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Publications (10 of 69) Show all publications
Grandahl, M., Nevéus, T., Dalianis, T., Larsson, M., Tydén, T. & Stenhammar, C. (2019). ‘I also want to be vaccinated!’ – adolescent boys’ awareness and thoughts, perceived benefits, information sources, and intention to be vaccinated against Human papillomavirus (HPV). Human Vaccines & Immunotherapeutics, 15(7-8), 1794-1802
Open this publication in new window or tab >>‘I also want to be vaccinated!’ – adolescent boys’ awareness and thoughts, perceived benefits, information sources, and intention to be vaccinated against Human papillomavirus (HPV)
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2019 (English)In: Human Vaccines & Immunotherapeutics, ISSN 2164-5515, E-ISSN 2164-554X, Vol. 15, no 7-8, p. 1794-1802Article in journal (Refereed) Published
Abstract [en]

This study investigates boys’ awareness and thoughts about human papillomavirus (HPV) and HPV vaccination, perceived benefits of vaccinating men, information sources and intention to be vaccinated against HPV. We used a qualitative approach and interviews were conducted with 31 upper secondary school male students. Two main themes 1) Promotion of equal health and 2) Increased knowledge facilitates the decision about HPV vaccination emerged from the analysis. The informants believed that it was important and fair to protect boys and girls equally against HPV. If HPV vaccination could prevent both girls and boys against an HPV-related disease, there was nothing to question or to discuss. It was not a matter of sex; it was a matter of equal rights. Moreover, an important reason for vaccinating boys was to prevent the transmission of the virus. However, the boys felt unsure and stated that they needed to know more. The school nurse and the school health were considered suitable both for distributing information and for providing the vaccinations.

In conclusion, the participants were in favor of introducing HPV vaccination also for boys in the national vaccination program. Sex-neutral HPV vaccinations were viewed both as a way to stop the virus transmission and a means to promote equal health for the entire population.

Keywords
Awareness, boys, equal health, gender neutral vaccination, health belief model, human
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-371524 (URN)10.1080/21645515.2018.1551670 (DOI)000482271400045 ()30481108 (PubMedID)
Funder
Swedish Cancer Society, 130744
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-10-18Bibliographically approved
Jönson Ring, I., Nevéus, T., Markström, A., Magnuson, A. & Bazargani, F. (2019). Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial. Angle orthodontist
Open this publication in new window or tab >>Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial
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2019 (English)In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103Article in journal (Other academic) Published
Keywords
Rapid maxillary expansion, nocturnal enuresis
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-383403 (URN)10.2319/031819-219.1. (DOI)
Available from: 2019-05-14 Created: 2019-05-14 Last updated: 2019-07-28
Nevéus, T. (2019). The amount of urine voided in bed by children with enuresis. Journal of Pediatric Urology, 15(1), 31.e1-31.e5
Open this publication in new window or tab >>The amount of urine voided in bed by children with enuresis
2019 (English)In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 15, no 1, p. 31.e1-31.e5Article in journal (Refereed) Published
Abstract [en]

Introduction: Enuretic children wet their beds either because of nocturnal polyuria or nocturnal detrusor over-activity. Polyuric children often respond to desmo-pressin, whereas children with nocturnal detrusor overactivity are often therapy resistant and may have low daytime voided volumes. It is logical to assume that the enuretic event in children with nocturnal polyuria occurs with a full bladder, i. e. with the enuretic voided volume (EVV) close to the child's expected bladder capacity (EBC) for his/her age. However, the EVV has only rarely been studied, and little is known about how it relates to case history, polyuria, or daytime bladder function. The aim of this study was to look at EVV and relate it to voiding chart data and treatment response.

Methods: Anamnestic data and voiding charts, including measurement of nocturnal urine production and EVV, in enuretic children with or without concomitant daytime incontinence attending a tertiary center were retrospectively reviewed. The EVV was analyzed and compared to anamnestic data, voiding chart data, and response to therapy in accordance with the guidelines of the International Children's Continence Society.

