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  • 1.
    Abrahamsson, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Using probiotics to prevent necrotising enterocolitis2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 11, p. 1718-1719Article in journal (Other academic)
    Abstract [en]

    n/a

  • 2.
    Akefeldt, Selma O
    et al.
    Karolinska University Hospital Solna, Sweden .
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Gavhed, Desiree
    Karolinska University Hospital Solna, Sweden .
    Henter, Jan-Inge
    Karolinska University Hospital Solna, Sweden .
    Langerhans cell histiocytosis in children born 1982-2005 after in vitro fertilization2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 11, p. 1151-1155Article in journal (Refereed)
    Abstract [en]

    Aim: In a recent Swedish study, comparing data from the Swedish Cancer Register with the Medical Birth Register including data on IVF, an increased risk of Langerhans cell histiocytosis (LCH) was found in children born 19822005 after IVF. Here, we aimed to verify the LCH diagnoses and examine whether any special forms of the disease were overrepresented in this population. Methods: Medical records for all children with LCH conceived by IVF were acquired and the diagnosis confirmed or discarded. Disease characteristics were compared with data from children diagnosed with LCH 19922001 in the Stockholm County. Results: We verified LCH in seven children born after IVF, all born prior to 2002. These children did not have milder disease forms. The odds ratio (OR) to develop LCH for the whole group born after IVF was 3.2 [95% confidence interval (CI), 1.47.3] and for children born before 2002, 5.2 [95% CI, 2.311.9], compared with children in Stockholm County 19922001. Conclusion: LCH was overrepresented in children born after IVF prior to 2002. Affected children did not have milder disease forms. These findings may be valuable to understand LCH aetiology. Additional studies on a putative correlation between IVF and LCH in the offspring are encouraged.

  • 3. Albertsson Wikland, K
    et al.
    Alm, F
    Aronsson, S
    Gustafsson, J
    Hagenäs, L
    Häger, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Ivarsson, S
    Kriström, B
    Marcus, C
    Moell, C
    Nilsson, KO
    Ritzén, M
    Tuvemo, T
    Westergren, U
    Westphal, O
    Åman, J
    Effect of growth hormone (GH) during puberty in GH-deficient children: preliminary results from an ongoing randomized trial with different dose regimens. 1999In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 428, p. 80-84Article in journal (Other (popular science, discussion, etc.))
  • 4.
    Allansson, Elin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per E
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Overweight and obese children have lower cortisol levels than normal weight children2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 295-299Article in journal (Refereed)
    Abstract [en]

    AimThe stress hormone cortisol is vital to survival, and a disturbed circadian rhythm can be deleterious to health. However, little is known about cortisol levels in healthy children. The aim of this study was to examine cortisol levels in relation to body mass index (BMI), age and sex. MethodsSalivary samples were collected in early morning, late morning and evening, on four consecutive days, from 342 children aged 6-12years using Salivette((R)) tubes. Samples were analysed using a commercial enzyme immunoassay (EIA). School nurses measured the childrens height and weight, and these measurements were used to calculate their BMI. ResultsThe children displayed a circadian rhythm in cortisol secretion, with morning zeniths and evening nadirs. Average cortisol levels in early morning, late morning and evening were significantly lower in overweight and obese children than in their normal weight counterparts. Cortisol levels did not vary significantly with age or sex. ConclusionOur findings may suggest cortisol suppression in overweight and obese children. We found no evidence that sex or age influences cortisol levels. These findings highlight the need for further research on the relationship between stress and obesity in children.

  • 5.
    Anders Eriksson, Mats
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden; Gothenburg University, Sweden.
    Lieden, Agne
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Westerlund, Joakim
    Stockholm University, Sweden.
    Bremer, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics. Division of Clinical Genetics, University Hospital, Link.
    Wincent, Josephine
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Sahlin, Ellika
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Gillberg, Christopher
    Gothenburg University, Sweden.
    Fernell, Elisabeth
    Gothenburg University, Sweden.
    Anderlid, Britt-Marie
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Rare copy number variants are common in young children with autism spectrum disorder2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 6, p. 610-618Article in journal (Refereed)
    Abstract [en]

    AimSeveral studies have suggested that rare copy number variants (CNVs) are an important genetic contributor to autism spectrum disorders. The aims of the study were to use chromosomal microarray to investigate the presence of rare copy number variants in a population-based cohort of well-characterised young children with autism spectrum disorders and to relate the genetic results to neurodevelopmental profiles and medical conditions. MethodsWe performed chromosomal microarray on samples from 162 children who had been referred to the Stockholm Autism Centre for Young Children in Sweden after being diagnosed with autism spectrum disorder between 20 and 54months of age. ResultsPathogenic aberrations were detected in 8.6% of the children and variants of uncertain significance were present in another 8.6%. CNVs were more frequent in children with congenital malformations or dysmorphic features as well as in the subgroup with intellectual disability. ConclusionOur results support the use of chromosomal microarray methods for the first tier genetic analysis of autism spectrum disorder. However, it is likely in the near future that chromosomal microarray methods will probably be replaced by whole-exome and whole-genome sequencing technologies in clinical genetic testing.

  • 6.
    Angbratt, Marianne
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Walter, Lars
    Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Prediction of obesity from infancy to adolescence2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 9, p. 1249-1252Article in journal (Refereed)
    Abstract [en]

    Aim: To examine the development of childhood obesity and to determine the earliest age when estimating body mass using only weight and height data is associated with a corresponding estimate at the age of 15. less thanbrgreater than less thanbrgreater thanMethods: Subjects included are all children born in 1991 in Ostergotland County, Sweden. Weight and height data collected during regular check-ups at well-child centres and school health care assessments up to 15 years of age were assembled from health records. Correlations between childhood estimates of body mass and the body mass index (BMI) at 15 years of age were computed pairwise. Correlations with r andgt; 0.5 were defined as reliably strong. less thanbrgreater than less thanbrgreater thanResults: Complete data were available for 3579 children (62%). Fewer girls (2.6%; C.I. 1.9-3.3) than boys (4.6%; C.I. 3.7-5.5) were obese at 15 years of age. Correlations with BMI at 15 years of age were strong (significantly higher than 0.5) from 5 years of age. Only 23% of girls and 8% of boys found to be obese at 5 years of age were of normal weight at the age of 15. less thanbrgreater than less thanbrgreater thanConclusion: From 5 years of age, point estimates of body mass using only weight and height data are strongly associated with BMI at the age of 15. More data sources are needed to predict weight trajectories in younger children.

  • 7.
    Angsten, G
    et al.
    Univ Childrens Hosp, Dept Paediat Surg, SE-75185 Uppsala, Sweden Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden Linkoping Univ, Dept Biomed & Surg, Linkoping, Sweden Univ Uppsala Hosp, Dept Anaesthesiol, Uppsala, Sweden.
    Boberg, M
    Cederblad, Gitten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery.
    Meurling, S
    Univ Childrens Hosp, Dept Paediat Surg, SE-75185 Uppsala, Sweden Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden Linkoping Univ, Dept Biomed & Surg, Linkoping, Sweden Univ Uppsala Hosp, Dept Anaesthesiol, Uppsala, Sweden.
    Stiernstrom, H
    Univ Childrens Hosp, Dept Paediat Surg, SE-75185 Uppsala, Sweden Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden Linkoping Univ, Dept Biomed & Surg, Linkoping, Sweden Univ Uppsala Hosp, Dept Anaesthesiol, Uppsala, Sweden.
    Metabolic effects in neonates receiving intravenous medium-chain triglycerides2002In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 91, no 2, p. 188-197Article in journal (Refereed)
    Abstract [en]

    The effects of two lipid emulsions, one with 5017( each of medium-chain and long-chain triglycerides, and a long-chain triglycerides lipid emulsion as a control, were evaluated for lipid and carnitine metabolism and respiratory quotient when given to neonates after major surgery during a short period of total parenteral nutrition. Each group included 10 neonates, and all tolerated the total parenteral nutrition well. The relative contents of linoleic acid and)alpha-linolenic acid increased in all lipid esters in plasma and adipose tissue in both groups, indicating that the content of these fatty acids is sufficient even in the medium-chain triglycerides emulsion. The serum concentration of ketones was within normal limits. Free fatty acids in plasma did not increase in either group. The total plasma carnitine concentration decreased in both groups but the distribution of free carnitine and acylcarnitine did not change. The total muscle carnitine did not change significantly but the ratio of acylcarnitine to free carnitine tended to increase in muscle in the treatment group, probably an effect of the medium-chain triglyceride supplementation. Conclusions: The two groups displayed the same fatty acid pattern in plasma and adipose tissue and the same respiratory quotient during the treatment period. Regarding carnitine status, essentially the same changes were seen in the two groups. However, discrete changes were seen in muscle tissue in the treatment group.

