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Dahl, Margareta
Publications (10 of 24) Show all publications
Kassa, A.-M., Dahl, M., Strinnholm, M. & Engstrand Lilja, H. (2018). Attention difficulties and physical dysfunction common in children with complex congenital malformations:: a study of preschool children with VACTERL association.. Acta Paediatrica
Open this publication in new window or tab >>Attention difficulties and physical dysfunction common in children with complex congenital malformations:: a study of preschool children with VACTERL association.
2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIM: Knowledge on the neurodevelopmental and physical function in children with vertebral defects, anorectal malformations, cardiac defects, tracheo-oesophageal fistula, renal and limb malformations (VACTERL) is scarce. We evaluated Swedish preschool children with VACTERL and identified whether they would need extra support in school.

METHODS: From 2015 to 2017, we recruited children aged 5-7 with VACTERL association from the paediatric surgical centre at the University Children's Hospital at Uppsala. Neurodevelopmental function was assessed by age-appropriate intelligence and visual and auditory attention tests, and the children's behaviour and attention were observed by an experienced psychologist. Physical function was evaluated through parental interviews and examinations. Data on patient characteristics, including any surgery and anaesthesia, were extracted from medical records.

RESULTS: Of the 13 eligible families, 10 agreed to participate. Intelligence was within the normal range for all children, but attention difficulties were found in eight of the children, requiring adjustments at school, and two of these were later diagnosed with attention deficit hyperactivity disorder. All children had physical dysfunctions that affected their daily nutrition, bowel or bladder functions.

CONCLUSION: Attention difficulties and physical dysfunction were common in Swedish preschool children aged 5-7 with VACTERL and they would need support and adjustments when they started school.

Keywords
Attention difficulties, Comorbidities, Congenital malformations, Neurodevelopmental function, Physical dysfunction
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-371838 (URN)10.1111/apa.14566 (DOI)30187514 (PubMedID)
Available from: 2019-01-02 Created: 2019-01-02 Last updated: 2019-08-21Bibliographically approved
Proos, L. A., Arnell, K., Gustafsson, J. & Dahl, M. (2017). Early/Precocious Puberty in Children with Pre/Perinatal Hydrocephalus. Hormone Research in Paediatrics, 88, 180-181
Open this publication in new window or tab >>Early/Precocious Puberty in Children with Pre/Perinatal Hydrocephalus
2017 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 88, p. 180-181Article in journal, Meeting abstract (Other academic) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-346841 (URN)000412595402162 ()
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-04-03Bibliographically approved
Ehrstedt, C., Kristiansen, I., Ahlsten, G., Casar Borota, O., Dahl, M., Libard, S. & Strömberg, B. (2016). Clinical characteristics and late effects in CNS tumours of childhood: Do not forget long term follow-up of the low grade tumours. European journal of paediatric neurology, 20(4), 580-587
Open this publication in new window or tab >>Clinical characteristics and late effects in CNS tumours of childhood: Do not forget long term follow-up of the low grade tumours
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2016 (English)In: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 20, no 4, p. 580-587Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate clinical characteristics and late effects of CNS tumours in childhood with a special focus on low-grade tumours, especially low-grade astrocytoma and glib neuronal tumours. Methods: A retrospective population based study was performed at Uppsala University Children's Hospital, a tertiary referral centre for children with CNS tumours. Patients were identified from the National Brain Tumour Registry and the National Epilepsy Surgery Registry. Hospital medical records were analysed for patients with a follow up of >= 5 years after diagnosis. A re-evaluation of the neuro-pathological diagnosis was performed. Results: A total of 193 patients (age 0-17.99 years) during a twelve-year period (1995-2006) were included; 149 survived >= 5 years. Three larger subgroups could be identified: astrocytic, embryonal and glioneuronal tumours. A supratentorial location was found in 52%. Medical late effects were mainly neurological and endocrinological, affecting 81% and 26% of surviving patients. Cognitive late effects were a frequent finding in the whole group but also in low-grade astrocytoma and glioneuronal tumours (53% and 67%). Thirty per cent had some kind of pedagogic support in school. Conclusion: Late effects are common in long-term survivors of CNS tumours in childhood. Low-grade astrocytoma and glioneuronal tumours are no exception, and the findings support the need for long-term follow up.