Results: Data were available for 220 children (age 5-24, median 9), 40 of whom were girls. The prevalence of previous or present daytime incontinence was 42.4%, and 50.5% sometimes experienced urgency. The average EVV was 54.9 +/- 32.8% of EBC. EVV correlated highly significantly to nocturnal urine production (p < 0.001). Still, EVV >= EBC was observed in only 16 children. EVV was slightly larger in girls (p = 0.013) and in children with urgency (p = 0.034), but there were no significant EVV differences between children responding or not responding to antidiuretic, anticholinergic, or antidepressant therapy. Relevant data are summarized in the Table below.

Discussion: Case history and daytime voiding chart data give very little information about nocturnal bladder function. The EVV is strongly influenced by nocturnal urine production but only rarely reaches up to a level close to or exceeding the EBC. The enuretic event only very rarely represents the emptying of a full bladder. Thus, a component of nocturnal detrusor overactivity can be assumed to be present in almost all enuretic children, even in children with nocturnal polyuria. The value of the EVV is limited in predicting response to therapy. 

National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-371522 (URN)10.1016/j.jpurol.2018.08.006 (DOI)000460056300009 ()30181098 (PubMedID)
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-03-26Bibliographically approved
Al-Mashhadi, A. N., Checa, A., Wåhlin, N., Nevéus, T., Fossum, M., Wheelock, C. E., . . . Carlström, M. (2018). Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children. Pediatric nephrology (Berlin, West), 33(4), 639-649
Open this publication in new window or tab >>Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children
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2018 (English)In: Pediatric nephrology (Berlin, West), ISSN 0931-041X, E-ISSN 1432-198X, Vol. 33, no 4, p. 639-649Article in journal (Refereed) Published
Abstract [en]

Objective Recent clinical studies have suggested an increased risk of elevated arterial pressure in patients with hydronephrosis. Animals with experimentally induced hydronephrosis develop hypertension, which is correlated to the degree of obstruction and increased oxidative stress. In this prospective study we investigated changes in arterial pressure, oxidative stress, and nitric oxide (NO) homeostasis following correction of hydronephrosis.

Methods Ambulatory arterial pressure (24 h) was monitored in pediatric patients with hydronephrosis (n = 15) before and after surgical correction, and the measurements were compared with arterial pressure measurements in two control groups, i.e. healthy controls (n = 8) and operated controls (n = 8). Markers of oxidative stress and NO homeostasis were analyzed in matched urine and plasma samples.

Results The preoperative mean arterial pressure was significantly higher in hydronephrotic patients [83 mmHg; 95% confidence interval (CI) 80–88 mmHg] than in healthy controls (74 mmHg; 95% CI 68–80 mmHg; p < 0.05), and surgical correction of ureteral obstruction reduced arterial pressure (76 mmHg; 95% CI 74–79 mmHg; p < 0.05). Markers of oxidative stress (i.e., 11- dehydroTXB2, PGF2α, 8-iso-PGF2α, 8,12-iso-iPF2α-VI) were significantly increased (p < 0.05) in patients with hydronephrosis compared with both control groups, and these were reduced following surgery (p < 0.05). Interestingly, there was a trend for increased NO synthase activity and signaling in hydronephrosis, which may indicate compensatory mechanism(s).

Conclusion This study demonstrates increased arterial pressure and oxidative stress in children with hydronephrosis compared with healthy controls, which can be restored to normal levels by surgical correction of the obstruction. Once reference data on ambulatory blood pressure in this young age group become available, we hope cut-off values can be defined for deciding whether or not to correct hydronephrosis surgically.

Keywords Blood pressure . Hydronephrosis . Hypertension . Nitric oxide . Oxidative stress . Ureteral obstruction 