  • 8.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Lindell, Charlotta
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Severe child abuse: A study of cases reported to the police2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 12, p. 1760-1764Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate the characteristics of severe abuse of children and possible differences in comparison with less severe abuse. Method: Cases of abuse reported to the police within a single police district (n = 142) in Sweden were studied. The severe cases were compared to all the remaining cases. Results: Severe abuse constituted 14% of the total cases and was reported by agencies to a greater degree than minor cases. The suspected perpetrators were socially disadvantaged people in both groups. Half of the most serious cases led to conviction in the courts, compared to 8% in the reference group. The children who had been subjected to abuse were often already known to social services and reports of child abuse had frequently been made. Conclusion: In comparison between cases of severe and minor child abuse reported to the police, the results did not show any crucial differences except the pattern of reporting and a higher occurrence of prosecution/conviction in the severe cases. This finding places a responsibility on agencies outside of the justice system to consider all cases of reported abuse as serious warning signals and to make independent evaluations to identify risks and the possible need for child protection. © 2007 The Author(s).

  • 9.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Göran Svedin, Carl
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Prevalence and characteristics of child physical abuse in Sweden - findings from a population-based youth survey2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 8, p. 1229-1236Article in journal (Refereed)
    Abstract [en]

    Aim: To examine prevalence rates of child physical abuse perpetrated by a parent/caretaker, abuse characteristics and the extent of disclosures. Methods: A population-based survey was carried out in 2008 amongst all the pupils in three different grades (n = 8494) in schools in Sodermanland County, Sweden. The pupils were asked about their exposure to violence and their experiences of parental intimate-partner violence. Data were analysed with bi- and multivariate models and a comparison between means of accumulating risk factors between three groups were performed. Results: A total of 15.2% of the children reported that they had been hit. There were strong associations between abuse and risk factors and there was a dose-response relationship between risks and reported abuse. It was shown that children who reported parental intimate-partner violence were at a considerably higher risk for abuse than other children and that only 7% of the children exposed to violence had disclosed this to authorities. Conclusion: Even though child abuse in Sweden has decreased markedly during the last 40 years, violence against children is still a considerable problem. It is a challenge to develop methods of assessment and interventions that will ensure that the violence and its underlying causes are directly addressed.

  • 10.
    Armuand, Gabriela
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Lampic, C.
    Karolinska Institute, Sweden.
    Skoog-Svanberg, A.
    Uppsala University of Uppsala, Sweden.
    Wanggren, K.
    Karolinska Institute, Sweden.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Survey shows that Swedish healthcare professionals have a positive attitude towards surrogacy but the health of the child is a concern2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 1, p. 101-109Article in journal (Refereed)
    Abstract [en]

    AimIn February 2016, Sweden upheld its ban on surrogacy following a Government enquiry. This survey investigated attitudes towards surrogacy among primary health professionals working with children and their experiences of working with families following surrogacy abroad. MethodsFrom April to November 2016, nurses, physicians and psychologist working in primary child health care in four counties in Sweden were invited to participate in a cross-sectional online survey about surrogacy. ResultsThe mean age of the 208 participants was 49.2years (range 27-68) and nearly 91% were women. Approximately 60% supported legalised surrogacy. Wanting a conscience clause to be introduced in Sweden was associated with not supporting surrogacy for any groups, while personal experiences of infertility and clinical experiences with families following surrogacy were associated with positive attitudes towards surrogacy for heterosexual couples. The majority (64%) disagreed that surrogate children were as healthy as other children, and many believed that they risked worse mental health (21%) and social stigmatisation (21%). ConclusionWe found that 60% supported legalised surrogacy, but many expressed concerns about the childrens health and greater knowledge about the medical and psychosocial consequences of surrogacy is needed.

  • 11.
    Backman, Sofia
    et al.
    Skane Univ Hosp, Sweden.
    Rosen, Ingmar
    Skane Univ Hosp, Sweden.
    Blennow, Mats
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Andersson, Thomas
    Karolinska Univ Hosp, Sweden.
    Englund, Marita
    Karolinska Univ Hosp, Sweden.
    Flink, Roland
    Uppsala Univ Hosp, Sweden.
    Hallberg, Boubou
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Liedholm, Lars-Johan
    Umea Univ Hosp, Sweden.
    Norman, Elisabeth
    Lund Univ, Sweden.
    Sailer, Alexandra
    Umea Univ Hosp, Sweden.
    Thordstein, Magnus
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Swedish consensus reached on recording, interpretation and reporting of neonatal continuous simplified electroencephalography that is supported by amplitude-integrated trend analysis2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 10, p. 1702-1709Article in journal (Refereed)
    Abstract [en]

    Continuous monitoring of electroencephalography (EEG), with a focus on amplitude-integrated EEG (aEEG), has been used in neonatal intensive care for decades. A number of systems have been suggested for describing and quantifying aEEG patterns. Extensive full-montage EEG monitoring is used in specialised intensive care units. The American Clinical Neurophysiology Society published recommendations for defining and reporting EEG findings in critically ill adults and infants. Swedish neonatologists and clinical neurophysiologists collaborated to optimise simplified neonatal continuous aEEG and EEG recordings based on these American documents. Conclusion: This paper describes the Swedish consensus document produced by those meetings.

  • 12.
    Benson, Mikael
    et al.
    Central Hospital, Helsingborg, Sweden.
    Blennow, G
    University Hospital, Lund, Sweden.
    Rosén, I
    University Hospital, Lund, Sweden.
    Intrathecal immunoglobulin production and minor motor seizures1987In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 76, no 1, p. 147-150Article in journal (Refereed)
    Abstract [en]

    Five infants with idiopathic infantile minor motor seizures had an elevated immunoglobulin G (IgG) index ((cerebrospinal fluid IgG/serum IgG):(cerebrospinal fluid albumin/serum albumin)). The infants had prolonged prodromal symptoms, and bad prognosis. It is suggested that immunological mechanisms may contribute to the pathophysiology in certain cases of infantile spasms.

  • 13.
    Berhan, Yonas T.
    et al.
    Umeå University, Sweden.
    Mollsten, Anna
    Umeå University, Sweden.
    Carlsson, Annelie
    Lund University, Sweden.
    Högberg, Lotta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Norrköping.
    Ivarsson, Anneli
    Umeå University, Sweden.
    Dahlquist, Gisela
    Umeå University, Sweden.
    Five-region study finds no evidence of undiagnosed type 2 diabetes in Swedish 11- to 13-year-olds2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 10, p. 1078-1082Article in journal (Refereed)
    Abstract [en]

    AimChildhood obesity is now an established public health problem in most developed countries, and there is concern about a parallel increase of type 2 diabetes. The aim of this study was to estimate the prevalence of undiagnosed type 2 diabetes in overweight Swedish school children from 11 to 13years of age. MethodsBody mass index (BMI) was measured in 5528 schoolchildren in the 6th grade, from 11 to 13years of age, in five different regions in Sweden. Overweight was defined by international age- and sex-specific BMI cut-offs, corresponding to adult BMI cut-offs of 25kg/m(2) at 18years of age (ISO-BMI 25, n=1275). Haemoglobin A1c (HbA1c) was measured in 1126 children with ISO-BMI 25. Children with a Diabetes Control and Complications Trial aligned HbA1c 6.1% on two occasions underwent an oral glucose tolerance test (OGTT) to establish the diabetes diagnosis. ResultsOf 1126 children with ISO-BMI 25, 24 (2.1%) had at least one HbA1c value 6.1%. Three of them had HbA1c 6.1% on two occasions, and all of them had a normal OGTT. ConclusionIn this cross-sectional, population-based screening study of a high-risk group of 11- to 13-year-old Swedish school children, we found no indication of undiagnosed diabetes or impaired glucose tolerance.

