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  • 1.
    Benson, Mikael
    et al.
    East Hospital, Gothenburg.
    Kjellmer, I.
    East Hospital, Gothenburg.
    Rosberg, S.
    East Hospital, Gothenburg.
    Billig, H.
    Gothenburg University, Gothenburg.
    Can paediatricians benefit from the Internet?1997In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 77, no 2, p. 179-182Article in journal (Refereed)
    Abstract [en]

    It is likely that many paediatricians will find the Internet useful. The main benefits are probably the ease and speed of communication and immediate access to a few databases such as MEDLINE. It is also practical to integrate the import, processing, storage, and export of data into one's own computer. It is also possible that the Internet in all its forms will become an integrated part of our daily paediatric practice as a result of the increased usage of the Internet by patients, parents, and paediatricians.

  • 2.
    Boggs, Dorothy
    et al.
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth Ctr, London, England;London Sch Hyg & Trop Med, Int Ctr Evidence Disabil, London, England.
    Milner, Kate M.
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth Ctr, London, England;Murdoch Childrens Res Inst, Melbourne, Vic, Australia.
    Chandna, Jaya
    Univ Liverpool, Inst Translat Med, Liverpool, Merseyside, England.
    Black, Maureen
    Univ Maryland, Sch Med, Baltimore, MD 21201 USA;RIT Int, Durham, NC USA.
    Cavallera, Vanessa
    WHO, Dept Mental Hlth & Subst Abuse, Geneva, Switzerland.
    Dua, Tarun
    WHO, Dept Mental Hlth & Subst Abuse, Geneva, Switzerland.
    Fink, Guenther
    Swiss Trop & Publ Hlth Inst, Basel, Switzerland;Univ Basel, Basel, Switzerland.
    KC, Ashish
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Grantham-McGregor, Sally
    UCL, Fac Populat Hlth Sci, Inst Child Hlth, London, England.
    Hamadani, Jena
    Int Ctr Diarrhoeal Dis Res, Maternal & Child Hlth Div, Dhaka, Bangladesh.
    Hughes, Rob
    Childrens Investment Fund Fdn, London, England;London Sch Hyg & Trop Med, Dept Populat Hlth, Maternal & Child Hlth Intervent Res Grp, London, England.
    Manji, Karim
    Muhimbili Univ Allied Hlth Sci, Dept Paediat & Child Hlth, Dar Es Salaam, Tanzania.
    Mccoy, Dana Charles
    Harvard Univ, Harvard Grad Sch Educ, Cambridge, MA 02138 USA.
    Tann, Cally
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth Ctr, London, England;Univ Coll Hosp NHS Trust, Neonatal Med, London, England.
    Lawn, Joy E.
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth Ctr, London, England.
    Rating early child development outcome measurement tools for routine health programme use2019In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 104, p. S22-S33Article in journal (Refereed)
    Abstract [en]

    Background Identification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). We systematically assess ECD measurement tools for accuracy and feasibility for use in routine services in low-income and middle-income countries (LMIC). Methods Building on World Bank and peer-reviewed literature reviews, we identified available ECD measurement tools for children aged 0-3 years used in >= 1 LMIC and matrixed these according to when (child age) and what (ECD domains) they measure at population or individual level. Tools measuring <2 years and covering >= 3 developmental domains, including cognition, were rated for accuracy and feasibility criteria using a rating approach derived from Grading of Recommendations, Assessment, Development and Evaluations. Results 61 tools were initially identified, 8% (n=5) population-level and 92% (n=6) individual-level screening or ability tests. Of these, 27 tools covering >= 3 domains beginning <2 years of age were selected for rating accuracy and feasibility. Recently developed population-level tools (n=2) rated highly overall, particularly in reliability, cultural adaptability, administration time and geographical uptake. Individual-level tool (n=25) ratings were variable, generally highest for reliability and lowest for accessibility, training, clinical relevance and geographical uptake. Conclusions and implications Although multiple measurement tools exist, few are designed for multidomain ECD measurement in young children, especially in LMIC. No available tools rated strongly across all accuracy and feasibility criteria with accessibility, training requirements, clinical relevance and geographical uptake being poor for most tools. Further research is recommended to explore this gap in fit-for-purpose tools to monitor ECD in routine LMIC health services.

  • 3.
    Brown, Nick
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Lanssjukhuset Gavle Sandviken, Dept Paediat, Gavle, Sweden;Aga Khan Univ, Dept Child Hlth, Karachi, Pakistan.
    [Editor's note:] Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial (vol 103, pg 155, 2018)2019In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 104, no 10, article id UNSP e3Article in journal (Other academic)
  • 4.
    Carbajal, Ricardo
    et al.
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Eriksson, Mats
    Centre for health care sciences, Örebro University Hospital, Örebro, Sweden.
    Courtois, Emilie
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Andersen, Randi Dovland
    Telemark Hospital, Skien, Norway.
    Avila-Alvarez,, A.
    Complexo Hospitalario Universitario de a Coruña, a Coruña, Spain.
    Boyle, Elaine
    University of Leicester, Leicester, UK.
    Lago, Paola
    University of Padova, Padova, Italy.
    Sarafidis, K.
    Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Simons, Sinno
    Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands.
    Pölkki, Tarja
    Institute of Health Sciences, University of Oulu, Oulu, Finland.
    Ilmoja, M.L.
    Tallinn Children’s Hospital, Tallinn, Estonia.
    Van Overmeire, Bart
    Erasme Hospital, Bruxelles, Belgium.
    Berger, A.
    Univ. Klinik F. Kinder and Jugendheilkunde, Vienna, Austria.
    Papadouri, T.
    Arch. Makarios Hospital, Nicosia, Cyprus.
    Schroth, M.
    Cnopf’sche Kinderklinik, Nuremberg, Germany.
    Tameliene, R.
    Perinatal Center, Kaunas, Lithuania.
    Attard Montalto, S.
    Mater Dei Hospital, Msida, Malta.
    Dobrzanska, A.
    Children’s Memorial Health Institute, Warsaw, Poland.
    Matos, C.
    Maternidade Dr Alfredo Da Costa, Lisboa, Portugal.
    Europain Study group, Group author
    Europain Study Group, Europain Study Group, Paris, France.
    Bergqvist, Lena
    Karolinska University Hospital, Stockholm, Sweden.
    Lagercrantz, Hugo
    Karolinska University Hospital, Stockholm, Sweden.
    Anand, K.J.S.
    Department of Pediatrics Critical Care Medecine Division, University of Tennessee Health Science Center, Memphis, USA.
    Pain Assessment In Ventilated And Non-ventilated Neonates In Nicus Across Europe: European Pain Audit In Neonates (europain Survey)2014In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 99, p. A68-A68Article in journal (Refereed)
    Abstract [en]

    Background: Neonates undergo many painful procedures during their NICU stay. These may include tracheal intubation/ventilation, skin-breaking procedures, drainage/suctioning of body orifices or cavities. Inherent subjectivity and difficulties of neonatal pain assessment contribute to a wide variety of assessment tools and clinical practices. To date, these practices have been not studied at a large scale.

    Objective: To determine current clinical practices for neonatal pain assessment in NICUs across Europe.

    Methods: An epidemiological observational study on bedside pain assessment practices collected data for all neonates in participating NICUs until infants left the unit (discharge, death, transfer to another hospital) or for 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to a gestational age of 44 weeks were included.

    Results: From October 2012 to June 2013, 243 NICUs from 18 European countries collected pain assessment data in 6680 neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, 58.5% of TV neonates, 45.0% of NIV neonates and 30.4% of SV neonates received bedside pain assessments (p < 0.001). Fig. shows pain assessments by country.

    Conclusions: Over half (58.5%) of TV neonates and less than half (45.0%) of NIV neonates had pain assessments performed in European NICUs. Wide variations in the rates of pain assessment exist among countries and an important improvement seems necessary.

