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  • 1.
    Broomé, Michael
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska Univ Hosp, Sweden.
    Scarce resources call for us to weigh the pros and cons of every single decision2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 8, p. 880-880Article in journal (Other academic)
  • 2. Edner, A
    et al.
    Ericson, Mats
    KTH, School of Technology and Health (STH), Ergonomics.
    Milerad, J
    Katz-Salamon, M
    Abnormal heart rate response to hypercapnia in boys with an apparent life-threatening event.2002In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 91, no 12, p. 1318-23Article in journal (Refereed)
    Abstract [en]

    AIM: To determine instantaneous cardiac variability responses to increased carbon dioxide (CO2) during quiet sleep in infants who may be at risk for the Sudden Infant Death syndrome (SIDS).

    METHODS: The cardiac rate variability before, during and after a CO2 challenge was examined in 41 infants who had experienced an apparent life-threatening event (ALTE) and 41 gender- and age-matched control infants.

    RESULTS: The ALTE infants responded to CO2 breathing with a significant increase in R-R intervals, i.e. decreases in heart rate, compared to the controls (45.1% increase in R-R intervals vs. 41.4%; p = 0.005). The differences between ALTE infants and controls depended primarily on the boys' responses.

    CONCLUSION: ALTE infants, particularly ALTE boys, have an autonomic dysfunction-lower sympathetic stimulation and/or inhibited vagal withdrawal when stressed with CO2. The outcome might provide clues to the mechanisms underlying the cardiovascular processes contributing to the terminal event in SIDS.

  • 3. Edner, A
    et al.
    Katz-Salamon, M
    Lagercrantz, H
    Ericson, Mats
    KTH, School of Technology and Health (STH), Ergonomics.
    Milerad, J
    Heart rate variability in infants with apparent life-threatening events.2000In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, no 11, p. 1326-9Article in journal (Refereed)
    Abstract [en]

    Heart rate variability (HRV) is often used as an index of sympatho-vagal balance. A decreased HRV has been observed in patients with central hypoventilation and in infants who have later succumbed to sudden infant death syndrome (SIDS). The aim of the present study was to investigate whether HRV is altered in infants with apparent life-threatening events (ALTE), a group with an increased risk of SIDS. Fifty infants with ALTE were compared with 50 age- and sex-matched controls. ECG was recorded overnight in all infants. Two sequences of RR intervals free of artefacts were selected from each sleep state and spectral analysis of RR variability was performed. The mean and SD of RR and the low (LFPow) and high (HFPow) frequency power were analysed. In active sleep (AS) the LF/HF ratio was lower in ALTE infants, but no differences were seen in either the LFPow or the HFPow. In quiet sleep (QS), however, ALTE infants had higher SD-RR (p = 0.006), greater HFPow (p = 0.02) and VLFPow (very low frequency power, p = 0.02) than the control infants. The same results were seen when the two sleep states were combined for analysis, ALTE infants had higher SD-RR (p = 0.004), HFPow (p = 0.006) and VLFPow (p = 0.04). Conclusion: The different HRV pattern in ALTE infants compared to healthy controls suggests an altered autonomic control.

  • 4.
    Elinder, Goran
    et al.
    Karolinska Inst, Dept Pediat, Stockholm, Sweden..
    Eriksson, Anders
    Umea Univ, Dept Community Med & Rehabil, Forens Med, Umea, Sweden.;Natl Board Forens Med, Stockholm, Sweden..
    Hallberg, Boubou
    Karolinska Inst, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Pediat & Neonatol, Stockholm, Sweden..
    Lynoe, Niels
    Karolinska Inst, Med Eth, Stockholm, Sweden..
    Sundgren, Pia Maly
    Lund Univ, Diagnost Radiol, Lund, Sweden.;Skane Univ Hosp, Dept Neuroradiol, Lund, Sweden..
    Rosen, Mans
    Karolinska Inst, Hlth Technol Assessment, Stockholm, Sweden..
    Engstrom, Ingemar
    Univ Orebro, Univ Hlth Care Res Ctr, Fac Med & Hlth, Child & Adolecent Psychiat, Orebro, Sweden..
    Erlandsson, Björn-Erik
    KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Human Communication Science.
    Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, p. 3-23Article, review/survey (Refereed)
    Abstract [en]

    The Swedish Agency for Health Technology Assessment and Assesment of Social Services (SBU) is an independent national authority, tasked by the government with assessing methods used in health, medical and dental services and social service interventions from a broad perspective, covering medical, economic, ethical and social aspects. The language in SBU's reports are adjusted to a wide audience. SBU's Board of Directors has approved the conclusions in this report. The systematic review showed the following graded results: There is limited scientific evidence that the triad (Three components of a whole. The triad associated with SBS usually comprises subdural haematoma, retinal haemorrhages and encephalopathy.) and therefore, its components can be associated with traumatic shaking (low-quality evidence). There is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low-quality evidence). Limited scientific evidence (low-quality evidence) represents a combined assessment of studies of high or moderate quality which disclose factors that markedly weaken the evidence. It is important to note that limited scientific evidence for the reliability of a method or an effect does not imply complete lack of scientific support. Insufficient scientific evidence (very low-quality evidence) represents either a lack of studies or situations when available studies are of low quality or show contradictory results. Evaluation of the evidence was not based on formal grading of the evidence according to GRADE but on an evaluation of the total scientific basis.

  • 5.
    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, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS) (Closed 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 neonates2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 10, p. 1338-1343Article in journal (Refereed)
    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.

  • 6.
    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, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS) (Closed 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?2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 10, p. 1493-1497Article in journal (Refereed)
    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.