  • 14.
    Bernfort, Lars
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nordfeldt, Sam
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry. Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics.
    Persson, Jan
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    ADHD from a socio-economic perspective2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 2, p. 239-245Article, review/survey (Refereed)
    Abstract [en]

    Aim: Attention deficit hyperactivity disorder (ADHD) and related disorders affect children's ability to function in school and other environments. Awareness has increased in recent years that the same problems often persist in adulthood. Based on previous studies, we aimed to outline and discuss a descriptive model for calculation of the societal costs associated with ADHD and related disorders. Methods: Following a literature review including childhood and adult studies, long-term outcomes of ADHD and associated societal costs were outlined in a simple model. Results: The literature concerning long-term consequences of ADHD and related disorders is scarce. There is some evidence regarding educational level, psychosocial problems, substance abuse, psychiatric problems and risky behaviour. The problems are likely to affect employment status, healthcare consumption, traffic and other accidents and criminality. A proposed model structure includes persisting problems in adulthood, possible undesirable outcomes (and their probabilities) and (lifetime) costs associated with these outcomes. Conclusions: Existing literature supports the conclusion that ADHD and related disorders are associated with a considerable societal burden. To estimate that burden with any accuracy, more detailed long-term data are needed. © 2007 The Author(s).

  • 15.
    Björkqvist, Maria
    et al.
    Department of Paediatrics, Örebro University Hospital, Örebro.
    Källman, J.
    Department of Infectious Diseases, Örebro University Hospital, Örebro.
    Fjaertoft, G.
    Women's and Children's Health, Section for Paediatrics, University Hospital, Uppsala, Sweden.
    Xu, S.
    Medical Sciences and Clinical Chemistry, University Hospital, Uppsala, Sweden.
    Venge, P.
    Medical Sciences and Clinical Chemistry, University Hospital, Uppsala, Sweden.
    Schollin, J.
    Department of Paediatrics, Örebro University Hospital, Örebro.
    Human neutrophil lipocalin: normal levels and use as a marker for invasive infection in the newborn2004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 4, p. 534-539Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate human neutrophil lipocalin (HNL) as a marker of neonatal invasive infection and determine the normal serum levels of HNL in newborns.

    Methods: HNL is released from neutrophil granulocytes and is regarded as a specific marker of neutrophil activity. In 81 newborns 28 d of age with signs of infection on a total of 87 occasions, HNL and C-reactive protein (CRP) were measured at inclusion and on the three following days. As controls, term healthy newborns were recruited at birth (cord blood, n= 45) and at ages 3-5 d (n= 46). Serum HNL was measured by a radioimmunoassay.

    Results: 25/87 episodes were classified as infection and 62 as non-proven infection. HNLmax was significantly higher in the infected group (mean 587.6 μg/1) than in the non-proven infected group (mean 217.7 μg/1, p > 0.001). HNL peaked at inclusion, 1 d earlier than CRP. In the healthy controls, HNL was the same at 3-5 d of age as at birth (mean 82.4-81.7 μg/1) and similar to normal adult levels.

    Conclusions: The release of HNL is not increased in healthy newborns at birth, but neonatal neutrophils rapidly release HNL upon microbial stimulation in vivo. HNL might be useful as an early marker of neonatal infection.

  • 16.
    Blomberg, Marie
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Selbing, Anders
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Källén, B.
    Tornblad Institute University of Lund, Lund, Sweden.
    Congenital malformations in the southeast of Sweden: a registry study with validation2000In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, no 10, p. 1238-1243Article in journal (Refereed)
    Abstract [en]

    A study was made of the occurrence of congenital malformations in the southeast region of Sweden, utilizing all available relevant health registries. Östergötland county had been pinpointed in a routine surveillance as having an increased malformation risk. Various validations of the register data were undertaken and different types of errors were detected. An increased risk was seen, in Östergötland county compared to the reference counties, for specific types of malformations: preauricular appendices, pylorostenosis, uterine/vaginal malformations, foot deformities, limb reduction defects and cardiovascular malformations. Variable classification or registration artefacts explained the excess among the first four conditions. Limb reduction defects were also mis-coded, but the increased risk in Östergötland county may persist.

    Conclusion: There is an increased risk of major cardiovascular malformations in Östergötland county compared to the reference counties that also shows an uneven distribution within the county.

  • 17.
    Borneskog, C.
    et al.
    Uppsala University, Sweden .
    Lampic, C.
    Karolinska Institute, Sweden .
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynecology and Obstetrics UHL.
    Skoog Svanberg, A.
    Uppsala University, Sweden .
    How do lesbian couples compare with heterosexual in vitro fertilization and spontaneously pregnant couples when it comes to parenting stress?2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 5, p. 537-545Article in journal (Refereed)
    Abstract [en]

    AimTo study parenting stress in lesbian parents and to compare that stress with heterosexual parents following in vitro fertilisation (IVF) or spontaneous pregnancies. MethodsThis survey took place during 2005-2008 and was part of the Swedish multicentre study on gamete donation. It comprised 131 lesbian parents, 83 heterosexual IVF parents, who used their own gametes, and 118 spontaneous pregnancy parents. The participants responded to the questionnaire when the child was between 12 and 36-months-old and parenting stress was measured by the Swedish Parenting Stress Questionnaire (SPSQ). ResultsLesbian parents experienced less parenting stress than heterosexual IVF parents when it came to the General Parenting Stress measure (p=0.001) and the subareas of Incompetence (pless than0.001), Social Isolation (p=0.033) and Role Restriction (p=0.004). They also experienced less parenting stress than heterosexual spontaneous pregnancy couples, according to the Social Isolation subarea (p=0.003). Birth mothers experienced higher stress than co-mothers and fathers, according to the Role Restriction measure (p=0.041). ConclusionThese are reassuring findings, considering the known challenges that lesbian families face in establishing their parental roles and, in particular, the challenges related to the lack of recognition of the co-mother.

  • 18.
    Bratteby Tollerz, L. U.
    et al.
    Uppsala University, Sweden; Uppsala University, Sweden.
    Forslund, A. H.
    Uppsala University, Sweden; Uppsala University, Sweden.
    Olsson, R. M.
    Uppsala University, Sweden; Uppsala University, Sweden.
    Lidström, Helene
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Holmback, U.
    Uppsala University, Sweden; Uppsala University, Sweden.
    Children with cerebral palsy do not achieve healthy physical activity levels2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 11, p. 1125-1129Article in journal (Refereed)
    Abstract [en]

    AimThis study compared daily activity energy expenditure (AEE) in children with cerebral palsy with a control group and investigated whether the children achieved healthy levels of physical activity. MethodsWe enrolled eight children with bilateral cerebral palsy, from eight to 10years of age, and a group of controls matched for age and gender. For three days, physical activity was simultaneously measured by accelerometers and self-reports using a diary. The daily AEE results were compared between groups and methods. The number of children that achieved healthy physical activity levels in each group was explored. ResultsChildren with cerebral palsy had significantly lower daily AEE, as measured by accelerometers, than the controls, and they did not achieve the healthy moderate to heavy physical activity level defined in the Nordic Nutrition Recommendations. Self-reports using the diaries resulted in an overestimation of physical activity compared with the ankle accelerometer measurements in both groups. ConclusionOur investigation of physical activity in children with cerebral palsy and controls using accelerometers and a diary found low levels of daily AEE and physical activity, and these results were most prominent in the group with cerebral palsy. The diaries overestimated physical activity in both groups.