  • 5.
    Carbajal, Ricardo
    et al.
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Eriksson, Mats
    Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Courtois, Emilie
    Emergency Department, Hôpital Armand-Trousseau, Paris, France.
    Avila-Alvarez,, A.
    Complexo Hospitalario Universitario de a Coruña, a Coruña, Spain.
    Berger, A.
    Univ. Klinik F. Kinder and Jugendheilkunde, Vienna, Austria.
    Lago, Paola
    University of Padova, Padova, Italy.
    Van Overmeire, Bart
    Erasme Hospital, Bruxelles, Belgium.
    Papadouri, T.
    Arch. Makarios Hospital, Nicosia, Cyprus.
    Ilmoja, M.L.
    Tallinn Children’s Hospital, Tallinn, Estonia.
    Pölkki, Tarja
    Institute of Health Sciences, University of Oulu, Oulu, Finland.
    Schroth, M.
    Cnopf’sche Kinderklinik, Nuremberg, Germany.
    Sarafidis, K.
    Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Tameliene, R.
    Perinatal Center, Kaunas, Lithuania.
    Attard Montalto, S.
    Mater Dei Hospital, Msida, Malta.
    Simons, Sinno
    Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands.
    Andersen, Randi Dovland
    Telemark Hospital, Skien, Norway.
    Dobrzanska, A.
    Children’s Memorial Health Institute, Warsaw, Poland.
    Matos, C.
    Maternidade Dr Alfredo Da Costa, Lisboa, Portugal.
    Boyle, Elaine
    University of Leicester, Leicester, UK.
    E Europain Study group, Group author
    Europain Study Group, Europain Study Group, Paris, France.
    Lagercrantz, Hugo
    Karoliniska institutet, Stocholm, Sweden.
    Bergqvist, Lena
    Karolinska institutet.
    Anand, K.J.S.
    Department of Pediatrics Critical Care Medecine Division, University of Tennessee Health Science Center, Memphis, USA.
    Sedation And Analgesia For Neonates In Nicus Across Europe: The Europain Survey2014In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 99, p. A64-A64Article in journal (Refereed)
    Abstract [en]

    Background: Pain and stress induced by mechanical ventilation, invasive procedures, or painful diseases supports the use of sedation/analgesia (S/A) in newborns admitted to Neonatal Intensive Care Units (NICUs). To date, these practices have not been studied at a large scale.

    Objective: To determine current clinical practices regarding the use of S/A drugs in NICUs across Europe.

    Methods: This epidemiological observational study on bedside clinical practices regarding S/A collected data for all neonates in participating NICUs until the infant left the unit (discharge, death, transfer) or for up to 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to 44 weeks gestation were included.

    Results: From October 2012 to June 2013, 243 NICUs from 18 European countries collected data on 6680 eligible neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, more TV neonates [81.5% (n = 1746)] received S/A drugs than NIV neonates [17.8% (n = 266)] and SV neonates [9.3% (n = 282)]; p < 0.001. Fig. shows the rate of S/A use by country; table shows S/A drugs used.

    Conclusions: Most ventilated but few non-ventilated neonates (NIV and SV) receive S/A therapy in European NICUs. Wide variations in S/A use, drugs used, and mode of administration (continuous, bolus, or both) exist among countries.

  • 6.
    Chopra, Mickey
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Rollins, Nigel
    Infant feeding in the time of HIV: Rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes2008In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 93, no 4, p. 288-91Article in journal (Refereed)
    Abstract [en]

    Objective: To assess the infant feeding components of prevention of mother to child HIV transmission (PMTCT) programmes. Methods: Assessments were performed across Botswana, Kenya, Malawi and Uganda. 29 districts offering PMTCT were selected by stratified random sampling with rural and urban strata. All health facilities in the selected PMTCT district were assessed. The facility level manager and the senior nurse in charge of maternal care were interviewed. 334 randomly selected health workers involved in the PMTCT programme completed self-administered questionnaires. 640 PMTCT counselling observations were carried out and 34 focus groups were conducted amongst men and women. Results: Most health workers (234/334, 70%) were unable to correctly estimate the transmission risks of breastfeeding irrespective of exposure to PMTCT training. Infant feeding options were mentioned in 307 of 640 (48%) observations of PMTCT counselling sessions, and in only 35 (5.5%) were infant feeding issues discussed in any depth; of these 19 (54.3%) were rated as poor. Several health workers also reported receiving free samples of infant formula in contravention of the International Code on Breastmilk Substitutes. National HIV managers stated they were unsure about infant feeding policy in the context of HIV. Finally, there was an almost universal belief that an HIV positive mother who breastfeeds her child will always infect the child and intentional avoidance of breastfeeding by the mother indicates that she is HIV positive. Conclusion: These findings underline the need to implement and support systematic infant feeding policies and programme responses in the context of HIV programmes.

  • 7.
    Crowley, R
    et al.
    Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
    Wolfe, Ingrid
    Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
    Lock, K
    Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
    McKee, M
    Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
    Improving the transition between paediatric and adult healthcare: A systematic review.2011In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 96, no 6, p. 548-553Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The transition between paediatric and adult care for young people with chronic illness or disability is often poorly managed, with adverse consequences for health. Although many agree that adolescent services need to be improved, there is little empirical data on which policies can be based.

    OBJECTIVES: To systematically review the evidence of effectiveness of transitional care programmes in young people aged 11-25 with chronic illness (physical or mental) or disability, and identify their successful components.

    DESIGN: A systematic literature review in July 2010 of studies which consistently evaluated health outcomes following transition programmes, either by comparison with a control group or by measurement pre-intervention and post-intervention.

    RESULTS: 10 studies met the inclusion criteria, six of which showed statistically significant improvements in outcomes. Descriptive analysis identified three broad categories of intervention, directed at: the patient (educational programmes, skills training); staffing (named transition co-ordinators, joint clinics run by paediatric and adult physicians); and service delivery (separate young adult clinics, out of hours phone support, enhanced follow-up). The conditions involved varied (eg, cystic fibrosis, diabetes mellitus), and outcome measures varied accordingly. All six interventions that resulted in significant improvements were in studies of patients with diabetes mellitus, with glycosylated haemoglobin level, acute and chronic complications, and rates of follow-up and screening used as outcome measures.

    CONCLUSIONS: The most commonly used strategies in successful programmes were patient education and specific transition clinics (either jointly staffed by paediatric and adult physicians or dedicated young adult clinics within adult services). It is not clear how generalisable these successful studies in diabetes mellitus will be to other conditions.

  • 8. Cuttini, M.
    et al.
    Casotto, V.
    Kaminski, M.
    de Beafort, I.
    Berbik, I.
    Hansen, G.
    Kollée, L.
    Kucinskas, A.
    Lenoir, S.
    Levin, A.
    Orzalesi, M.
    Persson, Jan
    Linköping University, The Institute of Technology. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Rebagliato, M.
    Reid, M.
    Saracci, R.
    Should euthanasia be legal? An international survey of neonatal intensive care units staff2004In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 89, no 1Article in journal (Refereed)
    Abstract [en]

    Objective: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. Design: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hungary, and the Baltic countries) or random sampling (in France, Germany, Italy, Spain, and the United Kingdom), 1391 doctors and 3410 nurses completed an anonymous questionnaire (response rates 89% and 86% respectively). Main outcome measure: The staff opinion that the law in their country should be changed to allow active euthanasia "more than now". Results: Active euthanasia appeared to be both acceptable and practiced in the Netherlands, France, and to a lesser extent Lithuania, and less acceptable in Sweden, Hungary, Italy, and Spain. More then half (53%) of the doctors in the Netherlands, but only a quarter (24%) in France felt that the law should be changed to allow active euthanasia "more than now". For 40% of French doctors, end of life issues should not be regulated by law. Being male, regular involvement in research, less than six years professional experience, and having ever participated in a decision of active euthanasia were positively associated with an opinion favouring relaxation of legal constraints. Having had children, religiousness, and believing in the absolute value of human life showed a negative association. Nurses were slightly more likely to consider active euthanasia acceptable in selected circumstances, and to feel that the law should be changed to allow it more than now. Conclusions: Opinions of health professionals vary widely between countries, and, even where neonatal euthanasia is already practiced, do not uniformly support its legalisation.

  • 9.
    Deyessa Kabeta, Negussie
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Berhane, Y
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Ellsberg, MC
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Joint effect of maternal depression and intimate partner violence on increased risk of child death in rural Ethiopia2010In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 95, no 10, p. 771-775Article in journal (Refereed)
    Abstract [en]

    An awareness of the devastating consequences on child survival in low income setting of violence against women and depression is needed among public health workers as well as clinicians, for both community and clinical interventions.

  • 10.
    Deyessa, N
    et al.
    School of Public Health, Addis Ababa University, Ethiopia.
    Berhane, Y
    Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
    Emmelin, M
    Epidemiology, Department of Public Health and Clinical Medicine, Sweden.
    Ellsberg, M C
    Epidemiology, Department of Public Health and Clinical Medicine, Sweden.
    Kullgren, G
    Epidemiology, Department of Public Health and Clinical Medicine, Sweden.
    Högberg, Ulf
    Epidemiology, Department of Public Health and Clinical Medicine, Sweden.
    Joint effect of maternal depression and intimate partner violence on increased risk of child death in rural Ethiopia.2010In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 95, no 10, p. 771-5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess independent and interaction effect of experience of intimate partner violence and depression on risk of child death.

