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  • 1.
    Abrahamsson, Lotta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Ljung, Ida-Karin
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Bliss i interaktion: - En samtalsanalytisk fallstudie av hur blissanvändare och tolkare tillsammans bygger upp yttranden2008Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 2.
    Ager, Emma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Solli, Elin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    The PhonicStick: A Swedish Study: How do children age 5 and 6 handle the PhonicStick and will the use of it affect their phonological awareness?2009Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Phonological awareness is the ability to recognise, identify and manipulate components in words. Phonological awareness is an important part of the early literacy learning, although researchers disagree on how the connection arises. In the United Kingdom, synthetic phonics is a recommended way to teach literacy and the Jolly Phonics is a common approach within this method. In Sweden, mostly synthetic but also analytic methods are used for literacy teaching. The PhonicStick is developed as a communication device for impaired people and is based on the Jolly Phonics. In this study, the PhonicStick was being tested on children aged 5 and 6 years in mainstream pre-school classes to evaluate the use of it and its use for improvement of phonological awareness. The participating children were randomly divided into a test and a control group. All children were pre- and post-tested to analyse the possible improvement of parts of the phonological awareness. The test group went through three PhonicStick sessions, including different games and tests. The results from the pre- and post-tests of phonological awareness showed no significant differences between the test and control group. However, four out of five PhonicStick tests showed a significant improvement between session 1 and session 3. This shows that the children in the study were able to handle the PhonicStick after only three sessions, including remembering phonics the without visual information and producing words including two or three phonics.

  • 3.
    Aittomäki, Minna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Winell, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Grammatisk språkförståelse vid fyra år - testar vi det vi tror?: En jämförande studie av två grammatiska språkförståelsetest2011Independent thesis Advanced level (degree of Master (One Year)), 30 credits / 45 HE creditsStudent thesis
    Abstract [en]

    Many studies have investigated the development of children's language production, yet knowledge about how and when language comprehension develops is scarce. Researchers are agreed that comprehension generally precedes production, even though some grammatical structures are produced before the child fully comprehends them. Testing language comprehension is difficult, requiring the child to perform some kind of action in order to show his or her understanding. The aim of this study is to examine two grammatical comprehension tests, Nya SIT and TROG-2, and to compare both their content, and the results they generate. Seventy-six monolingual Swedish and bilingual 4-year-old children were tested with both tests. The conclusion is that the results of the two tests for all the children correlate fairly well, 0.7 according to Spearman's rank correlation. The correlation for the bilingual children is 0.6 and for the monolingual Swedish children 0.5. A regression analysis shows that language is the factor that has the greatest influence on the results, and that gender and age have less influence. The analysis of the test items shows that TROG-2 is a more thorough test of grammar than Nya SIT which only partly reveals the child's understanding of grammar.

  • 4.
    Albinsson, Sophie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Berglund, Julia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Testbatteri för talapraxi: Utformning och pilotnormering av ett artikulationstest2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Apraxia of speech (AOS) is a motor speech disorder that affects the planning and programming of speech, resulting in articulatory and prosodic distortions. To this date there is no available test in Swedish for assessment of AOS. Therefore, the aim of this study was to construct a test battery that enables the assessment of level of severity of the disorder, including mild AOS. A pilot standardization was performed on 50 healthy speakers. In order to determine whether the performance on the test battery is affected by sex, age or level of education, the selection of participants was stratified by these variables.

    The tasks were constructed based on previous research regarding the perceptual characteristics of AOS, taking into account also the types of tasks that have proved to be challenging for patients with AOS.

    The performance varied between different tasks of the test battery. On some tasks a high portion of the participants got very high scores, while other tasks were shown to be challenging even for healthy speakers. No significant sex differences were found on any of the tasks. However, age and level of education significantly affected the performance on some of the tasks. Overall, the effect sizes for level of education were larger than for age.

    In the future, the test battery should be able to determine the presence or absence and severity of AOS. For further development of the test battery, the standardization should continue using a larger sample. A clinical validation on patients with diagnosed AOS is also of great importance.

  • 5.
    Alm, Per
    Department of Clinical Neuroscience and Department of Psychology, Lund University.
    Stuttering and sensory gating: a study of acoustic startle prepulse inhibition2006In: Brain and Language, ISSN 0093-934X, E-ISSN 1090-2155, Vol. 97, no 3, 317-321 p.Article in journal (Refereed)
    Abstract [en]

    It was hypothesized that stuttering may be related to impaired sensory gating, leading to overflow of superfluous disturbing auditory feedback and breakdown of the speech sequence. This hypothesis was tested using the acoustic startle prepulse inhibition (PPI) paradigm. A group of 22 adults with developmental stuttering were compared with controls regarding the degree of PPI. No significant differences were found between the stuttering adults and the control group; the groups showed similar means and distribution. Likewise, no relation between the degree of PPI and the effect of altered auditory feedback on stuttering was found. In summary, the results of the study indicate that there is no relation between stuttering and PPI.

  • 6.
    Alm, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Cluttering: a neurological perspective2011In: Cluttering: a handbook of research, intervention, and education / [ed] D. Ward & K. Scaler Scott, London: Psychology Press , 2011Chapter in book (Other academic)
  • 7.
    Alm, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    A new framework for understanding stuttering: The dual premotor model2007In: Research, Treatment, and Self-Help in Fluency Disorders: New Horizons : Proceedings of the Fifth World Congress on Fluency Disorders, Dublin, 25-28th July 2006 / [ed] James Au-Yeung and Margaret M. Leahy, Dublin: The International Fluency Association , 2007, 77-83 p.Conference paper (Other academic)
  • 8.
    Andersz, Caroline
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Hansson, Anna-Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    The use of the PhonicStick in group training: Can South African children age 5-6 improve their phonological awareness by using the PhonicStick?2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Phonological awareness is the ability to recognize, reflect on and manipulate sound structures of a language. This ability has been shown to be crucial when acquiring literacy. The PhonicStick is a speech-generation communication device, which was initially developed for individuals with complex communication needs (CCN) though more recent research has focused on the effects of the device on factors important for literacy acquisition. In the present study the effects on phonological awareness were evaluated after seven group training sessions with the PhonicStick. The participants of the study were 20 typically developing South African 5-6 year old children. All participants where pre and post tested with The Phonological Awareness Test part c) isolation and a PhonicStick test which tested the ability to produce isolated phonemes and combinations of three phonemes with the device. The results of the study showed that training with the PhonicStick did not appear to improve results on The Phonological Awareness Test part c) isolation. However, it was found that the participants of the training group had improved their ability to manoeuvre the PhonicStick and to produce isolated phonemes and combinations of three phonemes.

  • 9. Anmyr, Lena
    et al.
    Olsson, Mariann
    Freijd, Anders
    Larsson, Kjerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Sense of coherence, social networks, and mental health among children with a cochlear implant2015In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 79, no 4, 610-615 p.Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore the personal and social resources of children with a cochlear implant from a child's perspective. Method: This descriptive cross-sectional study included 19 children with cochlear implants, aged 9-12 years. Data was collected, using the children's sense of coherence (CSOC) scale, the Network map, and the strengths and difficulties questionnaire (SDQ). The data was analyzed using descriptive and correlation statistics. Results: Most children had a strong sense of coherence. School life was an important arena for their social network. The mental health was comparable to normal hearing children. Still, some of the children with implants had low SOC and poor mental health. High SOC and closeness of the social network, especially in school, were associated with good mental health. Conclusion: This study shows that Swedish school-aged children with cochlear implants as a group have access to personal and social resources as strong sense of coherence and social networks. Still, there are individual children with psychosocial problems who need support and treatment.

