| 1. |
- Bjellvi, Johan, et al.
(author)
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[Status epilepticus in children and adults]. : Status epilepticus hos barn och vuxna - Orsaken är ofta akut sjukdom – utredning och behandling bör ske parallellt.
- 2018
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In: Lakartidningen. - 1652-7518. ; 115
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Journal article (peer-reviewed)abstract
- Status epilepticus, a condition with prolonged or repeated seizures, is a common neurological emergency with significant morbidity and mortality. This text outlines the treatment and initial work-up for convulsive and non-convulsive status epilepticus in adults and children. The most serious form is convulsive (tonic-clonic) status epilepticus, which requires rapid treatment and work-up. Bensodiazepines are the preferred initial treatment, while antiepileptic drugs and anesthetics are added if seizures continue. For other forms of status epilepticus, the treatment depends on the type of seizures and the patient's general condition. Etiological work-up is essential in any case of status epilepticus. Effective treatment and work-up in status epilepticus requires a defined treatment protocol and multidisciplinary cooperation.
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| 2. |
- Demmelmair, Hans, et al.
(author)
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Benefits of Lactoferrin, Osteopontin and Milk Fat Globule Membranes for Infants
- 2017
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In: Nutrients. - : MDPI AG. - 2072-6643. ; 9:8
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Research review (peer-reviewed)abstract
- The provision of essential and non-essential amino acids for breast-fed infants is the major function of milk proteins. In addition, breast-fed infants might benefit from bioactivities of milk proteins, which are exhibited in the intestine during the digestive phase and by absorption of intact proteins or derived peptides. For lactoferrin, osteopontin and milk fat globule membrane proteins/lipids, which have not until recently been included in substantial amounts in infant formulas, in vitro experiments and animal models provide a convincing base of evidence for bioactivities, which contribute to the protection of the infant from pathogens, improve nutrient absorption, support the development of the immune system and provide components for optimal neurodevelopment. Technologies have become available to obtain these compounds from cow's milk and the bovine compounds also exhibit bioactivities in humans. Randomized clinical trials with experimental infant formulas incorporating lactoferrin, osteopontin, or milk fat globule membranes have already provided some evidence for clinical benefits. This review aims to compare findings from laboratory and animal experiments with outcomes of clinical studies. There is good justification from basic science and there are promising results from clinical studies for beneficial effects of lactoferrin, osteopontin and the milk fat globule membrane complex of proteins and lipids. Further studies should ideally be adequately powered to investigate effects on clinically relevant endpoints in healthy term infants.
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| 3. |
- Domellöf, Erik, et al.
(author)
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Formula feeding supplemented with milk fat globule membranes improves cognitive score in term infants at 12 months
- 2013
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In: Developmental Medicine & Child Neurology, 55 (Suppl. S2). - : Mac Keith Press. - 0012-1622. ; , s. 50-50
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Conference paper (peer-reviewed)abstract
- Introduction: Findings of enhanced cognitive development in breast‐fed compared with formula‐fed infants suggest that breast milk contains neurodevelopmentally beneficial components. Animal studies report positive behavioral effects of supplementation with components included in the bovine milkfat globule membrane fraction (MFGM). Behavioral effects of MFGM supplemented formula in human infants have not been studied. This study tested the hypothesis that infants fed an experimental formula (EF) supplemented with a bovine MFGM fraction would display a more favorable neurofunctional development than infants fed a standard formula (SF) at 12 months.Participants and Methods: Healthy term formula‐fed infants (n = 160) and a breast‐fed reference (BFR) group (n = 80) were included in a prospective double blind randomized trial before 2 months of age. Formula‐fed infants were randomized to receive EF or SF from inclusion until 6 months. At 12 months, cognitive, motor and verbal functions were tested using the Bayley Scales of Infant and Toddler Development‐III.Results: The cognitive score was significantly higher in the EF (105.8 ± 9.2) than SF (101.8 ± 8.0) group, but equal between the EF and BFR groups. No differences were found in motor or verbal score between the formula groups. The BFR group displayed higher verbal but not motor scores than the formula groups.Conclusion: In keeping with the hypothesis, feeding infants MFGM supplemented formula resulted in improved cognitive function at 12 months compared with a standard formula. The difference in cognitive score between the EF and SF groups is compliant with calculated differences between formula‐fed and breast‐fed infants in previous studies.
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| 4. |
- Grip, Tove, et al.
