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  • 151.
    Lundin, Cecilia
    et al.
    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
    Malmborg, Agota
    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.
    Slezak, Julia
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Gemzell-Danielsson, Kristina
    Department of Women’s and Children’s Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
    Bixo, Marie
    Department of Clinical Science, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden.
    Bengtsdotter, Hanna
    Department of Obstetrics and Gynaecology, Örebro University, Örebro, Sweden.
    Marions, Lena
    Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, Stockholm, Sweden.
    Lindh, Ingela
    Department of Obstetrics and Gynaecology, Sahlgrenska Academy at Gothenburg University; Sahlgrenska University Hospital, Gothenburg, Sweden.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Hammar, Mats
    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.
    Sundström-Poromaa, Inger
    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
    Sexual function and combined oral contraceptives: a randomised, placebo-controlled trial2018In: Endocrine Connections, ISSN 2049-3614, E-ISSN 2049-3614, Vol. 7, no 11, p. 1208-1216Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The effect of combined oral contraceptives (COC) on female sexuality has long been a matter of discussion, but placebo-controlled studies are lacking. Thus, the aim of the present study was to investigate if an estradiol-containing COC influences sexual function.

    DESIGN: Investigator-initiated, randomised, double-blinded, placebo-controlled clinical trial where 202 healthy women were randomized to a combined oral contraceptive (1.5 mg estradiol and 2.5 mg nomegestrol acetate) or placebo for three treatment cycles.

    METHODS: Sexual function at baseline and during the last week of the final treatment cycle was evaluated by the McCoy Female Sexuality Questionnaire. Serum and hair testosterone levels were assessed at the same time points.

    RESULTS: Compared to placebo, COC use was associated with a small decrease in sexual interest (COC median change score: -2.0; interquartile range (IQR): -5.0-0.5 vs. placebo: -1.0; IQR: -3.0-2.0, p = 0.019), which remained following adjustment for change in self-rated depressive symptoms B = -0.80 ± 0.30, Wald = 7.08, p = 0.008. However, the proportion of women who reported a clinically relevant deterioration in sexual interest did not differ between COC or placebo users (COC 18 (22.2%) vs. placebo 16 (17.8%), p = 0.47). Change in other measured aspects of sexual function as well as total score of sexual function did not differ between the two treatments.

    CONCLUSIONS: This study suggests that use of estradiol-based combined oral contraceptives is associated with reduced sexual interest. However, the changes are minute, and probably not of clinical relevance.

  • 152.
    Lundin, Evelyn
    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.
    Borendal Wodlin, Ninnie
    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.
    Nilsson, Lena
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping (ANOPIVA).
    Kjölhede, Preben
    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.
    A prospective randomized assessment of quality of life between open and robotic hysterectomy in early endometrial cancer2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 4, p. 721-727Article in journal (Refereed)
    Abstract [en]

    Objective There are limited prospective data on the evaluation of quality of life in patients undergoing robotic hysterectomy for endometrial cancer. Our objective was to determine whether post-operative recovery differs between robotic and abdominal hysterectomy.

    Methods At a Swedish tertiary referral university hospital, 50 women with low-risk endometrial cancer scheduled for surgery between February 2012 and May 2016 were included in a randomized trial. Surgery was performed according to principles for minimal invasive surgery. Anesthesia and peri-operative care followed a standardized enhanced recovery after surgery program in both groups. The EuroQol Group form EQ-5D and the Short Form-36 were used to evaluate patients' health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms pre-operatively, daily for 7 days from the day of surgery, and then weekly until 6 weeks post-operatively. Data were analyzed by means of non-parametric tests and repeated measures ANOVA. To evaluate the time-dependent occurrence of complications, Kaplan-Meier survival and Cox proportional-hazard models were used.

    Results A total of 50 women were enrolled in the study (25 robotic and 25 abdominal hysterectomy). Median age (68 years vs 67 years), estimated blood loss (50 mL vs 50 mL), length of hospital stay de facto (53 hours vs 51 hours), and time to meet discharge criteria (36 hours vs 36 hours) in the robotic and abdominal groups, respectively, did not differ significantly (p>0.05) Women in the robotic hysterectomy group recovered significantly faster (p=0.01) in the EQ-5D health index, and reached their pre-operative level after approximately 3 weeks, nearly 2 weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) were statistically significant in general health and social functioning only, and were in favor of robotic hysterectomy. Consumption of analgesics, pain intensity, and symptom sum score post-operatively were equal. Occurrence of complications was an independent risk factor and influenced significantly the EQ-5D health index, length of hospital stay, pain intensity, opioid consumption, and symptom sum score adversely.

    Conclusion Robotic hysterectomy in the setting of an enhanced recovery after surgery program led to faster recovery in health-related quality of life compared with abdominal hysterectomy.

  • 153.
    Lundin-Ström, Kristina B.
    et al.
    Lund Univ, Sweden.
    Biloglav, Andrea
    Lund Univ, Sweden.
    Lilljebjorn, Henrik
    Lund Univ, Sweden.
    Rissler, Marianne
    Lund Univ, Sweden.
    Fioretos, Thoas
    Lund Univ, Sweden; Department of Clinical Genetics and Pathology, Division of Laboratory Medicine, Lund, Sweden.
    Hansson, Markus
    Lund Univ, Sweden.
    Behrendtz, Mikael
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Castor, Anders
    Skane Univ Hosp, Sweden.
    Olsson, Linda
    Department of Clinical Genetics and Pathology, Division of Laboratory Medicine, Lund, Sweden.
    Johansson, Bertil
    Lund Univ, Sweden; Department of Clinical Genetics and Pathology, Division of Laboratory Medicine, Lund, Sweden.
    Whole-exome sequencing exploration of acquired uniparental disomies in B-cell precursor acute lymphoblastic leukemia2018In: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 32, no 9, p. 2058-2062Article in journal (Refereed)
    Abstract [en]

    n/a

  • 154.
    Ma, Tan
    et al.
    Nanjing University, Peoples R China.
    Yin, Xiaoqin
    Nanjing University, Peoples R China.
    Han, Ruitong
    Nanjing University, Peoples R China.
    Ding, Jie
    Nanjing University, Peoples R China.
    Zhang, Huan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Han, Xiaodong
    Nanjing University, Peoples R China.
    Li, Dongmei
    Nanjing University, Peoples R China.
    Effects of In Utero Exposure to Di-n-Butyl Phthalate on Testicular Development in Rat2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 10, article id 1284Article in journal (Refereed)
    Abstract [en]

    Humans are inevitably exposed to ubiquitous phthalate esters (PAEs). In utero exposure to di-n-butyl phthalate (DBP) induces abnormal development of the testis and reproductive tract in male offspring, which correspond closely with the human condition of testicular dysgenesis syndrome (TDS)-like syndrome. However, the underlying mechanisms have not been elucidated in detail. In this study, pregnant rats were orally exposed to either corn oil (controls) or DBP at three different doses by gavage during Gestational Days 12.5-21.5. Pathological examinations were performed for toxicity evaluation. Proliferation and apoptosis related proteins (ras related dexamethasone induced 1 (Rasd1), mitogen-activated protein kinase kinases1/2 (MEK1/2), Bcl-2, and Bax) were measured for mechanisms exploration. The results showed that different doses of DBP caused male developmental and reproductive toxicity in rats, including the decrease of anogenital distance (AGD), the histological damage of testis, and apoptosis of seminiferous tubule cells. Our data suggested that DBP played chronic and continuous toxic roles on male reproductive system by disrupting expression of Rasd1 and MEK1/2 as well as Bcl-2/Bax ratio. Further research is warranted.

  • 155.
    Magnusson, Rasmus
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics. Linköping University, Faculty of Science & Engineering.
    Mariotti, Guido
    Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics. Linköping University, Faculty of Science & Engineering.
    Köpsén, Mattias
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Lövfors, William
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Gawel, Danuta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Jornsten, Rebecka
    University of Gothenburg, Sweden.
    Linde, Joerg
    Hans Knoell Institute, Germany; Hans Knoell Institute, Germany.
    Nordling, Torbjorn
    National Cheng Kung University, Taiwan; Science Life Lab, Sweden.
    Nyman, Elin
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Schulze, Sylvie
    Hans Knoell Institute, Germany.
    Nestor, Colm
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Zhang, Hanmin
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, The Institute of Technology.
    Cedersund, Gunnar
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Benson, Mikael
    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, Heart and Medicine Center, Allergy Center.
    Tjärnberg, Andreas
    Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics. Linköping University, Faculty of Science & Engineering.
    Gustafsson, Mika
    Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics. Linköping University, Faculty of Science & Engineering.
    LASSIM-A network inference toolbox for genome-wide mechanistic modeling2017In: PloS Computational Biology, ISSN 1553-734X, E-ISSN 1553-7358, Vol. 13, no 6, article id e1005608Article in journal (Refereed)
    Abstract [en]

    Recent technological advancements have made time-resolved, quantitative, multi-omics data available for many model systems, which could be integrated for systems pharmacokinetic use. Here, we present large-scale simulation modeling (LASSIM), which is a novel mathematical tool for performing large-scale inference using mechanistically defined ordinary differential equations (ODE) for gene regulatory networks (GRNs). LASSIM integrates structural knowledge about regulatory interactions and non-linear equations with multiple steady state and dynamic response expression datasets. The rationale behind LASSIM is that biological GRNs can be simplified using a limited subset of core genes that are assumed to regulate all other gene transcription events in the network. The LASSIM method is implemented as a general-purpose toolbox using the PyGMO Python package to make the most of multicore computers and high performance clusters, and is available at https://gitlab.com/Gustafsson-lab/lassim. As a method, LASSIM works in two steps, where it first infers a non-linear ODE system of the pre-specified core gene expression. Second, LASSIM in parallel optimizes the parameters that model the regulation of peripheral genes by core system genes. We showed the usefulness of this method by applying LASSIM to infer a large-scale non-linear model of naive Th2 cell differentiation, made possible by integrating Th2 specific bindings, time-series together with six public and six novel siRNA-mediated knock-down experiments. ChIP-seq showed significant overlap for all tested transcription factors. Next, we performed novel time-series measurements of total T-cells during differentiation towards Th2 and verified that our LASSIM model could monitor those data significantly better than comparable models that used the same Th2 bindings. In summary, the LASSIM toolbox opens the door to a new type of model-based data analysis that combines the strengths of reliable mechanistic models with truly systems-level data. We demonstrate the power of this approach by inferring a mechanistically motivated, genome-wide model of the Th2 transcription regulatory system, which plays an important role in several immune related diseases.

  • 156.
    Malmborg, Agota
    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 Gynaecology and Obstetrics in Linköping.
    Brynhildsen, Jan
    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.
    Hammar, Mats
    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.
    A survey of young womens perceptions of the influence of the Levonorgestrel-Intrauterine System or copper-intrauterine device on sexual desire2019In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 21, p. 75-80Article in journal (Refereed)
    Abstract [en]

    Objectives: Few studies, with contradictory results, evaluate intrauterine contraceptives (IUC) and sexual function specifically. This study compares perception of sexual desire related to IUC use and aspects of sexual function in women who use the Lng-IUS with those using the Cu-IUD. Study design: A secondary analysis regarding IUC use based on a larger cross-sectional survey of contraceptive use in Sweden, conducted in 2013. In total, 153 IUC users (103 Cu-IUD and 50 Lng-IUS users) answered the questionnaire. The only inclusion criterion was intrauterine contraceptive use. Main outcome measures: Were self-reported sexual desire changes related to contraceptive method. We also analysed aspects of sexual functioning; sexual desire level, sexual activity, orgasm frequency, satisfaction with sex life and satisfaction of desire level. Results: A negative effect on sexual desire due to contraceptive method was reported by 28% of the Lng-IUS users and by 10.1% of the Cu-IUD users (p amp;lt; 0.05). Results were more marked after adjusting for age, body mass index, depression, parity, switching behaviour, and partnership (OR 5.0; CI: 1.8-13.8). The adjusted odds of reporting low sexual desire level (never or almost never feeling sexual desire) (OR 3.5; CI: 1.1-11.2) as well as low satisfaction with sex life (OR 2.7; CI: 1.2-6.3) was higher in the Lng-IUS group (adjusted for same confounders as above). Conclusions: The women in this study using the Lng-IUS more often report negative sexual desire effects of their contraception as well as lower sexual desire level compared with women using the Cu-IUD.

  • 157.
    Marcotte, Harold
    et al.
    Karolinska University Hospital Huddinge, Sweden.
    Krogh Andersen, Kasper
    Karolinska University Hospital Huddinge, Sweden.
    Lin, Yin
    Karolinska University Hospital Huddinge, Sweden.
    Zuo, Fanglei
    Karolinska University Hospital Huddinge, Sweden.
    Zeng, Zhu
    Karolinska University Hospital Huddinge, Sweden.
    Larsson, Per-Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Skaraborg Hospital, Sweden.
    Brandsborg, Erik
    Bifodan AS, Denmark.
    Bronstad, Gunnar
    Neurozym Biotech AS, Norway.
    Hammarstrom, Lennart
    Karolinska University Hospital Huddinge, Sweden.
    Characterization and complete genome sequences of L. rhamnosus DSM 14870 and L-gasseri DSM 14869 contained in the EcoVag (R) probiotic vaginal capsules2017In: Microbiology Research, ISSN 0944-5013, E-ISSN 1618-0623, Vol. 205, p. 88-98Article in journal (Refereed)
    Abstract [en]

    Lactobacillus rhamnosus DSM 14870 and Lactobacillus gasseri DSM 14869 were previously isolated from the vaginal epithelial cells (VEC) of healthy women and selected for the development of the vaginal EcoVag (R) probiotic capsules. EcoVag (R) was subsequently shown to provide long-term cure and reduce relapse of bacterial vaginosis (BV) as an adjunct to antibiotic therapy. To identify genes potentially involved in probiotic activity, we performed genome sequencing and characterization of the two strains. The complete genome analysis of both strains revealed the presence of genes encoding functions related to adhesion, exopolysaccharide (EPS) biosynthesis, antimicrobial activity, and CRISPR adaptive immunity but absence of antibiotic resistance genes. Interesting features of L. rhamnosus DSM 14870 genome include the presence of the spaCBA-srtC gene encoding spaCBA pill and interruption of the gene cluster encoding long galactose-rich EPS by integrases. Unique to L. gasseri DSM 14869 genome was the presence of a gene encoding a putative (1456 amino acid) new adhesin containing two rib/alpha-like repeats. L. rhamnosus DSM 14870 and L. gasseri DSM 14869 showed acidification of the culture medium (to pH 3.8) and a strong adhesion capability to the Caco-2 cell line and VEC. L gasseri DSM 14869 could produce a thick (40 nor) EPS layer and hydrogen peroxide. L. rhamnosus DSM 14870 was shown to produce SpaCBA pili and a 20 nor EPS layer, and could inhibit the growth of Gardnerella vaginalis, a bacterium commonly associated with BV. The genome sequences provide a basis for further elucidation of the molecular basis for their probiotic functions.