  • 10.
    Arbin, Linn
    et al.
    Vasteras Hosp, Dept Otorhinolaryngol, S-72189 Vasteras, Sweden..
    Enlund, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Dept Anaesthesiol, Cty Hosp, S-72189 Vasteras, Sweden..
    Knutsson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Dept Otorhinolaryngol, Vasteras Cent Hosp, S-72189 Vasteras, Sweden..
    Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study2017In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 274, no 5, 2281-2285 p.Article in journal (Refereed)
    Abstract [en]

    To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection). Sixty patients aged 7-40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0-10) at awakening and the worst pain level of the day in the postoperative period. All intake of pain medication was also recorded. No statistically significant differences were found between the two groups regarding postoperative pain levels or consumption of pain medication. Usage of the harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with usage of the bipolar diathermy scissors.

  • 11.
    Assadian, Farzaneh
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Sandström, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Bondeson, Kåre
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infection medicine.
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Lidian, Adnan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Svensson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Akusjärvi, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Bergqvist, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Punga, Tanel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Distribution and Molecular Characterization of Human Adenovirus and Epstein-Barr Virus Infections in Tonsillar Lymphocytes Isolated from Patients Diagnosed with Tonsillar Diseases2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 5, e0154814Article in journal (Refereed)
    Abstract [en]

    Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%). The most abundant adenovirus type was HAdV-5 (68%). None of the patients were positive for HCMV. Furthermore, 43 patients (39%) showed a co-infection of HAdV and EBV. The majority of young patients diagnosed with tonsillar hypertrophy were positive for HAdV, whereas all adult patients diagnosed with chronic/recurrent tonsillitis were positive for either HAdV or EBV. Most of the tonsils from patients diagnosed with either tonsillar hypertrophy or chronic/recurrent tonsillitis showed a higher HAdV DNA copy number in T compared to B cell-enriched fraction. Interestingly, in the majority of the tonsils from patients with chronic/recurrent tonsillitis HAdV DNA was detected in T cells only, whereas hypertrophic tonsils demonstrated HAdV DNA in both T and B cell-enriched fractions. In contrast, the majority of EBV positive tonsils revealed a preference for EBV DNA accumulation in the B cell-enriched fraction compared to T cell fraction irrespective of the patients' age.

  • 12.
    Atturo, Francesca
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Barbara, Maurizio
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Is the Human Round Window Really Round?: An Anatomic Study With Surgical Implications2014In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 35, no 8, 1354-1360 p.Article in journal (Refereed)
    Abstract [en]

    Hypothesis: Human round window (RW) presents anatomic variations that may influence surgical approach. Background: The true shape of the human RW has been divisive since its first description in 1772 by Antonio Scarpa. Introduction of novel surgical strategies in recent years have raised its significance. Here, the human RW size and shape variations were documented in microdissected human temporal bones. Methods: An archival collection of human microdissected temporal bones was analyzed. RW rim could be delineated and photographed from the labyrinthine aspect and its topography assessed. Results: Human RW is seldom round but ovoid or orthogonal, skewed, and nonplanar (saddlelike). Membrane is fan shaped or conical with an anteroinferior and a posterosuperior part. The mean longest diameter was 1.90 mm, and the smallest one is 1.54 mm. The mean diameter from the crista fenestra was 1.31 mm. The mean area of the RW was 2.08 mm(2), which varied between 0.99 and 3.20 mm(2). The crista fenestrae of the anterior component form a "doorstep" that may limit the entry to the scala tympani from the RW niche. Conclusion: The alternate anatomic features of the human RW may influence its surgical access and designs of implants aimed at targeting this region.

  • 13.
    Backlund, Charlotte
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Lindström, Emma
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Stavningsförmåga och allografisk förmåga hos vuxna personer med dyslexi: Preklinisk validering av STAVUX och Kasttranskription2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to determine if STAVUX (spelling test for adults) and Kasttranskription are suitable tests to use in the assessment of adults with spelling difficulties. At present, there are no such tests with norms for people older than 18 years. STAVUX was developed by Nilsson and Pettersson (2009) and consists of 45 words and 45 pseudo words of varying difficulty. The words are chosen to represent the different spelling patterns of the Swedish language and the pseudo words to represent the Swedish phonetic structure. A between group’s design was used to find out if STAVUX is a suitable test to use in the assessment of spelling difficulties. STAVUX was validated on 23 persons with dyslexia, aged 18-64 years, and the results were compared to a control group of 23 persons, aged 18-62 years. In this study it was also investigated if there was any correlation between spelling ability and allographic ability. The participants performed a case transcription task, where the participants were supposed to convert lower to upper case letters and upper to lower case letters, while time was measured. The test is named Kasttranskription and was designed by Hansson and Häägg (2008). The results of this study show that particularly the word part of STAVUX, contributes to the prediction of dyslexia. The dyslexic group performed significantly lower than the control group on both subtests (words and pseudo words). Both groups followed the same pattern in type of spelling errors. The majority of the participants in each group managed to perform Kasttranskription correctly. There was a significant difference in time of performance of Kasttranskription. The dyslexic group performed significantly worse in terms of time compared to the control group. The subtests of STAXUX and Kasttranskription were highly correlated with each other.

  • 14.
    Backlund, Josefine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Lindqvist, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Snabb automatiserad benämning som screeninginstrument vid kognitiva störningar: En klinisk studie baserad på AQT2009Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A Quick Test (AQT) Color-Form is a test that uses rapid automatized naming in order to identify cognitive impairment. It is divided into three parts, each of which consists of 40 stimuli that are to be named as quickly as possible. Previous studies have indicated that AQT separates patients with Alzheimer’s disease from normal controls with higher accuracy than the commonly used Mini-Mental State Examination (MMSE). The purpose of this study was to investigate, for the first time, whether AQT results collected from a consecutive series of patients at a Memory Clinic would be able to predict the diagnosis. Another aim was to study the possible relation between AQT results and Cerebrospinal Fluid (CSF) biomarkers for neurodegenerative diseases. 492 forms from AQT Color-Form tests were analyzed and diagnostic prediction and correlation with level of CSF biomarkers were determined for the first 374 patients. The results imply that AQT Color-Form may be sensitive to some symptoms of benign memory impairment that is found in patients admitted to a Memory Clinic, but that it is not always sensitive to mild degrees of dementia. Further research consecutive series of patients is needed in order to determine the diagnostic abilities of discrimination in clinical practice.