    DESIGN: Community-based cohort design.

    SETTING: The study was conducted within the demographic surveillance site of Butajira Rural Health Program in south central Ethiopia.

    PARTICIPANTS: Women (n=561) who gave birth to a live child.

    MAIN OUTCOME MEASURES: Exposure status comprising physical, sexual and emotional violence by intimate partner was based on the WHO multi-country questionnaire on violence against women. Depression status was measured using the Composite International Diagnostic Interview. Risk of child death and its association with maternal exposure to violence and/or being depressed was analysed by incidence, rate ratios and interaction.

    RESULTS: The child death in the cohort was 42.1 (95% CI, 32.7 to 53.5) children per 1000 person years, and maternal depression is associated with child death. The risk of child death increases when maternal depression is combined with physical and emotional violence (RR=4.0; 95% CI, 1.6 to 10.1) and (RR=3.7; 95% CI, 1.3 to 10.4), showing a synergistic interaction.

    CONCLUSION: An awareness of the devastating consequences on child survival in low income setting of violence against women and depression is needed among public health workers as well as clinicians, for both community and clinical interventions.

  • 11.
    Hansson, Mats G.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Gattorno, Marco
    Stjernschantz Forsberg, Joanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Feltelius, Nils
    Martini, Alberto
    Ruperto, Nicolino
    Ethics bureaucracy: a significant hurdle for collaborative follow-up of drug effectiveness in rare childhood diseases2012In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 97, no 6, p. 561-563Article in journal (Refereed)
  • 12.
    Hellgren, K
    et al.
    KI.
    Hellström, A
    GU.
    Jacobson, L
    KI.
    Flodmark, O
    Ki.
    Wadsby, Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry.
    Martin, L
    KI.
    Visual and cerebral sequelae of very low birth weight in adolescents2007In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 92, no 4Article in journal (Refereed)
    Abstract [en]

    Objective: To describe the visual functions and relate them to MRI findings and the intellectual level in adolescents born with very low birth weight (VLBW). Design: Population-based case-control study. Patients: 59 15-year-old VLBW adolescents and 55 sex and age-matched controls with normal birth weight. Main outcome measures: Objective clinical findings (visual acuity, stereo acuity and cycloplegic refraction) were recorded. Structured history taking was used to identify visual difficulties. The intellectual level was assessed with the Wechsler Intelligence Scale for Children (WISC). All VLBW adolescents underwent MRI of the brain. Results: Significant differences were found between the VLBW adolescents and controls regarding visual acuity (median -0.11 and -0.2, respectively, p = 0.004), stereo acuity (median 60″ and 30″, respectively, p<0.001), prevalence of astigmatism (11/58 and 0/55, respectively, p<0.001) and in full-scale IQ (mean IQ 85 and 97, respectively, p<0.001) and performance IQ (mean 87 and 99, respectively, p = 0.002). The structured history also revealed a borderline significant difference between the groups (mean problems 0.46 and 0.15 respectively, p = 0.051). 30% (17/57) of the VLBW adolescents had abnormal MRI findings and performed worse in all tests, compared with both the VLBW adolescents without MRI pathology and the normal controls. Conclusion: This study confirms previous observations that VLBW adolescents are at a disadvantage regarding visual outcome compared with those with normal birth weight. In 47%, visual dysfunction was associated with abnormal MRI findings and in 33% with learning disabilities. The adolescents with abnormal MRI findings had more pronounced visual and cognitive dysfunction. The findings indicate a cerebral causative component for the visual dysfunction seen in the present study.

  • 13.
    Högberg, Ulf
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Andersson, Jacob
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Högberg, Göran
    Karolinska Inst, Child & Adolescent Psychiat Unit, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Why is there a multi-fold difference in diagnosis of abuse among infants with long bone fracture in East Anglia compared with Sweden?2019In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 104, no 11Article in journal (Other academic)
  • 14. Iwata, S.
    et al.
    Iwata, O.
    Olson, L.
    Kapetanakis, A.
    Kato, T.
    Evans, S.
    Araki, Y.
    Kakuma, T.
    Matsuishi, T.
    Setterwall, Fredrik
    KTH, School of Chemical Science and Engineering (CHE), Chemical Engineering and Technology, Energy Processes.
    Lagercrantz, H.
    Robertson, N. J.
    Therapeutic hypothermia can be induced and maintained using either commercial water bottles or a "phase changing material'' mattress in a newborn piglet model2009In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 94, no 5, p. 387-391Article in journal (Refereed)
    Abstract [en]

    Background: Therapeutic hypothermia, a safe and effective treatment for neonatal encephalopathy in an intensive care setting, is not available in low-resource settings. Aims/Methods: To assess two low-tech, low-cost cooling devices for use in low-resource settings: (i) commercially available water bottles filled with tepid water (25 degrees C); (ii) a mattress made of phase changing material (PCM) with a melting point of 32 degrees C (PCM works as a heat buffer at this temperature). Eleven anaesthetised newborn piglets were studied following transient hypoxia-ischaemia. The cooling device was applied 2-26 h after hypoxia-ischaemia with a target rectal temperature (T-rectal) of 33-34 degrees C. T-rectal undershoot was adjusted using cotton blankets; the cooling device was renewed when T-rectal rose above 35 degrees C. T-rectal data during cooling were dichotomised (within or without target) to assess: (a) the total period within the target T-rectal range; (b) the stability and fluctuation of T-rectal during cooling. Results: Therapeutic hypothermia was achieved with both water bottles (n=5) and the PCM mattress (n=6). The mean (SD) time to reach target T-rectal was 1.8 (0.5) h with water bottles and 1.9 (0.3) h with PCM. PCM cooling led to a longer period within the target T-rectal range (p<0.01) and more stable cooling (p<0.05). Water bottle cooling required device renewal (in four out of five piglets). Conclusion: Simple, low-tech cooling devices can induce and maintain therapeutic hypothermia effectively in a porcine model of neonatal encephalopathy, although frequent fine tuning by adjusting the number of blankets insulating the piglet was required to maintain a stable temperature. PCM may induce more stable cooling compared with water bottles.

  • 15.
    Jing Xiong, Jiang
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Xiulan, Xia
    Greiner, Ted
    Guangli, Lian
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    A two-year family-based behaviour treatment for obese children2005In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 90, no 12, p. 1235-8Article in journal (Refereed)
    Abstract [en]

    Background: Childhood obesity has become a nutritional problem in China since the 1990s.

    Aims: A family based behavioural treatment was developed and tested, to see if its use was feasible in China and to evaluate its impact on obese schoolchildren.

    Methods: In a single school in Beijing, 33 obese children were randomly assigned to a treatment group and 35 to a control group. The treatment group participated in a family based behavioural treatment programme for two years. Height and weight were measured every six months for all participants. Blood pressure, cholesterol, and triglyceride levels were measured at baseline and after two years of programme implementation.

    Results: Body mass index (BMI, kg/m2) was significantly reduced in the treatment group (from 26.6 (1.7) to 24.0 (0.9), 95% CI 2.06 to 3.18) but not in the control group (from 26.1 (1.5) to 26.0 (1.6)). Total cholesterol decreased 5.5% and triglycerides 9.7% in the treatment group. There was a significant correlation between change in BMI and change in triglycerides. There were no significant changes in plasma lipids in the controls. Blood pressure values also decreased significantly in the treatment, but not the control group.

    Conclusions: A family based behavioural intervention was feasible to use in treating obesity in schoolchildren in Beijing, China. After two years of implementation, it successfully decreased the degree of obesity, reduced levels of blood pressure, and decreased serum lipids in treatment; there were no significant changes among control children.