  • 158.
    Martinez, C. A.
    et al.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cambra, J. M.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Nohalez, A.
    Univ Murcia, Spain; CISA, Spain.
    Parrilla, I.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Sanchez-Osorio, J.
    Topigs Norsvin Espana, Spain.
    Roca, J.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Gil, M. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Martinez, E. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cuello, C.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Porcine blastocyst viability and developmental potential is maintained for 48 h of liquid storage at 25 degrees C without CO2 gassing2019In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 135, p. 46-55Article in journal (Refereed)
    Abstract [en]

    Short- and medium-term storage of pig embryos has become relevant for commercial application of nonsurgical deep uterine embryo transfer (NsDU-ET) in the light of the strict legal and administrative requirements posed by the International Association for Air Transport (IATA) to allow shipment of liquid nitrogen (LN2) containers and the technical drawbacks when using vitrified embryos. Therefore, this study developed an efficient method for the liquid storage of in vivo-derived porcine blastocysts for a moderate duration (48 h) without controlled CO2 gassing. We evaluated two storage temperatures (25 degrees C and 37 degrees C) and three HEPES-supplemented media: the chemically defined media TL-PVA and NCSU-PVA and the semi-defined medium NCSU-BSA. We observed no differences in survival, hatching rate or final developmental stage between the two temperatures, but storage at 25 degrees C was more efficient to preserve zona pellucida (ZP) integrity. Blastocysts were successfully stored for 24 h in a chemically defined medium. Yet, only 48 h storage in NCSU-BSA medium supported blastocyst development. Although all storage conditions resulted in an embryonic developmental delay, blastocysts stored in NCSU-BSA at either tested temperature could hatch and attain the same final developmental stage as control blastocysts when cultured under standard conditions after storage. Moreover, blastocysts stored at 25 degrees C for 48 h in NCSU-BSA medium could produce pregnancies after surgical transfer. In conclusion, porcine blastocysts maintain their viability and developmental potential after storage in the semi-defined medium NCSU-BSA for at least 48 hat 25 degrees C. (C) 2019 Elsevier Inc. All rights reserved.

  • 159.
    Martinez, C. A.
    et al.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Nohalez, A.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Ceron, J. J.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Rubio, C. P.
    University of Murcia, Spain.
    Roca, J.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Cuello, C.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, E. A.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Gil, M. A.
    University of Murcia, Spain; Institute Biomed Research Murcia IMIB Arrixaca, Spain.
    Peroxidized mineral oil increases the oxidant status of culture media and inhibits in vitro porcine embryo development2017In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 103, p. 17-23Article in journal (Refereed)
    Abstract [en]

    The use of oils with undetected alterations is a long-recognized problem for in vitro embryo production systems. Since peroxides in oils have been associated with reduced embryo production outcomes, our goals were (1) to evaluate the effects of a batch of mineral oil (MO) that was suspected to be altered on the in vitro production of pig embryos and (2) to determine oil peroxide values throughout culture and the transfer of oxidant agents from oil to culture media. Sunflower oil, which has a completely different chemical composition than MO but a higher oxidative status, and unaltered MO were used as controls. Oocyte maturation, fertilization and embryo development were affected differently depending on the oil overlay used. While the suspected MO was not able to sustain in vitro maturation and fertilization, the oocytes incubated in the presence of sunflower oil were matured and fertilized similarly to those of the unaltered MO group. Moreover, the cleavage rate of presumed zygotes cultured under the suspected MO was severely reduced compared with those cultured under the other oils, and none of the cleaved embryos developed to the blastocyst stage. Although the cleavage rates in the sunflower oil and unaltered MO groups were similar, embryos cultured under sunflower oil also failed to develop to the blastocyst stage. Our results revealed that the suspected MO and sunflower oil had similar levels of peroxides and that these levels were much higher than those of the unaltered MO. The total oxidant status was higher in media incubated under peroxidized oils than in fresh media or media incubated without an oil overlay or under unaltered MO, indicating that oxidant agents were transferred to the incubation media. However, unlike the sunflower oil group, the culture media incubated under the suspected MO had high levels of total oxidant status and low levels of hydrogen peroxide and reactive oxygen species, suggesting the presence of other unknown oxidant agents in that oil. These results indicate that a peroxidized MO overlay dramatically decreases embryo production outcomes. This decrease could be associated with the higher peroxide values of the oil but cannot be explained by the levels of hydrogen peroxide and reactive oxygen species transferred from the oil to the culture media. It is likely that different oxidant agent(s) and/or other toxic compounds present in the peroxidized MO are responsible for its damaging effects on oocytes and embryos. (C) 2017 Elsevier Inc. All rights reserved.

  • 160.
    Martinez, C. A.
    et al.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Nohalez, A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Parrilla, I.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Lucas, X.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Sanchez-Osorio, J.
    Topigs Norsvin Espana, Spain.
    Roca, J.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cuello, C.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, E. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Gil, M. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Simple storage (CO2-free) of porcine morulae for up to three days maintains the in vitro viability and developmental competence2018In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 108, p. 229-238Article in journal (Refereed)
    Abstract [en]

    The advancement of porcine embryo transfer (ET) technology is constrained by regulatory hurdles (liquid nitrogen transportation) or, more importantly, the technical obstacles of using vitrified embryos in combination with nonsurgical deep uterine ET technology. Maintaining embryos in culture during transport and prior ET collides with the need of CO2 gassing and the best choice of culture medium. In this work, we describe storage conditions for short-term embryo CO2-free storage that allowed for a majority of in vivo-derived porcine morulae to survive after 3 days of storage in a liquid state, and to develop to the blastocyst stage unhatched, a sanitary prerequisite for ET. The storage conditions included NCSU-23 medium supplemented with bovine serum albumin, where bicarbonate was partially replaced by HEPES to avoid the need for CO2 gassing, and a temperature of 37 degrees C. These conditions were able to maintain the functionality of the stored embryos (hatching capacity after exposure to conventional culture conditions) and their developmental competence after ET (normal fetuses by day 38 of pregnancy). Use of this strategy of CO2-free storage should allow the shipment of fresh embryos worldwide in the absence of liquid nitrogen. (C) 2017 Elsevier Inc. All rights reserved.

  • 161.
    Martinez, C. A.
    et al.
    University of Murcia, Spain.
    Nohalez, A.
    University of Murcia, Spain.
    Parrilla, I.
    University of Murcia, Spain.
    Vazquez, J. L.
    University of Murcia, Spain.
    Roca, J.
    University of Murcia, Spain.
    Cuello, C.
    University of Murcia, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, E. A.
    University of Murcia, Spain.
    Gil, M. A.
    University of Murcia, Spain.
    Surgical embryo collection but not nonsurgical embryo transfer compromises postintervention prolificacy in sows2017In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 87, p. 316-320Article in journal (Refereed)
    Abstract [en]

    Recent advances in nonsurgical deep uterine (NsDU) embryo transfer (ET) technology allow the noninvasive transfer of porcine embryos into recipients, overcoming the most important impediment for commercial ET in this species. Although many factors in the porcine ET-field have been recently evaluated, many others remain to be explored. We investigated here the future reproductive performance of donors and recipients after artificial insemination subsequent to the default surgical embryo recovery approach and to the NsDU-ET procedure, respectively. Although surgical embryo collection did not influence subsequent farrowing rates (90.5%), litter size decreased severely (8.9 +/- 0.8 piglets) compared to presurgery (10.8 +/- 0.3 piglets) and control group (10.7 +/- 0.3 piglets). In contrast, NsDU-ETs did neither affect fertility nor prolificacy of recipients in the cycle subsequent to ET, regardless of whether they were pregnant after NsDU-ET or not. These results indicate that while the surgical embryo collection procedure compromises the reproductive future of donor sows, the NsDU-ET approach does not affect the reproductive potential of the recipients after reintroduction to the breeding stock of the farm. Further research is thus needed to improve surgical embryo collection. (C) 2016 Elsevier Inc. All rights reserved.

  • 162.
    Martinez, Cristina A.
    et al.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cambra, Josep M.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Nohalez, Alicia
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Parrilla, Inmaculada
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Roca, Jordi
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Vazquez, Jose L.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Gil, Maria A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Martinez, Emilio A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cuello, Cristina
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Prevention of hatching of porcine morulae and blastocysts by liquid storage at 20 degrees C2019In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 6219Article in journal (Refereed)
    Abstract [en]

    Vitrification is the ideal method for long-lasting storage of porcine embryos. However, both strict airline regulations for transport of liquid nitrogen dewars and the technical problems experienced when vitrified embryos are transferred using non-surgical procedures have led to the introduction of alternative storage methods, such as preserving embryos in liquid state. This study evaluated whether a pH-stable medium containing high concentrations of either foetal calf serum (FCS; 50%) or BSA (4%) combined with storage at temperatures of 17 degrees C or 20 degrees C maintained in vivo-derived morulae and blastocysts alive and unhatched (a sanitary requirement for embryo transportation) during 72 h of storage. Neither FCS nor BSA supplements were able to counteract the negative effect of low temperatures (17 degrees C) on embryonic survival after storage. At 20 degrees C, the protective effect of FCS or BSA depended on embryo stage. While FCS successfully arrested embryo development of only blastocysts, BSA arrested the development of both morulae and blastocysts. Over 80% of BSA arrested embryos restarted development by conventional culture and progressed to further embryonic stages, including hatching. In conclusion, porcine morulae and blastocysts can survive and remain unhatched during at least 72 h when stored at 20 degrees C in a BSA-containing medium.

  • 163.
    Martinez, Cristina A.
    et al.
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Nohalez, Alicia
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Parrilla, Inmaculada
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Motas, Miguel
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Roca, Jordi
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Romero, Inmaculada
    CSIC, Spain.
    Garcia-Gonzalez, Diego L.
    CSIC, Spain.
    Cuello, Cristina
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, Emilio A.
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    Gil, Maria A.
    University of Murcia, Spain; IMIB Arrixaca, Spain.
    The overlaying oil type influences in vitro embryo production: differences in composition and compound transfer into incubation medium between oils2017In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, article id 10505Article in journal (Refereed)
    Abstract [en]

    The oil overlay micro-drop system is widely used for cultures of mammalian gametes and embryos. We evaluated hereby the effects of two unaltered commercial oils-Sigma mineral oil (S-MO) and Nidoil paraffin oil (N-PO)-on in vitro embryo production (IVP) outcomes using a pig model. The results showed that while either oil apparently did not affect oocyte maturation and fertilization rates, S-MO negatively affected embryo cleavage rates, blastocyst formation rates, and, consequently, total blastocyst efficiency of the system. No differences in the oxidation state were found between the oils or culture media incubated under S-MO or N-PO. Although both oils slightly differed in elemental composition, there were no differences in the concentrations of elements between fresh media and media incubated under oils. By contrast, we demonstrated clear oil-type differences in both the composition of volatile organic compounds (VOC) and the transfer of some of these VOCs (straight-chain alkanes and pentanal and 1,3-diethyl benzene) to the culture medium, which could have influenced embryonic development.

  • 164.
    Martínez-Pastor, Felipe
    et al.
    Department of Molecular Biology (Cell Biology), Universidad de León, Spain; INDEGSAL, Universidad de León, León, Spain.
    Álvarez, Mercedes
    INDEGSAL, Universidad de León, León, Spain; Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain.
    Guerra, Camino
    Department of Animal Health and Anatomy, Veterinary Faculty, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Chamorro, César A
    Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; Department of Animal Health and Anatomy, Veterinary Faculty, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Anel-López, Luis
    INDEGSAL, Universidad de León, León, Spain; Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain.
    de Paz, Paulino
    Department of Molecular Biology (Cell Biology), Universidad de León, Spain; INDEGSAL, Universidad de León, León, Spain.
    Anel, Luis
    INDEGSAL, Universidad de León, León, Spain; Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain.
    Alvarez-Rodriguez, Manuel
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. INDEGSAL, Universidad de León, León, Spain; Department of Animal Health and Anatomy, Veterinary Faculty, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Extender osmolality, glycerol and egg yolk on the cryopreservation of epididymal spermatozoa for gamete banking of the Cantabric Chamois (Rupicapra pyrenaica parva)2019In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 125, p. 109-114, article id S0093-691X(18)30573-9Article in journal (Refereed)
    Abstract [en]

    Germplasm banking is a key technology enabling the ex-situ conservation of wild species. However, cryopreservation protocols must be tested to assure the applicability of the banked material. The objective of this study was defining a range of parameters for the composition of a semen extender for Cantabrian chamois epididymal spermatozoa (post-mortem collection). The freezing extender was based in a TES-Tris-fructose buffer, modifying its composition in three experiments: Osmolality of the buffer (320, 380 or 430 mOsm/kg, 8% glycerol, 15% egg yolk), glycerol (4 or 8%, 430 mOsm/kg, 15% egg yolk), egg yolk (10 or 15%, 430 mOsm/kg, 4% glycerol). Sperm was extended at 100 mill. spermatozoa/ml, cooled at 5 °C and frozen at -20 °C/min. Sperm quality was assessed pre and post-thawing (CASA, HOS test, abnormal forms, cytoplasmic droplets, and viability and acrosomal damage by flow cytometry). Freezability was good overall, with total motility of 65.5% ± 2.4 initial and 55.8% ± 2.4 post-thawing. The extenders affected the post-thaw sperm quality marginally. Whereas osmolalities and glycerol concentrations seemed not to differ, 430 mOsm/kg and 4% glycerol might be preferred. Egg yolk concentrations only differed on sperm velocity (VCL: 84.0 ± 6.7 μm/s in 10% vs. 70.7 ± 6.2 μm/s in 15%, P < 0.05). Our results suggest a good cryotolerance of chamois epididymal spermatozoa, with a preferred extender composition of hyperosmotic buffer, glycerol in the 4% range and lower egg yolk (10% range) than other ruminants.