  • 15. Bagger-Sjoback, Dan
    et al.
    Strömbäck, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Hultcrantz, Malou
    Papatziamos, Georgios
    Smeds, Henrik
    Danckwardt-Lillieström, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Tideholm, Bo
    Johansson, Ann
    Hellstrom, Sten
    Hakizimana, Pierre
    Fridberger, Anders
    High-frequency hearing, tinnitus, and patient satisfaction with stapedotomy: A randomized prospective study2015In: Scientific Reports, ISSN 2045-2322, Vol. 5, 13341Article in journal (Refereed)
    Abstract [en]

    Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

  • 16.
    Bengtsson, Caroline
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Jonsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Holmström, Mats
    Svensson, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Theorell-Haglöw, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Impact of nasal obstruction on sleep quality: a community-based study of women2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 1, 97-103 p.Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based sample of 400 women underwent a full night of polysomnography. Airway diseases, allergies and sleep-related symptoms were assessed by questionnaires. Women with subjective nasal obstruction were subdivided into three groups: persistent nasal obstruction (PNO, n = 46), hay fever (n = 88) and nasal obstruction at night (NON, n = 30). Sleep problems and related daytime symptoms were most prevalent among women with NON. After adjusting for age, BMI, smoking and asthma, NON was an independent predictor of 'Difficulties inducing sleep due to nasal obstruction' [adjusted odds ratio (95 % CI): 89.5 (27.0-296.7)], 'Snoring' [4.2 (1.7-10.2)], 'Sweating at night' [2.6 (1.1-6.1)], 'Difficulties maintaining sleep' [2.7 (1.2-6.2)], and 'Waking up hastily gasping for breath' [32.2 (8.7-119.1)]. 'Dry mouth on awakening' [7.7 (3.2-18.4)], 'Waking up unrefreshed' [2.7 (1.2-6.0)], 'Excessive daytime sleepiness' [2.6 (1.1-6.0)], and 'Daytime nasal obstruction' [12.2 (4.8-31.2)] were also associated with NON. Persistent nasal obstruction and hay fever were both associated with some reported sleep problems due to an overlap with NON. When women with NON were excluded, only 'Daytime nasal obstruction' was still significantly associated with PNO, while hay fever was associated with 'Daytime nasal obstruction' and 'Waking up hastily gasping for breath'. There were no significant differences in objectively measured sleep variables between any of the three subgroups and the study cohort. Self-reported nasal obstruction at night in women has a significant effect on several subjective day- and nighttime symptoms, but it does not appear to affect objectively measured sleep quality.

  • 17.
    Berg, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Medical Treatment and Grading of Bell's Palsy2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The main aim of this thesis was to evaluate the effect of prednisolone and valaciclovir in a large number of Bell's palsy patients. The incidence and intensity of pain around the ear, in the face or in the neck during the first two months of palsy, and its prognostic value, was also assessed. We also investigated how study design and choice of analysis method affect the rate of facial recovery. Furthermore, the agreement between the Sunnybrook, House-Brackmann and Yanagihara facial grading systems was evaluated.

    From May 2001 to September 2007, a prospective, randomised, double-blind, placebo-controlled, multicentre trial with 12-month follow-up was performed in patients with Bell's palsy. Of 839 randomised patients, 829 were included in the intention-to-treat analysis; 206 received placebo plus placebo, 210 prednisolone plus placebo, 207 valaciclovir plus placebo, and 206 prednisolone plus valaciclovir. Time to recovery was significantly shorter in the 416 patients who received prednisolone compared with the 413 who did not (p<0.0001). At 12 months, 300 of 416 patients (72%) in the prednisolone group had recovered compared with 237 of 413 patients (57%) in the no prednisolone group (p<0.0001). Valaciclovir was not found to affect time to facial recovery or outcome at 12 months. Prednisolone and/or valaciclovir did not affect the incidence or intensity of pain. Presence of pain at day 11 to 17 indicated a worse prognosis for facial recovery at 12 months. We also found that recovery rates in a Bell's palsy trial are substantially affected by the choice of analysis method and definition of facial recovery.

    We used weighted Kappa statistics in 100 examinations of patients with facial palsy to assess the agreement between the Sunnybrook, House-Brackmann and Yanagihara scales. The highest agreement was found between the regional Sunnybrook and Yanagihara scales. An evaluative difference between the Sunnybrook and House-Brackmann systems was observed.

  • 18.
    Berg, Thomas
    et al.
    Department of Plastic Surgery, Rigshospitalet, Oslo.
    Jonsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Are patients with Bell's palsy receiving the right treatment?2015In: Tidsskrift for Den norske lægeforening, ISSN 0029-2001, E-ISSN 0807-7096, Vol. 135, no 11, 1026-1027 p.Article in journal (Refereed)
  • 19.
    Berg, Thomas
    et al.
    Department of Plastic Surgery, Rigshospitalet, Oslo.
    Stjernquist-Desatnik, Anna
    Kanerva, Mervi
    Hultcrantz, Malou
    Engström, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Jonsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Bells pares ger resttillstånd hos 30 procent av vuxna patienter: Tidig behandling med kortison ökar utläkningen2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, 1-5 p., C6RDArticle in journal (Refereed)
  • 20.
    Berglin, Cecilia Engmer
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden..
    Pierre, Pernilla Videhult
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery. Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Ekborn, Andreas
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden..
    Bramer, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
    Edsman, Katarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
    Hultcrantz, Malou
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden..
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Local treatment of the inner ear: A study of three different polymers aimed for middle ear administration2015In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 10, 985-994 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: A formulation based on sodium hyaluronate (NaHYA) was the most promising candidate vehicle for intra-tympanic drug administration regarding conductive hearing loss, inflammatory reactions, and elimination. Objectives: Recent advances in inner ear research support the idea of using the middle ear cavity for drug administration to target the inner ear. This paper presents rheological and safety assessments of three candidate polymer formulations for intra-tympanic drug administration. Method: The formulations were based on sodium carboxymethyl cellulose (NaCMC), sodium hyaluronate (NaHYA), and poloxamer 407 (POL). Rheological studies were performed with a controlled rate instrument of the couette type. Safety studies were performed in guinea pigs subjected to an intra-tympanic injection of the formulations. Hearing function was explored with ABR before and 1, 2, and 3 weeks after the injection. Elimination of the formulations marked with coal was explored with an endoscopic digital camera 1, 2, and 3 weeks after injection. Middle and inner ear morphology was examined with light microscopy 6 days after injection. Results: The results speak in favor of NaHYA, since it did not cause prolonged hearing threshold elevations. The results of the elimination and morphological investigations support the conclusion of NaHYA being the most promising candidate for intra-tympanic administration.

  • 21.
    Bergström, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Due, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Att mäta kommunikativ förmåga: Utvecklandet av ett självskattningsinstrument2009Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Working with communication is a key element in professional speech and language therapy. The aim of this study was to develop a self-report instrument that measures communicative ability, with a possibility to capture both positive and negative aspects of communication. The instrument was developed in accordance with classical measurement theory. A first evaluation of the instrument with 13 respondents was conducted. As a result the number of items, ie questions, was reduced from 133 to 78 and individual items were altered when needed. 254 respondents then answered the revised form on the internet. Four factors could be extracted from the material. These were: behavior in social situations, functional communication, linguistic skills and receptive skills plus voice. The four factors explained 30,4% of the variance within the material. Cronbach's alpha for all 78 items was α = 0,76. The result of this study is an instrument in need of further revision and development, primarily with respect to validation.

  • 22.
    Berling Holm, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Knutsson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Strömbäck, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Danckwardt-Lillieström, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Papatziamos, Georgios
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    von Unge, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Taste disturbance after stapes surgery: an evaluation of frequency, severity, duration, and quality-of-life2017In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 37, no 1, 39-43 p.Article in journal (Refereed)
    Abstract [en]

     

    Conclusion: The incidence of taste disturbance after stapes surgery is high (61.9 %), whereas the majority (94.8 %) recovers within 1 year. More severe surgical nerve trauma caused more disturbance, implying that the nerve should be handled carefully during surgery.