  • 16.
    Juul, Jolanta
    et al.
    Univ Gothenburg, Dept Otorhinolaryngol, Sect Audiol,Sahlgrenska Acad, Inst Neurosci & Physiol,Sahlgrenska Univ Hosp, SE-41345 Gothenburg, Sweden.
    Barrenas, Marie-Louise
    Univ Gothenburg, Dept Paediat, Gothenburg Paediat Growth Res Ctr, Inst Clin Sci,Sahlgrenska Acad,Queen Silvia Child, SE-41345 Gothenburg, Sweden.
    Holgers, Kajsa-Mia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Tinnitus and hearing in 7-year-old children2012In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 97, no 1, p. 28-30Article in journal (Refereed)
    Abstract [en]

    Background Tinnitus occurs with or without prior noise exposure (noise-induced tinnitus (NIT) and spontaneous tinnitus (ST)), and is considered a symptom related to permanent hearing impairment (HI) or temporary hearing threshold shift (TTS). Objective To carry out a cross-sectional interview study on TTS, ST and NIT during a standard audiometric screening of 756 7-year-old children in Gothenburg. Results 41% out of 756 children reported either NIT or ST on several occasions, 17% reported recurrent TTS and 7% failed the audiometry screening. The probability of ST was 27% for children with no HI or TTS (OR=1.23 (95% CI 1.12 to 1.34)) but 63% (OR=1.16 (95% CI 1.02 to 1.33)) if exhibiting both HI and TTS. Conclusion This study confirms an increased occurrence of spontaneous tinnitus in children with TTS or HI and in children with both TTS and HI, in particular, but also in children with normal hearing. Possibly, tinnitus in young children correlates with stress as in adolescents and adults.

  • 17.
    Kallen, Bengt
    et al.
    Lund University, Sweden .
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Nygren, Karl-Gosta
    Karolinska Institute, Sweden .
    Otterblad Olausson, Petra
    National Board Health and Welf, Sweden .
    Asthma in Swedish children conceived by in vitro fertilisation2013In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 98, no 2, p. 92-96Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate a proposed association between in vitro fertilisation (IVF) and child asthma. less thanbrgreater than less thanbrgreater thanDesign The risk for asthma after IVF was estimated as ORs using Mantel-Haenszel analysis. less thanbrgreater than less thanbrgreater thanSetting The Swedish Medical Birth Register. less thanbrgreater than less thanbrgreater thanPatients Of the 2 628 728 children born in 1982-2007 and surviving the perinatal period, 31 918 were conceived by IVF. Presence of asthma was defined as at least five prescriptions of antiasthmatic drugs during the period 1 July 2005-31 December 2009 according to the Swedish Prescribed Drug Register (115 767 children, 2323 of whom were born after IVF). less thanbrgreater than less thanbrgreater thanResults A significantly increased risk for asthma, albeit small, was found in children conceived by IVF (aOR 1.28, 95% CI 1.23 to 1.34), increasing the absolute risk from 4.4% to 5.6%. The risk increase for asthma was the same in boys and girls, in singletons and twins, and after caesarean section and vaginal delivery. The risk was higher for preterm than term singletons. For children with a low Apgar score, respiratory diagnoses, mechanical ventilation, continuous positive airway pressure or neonatal sepsis, the effect of IVF on asthma risk was low and statistically non-significant. Adjustment for length of involuntary childlessness eliminated the effect, and removal of infants whose mothers had used antiasthmatics in early pregnancy reduced the risk. less thanbrgreater than less thanbrgreater thanConclusions This study verifies an association between IVF and asthma in children. This can be partly explained by neonatal morbidity and by maternal asthma acting as mediators, but the main risk factor is parental subfertility. The mechanism for this is unclear.

  • 18.
    Karlsson, B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Pediatrics.
    Gustafsson, J
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Pediatrics.
    Hedov, Gerth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Genetics and Pathology.
    Ivarsson, S A
    Annerén, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Genetics and Pathology.
    Thyroid dysfunction in Down's syndrome: relation to age and thyroid autoimmunity1998In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 79, no 3, p. 242-245Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The prevalence of thyroid disease is increased in Down's syndrome. Most available data come from cross sectional studies.

    AIMS:

    To study longitudinally thyroid function in patients with Down's syndrome in Uppsala county (85 patients) up to the age of 25 years.

    METHODS:

    Observational study based on yearly follow up in a children's clinic. Thyroid function tests were performed at each visit to the clinic.

    RESULTS:

    Hypothyroidism was found in 30 and hyperthyroidism was found in two of the 85 patients. No sex difference was seen. Half of the patients with hypothyroidism acquired the condition before the age of 8 years, but only one of them displayed thyroid autoantibodies at diagnosis. Most patients who developed hypothyroidism after this age had thyroid autoantibodies. In the prepubertal patients with hypothyroidism, growth velocity was lower during the year before the start of thyroxine treatment than during the year after treatment began; it was also lower than that of sex and age matched euthyroidic children with Down's syndrome.

    CONCLUSION:

    Thyroid dysfunction in patients with Down's syndrome is common in childhood. Consequently, annual screening is important. Autoimmune thyroid disease is uncommon in young children with Down's syndrome but is common after 8 years of age.

  • 19. Karlsson, Bengt
    et al.
    Gustafsson, Jan
    Hedov, Gerth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Ivarsson, S A
    Annerén, Göran
    Thyroid dysfunction in Down's syndrome: relation to age and thyroid autoimmunity.1998In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 79, no 3, p. 242-245Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prevalence of thyroid disease is increased in Down's syndrome. Most available data come from cross sectional studies. AIMS: To study longitudinally thyroid function in patients with Down's syndrome in Uppsala county (85 patients) up to the age of 25 years. METHODS: Observational study based on yearly follow up in a children's clinic. Thyroid function tests were performed at each visit to the clinic. RESULTS: Hypothyroidism was found in 30 and hyperthyroidism was found in two of the 85 patients. No sex difference was seen. Half of the patients with hypothyroidism acquired the condition before the age of 8 years, but only one of them displayed thyroid autoantibodies at diagnosis. Most patients who developed hypothyroidism after this age had thyroid autoantibodies. In the prepubertal patients with hypothyroidism, growth velocity was lower during the year before the start of thyroxine treatment than during the year after treatment began; it was also lower than that of sex and age matched euthyroidic children with Down's syndrome. CONCLUSION: Thyroid dysfunction in patients with Down's syndrome is common in childhood. Consequently, annual screening is important. Autoimmune thyroid disease is uncommon in young children with Down's syndrome but is common after 8 years of age.

  • 20.
    Karlsson, Bengt
    et al.
    Department of Paediatrics, Uppsala University Children’s Hospital.
    Gustafsson, Jan
    Department of Paediatrics, Uppsala University Children’s Hospital.
    Hedov, Gerth
    Department of Clinical Genetics, Uppsala University Children’s Hospital.
    Ivarsson, S.A.
    Department of Paediatrics, General Hospital, Malmö.
    Annerén, Göran
    Department of Clinical Genetics, Uppsala University Children’s Hospital.
    Thyroid dysfunction in Down's syndrome: relation to age and thyroid autoimmunity1998In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 79, no 3, p. 242-245Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prevalence of thyroid disease is increased in Down's syndrome. Most available data come from cross sectional studies. AIMS: To study longitudinally thyroid function in patients with Down's syndrome in Uppsala county (85 patients) up to the age of 25 years. METHODS: Observational study based on yearly follow up in a children's clinic. Thyroid function tests were performed at each visit to the clinic. RESULTS: Hypothyroidism was found in 30 and hyperthyroidism was found in two of the 85 patients. No sex difference was seen. Half of the patients with hypothyroidism acquired the condition before the age of 8 years, but only one of them displayed thyroid autoantibodies at diagnosis. Most patients who developed hypothyroidism after this age had thyroid autoantibodies. In the prepubertal patients with hypothyroidism, growth velocity was lower during the year before the start of thyroxine treatment than during the year after treatment began; it was also lower than that of sex and age matched euthyroidic children with Down's syndrome. CONCLUSION: Thyroid dysfunction in patients with Down's syndrome is common in childhood. Consequently, annual screening is important. Autoimmune thyroid disease is uncommon in young children with Down's syndrome but is common after 8 years of age.

  • 21. Langusch, Catherine C
    et al.
    Norlén, Olov
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
    Titmuss, Angela
    Donoghue, Kim
    Holland, Andrew J A
    Shun, Albert
    Delbridge, Leigh
    Focused image-guided parathyroidectomy in the current management of primary hyperparathyroidism.2015In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 100, no 10Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Primary hyperparathyroidism (PHPT) in childhood and adolescence has been considered a different disease to that seen in adults, with predominantly familial aetiology mandating open exploration to exclude parathyroid hyperplasia in contrast to the adoption of focused image-guided parathyroidectomy (FP) in adults.

    STUDY DESIGN: A retrospective cohort study in a tertiary referral hospital setting of all children and adolescents (<18 years) undergoing parathyroid surgery for PHPT. Data were obtained from a dedicated endocrine surgery database and hospital medical records.