  • 19.
    Bruun, C.F.
    et al.
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Langbakk, B.
    Department of Clinical Chemistry, University Hospital of Northern Norway, Norway.
    Steigen, S.E.
    Department of Pathology, University Hospital of Northern Norway, Norway.
    Purpura fulminans as a sequel to erythema nodosum in a child with homozygous Leiden mutation and acquired protein S deficiency2005In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 94, no 8, p. 1155-1158Article in journal (Refereed)
    Abstract [en]

    A 6-y-old boy presented with generalized, bruise-like swelling of both legs. Three weeks later, he developed purpura fulminans in one of the affected feet. Histology of the leg swelling was in accordance with erythema nodosum. The boy proved to be homozygous for the Factor V Leiden mutation and to have acquired protein S deficiency. He recovered, with partial loss of two toes. Conclusion: In contrast to what is often stated, erythema nodosum is not always a benign condition. On the basis of this report, we suggest that if extensive erythema nodosum develops in an individual without any known thrombophilic disorder, investigations with respect to the latter should be performed. © 2005 Taylor & Francis Group Ltd.

  • 20.
    Brynhildsen, Jan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Blomberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Claesson, Ing-Marie
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Nyström, Fredrik H.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Sydsjö, Adam
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Leptin and adiponectin in cord blood from children of normal weight, overweight and obese mothers2013In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 6, p. 620-624Article in journal (Refereed)
    Abstract [en]

    Aim To study cord blood concentrations of adiponectin and leptin in children born by normal weight, overweight and obese mothers and to study these parameters in relation to a weight gain intervention programme for obese mothers. Methods Ten millilitre cord blood was collected and analysed for leptin and adiponectin concentrations in children with gestational age andgt;37weeks born by 60 normal weight, 45 overweight and 145 obese mothers. 82 obese mothers took part in a weight gain intervention programme. Results Concentrations of leptin and adiponectin were higher in cord blood from children of overweight and obese mothers compared with children of normal weight mothers (leptin: Md 13.2, 30, 3 and 90.2ng/mL respectively, pandlt;0.001; adiponectin 35.9, 205.4, 213.8ng/L pandlt;0.001). No differences were found between overweight and obese mothers. The weight gain intervention programme for obese pregnant women had significant effects on the weight gain during pregnancy but had no effects on cord blood serum concentrations of leptin and adiponectin. Conclusion Cord blood leptin and adiponectin concentrations were higher in children born by overweight or obese women compared with children of normal weight mothers. A weight gain intervention programme for obese pregnant women did not affect these results. Intrauterine exposition to high concentrations of leptin and adiponectin may play a role in weight development later in life.

  • 21.
    Cedergren, Marie
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Selbing, Anders
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Källén, B.
    Tornblad Institute, University of Lund, Lund, Sweden.
    Geographic variations in possible risk factors for severe cardiac malformations2002In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 91, no 2, p. 222-228Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate various putative risk factors in a county in Sweden, described as having a 28% increased prevalence of cardiovascular malformations, and to compare them with the risk factors in two reference counties. Women giving birth in the studied counties differed in age and parity distribution, smoking, and educational level but these differences could not explain the increased risk of cardiovascular malformations in the county, since after stratification for these variables, the risk estimate did not change substantially. A number of potential risk factors were studied in a case/control design: spontaneous abortions, involuntary childlessness, maternal disease, body mass index, medical drug use, alcohol use, parental employment, paternal age, and urban/rural residency. No single factor could be attributed to the increased rate, with the exception of living in a rural district. Nearly all risk factors, however, were stronger in the county studied than those in the reference counties (0.02 > p > 0.01).

    Conclusion: The only single putative risk factor that could have contributed to the increased risk for cardiac defects described in the county studied was maternal residency in a rural district. Notably, nearly all potential risk factors studied were stronger in the county studied compared with those in the reference area. A conceivable explanation is that one or more unidentified factors related to rural residency could potentiate prevalent and weak teratogenic risk factors for cardiac defects.

  • 22.
    Cocozza, Madeleine
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Child Protection in Sweden: Are routine assesments reliable?2006In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 95, no 11, p. 1474-1480Article in journal (Refereed)
    Abstract [en]

    Aim: To study the validity of the decision not to investigate mandatory reports of suspected child maltreatment.

    Methods: Written files of 220 reports indicating possible child maltreatment were analysed and re-evaluated. As a measure of the justification for the decisions, a 5-y follow-up study was done.

    Results: We determined that 76% of the reports still indicated child maltreatment after the initial assessment was done. In the follow-up study, 45% of the children had been investigated. The social worker used the family as the only source of information in 74% of the cases, in 6% someone outside the family was contacted, and in 11% no further information in addition to the report was collected. In 9%, data on information sources were missing.

    Conclusion: The findings are rather discouraging, as they challenge the belief that a report is a means of ensuring that maltreatment does not continue. The study shows that, depending upon the way in which the initial assessments are made, maltreated children may run a risk of not being identified, even though the maltreatment has been reported. This suggests that there may be a need for national guidelines concerning the reporting of maltreatment.

  • 23.
    Dahl, Sara
    et al.
    Karolinska Inst, Sweden.
    Kristoffersen Wiberg, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Fahnehjelm, Kristina Tear
    Karolinska Inst, Sweden; St Erik Eye Hosp, Sweden; Univ Gothenburg, Sweden.
    Savendahl, Lars
    Karolinska Inst, Sweden.
    Wickstrom, Ronny
    Karolinska Inst, Sweden.
    High prevalence of pituitary hormone deficiency in both unilateral and bilateral optic nerve hypoplasia2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 9, p. 1677-1685Article in journal (Refereed)
    Abstract [en]

    Aim This study examined the prevalence of neurological impairment and pituitary hormone deficiency (PHD) in patients with unilateral and bilateral optic nerve hypoplasia (ONH). Methods A population-based cross-sectional cohort study of 65 patients (51% female) with ONH was conducted in Stockholm. Of these were 35 bilateral and 30 unilateral. The patients were below 20 years of age, living in Stockholm in December 2009 and found through database searching. The median age at the analysis of the results in January 2018 was 16.1 years (range 8.1-27.5 years). Neurological assessments and blood sampling were conducted, neuroradiology was reviewed and growth curves were analysed. Diagnoses of PHDs were based on clinical and biochemical evidence of hormone deficiency. Results Neurological impairments were identified in 47% of the patients and impairments in gross and fine motor function were more prevalent in bilateral ONH (p amp;lt; 0.001). In addition, 9% had cerebral palsy and 14% had epilepsy. The prevalence of PHD was 29 and 19% had multiple PHD. Conclusion Children with ONH had a high risk of neurological impairment, especially in bilateral disease. Both unilateral and bilateral ONH signified an increased prevalence of PHD and all these children should be endocrinologically followed up until completed puberty.