Keywords
Childhood, CNS-tumour, Cognitive, Late effects, Low grade
National Category
Neurology Pediatrics Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-300544 (URN)10.1016/j.ejpn.2016.04.009 (DOI)000379106700014 ()27157245 (PubMedID)
Available from: 2016-08-10 Created: 2016-08-09 Last updated: 2019-04-02Bibliographically approved
Dahl, M., Bergsten, C., Hammarberg, A., Sandström, M. & Strinnholm, M. (2014). Autismspektrumtillstånd vid svår CP upptäcks ofta sent: Retrospektiv genomgång av 10 års journaler. Läkartidningen (32-33), 1296-8
Open this publication in new window or tab >>Autismspektrumtillstånd vid svår CP upptäcks ofta sent: Retrospektiv genomgång av 10 års journaler
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2014 (Swedish)In: Läkartidningen, ISSN 0023-7205, no 32-33, p. 1296-8Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-244969 (URN)
Available from: 2015-02-23 Created: 2015-02-23 Last updated: 2018-01-17
Proos, L. A., Tuvemo, T., Ahlsten, G., Gustafsson, J. & Dahl, M. (2011). Increased perinatal intracranial pressure and brainstem dysfunction predict early puberty in boys with myelomeningocele. Acta Paediatrica, 100(10), 1368-1372
Open this publication in new window or tab >>Increased perinatal intracranial pressure and brainstem dysfunction predict early puberty in boys with myelomeningocele
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2011 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 10, p. 1368-1372Article in journal (Refereed) Published
Abstract [en]

Background: Children with myelomeningocele (MMC) run an increased risk of developing early or precocious puberty (E/PP).

Aim: To identify risk factors for E/PP in boys with MMC.

Methods: Boys born between 1970 and 1992, treated for MMC at the University Children's Hospital, Uppsala, were identified. Thirty-eight boys were eligible to be included. Medical records were examined retrospectively. Early puberty was defined as pubertal signs before the age of 10 years and 2 months. Precocious puberty was defined as the appearance of these signs before 9 years of age. Increased intracranial pressure perinatally was defined as wide sutures, bulging fontanelles and increased/increasing head circumference at birth and/or during the first week after birth. Early brainstem dysfunction was defined as severe and persistent feeding and respiratory problems before the age of 3 months despite proper control of the hydrocephalus.

Results: Of the 38 boys, 8 (21%) had E/PP, which was strongly associated with increased intracranial pressure perinatally and also with early brainstem dysfunction. Multivariate regression analysis showed early brainstem dysfunction to have the highest explanatory value regarding the occurrence of early puberty.

Conclusion: Increased intracranial pressure perinatally and brainstem dysfunction early in life are strong predictors of E/PP in boys with MMC.

Keywords
Brainstem dysfunction, Early puberty, Intracranial pressure, Myelomeningocele, Perinatal
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-159462 (URN)10.1111/j.1651-2227.2011.02335.x (DOI)000294900300030 ()
Available from: 2011-10-04 Created: 2011-10-03 Last updated: 2018-01-17Bibliographically approved
Dahl, M. & Ahlsten, G. (2010). Spina bifida occulta in children: presentationand outcome. In: : . Paper presented at 54th Annual Meeting of the Society for Research into Hydrocephalus and Spina BifidaVancouver, Canada, 7-10 July 2010..
Open this publication in new window or tab >>Spina bifida occulta in children: presentationand outcome
2010 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-221539 (URN)10.1186/1743-8454-7-S1-S9 (DOI)
Conference
54th Annual Meeting of the Society for Research into Hydrocephalus and Spina BifidaVancouver, Canada, 7-10 July 2010.
Available from: 2014-04-01 Created: 2014-04-01 Last updated: 2018-01-17
Jemtå, L., Dahl, M., Nordahl, G. & Fugl-Meyer, K. (2007). Coping strategies among Swedish children and adolescents with mobility impairment in relation to demographic data, disability characteristics and well-being. Acta Paediatrica, 96(8), 1184-1189
Open this publication in new window or tab >>Coping strategies among Swedish children and adolescents with mobility impairment in relation to demographic data, disability characteristics and well-being
2007 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 8, p. 1184-1189Article in journal (Refereed) Published
Abstract [en]

Aim: The first aim of the present study was to evaluate the applicability of a four-dimensional model of coping strategies, which includes 'active coping', 'distraction', 'avoidance' and 'support seeking' strategies, on children and adolescents with mobility impairment. The second aim was to identify coping strategies in this group. Finally, we analysed the relation between coping strategies and demographic data, disability characteristics and well-being.

Methods: Children and adolescents aged 7–18 years with mobility impairment (n = 133) were interviewed, and demographic and disability characteristics were recorded. The Children's Coping Strategies Checklist, a 52-item self-report inventory, was used to characterise dispositional style in coping.

Results: The four-factor model of coping strategies provides an adequate fit to the data of the sample studied. Three of the four coping strategies, all except 'avoidance', were significantly related to several demographic and disability features. Well-being was not significantly related to any of the four coping strategies, although the higher the trust in the strategies, the higher the estimation of one's own well-being.

Conclusion: Identification of coping strategies among children and adolescents with mobility impairment should form the basis of our understanding of how they face the complexity of challenges while growing up.