    RESULTS: Over the 35-year study period (1980-2014), there were 31 patients who underwent parathyroidectomy for PHPT. 3 patients were from known multiple endocrine neoplasia type 1 syndrome (MEN1) families, 3 had an isolated family history of PHPT and 25 were sporadic. In the sporadic group, 24 (96%) presented with symptomatic hypercalcaemia, affecting the gastrointestinal, musculoskeletal, genitourinary or neuropsychiatric systems. In the 25 patients with sporadic PHPT, nine (36%) had FP with a single adenoma removed with a 100% initial cure rate. Sixteen patients (64%) in the sporadic group had an open exploration: 14 had single gland disease while 2 patients required a second procedure to achieve a final cure rate of 100%. Of the three patients with MEN1, one was cured, one has persistent hyperparathyroidism after FP and the third has permanent hypoparathyroidism after open exploration.

    CONCLUSIONS: The majority of children and adolescents with PHPT have symptomatic disease due to a single adenoma. They can therefore be managed in a similar fashion to their adult counterparts with preoperative localisation studies aiming to permit FP in a day case setting.

  • 22.
    Lebwohl, Benjamin
    et al.
    Dept Med, Coeliac Dis Ctr, Columbia University Vagelos College of Physicians and Surgeons, New York NY, USA; Karolinska Inst, Stockholm, Sweden.; Dept Med, Clin Epidemiol Unit, Karolinska University Hospital, Stockholm, Sweden.
    Green, Peter H. R.
    Dept Med, Coeliac Dis Ctr, Columbia University Vagelos College of Physicians and Surgeons, New York NY, USA.
    Murray, Joseph A.
    Coll Med, Dept Med, Div Gastroenterol & Hepatol, Mayo Clin, Rochester MN, USA.
    Ludvigsson, Jonas F.
    Örebro University Hospital. Dept Paediat, Örebro University Hospital, Örebro, Sweden; Karolinska Institute, Stockholm, Sweden; Dept Med, Clin Epidemiol Unit, Karolinska University Hospital, Stockholm, Sweden.
    Season of birth in a nationwide cohort of coeliac disease patients2013In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 98, no 1, p. 48-51Article in journal (Refereed)
    Abstract [en]

    Background and objective Genetic factors alone cannot explain the risk of developing coeliac disease (CD). Children born in summer months are likely to be weaned and introduced to gluten during winter when viral infections are more frequent. Earlier studies on birth season and CD are limited in sample size and results are contradictory. Method Case-control study. We used biopsy reports from all 28 Swedish pathology departments to identify individuals with CD, defined as small intestinal villous atrophy (n=29 096). The government agency Statistics Sweden then identified 144 522 controls matched for gender, age, calendar year and county. Through conditional logistic regression we examined the association between summer birth (March-August) and later CD diagnosis (outcome measure). Results Some 54.10% of individuals with CD versus 52.75% of controls were born in the summer months. Summer birth was hence associated with a small increased risk of later CD (OR 1.06; 95% CI 1.03 to 1.08; p<0.0001). Stratifying CD patients according to age at diagnosis, we found the highest OR in those diagnosed before age 2 years (OR 1.17; 95% CI 1.10 to 1.26), while summer birth was not associated with a CD diagnosis in later childhood (age 2-18 years: OR 1.02; 95% CI 0.97 to 1.08), but had a marginal effect on the risk of CD in adulthood (age >= 18 years: OR 1.04; 95% CI 1.01 to 1.07). Conclusions In this study, summer birth was associated with an increased risk of later CD, but the excess risk was small, and general infectious disease exposure early in life is unlikely to be a major cause of CD.

  • 23.
    Leijon, Ingemar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Finnström, Orvar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Sydsjö, Gunilla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology.
    Wadsby, Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry.
    Use of healthcare resources, family function, and socioeconomic support during the first four years after preterm birth2003In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 88, no 5Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the use of healthcare resources for preterm infants and to evaluate family function and socioeconomic support in a defined population from birth to 4 years of age. Methods: In a prospective case-control study, 39 singleton preterm infants without prenatal abnormalities born during an 18 month period were studied together with their families. The population consisted of 19 very preterm infants (less than 32 weeks) and 20 randomised moderate preterm infants (32-35 weeks), and the control group comprised 39 full term infants. Contacts with medical services, child health services, and the social welfare system were registered, and family function and life events were studied. Results: The preterm children were more often readmitted to hospital (odds ratio (OR) 6.6, 95% confidence interval (CI) 2.0 to 22.1) and had more outpatient attendances (OR 5.6, 95% CI 2.1 to 15.0) during their first year of life. Mothers in the preterm group more often used temporary parental allowance than the control mothers (p < 0.001). The number of contacts with the child health services and the social welfare system did not differ significantly from the controls. Neither was there any significant difference with regard to family function or life events at 4 years of age. Conclusions: A large proportion of the premature children used specialist care during the first years of life. However, the families of the preterm infants were socially well adapted up to four years after birth compared with the control families.

  • 24.
    Ludvigsson, Johnny
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Samuelsson, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Ernerudh, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Clinical Immunology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Johansson, C
    Stenhammar, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Berlin, Gösta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Photopheresis at onset of type 1 diabetes: A randomised, double blind, placebo controlled trial2001In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 85, no 2, p. 149-154Article in journal (Refereed)
    Abstract [en]

    Background - In recent years photopheresis, an extracorporeal form of photochemotherapy using psoralen and ultraviolet A irradiation of leucocytes, has been claimed to be an effective form of immunomodulation. Aim - To evaluate its effect in type 1 diabetes we performed a double blind, controlled study using placebo tablets and sham pheresis in the control group. Methods - A total of 49 children, aged 10-18 years of age at diagnosis of type 1 diabetes were included, 40 fulfilled the study and were followed for three years (19 received active treatment with photopheresis and 21 placebo treatment). Results - The actively treated children secreted significantly more C peptide in urine during follow up than control children. C peptide values in serum showed corresponding differences between the two groups. The insulin dose/kg body weight needed to achieve satisfactory HbA1c values was always lower in the photopheresis group, there was no difference between the groups regarding HbAlc values during follow up. The treatment was well accepted except for nausea (n = 3) and urticaria (n = 1) in the actively treated group. There were no differences regarding weight or height, or episodes of infection between the two groups during follow up. Conclusion - Photopheresis does have an effect in addition to its possible placebo effect, shown as a weak but significant effect on the disease process at the onset of type 1 diabetes, an effect still noted after three years of follow up.

  • 25. Lynøe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Easier to see the speck in your critical peers' eyes than the log in your own? Response to Debelle et al.2018In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 103, no 7, p. 714-Article in journal (Refereed)
  • 26. Lyons, Ronan
    et al.
    Sellström, Eva
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Delahunty, Annie M
    Loeb, Mitch
    Varilo, Susanna
    Incidence and cause of fractures in European districts2000In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 82, no 6, p. 452-455Article in journal (Refereed)
    Abstract [en]

    Aims - To compare fracture rates in European districts. Setting - Geographically defined areas of Wales (Swansea and Neath Port Talbot), Norway (Harstad, Trondheim, Stavanger, and Drammen), Sweden (Jamtlands), and Finland (Porvoo). Methods - Surveillance of fractures at emergency departments and hospitals and linkage with population data. Comparison of age adjusted and crude rates. Calculation of confidence intervals for ratios. Results - A total of 4113 fractures occurred in 167 560 children during 1996. Fracture rates in south Wales (36 per 1000) were substantially higher than in Scandinavian districts (which were similar). Limiting analysis to the most severe injuries to correct for the possibility of ascertainment bias reduced some of the excess rate in Wales: the Welsh:Scandinavian fracture ratio was 1.82 (95% confidence interval: 1.64 to 2.03). Conclusions - Fracture rates in Welsh children are substantially higher than in Scandinavian children.

  • 27.
    Mai, Xiao-Mei
    et al.
    Canada.
    Almqvist, Catarina
    Astrid Lindgrens barnsjukhus Stockholm.
    Nilsson, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Wickman, Magnus
    Karolinska Institutet Stockholm.
    Birth anthropometric measures, body mass index and allergic diseases in a birth cohort study (BAMSE)2007In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 92, no 10, p. 881-886Article in journal (Refereed)
    Abstract [en]

    Objective: We aimed to assess increased birth weight or birth length in relation to allergic diseases at 4 years of age, taking body mass index (BMI) at age 4 as a covariate in the adjustment. Methods: The parents of a large prospective birth cohort answered questionnaires on environmental factors and allergic symptoms when their children were 2 months and 1, 2 and 4 years old. Perinatal data on weight and length at birth were received from the child care health centres. The children were clinically examined at 4 years of age and height and weight recorded. Blood was drawn for analysis of specific IgE antibodies to common inhalant allergens. Risk associations between birth anthropometric measures and wheeze, allergic diseases or sensitisation were estimated in multivariate logistic regression analyses (n = 2869). Results: There were no clear overall associations between birth weight and allergic diseases at 4 years of age. Birth length ≥90th percentile was inversely associated with any wheeze at age 4 (adjusted OR 0.64, 95% Cl 0.44 to 0.92) but was significantly associated only with late-onset wheeze (adjusted OR 0.40, 95% Cl 0.21 to 0.77). No such associations were seen for persistent or transient wheeze, eczema, rhinitis or allergic sensitisation. Transient wheeze during the first 2 years of age tended to be associated with increased BMI at age 4. Conclusion: Increased birth weight was not associated with wheeze or allergic disease. Increased birth length may play a protective role in late-onset wheeze in early childhood.