  • 165.
    Mattsson, Sven
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Persson, D.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Glad Mattsson, 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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Lindström, S.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Night-time diuresis pattern in children with and without primary monosymptomatic nocturnal enuresis2019In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 15, no 3, p. 229.e1-229.e8Article in journal (Refereed)
    Abstract [en]

    Introduction

    Night-time polyuria as the dominating pathophysiological mechanism for primary monosymptomatic nocturnal enuresis (PMNE) has been put in question with nocturnal detrusor overactivity and high arousal thresholds as alternatives. An earlier finding of night-time polyuria in 12% of healthy non-enuretic schoolchildren underscores that excessive night-time diuresis per se is unlikely the major cause of PMNE.

    Objective

    The objective of this study was to compare the night-time diuresis pattern in children with and without PMNE and to evaluate the role of night-time polyuria in provoking enuretic episodes in children with PMNE.

    Study design

    Night-time diuresis pattern was recorded in 27 children with PMNE, aged 6–15 years, and 29 non-enuretic children, aged 6–13 years. Using a portable ultrasound recorder, the bladder volume was estimated at 15-min intervals for at least three nights with the child sleeping in its own bed at home. The volume of enuretic episodes was controlled using preweighed diapers. All voids were registered by time and volume. Diuresis during night time was estimated from the slope of regression lines fitted to ultrasound recording points. Mean night-time diuresis was calculated from total urine production during the night and time interval from the last void before bedtime to the first morning void.

    Results

    Night-time bladder filling pattern was recorded from 189 nights, giving 149 interpretable patterns for analysis (77 children with PMNE and 72 dry children). The night-time diuresis pattern was similar for children with or without PMNE, showing large variability between different nights of the same child. Most nights displayed a smooth bladder filling at constant low rate, whereas other nights showed an early phase with high diuresis followed by a longer period of low diuresis with no difference between the two groups.

    Discussion

    Night-time diuresis has been non-invasively monitored in children while asleep in their own beds at home. The pattern of night-time diuresis varies considerably between different nights of the same child, with no obvious differences in any diuresis parameters between children with or without PMNE.

    Conclusion

    Non-enuretic children have similar diuresis pattern and maximal night-time diuresis values as children with PMNE, making it unlikely that PMNE is caused by night-time polyuria per se (Summary figure). Delayed maturation of sleep mechanisms such as decreased arousability or sleep inhibition of the micturition reflex is more likely to be the main etiology for enuresis.

  • 166.
    Meehan, Richard R.
    et al.
    Univ Edinburgh, Scotland.
    Thomson, John P.
    Univ Edinburgh, Scotland.
    Lentini, Antonio
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Nestor, Colm
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Pennings, Sari
    Univ Edinburgh, Scotland.
    DNA methylation as a genomic marker of exposure to chemical and environmental agents2018In: Current opinion in chemical biology, ISSN 1367-5931, E-ISSN 1879-0402, Vol. 45, p. 48-56Article, review/survey (Refereed)
    Abstract [en]

    Recent progress in interpreting comprehensive genetic and epigenetic profiles for human cellular states has contributed new insights into the developmental origins of disease, elucidated novel signalling pathways and enhanced drug discovery programs. A similar comprehensive approach to decoding the epigenetic readouts from chemical challenges in vivo would yield new paradigms for monitoring and assessing environmental exposure in model systems and humans.

  • 167.
    Menditto, E.
    et al.
    CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy; University of Naples Federico II, Naples, Italy.
    Costa, E.
    UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal.
    Midão, L.
    UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal.
    Bosnic-Anticevich, S.
    Woolcock Institute of Medical Research, University of Sydney Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia.
    Novellino, E.
    University of Naples Federico II, Naples, Italy.
    Bialek, S.
    Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland.
    Briedis, V.
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Mair, A.
    DG for Health and Social Care, Scottish Government, Edinburgh, United Kingdom.
    Rajabian-Soderlund, R.
    Department of Nephrology and Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
    Arnavielhe, S.
    KYomed INNOV, Montpellier, France.
    Bedbrook, A.
    MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
    Czarlewski, W.
    Medical Consulting Czarlewski, Levallois, France.
    Annesi-Maesano, I.
    Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris, France.
    Anto, J.M.
    ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
    Devillier, P.
    Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes, France; Université Versailles Saint-Quentin, Université Paris Saclay, Paris Saclay, France.
    De, Vries G.
    Peercode BV, Geldermalsen, Netherlands.
    Keil, T.
    Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.
    Sheikh, A.
    The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.
    Orlando, V.
    CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy; University of Naples Federico II, Naples, Italy.
    Larenas-Linnemann, D.
    Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
    Cecchi, L.
    SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
    De, Feo G.
    Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy.
    Illario, M.
    Division for Health Innovation, Campania Region and Federico II University Hospital Naples (RandD and DISMET), Naples, Italy.
    Stellato, C.
    Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy.
    Fonseca, J.
    CINTESIS, Center for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; MEDIDA, Lda, Porto, Portugal.
    Malva, J.
    Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal; Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
    Morais-Almeida, M.
    Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
    Pereira, A.M.
    Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal; Center for Research in Health Technologies and Information Systems CINTESIS, Universidade do Porto, Porto, Portugal.
    Todo-Bom, A.M.
    Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
    Kvedariene, V.
    Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
    Valiulis, A.
    Department of Public Health, Clinic of Childrens Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
    Bergmann, K.C.
    Charité – Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany.
    Klimek, L.
    Euforea, Brussels, Belgium.
    Mösges, R.
    Medical Faculty, Institute of Medical Statistics, and Computational Biology, University of Cologne, Cologne, Germany; CRI-Clinical Research International-Ltd, Hamburg, Germany.
    Pfaar, O.
    Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany.
    Zuberbier, T.
    Charité – Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany.
    Cardona, V.
    Allergy Section, Department of Internal Medicine, Hospital Vall dHebron, and ARADyAL Spanish Research Network, Barcelona, Spain.
    Mullol, J.
    Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
    Papadopoulos, N.G.
    Division of Infection, Immunityand Respiratory Medicine, Royal Manchester Childrens Hospital, University of Manchester, Manchester, United Kingdom; Allergy Department, 2nd Pediatric Clinic, Athens General Childrens Hospital “PandA Kyriakou”, University of Athens, Athens, Greece.
    Prokopakis, E.P.
    Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece.
    Bewick, M.
    iQ4U Consultants Ltd, London, United Kingdom.
    Ryan, D.
    Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, United Kingdom.
    Roller-Wirnsberger, R.E.
    Department of Internal Medicine, Medical University of Graz, Graz, Austria.
    Tomazic, P.V.
    Department of ENT, Medical University of Graz, Graz, Austria.
    Cruz, A.A.
    ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil; WHO GARD Planning Group, Salvador, Brazil.
    Kuna, P.
    Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
    Samolinski, B.
    Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
    Fokkens, W.J.
    Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands.
    Reitsma, S.
    Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands.
    Bosse, I.
    Allergist, La Rochelle, France.
    Fontaine, J.-F.
    Allergist, Reims, France.
    Laune, D.
    KYomed INNOV, Montpellier, France.
    Haahtela, T.
    Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
    Toppila-Salmi, S.
    Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
    Bachert, C.
    Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
    Hellings, P.W.
    Euforea, Brussels, Belgium.
    Melén, E.
    Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wickman, M.
    Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Bindslev-Jensen, C.
    Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
    Eller, E.
    Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
    OHehir, R.E.
    Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Immunology, Monash University, Melbourne, VIC, Australia.
    Cingi, C.
    ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey.
    Gemicioglu, B.
    Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
    Kalayci, O.
    Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.
    Ivancevich, J.C.
    Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
    Bousquet, J.
    Euforea, Brussels, Belgium.
    the, MASK group
    Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study2019In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 4, p. 442-460Article in journal (Refereed)
    Abstract [en]

    Background

    Mobile technology may help to better understand the adherence to treatment. MASK‐rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient‐centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries.

    Objectives

    To assess the adherence to treatment in allergic rhinitis patients using the Allergy DiaryApp.

    Methods

    An observational cross‐sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach.

    Results

    A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty‐six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non‐adherent to medications (MPR <70%). Of those, the largest group was non‐adherent to medications and the time interval was increased in 442 (36.68%) users.

    Conclusion and clinical relevance

    Adherence to treatment is low. The relative efficacy of continuous vs on‐demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication‐taking behaviour in a real‐world setting.

  • 168.
    Munoz, P. Martin
    et al.
    University of Extremadura, Spain.
    Anel-Lopez, L.
    University of Leon, Spain.
    Ortiz-Rodriguez, J. M.
    University of Extremadura, Spain.
    Alvarez, M.
    University of Leon, Spain.
    de Paz, P.
    University of Leon, Spain.
    Balao da Silva, C.
    Super Agriculture School Elvas, Portugal.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Gil, M. C.
    University of Extremadura, Spain.
    Anel, L.
    University of Leon, Spain.
    Pena, F. J.
    University of Extremadura, Spain.
    Ortega Ferrusola, C.
    University of Leon, Spain.
    Redox cycling induces spermptosis and necrosis in stallion spermatozoa while the hydroxyl radical (OH center dot) only induces spermptosis2018In: Reproduction in domestic animals, ISSN 0936-6768, E-ISSN 1439-0531, Vol. 53, no 1, p. 54-67Article in journal (Refereed)
    Abstract [en]

    Oxidative stress is a major factor explaining sperm dysfunction of spermatozoa surviving freezing and thawing and is also considered a major inducer of a special form of apoptosis, visible after thawing, in cryopreserved spermatozoa. To obtain further insights into the link between oxidative stress and the induction of apoptotic changes, stallion spermatozoa were induced to oxidative stress through redox cycling after exposure to 2-methyl-1,4-naphthoquinone (menadione), or hydroxyl radical formation after FeSO4 exposure. Either exposure induced significant increases (p amp;lt; 0.05) in two markers of lipid peroxidation: 8-iso-PGF(2) and 4-hydroxynonenal (4-HNE). While both treatments induced changes indicative of spermptosis (caspase-3 activation and decreased mitochondrial membrane potential) (p amp;lt; 0.01), menadione induced sperm necrosis and a dramatic reduction in motility and thiol content in stallion spermatozoa. Thus, we provided evidence that oxidative stress underlies spermptosis, and thiol content is a key factor for stallion sperm function.

  • 169.
    Myleus, Anna
    et al.
    Umea Univ, Sweden.
    Stenhammar, Lars
    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 Norrköping.
    Högberg, Lotta
    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 Norrköping.
    Browaldh, Lars
    Karolinska Inst, Sweden; Soder Sjukhuset, Sweden.
    Daniels, Ing-Marie
    Uppsala Univ Hosp, Sweden.
    Fagerberg, Ulrika L.
    Vastmanland Hosp, Sweden; Karolinska Inst, Sweden.
    Gudjonsdottir, Audur H.
    Sahlgrens Univ Hosp, Sweden.
    Malmquist, Marianne
    Sahlgrens Univ Hosp, Sweden.
    Sandstrom, Olof
    Umea Univ, Sweden.
    Ivarsson, Anneli
    Umea Univ, Sweden.
    Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1140-1143Article in journal (Refereed)
    Abstract [en]

    Aim In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction. Methods In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies. Results All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia. Conclusion The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

  • 170.
    Möller, Louise
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Health, obstetric outcomes and reproduction in women with vulvar pain or primary fear of childbirth2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Fear of childbirth (FOC) is common and affects approximately 5-20 % of all pregnant women. FOC is associated with giving birth by caesarean section on maternal request (CSMR). The rate of caesarean sections (CS) and CSMR has increased during the last decades. To decrease these women’s fear, the rate of CSMR and to promote a more positive birth experience, many treatments for FOC have been evaluated. In Sweden, the treatment is individualized and given by obstetricians, midwives, psychologists or psychotherapists in the specialist care.

    Women with FOC suffer more often from psychiatric illness and rate their general health as less good, which is important to consider when counselling these women and deciding on mode of delivery. Little is known about the long term obstetric and reproductive outcomes for women with FOC. Therefore, the aim of the studies on which this thesis is based was to compare psychiatric care before and after childbirth in women giving birth by CSMR to women giving birth by other modes of delivery and to follow the subsequent obstetric and reproductive outcomes in women receiving counselling for FOC in their first childbirth. Furthermore, we hypothesized that women with localized provoked vulvodynia (LPV) and/or vaginismus might fear vaginal childbirth and little is known about their reproduction and obstetric outcomes which is why we investigated the parity and obstetric outcomes in women diagnosed with LPV/vaginismus before first childbirth.

    Based on data linked from several Swedish National registers, the prevalence of psychiatric in- and outpatient care before (paper I) and after first childbirth (paper II) was compared in primiparae giving birth by CSMR to primiparae giving birth by other modes of delivery. The prevalence of psychiatric disorders was found to be significantly higher in women giving birth by CSMR, indicating a severe burden of psychiatric illness in these women.