  • 24. Dahlqvist, G
    et al.
    Mustonen, L
    Ludvigsson, Johnny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Analysis of 20 years of prospective registration of childhood onset diabetes - time trends and birth cohort effects.2000In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, p. 1231-1237Article in journal (Refereed)
  • 25.
    Dawson, J. A.
    et al.
    Royal Womens Hospital, Australia; Murdoch Childrens Research Institute, Australia; University of Melbourne, Australia.
    Ekström, A.
    Linköping University.
    Frisk, C.
    Linköping University.
    Thio, M.
    The Royal Women's Hospital, Parkville, VIC, Australia.
    Roehr, C. C.
    Royal Womens Hospital, Australia; Charite University of Medical Centre, Germany; Monash University, Australia.
    Kamlin, C. O. F.
    Royal Womens Hospital, Australia; Murdoch Childrens Research Institute, Australia; University of Melbourne, Australia.
    Donath, S. M.
    Murdoch Childrens Research Institute, Australia.
    Davis, P. G.
    Royal Womens Hospital, Australia; Murdoch Childrens Research Institute, Australia; University of Melbourne, Australia.
    Assessing the tongue colour of newly born infants may help to predict the need for supplemental oxygen in the delivery room2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 4, p. 356-359Article in journal (Refereed)
    Abstract [en]

    AimIt takes several minutes for infants to become pink after birth. Preductal oxygen saturation (SpO(2)) measurements are used to guide the delivery of supplemental oxygen to newly born infants, but pulse oximetry is not available in many parts of the world. We explored whether the pinkness of an infants tongue provided a useful indication that supplemental oxygen was required. MethodsThis was a prospective observational study of infants delivered by Caesarean section. Simultaneous recording of SpO(2) and visual assessment of whether the tongue was pink or not was made at 1-7 and 10min after birth. ResultsThe 38 midwives and seven paediatric trainees carried out 271 paired assessments on 68 infants with a mean (SD) birthweight of 3214 (545) grams and gestational age of 38 (2) weeks. When the infant did not have a pink tongue, this predicted SpO(2) of less than70% with a sensitivity of 26% and a specificity of 96%. ConclusionTongue colour was a specific but insensitive sign that indicated when SpO(2) was less than70%. When the tongue is pink, it is likely that an infant has an SpO(2) of more than 70% and does not require supplemental oxygen.

  • 26.
    Duchén, Karel
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Lindberg, Anders
    Pfizer, Sweden.
    Kiplok, Kaire
    Pfizer, Sweden.
    Kriström, Berit
    Umeå University, Sweden.
    Using a spontaneous profile rather than stimulation test makes the KIGS idiopathic growth hormone deficiency model more accessible for clinicians2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 9, p. 1481-1486Article in journal (Refereed)
    Abstract [en]

    Aim: Children treated with a growth hormone (GH) for idiopathic growth hormone deficiency (IGHD) may be monitored with the first-year prediction model from the Pfizer International Growth Database (KIGS) using auxology, age, GH dose and the maximum GH concentration from a stimulation test (GH(max)stim). We tested the hypothesis that using a 12-hour spontaneous profile (GH(max)12h) would be as accurate. Methods: We studied 98 prepubertal Swedish children (78boys) aged2-12 years enrolled in KIGS. The first-year growth was predicted using the GH(max) from the GHprofile and a stimulation test, and both of these were compared separately with the observed growth response. Results: The increased height observed in the first year was 0.74 standard deviation scores (SDS), and the studentised residuals for the predicted and observed growth with GH(max)stim (-0.16 SDS) and GH(max)12h (-0.22) were similar. Individual predictions calculated with stimulated or spontaneous GH(max) showed a significant correlation (r = 0.80). Conclusion: We validated the KIGS IGHD prediction model and found that the stimulated GH(max) peak can be reliably replaced by the GH(max) 12h with similar accuracy. This makes the model more accessible for clinicians, who can then provide realistic expectations for the growth response during the first year of treatment.

  • 27.
    Duchén, Karel
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Thorell, L
    Nucleotide and polyamine levels in colostrum and mature milk in relation to maternal atopy and atopic development in the children. 1999In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 88, p. 1338-1343Article in journal (Other (popular science, discussion, etc.))
  • 28.
    Ehlersson, Gustaf
    et al.
    Örebro University, Sweden; Örebro University Hospital, Sweden.
    Hellmark, Bengt
    Örebro University, Sweden; Örebro University Hospital, Sweden.
    Svartström, Olov
    Region Östergötland, Center for Diagnostics, Department of Clinical Microbiology.
    Stenmark, Bianca
    Örebro University, Sweden; Örebro University Hospital, Sweden.
    Soderquist, Bo
    Örebro University, Sweden; Örebro University Hospital, Sweden.
    Phenotypic characterisation of coagulase-negative staphylococci isolated from blood cultures in newborn infants, with a special focus on Staphylococcus capitis2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 10, p. 1576-1582Article in journal (Refereed)
    Abstract [en]

    Aim: This Swedish study determined which species of coagulase-negative staphylococci (CoNS) were found in neonatal blood cultures and whether they included Staphylococcus capitis clones with decreased susceptibility to vancomycin. Methods: CoNS isolates (n = 332) from neonatal blood cultures collected at orebro University Hospital during 1987-2014 were identified to species level with matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). The antibiotic susceptibility pattern of S. capitis isolates was determined by the disc diffusion test and Etest, and the presence of heterogeneous glycopeptide-intermediate S. capitis (hGISC) was evaluated. Results: Staphylococcus epidermidis (67.4%), Staphylococcus haemolyticus (10.5%) and S. capitis (9.6%) were the most common CoNS species. Of the S. capitis isolates, 75% were methicillin-resistant and 44% were multidrug-resistant. No isolate showed decreased susceptibility to vancomycin, but at least 59% displayed the hGISC phenotype. Staphylococcus capitis isolates related to the strain CR01 displaying pulsotype NRCS-A were found. Conclusion: Staphylococcus epidermidis, S. haemolyticus and S. capitis were the predominant species detected in neonatal blood cultures by MALDI-TOF MS. The number of episodes caused by S. capitis increased during the study period, but no isolates with decreased susceptibility to vancomycin were identified. However, S. capitis isolates related to the strain CR01 displaying pulsotype NRCS-A were found.

  • 29.
    Eriksson, Britt
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition. Linköping University, Faculty of Health Sciences.
    Hannestad, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition. Linköping University, Faculty of Health Sciences.
    Fat-free mass hydration in newborns: assessment and implications for body composition studies2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 5, p. 680-686Article in journal (Refereed)
    Abstract [en]

    Equipment (Pea Pod) for assessing infant body density accurately and conveniently has recently become available. This density can be converted to body composition using the “Fomon” or the “Butte” model. These models differ regarding the water content in fat-free mass (hydration factor, HF). We assessed HF and its biological variability in newborns and compared results calculated using the two models at one and 12 weeks. Body volume and body weight were measured in 12 infants less than 10 days old using Pea Pod. Their total body water was assessed using isotope dilution. Their HF was found to be 80.9% with low biological variability (0.81% of average HF). Further, Pea Pod was used to assess body density of 108 infants at one and 12 weeks of age. Values for body fat (%) calculated using the “Butte” model were significantly lower than when using the “Fomon” model at one week (p<0.05) and 12 weeks (p<0.01). The difference between the two models was particularly large at one week, probably due to their different HF-values. Our HF-value is in agreement with that in the “Fomon” model and our results support the conclusion that this model is preferable when calculating body composition in infants.

  • 30.
    Eriksson, Marit
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Futurum, Region Jönköping County, Jönköping, Sweden.
    Lingfors, Hans
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Futurum, Region Jönköping County, Jönköping, Sweden.
    Golsäter, Marie
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Jönköping University, Sweden.
    Trends in prevalence of thinness, overweight and obesity among Swedish children and adolescents between 2004 and 20152018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 10, p. 1818-1825Article in journal (Refereed)
    Abstract [en]

    Aim: This study explored weight trends among children aged 4, 7, 11, 14 and 17years in Jonkoping County Sweden, from 2004 to 2015. Methods: The study had a repeated cross-sectional design, and body mass index (BMI) was calculated based on height and weight measurements collected from child health and school health records. The prevalence of thinness, overweight and obesity was estimated with international cut-offs, with linear trends calculated separately for boys and girls. Results: There were 190 965 measurements of BMI and these covered 82-97% of the younger children and 55-69% of the older children during the study period. The prevalence of thinness varied between 0.2% and 2.2% across time and age groups and did not change over the study period. There was a small decrease in overweight among both girls and boys aged four years. There were increasing trends in overweight and obesity in both girls and boys aged 11 and 14years of age and a sharp increase among 17-year-old boys, with 7.3% obese in 2014/2015 and 3.6% in 2004/2005. Conclusion: The prevalence of obesity decreased from 2004 to 2015 or was stable in younger Swedish children, but increased among older children, with a large increase in adolescent boys.