  • 7. Henje Blom, E
    et al.
    Olsson, E M
    Serlachius, E
    Ericson, Mats
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Ingvar, M
    Heart rate variability (HRV) in adolescent females with anxiety disorders and major depressive disorder2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 4, p. 604-611Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to investigate heart rate variability (HRV) in a clinical sample of female adolescents with anxiety disorders (AD) and/or major depressive disorder (MDD) compared with healthy controls and to assess the effect of selective serotonin reuptake inhibitors (SSRI) on HRV.

    METHODS: Heart rate variability was measured in adolescent female psychiatric patients with AD and/or MDD (n = 69), mean age 16.8 years (range: 14.5-18.4), from 13 out-patient clinics and in healthy controls (n = 65), mean age 16.5 years (range: 15.9-17.7). HRV was registered in the sitting position during 4 min with no interventions.

    RESULTS: Logarithmically transformed high frequency HRV (HF), low frequency HRV (LF) and standard deviation of inter beat intervals (SDNN) were lower in the clinical sample compared with the controls (Cohen's d for HF = 0.57, LF = 0.55, SDNN = 0.60). This was not explained by body mass index, blood pressure or physical activity. Medication with SSRI explained 15.5% of the total variance of HF, 3.0% of LF and 6.5% of SDNN.

    CONCLUSIONS: Adolescent female psychiatric patients with AD and/or MDD show reduced HRV compared with healthy controls. Medication with SSRI explained a part of this difference.

  • 8.
    Kapetanakis, A. B.
    et al.
    UCL, Ctr Perinatal Brain Res, Inst Womens Hlth, London, England..
    Iwata, S.
    UCL, Ctr Perinatal Brain Res, Inst Womens Hlth, London, England..
    Olson, L.
    Karolinska Inst, Dept Woman & Child Hlth, S-10401 Stockholm, Sweden..
    Iwata, O.
    UCL, Ctr Perinatal Brain Res, Inst Womens Hlth, London, England..
    Kato, T.
    UCL, Ctr Perinatal Brain Res, Inst Womens Hlth, London, England..
    Evans, S.
    UCL, Ctr Perinatal Brain Res, Inst Womens Hlth, London, England..
    Setterwall, F.
    KTH, School of Chemical Science and Engineering (CHE), Chemical Engineering and Technology.
    Lagercrantz, H.
    Karolinska Inst, Dept Woman & Child Hlth, S-10401 Stockholm, Sweden..
    Robertson, N.
    UCL, Ctr Perinatal Brain Res, Inst Womens Hlth, London, England..
    Low tech versus high tech methods of cooling: both are effective but need similar monitoring and device adjustment for safe therapeutic hypothermia2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, p. 162-163Article in journal (Other academic)
  • 9.
    Kato, T.
    et al.
    UCL, Inst Womens Hlth, Ctr Perinatal Brain Res, London, England..
    Iwata, O.
    UCL, Inst Womens Hlth, Ctr Perinatal Brain Res, London, England..
    Olson, L.
    Karolinska Inst, Dept Woman & Child Hlth, Stockholm, Sweden..
    Iwata, S.
    UCL, Inst Womens Hlth, Ctr Perinatal Brain Res, London, England..
    Kapetanakis, A. B.
    UCL, Inst Womens Hlth, Ctr Perinatal Brain Res, London, England..
    Evans, S.
    UCL, Inst Womens Hlth, Ctr Perinatal Brain Res, London, England..
    Setterwall, F.
    KTH, School of Chemical Science and Engineering (CHE), Chemical Engineering and Technology.
    Lagercrantz, H.
    Karolinska Inst, Dept Woman & Child Hlth, Stockholm, Sweden..
    Robertson, N.
    UCL, Inst Womens Hlth, Ctr Perinatal Brain Res, London, England..
    Therapeutic hypothermia can be effectively maintained using simple, low tech cooling devices: Implications for the global application of newborn neuroprotection2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, p. 164-164Article in journal (Other academic)
  • 10. Li, Yanhong
    et al.
    Marcoux, Marie-Odile
    Gineste, Martine
    Vanpee, Mireille
    Zelenina, Marina
    KTH, School of Engineering Sciences (SCI), Applied Physics, Cell Physics.
    Casper, Charlotte
    Expression of water and ion transporters in tracheal aspirates from neonates with respiratory distress2009In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 11, p. 1729-1737Article in journal (Refereed)
    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.

  • 11. Li, Yanhong
    et al.
    Zelenina, Marina
    KTH, School of Engineering Sciences (SCI), Applied Physics, Cell Physics. 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 arteriosus2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 1, p. 59-66Article in journal (Refereed)
    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.

  • 12. Svensson, V.
    et al.
    Ek, A.
    Forssén, M.
    Ekbom, K.
    Cao, Y.
    Ebrahim, M.
    Johansson, E.
    Nero, H.
    Hagströmer, M.
    Ekstedt, Mirjam
    KTH, School of Technology and Health (STH), Health Systems Engineering, Systems Safety and Management.
    Nowicka, P.
    Marcus, C.
    Infant growth is associated with parental education but not with parental adiposity - Early Stockholm Obesity Prevention Project2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 4, p. 418-425Article in journal (Refereed)
    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.

  • 13. Tedroff, K.
    et al.
    Lowing, K.
    Haglund-Akerlind, Y.
    Gutierrez-Farewik, Elena
    KTH, School of Engineering Sciences (SCI), Mechanics, Structural Mechanics.
    Forssberg, H.
    Botulinumtoxin A treatment in toddlers with cerebral palsy2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 8, p. 1156-1162Article in journal (Refereed)
    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.

1 - 13 of 13
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