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  • 1. Bartonek, A.
    et al.
    Lidbeck, C. M.
    Gutierrez-Farewik, Elena
    KTH, Skolan för teknikvetenskap (SCI), Mekanik, Biomekanik.
    Influence of external visual focus on gait in children with bilateral cerebral palsy2016Ingår i: Pediatric Physical Therapy, ISSN 0898-5669, E-ISSN 1538-005X, Vol. 28, nr 4, s. 393-399Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To explore whether focusing a target influenced gait in children with cerebral palsy (CP) and typical development (TD). Methods: Thirty children with bilateral CP (Gross Motor Function Classification System [GMFCS] I-III) and 22 with TD looked at a light at walkway end (Gaze Target) while walking and returned (No Target). Results: During Gaze versus No Target, children with TD reduced temporal-spatial parameters and movements in the sagittal (SPM) and transverse planes. In comparison, during Gaze Target, children in CP1 (GMFCS I) had larger trunk SPM, children in CP2 (GMFCS II) larger neck (SPM), and children in CP3 (GMFCS III) greater head and neck frontal plane movements, and reduced cadence and single support. Conclusions: Focusing a target altered gait in children with CP. Children in CP1 reduced movements similar to children with TD, children in CP2 behaved nearly unchanged, whereas children in CP3 reduced movements and temporalspatial parameters, potentially as a consequence of lack of sensory information from lower limbs.

  • 2.
    Flisberg, A.
    et al.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Sweden.
    Kjellmer, I.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Sweden.
    Löfhede, J.
    School of Engineering, University of Borås, Sweden.
    Lindecrantz, Kaj
    KTH, Skolan för teknik och hälsa (STH), Medicinska sensorer, signaler och system (MSSS) (Stängd 20130701).
    Thordstein, M.
    Department of Clinical Neurophysiology, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Prognostic capacity of automated quantification of suppression time in the EEG of post-asphyctic full-term neonates2011Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 10, s. 1338-1343Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To evaluate the prognostic capacity of a new method for automatic quantification of the length of suppression time in the electroencephalogram (EEG) of a group of asphyxiated newborn infants. Methods: Twenty-one full-term newborn infants who had been resuscitated for severe birth asphyxia were studied. Eight channel continuous EEG was recorded for prolonged time periods during the first days of life. Artefact detection or rejection was not applied to the signals. The signals were fed through a pretrained classifier and then segmented into burst and suppression periods. Total suppression length per hour was calculated. All surviving patients were followed with structured neurodevelopmental assessments to at least 18 months of age. Results: The patients who developed neurodevelopmental disability or died had significant suppression periods in their EEG during the first days of life while the patients who had a normal follow-up had no or negligible amount of suppression. Conclusions: This new method for automatic quantification of suppression periods in the raw, neonatal EEG discriminates infants with good from those with poor outcome.

  • 3.
    Flisberg, A.
    et al.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital-Östra.
    Kjellmer, I.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital-Östra.
    Löfhede, J.
    School of Engineering, University of Borås.
    Löfgren, N.
    Neoventa Medical AB, Göteborg.
    Rosa-Zurera, M.
    Department of Signal Theory and Communications, University of Alcalá.
    Lindecrantz, Kaj
    KTH, Skolan för teknik och hälsa (STH), Medicinska sensorer, signaler och system (MSSS) (Stängd 20130701).
    Thordstein, M.
    Department of Clinical Neurophysiology, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Does indomethacin for closure of patent ductus arteriosus affect cerebral function?2010Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 10, s. 1493-1497Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study whether indomethacin used in conventional dose for closure of patent ductus arteriosus affects cerebral function measured by Electroencephalograms (EEG) evaluated by quantitative measures. Study design: Seven premature neonates with haemodynamically significant persistent ductus arteriosus were recruited. EEG were recorded before, during and after an intravenous infusion of 0.2 mg/kg indomethacin over 10 min. The EEG was analysed by two methods with different degrees of complexity for the amount of low-activity periods (LAP, "suppressions") as an indicator of affection of cerebral function. Results: Neither of the two methods identified any change in the amount of LAPs in the EEG as compared to before the indomethacin infusion. Conclusion: Indomethacin in conventional dose for closure of patent ductus arteriosus does not affect cerebral function as evaluated by quantitative EEG.