     

    Objectives: Patients operated on for otosclerosis seem more often to complain about post-operative taste disturbance than those operated on for chronic otitis media, although the chorda tympani nerve more seldom becomes maltreated in stapedotomy. These observations seem paradoxical. It is unclear to what extent a post-operative taste disturbance affects the quality-of-life. This study aims to shed light on the occurrence of post-operative taste disturbances, on possible prognostic factors, and to what extent post-operative taste disturbance impairs the quality-of-life.

     

    Methods: One hundred and thirty-four adults undergoing primary stapedotomy were included. Questionnaires on taste disturbance and quality-of-life (SF-36) were answered before and after surgery, until 1 year post-operatively.

     

    Results: Eighty-three (61.9%) study persons reported post-operative taste disturbance. Seven (5.2%) reported persisting disturbance at 1 year. Surgically more traumatized chorda tympani nerves correlated with more severe taste disturbance post-operatively than less traumatized.  Taste disturbance at 1 year post-operatively correlate with a decrease of the physical function domain in the SF-36.

  • 23.
    Berling, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Mannstrom, Paula
    Ulfendahl, Mats
    Lillieström, Niklas Danckwardt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Von Unge, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    The chorda tympani degenerates during chronic otitis media: an electron microscopy study2015In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 135, no 6, 542-548 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: Chorda tympani nerve specimens from ears with chronic inflammatory middle ear disease exhibit structural signs of degeneration. These correlate well with taste disturbance. Simultaneously, they exhibit signs of regeneration, which may explain the ability for taste recovery. Objectives: The chorda tympani, the major taste nerve, runs uncovered through the middle ear cavity. This situation exposes it to various forms of middle ear pathology. A difference has been noticed regarding taste symptoms pre- and postoperatively between inflammatory and non-inflammatory diseases. The present study aimed to investigate ultrastructural changes of chorda tympani in different forms of inflammatory middle ear disease, such as chronic suppurative otitis media and cholesteatoma, as compared with normal. Methods: Five chorda tympani specimens were collected from healthy middle ears of patients subjected to surgery for acoustic neuroma, to be used as normal controls, and five from middle ears with chronic otitis media or cholesteatoma, where the nerve could not be saved during the operation. Light and electron microscopy were performed. Results: For all five nerves from diseased ears, microscopy showed a higher percentage of axon and myelin sheath degeneration than in the normal controls. Furthermore, three of the five also exhibited sprouting.

  • 24.
    Bohman, Anton
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Oscarsson, Martin
    Holmberg, Kenneth
    Johansson, Leif
    Millqvist, Eva
    Nasic, Salmir
    Torinsson-Naluai, Asa
    Bende, Mats
    Heredity of nasal polyps2015In: Rhinology, ISSN 0300-0729, Vol. 53, no 1, 25-28 p.Article in journal (Refereed)
    Abstract [en]

    Background: Nasal polyps is a common disease but little is known about its' pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps. Methodology: Patients with nasal polyps who attended the clinic were recruited to the study and were asked whether they had any close adult relatives (siblings, parents or children). We intended to recruit two relatives per patient, one of each gender, for nasal endoscopy. The prevalence of nasal polyps in these relatives was compared with the prevalence of nasal polyps in a general population. Results: During a 4-year period, 368 patients and 410 relatives were recruited to the study. Although we were unable to recruit two close relatives for every patient, we were able to calculate nasal polyp prevalence within families as being 19.2%. Compared with the prevalence of nasal polyps among individuals in a general Swedish population from the same geographical area, the relative risk for polyps among relatives was almost five times higher. Conclusion: This study strongly indicates that heredity is a factor of importance for development of nasal polyps.

  • 25.
    Bylund, Nina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Jensson, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Enghag, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Berg, T
    Marsk, E
    Hultcrantz, M
    Hadziosmanovic, Nermin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Rodriguez-Lorenzo, Andres
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Jonsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Synkinesis in Bell's palsy in a randomised controlled trial2017In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 42, no 3, 673-680 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study the development of synkinesis in Bell's palsy. Frequency, severity, gender aspects and predictors were analysed.

    DESIGN: Data from the randomised controlled Scandinavian Bell's palsy trial including 829 patients.

    MAIN OUTCOME MEASURES: Frequency and severity of synkinesis at 12 months were the main outcome measures. Mean Sunnybrook synkinesis scores, voluntary movement scores and composite scores between 6 and 12 months were compared.

    RESULTS: In 743 patients with a 12-month follow-up, synkinesis frequency was 21.3%. There was no gender difference. Synkinesis was moderate to severe in 6.6% of patients. Those with synkinesis at 6 months had a synkinesis score of 4.1 (±2.8 sd), which increased to 4.7 (±3.2) (P = 0.047) at 12 months (n = 93). Sunnybrook composite score at 1 month was the best predictor for synkinesis development with receiver operating characteristics and area under the curve (AUC) 0.87. Risk for synkinesis increased with a lower Sunnybrook composite score. Furthermore, at 1 month, symmetry of voluntary movement had higher predictive value for synkinesis than resting symmetry with AUC 0.87 and 0.77, respectively. Gentle eye closure and open-mouth smile were the only independent significant predictive items (AUC 0.86).

    CONCLUSIONS: Moderate-to-severe synkinesis was present in 6.6% of patients. The mean synkinesis score increased between 6 and 12 months, and outcome should therefore be evaluated after at least 12 months. Sunnybrook composite score and symmetry of voluntary movement at 1 month were good predictors for synkinesis.

  • 26.
    Cheng, Junping
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
    Radioimmunotherapy in Experimental Head and Neck Squamous Cell Carcinoma: Tumour-targeting in vitro and in vivo2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Radioimmunotherapy (RIT) has been shown to be a practicable way to treat head and neck squamous cell carcinoma. A specific antibody recognizes the charasteristic structure of tumour cells when loaded with cytotoxic agents (toxins, drugs, radionuclides, etc). But RIT kills not only tumour cells with attached radionuclides but also adjacent tumour cells due to the “cross fire effect”. To be efficacious, RIT depends closely on suitable monoclonal antibody, on the properties of the chosen radionuclides, and on a suitable labelling method for attaching radionuclide to antibody.

    In this study we initially used radionuclide-labelled cMAB U36, via linker DABI in order to improve the retention of radio-conjugates in the tumour cells. Improved retention is important because the longer the radionuclide remains in tumour cells, the more effective will the tumour cells be eradicated. In the investigation, both normal mice and HNSCC-bearing nude mice were used to compare our form of treatment against other radio-iodination methods. In the biodistribution study, normal mice showed that radioactive uptake in organs diminished with time, irrespectively of whether the conjugate was directly or indirectly labelled. But in thyroid, there was a tenfold greater accumulation of direct-labelled than of indirectly labelled conjugate.

    In tumour-bearing nude mice, by contrast, the results showed promising uptake of radioactivity, but little uptake in direct-labelled conjugate in thyroid. Significant differences were observed on comparing tumour: organ ratios between 131I-cMAb U36 vs. 125I-DABI-cMAb U36.

    In the present study, cMAb U36 labelled with 211Astatine was initially used to treat HNSCC in nude mice. The biodistribution of 211At-cMAb U36 did not reveal any significant difference between an antibody-blocked group and a non-blocked group. But it did highlight the characteristics of a successful targeting conjugate in HNSCC-bearing nude mice.