    In paper III, also based on data from several Swedish National registers, a diagnosis of LPV/vaginismus before childbirth was shown to decrease the odds of giving birth. When giving birth these women had an increased risk of CS, especially CSMR. This could possibly indicate FOC in these women. Further, women with vaginismus had an increased risk of pelvic floor injuries.

    Paper IV was a follow-up study of women who received counselling for FOC in their first pregnancy leading to parturition. It was based on data from medical records and a questionnaire. The women were followed 7-14 years after their first childbirth. Women treated for FOC more often gave birth by CS, rated their first birth experience as less positive and more often required counselling for FOC in their subsequent pregnancies compared to women without FOC in their first pregnancy. There were no significant differences in the rate of complications during pregnancy and childbirth compared to the other women. Women treated for FOC less often gave birth more than twice. Despite being given counselling and being exposed to childbirth almost one in five women felt fearful towards childbirth 7-14 years after the first childbirth.

    In conclusion, women with FOC are a vulnerable group suffering from a significant burden of psychiatric illness. FOC is not easily treated; many women require counselling in subsequent pregnancies and many still fear childbirth after the childbearing years. Furthermore, LPV/vaginismus is a risk factor for giving birth by CSMR, possibly indicating FOC, and these women are less likely to give birth. Our study shows it is important not only to address sexual function in these women but reproductive function as well. Further studies are needed to establish how to optimize their care regarding fertility, antenatal, obstetric and post-partum care.

    List of papers
    1. Psychiatric illness in women requesting caesarean section
    Open this publication in new window or tab >>Psychiatric illness in women requesting caesarean section
    Show others...
    2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 3, p. 351-358Article in journal (Refereed) Published
    Abstract [en]

    Objective To compare psychiatric in-and outpatient care during the 5 years before first delivery in primiparae delivered by caesarean section on maternal request with all other primiparae women who had given birth during the same time period. Design Prospective, population-based register study. Setting Sweden. Sample Women giving birth for the first time between 2002 and 2004 (n = 64 834). Methods Women giving birth by caesarean section on maternal request (n = 1009) were compared with all other women giving birth (n = 63 825). The exposure of interest was any psychiatric diagnosis according to the International Statistical Classification of Diseases and Related Health Problems (ninth revision, ICD-9, 290-319; tenth revision, ICD-10, F00-F99) in The Swedish national patient register during the 5 years before first delivery. Main outcome measures Psychiatric diagnoses and delivery data. Results The burden of psychiatric illnesses was significantly higher in women giving birth by caesarean section on maternal request (10 versus 3.5%, P less than 0.001). The most common diagnoses were ` Neurotic disorders, stress-related disorders and somatoform disorders (5.9%, aOR 3.1, 95% CI 1.1-2.9), and ` Mood disorders (3.4%, aOR 2.4, 95% CI 1.7-3.6). The adjusted odds ratio for caesarean section on maternal request was 2.5 (95% CI 2.0-3.2) for any psychiatric disorder. Women giving birth by caesarean section on maternal request were older, used tobacco more often, had a lower educational level, higher body mass index, were more often married, unemployed, and their parents were more often born outside of Scandinavia (P less than 0.05). Conclusions Women giving birth by caesarean section on maternal request more often have a severe psychiatric disease burden. This finding points to the need for psychological support for these women as well as the need to screen and treat psychiatric illness in pregnant women.

    Place, publisher, year, edition, pages
    Wiley: 12 months, 2015
    Keywords
    Caesarean section; maternal request; mental health; psychiatric diagnoses
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-115326 (URN)10.1111/1471-0528.12714 (DOI)000348866600015 ()24628766 (PubMedID)
    Note

    Funding Agencies|County Council of Ostergotland, Sweden

    Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2019-06-28
    2. Mental health after first childbirth in women requesting a caesarean section; a retrospective register-based study
    Open this publication in new window or tab >>Mental health after first childbirth in women requesting a caesarean section; a retrospective register-based study
    Show others...
    2017 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, article id 326Article in journal (Refereed) Published
    Abstract [en]

    Background: Psychiatric illness before delivery increases the risk of giving birth by caesarean section on maternal request (CSMR) but little is known about these womens mental health after childbirth. In this study we aimed to compare the prevalence of psychiatric disorders five years before and after delivery in primiparae giving birth by CS on maternal request to all other primiparae giving birth, indifferent on their mode of delivery. Methods: The study population comprised all women born in Sweden 1973-1983 giving birth for the first time in 2002-2004. Psychiatric diagnoses, in- and outpatient care were retrieved from the National Patient Register in Sweden. The risk of psychiatric care after childbirth was estimated using CSMR, previous mental health and sociodemographic variables as covariates. Results: Psychiatric disorders after childbirth were more common in women giving birth by CSMR compared to the other women (11.2% vs 5.5%, p amp;lt; 0.001). CSMR increased the risk of psychiatric disorders after childbirth (aOR 1. 5, 95% CI 1.2-1.9). The prevalence of psychiatric disorders had increased after compared to before childbirth (mean difference 0.02 +/- 0.25, 95% CI 0.018-0.022, p amp;lt; 0.001). Women giving birth by CSMR tended to be diagnosed in the inpatient care more often (54.9% vs. 45.8%, p = 0.056) and were more likely to have been diagnosed before childbirth as well (39.8% vs. 24.2%, p amp;lt; 0.001). Conclusions: Women giving birth by CSMR more often suffer from psychiatric disorders both before and after delivery. This indicates that these women are a vulnerable group requiring special attention from obstetric-and general health-care providers. This vulnerability should be taken into account when deciding on mode of delivery.

    Place, publisher, year, edition, pages
    BIOMED CENTRAL LTD, 2017
    Keywords
    Psychiatric disorders; Caesarean section; Maternal request
    National Category
    Obstetrics, Gynecology and Reproductive Medicine
    Identifiers
    urn:nbn:se:liu:diva-142173 (URN)10.1186/s12884-017-1514-2 (DOI)000412205800001 ()28969603 (PubMedID)
    Note

    Funding Agencies|Research Council in the southeast of Sweden, FORSS

    Available from: 2017-10-23 Created: 2017-10-23 Last updated: 2019-06-28
    3. Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study
    Open this publication in new window or tab >>Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study
    Show others...
    2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 3, p. 329-334Article in journal (Refereed) Published
    Abstract [en]

    Objective To compare sociodemographics, parity and mode of delivery between women diagnosed with vaginismus or localised provoked vestibulodynia (LPV) to women without a diagnosis before first pregnancy. Design Retrospective, population-based register study. Setting Sweden. Sample All women born in Sweden 1973-83 who gave birth for the first time or remained nulliparous during the years 2001-09. Methods Nationally linked registries were used to identify the study population. Women diagnosed with vaginismus or LPV were compared to all other women. Odds ratios for parity and mode of delivery were calculated using multinominal regression analysis and logistic regression. Main outcome measures Parity and mode of delivery. Results Women with vaginismus/LPV were more likely to be unmarried (P = 0.001), unemployed (P = 0.012), have a higher educational level (P less than 0.001), a lower body mass index (P less than 0.001) and use nicotine during pregnancy (P = 0.008). They were less likely to give birth (adjusted odds ratio [OR] 0.61, 95% confidence interval [95% CI] 0.56-0.67). Women with vaginismus/LPV more often delivered by caesarean section (P less than 0.001) especially for maternal request (adjusted OR 3.48, 95% CI 2.45-4.39). In women having vaginal delivery, those with vaginismus/LPV were more likely to suffer a perineal laceration (adjusted OR 1.87, 95% CI 1.56-2.25). Conclusions Women with vaginismus/LPV are less likely to give birth and those that do are more likely to deliver by caesarean section and have a caesarean section based upon maternal request. Those women delivering vaginally are more likely to suffer perineal laceration. These findings point to the importance of not only addressing sexual function in women with vaginismus/LPV but reproductive function as well.

    Place, publisher, year, edition, pages
    Wiley: 12 months, 2015
    Keywords
    Caesarean section; localised provoked vestibulodynia; reproduction; vaginismus
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-115325 (URN)10.1111/1471-0528.12946 (DOI)000348866600011 ()24990073 (PubMedID)
    Note

    Funding Agencies|Medical Research Council of Southeast Sweden

    Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2019-06-28
    4. Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort
    Open this publication in new window or tab >>Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort
    Show others...
    2019 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 3, p. 374-381Article in journal (Refereed) Published
    Abstract [en]

    Introduction About 8% of the pregnant women in Sweden receive counseling for fear of childbirth (FOC) during pregnancy. Little is known about the long-term reproductive and obstetric outcomes after counseling for FOC: Therefore, the objective of this historical cohort study was to compare the long-term reproductive and obstetric outcomes in women treated for FOC in their first pregnancy to women without FOC. Material and methods All nulliparas consecutively referred for treatment of severe FOC between 2001 and 2007 (n = 608) were compared with all other nulliparas giving birth on the same day (n = 431). Women who were not fluent in Swedish, missing a postal address, had moved out of the area, given birth at another hospital or had a late spontaneous abortion were excluded (n = 555). A total of 235 women agreed to participate in the study, 63 (39%) women in the index group and 172 (53%) in the reference group. The women were contacted by letter in 2015, ie 7-14 years after first childbirth, and asked to permit access to their medical charts from pregnancies and childbirths and to fill out a study specific questionnaire. Based on data from the medical charts and questionnaire, the mode of delivery, birth experience, obstetric complications, FOC, counseling for FOC and number of childbirths were compared in the two groups. Results Women in the index group less often gave birth more than twice compared with the reference group (8.2% vs 22.0%, P = 0.012). We found no significant differences in complications during subsequent pregnancies and deliveries. Women in the index group more often gave birth by CS in their first (P = 0.002) and second childbirth (P = 0.001), more often had a less positive birth experience (index group NRS: median 6.0, interquartile range 6 vs reference group NRS: 7.0, interquartile range 5, P = 0.004) in their first delivery and more often received counseling for FOC (58.7% vs 12.5%, P amp;lt; 0.001) in subsequent pregnancies. Women in the index group more often experienced FOC (18% vs 5.3%, P = 0.001) 7-14 years after first childbirth. Conclusions FOC is not easily treated. Despite treatment and exposure to childbirth many women received treatment in their next pregnancy and still suffered from FOC 7-14 years after the first childbirth.

    Place, publisher, year, edition, pages
    WILEY, 2019
    Keywords
    birth experience; cesarean section on maternal request; counseling; fear of childbirth
    National Category
    Obstetrics, Gynecology and Reproductive Medicine
    Identifiers
    urn:nbn:se:liu:diva-154981 (URN)10.1111/aogs.13503 (DOI)000459481000013 ()30431149 (PubMedID)
    Note

    Funding Agencies|Medical Research Council of Southeast Sweden, FORSS

    Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-06-28
  • 171.
    Möller, Louise
    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.
    Josefsson, Ann
    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.
    Bladh, Marie
    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.
    Lilliecreutz, Caroline
    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.
    Andolf, Ellika
    Danderyd Hospital, 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.
    Mental health after first childbirth in women requesting a caesarean section; a retrospective register-based study2017In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, article id 326Article in journal (Refereed)
    Abstract [en]

    Background: Psychiatric illness before delivery increases the risk of giving birth by caesarean section on maternal request (CSMR) but little is known about these womens mental health after childbirth. In this study we aimed to compare the prevalence of psychiatric disorders five years before and after delivery in primiparae giving birth by CS on maternal request to all other primiparae giving birth, indifferent on their mode of delivery. Methods: The study population comprised all women born in Sweden 1973-1983 giving birth for the first time in 2002-2004. Psychiatric diagnoses, in- and outpatient care were retrieved from the National Patient Register in Sweden. The risk of psychiatric care after childbirth was estimated using CSMR, previous mental health and sociodemographic variables as covariates. Results: Psychiatric disorders after childbirth were more common in women giving birth by CSMR compared to the other women (11.2% vs 5.5%, p amp;lt; 0.001). CSMR increased the risk of psychiatric disorders after childbirth (aOR 1. 5, 95% CI 1.2-1.9). The prevalence of psychiatric disorders had increased after compared to before childbirth (mean difference 0.02 +/- 0.25, 95% CI 0.018-0.022, p amp;lt; 0.001). Women giving birth by CSMR tended to be diagnosed in the inpatient care more often (54.9% vs. 45.8%, p = 0.056) and were more likely to have been diagnosed before childbirth as well (39.8% vs. 24.2%, p amp;lt; 0.001). Conclusions: Women giving birth by CSMR more often suffer from psychiatric disorders both before and after delivery. This indicates that these women are a vulnerable group requiring special attention from obstetric-and general health-care providers. This vulnerability should be taken into account when deciding on mode of delivery.

  • 172.
    Möller, Louise
    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.
    Josefsson, Ann
    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.
    Lilliecreutz, Caroline
    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.
    Gunnervik, Christina
    Värnamo Cty Hosp, Sweden.
    Bladh, Marie
    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.
    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.
    Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort2019In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 3, p. 374-381Article in journal (Refereed)
    Abstract [en]

    Introduction About 8% of the pregnant women in Sweden receive counseling for fear of childbirth (FOC) during pregnancy. Little is known about the long-term reproductive and obstetric outcomes after counseling for FOC: Therefore, the objective of this historical cohort study was to compare the long-term reproductive and obstetric outcomes in women treated for FOC in their first pregnancy to women without FOC. Material and methods All nulliparas consecutively referred for treatment of severe FOC between 2001 and 2007 (n = 608) were compared with all other nulliparas giving birth on the same day (n = 431). Women who were not fluent in Swedish, missing a postal address, had moved out of the area, given birth at another hospital or had a late spontaneous abortion were excluded (n = 555). A total of 235 women agreed to participate in the study, 63 (39%) women in the index group and 172 (53%) in the reference group. The women were contacted by letter in 2015, ie 7-14 years after first childbirth, and asked to permit access to their medical charts from pregnancies and childbirths and to fill out a study specific questionnaire. Based on data from the medical charts and questionnaire, the mode of delivery, birth experience, obstetric complications, FOC, counseling for FOC and number of childbirths were compared in the two groups. Results Women in the index group less often gave birth more than twice compared with the reference group (8.2% vs 22.0%, P = 0.012). We found no significant differences in complications during subsequent pregnancies and deliveries. Women in the index group more often gave birth by CS in their first (P = 0.002) and second childbirth (P = 0.001), more often had a less positive birth experience (index group NRS: median 6.0, interquartile range 6 vs reference group NRS: 7.0, interquartile range 5, P = 0.004) in their first delivery and more often received counseling for FOC (58.7% vs 12.5%, P amp;lt; 0.001) in subsequent pregnancies. Women in the index group more often experienced FOC (18% vs 5.3%, P = 0.001) 7-14 years after first childbirth. Conclusions FOC is not easily treated. Despite treatment and exposure to childbirth many women received treatment in their next pregnancy and still suffered from FOC 7-14 years after the first childbirth.