  • 4. Li, Yanhong
    et al.
    Marcoux, Marie-Odile
    Gineste, Martine
    Vanpee, Mireille
    Zelenina, Marina
    KTH, Skolan för teknikvetenskap (SCI), Tillämpad fysik, Cellens fysik.
    Casper, Charlotte
    Expression of water and ion transporters in tracheal aspirates from neonates with respiratory distress2009Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, nr 11, s. 1729-1737Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of the study was to determine whether neonatal respiratory distress is related to changes in water and ion transporter expression in lung epithelium. Methods: The study included 32 neonates on mechanical ventilation: 6 patients with normal lung X-rays (control group), eight with respiratory distress syndrome (RDS), eight with transient tachypnea of the newborn (TTN), 10 with abnormal lung X-rays (mixed group). The protein abundance of water channel AQP5, epithelial sodium channel (ENaC; alpha-, beta- and gamma-ENaC) and Na+, K+-ATPase alpha 1 were examined in tracheal aspirates using semiquantitative immunoblotting. Results: beta-ENaC level was significantly lower in RDS group compared with infants with TTN and infants in the control group. AQP5 expression was significantly higher in TTN compared with the infants with RDS and all other infants with abnormal lung X-rays. Conclusion: Neonatal respiratory distress is associated with changes in beta-ENaC and AQP5 expression. The lower beta-ENaC expression may be one of the factors that predispose to the development of RDS. The higher AQP5 expression may provide the possibility for reabsorption of postnatal lung liquid, which contributes to quick recovery of infants with TTN.

  • 5. Li, Yanhong
    et al.
    Zelenina, Marina
    KTH, Skolan för teknikvetenskap (SCI), Tillämpad fysik, Cellens fysik. Karolinska Institutet, Sweden.
    Plat-Willson, Genevieve
    Marcoux, Marie-Odile
    Aperia, Anita
    Casper, Charlotte
    Urinary aquaporin-2 excretion during ibuprofen or indomethacin treatment in preterm infants with patent ductus arteriosus2011Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 1, s. 59-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Water channel AQP2 is the target for vasopressin (AVP) and a major determinant of urinary concentrating capacity. In mature kidneys, prostaglandins counteract the effect of AVP on AQP2 expression at functional sites. We investigated whether disturbances in water homeostasis in infants with patent ductus arteriosus (PDA) treated with prostaglandin inhibitors can be attributed to activation of AQP2. Methods: In 53 infants with symptomatic PDA (gestational age 24-33 weeks), 30 receiving ibuprofen and 23 indomethacin starting at 2-15 days of life, clinical and biochemical data were collected before treatment and after each dose of the drugs. Urinary AQP2 was determined by dot immunoblotting. Results: Urinary AQP2 level and osmolality were decreased in both groups. Urinary osmolality was overall low and correlated inversely with fluid uptake. In ibuprofen group, there was no correlation of AQP2 level with urinary osmolality. Conclusion: There was no AQP2 upregulation in the infants. The low urinary osmolality and dissociation between urinary osmolality and urinary AQP2 level indicate that the fluid retention sometimes observed in PDA infants treated with prostaglandin inhibitors is not caused by increased levels of functional AQP2. Thus, knowledge about the renal physiology of the adult cannot always be transferred to the infant kidney.

  • 6. Lidbeck, Cecilia M.
    et al.
    Gutierrez-Farewik, Elena
    KTH, Skolan för teknikvetenskap (SCI), Mekanik, Biomekanik. KTH, Skolan för teknikvetenskap (SCI), Mekanik, Strukturmekanik.
    Broström, Eva
    Karolinska Institutet, Stockholm, Sweden .
    Bartonek, Åsa
    Karolinska Institutet, Stockholm, Sweden .
    Postural Orientation During Standing in Children With Bilateral Cerebral Palsy2014Ingår i: Pediatric Physical Therapy, ISSN 0898-5669, E-ISSN 1538-005X, Vol. 26, nr 2, s. 223-229Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate postural orientation and maintenance of joint position during standing in children with bilateral spastic cerebral palsy (BSCP). Methods: Standing was examined with 3-D motion analysis in 26 children with BSCP, and 19 children typically developing (TD). Two groups of children with cerebral palsy (CP) were analyzed: 15 who were able to maintain standing without support and 11 who needed support. Results: Children with CP stood with more flexion than children TD. In the CP groups, children standing without support stood more asymmetrically with less hip and knee flexion and less movement than those who required support. Conclusion: Children with CP had varying abilities to stand and maintain standing posture with or without support. Both CP groups stood with more flexion than their potential passive joint angle, more obvious in children requiring support. Investigations on how muscle strength and spatial perception influence posture remains to be explored.