    In the subcutaneous therapy experiment, most of the treated tumours (n=18) had disappeared by the 26th day, in both U36-blocked and non-blocked groups. Treatment in the intravenous therapy experiment had also proved effective. In the antibody non-blocked group, the smallest tumour volume was 25 mm3 (average 111 mm3) vis-á-vis 65 mm3 (average 145 mm3) in the blocked group. None of tumours grew again following treatment.

    List of papers
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    3. Effect of closo-dodecarborate-containg linker on targeting HNSCC xenografts with radio-iodinated chimeric monoclonal antibody U36. Dual isotope comparative biodistribution study
    Open this publication in new window or tab >>Effect of closo-dodecarborate-containg linker on targeting HNSCC xenografts with radio-iodinated chimeric monoclonal antibody U36. Dual isotope comparative biodistribution study
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    Manuscript (Other academic)
    Identifiers
    urn:nbn:se:uu:diva-93172 (URN)
    Available from: 2005-04-27 Created: 2005-04-27 Last updated: 2010-01-13Bibliographically approved
    4. Radioimmunotherapy with 211 Astatine, using chimeric monoclonal antibody U36 in hed and neck squamous cell carcinoma in vivo
    Open this publication in new window or tab >>Radioimmunotherapy with 211 Astatine, using chimeric monoclonal antibody U36 in hed and neck squamous cell carcinoma in vivo
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    Identifiers
    urn:nbn:se:uu:diva-93173 (URN)
    Available from: 2005-04-27 Created: 2005-04-27 Last updated: 2010-01-13Bibliographically approved
  • 27.
    Counter, S. Allen
    et al.
    Harvard Med Sch, Biol Labs, Dept Neurol, 16 Divin Ave, Cambridge, MA 02138 USA.;Massachusetts Gen Hosp, Dept Neurophysiol, Boston, MA 02114 USA..
    Buchanan, Leo H.
    Harvard Univ Hlth Serv, Audiol Clin, Dept Otolaryngol, Cambridge, MA USA..
    Ortega, Fernando
    Univ San Francisco Quito, Galapagos Inst Arts & Sci GAIAS, Colegio Ciencias Salud, Escuela Salud Publ, Quito, Ecuador..
    Jacobs, Anthony B.
    Harvard Biol Labs, Cambridge, MA USA..
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Assessment of the Brainstem- Mediated Stapedius Muscle Reflex in Andean Children Living at High Altitudes2017In: High Altitude Medicine & Biology, ISSN 1527-0297, E-ISSN 1557-8682, Vol. 18, no 1, 37-45 p.Article in journal (Refereed)
    Abstract [en]

    This study examined the physiological thresholds, amplitude growth, and contraction duration of the acoustic stapedius reflex (ASR) in Andean children aged 2-17 years living at altitudes of 2850m (Altitude I Group) and 3973m (Altitude II Group) as part of a general medical assessment of the health status of the children. The brainstem-mediated ASR reveals the integrity of the neuronal components of the auditory reflex arc, including the cochlea receptors, eight cranial nerves, and brainstem neural projections to the cochlear nuclei, bilateral superior olivary nuclei, facial nerve nuclei, and facial nerve and its stapedius branch. Uncrossed (ipsilateral) and crossed (contralateral) ASR thresholds (ASRT), ASR amplitude growth (ASRG) function, and ASR muscle contraction duration (decay/ fatigue) (ASRD) were measured noninvasively with 500, 1000 Hz and broadband (bandwidth = 125-4000 Hz) noise stimulus activators using a middle ear immittance system. Oxygen saturation (SaO(2)) level and heart rate were measured in a subsample of the study group. Statistical analyses revealed that the Altitude I and Altitude II groups had ASRT, ASRG function, and ASRD rates comparable to children at sea level and that the two groups were not significantly different for any of the ASR measures. No significant association was found between SaO(2) or heart rate and ASRT, growth, and muscle fatigue rate. In conclusion, the assessment of the ASR in children in the high-altitude groups revealed normal function. Furthermore, the results indicate no adverse oto-physiological effects of altitude on the brainstem-mediated ASR at elevations between 2850 and 4000m and suggest normal middle ear and auditory brainstem function.

  • 28. Counter, S Allen
    et al.
    Damberg, Peter
    Aski, Sahar Nikkhou
    Nagy, Kálmán
    Berglin, Cecilia Engmér
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Experimental Fusion of Contrast Enhanced High-Field Magnetic Resonance Imaging and High-Resolution Micro-Computed Tomography in Imaging the Mouse Inner Ear2015In: The Open Neuroimaging Journal, ISSN 1874-4400, E-ISSN 1874-4400, Vol. 9, 7-12 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Imaging cochlear, vestibular, and 8th cranial nerve abnormalities remains a challenge. In this study, the membranous and osseous labyrinths of the wild type mouse inner ear were examined using volumetric data from ultra high-field magnetic resonance imaging (MRI) with gadolinium contrast at 9.4 Tesla and high-resolution micro-computed tomography (µCT) to visualize the scalae and vestibular apparatus, and to establish imaging protocols and parameters for comparative analysis of the normal and mutant mouse inner ear.

    METHODS: For in vivo MRI acquisition, animals were placed in a Milleped coil situated in the isocenter of a horizontal 9.4 T Varian magnet. For µCT examination, cone beam scans were performed ex vivo following MRI using the µCT component of a nanoScan PET/CT in vivo scanner.

    RESULTS: The fusion of Gd enhanced high field MRI and high-resolution µCT scans revealed the dynamic membranous labyrinth of the perilymphatic fluid filled scala tympani and scala vestibule of the cochlea, and semicircular canals of the vestibular apparatus, within the µCT visualized contours of the contiguous osseous labyrinth. The ex vivo µCT segmentation revealed the surface contours and structural morphology of each cochlea turn and the semicircular canals in 3 planes.

    CONCLUSIONS: The fusion of ultra high-field MRI and high-resolution µCT imaging techniques were complementary, and provided high-resolution dynamic and static visualization of the complex morphological features of the normal mouse inner ear structures, which may offer a valuable approach for the investigation of cochlear and vestibular abnormalities that are associated with birth defects related to genetic inner ear disorders in humans.

  • 29. Dammeyer, Pascal
    et al.
    Hellberg, Victoria
    Wallin, Inger
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Shoshan, Maria
    Ehrsson, Hans
    Arner, Elias S. J.
    Kirkegaard, Mette
    Cisplatin and oxaliplatin are toxic to cochlear outer hair cells and both target thioredoxin reductase in organ of Corti cultures2014In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 134, no 5, 448-454 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: Inhibition of thioredoxin reductase (TrxR) may be a contributing factor in cisplatin- induced ototoxicity. Direct exposure of organ of Corti to cisplatin and oxaliplatin gives equal loss of hair cells. Objectives: Platinum- containing drugs are known to target the anti- oxidant selenoprotein TrxR in cancer cells. Two such anti- cancer, platinum- containing drugs, cisplatin and oxaliplatin, have different side effects. Only cisplatin induces hearing loss, i.e. has an ototoxic side effect that is not seen after treatment with oxaliplatin. The objective of this study was to evaluate if TrxR is a target in the cochlea. Loss of outer hair cells was also compared when cisplatin and oxaliplatin were administered directly to the organ of Corti. Methods: Organ of Corti cell culture was used for direct exposure to cisplatin and oxaliplatin. Hair cells were evaluated and the level of TrxR was assessed. Immunohistochemical staining for TrxR was performed. An animal model was used to evaluate the effect on TrxR after treatment with cisplatin and oxaliplatin in vivo. Results: Direct exposure of cochlear organotypic cultures to either cisplatin or oxaliplatin induced comparable levels of outer hair cell loss and inhibition of TrxR, demonstrating that both drugs are similarly ototoxic provided that the cochlea becomes directly exposed.