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Blood pressure, Hydronephrosis, Hypertension, Nitric oxide, Oxidative stress, Ureteral obstruction
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-337796 (URN)10.1007/s00467-017-3848-4 (DOI)000427901900012 ()29196979 (PubMedID)
Funder
Swedish Research Council, 2016-01381 MC 65X-03522-43-3 AEGPSwedish Heart Lung Foundation, 20140448The Karolinska Institutet's Research Foundation
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2019-11-11Bibliographically approved
Al-Mashhadi, A., Häggman, M., Läckgren, G., Ladjevardi, S., Nevéus, T., Stenberg, A., . . . Carlstrom, M. (2018). Changes of arterial pressure following relief of obstruction in adults with hydronephrosis. Upsala Journal of Medical Sciences, 123(4), 216-224
Open this publication in new window or tab >>Changes of arterial pressure following relief of obstruction in adults with hydronephrosis
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2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 4, p. 216-224Article in journal (Refereed) Published
Abstract [en]

Background: As much as 20% of all cases of hypertension are associated with kidney malfunctions. We have previously demonstrated in animals and in pediatric patients that hydronephrosis causes hypertension, which was attenuated by surgical relief of the ureteropelvic junction (UPJ) obstruction. This retrospective cohort study aimed to investigate: (1) the proposed link between hydronephrosis, due to UPJ obstruction, and elevated arterial pressure in adults; and (2) if elevated blood pressure in patients with hydronephrosis might be another indication for surgery.

Materials and methods: Medical records of 212 patients undergoing surgical management of hydronephrosis, due to UPJ obstruction, between 2000 and 2016 were assessed. After excluding patients with confounding conditions and treatments, paired arterial pressures (i.e. before/after surgery) were compared in 49 patients (35 years old; 95% CI 29–39). Split renal function was evaluated by using mercaptoacetyltriglycine (MAG3) renography before surgical management of the hydronephrotic kidney.

Results: Systolic (−11 mmHg; 95% CI 6–15 mmHg), diastolic (−8 mmHg; 95% CI 4–11 mmHg), and mean arterial (-9 mmHg; 95% CI 6–12) pressures were significantly reduced after relief of the obstruction (p < 0.001). Split renal function of the hydronephrotic kidney was 39% (95% CI 37–41). No correlations were found between MAG3 and blood pressure level before surgery or between MAG3 and the reduction of blood pressure after surgical management of the UPJ obstruction.

Conclusions: In adults with hydronephrosis, blood pressure was reduced following relief of the obstruction. Our findings suggest that elevated arterial pressure should be taken into account as an indication to surgically correct hydronephrosis.

Keywords
Blood pressure, hydronephrosis, hypertension, kidney, renal function, ureteral obstruction
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-375862 (URN)10.1080/03009734.2018.1521890 (DOI)000455702800004 ()30293474 (PubMedID)
Funder
Swedish Research Council, 2016-01381Swedish Research Council, 65X-03522-43-3Swedish Heart Lung Foundation, 20140448; 20170124
Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2019-02-01Bibliographically approved
Kaarme, J., Riedel, H. M., Schaal, W., Yin, H., Nevéus, T. & Melhus, Å. (2018). Rapid Increase in Carriage Rates of Enterobacteriaceae Producing Extended-Spectrum β-Lactamases in Healthy Preschool Children, Sweden. Emerging Infectious Diseases, 24(10), 1874-1881
Open this publication in new window or tab >>Rapid Increase in Carriage Rates of Enterobacteriaceae Producing Extended-Spectrum β-Lactamases in Healthy Preschool Children, Sweden
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2018 (English)In: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 24, no 10, p. 1874-1881Article in journal (Refereed) Published
Abstract [en]

By collecting and analyzing diapers, we identified a >6-fold increase in carriage of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae for healthy preschool children in Sweden (p<0.0001). For 6 of the 50 participating preschools, the carriage rate was >40%. We analyzed samples from 334 children and found 56 containing >1 ESBL producer. The prevalence in the study population increased from 2.6% in 2010 to 16.8% in 2016 (p<0.0001), and for 6 of the 50 participating preschools, the carriage rate was >40%. Furthermore, 58% of the ESBL producers were multidrug resistant, and transmission of ESBL-producing and non-ESBL-producing strains was observed at several of the preschools. Toddlers appear to be major carriers of ESBL producers in Sweden.