  • 7.
    Löfhede, J.
    et al.
    School of Engineering, University of Borås.
    Löfgren, N.
    School of Engineering, University of Borås.
    Thordstein, M.
    Department of Clinical Neurophysiology, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Flisberg, A.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital-Östra.
    Kjellmer, I.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital-Östra.
    Lindecrantz, Kaj
    School of Engineering, University of Borås.
    Detection of bursts in the EEG of post asphyctic newborns2006Ingår i: 2006 28th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2006, Vol. 1, s. 2179-2182Konferensbidrag (Refereegranskat)
    Abstract [en]

    Eight features inherent in the electroencephalogram (EEG) have been extracted and evaluated with respect to their ability to distinguish bursts from suppression in burst-suppression EEG. The study is based on EEG from six full term infants who had suffered from lack of oxygen during birth. The features were used as input in a neural network, which was trained on reference data segmented by an experienced electroencephalographer. The performance was then evaluated on validation data for each feature separately and in combinations. The results show that there are significant variations in the type of activity found in burst-suppression EEG from different subjects, and that while one or a few features seem to be sufficient for most patients in this group, some cases require specific combinations of features for good detection to be possible.

  • 8.
    Löfhede, J.
    et al.
    School of Engineering, University of Borås.
    Löfgren, N.
    Neoventa Medical AB, Göteborg.
    Thordstein, M.
    Department of Clinical Neurophysiology, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Kjellmer, I.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital-Östra.
    Kjellmer, I.
    Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital-Östra.
    Lindecrantz, Kaj
    School of Engineering, University of Borås.
    Classification of burst and suppression in the neonatal electroencephalogram2008Ingår i: Journal of Neural Engineering, ISSN 1741-2560, Vol. 5, nr 4, s. 402-410Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fisher's linear discriminant (FLD), a feed-forward artificial neural network (ANN) and a support vector machine (SVM) were compared with respect to their ability to distinguish bursts from suppressions in electroencephalograms (EEG) displaying a burst-suppression pattern. Five features extracted from the EEG were used as inputs. The study was based on EEG signals from six full-term infants who had suffered from perinatal asphyxia, and the methods have been trained with reference data classified by an experienced electroencephalographer. The results are summarized as the area under the curve (AUC), derived from receiver operating characteristic (ROC) curves for the three methods. Based on this, the SVM performs slightly better than the others. Testing the three methods with combinations of increasing numbers of the five features shows that the SVM handles the increasing amount of information better than the other methods.

  • 9. Löwing, K.
    et al.
    Thews, K.
    Haglund-Åkerlind, Y.
    Gutierrez-Farewik, Elena M.
    KTH, Skolan för teknikvetenskap (SCI), Mekanik, Biomekanik. Karolinska Institutet, Sweden.
    Effects of Botulinum Toxin-A and Goal-Directed Physiotherapy in Children with Cerebral Palsy GMFCS Levels I & II2017Ingår i: Physical & Occupational Therapy in Pediatrics, ISSN 0194-2638, E-ISSN 1541-3144, Vol. 37, nr 3, s. 268-282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To evaluate short and long-term effects of botulinum toxin-A combined with goal-directed physiotherapy in children with cerebral palsy (CP). Method: A consecutive selection of 40 children, ages 4–12 years, diagnosed with unilateral or bilateral CP, and classified in GMFCS levels I–II. During the 24 months, 9 children received one BoNT-A injection, 10 children two injections, 11 children three injections, and 10 children received four injections. 3D gait analysis, goal-attainment scaling, and body function assessments were performed before and at 3, 12, and 24 months after initial injections. Results: A significant but clinically small long-term improvement in gait was observed. Plantarflexor spasticity was reduced after three months and remained stable, while passive ankle dorsiflexion increased after 3 months but decreased slightly after 12 months. Goal-attainment gradually increased, reached the highest levels at 12 months, and levels were maintained at 24 months. Conclusion: The treatments’ positive effect on spasticity reduction was identified, but did not relate to improvement in gait or goal-attainment. No long-term positive change in passive ankle dorsiflexion was observed. Goal attainment was achieved in all except four children. The clinical significance of the improved gait is unclear. Further studies are recommended to identify predictors for positive treatment outcome.