(author)
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Serum, plasma and erythrocyte membrane lipidomes in infants fed formula supplemented with bovine milk fat globule membranes
- 2018
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In: Pediatric Research. - : Nature Publishing Group. - 0031-3998 .- 1530-0447. ; 84:5, s. 726-732
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Journal article (peer-reviewed)abstract
- BACKGROUND: Supplementation of formula with bovine milk fat globule membranes has been shown to narrow the gap in immunological and cognitive development between breast-fed and formula-fed infants.METHOD: In a double-blinded randomized controlled trial 160 formula-fed infants received an experimental formula (EF), supplemented with bovine milk fat globule membranes, or standard formula until 6 months of age. A breast-fed reference group was recruited. Lipidomic analyses were performed on plasma and erythrocyte membranes at 6 months and on serum at 4 and 12 months of age.RESULTS: At 6 months of age, we observed a significant separation in the plasma lipidome between the two formula groups, mostly due to differences in concentrations of sphingomyelins (SM), phosphatidylcholines (PC), and ceramides, and in the erythrocyte membrane lipidome, mostly due to SMs, PEs and PCs. Already at 4 months, a separation in the serum lipidome was evident where SMs and PCs contributed. The separation was not detected at 12 months.CONCLUSIONS: The effect of MFGM supplementation on the lipidome is likely part of the mechanisms behind the positive cognitive and immunological effects of feeding the EF previously reported in the same study population.
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| 5. |
- He, Xuan, et al.
(author)
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Fecal microbiome and metabolome of infants fed bovine MFGM supplemented formula or standard formula with breast-fed infants as reference : a randomized controlled trial
- 2019
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In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 9
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Journal article (peer-reviewed)abstract
- Human milk delivers an array of bioactive components that safeguard infant growth and development and maintain healthy gut microbiota. Milk fat globule membrane (MFGM) is a biologically functional fraction of milk increasingly linked to beneficial outcomes in infants through protection from pathogens, modulation of the immune system and improved neurodevelopment. In the present study, we characterized the fecal microbiome and metabolome of infants fed a bovine MFGM supplemented experimental formula (EF) and compared to infants fed standard formula (SF) and a breast-fed reference group. The impact of MFGM on the fecal microbiome was moderate; however, the fecal metabolome of EF-fed infants showed a significant reduction of several metabolites including lactate, succinate, amino acids and their derivatives from that of infants fed SF. Introduction of weaning food with either human milk or infant formula reduces the distinct characteristics of breast-fed- or formula-fed-like infant fecal microbiome and metabolome profiles. Our findings support the hypothesis that higher levels of protein in infant formula and the lack of human milk oligosaccharides promote a shift toward amino acid fermentation in the gut. MFGM may play a role in shaping gut microbial activity and function.
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| 6. |
- He, Xuan, et al.
(author)
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Metabolic phenotype of breast-fed infants, and infants fed standard formula or bovine MFGM supplemented formula : a randomized controlled trial
- 2019
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In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 9
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Journal article (peer-reviewed)abstract
- Formula-fed (FF) infants exhibit a different metabolic profile than breast-fed (BF) infants. Two potential mechanisms are the higher protein level in formula compared with breast milk and the removal of the milk fat and associated milk fat globule membranes (MFGM) during production of infant formula. To determine whether MFGM may impact metabolism, formula-fed infants were randomly assigned to receive either an MFGM isolate-supplemented experimental formula (EF) or a standard formula (SF) from 2 until 6 months and compared with a BF reference group. Infants consuming EF had higher levels of fatty acid oxidation products compared to infants consuming SF. Although the protein level in the study formula was approximately 12 g/L (lower than most commercial formulas), a metabolic difference between FF and BF remained such that FF infants had higher levels of amino acid catabolism by-products and a low efficiency of amino acid clearance (preference for protein metabolism). BF infants had higher levels of fatty acid oxidation products (preference for fat metabolism). These unique, energy substrate-driven metabolic outcomes did not persist after diet was shifted to weaning foods and appeared to be disrupted by complementary feeding. Our results suggest that MFGM may have a role in directing infant metabolism.
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| 7. |
- Hernell, Olle, et al.
(author)
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Clinical Benefits of Milk Fat Globule Membranes for Infants and Children
- 2016
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In: Journal of Pediatrics. - : Elsevier BV. - 0022-3476 .- 1097-6833. ; 173, s. S60-S65
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Journal article (peer-reviewed)abstract
- The milk fat globule membrane (MFGM) in breast milk contains many bioactive components. Infant formulas traditionally have been devoid of the MFGM fraction, but dairy technology now has made the addition of bovine MFGM technically feasible. We identified 6 double-blinded randomized controlled trials exploring the effects of MFGM supplementation on the diets of infants or children. Results suggest that supplementation is safe and indicate positive effects on both neurodevelopment and defense against infections. MFGM supplementation of infant formula may narrow the gap in cognitive performance and infection rates between breastfed and formula-fed infants. Because of the small number of studies and the heterogeneity of interventions, more high-quality double-blinded randomized controlled trials are needed, with well characterized and clearly defined MFGM fractions, before firm conclusions on the effects of MFGM supplementation on the health and development of infants can be drawn.