Keywords
AmpC, ESBLs, Enterobacteriaceae, Sweden, antimicrobial resistance, bacteria, carriage rates, cephalosporin resistance, enteric infections, extended-spectrum β-lactamases, healthy preschool children, preschool children, respiratory infections, whole-genome sequencing
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-368814 (URN)10.3201/eid2410.171842 (DOI)000444801900011 ()30226162 (PubMedID)
Funder
Swedish Research CouncilScience for Life Laboratory - a national resource center for high-throughput molecular bioscienceSwedish Research Council Formas
Available from: 2018-12-07 Created: 2018-12-07 Last updated: 2019-02-01Bibliographically approved
Jansson, E. & Nevéus, T. (2018). Rectal diameter assessment in enuretic children-exploring the association between constipation and bladder function. Upsala Journal of Medical Sciences, 123(3), 179-182
Open this publication in new window or tab >>Rectal diameter assessment in enuretic children-exploring the association between constipation and bladder function
2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 3, p. 179-182Article in journal (Refereed) Published
Abstract [en]

Objectives: Detrusor overactivity and constipation often co-exist in children with enuresis. Constipation is known to be linked to detrusor overactivity. The voiding chart is the best non-invasive way to investigate bladder function, whereas the ultrasonographical detection of rectal dilatation is the best way to objectify constipation. We wanted to investigate a possible relationship between the rectal diameter and voiding chart data in enuretic children.

Methods: Children with therapy-resistant enuresis were retrospectively evaluated. All had completed a voiding chart for at least 48 h. The rectal diameter was assessed ultrasonographically. The cutoff for rectal dilatation was set at 30 mm.

Results: We evaluated 74 patients (12 girls) aged 10.2 +/- 2.8years, 35 of whom had rectal dilatation. No significant differences in voiding chart parameters were found between children with normal versus dilated rectum. Neither did urgency or a history of daytime incontinence differ between the groups. Boys were more likely to have rectal dilatation than girls (p = 0.02).

Conclusions: The absence of differences regarding voiding chart data may be explained as two mechanisms neutralizing each other: behavioral factors may make the constipated children void seldom and with large volumes, whereas detrusor overactivity caused by rectal compression of the bladder may have the opposite effect. Another option may be that the voiding chart is too blunt an instrument to detect detrusor overactivity. Constipation, and thus presumably bladder dysfunction, seems to be more important in enuretic boys than girls.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2018
Keywords
Constipation, detrusor overactivity, enuresis, rectal diameter, voiding chart
National Category
Pediatrics Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-368777 (URN)10.1080/03009734.2018.1488778 (DOI)000446977000007 ()30176757 (PubMedID)
Available from: 2018-12-10 Created: 2018-12-10 Last updated: 2019-02-01Bibliographically approved
Vivier, P.-H., Augdal, T. A., Avni, F. E., Bacchetta, J., Beetz, R., Bjerre, A. K., . . . Riccabona, M. (2018). Standardization of pediatric uroradiological terms: a multidisciplinary European glossary. Pediatric Radiology, 48(2), 291-303
Open this publication in new window or tab >>Standardization of pediatric uroradiological terms: a multidisciplinary European glossary
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2018 (English)In: Pediatric Radiology, ISSN 0301-0449, E-ISSN 1432-1998, Vol. 48, no 2, p. 291-303Article in journal (Refereed) Published
Abstract [en]

To promote the standardization of nephro-uroradiological terms used in children, the European Society of Paediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication between different clinicians involved in pediatric urology and nephrology.

Place, publisher, year, edition, pages
SPRINGER, 2018
Keywords
Imaging, Nephrology, Pediatrics, Radiology, Glossary, Urology, Standardization
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-346220 (URN)10.1007/s00247-017-4006-7 (DOI)000423715200018 ()29138893 (PubMedID)
Available from: 2018-03-19 Created: 2018-03-19 Last updated: 2019-02-01Bibliographically approved
Grandahl, M., Larsson, M., Dalianis, T., Stenhammar, C., Tydén, T., Westerling, R. & Nevéus, T. (2017). Catch-up HPV vaccination status of adolescents in relation to socioeconomic factors, individual beliefs and sexual behaviour. PLoS ONE, 12(11), Article ID e0187193.
Open this publication in new window or tab >>Catch-up HPV vaccination status of adolescents in relation to socioeconomic factors, individual beliefs and sexual behaviour
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 11, article id e0187193Article in journal (Refereed) Published
Abstract [en]