  • 30.
    Edin, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Liu, Wei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Boström, Marja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Magnusson, Peetra U.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Differentiation of human neural progenitor cell-derived spiral ganglion-like neurons: a time-lapse video study2014In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 5, 441-447 p.Article in journal (Refereed)
    Abstract [en]

    Conclusions: Human neural progenitor cells can differentiate into spiral ganglion-like cells when exposed to inner ear-associated growth factors. The phenotype bears resemblance to human sphere-derived neurons. Objective: To establish an in vitro model for the human auditory nerve to replace and complement in vivo animal experiments and ultimately human in vivo transplantation. Methods: Human neural progenitors were differentiated under conditions developed for in vitro survival of human primary spiral ganglion culture with media containing growth factors associated with inner ear development. Differentiation was documented using time-lapse video microscopy. Time-dependent marker expression was evaluated using immunocytochemistry with fluorescence and laser confocal microscopy. Results: Within 14 days of differentiation, neural progenitors adopted neural phenotype and expressed spiral ganglion-associated markers.

  • 31.
    Edin, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Liu, Wei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Li, Hao
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Atturo, Francesca
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Magnusson, Peetra U
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    3-D gel culture and time-lapse video microscopy of the human vestibular nerve2014In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 12, 1211-1218 p.Article in journal (Refereed)
    Abstract [en]

    UNLABELLED: Abstract Conclusions: Human inner ear neurons have an innate regenerative capacity and can be cultured in vitro in a 3-D gel. The culture technique is valuable for experimental investigations of human inner ear neuron signaling and regeneration.

    OBJECTIVES: To establish a new in vitro model to study human inner ear nerve signaling and regeneration.

    METHODS: Human superior vestibular ganglion (SVG) was harvested during translabyrinthine surgery for removal of vestibular schwannoma. After dissection tissue explants were embedded and cultured in a laminin-based 3-D matrix (Matrigel™). 3-D growth cone (GC) expansion was analyzed using time-lapse video microscopy (TLVM). Neural marker expression was appraised using immunocytochemistry with fluorescence and laser confocal microscopy.

    RESULTS: Tissue explants from adult human SVG could be cultured in 3-D in a gel, indicating an innate potential for regeneration. Cultured GCs were found to expand dynamically in the gel. Growth cone expansion and axonal Schwann cell alignment were documented using TLVM. Neurons were identified morphologically and through immunohistochemical staining.

  • 32.
    Ehnhage, Anders
    et al.
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Johnsson, Pernilla Sahlstrand
    Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lund, Sweden.;Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Malmo, Sweden..
    Ahlström-Emanuelsson, Cecilia
    Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lund, Sweden.;Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Malmo, Sweden..
    Andersson, Morgan
    Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lund, Sweden.;Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Malmo, Sweden..
    Knutsson, Johan
    Vastmanland Hosp, Clin Res Ctr, Dept Otorhinolaryngol, Vasteras, Sweden..
    Lien, Jacob
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Norlander, Tomas
    Aleris Sabbatsbergs Hosp, Stockholm, Sweden..
    Olsson, Petter
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Friis-Liby, Jan-Eric
    Friis Liby & Ronndahl ENT Practice, Gothenburg, Sweden..
    Holmstrom, Mats
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Treatment of idiopathic rhinitis with kinetic oscillations - a multi-centre randomized controlled study2016In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 8, 852-859 p.Article in journal (Refereed)
    Abstract [en]

    Conclusions: The potential effects of KOS are still uncertain regarding the most effective air pressure to be used as well as the physiological effects on the nasal mucosa. The results of the study do not support a convincing treatment effect by KOS on IR. Objectives: Idiopathic rhinitis (IR) is a common disorder, affecting approximate to 10-20% of the population. A new method for treating IR, Kinetic Oscillation Stimulation (KOS), has been reported to have beneficial effects on total vasomotor symptom scores (TVRSS). The primary objective with this study was to evaluate if a mean pressure of 65 mbar, pressure amplitude of 100 mbar, and 68Hz treatment with KOS had a positive effect on total vasomotor symptom scores (TVRSS), as compared with a mean pressure of 65 mbar, pressure amplitude of 4 mbar, and 68Hz treatment in patients with idiopathic rhinitis. Methods: Two hundred and seven patients were randomized (Full Analysis Set, FAS) in the study, including five visits and lasting for approximate to 25 weeks. All patients had two treatment episodes, and all patients had at least one treatment, meant as active, with high amplitude pressure for 10min in each nostril. Group 1 had two such treatments, and Group 2 had one treatment with low amplitude pressure, initially meant as placebo, on one occasion. Because of numerical improvements in these two groups, a new control group, Group 3, was introduced. They had one new control treatment where the balloon was inserted into the nose, without any air inflation and without oscillations. Results: KOS treatment with high amplitude pressure did not have significant beneficial effects as compared to low amplitude pressure on TVRSS. Numerical improvements in TVRSS and SNOT 22 were found when comparing high and low amplitude pressure treatments with uninflated balloon treatment. However, this part of the study was initially single-blinded, and these results were secondary objectives.

  • 33.
    Ek, Tom
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Does training with the PhonicStick improve phonological awareness?: A meta study including one new pilot study2011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The PhonicStick is a joystick which has been developed as a communicative device to be used by people with severe physical disabilities. During the developmental phase the possibility of using this device in order to train the phonological awareness of 6 – 8 year old children was examined. The studies conducted did not show any statistical difference in phonological awareness when this was tested with current tests after the children had trained with the PhonicStick. One explanation for this could be that the children had already begun to read and write in school. Therefore, a part of the present study was aimed at investigating if a difference in results on the norm referenced tests could be obtained if the children were 4-5 years old instead of 6-8. Parts of a norm referenced test for phonological awareness and an adapted test material for the PhonicStick were used for this evaluation. The 10 examined children were equally divided into a test and a control group.In addition, a meta study was performed, where all the studies relevant to phonological awareness and the PhonicStick were evaluated. Data from these studies were summarized, and processed statistically. Only two statistically significant (p<0.05) differences could be shown after the training with the PhonicStick: both the test group and the control group obtained better results in the posttest in the test of “phoneme identification” and the test group performed better at the test “word production” then the control group. A possible interpretation of the results could be that there might be an intuitive phonological awareness that can not be tested with the current tests for phonological awareness.

  • 34.
    Eklinder, Jeanette
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Svensson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Reparationer i AKK-samtal med Tellusdator: En samtalsanalytisk fallstudie om hur ett barn löser kommunikativa problem i interaktion med sin omgivning2009Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The main purpose of this study is to describe how a child, who uses a computer based graphical communication aid (Tellus), with the help of repairs resolves local communi­cative problems in cooperation with people in the immediate surroundings. The child has been videotaped in natural occurring activities – school and home. Conversation Analysis (CA) has been used as a method. The results show that repairs are a set of re­sources for the participants to, among other things, create mutual understanding by clarifying ambiguities and misunderstandings in the talk. The sequences of repair are often long, and lead to inserted sequences in the talk, but have an important interac­tional meaning in achieving mutual understanding. The analysis also shows that the computer based AAC is multimodal, despite the fact that the computer is the user’s pri­mary technical communication aid. For example, signs, gestures and sounds are used to indicate errors and to display emotion. The activity and the placement of the computer also affect the interaction. In school the computer is more often used as a traditional communication map. This is largely due to the fact that the communication partner is positioned in such a way that what the child is doing with the computer becomes visible to both of them. Presently, research that illustrates repair in these kinds or AAC conver­sations is sparse. This study will hopefully create interest for continuing research that, with an interactional approach, identifies and describes functional communicative prac­tices in AAC conversations.