  • 31.
    Eriksson, Mats
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Bodin, L
    Finnström, Orvar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Schollin, Jens
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Can severity-of-illness indices for neonatal intensive care predict outcome at 4 years of age?2002In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 91, p. 1093-1100Article in journal (Refereed)
  • 32.
    Eriksson, Mats
    et al.
    Department of Paediatrics, Örebro University Hospital.
    Finnström, Orvar
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Can daily repeated doses of orally administered glucose induce tolerance when given for neonatal pain relief?2004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 2, p. 246-249Article in journal (Refereed)
    Abstract [en]

    Aim: Orally administered sweet solutions have a pain-relieving effect during painful procedures in newborn infants. The underlying mechanism is not fully understood, but, from the results of animal research, an opioid-like mechanism is often suggested. The aim of this study was to determine whether repeated doses of orally administered glucose would cause tolerance to glucose.

    Methods: Fifty-seven healthy, full-term infants were recruited on the day of birth to receive three daily doses of either 1 ml 30% glucose or sterile water for 3–5 d, after which routine blood samples were collected by heel-lance. All infants received 1 ml 30% glucose before the heel-lance was carried out. Crying time, Premature Infant Pain Profile scores and changes in heart rate were used as pain measures.

    Results: No differences were found between the groups, either in demographic data or in the outcome variables.

    Conclusion: No tolerance was observed under the conditions prevailing in this study. However, we cannot rule out an endogenous opioid mechanism. What is clinically important is that repeated doses of glucose do not decrease the pain-relieving effect.

  • 33.
    Eriksson, Mats
    et al.
    Department of Clinical Research and Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Storm, Hanne
    Department of Paediatric Research and Section of Neonatology, The National Hospital, Oslo, Norway.
    Fremming, Asbjörn
    Department of Paediatric Research and Section of Neonatology, The National Hospital, Oslo, Norway.
    Schollin, Jens
    Department of Clinical Research and Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Skin conductance compared to a combined behavioural and physiological pain measure in newborn infants2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 1, p. 27-30Article in journal (Refereed)
    Abstract [en]

    Aim: To assess the ability of galvanic skin response (GSR) to differentiate between tactile and painful stimulation in newborn infants, and to compare this with the ability of the premature infant pain profile (PIPP).

    Methods: Thirty-two healthy full-term infants undergoing routine blood sampling were recruited. In a randomized order they were subjected to tactile and painful stimulation. The three GSR variables conductance baseline level, number of waves per second and mean amplitude of the waves were recorded together with the behavioural and physiological variables of PIPP.

    Results: The GSR variables number of waves and amplitude of the waves increased more during painful stimulation than during tactile stimulation, as did also the PIPP score. Receiver operating characteristic curves analysis revealed no significant differences between the studied methods.

    Conclusion: GSR can differentiate painful from tactile stimulation, but more research is needed to achieve a clinically useful application.

  • 34.
    Finnström, Orvar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    A genetic reason for male excess in infant respiratory mortality?2004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 9, p. 1154-1155Article in journal (Refereed)
    Abstract [en]

    Male infants have a 50% higher risk of death from respiratory diseases and a number of congenital heart diseases that can lead to cerebral hypoxia. The most important of these diseases are infant respiratory distress syndrome and sudden infant death syndrome. Conclusion: The mechanism behind the excess peri-mortality rate in male infants is not known. A genetic factor leading to reduced tolerance to hypoxia is possible.

  • 35.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Ethical decision-making in neonatology - a Scandinavian perspective2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 6, p. 555-556Article in journal (Refereed)
    Abstract [en]

    n/a

  • 36.
    Finnström, Orvar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Persson, J
    Ethical aspects of decision-making at the limit of viability.1999In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 88, p. 708-709Article in journal (Other (popular science, discussion, etc.))
  • 37.
    Forsum, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Eriksson, Britt
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Flinke Carlsson, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Henriksson, Hanna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Henriksson, Pontus
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Löf, Marie
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Fat and fat-free mass of healthy Swedish children show tracking during early life, but there are differences2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 9, p. 1704-1708Article in journal (Refereed)
    Abstract [en]

    Aim Obesity may start early in life. We investigated relationships between size and body composition variables in infancy and at 4 years of age using valid estimates of body composition. The results were compared to those obtained when body mass index (BMI) was used to estimate body fatness at 4 years. Methods Using air displacement plethysmography, size, fat mass and fat-free mass were studied, between 2007 and 2015, in 253 full-term healthy Swedish children at 1 week, 12 weeks and 4 years of age. Results Positive associations between variables in infancy and at 4 years were found at 1 and 12 weeks for weight, height, BMI, fat-free mass and fat-free mass index (p amp;lt;= 0.002) and for fat mass, per cent body fat and fat mass index (p amp;lt;= 0.04) at 12 weeks. Fat mass gained during infancy correlated positively (p amp;lt;= 0.031) with per cent fat mass, fat mass index and BMI, all at 4 years. In girls, gains in fat-free mass during infancy correlated with BMI (p = 0.0005) at 4 years. Conclusion The results provide information regarding body composition trajectories during early life and demonstrate limitations of BMI as a proxy for body fatness when relating early weight gain to variables, relevant for later obesity risk.

  • 38. Frid, C
    et al.
    Drott, Peder
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Otterblad Olausson, P
    Sundelin, C
    Anneren, G
    Maternal and neonatal factors and mortality in children with Down syndrome born in 1973-1980 and 1995-19982004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, p. 106-112Article in journal (Refereed)
  • 39.
    Frost, B.-M.
    et al.
    Dept. of Women's/Children's Health, University Children's Hospital, Uppsala, Sweden.
    Lonnerholm, G.
    Lönnerholm, G., Dept. of Women's/Children's Health, University Children's Hospital, Uppsala, Sweden, University Children's Hospital, SE-751 85 Uppsala, Sweden.
    Koopmans, P.
    Department of Pharmacy, University Hospital, Groningen, Netherlands.
    Abrahamsson, J.
    University Children's Hospital, Uppsala, Sweden, Queen Silvia Children's Hospital, Gothenburg, Sweden.
    Behrendtz, M.
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Castor, A.
    Department of Paediatrics, University Hospital, Lund, Sweden.
    Forestier, E.
    Department of Clinical Sciences, Paediatrics, University of Umeå, Umeå, Sweden.
    Uges, D.R.A.
    Department of Pharmacy, University Hospital, Groningen, Netherlands.
    De, Graaf S.S.N.
    De Graaf, S.S.N., University Children's Hospital, Nijmegen, Netherlands, Beatrix Children's Hospital, Groningen, Netherlands.
    Vincristine in childhood leukaemia: No pharmacokinetic rationale for dose reduction in adolescents2003In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, no 5, p. 551-557Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate whether there is any pharmacokinetic rationale for the common practice of administering vincristine to adolescents at relatively lower doses than those to younger children. Methods: A total of 98 children, aged 1.3-17.3 y, with acute lymphoblastic leukaemia (ALL) were studied on day 1 of induction therapy. Plasma samples were drawn before and 10, 30, 360 and 1380 min after injection of vincristine 2.0 mg/m2 (maximum dose 2.0 mg) and analysed by high-performance liquid chromatography. Results: The median value (and range) for distribution half-life was 6.4 min (0.8-11.8), elimination half-life 1014 min (258-2570), volume of distribution 445 L/m 2 (137-1241) and total body clearance 362 ml/min/m2 (134-2553). No correlation was found between age and any of these pharmacokinetic parameters. The area under the concentration time curve (AUC) was significantly correlated to age (p = 0.002, ?-0.31), as expected from the dosage of vincristine. The lower AUC in children with a body surface area > 1 m2, which is reached at 8-9 y of age, indicates that they received a less intense treatment because of the capping of the vincristine dose at 2.0 mg. Conclusions: Vincristine pharmacokinetics were not age dependent in this paediatric population. Thus, we found no pharmacokinetic rationale for dose reduction in adolescents. The common practice of limiting the vincristine dose to 2.0 mg should be carefully reconsidered.