In 2012, human papillomavirus (HPV) vaccination was introduced free of charge in the Swedish national school-based vaccination programme for 10-12-year-old girls, and as catch-up vaccination for young women. In Sweden, there is an ongoing discussion about including boys in the national vaccination programme. Few studies are undertaken about adolescents' knowledge, beliefs and HPV vaccination status in relation to socioeconomic status and sexual experience. Thus, the aim was to examine HPV catch-up vaccination status in adolescents in relation to 1) socioeconomic factors, 2) beliefs and knowledge about HPV prevention, and 3) sexual behaviour. The Health Belief Model was used as a theoretical framework. Upper secondary school students (n = 832) aged 16, randomly chosen from a larger sample, were invited to participate in conjunction with the general health interview with the school nurse. A total of 751/832 (90.3%), girls (n = 391, 52%) and boys (n = 360, 48%) completed the questionnaire. HPV vaccination was associated with ethnicity and the mothers' education level; i.e. girls with a non-European background and girls with a less educated mother were less likely to have received the vaccine (p<0.01 and p = 0.04 respectively). Vaccinated girls perceived HPV infection as more severe (p = 0.01), had more insight into women's susceptibility to the infection (p = 0.02), perceived more benefits of the vaccine as protection against cervical cancer (p<0.01) and had a higher intention to engage in HPV-preventive behaviour (p = 0.01). Furthermore, boys and girls were almost equally sexually experienced, although fewer girls had used condom during first intercourse with their latest partner (p = 0.03). Finally, HPV vaccinated girls were less likely to have unprotected sex (p<0.01). In summary, catch-up HPV vaccination among young girls was associated with a European background and high maternal education level, as well as more favourable beliefs towards HPV prevention and less sexual risk-taking. Further preventive measures should therefore be directed at the migrant population.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-333214 (URN)10.1371/journal.pone.0187193 (DOI)000414377900014 ()29099839 (PubMedID)
Projects
Prevention of Human Papillomavirus in a school-based setting
Funder
Swedish Cancer Society, 130744
Available from: 2017-11-08 Created: 2017-11-08 Last updated: 2019-10-18Bibliographically approved
Ring, I. J., Nevéus, T., Markström, A., Arnrup, K. & Bazargani, F. (2017). Nocturnal enuresis impaired children's quality of life and friendships. Acta Paediatrica, 106(5), 806-811
Open this publication in new window or tab >>Nocturnal enuresis impaired children's quality of life and friendships
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 5, p. 806-811Article in journal (Refereed) Published
Abstract [en]

AimThere have not been any continence-specific measurement tools in Swedish that have allowed clinicians to investigate the quality of life (QoL) in children with bladder dysfunction. This study evaluated the QoL in Swedish children with nocturnal enuresis and tested the reliability of a Swedish translation of the Paediatric Incontinence Questionnaire (PinQ). MethodsThis prospective study comprised 46 children aged six to 18 years with nocturnal enuresis, who completed the PinQ after it was translated into Swedish. It was completed twice by 33 patients, and these responses were included in the test-retest evaluation. ResultsThe self-reported mean sum score for the whole group was 26.3 13.37 (range: 5-58), and the most affected domains were social relations with peers and self-esteem. The highest individual scores were four, three or two for 71.7%, 17.4% and 10.9% of the study population, respectively. Cronbach's alpha was 0.87 for the whole questionnaire, indicating good internal consistency. The test-retest stability was excellent, with an intra-class correlation coefficient of 0.76. ConclusionChildren with nocturnal enuresis had impaired self-esteem, and their impaired QoL affected their relationships with friends. The Swedish version of the PinQ proved to be a reliable tool that will be used in further studies.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
Nocturnal enuresis, Quality of life, Questionnaire, Self-esteem, Urinary incontinence
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-321783 (URN)10.1111/apa.13787 (DOI)000398859300021 ()28199734 (PubMedID)
Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2019-05-14Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4590-4957

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