  • 10.
    Mihaescu, Mihai
    et al.
    Aerospace Engineering, University of Cincinnati.
    Murugappan, Shanmugam
    Otolargyngology, Head and Neck Surgery, University of Cincinnati-Medical Center.
    Gutmark, Ephraim
    Aerospace Engineering, University of Cincinnati.
    Elluru, Ravindhra
    Cincinnati Children's Hospital.
    Cohen, Aliza
    Cincinnati Children's Hospital.
    Willging, J. Paul
    Cincinnati Children's Hospital.
    Modeling Flow in a Compromised Pediatric Airway Breathing Air and Heliox2008Ingår i: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 118, nr 12, s. 2205-2211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives/Hypothesis: The aim of this study was to perform computer simulations of flow within an accurate model of a pediatric airway with subglottic stenosis. It is believed that the airflow characteristics in a stenotic airway are strongly related to the sensation of dyspnea. Methodology: Computed tomography images through the respiratory tract of an infant with subglottic stenosis, were used to construct the three-dimensional geometry of the airway. By using computational fluid dynamics (CFD) modeling to capture airway flow patterns during inspiration and expiration, we obtained information pertaining to flow velocity, static airway wall pressure, pressure drop across the stenosis, and wall shear stress. These simulations were performed with both air and heliox. Results: Unlike air, heliox maintained laminar flow through the stenosis. The calculated pressure drop over stenosis was lower for the heliox flow, in contrast to the airflow case. This lead to an approximately 40% decrease in airway resistance when using heliox, and presumably causes a decrease in the level of effort required for breathing. Conclusions: CFD simulations offer a quantitative method of evaluating airway flow dynamics in patients with airway abnormalities. CFD modeling illustrated the flow features and quantified flow parameters within a pediatric airway with subglottic stenosis. Simulations with air and heliox conditions mirrored the known clinical benefits of heliox as compared with air. We anticipate that computer simulation models will ultimately allow a better understanding of changes in flow caused by specific medical and surgical interventions in patients with conditions associated with dyspnea.

  • 11.
    Olin, Axel
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden..
    Henckel, Ewa
    Karolinska Inst, Dept Clin Sci Intervent & Technol, S-14152 Solna, Sweden.;Karolinska Univ Hosp, Dept Neonatol, S-17176 Solna, Sweden..
    Chen, Yang
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden..
    Lakshmikanth, Tadepally
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden..
    Pou, Christian
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden..
    Mikes, Jaromir
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden..
    Gustafsson, Anna
    Karolinska Inst, Dept Clin Sci Intervent & Technol, S-14152 Solna, Sweden.;Karolinska Univ Hosp, Dept Neonatol, S-17176 Solna, Sweden..
    Bernhardsson, Anna Karin
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden.;Karolinska Univ Hosp, Dept Neonatol, S-17176 Solna, Sweden..
    Zhang, Cheng
    KTH, Centra, Science for Life Laboratory, SciLifeLab.
    Bohlin, Kajsa
    Karolinska Inst, Dept Clin Sci Intervent & Technol, S-14152 Solna, Sweden.;Karolinska Univ Hosp, Dept Neonatol, S-17176 Solna, Sweden..
    Brodin, Petter
    Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, S-17121 Solna, Sweden.;Karolinska Univ Hosp, Dept Neonatol, S-17176 Solna, Sweden..
    Stereotypic Immune System Development in Newborn Children2018Ingår i: Cell, ISSN 0092-8674, E-ISSN 1097-4172, Vol. 174, nr 5, s. 1277-+Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Epidemiological data suggest that early life exposures are key determinants of immune-mediated disease later in life. Young children are also particularly susceptible to infections, warranting more analyses of immune system development early in life. Such analyses mostly have been performed in mouse models or human cord blood samples, but these cannot account for the complex environmental exposures influencing human newborns after birth. Here, we performed longitudinal analyses in 100 newborn children, sampled up to 4 times during their first 3 months of life. From 100 mu L of blood, we analyze the development of 58 immune cell populations by mass cytometry and 267 plasma proteins by immunoassays, uncovering drastic changes not predictable from cord blood measurements but following a stereotypic pattern. Preterm and term children differ at birth but converge onto a shared trajectory, seemingly driven by microbial interactions and hampered by early gut bacterial dysbiosis.