  • 173.
    Möller, Louise
    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.
    Josefsson, Ann
    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.
    Lilliecreutz, Caroline
    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.
    Gunnervik, Christina
    Värnamo Cty Hosp, Sweden.
    Bladh, Marie
    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.
    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.
    Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort2019In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 3, p. 374-381Article in journal (Refereed)
    Abstract [en]

    Introduction About 8% of the pregnant women in Sweden receive counseling for fear of childbirth (FOC) during pregnancy. Little is known about the long-term reproductive and obstetric outcomes after counseling for FOC: Therefore, the objective of this historical cohort study was to compare the long-term reproductive and obstetric outcomes in women treated for FOC in their first pregnancy to women without FOC. Material and methods All nulliparas consecutively referred for treatment of severe FOC between 2001 and 2007 (n = 608) were compared with all other nulliparas giving birth on the same day (n = 431). Women who were not fluent in Swedish, missing a postal address, had moved out of the area, given birth at another hospital or had a late spontaneous abortion were excluded (n = 555). A total of 235 women agreed to participate in the study, 63 (39%) women in the index group and 172 (53%) in the reference group. The women were contacted by letter in 2015, ie 7-14 years after first childbirth, and asked to permit access to their medical charts from pregnancies and childbirths and to fill out a study specific questionnaire. Based on data from the medical charts and questionnaire, the mode of delivery, birth experience, obstetric complications, FOC, counseling for FOC and number of childbirths were compared in the two groups. Results Women in the index group less often gave birth more than twice compared with the reference group (8.2% vs 22.0%, P = 0.012). We found no significant differences in complications during subsequent pregnancies and deliveries. Women in the index group more often gave birth by CS in their first (P = 0.002) and second childbirth (P = 0.001), more often had a less positive birth experience (index group NRS: median 6.0, interquartile range 6 vs reference group NRS: 7.0, interquartile range 5, P = 0.004) in their first delivery and more often received counseling for FOC (58.7% vs 12.5%, P amp;lt; 0.001) in subsequent pregnancies. Women in the index group more often experienced FOC (18% vs 5.3%, P = 0.001) 7-14 years after first childbirth. Conclusions FOC is not easily treated. Despite treatment and exposure to childbirth many women received treatment in their next pregnancy and still suffered from FOC 7-14 years after the first childbirth.

    The full text will be freely available from 2019-11-15 15:39
  • 174.
    Mörelius, Evalotte
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Ivars, Katrin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Nelson Follin, Nina
    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. Karolinska University Hospital, Sweden.
    Salivary cortisol circadian rhythm in infants at psychosocial risk showed more variations than previous studies of healthy full-term infants2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 12, p. 2060-2061Article in journal (Refereed)
    Abstract [en]

    n/a

  • 175.
    Nagy, Szabolcs
    et al.
    Univ Pannonia, Hungary.
    Tamminen, Tuire
    Univ Helsinki, Finland.
    Andersson, Magnus
    Univ Helsinki, Finland.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Ejaculated boar spermatozoa displaying a rare multivesicular defect2018In: ACTA VETERINARIA SCANDINAVICA, ISSN 0044-605X, Vol. 60, article id 21Article in journal (Refereed)
    Abstract [en]

    Two cases of a previously unreported sperm defect appearing in boar studs in Finland are presented. Spermatozoa showed small particles scattered on their surface with a prevalence decreasing with boar age. Semen samples, either stained with eosin-nigrosin or examined with phase contrast optics on formaldehyde-fixed spermatozoa, revealed the presence of multiple particles attached to the surface of spermatozoa counted as dead cells at fixation. Transmission electron microscopy revealed these were multivesicular and multilamellar vesicles, built up by phospholipid membranes. The case is classified as a post-epididymal multivesicular sperm defect with a favorable prognosis.

  • 176.
    Najafi, Abouzar
    et al.
    Department of Animal Science, College of Agriculture, University of Tabriz, Tabriz, Iran.
    Daghigh-Kia, Hossein
    Department of Animal Science, College of Agriculture, University of Tabriz, Tabriz, Iran.
    Dodaran, Hossein Vaseghi
    Department of Animal Science, College of Agriculture, University of Tabriz, Tabriz, Iran.
    Mehdipour, Mahdieh
    Department of Animal Science, College of Agriculture, University of Tabriz, Tabriz, Iran.
    Alvarez-Rodriguez, Manuel
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Ethylene glycol, but not DMSO, could replace glycerol inclusion in soybean lecithin-based extenders in ram sperm cryopreservation.2017In: Animal Reproduction Science, ISSN 0378-4320, E-ISSN 1873-2232, Vol. 177, p. 35-41Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the effects of glycerol, ethylene glycol or DMSO in a soybean lecithin extender for freezing ram semen. In this study, 20 ejaculates were collected from four Ghezel rams and diluted with soybean lecithin extender with glycerol (7%), ethylene glycol (3%, 5% and 7%) or DMSO (3%, 5% and 7%). Sperm motility (CASA), membrane integrity (HOS test), viability, total abnormality, mitochondrial activity (Rhodamine 123) and apoptotic features (Annexin V/Propidium iodide) were assessed after thawing. There was no significant difference between glycerol and ethylene glycol at different concentrations (3% and 5%) regarding sperm total and progressive motility, viability, and membrane integrity. The least percentages of mitochondrial functionality were observed in samples frozen with all different DMSO concentrations tested (P<0.05). Moreover, the percentage of post-thawed dead sperm was the greatest for all the DMSO concentrations compared with other groups (P<0.05). Thus, DMSO had an adverse effect on the post thaw ram sperm parameters. In contrast, ethylene glycol could be a desirable substitute of glycerol in the freezing extender, in view of similar results obtained in post-thaw quality of ram semen cryopreserved in a soybean lecithin extender. We propose that glycerol in a soybean lecithin based extender could be replaced by ethylene glycol at 3% or 5% concentrations.

  • 177.
    Najafi, Davood
    et al.
    Baqiyatallah Univ Med Sci, Iran; Univ Tabriz, Iran.
    Taheri, Ramezan Ali
    Baqiyatallah Univ Med Sci, Iran.
    Najafi, Abouzar
    Baqiyatallah Univ Med Sci, Iran; Univ Tabriz, Iran.
    Rouhollahi, Abbas Abbas
    Univ Tehran, Iran.
    Alvarez-Rodriguez, Manuel
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Univ Autonoma Barcelona, Spain.
    Effect of Achillea millefolium-loaded nanophytosome in the post-thawing sperm quality and oxidative status of rooster semen2018In: Cryobiology, ISSN 0011-2240, E-ISSN 1090-2392, Vol. 82, p. 37-42Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the effectiveness of antioxidants including Achillea millefolium extract (AmE) (n0t1.5: 1.5, n0t3: 3 and n0t4.5: 4.5 mg/L) and AmE loaded in nano phytosome (n1t1.5: 1.5, n1t3: 3 and n1t4.5: 4.5 mg/L) in the freezing of Ross 308 rooster semen. Sperm motility (CASA), membrane integrity (HOS test), viability, total abnormality and enzymatic parameters (SOD, CAT and GPx) were assessed after thawing. AmE-loaded nano phytosome at a concentration of 3 mg/l resulted in significantly (P amp;lt; 0.05) higher total motility (MOT) (73.78 +/- 2.92) and at concentrations of 1.5 mg/L and 3 mg/L in progressive motility (PROG) (14.12 +/- 0.38, 16.78 +/- 0.38) in comparison with the control group (MOT: 58.48 +/- 2.92; PROG: 9.08 +/- 0.38). Sperm viability (Vi) was higher (P amp;lt; 0.05) in n1t3 (74.62 +/- 1.55) and membrane integrity (Mi) in n0t3 and n1t3 groups (65.91 +/- 1.91, 63.73 +/- 1.91, respectively) compared to the control groups (Vi: 66.85 +/- 1.55; Mi: 53.18 +/- 1.91). Moreover, the lowest percentage of MDA was measured in n1t3 group (1.31 +/- 0.31). There was no significant difference for SOD and CAT values with the use of various extenders. In conclusion, we suggest that AmE loaded in nano phytosome at 3 mg/l dose can be added to basic extender for improving rooster sperm motility, viability and oxidative stress values during the freezing procedure.

  • 178.
    Nieminen, Katri
    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 Gynaecology and Obstetrics in Norrköping.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Johansson, Sanna
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health.
    Kinberger, Emelie K
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health.
    Ryding, Elsa-Lena
    Karolinska Institutet, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Stockholm, Sweden.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Wijma, Barbro
    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.
    Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child.2017In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 96, no 4, p. 438-446Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The objective of this study was to calculate costs associated with severe fear of childbirth (FOC) during pregnancy and peripartum by comparing two groups of women expecting their first child and attending an ordinary antenatal program; one with low FOC and one with severe FOC.

    MATERIAL AND METHODS: In a prospective case-control cohort study one group with low FOC [Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) sum score ≤60, n = 107] and one with severe FOC (W-DEQ ≥85, n = 43) were followed up till 3 months postpartum and included in the analysis. Medical records were assessed and medical parameters were mapped. Mean costs for healthcare consumption and sick leave during pregnancy were calculated and compared.

    RESULTS: When means were compared between the groups, the group with severe FOC had more visits for psychosocial reasons (p = 0.001) and more hours on sick leave (p = 0.03) during pregnancy, and stayed longer at the maternity ward (p = 0.04). They also more seldom had normal spontaneous deliveries (p = 0.03), and more often had an elective cesarean section on maternal request (p = 0.02). Postpartum, they more often than the group with low FOC paid visits to the maternity clinic because of complications (p = 0.001) and to the antenatal unit because of adverse childbirth experiences (p = 0.001). The costs for handling women with severe FOC was 38% higher than those for women with low FOC.

    CONCLUSION: Women with severe FOC generate considerably higher perinatal costs than women with low FOC when handled in care as usual.

  • 179.
    Nilsson, John
    et al.
    Ryhov County Hospital, Sweden.
    Åkesson, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Hospital, Sweden; Jonköping University, Sweden; Jonköping University, Sweden.
    Hanberger, Lena
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Samuelsson, Ulf
    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.
    High HbA1c at onset cannot be used as a predictor for future metabolic control for the individual child with type 1 diabetes mellitus2017In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 18, no 8, p. 848-852Article in journal (Refereed)
    Abstract [en]

    BackgroundTo study how metabolic control at onset of type 1 diabetes correlates to metabolic control and clinical parameters during childhood until transition from pediatric care to adult diabetes care. Materials and MethodsData at onset, three months, one, three, and five years after diagnosis and at transition, on HbA1c and clinical parameters, on 8084 patients in the Swedish pediatric quality registry, SWEDIABKIDS, were used. Of these patients, 26% had been referred to adult diabetes care by 2014. ResultsChildren with HbA1c amp;lt; 72mmol/mol (8.7%) (20% of patients, low group) at diagnosis continued to have good metabolic control during childhood, in contrast to children with HbA1c amp;gt; 114mmol/mol (12.6%) (20% of patients, high group) at diagnosis, who continued to have high HbA1c at follow-up. For the individual, there was no significant correlation between high HbA1c at onset and during follow-up. During follow-up, children in the high group were more often smokers, less physically active, and more often had retinopathy than children in the low group (Pamp;lt;.01, .01, .03 respectively). ConclusionHigh HbA1c at onset was associated with high HbA1c during follow-up on a group level, but it cannot be used as a predictor of future metabolic control on an individual level. These results emphasize the important work done by the diabetes team in the first years after diagnosis. It is important to continuously set high goals for the achievement of tight metabolic control, in order to decrease the risk of microvascular complications.

  • 180.
    Nohalez, A.
    et al.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Martinez, C. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Parrilla, I.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Roca, J.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Gil, M. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, E. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cuello, C.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Exogenous ascorbic acid enhances vitrification survival of porcine in vitro-developed blastocysts but fails to improve the in vitro embryo production outcomes2018In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 113, p. 113-119Article in journal (Refereed)
    Abstract [en]

    In this study, the effects of addition of the antioxidant ascorbic acid (AsA) were evaluated during porcine in vitro embryo production (IVP) and vitrification. In experiment 1, the effects of AsA supplementation during IVM, IVF and IVC were evaluated, using a total of 2744 oocytes in six replicates. The IVM, IVF and embryo IVC media were supplemented or not (control) with 50 mu g/mL AsA in all possible combinations. No significant effects of AsA were detected in any of the maturation, fertilization or embryo development parameters assessed. In experiment 2, we evaluated the effects of adding AsA to vitrification-warming media on the post-warming survival and quality of blastocysts. Day-6 in vitro-produced blastocysts (N = 588) from six replicates were randomly divided in two groups, with vitrification and warming media either supplemented with 50 mu g/mL AsA (VW + group) or un-supplemented (VW- control). Addition of AsA increased (P amp;lt; 0.05) blastocyst survival rate after vitrification compared with that of VW control embryos. Vitrification and warming increased (P amp;lt; 0.05) the production of oxygen species (ROS) and reduced (P amp;lt; 0.05) the glutathione levels in blastocysts. Although VW + blastocysts displayed higher (P amp;lt; 0.05) ROS levels than those of fresh control blastocysts, the levels were lower (P amp;lt; 0.05) than those found in VW- control blastocysts. In conclusion, under the experimental conditions, supplementation of IVM/IVF/IVC media with AsA did not improve the embryo production in vitro. By contrast, the addition of AsA to chemically defined vitrification and warming media increased the survival of in vitro-produced porcine blastocysts by decreasing ROS production. (C) 2018 Elsevier Inc. All rights reserved.