  • 40.
    Furuhjelm, Catrin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Warstedt, Kristina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Larsson, Johanna
    Ryhov Hospital.
    Fredriksson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Böttcher, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Fälth-Magnusson, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Duchén, Karel
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy2009In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 9, p. 1461-1467Article in journal (Refereed)
    Abstract [en]

    Maternal intake of omega-3 (-3) polyunsaturated fatty acids (PUFAs) during pregnancy has decreased, possibly contributing to a current increased risk of childhood allergy. Aim: To describe the effects of maternal -3 long-chain PUFA supplementation during pregnancy and lactation on the incidence of allergic disease in infancy. Methods: One hundred and forty-five pregnant women, affected by allergy themselves or having a husband or previous child with allergies, were included in a randomized placebo-controlled trial. Daily maternal supplementation with either 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo was given from the 25(th) gestational week to average 3-4 months of breastfeeding. Skin prick tests, detection of circulating specific immunoglobulin E (IgE) antibodies and clinical examinations of the infants were performed. Results: The period prevalence of food allergy was lower in the -3 group (1/52, 2%) compared to the placebo group (10/65, 15%, p andlt; 0.05) as well as the incidence of IgE-associated eczema (-3 group: 4/52, 8%; placebo group: 15/63, 24%, p andlt; 0.05). Conclusion: Maternal -3 fatty acid supplementation may decrease the risk of food allergy and IgE-associated eczema during the first year of life in infants with a family history of allergic disease.

  • 41.
    Garpenholt, Ö.
    et al.
    Department of Clinical Microbiology, Sec. of Infect. Disease Epidemiology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Hugosson, S.
    Department of Clinical Microbiology, Sec. of Infect. Disease Epidemiology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Fredlund, Hans
    Department of Clinical Microbiology, Sec. of Infect. Disease Epidemiology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Giesecke, J.
    Department of Clinical Microbiology, Sec. of Infect. Disease Epidemiology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Olcén, Per
    Department of Clinical Microbiology, Sec. of Infect. Disease Epidemiology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Invasive disease due to Haemophilus influenzae type b during the first six years of general vaccination of Swedish children2000In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, no 4, p. 471-474Article in journal (Refereed)
    Abstract [en]

    Since 1992-93 vaccination against Haemophilus influenzae type b (Hib) has been included in the general Swedish childhood vaccination programme. The aim of the present study is to describe the epidemiology, identify and describe vaccine failures and calculate vaccine effectiveness during the first 6 y after introduction of vaccination against Hib. Laboratory reports of blood and cerebrospinal isolates to the Swedish Institute for Infectious Disease Control were used as the source for identifying the patients. Additional information was subsequently obtained from physicians and parents of children who had developed the disease during the study period. Vaccine failures were identified and vaccine effectiveness calculated. During the study period, 152 cases of invasive H. influenzae were identified in the age group 0-14 y. During the 6-y period, 6 true vaccine failures, 6 apparent vaccine failures and 1 possible vaccine failure were found in nearly two million vaccinated child-years. The effectiveness of the Hib vaccination in the birth cohort of children 1993 to 1997 in Sweden was calculated to be 96.1% (95% confidence interval 94.2-97.5). The study supports earlier studies from several countries that conjugated Hib vaccination introduced in general childhood vaccination programs is effective and substantially decreases suffering from invasive Hib diseases.

  • 42.
    Gladh, Gunilla
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Eldh, Monica
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Mattsson, Sven
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Quality of life in neurologically healthy children with urinary incontinence2006In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 95, no 12, p. 1648-1652Article in journal (Refereed)
    Abstract [en]

    Aim: To bring forward the arguments for active treatment of urine incontinence in otherwise healthy children, a quality-of-life (QoL) study was performed.

    Subjects and methods: A self-rating QoL questionnaire, child-adjusted and validated, was completed by 120 neurologically healthy children, aged 6–16 y, with urinary incontinence. Another 239 age-matched children made up a control group. The two groups were compared both totally and in age-related subgroups (6–8, 9–12, >12 y) concerning the index for all questions, for universal parts (without questions dealing with incontinence) as well as for specific key domains.

    Results: The patient group had a significantly lower index than the control group both with and without items related to incontinence (p <0.0001). Social situation, self-esteem and self-confidence were most influenced, particularly in the youngest children. Thirty-one children (13%) of the control group reported incontinence and did not score their QoL as good as their continent peers but better than the study patients.

    Conclusion: From the quality-of-life aspects, the study supports active treatment of urinary incontinence in children already at younger ages.

  • 43.
    Gradin, Maria
    Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Effect of oral glucose on the heart rate of healthy newborns2005In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 94, no 3, p. 324-328Article in journal (Refereed)
    Abstract [en]

    Aim: Increases in heart rate have been widely utilized as pain responses in different studies. In a previous study, we found an increase in heart rate in newborns when they received glucose as pain relief. Other research groups have shown a smaller increase in heart rate on administration of sweet solutions. We therefore investigated the question as to whether or not oral glucose itself can cause an increased heart rate in healthy infants.

    Method: This was a randomized, controlled, double-blind study comprising 70 healthy newborns. They were randomly allocated to receive 1 ml 30% glucose or 1 ml placebo solution (sterile water) orally without undergoing any painful procedure. The heart rate was recorded during and at different times after this administration.

    Results: The heart rate was significantly higher in the glucose than in the placebo group (p=0.020). The highest heart rate was noted during treatment, and the heart rate subsequently decreased in both groups (p = 0.002).

    Conclusion: Oral glucose causes an increase in heart rate in healthy newborns not undergoing any painful intervention.

  • 44.
    Granbom, Elin
    et al.
    Umeå University, Sweden .
    Fernlund, Eva
    Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Children's Heart Centre, Lund, Sweden .
    Sunnegårdh, Jan
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Lundell, Bo
    Astrid Lindgren Childrens Hospital, Stockholm, Sweden.
    Naumburg, Estelle
    Umeå University, Sweden .
    Evaluating national guidelines for the prophylactic treatment of respiratory syncytial virus in children with congenital heart disease2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 8, p. 840-845Article in journal (Refereed)
    Abstract [en]

    Aim: This is the first study to evaluate compliance with the 2003 Swedish national guidelines for prophylactic treatment of respiratory syncytial virus (RSV) in children with congenital heart disease (CHD). We estimated the relative risk (RR) of children with CHD being hospitalised with a RSV infection, studied the extent to which RSV prophylactic treatment with palivizumab corresponded to the guidelines and determined the morbidity of children with CHD who developed RSV infection despite prophylaxis.

    Methods: This national observational study comprised prospectively registered data on 219 children with CHD treated with palivizumab, medical records on RSV cases and information on hospitalisation rates of children with CHD and RSV infection.

    Results: The calculated RR of children with CHD being hospitalised with RSV infection was 2.06 (950/0 Cl 1.6-2.6; p less than 0.0001) compared with children without CHD. Approximately half of the patients (49%) born before the RSV season and 25% born during the RSV season did not start treatment as recommended by the guidelines.

    Conclusion: Having CHD increased the rate and estimated RR of children being hospitalised with RSV infection. The guidelines were not followed for about half of the children born before a RSV season and a quarter of the children born during a RSV season and need updating.