  • 35.
    Elinder, Karolina
    et al.
    Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden..
    Soderman, Anne-Charlotte Hessen
    Karolinska Inst, Div Clin Sci Intervent & Technol, Dept Otorhinolaryngol Aleris Sabbatsberg, Stockholm, Sweden..
    Stalfors, Joacim
    Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Otorhinolaryngol, Gothenburg, Sweden.;Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Gothenburg, Sweden..
    Knutsson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden..
    Factors influencing morbidity after paediatric tonsillectomy: a study of 18,712 patients in the National Tonsil Surgery Register in Sweden2016In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 273, no 8, 2249-2256 p.Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to examine factors affecting morbidity after tonsillectomy in children. Data from the National Tonsil Surgery Register in Sweden on 18,712 patients who underwent tonsillectomy with or without simultaneous adenoidectomy between 1 and 18 years of age were analysed. This register includes data on sex, gender, surgical indication, and the surgical and haemostasis techniques used for each patient, as well as patient-reported outcomes for haemorrhage, analgesic use and antibiotic use. Comparison of patients who underwent surgery for infection versus upper airway obstruction revealed a significant increase in haemorrhage complications in the infection group. However, no significant difference remained after the adjustments for confounders in multivariable regression analysis. Instead, the increased risk among patients who underwent surgery for infection was mainly attributable to the use of bipolar diathermy and increased patient age. Patients who received surgery for infection reported more days of analgesic use, as well as more unplanned contacts with a health care service provider due to pain, compared with those who underwent surgery for upper airway obstruction. These results remained significant in multivariate analysis. The use of bipolar diathermy for haemostasis resulted in an increased risk, while the use of cold steel surgical instruments, a younger patient age and female sex led to a decreased risk. The surgical and haemostasis techniques used are the most important factors that affect morbidity after tonsillectomy in the paediatric age group. The choice of surgical techniques is of utmost importance for decreasing morbidity in these patients.

  • 36.
    Eriksson, Ann-Sofie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Bremer Zerpe, Linnéa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Logopedi i Öppna Vårdformer: utvärdering av pågående projekt2008Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In Uppsala, patients in long-term care with geriatric communication and swallowing disorders have not generally received services from speech-language pathologists. To remedy the need for intervention in this group a trial project was initiated in 2007. Its aim was to estimate the need for continued intervention in long-term care and to develop effective working strategies for the speech-language pathologists. The target group was persons above 65 years old with eating and/or communication disabilities caused by stroke or progressive cognitive/neurologic disorders. The purpose of this study was to evaluate the project at its half-way point. The working processes were analyzed based on documentation from the project. Statistical analyses were conducted on ratings and objective measures of the patients’ eating and communication abilities. Finally, relatives of eight of the patients were interviewed to see how the project had affected them. The results indicate a need for intervention by speech-language pathologists for patients in long-term care. It is also necessary to inform patients, relatives and employees at care centers about how speech-language pathologists can help. Both communication and swallowing improved after interventions by speech-language pathologists. The interviews also indicate that speech-language pathologists have little impact on the relatives. A future study should assess how the project has affected the employees at care centers.

  • 37.
    Erixon, Elsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Hearing Preservation CI Surgery and Hybrid Hearing: From Anatomical Aspects to Patient Satisfaction2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A common cause of profound deafness is hair cell dysfunction in the cochlea. Cochlear implants (CI) bypass the hair cells via an electrode and stimulate the cochlear nerve directly. Nowadays, it is possible to preserve residual hair cell function and hearing through flexible electrodes and a-traumatic CI surgery techniques; called hearing preservation CI surgery. This may suit partially deaf patients who can use natural low frequency hearing in combination with electric high frequency hearing; so-called hybrid hearing. The aim of this thesis was to elucidate the effectiveness of hearing preservation CI surgery. The thesis demonstrates human cochlear anatomy in relation to CI and evaluates hearing and patient satisfaction after hearing preservation CI surgery.

    Analyses of human cochlear moulds belonging to the Uppsala collection showed large variations in dimensions and coiling characteristics of the cochlea. Each cochlea was individually shaped. The size and shape of the cochlea influences the position of the electrode. The diameter of the basal cochlear turn could predict insertion depth of the electrode, which is crucial for hearing preservation. The first 21 patients operated with hearing preservation CI surgery in Uppsala, showed preserved hearing.

    Nine-teen partially deaf patients receiving implants intended for hybrid hearing, were evaluated concerning pure tone audiometry, monosyllables (MS) and hearing in noise test (HINT). They also responded to a questionnaire, consisting of the IOI-HA, EQ-5D VAS and nine questions about residual hearing. The questionnaire results indicated a high degree of patient satisfaction with improved speech perception in silence and noise. This was also reflected by improved results in MS and HINT. Hearing was preserved in all patients, but there was an on-going deterioration of the residual hearing in the operated ear which surpassed the contralateral ear. There were no correlations between the amount of residual hearing and patient satisfaction or speech perception results. Electric stimulation provides a major contribution to speech comprehension in partially deaf patients. All the patients showed a high degree of satisfaction with their CI, regardless of varying hearing preservation.

    List of papers
    1. Variational anatomy of the human cochlea: implications for cochlear implantation
    Open this publication in new window or tab >>Variational anatomy of the human cochlea: implications for cochlear implantation
    2009 (English)In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 30, no 1, 14-22 p.Article in journal (Refereed) Published
    Abstract [en]

    HYPOTHESIS: To study variations in human cochlea anatomy with potential implications for cochlear implantation surgery. BACKGROUND: A comprehension of the anatomic variations of the human cochlea is essential for understanding the degree of surgical trauma induced by inserting various electrode arrays in cochlear implantation surgery. Variations in anatomy may also limit the potential for performing hearing preservation. METHODS: We studied 73 archival, nonselected, adult, corrosion casts of human inner ears. Anatomic reference points were constructed from photographic reproductions taken at different angles, and various dimensions were assessed using planimetry. Anatomic variants with particular clinical/surgical interests were pinpointed. RESULTS: Results showed that the human cochlea is individually shaped, varying greatly in dimensions ("fingerprint"). The outer cochlear wall length ranged from 38.6 to 45.6 mm with a mean length of 42.0 mm. The first turn represented 53% of the total length and ranged from 20.3 to 24.3 mm. The number of quadrants varied from slightly more than 8 to 12. The facial nerve canal ran in close proximity to the upper first turn explaining facial nerve excitement during stimulation of electrodes in this region in some instances. The internal diameter (height) of the cochlear tube in the first turn varied broadly (1.6-2.6 mm), occasionally with limited space for conventional implants. CONCLUSION: The human cochlea exhibits extensive anatomic variations. These variations will influence the location of cochlear implant arrays and affect the potential of hearing preservation surgery. Our results may explain the surgeon's difficulties sometimes to insert electrode arrays even in so-called "normal" cochleae.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-113210 (URN)10.1097/MAO.0b013e31818a08e8 (DOI)000276925300003 ()18833017 (PubMedID)
    Available from: 2010-01-26 Created: 2010-01-26 Last updated: 2014-06-30Bibliographically approved
    2. How to predict cochlear length before cochlear implantation surgery
    Open this publication in new window or tab >>How to predict cochlear length before cochlear implantation surgery
    2013 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 133, no 12, 1258-1265 p.Article in journal (Refereed) Published
    Abstract [en]