  • 181.
    Nohalez, A.
    et al.
    University of Murcia, Spain.
    Martinez, C. A.
    University of Murcia, Spain.
    Reixach, J.
    Selecc Batalle SA, Spain.
    Diaz, M.
    Selecc Batalle SA, Spain.
    Vila, J.
    Selecc Batalle SA, Spain.
    Colina, I.
    Selecc Batalle SA, Spain.
    Parrilla, I.
    University of Murcia, Spain.
    Vazquez, J. L.
    University of Murcia, Spain.
    Roca, J.
    University of Murcia, Spain.
    Gil, M. A.
    University of Murcia, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinezl, E. A.
    University of Murcia, Spain.
    Cuello, C.
    University of Murcia, Spain.
    Factors of importance when selecting sows as embryo donors2017In: Animal, ISSN 1751-7311, E-ISSN 1751-732X, Vol. 11, no 8, p. 1330-1335Article in journal (Refereed)
    Abstract [en]

    The improvement in porcine embryo preservation and non-surgical embryo transfer (ET) procedures achieved in recent years represents essential progress for the practical use of ET in the pig industry. This study aimed to evaluate the effects of parity, weaning-to-estrus interval (WEI) and season on reproductive and embryonic parameters at day 6 after insemination of donor sows superovulated after weaning. The selection of donor sows was based on their reproductive history, body condition and parity. The effects of parity at weaning (2 to 3, 4 to 5 or 6 to 7 litters), season (fall, winter and spring), and WEI (estrus within 3 to 4 days), and their interactions on the number of corpus luteum, cysts in sows with cysts, number and quality of viable and transferable embryos, embryo developmental stage and recovery and fertilization rates were evaluated using linear mixed effects models. The analyses showed a lack of significant effects of parity, season, WEI or their interactions on any of the reproductive and embryonic parameters examined. In conclusion, these results demonstrate that fertilization rates and numbers of viable and transferable embryos collected at day 6 of the cycle from superovulated donor sows are not affected by their parity, regardless of the time of the year (from fall to spring) and WEI (3 or 4 days).

  • 182.
    Nohalez, Alicia
    et al.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Martinez, Cristina A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Parrilla, Inmaculada
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Maside, Carolina
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Roca, Jordi
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Gil, Maria A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, Emilio A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Cuello, Cristina
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Eventual re-vitrification or storage in liquid nitrogen vapor does not jeopardize the practical handling and transport of vitrified pig embryos2018In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 113, p. 229-236Article in journal (Refereed)
    Abstract [en]

    This study aimed (1) to evaluate the in vitro post-warming survival of porcine embryos after re vitrification and (2) to assess the efficacy of transport of embryos in dry shipper (DS) in maintaining the viability and quality of vitrified embryos for a 3-day period. Embryos at the compacted or cavitating morula (CCM) and unhatched blastocyst (UBL) stages were surgically obtained from weaned, crossbred sows. In the first experiment, more than 85% of the embryos survived an initial vitrification and warming and achieved comparable survival rates to those of their fresh counterparts. In contrast, those embryos subjected to a second vitrification and warming had clearly lower survival rates (60% and 64% for re vitrified embryos from the CCM and UBL groups, respectively) compared to the survival rates of the initial vitrification and fresh control groups (P amp;lt; 0.01). Hatching rates were similar in re-vitrified blastocysts derived from vitrified CCMs and fresh control groups (50.8% and 55.3%, respectively). However, differences (P amp;lt; 0.01) in hatching rates were recorded in re-vitrified blastocysts derived from vitrified UBLs and fresh control blastocysts (14.7% and 90.0%, respectively). In the second experiment, vitrified embryos were stored in a liquid nitrogen tank for one month. Then, the straws containing the embryos were transferred to a DS (DS group) or to another liquid nitrogen tank (control group) for an additional three days. Embryos from the DS and control groups had similar survival and hatching rates, regardless of the embryonic stage considered. The DS storage of CCMs and UBLs did not affect their development after culturing, including total cell numbers, compared to the control, although their apoptotic index was slightly higher (P amp;lt; 0.05), regardless of the developmental stage. In conclusion, although re-vitrification negatively affects embryo survival, this study demonstrated that amp;gt;60% of vitrified embryos could be successfully re-vitrified and re-warmed. The present study also showed the effectiveness of the DS for the storage of vitrified porcine CCMs and UBLs for at least three 3 days. (C) 2018 Elsevier Inc. All rights reserved.

  • 183.
    Nordwall, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Norrköping. Vrinnevi Hosp, Sweden.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences, Forum Östergötland.
    Ludvigsson, Johnny
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Arnqvist, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Impact of Age of Onset, Puberty, and Glycemic Control Followed From Diagnosis on Incidence of Retinopathy in Type 1 Diabetes: The VISS Study2019In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 42, no 4, p. 609-616Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To evaluate sex, age at diabetes onset, puberty, and HbA1c, with subjects followed from diabetes diagnosis and during different time periods, as risk factors for developing diabetic simplex and proliferative retinopathy.

    RESEARCH DESIGN AND METHODS In a population-based observational study, HbA1c for 451 patients diagnosed with diabetes before 35 years of age during 1983–1987 in southeast Sweden was followed for up to 18–24 years from diagnosis. Long-term mean weighted HbA1c(wHbA1c) was calculated. Retinopathy was evaluated by fundus photography and analyzed in relation to wHbA1c levels.

    RESULTS Lower wHbA1c, diabetes onset ≤5 years of age, and diabetes onset before puberty, but not sex, were associated with longer time to appearance of simplex retinopathy. Proliferative retinopathy was associated only with wHbA1c. The time to first appearance of any retinopathy decreased with increasing wHbA1c. Lower wHbA1c after ≤5 years’ diabetes duration was associated with later onset of simplex retinopathy but not proliferative retinopathy. With time, most patients developed simplex retinopathy, except for those of the category wHbA1c≤50 mmol/mol (6.7%), for which 20 of 36 patients were without any retinopathy at the end of the follow-up in contrast to none of 49 with wHbA1c >80 mmol/mol (9.5%).

    CONCLUSIONS Onset at ≤5 years of age and lower wHbA1c the first 5 years after diagnosis are associated with longer duration before development of simplex retinopathy. There is a strong positive association between long-term mean HbA1c measured from diagnosis and up to 20 years and appearance of both simplex and proliferative retinopathy.

  • 184.
    Norman, Mikael
    et al.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden; Umea Univ Hosp, Sweden.
    Hallberg, Boubou
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Bjorklund, Lars J.
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Domellof, Magnus
    Umea Univ, Sweden.
    Farooqi, Aijaz
    Umea Univ, Sweden; Umea Univ, Sweden.
    Foyn Bruun, Cathrine
    Umea Univ, Sweden.
    Gadsboll, Christian
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Hellstrom-Westas, Lena
    Uppsala Univ, Sweden.
    Ingemansson, Fredrik
    Ryhov Cty Hosp, Sweden.
    Kallen, Karin
    Lund Univ, Sweden.
    Ley, David
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Marsal, Karel
    Lund Univ, Sweden.
    Normann, Erik
    Uppsala Univ, Sweden.
    Serenius, Fredrik
    Uppsala Univ, Sweden.
    Stephansson, Olof
    Karolinska Inst, Sweden.
    Stigson, Lennart
    Gothenburg Univ, Sweden.
    Um-Bergstrom, Petra
    Karolinska Inst, Sweden; Soder Sjukhuset, Sweden.
    Hakansson, Stellan
    Umea Univ, Sweden.
    Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-20162019In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 321, no 12, p. 1188-1199Article in journal (Refereed)
    Abstract [en]

    Importance  Since 2004-2007, national guidelines and recommendations have been developed for the management of extremely preterm births in Sweden. If and how more uniform management has affected infant survival is unknown.

    Objective  To compare survival of extremely preterm infants born during 2004-2007 with survival of infants born during 2014-2016.

    Design, Setting and Participants  All births at 22-26 weeks’ gestational age (n = 2205) between April 1, 2004, and March 31, 2007, and between January 1, 2014, and December 31, 2016, in Sweden were studied. Prospective data collection was used during 2004-2007. Data were obtained from the Swedish pregnancy, medical birth, and neonatal quality registries during 2014-2016.

    Exposures  Delivery at 22-26 weeks’ gestational age.

    Main Outcomes and Measures  The primary outcome was infant survival to the age of 1 year. The secondary outcome was 1-year survival among live-born infants who did not have any major neonatal morbidity (specifically, without intraventricular hemorrhage grade 3-4, cystic periventricular leukomalacia, necrotizing enterocolitis, retinopathy of prematurity stage 3-5, or severe bronchopulmonary dysplasia).

    Results  During 2004-2007, 1009 births (3.3/1000 of all births) occurred at 22-26 weeks’ gestational age compared with 1196 births (3.4/1000 of all births) during 2014-2016 (P = .61). One-year survival among live-born infants at 22-26 weeks’ gestational age was significantly lower during 2004-2007 (497 of 705 infants [70%]) than during 2014-2016 (711 of 923 infants [77%]) (difference, −7% [95% CI, −11% to −2.2%], P = .003). One-year survival among live-born infants at 22-26 weeks’ gestational age and without any major neonatal morbidity was significantly lower during 2004-2007 (226 of 705 infants [32%]) than during 2014-2016 (355 of 923 infants [38%]) (difference, −6% [95% CI, −11% to −1.7%], P = .008).

    Conclusions and Relevance  Among live births at 22-26 weeks’ gestational age in Sweden, 1-year survival improved between 2004-2007 and 2014-2016.

  • 185.
    Norman, Mikael
    et al.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden; Vasterbotten Cty Council, Sweden.
    Kallen, Karin
    Vasterbotten Cty Council, Sweden; Lund Univ, Sweden.
    Wahlstrom, Erik
    Natl Board Hlth and Welf, Sweden.
    Hakansson, Stellan
    Vasterbotten Cty Council, Sweden; Umea Univ, Sweden.
    Skiold, Beatrice
    Swedish Neonatal Soc, Sweden; Karolinska Inst, Sweden.
    Naver, Lars
    Karolinska Inst, Sweden.
    Domellof, Magnus
    Umea Univ, Sweden.
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Stigson, Lennart
    Gothenburg Univ, Sweden.
    Blomqvist, Ylva Thernstrom
    Uppsala Univ, Sweden.
    Nyholm, Annika
    Umea Univ, Sweden.
    Ingemansson, Fredrik
    Jonkoping Acad, Sweden.
    Holmstrom, Gerd
    Uppsala Univ, Sweden.
    Bjorklund, Lars
    Lund Univ, Sweden.
    Wikstrom, Anna-Karin
    Uppsala Univ, Sweden.
    Wallin-Gyokeres, Annica
    Parent Representat, Sweden.
    The Swedish Neonatal Quality Register - contents, completeness and validity2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 8, p. 1411-1418Article in journal (Refereed)
    Abstract [en]

    Aim To describe the Swedish Neonatal Quality Register (SNQ) and to determine its completeness and agreement with other registers. Methods SNQ collects data for infants admitted to neonatal units during the first four postnatal weeks. Completeness and registers agreement were determined cross-linking SNQ data with Swedish population registers (the Inpatient, Medical Birth and Cause of Death Registers) for a study period of five years. Results In total, 84 712 infants were hospitalised. A total of 52 806 infants occurred in both SNQ and the population registers; 28 692 were only found in the population registers, and 3214 infants were only found in SNQ. Between gestational weeks 24-34, completeness of SNQ was 98-99%. Below and above these gestational ages, completeness was lower. Infants missing in SNQ were term or near-term in 99% of the cases, and their diagnoses indicated conditions managed in maternity units, or re-admissions for acute infections, managed in paediatric units. For most diagnoses, the agreement between SNQ and population registers was high, but some (bronchopulmonary dysplasia and grade of hypoxic-ischaemic encephalopathy) were often missing in the population registers. Conclusion SNQ completeness and agreement against other registers, especially for preterm infants, is excellent. SNQ is a valid tool for benchmarking, quality improvement and research.

  • 186.
    Norstrom, Fredrik
    et al.
    Umea Univ, Sweden.
    van der Pals, Maria
    Lund Univ, Sweden.
    Myleus, Anna
    Umea Univ, Sweden.
    Hammarroth, Solveig
    Praktikertjanst, Sweden.
    Högberg, Lotta
    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 Norrköping.
    Isaksson, Anders
    Lund Univ, Sweden.
    Ivarsson, Anneli
    Umea Univ, Sweden.
    Carlsson, Annelie
    Lund Univ, Sweden.
    Impact of Thyroid Autoimmunity on Thyroid Function in 12-year-old Children With Celiac Disease2018In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 67, no 1, p. 64-68Article in journal (Refereed)
    Abstract [en]

    Objectives: Celiac disease (CD) is associated with thyroid autoimmunity and other autoimmune diseases. Data are, however, lacking regarding the relationship between thyroid autoimmunity and thyroid function, especially in regard to CD. Our aim was to investigate the impact of thyroid autoimmunity on thyroid function in 12-year-old children with CD compared to their healthy peers. Methods: A case-referent study was conducted as part of a CD screening of 12-year-olds. Our study included 335 children with CD and 1695 randomly selected referents. Thyroid autoimmunity was assessed with antibodies against thyroid peroxidase (TPOAb). Thyroid function was assessed with thyroid-stimulating hormone and free thyroxine. Results: TPOAb positivity significantly increased the risk of developing hypothyroidism in all children. The odds ratios (with 95% confidence intervals) were 5.3 (2.7-11) in healthy 12-year-olds, 10 (3.2-32) in screening-detected CD cases, 19 (2.6-135) in previously diagnosed CD cases, and 12 (4.4-32) in all CD cases together. Among children with TPOAb positivity, hypothyroidism was significantly more common (odds ratio 3.1; 95% CI 1.03-9.6) in children with CD (10/19) than in children without CD (12/46). Conclusions: The risk of thyroid dysfunction due to thyroid autoimmunity is larger for those with CD than their healthy peers. Our study indicates that a gluten-free diet does not reduce the risk of thyroid dysfunction. Further studies are required for improved understanding of the role of the gluten-free diet for the risk of autoimmune diseases in children with CD.

