| 31. |
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| 32. |
- Mörse, Helena, et al.
(författare)
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Acute onset of ovarian dysfunction in young females after start of cancer treatment.
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 60:4, s. 676-681
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors. PROCEDURE: Thirty-four consecutive female cancer patients aged 0-18 year were included after informed consent. Serum/Plasma levels of anti-Müllerian hormone (AMH), inhibin B, FSH, LH, and oestradiol (E2) were measured at diagnosis and every 3-4 months during and after treatment. RESULTS: All patients had detectable AMH levels at diagnosis. Eleven patients had reached menarche (mean age 14½ years) and the remaining patients had a mean age of 6½ years. They all showed a rapid decline in AMH after 3 months of treatment, regardless of AMH at diagnosis, age, menarche, or treatment given. Those given radiotherapy below the diaphragm and/or stem cell transplantation (SCT) (n = 9) had no ovarian recovery during or 1½-year after treatment. However, recovery was observed in those given standard treatment for acute lymphatic leukemia (n = 7) already during maintenance chemotherapy. For the remaining patients, longer follow-up is required for analysis of ovarian recovery after treatment. CONCLUSIONS: Rapid ovarian dysfunction is observed in all females after initiation of cancer treatment as measured by AMH and inhibin B. Our data regarding those who require abdominal radiotherapy and/or SCT confirms the recommendations in the Nordic countries where these patients are eligible for cryopreservation of ovarian cortical tissue before start of cancer treatment. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc.
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| 33. |
- Mörse, Helena, et al.
(författare)
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Reliability of AMH in Serum after Long-term Storage at -80°C and an Extended Thawing Episode
- 2016
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Ingår i: Annals of Clinical and Laboratory Research. - 2386-5180. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Measurement of anti-Müllerian hormone (AMH) is a valuable clinical tool for evaluating ovarian function. The present study aims to evaluate the reliability of AMH measurements obtained from samples kept for long-term storage with or without intermittent thawing.Methods and findings: Serum samples from 35 young female cancer patients were prospectively collected and stored at -80°C from 2007 until 2010. In 2011, AMH was analyzed with the DSL assay. During storage, the samples were exposed to a freezer error in 2013 that resulted in their being thawed up to 11°C for a maximum of 21 days and then refrozen. In 2014, the same samples (new aliquots) were analyzed with the Ansh-AMH assay. To test the reliability of the results from 2014, we conducted a thawing experiment on serum samples from 10 randomly selected females and compared the Ansh-AMH results for samples stored in a freezer with aliquots from the same samples that were stored at 11°C for 1, 3, 7, 14, and 21 days, respectively. Average AMH levels were 1.6 times higher when assayed with the Ansh-AMH compared with the DSL-AMH, which is in line with reported agreement between these types of assays. The same difference between the assays was found in samples that differed two years in storage time. The Ansh-AMH levels from ten serum samples without long-term storage were not influenced by exposure to 11°C for up to 21 days.Conclusions: The results indicate that long-term storage at -80°C and episodes of thawing have little impact on AMH levels analyzed with current methods. These data are reassuring and enable longitudinal studies to be planned that will analyze all collected serum samples simultaneously.
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| 34. |
- Mörse, Helena, et al.
(författare)
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Severe gonadotoxic insult manifests early in young girls treated for Ewing sarcoma
- 2016
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Ingår i: Medicine. - 0025-7974. ; 95:33
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Tidskriftsartikel (refereegranskat)abstract
- We prospectively investigated anti-Müllerian hormone (AMH) as a measure of ovarian insult in young females during and after treatment for Wilms tumor (WT), osteosarcoma (OS), and Ewing sarcoma (ES). Twenty-one female childhood cancer patients, with a mean age of 7.9 years (range 0.6-17), entered the study. Levels of AMH, follicle-stimulating hormone (FSH), and luteinizing hormone were monitored at diagnosis and every 3 to 4 months during, and regularly for a mean of 2.6 years after treatment. A profound decline in AMH was seen in the majority of the 21 study patients 3 to 4 months after the beginning of treatment, the exception being patients with WT, of whom 60% showed no such decline. During the remaining treatment, all patients except those with WT not treated with whole abdominal radiotherapy or stem cell transplantation (SCT) had AMH below detection limit. After completion of treatment, patients with OS and WT (without whole abdominal radiotherapy and SCT) recovered in AMH and had FSH in the normal range. In contrast, ES patients showed no AMH recovery and highly fluctuating FSH in the first years of follow-up, except for the 2 youngest patients, who had a late, slow AMH recovery. In conclusion, young female ES patients already showed signs of severe ovarian dysfunction during the first years after cancer treatment similar to patients treated with SCT and abdominal radiotherapy, in contrast to females with WT and OS. Fertility counseling and information concerning fertility preservation procedures should be considered before starting to treat young females with ES.
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| 35. |
- Netterlid, Axel, et al.
(författare)
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Premature ovarian failure after childhood cancer and risk of metabolic syndrome : A cross-sectional analysis
- 2021
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Ingår i: European Journal of Endocrinology. - 0804-4643. ; 185:1, s. 67-75
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Female childhood cancer survivors (CCS) are at risk of several late effects, such as metabolic syndrome (MetS) and premature ovarian insufficiency (POI). The objective is to study if POI is associated with risk of MetS and increased cardiovascular risk in CSS. Design: A cross-sectional study with a median time since the cancer diagnosis of 25 (12-41) years. Patients and controls were recruited from the South Medical Region of Sweden. Methods: The study included 167 female CCS, median age 34 (19-57) years, diagnosed with childhood cancer at median age 8.4 (0.1-17.9) years together with 164 controls, matched for age, sex, ethnicity, residence, and smoking habits. All subjects were examined with fasting glucose, insulin, HbA1c, and lipid profile. Fat mass was calculated with dual-energy X-ray absorptiometry (DXA), and questionnaires for medication were obtained. Detailed information of cancer treatment was available. Results: POI was present in 13% (22/167) among CCS (hypothalamic/pituitary cause excluded) and in none among controls. MetS was present in 14% (24/167) among all CCS (P = 0.001), in 23% (5/22) of those with POI (P < 0.001), compared with 4% (6/164) among controls. OR for MetS in all CCS compared with controls was 4.4 (95% CI: 1.8, 11.1) (P = 0.002) and among CCS with POI the OR was 7.7 (CI: 2.1, 28.1) (P = 0.002). Conclusion: The prevalence of MetS was higher in females treated for childhood cancer compared with controls, and the presence of POI significantly increased the risk of developing MetS.