  • 12. Rakow, Alexander
    et al.
    Katz-Salamon, Miriam
    Ericson, Mats
    KTH, Skolan för teknik och hälsa (STH), Ergonomi.
    Edner, Ann
    Vanpée, Mireille
    Decreased heart rate variability in children born with low birth weight2013Ingår i: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 74, nr 3, s. 339-343Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Low birth weight (LBW) is associated with cardiovascular morbidity in adulthood. Imbalance in the autonomic nervous system (ANS) has been implicated as a mechanism behind the developmental programming of cardiovascular function. We hypothesized that deviations in the ANS function are seen in children born with LBW. METHODS: Eighty-six children were included: 31 born pre-term (<32 wk gestational age), 27 born at term but small for gestational age (SGA), and 28 born at term with normal birth weight (control). Twenty-four-hour Holter-electrocardiogram monitoring was performed at an average age of 9 y. Heart rate variability results were analyzed using frequency and time domain methods. RESULTS: All frequency components and both time domain parameters tested were significantly lower in the preterm and SGA children compared with controls. The low frequency/high frequency ratio was not significantly different between children born with LBW and controls. CONCLUSION: The autonomic control appears to be affected in children born with LBW despite gestational age at birth. Decreased total power, as an estimation of the ANS's global activity, rather than the balance between parasympathetic and sympathetic modulation might be an early marker of cardiovascular disease later on in life for LBW born children.

  • 13. Ringman Uggla, Andreas
    et al.
    von Schewelov, Katarina
    Zelenina, Marina
    KTH, Skolan för teknikvetenskap (SCI), Tillämpad fysik, Cellens fysik.
    Aperia, Anita
    Nordic Centre of Excellence for Research in Water Imbalance Related Disorders (WIRED), Stockholm, Sweden.
    Frenckner, Björn
    Low pulmonary expression of epithelial Na(+) channel and Na(+), K(+)-ATPase in newborn infants with congenital diaphragmatic hernia2011Ingår i: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 99, nr 1, s. 14-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It has been suggested from several animal studies and clinical observations that congenital diaphragmatic hernia (CDH) with pulmonary hypoplasia is accompanied by a disturbed perinatal ion transport. This could lead to respiratory distress due to slower clearance of fetal lung fluid at birth.

    OBJECTIVES: The purpose of this study was to determine whether CDH is related to changes in the expression of three rate-limiting transporter proteins in lung epithelium at birth.

    METHODS: Tracheal aspirate was collected from 12 newborn infants with CDH and from 8 newborn control patients. Sampling was performed at postnatal age 18 and at 43 h in the CDH group and at 18 h in the control group. The protein abundance of α-, β- and γ-epithelial Na(+) channel (ENaC), aquaporin 5 and Na(+), K(+)-ATPase α(1) was analyzed using semiquantitative immunoblotting.

    RESULTS: The levels of β-ENaC, γ-ENaC and Na(+), K(+)-ATPase α(1) collected at 18 h postnatally were significantly lower in CDH infants compared to control infants. In the CDH group, no significant difference in the expression of the ENaC subunits, Na(+), K(+)-ATPase α(1) or aquaporin 5 could be detected between the two sampling time points.

    CONCLUSIONS: This downregulation may result in an abnormal lung fluid absorption which could be an important mechanism behind the respiratory distress seen in newborn CDH patients.