  • 187.
    Oberg, Daniel
    et al.
    Vastervik Hosp, Sweden.
    Salemyr, Jenny
    Karolinska Inst, Sweden; Univ Hosp, Sweden.
    Ortqvist, Eva
    Karolinska Inst, Sweden; Univ Hosp, Sweden.
    Juul, Anders
    Rigshosp, Denmark; Univ Copenhagen, Denmark.
    Bang, Peter
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    A longitudinal study of serum insulin-like growth factor-I levels over 6 years in a large cohort of children and adolescents with type 1 diabetes mellitus: A marker reflecting diabetic retinopathy2018In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 5, p. 972-978Article in journal (Refereed)
    Abstract [en]

    Objective

    To evaluate longitudinal serum insulin‐like growth factor‐I (IGF‐I) in a large cohort of children and adolescents with type 1 diabetes in relation to hemoglobin A1c (HbA1c), age, diabetes duration, and body mass index (BMI), its association to height and retinopathy, and in comparison with healthy subject references.

    Methods

    A total of 2683 serum IGF‐I values were obtained from 806 children and adolescents with T1DM, from annual blood samples for up to 6 consecutive years.

    Results

    In a multiple regression analysis IGF‐I values were negatively correlated to HbA1c and diabetes duration, and positively correlated to BMI (P < .001, P < .001, and P < .001, respectively, adjusted r2 = 0.102). Children and adolescents with T1DM had lower mean IGF‐I levels and reference interval limits compared to healthy subjects. In boys, mean (SD) IGF‐I SD score (SDS) levels were −1.04 (±1.3) calculated from the healthy reference. IGF‐I peaked at 15 years of age, similarly to healthy controls, but with markedly lower levels in late puberty. Girls were more affected at later stages of puberty but with a slightly less depressed overall mean IGF‐I SDS of −0.69 (±1.2). In a subgroup of 746 subjects with fundus photography, a negative correlation was seen between individual mean IGF‐I SDS and preproliferative retinopathy (P = .004, adjusted r2 = 0.021). In another subgroup of 84 adolescents, no correlation was seen between individual mean IGF‐I SDS and target height SDS or distance to target height SDS.

    Conclusion

    Poor metabolic control and diabetes duration impact negatively on serum IGF‐I levels. A low individual mean IGF‐I level was associated with progression of retinopathy independently of HbA1c, age, gender, and diabetes duration. Disease, sex and age related IGF‐I SDS may become clinical helpful as a supplement to HbA1c in predicting the long‐term outcome for children and adolescents with T1DM.

  • 188.
    Olsen Faresjö, Åshild
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ludvigsson, Johnny
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Pet exposure in the family during pregnancy and risk for type 1 diabetes: The prospective ABIS study2018In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 7, p. 1206-1210Article in journal (Refereed)
    Abstract [en]

    Background: The autoimmune process later leading to type 1 diabetes (T1D) seems to start very early in life. Different viruses have been suspected to contribute to the development of T1D, some already during pregnancy. As viruses may be hosted by animals and from them transferred to humans we decided to investigate if exposure to pets during pregnancy is related to later development of T1D. Methods: ABIS (All Babies in Southeast Sweden)-is a prospective population-based cohort study of unselected children born in southeast Sweden between Oct first 1997 to Oct first 1999. Parents of 16384 children answered a questionnaire within 3 days after birth including information about exposure to different pets. The ABIS registry has been connected to the National Registry of diagnosis and also the national Registry of Drug prescriptions so we know that 137 children have got T1D, and they were compared with the non-diabetic population. Results: During pregnancy, 45.5% of the mothers had pet animals at home. Most common were cats (25.0%) and dogs (18.7%). Neither exposure to dogs (OR = 1.27, P = 0.23) or cats (OR = 0.81, P = 0.31) were associated to later T1D risks. However, exposure to hamsters increased the T1D risk (OR 4.21, P = 0.0007). In a multiple regression this association remained (P = 0.005) when adjusted for other possible risk factors. Conclusions: Exposure to hamster during pregnancy seems to increase the risk of T1D in the child. One possibility could be infection by virus hosted by the pet.

  • 189.
    Olsson, Linda
    et al.
    Div Lab Med, Sweden.
    Lundin-Ström, Kristina B.
    Lund Univ, Sweden.
    Castor, Anders
    Skåne Univ Hosp, Sweden.
    Behrendtz, Mikael
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus. Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Biloglav, Andrea
    Lund Univ, Sweden.
    Noren-Nyström, Ulrika
    Umeå Univ, Sweden.
    Paulsson, Kajsa
    Lund Univ, Sweden.
    Johansson, Bertil
    Div Lab Med, Sweden; Lund Univ, Sweden.
    Improved cytogenetic characterization and risk stratification of pediatric acute lymphoblastic leukemia using single nucleotide polymorphism array analysis: A single center experience of 296 cases2018In: Genes, Chromosomes and Cancer, ISSN 1045-2257, E-ISSN 1098-2264, Vol. 57, no 11, p. 604-607Article in journal (Refereed)
    Abstract [en]

    Single nucleotide polymorphism array (SNP-A) analyses are increasingly being introduced in routine genetic diagnostics of acute lymphoblastic leukemia (ALL). Despite this, only few studies that have compared the diagnostic value of SNP-A with conventional chromosome banding have been published. We here report such a comparison of 296 ALL cases, the largest series to date. Only genomic imbalances amp;gt;5Mb and microdeletions targeting the BTG1, CDKN2A/B, EBF1, ERG, ETV6, IKZF1, PAX5, and RB1 genes and the pseudoautosomal region 1 (PAR1) were ascertained, in agreement with recent guidelines. Of 36 T-cell ALL cases, the karyotypes of 24 cases (67%) were revised by SNP-A analyses that either revealed additional imbalances amp;gt;5Mb or better characterized the changes found by G-banding. Of 260 B-cell precursor (BCP) ALL cases, SNP-A analyses identified additional copy number alterations, including the above-mentioned microdeletions, or better characterized the imbalances found by G-banding in 236 (91%) cases. Furthermore, the cytogenetic subtype classification of 41/260 (16%) BCP ALL cases was revised based on the SNP-A findings. Of the subtype revisions, 12/41 (29%) had clinical implications as regards risk stratifying cytogenetic groups or genotype-specific minimal residual disease stratification. We conclude that SNP-A analyses dramatically improve the cytogenetic characterization of both T-cell and BCP ALL and also provide important information pertinent to risk stratification of BCP ALL.

  • 190.
    Ortega Ferrusola, C.
    et al.
    University of Leon, Spain.
    Anel-Lopez, L.
    University of Leon, Spain.
    Ortiz-Rodriguez, J. M.
    University of Extremadura, Spain.
    Martin Munoz, P.
    University of Extremadura, Spain.
    Alvarez, M.
    University of Leon, Spain.
    de Paz, P.
    University of Leon, Spain.
    Masot, J.
    University of Extremadura, Spain.
    Redondo, E.
    University of Extremadura, Spain.
    Balao da Silva, C.
    Super Agriculture School Elvas, Portugal.
    Morrell, J. M.
    Swedish University of Agriculture Science, Sweden.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Tapia, J. A.
    University of Extremadura, Spain.
    Gil, M. C.
    University of Extremadura, Spain.
    Anel, L.
    University of Leon, Spain.
    Pena, F. J.
    University of Extremadura, Spain.
    Stallion spermatozoa surviving freezing and thawing experience membrane depolarization and increased intracellular Na+2017In: Andrology, ISSN 2047-2919, E-ISSN 2047-2927, Vol. 5, no 6, p. 1174-1182Article in journal (Refereed)
    Abstract [en]

    In order to gain insight of the modifications that freezing and thawing cause to the surviving population of spermatozoa, changes in the potential of the plasma membrane (Em) and intracellular Na+ content of stallion spermatozoa were investigated using flow cytometry. Moreover, caspase 3 activity was also investigated and the functionality of the Na+-K+ ATPase pump was investigated before and after freezing and thawing. Cryopreservation caused a significant (pamp;lt;0.001) increase in the subpopulation of spermatozoa with depolarized sperm membranes, concomitantly with an increase (pamp;lt;0.05) in intracellular Na+. These changes occurred in relation to activation of caspase 3 (pamp;lt;0.001). Cryopreservation reduced the activity of the Na-K+ pump and inhibition of the Na+-K+ ATPase pump with ouabain-induced caspase 3 activation. It is concluded that inactivation of Na+-K+ ATPase occurs during cryopreservation, an inhibition that could play a role explaining the accelerated senescence of the surviving population of spermatozoa.

  • 191.
    Ortega-Ferrusola, C.
    et al.
    University of Leon, Spain.
    Gil, M. C.
    University of Extremadura, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Anel, L.
    University of Leon, Spain.
    Pena, F. J.
    University of Extremadura, Spain.
    Martin-Munoz, P.
    University of Extremadura, Spain.
    Flow cytometry in Spermatology: A bright future ahead2017In: Reproduction in domestic animals, ISSN 0936-6768, E-ISSN 1439-0531, Vol. 52, no 6, p. 921-931Article, review/survey (Refereed)
    Abstract [en]

    Techniques such as mass spectrometry have led to unprecedented knowledge of the proteins that are present in the spermatozoa of humans and other mammals. However, in spite of their high-throughput and fractioning techniques, most of the techniques in use only offer average values for the entire sperm population. Yet, ejaculate is very heterogeneous, and average values may mask relevant biological information. The application of flow cytometry may overcome this disadvantage, allowing proteomic analysis at the single-cell level. Moreover, recent advances in cytometry, allowing multiple analyses within a single cell combined with powerful statistical tools, as an expanding subfield in spermatology, are described. The increased use of advanced flow cytometers in andrology laboratories will allow the rapid development of multiparametric, multicolour flow cytometry in andrology that will expand the clinical applications and research possibilities of flow cytometry-based proteomic approaches, especially in the subfields of clinical andrology and sperm biotechnology.

  • 192.
    Ortiz-Rodriguez, Jose M.
    et al.
    Univ Extremadura, Spain.
    Ortega-Ferrusola, Cristina
    Univ Extremadura, Spain.
    Gil, Maria C.
    Univ Extremadura, Spain.
    Martin-Cano, Francisco E.
    Univ Extremadura, Spain.
    Gaitskell-Phillips, Gemma
    Univ Extremadura, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Hinrichs, Katrin
    Texas AandM Univ, TX 77843 USA.
    Alvarez-Barrientos, Alberto
    Univ Extremadura, Spain.
    Roman, Angel
    Univ Extremadura, Spain.
    Pena, Fernando J.
    Univ Extremadura, Spain.
    Transcriptome analysis reveals that fertilization with cryopreserved sperm downregulates genes relevant for early embryo development in the horse2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 6, article id e0213420Article in journal (Refereed)
    Abstract [en]

    Artificial insemination with cryopreserved spermatozoa is a major assisted reproductive technology in many species. In horses, as in humans, insemination with cryopreserved sperm is associated with lower pregnancy rates than those for fresh sperm, however, direct effects of sperm cryopreservation on the development of resulting embryos are largely unexplored. The aim of this study was to investigate differences in gene expression between embryos resulting from fertilization with fresh or cryopreserved sperm. Embryos were obtained at 8, 10 or 12 days after ovulation from mares inseminated post-ovulation on successive cycles with either fresh sperm or frozen-thawed sperm from the same stallion, providing matched embryo pairs at each day. RNA was isolated from two matched pairs (4 embryos) for each day, and cDNA libraries were built and sequenced. Significant differences in transcripts per kilobase million (TPM) were determined using (i) genes for which the expression difference between treatments was higher than 99% of that in the random case (P amp;lt; 0.01), and (ii) genes for which the fold change was amp;gt;= 2, to avoid expression bias in selection of the candidate genes. Molecular pathways were explored using the DAVID webserver, followed by network analyses using STRING, with a threshold of 0.700 for positive interactions. The transcriptional profile of embryos obtained with frozen-thawed sperm differed significantly from that for embryos derived from fresh sperm on all days, showing significant down-regulation of genes involved in biological pathways related to oxidative phosphorylation, DNA binding, DNA replication, and immune response. Many genes with reduced expression were orthologs of genes known to be embryonic lethal in mice. This study, for the first time, provides evidence of altered transcription in embryos resulting from fertilization with cryopreserved spermatozoa in any species. As sperm cryopreservation is commonly used in many species, including human, the effect of this intervention on expression of developmentally important genes in resulting embryos warrants attention.

  • 193.
    Parrilla, I.
    et al.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Perez-Patino, C.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Li, J.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Barranco, I.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Padilla, L.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, E. A.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Roca, J.
    Univ Murcia, Spain; Inst Biomed Res Murcia IMIB Arrixaca, Spain.
    Boar semen proteomics and sperm preservation2019In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 137, p. 23-29Article in journal (Refereed)
    Abstract [en]

    Recently numerous proteomic approaches have been undertaken to identify sperm and seminal plasma (SP) proteins that can be used as potential biomarkers for sperm function, including fertilization ability. This review aims firstly to briefly introduce the proteomic technologies and workflows that can be successfully applied for sperm and SP proteomic analysis. Secondly, we summarize the current knowledge about boar SP and the sperm proteome, focusing mainly on its relevance to sperm preservation procedures (liquid storage or cryopreservation) and their outcomes in terms of sperm function and fertility. (C) 2019 Elsevier Inc. All rights reserved.