  • 28.
    Montgomery, Scott M.
    et al.
    Örebro University, Department of Clinical Medicine.
    Ehlin, A.
    Sacker, A.
    Breast feeding and resilience against psychosocial stress2006In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 91, no 12, p. 990-994Article in journal (Refereed)
    Abstract [en]

    Background: Some early life exposures may result in a well controlled stress response, which can reduce stress related anxiety. Breast feeding may be a marker of some relevant exposures.

    Aims: To assess whether breast feeding is associated with modification of the relation between parental divorce and anxiety.

    Methods: Observational study using longitudinal birth cohort data. Linear regression was used to assess whether breast feeding modifies the association of parental divorce/separation with anxiety using stratification and interaction testing. Data were obtained from the 1970 British Cohort Study, which is following the lives of those born in one week in 1970 and living in Great Britain. This study uses information collected at birth and at ages 5 and 10 years for 8958 subjects. Class teachers answered a question on anxiety among 10 year olds using an analogue scale (range 0–50) that was log transformed to minimise skewness.

    Results: Among 5672 non-breast fed subjects, parental divorce/separation was associated with a statistically significantly raised risk of anxiety, with a regression coefficient (95% CI) of 9.4 (6.1 to 12.8). Among the breast fed group this association was much lower: 2.2 (−2.6 to 7.0). Interaction testing confirmed statistically significant effect modification by breast feeding, independent of simultaneous adjustment for multiple potential confounding factors, producing an interaction coefficient of −7.0 (−12.8 to −1.2), indicating a 7% reduction in anxiety after adjustment.

    Conclusions: Breast feeding is associated with resilience against the psychosocial stress linked with parental divorce/separation. This could be because breast feeding is a marker of exposures related to maternal characteristics and parent–child interaction.

  • 29.
    Montgomery, Scott M.
    et al.
    Örebro University, Department of Clinical Medicine.
    Ehlin, A.
    Sacker, A.
    Pre-pubertal growth and cognitive function2006In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 91, no 1, p. 61-62Article in journal (Refereed)
    Abstract [en]

    British longitudinal data were used to investigate the association of heights at 22 months and 5 years with a digit recall test at age 10 years. Greater height, particularly at 5 years, was associated with higher scores, suggesting that some exposures influence both growth and capability for cognitive function.

  • 30.
    Målqvist, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Abolishing inequity, a necessity for poverty reduction and the realisation of child mortality targets2015In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 100 Suppl 1, p. S5-S9Article in journal (Refereed)
    Abstract [en]

    The first Millennium Development Goal (MDG 1) due in 2015 concerns poverty reduction. It has been claimed to be fulfilled on a global level, but still more than 1 billion people are living in abject poverty. There is a strong link between the economy and child survival, and only a minority of countries will have reached the MDG target for child mortality reduction by 2015. This paper discusses the relationship between poverty and child survival. It argues that a focus on equity is necessary to further reduce child mortality, through poverty reduction in absolute terms and also through targeting interventions for increased child survival to disadvantaged populations. The political will to actually achieve real change for those in greatest need is crucial but not to be taken for granted, and the distribution rather than the generation of wealth needs to be made a priority in the post-MDG era.

  • 31.
    Namatovu, Fredinah
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sandström, Olof
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. olof.sandstrom@pediatri.umu.se.
    Season and region as risk factors for celiac disease: a key to the aetiology?2016In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, p. 1114-1118Article in journal (Refereed)
    Abstract [en]

    Background: Coeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.

    Methods: A nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0–14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.

    Results: Overall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at <2 years had an increased CD risk if born in spring while those diagnosed at 2–14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991–1996 had increased CD risk if born during spring, for the 1997–2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003–2009 the risk was increased if born during autumn.

    Conclusions: Season of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation.

  • 32.
    Namatovu, Fredinah
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Strandh, Mattias
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Nilsson, Karina
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study2018In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 103, no 2, p. 143-148Article in journal (Refereed)
    Abstract [en]

    Background: Coeliac disease might affect school performance due to its effect on cognitive performance and related health consequences that might increase school absenteeism. The aim of this study was to investigate whether children with coeliac disease performed differently on completion of ninth grade in school compared with children without coeliac disease.

    Methods: Analysis was performed on a population of 445 669 children born in Sweden between 1991 and 1994 of whom 1767 were diagnosed with coeliac disease. School performance at ninth grade was the outcome and coeliac disease was the exposure. Other covariates included sex, Apgar score at 5 min, small for gestational age, year of birth, family type, parental education and income.

    Results: There was no association between coeliac disease and school performance at ninth grade (adjusted coefficient -2.4, 95% CI 5.1 to 0.4). A weak association was established between late coeliac diagnosis and higher grades, but this disappeared after adjusting for parent socioeconomic conditions. Being small for gestational age affected performance negatively (adjusted coefficient -6.9, 95% CI 8.0 to 5.7). Grade scores were significantly lower in children living with a single parent (adjusted coefficient -20.6, 95% CI 20.9 to 20.2), compared with those with married/cohabiting parents. A positive association was found between scores at ninth grade and parental education and income.

    Conclusion: Coeliac disease diagnosis during childhood is not associated with poor school performance at ninth grade.

  • 33.
    Namatovu, Fredinah
    et al.
    Umeå universitet.
    Strandh, Mattias
    Umeå universitet.
    Ivarsson, Anneli
    Umeå universitet.
    Nilsson, Karina
    Umeå universitet.
    Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study2018In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 103, no 2, p. 143-148Article in journal (Refereed)
    Abstract [en]

    Background: Coeliac disease might affect school performance due to its effect on cognitive performance and related health consequences that might increase school absenteeism. The aim of this study was to investigate whether children with coeliac disease performed differently on completion of ninth grade in school compared with children without coeliac disease.

    Methods: Analysis was performed on a population of 445 669 children born in Sweden between 1991 and 1994 of whom 1767 were diagnosed with coeliac disease. School performance at ninth grade was the outcome and coeliac disease was the exposure. Other covariates included sex, Apgar score at 5 min, small for gestational age, year of birth, family type, parental education and income.

    Results: There was no association between coeliac disease and school performance at ninth grade (adjusted coefficient -2.4, 95% CI 5.1 to 0.4). A weak association was established between late coeliac diagnosis and higher grades, but this disappeared after adjusting for parent socioeconomic conditions. Being small for gestational age affected performance negatively (adjusted coefficient -6.9, 95% CI 8.0 to 5.7). Grade scores were significantly lower in children living with a single parent (adjusted coefficient -20.6, 95% CI 20.9 to 20.2), compared with those with married/cohabiting parents. A positive association was found between scores at ninth grade and parental education and income.

    Conclusion: Coeliac disease diagnosis during childhood is not associated with poor school performance at ninth grade.

  • 34.
    Nelson, Nina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Selbing, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Prenatal bowel dilatation: congetinal chloride diarrhoea.2001In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 85, p. 65-65Article in journal (Refereed)
  • 35.
    Nordfeldt, Sam
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, CPS - Centrum för psykiatri och samhällsmedicin, BUP - Barn- och ungdomspsykiatri.
    Johansson, C
    Carlsson, E
    Hammersjö, J-Å
    Prevention of severe hypoglycaemia in type I diabetes: A randomised controlled population study2003In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 88, no 3, p. 240-245Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate use of targeted self study material in type I diabetes patient education regarding dissemination, perceived patient benefit, and prevention of severe hypoglycaemia. Methods: In a randomised 1:1:1 controlled study, 332 patients with type I diabetes (aged 2.6-18.9 years) were studied, 313 completed clinical follow up, 261 completed endpoint questionnaire. The intervention group received videotapes and a brochure designed to review skills for self control and treatment, aimed at preventing severe hypoglycaemia. Two control groups received a videotape and brochure with general diabetes information, or traditional treatment only, respectively. Results: Yearly incidence of severe hypoglycaemia decreased from 42% to 27% in the intervention group, but not in controls. HbA1c remained unchanged. Levels of use ranged from 1 to 20 times (median 2), 40-49% had shown the materials to friends, relatives, school staff, sports coaches, etc (there was little difference between intervention and control groups). Higher benefit and learning levels resulted from the intervention material, especially in patients with severe hypoglycaemia. Conclusions: Mass distributed pedagogical devices such as high quality video programmes and brochures may contribute to the prevention of severe hypoglycaemia. Such self study materials can reach high dissemination levels and constitute a cost effective complement to regular visits to a diabetes team and to other types of education. The findings may have implications for other topics, other ages, and other diagnosis groups.