Keywords
Adolescent, Children, Coping strategy, Disability, Well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97552 (URN)10.1111/j.1651-2227.2007.00387.x (DOI)000248282500018 ()17590192 (PubMedID)
Available from: 2008-10-03 Created: 2008-10-03 Last updated: 2018-01-17Bibliographically approved
Norrlin, S., Strinnholm, M., Butler, A., Stagling, E., Bergh, M., Rönnblom, E., . . . Dahl, M. (2007). Independence and perceived quality of life in young adults with myelomeningocele. Function, needs and recommendations for what to do. In: Cerebrospinal Fluid Research, 2007, 4 (Suppl I ) Poster presentation: .
Open this publication in new window or tab >>Independence and perceived quality of life in young adults with myelomeningocele. Function, needs and recommendations for what to do
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2007 (English)In: Cerebrospinal Fluid Research, 2007, 4 (Suppl I ) Poster presentation, 2007Conference paper, Published paper (Other academic)
Identifiers
urn:nbn:se:uu:diva-16827 (URN)10.1186/1743-8454-4-SI-S50 (DOI)
Available from: 2008-06-05 Created: 2008-06-05 Last updated: 2018-01-17
Caines, E., Dahl, M. & Holmström, G. (2007). Longterm oculomotor and visual function in spina bifida cystica: a population-based study. Acta Ophthalmologica Scandinavica, 85(6), 662-666
Open this publication in new window or tab >>Longterm oculomotor and visual function in spina bifida cystica: a population-based study
2007 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 6, p. 662-666Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To document and describe the development from birth of visual and oculomotor functions in a group of children with spina bifida cystica (myelomeningocele and myeloschisis [MMC]). The emphasis in this study is on findings at 12-14 year follow-up. METHODS: Twenty children aged 12-14 years with myelomeningocele and Chiari-related malformations were examined by an orthoptist and a paediatric ophthalmologist. A further child who did not wish to participate actively in the study is also reported. Visual acuity for near and distance, refractometer readings in cycloplegia, the presence of ocular motility disorders and nystagmus were recorded. Accommodation, convergence, colour vision and stereo acuity were assessed and the fundus and media were examined. RESULTS: Six children (29%) in the study group had subnormal vision, although no child was visually impaired. Eleven (52%) showed manifest strabismus and 17 (81%) had a significant refractive error. Near visual acuity was normal in nearly all the children, but accommodation was defective in 10. Nine children had nystagmus and two had optic atrophy. No visual field defects were found. CONCLUSIONS: The high incidence of ocular disturbances in children with spina bifida highlights the importance of regular ophthalmological investigation and follow-up.

Keywords
Arnold Chiari, Hydrocephalus, Myelomeningocele (MMC), Spina bifida cystica, Visual function
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-14224 (URN)10.1111/j.1600-0420.2007.00905.x (DOI)000248922800016 ()17403023 (PubMedID)
Available from: 2008-01-29 Created: 2008-01-29 Last updated: 2018-01-17Bibliographically approved
Olsson, I., Dahl, M., Mattsson, S., Wendelius, M., Åström, E. & Westbom, L. (2007). Medical problems in adolescents with myelomeningocele (MMC): an inventory of the Swedish MMC population born during 1986-1989. Acta Paediatrica, 96(3), 446-449
Open this publication in new window or tab >>Medical problems in adolescents with myelomeningocele (MMC): an inventory of the Swedish MMC population born during 1986-1989
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2007 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 3, p. 446-449Article in journal (Refereed) Published
Abstract [en]

Aim: To describe the prevalence of myelomeningocele (MMC) and the medical needs of adolescents, 15–18 years, with MMC in Sweden, at a time when they are on the threshold of adulthood, leaving paediatrics.

Methods: In a retrospective study, we identified all adolescents with MMC, born during 1986–1989 and living in Sweden on July 1, 2004. An inventory was agreed upon with questions concerning their medical problems and need for medical care.

Results: There were 175 persons 15–18 years of age, born with MMC or lipoMMC (prevalence 3.8 per 10 000). Hydrocephalus was seen in 86%, 31% had been operated because of tethered cord syndrome, and 6% for Chiari malformation symptoms. The majority had motor impairments. Clean intermittent catheterisation for bladder emptying was used by 85%, and 59% used enemas on a regular basis because of the neurogenic bowel dysfunction. Renal dysfunction was seen in 1.7% of the adolescents.

Conclusion: Lifelong follow-up by many specialists, among others neurologists and neurosurgeons, urotherapists and urologists, orthopaedic surgeons and orthotists, is necessary for individuals with MMC. The complex medical situation, often in combination with cognitive difficulties, makes it necessary to coordinate medical services for this increasing group of adults with multiple impairments.

Keywords
Adolescence, Adult, Comprehensive care, Myelomeningocele, Spina bifida
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-11059 (URN)10.1111/j.1651-2227.2006.00153.x (DOI)000244716300028 ()17407475 (PubMedID)
Available from: 2007-05-16 Created: 2007-05-16 Last updated: 2018-01-17Bibliographically approved
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