  • 14. Rodionova, Elena A.
    et al.
    Kuznetsova, Alla A.
    Shakhmatova, Elena I.
    Prutskova, Natalia
    Nielsen, Søren
    Holtbäck, Ulla
    Natochin, Yuri
    Zelenina, Marina
    Nordic Center of Excellence for Research in Water Imbalance Related Disorders (WIRED), Department of Woman and Child Health, Karolinska Institutet.
    Urinary aquaporin-2 in children with acute pyelonephritis2006Ingår i: Pediatric nephrology (Berlin, West), ISSN 0931-041X, E-ISSN 1432-198X, Vol. 21, nr 3, s. 361-367Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Children with acute pyelonephritis develop polyuria and have reduced maximum urinary concentration capacity. We studied whether these abnormalities are associated with altered urinary excretion of the water channel aquaporin-2 (AQP2) in the renal collecting duct. AQP2 is the main target for antidiuretic action of arginine vasopressin (AVP), and the urinary excretion of this protein is believed to be an index of AVP signaling activity in the kidney. Children with acute pyelonephritis, aged 5-14 years, were examined for urinary flow rate, creatinine clearance, unchallenged urine osmolality, and urinary ion excretion. Urinary excretion of AQP2 was measured by dot immunoblotting technique. Studies were performed in the acute phase of pyelonephritis, in the same children after treatment, and in control patients. At the onset of pyelonephritis, urinary flow rate and solute excretion were increased, but the urinary osmolality was unchanged. The urinary level and urinary excretion of AQP2 was increased in acute pyelonephritis and decreased after treatment. Excretion of aquaporin-3 was unchanged, suggesting that the increase in AQP2 urinary excretion was not due to a shedding of collecting duct cells. The results suggest that a mechanism proximal to the collecting duct may be responsible for the polyuria observed in children with acute pyelonephritis. Increased urinary AQP2 levels suggest that a compensatory activation of apical plasma membrane targeting of AQP2 may occur in pyelonephritis.

  • 15.
    Seoane, Fernando
    KTH, Skolan för teknik och hälsa (STH), Medicinska sensorer, signaler och system (MSSS) (Stängd 20130701).
    Electrical Bioimpedance Cerebral Monitoring: Fundamental Steps towards Clinical Application2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
  • 16.
    Seoane, Fernando
    et al.
    Chalmers University, Sweden.
    Lindecrantz, Kaj
    The effect of the scalp and the skull bone in the total impedivity of the neonatal head and its implications in the detection of brain cellular edema2005Ingår i: The 3rd European Medical and Biological Engineering Conference EMBEC´05. IFBME European Conference on BME, Prague: IFMBE , 2005Konferensbidrag (Refereegranskat)
    Abstract [en]

    Hypoxic-ischemic encephalopathy (HIE) affects severely and frequently on newborns and yet not an efficient detection method has been implemented to assist the early initiation of a saving therapy. Invasive measurements of electrical bioimpedance can be used to detect the changes in the electrical properties of brain tissue as a consequence of the hypoxic cellular edema. In the case of non-invasive measurement the skull and the scalp will modified the measurements in a certain way. In this work, using numerical calculations on a four-concentric spheres model, we study the contribution of the scalp and the skull bone to the total equivalent impedivity, complex resistivity, of the neonatal head and its effect on the non-invasive detection of brain cellular edema. The results confirm the importance of the reactive part of the impedivity on the electrical bioimpedance monitoring of hypoxic brain damage.

  • 17. Svensson, V.
    et al.
    Ek, A.
    Forssén, M.
    Ekbom, K.
    Cao, Y.
    Ebrahim, M.
    Johansson, E.
    Nero, H.
    Hagströmer, M.
    Ekstedt, Mirjam
    KTH, Skolan för teknik och hälsa (STH), Hälso- och systemvetenskap, Systemsäkerhet och organisation.
    Nowicka, P.
    Marcus, C.
    Infant growth is associated with parental education but not with parental adiposity - Early Stockholm Obesity Prevention Project2014Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, nr 4, s. 418-425Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AimTo explore the simultaneous impact of parental adiposity and education level on infant growth from birth to 12months, adjusting for known early-life risk factors for subsequent childhood obesity. MethodsBaseline data for 197 one-year-old children and their parents, participating in a longitudinal obesity intervention, were used. Obesity risk groups, high/low, were defined based on parental body mass index (n=144/53) and parental education (n=57/139). Observational data on infant growth between 0 and 12months were collected. The children's relative weight (body mass index standard deviation score) at 3, 6 and 12months and rapid weight gain 0-6months were analysed in regression models, with obesity risk as primary exposure variables, adjusting for gestational weight gain, birth weight, short exclusive breastfeeding and maternal smoking. ResultsRelative weight at 3, 6 and 12months was associated with low parental education but not with parental adiposity. No significant associations were observed with rapid weight gain. None of the early-life factors could explain the association with parental education. ConclusionLow parental education level is independently associated with infant growth, whereas parental obesity does not contribute to a higher weight or to rapid weight gain during the first year.