  • 36.
    Osika, Walter
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Montgomery, S. M.
    Dangardt, F.
    Währborg, P.
    Gan, L. M.
    Tideman, E.
    Friberg, P.
    Anger, depression and anxiety associated with endothelial function in childhood and adolescence2011In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 96, no 1, p. 38-43Article in journal (Refereed)
    Abstract [en]

    Objective Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. The authors assessed associations of reactive hyperaemia peripheral arterial tonometry (RH-PAT), a measure of endothelial function predictive of CVD, with self-assessed psychological health among school children.

    Methods A total of 248 healthy school children (mean (SD) age 14.0 (1.0); 136 girls and 112 boys) underwent RH-PAT testing. They completed the Beck Youth Inventories (BYI) of emotional and social impairment scales, which is used to screen for depression, anxiety, anger and disruptive behaviour.

    Results No sex differences were observed for the RH-PAT score. Statistically significant differences were observed for the BYI scores; girls had higher scores for depression, anger and anxiety. Among the girls, there were statistically significant associations between lower RH-PAT scores and higher scores for anger (B coefficient=−0.100, p=0.040), depression (−0.108, p=0.009) and anxiety (−0.138, p=0.039) after adjustment for age. Among the boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006).

    Conclusions The girls have higher levels of self-assessed anger; depression and anxiety compared with the boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among the boys, disruptive behaviour was associated with better endothelial function. Although psychological ill-health is associated with impaired endothelial function and CVD among adults, such processes may also be relevant to children. Psychosocial adversity in childhood might be a risk factor for subsequent CVD.

  • 37.
    Osika, Walter
    et al.
    Department of Metabolism and Cardiovascular Research, Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott M.
    Örebro University, School of Health and Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, United Kingdom.
    Dangardt, Frida
    Department of Metabolism and Cardiovascular Research, Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Währborg, Peter
    Department of Metabolism and Cardiovascular Research, Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Gan, Li Ming
    Department of Metabolism and Cardiovascular Research, Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Tideman, Eva
    Division of Clinical Psychology, Lund University, Lund, Sweden.
    Friberg, Peter
    Department of Metabolism and Cardiovascular Research, Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Anger, depression and anxiety associated with endothelial function in childhood and adolescence2010In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 96, no 1, p. 38-43Article in journal (Refereed)
    Abstract [en]

    Objective Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. The authors assessed associations of reactive hyperaemia peripheral arterial tonometry (RH-PAT), a measure of endothelial function predictive of CVD, with self-assessed psychological health among school children. Methods A total of 248 healthy school children (mean (SD) age 14.0 (1.0); 136 girls and 112 boys) underwent RH-PAT testing. They completed the Beck Youth Inventories (BYI) of emotional and social impairment scales, which is used to screen for depression, anxiety, anger and disruptive behaviour. Results No sex differences were observed for the RH-PAT score. Statistically significant differences were observed for the BYI scores; girls had higher scores for depression, anger and anxiety. Among the girls, there were statistically significant associations between lower RH-PAT scores and higher scores for anger (B coefficient=-0.100, p=0.040), depression (-0.108, p=0.009) and anxiety (-0.138, p=0.039) after adjustment for age. Among the boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006). Conclusions The girls have higher levels of self-assessed anger; depression and anxiety compared with the boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among the boys, disruptive behaviour was associated with better endothelial function. Although psychological ill-health is associated with impaired endothelial function and CVD among adults, such processes may also be relevant to children. Psychosocial adversity in childhood might be a risk factor for subsequent CVD.

  • 38. Petridou, E
    et al.
    Skalkidou, Alkistis
    Department of Hygiene and Epidemiology, Athens University Medical School, Greece.
    Lescohier, I
    Trichopoulos, D
    Car restraints and seating position for prevention of motor vehicle injuries in Greece1998In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 78, no 4, p. 335-339Article in journal (Refereed)
    Abstract [en]

    The protective effect of child restraint and the relative safety of front and rear seating in a population where children often travel unrestrained was assessed in a population based case-control study. The cases were all 129 children aged 0-11 years injured as car passengers in a motor vehicle accident who contacted, during 1996, one of the two major children's hospitals in Athens; emergency cases are accepted by the two hospitals on alternate days throughout the year, thus generating a random sample of children injured as car passengers. The prevalence of the studied exposures in the study base was estimated from an inspection survey comprising a random sample of 191 children of the same age who travelled in passenger cars. The survey was conducted by medical staff from our centre in collaboration with the road traffic police. Odds ratios (ORs) were calculated after adjustment for confounding factors through the Mantel-Haenszel procedure. The OR for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0-4 years) and 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children). Protective effect estimates derived from this analytical study suggest that in Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint. The data also indicate that, in the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traffic mortality as well as a high childhood accident mortality.

  • 39.
    Samuelsson, Ulf
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Johansson, C
    Ludvigsson, Johnny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Month of birth and risk of developing insulin dependent diabetes in south east Sweden.  1999In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 81, p. 143-146Article in journal (Refereed)
  • 40. Skovbjerg, S
    et al.
    Roos, K
    Holm, Stig
    Grahn Håkansson, Eva
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology.
    Nowrouzian, F
    Ivarsson, M
    Adlerberth, I
    Wold, AE
    Spray bacteriotherapy decreases middle ear fluid in children with secretory otitis media2009In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 94, no 2, p. 92-98Article in journal (Refereed)
    Abstract [en]

    This study shows that spray treatment with S sanguinis may be effective against SOM. The mechanism for the effect remains to be investigated.

  • 41. Sommerfelt, K
    et al.
    Andersson, HW
    Sonnander, K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Ahlsten, G
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ellertsen, B
    Markestad, T
    Jacobsen, G
    Hoffman, HJ
    Bakketeig, L
    Cognitive development of term small for gestational age children of five years of age2000In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 83, no 1, p. 25-30Article in journal (Refereed)
    Abstract [en]

    AIM

    To assess the relative significance for cognitive development of small for gestational age, parental demographic factors, and factors related to the child rearing environment.

    METHODS

    IQ of a population based cohort of 338 term infants who were small for gestational age (SGA) and without major handicap, and a random control sample of 335 appropriate for gestational age (AGA) infants were compared at 5 years of age.

    RESULTS

    The mean non-verbal IQ was four points lower, while the mean verbal IQ was three points lower for the children in the SGA group. The results were not confounded by parental demographic or child rearing factors. However, parental factors, including maternal non-verbal problem solving abilities, and child rearing style, accounted for 20% of the variance in non-verbal IQ, while SGA versus AGA status accounted for only 2%. The comparable numbers for verbal IQ were 30 and 1%. Furthermore, we found no evidence that the cognitive development of SGA children was more sensitive to a non-optimal child rearing environment than that of AGA children. Maternal smoking at conception was associated with a reduction in mean IQ comparable to that found for SGA status, and this effect was the same for SGA and AGA children. The cognitive function of asymmetric SGA was comparable to that of symmetric SGA children.

    CONCLUSIONS

    Our findings indicate that child cognitive development is strongly associated with parental factors, but only marginally associated with intrauterine growth retardation.