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| 36. |
- Orfanos, Ioannis, et al.
(författare)
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Age- and sex-specific prevalence of serious bacterial infections in febrile infants <= 60 days, in Sweden
- 2021
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:11, s. 3069-3076
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of the study was to describe age- and sex-specific prevalence of serious bacterial infections (SBI: urinary tract infection, bacteraemia, meningitis) among febrile infants <= 60 days in Sweden. Methods This is a retrospective study in 4 Pediatric Emergency Departments from 2014 to 2017, in previously healthy, full-term infants <= 60 days with fever without a source. Results Of the 1,701 included infants, 214 (12.6%; 95% CI, 11.1-14.3) had an SBI. Urinary tract infection (UTI) was diagnosed in 196 (11.5%; 95% CI, 10.0-13.1) patients. In the <= 28 and 29-60 days age-groups, meningitis prevalence was 0.9% (95% CI, 0.3-2.0) and 0.3% (95% CI, 0.1-0.8), whereas bacteraemia prevalence was 3.2% (95% CI, 1.9-4.9) and 0.6% (95% CI, 0.2-1.3). The SBI prevalence was higher in boys 16.0% (95% CI, 13.8-18.5) than girls 8.0% (95% CI, 6.2-10.2; p<0.001), due to 2-fold higher UTI risk. The prevalence of meningitis in boys was 0.3% (95% CI, 0.1- 0.9) vs. 0.7% (95% CI, 0.2-1.6) in girls and of bacteraemia 1.8% (95% CI, 1.0-2.8) vs. 1.0% (95% CI, 0.4-2.0), respectively. Conclusions The total SBI prevalence was 12.6%, and UTI represented the vast majority. The prevalence of bacteraemia and meningitis was low, particularly in the 29-60 days age group, without significant difference between boys and girls.
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| 37. |
- Rignell-Hydbom, Anna, et al.
(författare)
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A nested case-control study of intrauterine exposure to persistent organochlorine pollutants in relation to risk of type 1 diabetes.
- 2010
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The incidence of type 1 diabetes in Europe is increasing at a rate of about 3% per year and there is also an increasing incidence throughout the world. Type 1 diabetes is a complex disease caused by multiple genetic and environmental factors. Persistent organochlorine pollutants (POPs) have been suggested as a triggering factor for developing childhood type 1 diabetes. The aim of this case-control study was to assess possible impacts of in utero exposure to POPs on type 1 diabetes. METHODOLOGY/ PRINCIPAL FINDINGS: The study was performed as a case-control study within a biobank in Malmö, a city located in the Southern part of Sweden. The study included 150 cases (children who had their diagnosis mostly before 18 years of age) and 150 controls, matched for gender and day of birth. 2,2',4,4',5,5'-hexachlorobiphenyl (PCB-153) and the major DDT metabolite 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE) were used as a biomarkers for POP exposure. When comparing the quartile with the highest maternal serum concentrations of PCB-153 with the other quartiles, an odds ratio (OR) of 0.73 (95% confidence interval [CI] 0.42, 1.27) was obtained. Similar results was obtained for p,p'-DDE (OR 0.56, 95% CI 0.29, 1.08). CONCLUSIONS: The hypothesis that in utero exposure to POPs will trigger the risk for developing type 1 diabetes was not supported by the results. The risk estimates did, although not statistically significant, go in the opposite direction. However, it is not reasonable to believe that exposure to POPs should protect against type 1 diabetes.
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| 38. |
- Rollof, Lena, et al.
(författare)
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Evaluation of self-assessment of pubertal maturation in boys and girls using drawings and orchidometer.
- 2012
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Ingår i: Journal of Pediatric Endocrinology & Metabolism. - 2191-0251. ; 25:1-2, s. 125-129
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-assessment of puberty has been reported to correlate well with staging by a physician. No previous study has evaluated the use of an orchidometer to assess testicular size in boys. STUDY DESIGN: This study included 44 girls and 56 boys, 10-16 years old, with assessed Tanner staging. The boys also used an orchidometer. The correlation with a professional's staging was analyzed using percentage agreement (PA). RESULTS: For girls, the PA for breast development was 52%, and for pubic hair, 64%. There was no case of the difference being greater than one stage. For boys, the PA for pubic hair was 75%. For testicular volume, the PA was 36%; in 95%, the difference was only one size. CONCLUSIONS: We found pubertal self-assessment, including the use of an orchidometer for boys, to be a useful method. However, if the purpose is to determine exact pubertal onset, the assessment should be made by a trained professional.
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| 39. |
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| 40. |
- Söderström-Fiscella, Hanna, et al.
(författare)
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Vaginal bleeding in prepubertal girls - etiology and clinical management.
- 2015
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Ingår i: Journal of Pediatric and Adolescent Gynecology. - : Elsevier BV. - 1873-4332 .- 1083-3188.
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to investigate the etiology and clinical management of vaginal bleeding in girls aged 0-9 years and to compare our results with previous publications.
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