  • 18. Tedroff, K.
    et al.
    Lowing, K.
    Haglund-Akerlind, Y.
    Gutierrez-Farewik, Elena
    KTH, Skolan för teknikvetenskap (SCI), Mekanik, Strukturmekanik.
    Forssberg, H.
    Botulinumtoxin A treatment in toddlers with cerebral palsy2010Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 8, s. 1156-1162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: In this study the aim was to evaluate the effect of botulinum toxin A (BoNT-A) treatment on muscle tone, contracture development and gait pattern in young children with cerebral palsy (CP). Method: Fifteen children with spastic CP (mean age = 16 months) were included in a randomized control study. All received a daily stretching programme and children in the BoNT-A group additionally received two injections, 6 months apart in the gastrocnemius muscle. Outcomes were assessed at baseline, and after 1 and 3.5 years. A 3D gait-analysis was performed at 5 years of age. Results: Plantarflexor muscle tone in the BoNT-A group was significantly reduced after 3.5 years, while the muscle tone at the ankle and knee in the control group remained unchanged. The change-score in knee-flexion muscle tone between the groups was significantly different after 3.5 years. The knee joint ROM was significantly increased at 1 year in the BoNT-A group but reduced at the knee and ankle joints in the control group after 3.5 years. No group differences were found for gait analysis, GMFM-66 or PEDI. Conclusion: Early treatment of BoNT-A in children with spastic CP may decrease muscle tone and decelerate contracture development after 3.5 years. The effect on gait development remains inconclusive.

  • 19. Vieux, Rachel
    et al.
    Zelenina, Marina
    Nordic Center of Excellence for Research in Water Imbalance Related Disorders (WIRED), Karolinska Institutet, Stockholm, Sweden. Department of Women's and Children's Health, Karolinska Institutet.
    Aperia, Anita
    Nordic Center of Excellence for Research in Water Imbalance Related Disorders (WIRED), Karolinska Institutet, Stockholm, Sweden. Department of Women's and Children's Health, Karolinska Institutet.
    Hascoët, Jean-Michel
    The renal adverse effects of ibuprofen are not mediated by AQP2 water channels2010Ingår i: Pediatric nephrology (Berlin, West), ISSN 0931-041X, E-ISSN 1432-198X, Vol. 25, nr 7, s. 1277-1284Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to determine (1) whether ibuprofen treatment in very preterm infants causes an increase in the renal water channel aquaporin-2 (AQP2) activity in the collecting duct via prostaglandin synthesis inhibition and (2) whether AQP2 activity remains disturbed long after ibuprofen treatment has ended. This was a prospective study involving premature infants with a gestation age of 27-31 weeks who received treatment between December 2005 and August 2006 in a tertiary Neonatal Intensive Care Unit. Each ibuprofen-treated infant was matched to two controls. Renal glomerular and tubular function were evaluated weekly for 1 month, and urinary AQP2 was measured by immuno-dotting. In total, 166 longitudinal samples were analyzed in 36 infants. Median [interquartile range] gestational age and birthweight were 28 [27.0-29.5] weeks and 1160 [1041-1242] g, respectively. Perinatal factors were similar in both groups. Urine output was significantly decreased in the ibuprofen-treated infants during the treatment. The urinary AQP2 level decreased significantly from day 2 to day 7 in both groups and was similar thereafter for the first month of life in ibuprofen-treated and control groups. Based on our results, we conclude that ibuprofen-induced oligo-anuria is not associated with a change in AQP2 activity and that ibuprofen does not affect AQP2 activity during the first month of life in very preterm neonates.