  • 194.
    Perez-Fatino, Cristina
    et al.
    Univ Murcia, Spain.
    Parrilla, Inmaculada
    Univ Murcia, Spain.
    Barranco, Isabel
    Univ Murcia, Spain.
    Vergara-Barberan, Maria
    Univ Valencia, Spain.
    Simo-Alfonso, Ernesto F.
    Univ Valencia, Spain.
    Herrero-Martinez, Jose M.
    Univ Valencia, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Martinez, Emilio A.
    Univ Murcia, Spain.
    Roca, Jordi
    Univ Murcia, Spain.
    A New In-Depth Analytical Approach of the Porcine Seminal Plasma Proteome Reveals Potential Fertility Biomarkers2018In: Journal of Proteome Research, ISSN 1535-3893, E-ISSN 1535-3907, Vol. 17, no 3, p. 1065-1076Article in journal (Refereed)
    Abstract [en]

    A complete characterization of the proteome of seminal plasma (SP) is an essential step to understand how SP influences sperm function and fertility after artificial insemination (AI). The purpose of this study was to identify which among characterized proteins in boar SP were differently expressed among AI boars with significantly different fertility outcomes. A total of 872 SP proteins, 390 of them belonging specifically to Sus Scrofa taxonomy, were identified (Experiment 1) by using a novel proteomic approach that combined size exclusion chromatography and solid-phase extraction as prefractionation steps prior to Nano LC-ESI-MS/MS analysis. The SP proteomes of 26 boars showing significant differences in farrowing rate (n = 13) and litter size (n = 13) after the AI of 10 526 sows were further analyzed (Experiment 2). A total of 679 SP proteins were then quantified by the SWATH approach, where the penalized linear regression LASSO revealed differentially expressed SP proteins for farrowing rate (FURIN, AKR1B1, UBA1, PIN1, SPAM1, BLMH, SMPDL3A, KRT17, KRT10, TTC23, and AGT) and litter size (PN-1, THBS1, DSC1, and CAT). This study extended our knowledge of the SP proteome and revealed some SP proteins as potential biomarkers of fertility in AI boars.

  • 195.
    Perez-Patino, Cristina
    et al.
    Univ Murcia, Spain.
    Barranco, Isabel
    Univ Murcia, Spain; Univ Girona, Spain.
    Li, Junwei
    Univ Murcia, Spain; Yangzhou Univ, Peoples R China.
    Padilla, Lorena
    Univ Murcia, Spain.
    Martinez, Emilio A.
    Univ Murcia, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Roca, Jordi
    Univ Murcia, Spain.
    Parrilla, Inmaculada
    Univ Murcia, Spain.
    Cryopreservation Differentially Alters the Proteome of Epididymal and Ejaculated Pig Spermatozoa2019In: International Journal of Molecular Sciences, ISSN 1422-0067, E-ISSN 1422-0067, Vol. 20, no 7, article id 1791Article in journal (Refereed)
    Abstract [en]

    Cryopreservation induces differential remodeling of the proteome in mammalian spermatozoa. How these proteome changes relate to the loss of sperm function during cryopreservation remains unsolved. The present study aimed to clarify this issue evaluating differential changes in the proteome of fresh and frozen-thawed pig spermatozoa retrieved from the cauda epididymis and the ejaculate of the same boars, with clear differences in cryotolerance. Spermatozoa were collected from 10 healthy, sexually mature, and fertile boars, and cryopreserved using a standard 0.5 mL-straw protocol. Total and progressive motility, viability, and mitochondria membrane potential were higher and membrane fluidity and reactive oxygen species generation lower in frozen-thawed (FT) epididymal than ejaculated spermatozoa. Quantitative proteomics of fresh and FT spermatozoa were analyzed using a LC-ESI-MS/MS-based Sequential Window Acquisition of All Theoretical Spectra approach. Cryopreservation quantitatively altered more proteins in ejaculated than cauda epididymal spermatozoa. Differential protein-protein networks highlighted a set of proteins quantitatively altered in ejaculated spermatozoa, directly involved in mitochondrial functionality which would explain why ejaculated spermatozoa deteriorate during cryopreservation.

  • 196.
    Perez-Patino, Cristina
    et al.
    Univ Murcia, Spain.
    Li, Junwei
    Univ Murcia, Spain.
    Barranco, Isabel
    Univ Murcia, Spain.
    Martinez, Emilio A.
    Univ Murcia, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Roca, Jordi
    Univ Murcia, Spain.
    Parrilla, Inmaculada
    Univ Murcia, Spain.
    The proteome of frozen-thawed pig spermatozoa is dependent on the ejaculate fraction source2019In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 705Article in journal (Refereed)
    Abstract [en]

    The preservation of sperm functional parameters and fertility post-cryopreservation largely varies in the porcine, a species with a fractionated ejaculate. Although intrinsic individual differences have primarily been linked to this variation, differences in protein abundance among frozen-thawed (FT)-spermatozoa are far more relevant. This study, performed in two experiments, looked for proteomic quantitative differences between FT-sperm samples differing in post-thaw viability, motility, apoptosis, membrane lipid peroxidation and nuclear DNA fragmentation. The spermatozoa were either derived from the sperm-rich ejaculate fraction (SRF) or the entire ejaculate (Experiment 1) or from the first 10 mL of the SRF, the remaining SRF and the post-SRF (Experiment 2). Quantitative sperm proteomic differences were analysed using a LC-ESI-MS/MS-based SWATH approach. In Experiment 1, FT-spermatozoa from the SRF showed better preservation parameters than those from the entire ejaculate, with 26 Sus scrofa proteins with functional sperm relevance showing relative quantitative differences (FC amp;gt;= 1.5) between sperm sources. In Experiment 2, FT-spermatozoa from the first 10 mL of the SRF and the remaining SRF were qualitatively better than those from the post-SRF, and 187 proteins showed relative quantitative differences among the three ejaculate sources. The results indicate that quantitative proteome differences are linked to sperm cryosurvival.

  • 197.
    Perez-Patino, Cristina
    et al.
    Univ Murcia, Spain.
    Parrilla, Inmaculada
    Univ Murcia, Spain.
    Li, Junwei
    Univ Murcia, Spain.
    Barranco, Isabel
    Univ Murcia, Spain.
    Martinez, Emilio A.
    Univ Murcia, Spain.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Roca, Jordi
    Univ Murcia, Spain.
    The Proteome of Pig Spermatozoa Is Remodeled During Ejaculation2019In: Molecular & Cellular Proteomics, ISSN 1535-9476, E-ISSN 1535-9484, Vol. 18, no 1, p. 41-50, article id RA118.000840Article in journal (Refereed)
    Abstract [en]

    Proteins are essential for sperm function, including their fertilizing capacity. Pig spermatozoa, emitted in well-defined ejaculate fractions, vary in their functionality, which could be related to different sperm protein composition. This study aimed (i) to update the porcine sperm proteome and (ii) to identify proteins differentially expressed in mature spermatozoa from cauda epididymis and those delivered in separate ejaculate fractions. Ejaculates from nine mature and fertile boars were manually collected in three separate portions: the first 10 ml of the sperm-rich ejaculate fraction (SRF), the rest of the SRF and the post-SRF. The contents of cauda epididymides of the boars were collected post-mortem by retrograde duct perfusion, generating four different semen sources for each boar. Following centrifugation, the resulting pellets of each semen source were initially pooled and later split to generate two technical replicates per source. The resulting eight sperm samples (two per semen source) were subjected to iTRAQ-based 2D-LC-MS/MS for protein identification and quantification. A total of 1,723 proteins were identified (974 of Sus scrofa taxonomy) and 1,602 of them were also quantified (960 of Sus scrofa taxonomy). After an ANOVA test, 32 Sus scrofa proteins showed quantitative differences (p amp;lt; 0.01) among semen sources, which was particularly relevant for sperm functionality in the post-SR F. The present study showed that the proteome of boar spermatozoa is remodeled during ejaculation involving proteins clearly implicated in sperm function. The findings provide valuable groundwork for further studies focused on identifying protein biomarkers of sperm fertility.

  • 198.
    Persson, M.
    et al.
    Karolinska Univ Hosp, Sweden.
    Becker, C.
    Skane Univ Hosp, Sweden.
    Larsson, H. Elding
    Lund Univ, Sweden.
    Lernmark, A.
    Lund Univ, Sweden.
    Forsander, G.
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Ivarsson, S. A.
    Lund Univ, Sweden.
    Ludvigsson, Johnny
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Samuelsson, Ulf
    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, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Marcus, C.
    Karolinska Inst, Sweden.
    Carlsson, A.
    Lund Univ, Sweden.
    The Better Diabetes Diagnosis (BDD) study - A review of a nationwide prospective cohort study in Sweden2018In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 140, p. 236-244Article, review/survey (Refereed)
    Abstract [en]

    The incidence of type 1 diabetes (T1D) in Sweden is one of the highest in the world. However, the possibility of other types of diabetes must also be considered. In addition, individuals with T1D constitute a heterogeneous group. A precise classification of diabetes is a prerequisite for optimal outcome. For precise classification, knowledge on the distribution of genetic factors, biochemical markers and clinical features in individuals with new onset of diabetes is needed. The Better Diabetes Diagnosis (BDD), is a nationwide study in Sweden with the primary aim to facilitate a more precise classification and diagnosis of diabetes in order to enable the most adequate treatment for each patient. Secondary aims include identification of risk factors for diabetes-related co-morbidities. Since 2005, data on almost all children and adolescents with newly diagnosed diabetes in Sweden are prospectively collected and including heredity of diabetes, clinical symptoms, levels of C peptide, genetic analyses and detection of autoantibodies. Since 2011, analyses of HLA profile, autoantibodies and C peptide levels are part of clinical routine in Sweden for all pediatric patients with suspected diagnosis of diabetes. In this review, we present the methods and main results of the BDD study so far and discuss future aspects. (C) 2018 Elsevier B.V. All rights reserved.

  • 199.
    Petersson, Jonathan
    et al.
    Orebro Univ, Sweden.
    Åkesson, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
    Sundberg, Frida
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Sarnblad, Stefan
    Orebro Univ, Sweden; Univ Hosp Orebro, Sweden.
    Translating glycated hemoglobin A1c into time spent in glucose target range: A multicenter study2019In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 20, no 3, p. 339-344Article in journal (Refereed)
    Abstract [en]

    Background Approximately 90% of children and adolescents with type 1 diabetes in Sweden use continuous glucose monitoring (CGM), either as real-time CGM or intermittently scanned CGM to monitor their glucose levels. Time in target range (TIT) is an easily understandable metric for assessing glycemic control. Objective The aim of this study was to examine the relation between TIT and hemoglobin A1c (HbA1c). Subjects and Methods Subjects were recruited from three diabetes care centers in Sweden. Glucose data were collected for 133 children and adolescents with type 1 diabetes through CGM using Diasend. Subjects with registration time over 80% were included in the analysis. HbA1c was collected from SWEDIABKIDS, the Swedish pediatric diabetes quality registry. TIT was defined as 3.9 to 7.8 mmol/L (70-140 mg/dL) and time in range (TIR) as 3.9 to 10 mmol/L (70-180 mg/dL). Results During the period of 60 days, 105 subjects provided complete data for analysis. Mean age was 12.2 (+/- 3.3) years, mean HbA1c was 53.9 (+/- 8.2) mmol/mol or 7.1% (+/- 0.7%). Mean sensor glucose value was 8.6 (+/- 1.3) mmol/L, mean coefficient of variation was 42.2% (+/- 7.2%), mean TIT was 40.9% (+/- SD 12.2%), and mean TIR was 60.8% (+/- 13.1%). There was a significant nonlinear relation between TIT during 60 days and HbA1c, R-2 = 0.69. Conclusion This study suggests a nonlinear relation between time spent in glucose target range and HbA1c. The finding implies that time spent in TIT could be a useful metric in addition to HbA1c to assess glycemic control.

  • 200.
    Pihl, Mikael
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Barcenilla, Hugo
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Axelsson Chéramy, Stina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Chéramy, Mikael
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Åkerman, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Johansson, Ingela
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Ludvigsson, Johnny
    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.
    Casas, Rosaura
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    GAD-specific T cells are induced by GAD-alum treatment in Type-1 diabetes patients2017In: Clinical Immunology, ISSN 1521-6616, E-ISSN 1521-7035, Vol. 176, p. 114-121Article in journal (Refereed)
    Abstract [en]

    Administration of Glutamic Acid Decarboxylase (GAD)(65) formulated in aluminium hydroxide preserved insulin secretion in a phase II trial in recent onset Type 1 Diabetes. A subsequent European phase III trial was closed at 15 months after failing to reach primary endpoint, but the majority of the Swedish patients completed the 21 months follow-up. We studied the frequencies and phenotype of T cells, suppressive capacity of Tregs, GAD(65)-induced proliferation, and frequencies of T cells with a GAD(65)-specific TCR in Swedes participating in the trial. Stimulation with GAD(65) induced activated T cells and also cells with a suppressive phenotype. Activated GAD(65)-specific effector T cells were detected by tetramer staining while the frequency of GAD(65)-specific Treg was not affected by the treatment. Additional doses of GAD-alum increased frequencies of CD25(+)CD127(+), but had no effect on CD25(hi)CD127(lo). Our findings indicate that GAD-alum treatment primarily induced activated T cells. GAD(65)-specific cells were mainly of activated phenotype. (C) 2017 Elsevier Inc. All rights reserved.

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