  • 42.
    Videholm, Samuel
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Unit of Research, Development, and Education, Östersund Hospital, Östersund, Sweden.
    Silfverdal, Sven-Arne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Reniers, Georges
    Maternal weight and infections in early childhood: a cohort study2019In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 104, no 1, p. 58-63Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this study was to examine this association between maternal weight during pregnancy and the incidence of hospitalisations for infectious diseases during early childhood. Design A population-based cohort study. Setting A national cohort was created by combining data from the Swedish Medical Birth Register, the National Inpatient Register, the Cause of Death Register, the Total Population Register and the Longitudinal integration database for health insurance and labour market studies. Patients 693 007 children born in Sweden between 1998 and 2006. Main outcome measures Number of hospitalisations for infectious diseases during the first 5 years of life, overall and for categories of infectious diseases (lower respiratory, enteric, upper respiratory, genitourinary, perinatal, skin and soft tissue, neurological and eye, digestive tract, bloodstream and other infections). Results Overweight (body mass index (BMI) 25.0-29.9) and obesity (BMI >= 30) during pregnancy were associated with a higher overall incidence of hospitalisations for infectious diseases, adjusted incidence rate ratio (IRR) 1.05 (95% CI 1.03 to 1.06) and adjusted IRR 1.18 (95% CI 1.16 to 1.21). Overweight and obesity during pregnancy were strongly associated with perinatal infections, adjusted IRR 1.34 (95% CI 1.25 to 1.44) and adjusted IRR 1.72 (95% CI 1.57 to 1.88). In contrast, we found no association between maternal weight during pregnancy and infections of skin and soft tissue, the nervous system, the digestive tract or the bloodstream. Conclusions We observed an association between overweight and obesity during pregnancy, and hospitalisations for infectious diseases during early childhood.

  • 43.
    Wiklund, Lars
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Ronquist, G
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    George, Mary
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Ammonia: not the culprit2001In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 84, no 6, p. 525-533Article in journal (Refereed)
  • 44.
    Wolfe, Ingrid
    et al.
    London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
    Donkin, Angela
    Marmot, Michael
    McFarlane, Alison
    Cass, Hilary
    Viner, Russel
    UK child survival in a European context: Recommendations for a national Countdown Collaboration2015In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 100, no 10, p. 907-914Article in journal (Other academic)
  • 45. Zylbersztejn, Ania
    et al.
    Gilbert, Ruth
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Hardelid, Pia
    Origins of disparities in preventable child mortality in England and Sweden: a birth cohort study2020In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 105, no 1, p. 53-61Article in journal (Refereed)
    Abstract [en]

    Objective To compare mortality in children aged <5 years from two causes amenable to healthcare prevention in England and Sweden: respiratory tract infection (RTI) and sudden unexpected death in infancy (SUDI).

    Design Birth cohort study using linked administrative health databases from England and Sweden.

    Setting and participants Singleton live births between 2003 and 2012 in England and Sweden, followed up from age 31 days until the fifth birthday, death or 31 December 2013.

    Main outcome measures The main outcome measures were HR for RTI-related mortality at 31-364 days and at 1-4 years and SUDI mortality at 31-364 days in England versus Sweden estimated using Cox proportional hazards models. We calculated unadjusted HRs and HRs adjusted for birth characteristics (gestational age, birth weight, sex and congenital anomalies) and socioeconomic factors (maternal age and socioeconomic status).

    Results The English cohort comprised 3 928 483 births, 768 RTI-related deaths at 31-364 days, 691 RTI-related deaths at 1-4 years and 1166 SUDIs; the corresponding figures for the Swedish cohort were 1 012 682, 131, 118 and 189. At 31-364 days, unadjusted HR for RTI-related death in England versus Sweden was 1.52 (95% CI 1.26 to 1.82). After adjusting for birth characteristics, the HR reduced to 1.16 (95% CI 0.96 to 1.40) and for socioeconomic factors to 1.11 (95% CI 0.92 to 1.34). At 1-4 years, unadjusted HR was 1.58 (95% CI 1.30 to 1.92) and decreased to 1.32 (95% CI 1.09 to 1.61) after adjusting for birth characteristics and to 1.30 (95% CI 1.07 to 1.59) after further adjustment for socioeconomic factors. For SUDI, the respective HRs were 1.59 (95% CI 1.36 to 1.85) in the unadjusted model, and 1.40 (95% CI 1.20 to 1.63) after accounting for birth characteristics and 1.19 (95% CI 1.02 to 1.39) in the fully adjusted model.

    Conclusion Interventions that improve maternal health before and during pregnancy to reduce the prevalence of adverse birth characteristics and address poverty could reduce child mortality due to RTIs and SUDIs in England.

  • 46. Zylbersztejn, Anna Maria
    et al.
    Gilbert, Ruth
    Hardelid, Pia
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Where do the differences in childhood mortality rates between England and Wales and Sweden originate?2015In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 100, no 10, p. 1007-1007Article in journal (Refereed)
  • 47.
    Åsling Monemi, Kajsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Tabassum Naved, Ruchira
    Persson, Lars Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Violence against women increases the risk of foetal and early childhood growth impairment: A cohort study in rural Bangladesh2009In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 94, p. 775-779Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To assess whether different forms of family violence against women were associated with impaired size at birth and early childhood growth.

    METHODS:

    A substudy embedded into a community-based food and micronutrient supplementation trial (MINIMat) of pregnant women in rural Bangladesh included a 2-year follow-up of the 3164 live-born children of participating women. Anthropometric data were collected from birth up to 24 months of age, and converted to WHO growth standard SD scores. Size at birth and early childhood growth were assessed in relation to women's exposure to physical, sexual and emotional violence and the level of controlling behaviour in the family.

    RESULTS:

    Fifty per cent of all women reported a lifetime experience of some form of family violence. The mean birth weight was 2701 g, 30% were low birth weight (<2500 g), mean birth length was 47.8 cm (17.5%, <or=2 SD) and at 24 months of age 37% were underweight and 50% of the children were stunted. Exposure to any form of violence was negatively associated with weight and length at birth and weight-for-age and height-for-age SD scores at 24 months of age, as well as a change in weight and height SD score from birth to 24 months of age (p<0.05, adjusted for potential confounders).

    CONCLUSIONS:

    Violence against women was associated with an increased risk of fetal and early childhood growth impairment, adding to the multitude of confirmed and plausible health consequences caused by this problem.

  • 48.
    Åsling-Monemi, Kajsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Naved, R .T.
    Persson, Lars-Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Violence against women and the risk of fetal and early childhood growth impairment: a cohort study in rural Bangladesh2009In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 94, no 10, p. 775-779Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess whether different forms of family violence against women were associated with impaired size at birth and early childhood growth. METHODS: A substudy embedded into a community-based food and micronutrient supplementation trial (MINIMat) of pregnant women in rural Bangladesh included a 2-year follow-up of the 3164 live-born children of participating women. Anthropometric data were collected from birth up to 24 months of age, and converted to WHO growth standard SD scores. Size at birth and early childhood growth were assessed in relation to women's exposure to physical, sexual and emotional violence and the level of controlling behaviour in the family. RESULTS: Fifty per cent of all women reported a lifetime experience of some form of family violence. The mean birth weight was 2701 g, 30% were low birth weight (<2500 g), mean birth length was 47.8 cm (17.5%, <0.05, adjusted for potential confounders). CONCLUSIONS: Violence against women was associated with an increased risk of fetal and early childhood growth impairment, adding to the multitude of confirmed and plausible health consequences caused by this problem.

  • 49. Åström, Eva
    et al.
    Jorulf, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Söderhäll, Stefan
    Intravenous pamidronate treatment of infants with severe osteogenesis imperfecta2007In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, ISSN 1468-2044, Vol. 92, no 4, p. 332-338Article in journal (Refereed)
    Abstract [en]

    Objective: Children with the severe forms of osteogenesis imperfecta have in several studies been treated with intravenous pamidronate, but there are only few reports of the effect of early treatment.

    Aim: To evaluate the effect of treatment started in infancy.

    Methods: In a prospective observational study, with a historic control group, intravenous disodium pamidronate (APD) was given as monthly infusions to 11 children with osteogenesis imperfecta aged 3–13 (median 3.6) months, who had severe osteogenesis imperfecta with congenital bowing of the femora and vertebral compression fractures.

    Results: During treatment of children aged between 3 and 6 (median 4.5) years, dual-energy x ray absorptiometry measurements of the lumbar spine showed a gradual increase in bone density. Bone metabolism parameters in serum (alkaline phosphatase, osteocalcin, procollagen 1 carboxy-terminal peptide, collagen 1 teleopeptide) and in urine (deoxypyridinoline) indicated a decrease in bone turnover. An improvement of mobility was seen and at the latest recording, at the age of 3.3–6.5 (median 4.8) years, the children could all walk. Vertebral remodelling was seen, with increased vertebral height, and no child developed scoliosis, kyphosis or basilar impression. All children required femoral intramedullar rods for fractures, and five needed tibial rodding for extreme curvatures that prevented functional standing and walking. No adverse effects were seen on growth, fracture healing or blood chemistry.

    Conclusions: APD is an efficient symptomatic treatment for infants with severe osteogenesis imperfecta, but additional orthopaedic surgery is often needed. Early treatment may prevent scoliosis and basilar impression. Long-term follow-up is important.

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