  • 20. Wampach, Linda
    et al.
    Heintz-Buschart, Anna
    Hogan, Angela
    Muller, Emilie E. L.
    Narayanasamy, Shaman
    Laczny, Cedric C.
    Hugerth, Luisa
    KTH, Skolan för bioteknologi (BIO), Genteknologi. KTH, Centra, Science for Life Laboratory, SciLifeLab.
    Bindl, Lutz
    Bottu, Jean
    Andersson, Anders F.
    KTH, Skolan för bioteknologi (BIO), Genteknologi. KTH, Centra, Science for Life Laboratory, SciLifeLab.
    de Beaufort, Carine
    Wilmes, Paul
    Colonization and Succession within the Human Gut Microbiome by Archaea, Bacteria, and Microeukaryotes during the First Year of Life2017Ingår i: Frontiers in Microbiology, ISSN 1664-302X, E-ISSN 1664-302X, Vol. 8, artikel-id 738Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Perturbations to the colonization process of the human gastrointestinal tract have been suggested to result in adverse health effects later in life. Although much research has been performed on bacterial colonization and succession, much less is known about the other two domains of life, archaea, and eukaryotes. Here we describe colonization and succession by bacteria, archaea and microeukaryotes during the first year of life (samples collected around days 1, 3, 5, 28, 150, and 365) within the gastrointestinal tract of infants delivered either vaginally or by cesarean section and using a combination of quantitative real-time PCR as well as 16S and 18S rRNA gene amplicon sequencing. Sequences from organisms belonging to all three domains of life were detectable in all of the collected meconium samples. The microeukaryotic community composition fluctuated strongly over time and early diversification was delayed in infants receiving formula milk. Cesarean section-delivered (CSD) infants experienced a delay in colonization and succession, which was observed for all three domains of life. Shifts in prokaryotic succession in CSD infants compared to vaginally delivered (VD) infants were apparent as early as days 3 and 5, which were characterized by increased relative abundances of the genera Streptococcus and Staphylococcus, and a decrease in relative abundance for the genera Bifidobacterium and Bacteroides. Generally, a depletion in Bacteroidetes was detected as early as day 5 postpartum in CSD infants, causing a significantly increased Firmicutes/Bacteroidetes ratio between days 5 and 150 when compared to VD infants. Although the delivery mode appeared to have the strongest influence on differences between the infants, other factors such as a younger gestational age or maternal antibiotics intake likely contributed to the observed patterns as well. Our findings complement previous observations of a delay in colonization and succession of CSD infants, which affects not only bacteria but also archaea and microeukaryotes. This further highlights the need for resolving bacterial, archaeal, and microeukaryotic dynamics in future longitudinal studies of microbial colonization and succession within the neonatal gastrointestinal tract.

  • 21.
    Zelenina, Marina
    et al.
    Nordic Centre of Excellence for Research in Water Imbalance Related Disorders (WIRED), Department of Woman and Child Health, Karolinska Institute.
    Li, Yanhong
    Glorieux, Isabelle
    Arnaud, Catherine
    Cristini, Christelle
    Decramer, Stéphane
    Aperia, Anita
    Casper, Charlotte
    Urinary aquaporin-2 excretion during early human development2006Ingår i: Pediatric nephrology (Berlin, West), ISSN 0931-041X, E-ISSN 1432-198X, Vol. 21, nr 7, s. 947-952Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study was undertaken to assess one of the determinants of kidney concentrating capacity, aquaporin-2 (AQP2), in order to understand the physiopathology of water balance in newborn babies. Urinary AQP2 excretion has been shown to be proportional to AQP2 level in the apical plasma membrane of the kidney collecting ducts and has been suggested as a marker of vasopressin (AVP) action. Urinary AQP2 excretion in the early postnatal period and at 3 weeks of age was measured in 123 neonates admitted during a 6-month period to the neonatal intensive care unit of the Children's Hospital of Toulouse, France. Clinical and biochemical data were collected for each child. During the first days after birth, higher urinary AQP2 was observed in boys than in girls (P=0.01) and positively correlated with urinary sodium/potassium (Na/K) ratio (r=0.33, P=0.01). When the babies had reached 3 weeks of age, urinary AQP2 was proportional to the gestational age at birth (r=0.33, P=0.0068) and daily weight gain (r=0.36, P=0.003). It did not correlate with urinary osmolality, which was overall very low in all babies. Urinary AQP2 was decreased in conditions of impaired renal function (r=-0.42, P=0.0005) and acidosis (P=0.03). Prenatal corticosteroid treatment had no significant impact on urinary AQP2 level. Our data show that urinary AQP2 correlates with the overall maturity of tubular function in human neonates. In babies at this early age, urinary AQP2 cannot serve as a direct marker of the renal action of AVP but reflects AQP2 expression level associated with different physiopathological conditions.

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