min. Changes in the AFMBV and the CBF were highly correlated to the changes in MABP. Adrenal FMBV and cortisol levels were higher in lamb neonates exposed to severe intrauterine asphyxia.
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| 46. |
- Holmdahl, Gundela, 1956, et al.
(författare)
-
Self-catheterization during adolescence.
- 2007
-
Ingår i: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:3, s. 214-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: It has been suggested that clean intermittent catheterization (CIC) during the teenage years is associated with poor motivation to comply with the treatment, recurrent urinary tract infections and epididymitis. The aim of this study was to identify the main problems and complications associated with self-CIC in a group of adolescents with no overt neurological problems. MATERIAL AND METHODS: The medical records of 24 boys and girls aged >/=12 years on self-CIC with severe bladder dysfunction and intact perineal sensibility and motor function in the lower limbs were reviewed. The median age of the patients was 16.5 years (range 12-24 years) and they had been on CIC for a median of 11 years (range 2-16 years). RESULTS: No urethral damage was reported. Of the 11 patients (46%) who had good CIC routines, two had cystitis and none had epididymitis. Thirteen patients (54%) reported a poor CIC regimen at a median age of 11.5 years (range 9-16 years). In this group, 10 had recurrent cystitis, five had pyelonephritis, four had increasing creatinine levels and three of nine boys had epididymitis. CONCLUSIONS: One of the main problems associated with CIC during adolescence is poor compliance with the treatment. Epididymitis and recurrent urinary tract infections were seen more frequently in connection with poor CIC routines.
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| 47. |
- Hård, Anna-Lena, 1949, et al.
(författare)
-
Ophthalmological follow-up at 2 years of age of all children previously screened for retinopathy of prematurity: is it worthwhile?
- 2006
-
Ingår i: Acta Ophthalmol Scand. - : Wiley. - 1395-3907. ; 84:5, s. 631-5
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the extent to which ophthalmological follow-up at 2 years of age of children born before 32 weeks gestation identifies obvious visual problems, strabismus and significant ametropia (target conditions). METHODS: Of 172 children born during a period of 2.5 years from January 2000, 142 underwent an ophthalmological examination at a median age of 2.33 years. This included evaluation of visual behaviour, cover testing and autorefractometry in cycloplegia. For children with the target conditions, we investigated whether the child had been followed in the eye clinic or referred before 2 years of age, or whether the abnormality was detected as a result of the follow-up examination. RESULTS: None of the target conditions were found in 117 children. None of four children with obviously abnormal visual behaviour, two of 10 children with strabismus and four of 11 with large refractive errors were detected in the follow-up examination. Thus the target conditions were detected at the follow-up examination in only six of 142 children (4.2%). CONCLUSIONS: Although ophthalmic abnormalities are common in children born prematurely, most of them are identified because high-risk children are followed regularly in eye clinics and because parents and primary health care personnel detect strabismus. Ophthalmological follow-up of all children born before 32 weeks appears not to be worthwhile and is therefore only recommended for high-risk children.
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| 48. |
- Hård, Anna-Lena, 1949, et al.
(författare)
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Severe ROP in twins after blockage of the renin-angiotensin system during gestation.
- 2008
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253 .- 1651-2227. ; 97:8, s. 1142-4
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Tidskriftsartikel (refereegranskat)abstract
- Blockage of the renin-angiotensin system (RAS) during pregnancy is known to cause serious dysfunction of many organs of the foetus and newborn. Angiotensin II is an angiogenic factor and angiotensin-converting enzyme (ACE) inhibitors prevent retinal neovascularisation and their use in preventing proliferative retinopathy of prematurity has been suggested. We report on twin girls born after 32 gestational weeks, who were exposed to blockage of the RAS during gestation, had severely reduced retinal vasculature and developed severe retinopathy of prematurity (ROP) despite receiving very little extra oxygen. CONCLUSION: It is likely that ACE inhibitors and angiotensin receptor blockers not only reduce pathological neovascularisation but also normal vascularisation of the eyes and other organs.
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| 49. |
- Jangsten, Elisabeth, 1954, et al.
(författare)
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Women's perceptions of pain and discomfort after childbirth in Angola.
- 2005
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Ingår i: African journal of reproductive health. - 1118-4841. ; 9:3, s. 148-58
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Tidskriftsartikel (refereegranskat)abstract
- Prophylactic treatment against postpartum haemorrhage is a widely investigated area and injection of Oxytocics has been considered as the best choice. The occurrence of postpartum pain and discomfort was studied in a population of birthing women in an overcrowded labour ward in Angola where the oxytocin-filled device Uniject was used. This study indicates that birthing women's perceived postpartum pain increases with parity and during breastfeeding, but does not confirm that injection of oxytocin increases pain and discomfort. This is an important finding, since it might facilitate the introduction of a management practice, likely to reduce haemorrhage-related maternal morbidity and mortality after delivery in underprivileged populations. The birthing women were, by and large, satisfied with the care and treatment provided, but the encounters with midwives seem to vary in quality. Further investigation is needed to elucidate parturient women's experience of postpartum pain and their perceptions of the quality of care and treatment.
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| 50. |
- Jansson, Ulla-Britt, 1950, et al.
(författare)
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Life events and their impact on bladder control in children.
- 2007
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 3:3, s. 171-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the relationship between incidence and nature of life events within families and age of bladder control acquisition in healthy children. SUBJECTS AND METHODS: Thirty-five parents of 36, 6-year-old children were interviewed using the Coddington life events questionnaire. RESULTS: The children had experienced a total of 185 life events (mean 5, median 4.5, range 1-12) before the time of dryness. The most common were related to childcare/occupation of parent (51%), illness/injury/death (24%), family composition (16%) and living conditions (9%). There was a strong correlation between the number of life events and the age of dryness; the more life events and the older the child was when experiencing them, the later the child became dry. The only single event that was significantly associated with a later age of dryness was the birth of a sister or brother. In general, children had reacted positively (39%) or neutrally, but to 30% of events there was a negative reaction. There was a correlation between the reaction of the child and adaptation to the life event, and if the child had difficulty adapting to an event, that child became day dry at a later age. CONCLUSION: Although life events are a natural part of daily life, this study supports the conclusion that a large number of events and events to which the child has difficulty adapting can be of importance for the age of acquisition of bladder control.
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