  • 45. Grant, C
    et al.
    Högberg, Lotta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Norrköping.
    Fälth-Magnusson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Grodzinsky, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Sundqvist, Tommy
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Medical Microbiology .
    Stenhammar, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    The clinical relevance of duodenal intraepithelial lymphocyte counts in children treated for disease2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed)
    Abstract [en]

      

  • 46.
    Grodzinsky, Ewa
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Faculty of Health Sciences.
    Fälth-Magnusson, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Högberg, Lotta
    Norrköping Hospital, Norrköping, Sweden.
    Jansson, Gunnar
    Motala Hospital, Motala, Sweden.
    Laurin, Pia
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Stenhammar, Lars
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    IgA endomysium antibodies: an early predictor for celiac disease in children without villous atrophy2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 7, p. 972-976Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate possible differences between children with anti-endomysium antibodies (EMA) positivity and normal small bowel mucosa and children with positive EMA and an enteropathy diagnosed as celiac disease (CD).

    Methods: Children with suspected CD and positive EMA (≥1/10) undergoing small bowel biopsy during 1996 to 2002, were investigated (n = 133). Data registered were: year and month of birth, timing of the first biopsy, sex, heredity for CD, dermatitis herpetiformis and diabetes mellitus and outcome of the anti-gliadin antibody test (AGA). The case group, with EMA positivity and normal histology (n = 39; 59% female, mean age at the first biopsy 7.3 years, range 1.4–16), was compared with the disease control group, with positive EMA and a biopsy suggestive and further on diagnosed as CD (n = 94; 56% female; mean age 7.6 years at the first biopsy, range 0.70–17).

    Results: AGA positivity and heredity for CD were found to predict the outcome of a pathological jejunal mucosa. Nineteen of the 39 children in the case group were rebiopsied of whom 11 had developed an enteropathy during a follow-up period of 2–7 years (median 4.5 years).

    Conclusions: EMA positivity in the absence of small bowel enteropathy could be a very early predictor for later overt CD, and necessitates further follow-up, especially if the child is AGA positive and there is a family history of CD.

  • 47.
    Gustafsson, P
    et al.
    Dept of Child and Adolescent Psychiatry Lund University.
    Thernlund, G
    Dept of Child and Adolescent Psychiatry Lund University.
    Besjakov, J
    Dept of Radiology Malmö University Hospital.
    Karlsson, MK
    Dept of Orthopaedics Malmö University Hospital.
    Ericsson, I
    School of Education Malmö University.
    Svedin, Carl Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    ADHD symptoms and maturity - A study in primary school children2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 2, p. 233-238Article in journal (Refereed)
    Abstract [en]

    Aim: To study if age and non-behavioural measures of biological maturity have any associations with attention deficit hyperactivity disorder (ADHD). Methods: Two hundred fifty-one children 7 to 9 years of age in a Swedish school were screened for ADHD-symptom. ADHD-symptoms were estimated by Conners Abbreviated Questionnaire by both parents and teachers. Motor function, body weight and body height were measured. Skeletal age was estimated through hand radiographs. Results: Height, weight and skeletal bone-age did correlate significantly with age (rs = 0.44-0.69, p < 0.001) but not with ADHD symptom scores. Motor dysfunction had a weak negative correlation with age (rs = -0.21, p < 0.05). Parent and teacher scores of ADHD-symptoms did not correlate with age. Conclusion: This study showed that the variables measuring general biological maturity had a strong association with age, whereas motor dysfunction and ADHD symptoms had no significant association with age. ADHD symptoms did not correlate with the variables measuring general biological maturity. These results do not support the hypothesis that a general biological immaturity is an important etiologic factor for ADHD symptomatology. © 2007 The Author(s).

  • 48.
    Gustafsson, Per
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Birberg Thornberg, Ulrika
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Duchén, Karel
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Landgren, Magnus
    Department of Pediatrics, Mariestad, Sweden .
    Malmberg, Kerstin
    Karolinska Institutet, Stockholm.
    Pelling, Henrik
    Uppsala University.
    Strandvik, Birgitta
    Gothenburg University, Sweden.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 10, p. 1540-1549Article in journal (Refereed)
    Abstract [en]

    Aim: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography. Results: EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners total score. In oppositional children (n = 48), CTRS total score improved andgt;= 25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), andgt;= 25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved andgt;= 25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011). Conclusion: Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.

  • 49.
    Gustafsson, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Duchén, Karel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Birberg, Ulrika
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Breastfeeding, very long polyunsaturated fatty acids (PUFA) and IQ at 6 1/2 years of age2004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 10, p. 1280-1287Article in journal (Refereed)
    Abstract [en]

    Aim: Breastfeeding seems to be favorable for cognitive development. Could levels of polyunsaturated fatty acids (PUFA) explain this? Methods: Pregnant mothers were recruited consecutively at maternity care centres. PUFA were analysed in colostrum and breast milk at 1 and 3 mo. The product-precursor ratios of n-6+n-3 PUFA were examined as measures of activity in respective steps in the fatty acid metabolic chain. Also, the quotient between DHA and AA was analysed. The children were tested with the full WISC-III at 6.5 y. Results: First, the influence of length of breastfeeding was analysed by multiple regression together with relevant cofactors (except for PUFA). In the best models, 46% of the variation in total IQ was explained. Length of breastfeeding contributed significantly to total IQ (beta = 0.228, p = 0.021), verbal IQ (beta = 0.204, p = 0.040) and performance IQ (beta = 0.210, p = 0.056). There were no significant single correlations between PUFA and measures of cognitive development. However, in multiple regression analysis of colostrum, significant beta-coefficients were found for steps 4+5 in the fatty acid metabolic chain (beta = 0.559, p = 0.002). If length of breastfeeding and gestation week were added to steps 4+5, this three-factor model could explain 67% of the variation of total IQ. Introducing length of breastfeeding and gestation week together with the quotient DHA/AA (beta = 0.510, p < 0.001) yielded a three-factor model, which explained 76% of the variation in total IQ. Conclusion: Our findings could be interpreted as supporting the importance of high levels of PUFA for cognitive development. However, the sample is small and the results must be interpreted with caution.

  • 50.
    Gäddlin, Per-Olof
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Hellgren, Kerstin
    Department of Ophthalmology, University Hospital, Uppsala, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 4, p. 499-505Article in journal (Refereed)
    Abstract [en]

    Aim: To study the effect of very low birthweight on hospital care and morbidity, and their relationship to gender, birthweight, and neonatal complications.

    Methods: 85 very low birthweight (VLBW; ≤1500 g) children and term controls born in 1987-1988 in south-east region of Sweden were checked in registers regarding readmissions and diagnoses, need for habilitation and child psychiatric care up to 15 years of age. Ophthalmological examinations were made at age 4 in 64 of VLBW and 61 of control children, and at age 15 in 59 of VLBW and 55 of control children.

    Results: VLBW boys had three times more readmissions compared with normal weight control boys (p=0.003). Neonatal risk factors for readmissions were gestational age under 30 weeks (OR 3.1), birthweight less than 1000 g (OR 4.6), mechanical ventilation (OR 9.5), and more than 60 days’ stay in neonatal ward (OR 5.0). A minority of VLBW children had an impairment/handicap such as cerebral palsy (CP) in five (5.9 %) children, attention deficit hyperactivity disorders (ADHD) in five children, and blindness due to retinopathy of prematurity in one child. One child in the control group had ADHD. At the 15-year examination median visual acuity in the best eye was better in the control group (1.6) than in the VLBW group (1.3) (p=0.009). 32% of VLBW children and 11% of controls had latent or manifest strabismus (p=0.007).

    Conclusion: Risk factors for readmissions were gender, low gestational age, birthweight <1000 g or mechanical ventilation. A minority of VLBW children had a handicap that influenced their daily life activities at 15 years of age.

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