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| 8. |
- Hernell, Olle, et al.
(author)
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Milk Fat Globule Membranes : Effects on Microbiome, Metabolome, and Infections in Infants and Children
- 2020
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In: Milk, Mucosal Immunity and the Microbiome. - : S. Karger. - 9783318066852 - 9783318066845 ; , s. 133-140
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Conference paper (peer-reviewed)abstract
- Dietary supplementation with bovine milk fat globule membrane (MFGM) concentrates has recently emerged as a possible means to improve the health of infants and young children, or defense against infections. We identified 5 double-blind, randomized, controlled trials (DBRCT) exploring the effects of supplementing the diet of infants and children with bovine MFGM concentrates on infections. We reviewed 3 studies which found a protective effect against infections at different ages during infancy and early childhood. Two of them have reported effects on the metabolome, and 1 study also on the microbiome and lipidome. MFGM supplementation had moderate, albeit interesting, effects on the oral and fecal microbiome, fecal and serum/plasma metabolome, and serum and erythrocyte membrane lipidome, which also are reviewed. We conclude that studies on MFGM supplementation during infancy and childhood indicate positive effects on the defense against infections and other outcomes, but more high-quality DBRCTs with well-defined MFGM fractions and outcome measures are needed before firm conclusions can be drawn.
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| 9. |
- Hernell, Olle, et al.
(author)
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Physiological Effects of Feeding Infants and Young Children Formula Supplemented with Milk Fat Globule Membranes
- 2019
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In: Human Milk. - : S. Karger. ; , s. 35-42
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Conference paper (peer-reviewed)abstract
- Dietary supplementation with bovine milk fat globule membrane (MFGM) concentrates has recently emerged as a possible means to improve the health of infants and young children. Formula-fed infants are of special interest since infant formulas traditionally have lower concentrations of biologically active MFGM components than human milk. We identified 6 double-blind randomized controlled trials (DBRCT) exploring the effects of supplementing the diet of infants and children with bovine MFGM concentrates. Two studies found a positive effect on cognitive development in formula-fed infants. Three studies found a protective effect against infections at different ages during infancy and early childhood. We conclude that supplementation with MFGM during infancy and childhood appears safe, and the studies indicate positive effects on both neurodevelopment and defense against infections, especially in formula-fed infants. However, due to the small number of studies and the heterogeneity of interventions and outcomes, more high-quality DBRCTs are needed before firm conclusions can be drawn on the likely health benefits of MFGM supplementation to infants and children.
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| 10. |
- Makhani, Naila, et al.
(author)
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The diagnostic workup of children with the radiologically isolated syndrome differs by age and by sex
- 2024
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In: Journal of Neurology. - : Springer. - 0340-5354 .- 1432-1459.
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Journal article (peer-reviewed)abstract
- Background: Cerebrospinal fluid (CSF) and spinal MRIs are often obtained in children with the radiologically isolated syndrome (RIS) for diagnosis and prognosis. Factors affecting the frequency and timing of these tests are unknown.Objective: To determine whether age or sex were associated with (1) having CSF or spinal MRI obtained or (2) the timing of these tests.Methods: We analyzed children (≤ 18 y) with RIS enrolled in an international longitudinal study. Index scans met 2010/2017 multiple sclerosis (MS) MRI criteria for dissemination in space (DIS). We used Fisher's exact test and multivariable logistic regression (covariates = age, sex, MRI date, MRI indication, 2005 MRI DIS criteria met, and race).Results: We included 103 children with RIS (67% girls, median age = 14.9 y). Children ≥ 12 y were more likely than children < 12 y to have CSF obtained (58% vs. 21%, adjusted odds ratio [AOR] = 4.9, p = 0.03). Pre-2017, girls were more likely than boys to have CSF obtained (n = 70, 79% vs. 52%, AOR = 4.6, p = 0.01), but not more recently (n = 30, 75% vs. 80%, AOR = 0.2, p = 0.1; p = 0.004 for interaction). Spinal MRIs were obtained sooner in children ≥ 12 y (median 11d vs. 159d, p = 0.03).Conclusions: Younger children with RIS may be at continued risk for misdiagnosis and misclassification of MS risk. Consensus guidelines are needed.
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