    Conclusions: The basal turn diameter of the human cochlea predicts the outer wall length of the basal and two first turns relatively well but there was less correlation for the total cochlear length. The linear regression graph defines the length of the basal turn within an error of +/- 1 mm and could be used clinically to distinguish small and large cochleae. Objective: The human cochlea varies in size. The preoperative assessment of cochlear length can be crucial for non-traumatic electrode insertion and hearing preservation. In this study, we estimated the external cochlear wall length by assessing the basal turn diameter. Methods: A total of 51 non-selected, human inner ear moulds were analysed. A line was drawn from the midpoint of the round window through the cochlear mid-portion to the opposite side (A) and correlated to the cochlear turn lengths. Linear regression analyses were carried out. Results: Mean diameter A was 9.3 mm. The mean basal turn length was 22.8 mm, the two first turns were 35.1 mm and the total length was 41.2 mm. Linear regression analyses indicated a coefficient of determination (R-2) of 0.74 for diameter A and the basal turn length, R-2 = 0.70 for the two-turn length and R-2 = 0.39 for the total length.

    Keyword
    Human cochlea, electro-acoustic-stimulation, EAS, partial deafness, cochlear implant, hearing preservation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-213453 (URN)10.3109/00016489.2013.831475 (DOI)000327419700004 ()
    Available from: 2013-12-30 Created: 2013-12-23 Last updated: 2014-06-30Bibliographically approved
    3. Cochlear implantation and hearing preservation: results in 21 consecutively operated patients using the round window approach
    Open this publication in new window or tab >>Cochlear implantation and hearing preservation: results in 21 consecutively operated patients using the round window approach
    2012 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 132, no 9, 923-931 p.Article in journal (Refereed) Published
    Abstract [en]

    Conclusion:

    Prevalent hearing conservation may be achieved after round window (RW) cochlear implantation using soft and flexible electrode arrays if variations of RW anatomy, topography, and facial nerve position are considered. The most favorable electrode insertion depth remains to be established.

    Objectives:

    We assessed the incidence of cochlear function after cochlear implant (CI) electrode insertion through the RW in our first 21 consecutively operated patients aimed at hearing conservation.

    Methods:

    Eleven patients had a preoperative low frequency hearing suitable for electro-acoustic stimulation. Hearing was preserved in an additional nine patients at their request with the intention to use full frequency CI stimulation. Anatomic variations of the RW were carefully considered using our temporal bone collection of micro-dissected ears. Electrode extension was assessed on X-ray by measuring the insertion angle of the first electrode and intra-cochlear length and correlated with audiometric data.

    Results:

    There was no incidence of total loss of residual hearing in any of the patients. A slight deterioration of low frequency thresholds occurred in some patients. Mean hearing loss at 125-500 Hz was 14.4 dB at 1 month following surgery and 15.6 dB after 1 year. Insertion angle (300-540°) and depth (17.5-28.5 mm) were not statistically correlated to hearing loss.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-181696 (URN)10.3109/00016489.2012.680198 (DOI)000307995600003 ()22667762 (PubMedID)
    Available from: 2012-09-27 Created: 2012-09-27 Last updated: 2014-06-30Bibliographically approved
    4. Hearing and patient satisfaction in 19 patients receiving implants intended for hybrid hearing: A two-year follow-up
    Open this publication in new window or tab >>Hearing and patient satisfaction in 19 patients receiving implants intended for hybrid hearing: A two-year follow-up
    (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186Article in journal (Refereed) Accepted
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-221532 (URN)
    Available from: 2014-04-01 Created: 2014-04-01 Last updated: 2014-09-17Bibliographically approved
  • 38.
    Erixon, Elsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Hearing and Patient Satisfaction Among 19 Patients Who Received Implants Intended for Hybrid Hearing: A Two-Year Follow-Up2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 5, E271-E278 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: To measure patient satisfaction and correlate to hearing results in partially deaf patients, after hearing preservation cochlear implant surgery with hybrid hearing strategy, and to evaluate the stability of residual low-frequency hearing (LFH) over time. Design: A patient satisfaction survey and a retrospective, 2-year follow-up journal study. Nineteen partially deaf patients intended for hybrid hearing responded to a questionnaire when they had used their cochlear implants for at least a year. The questionnaire consisted of the International Outcome Inventory for Hearing Aids, EuroQol Group visual analogue scale and nine questions about hybrid hearing. Pure-tone audiometry, monosyllables, and hearing in noise test results from the patients' medical records were evaluated and compared with the results from the patient satisfaction survey. Results: All of the patients were satisfied with their CIs. The mean International Outcome Inventory for Hearing Aids score was 29. The CIs provided a major contribution to the speech comprehension of these partially deaf patients. Two years after surgery, the patients' mean binaural score on tests of monosyllables was 58%, and the mean signal to noise ratio was 4.6 dB. We observed ongoing deteriorations in the residual hearing of the operated ears that surpassed the deteriorations observed in the contralateral ears. One month after surgery, the LFH loss (125-500 Hz) was 17 dB, and after 2 years, this loss was 24 dB compared with 5 dB in the nonoperated ear. There were no significant correlations between preserved LFH and patient satisfaction or speech perception results. Conclusions: Electric stimulation provided a major contribution to speech comprehension of partially deaf patients. The gain reached in speech understanding widely exceeded the downside in losing some residual hearing. All the patients showed a high degree of satisfaction with their CIs regardless of varying hearing preservation.

  • 39.
    Farnebo, Lovisa
    et al.
    Linkoping Univ, Dept Otorhinolaryngol, Dept Clin & Expt Med, SE-58185 Linkoping, Sweden..
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Makitie, Antti
    Univ Helsinki, Dept Otorhinolaryngol, Helsinki, Finland.;Helsinki Univ Hosp, Helsinki, Finland.;Karolinska Inst, Div Ear Nose & Throat Dis, Dept Clin Sci Intervent & Technol, Karolinska Univ Hosp, Stockholm, Sweden..
    A Nordic survey on the management of head and neck CUP2016In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 11, 1159-1163 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: The management of Head and Neck Cancer of Unknown Primary (HNCUP) patients varies both between centres within and also between the Nordic countries. This study contributes to a continuing discussion of how to improve the accuracy of diagnosis and quality of treatment of HNCUP patients.Objectives: The initiative for this study was based on the lack of common guidelines for diagnostic procedures and for treatment of HNCUP patients in the Nordic countries constituting a region having a rather homogeneous population.Method: A structured questionnaire was sent to all university hospitals in the five Nordic countries.Results: Four of the five Nordic countries use either national guidelines or specific protocols when handling HNCUP. The main diagnostic tools are PET-CT, fine needle aspiration, endoscopic evaluation with biopsies, and most often bilateral tonsillectomy. At 21 of 22 university hospitals the treatment decision is made at a multidisciplinary conference. Three of seven Swedish centres use only radiotherapy or chemoradiotherapy to treat N+ HNCUP patients. Robotic surgery for biopsy of the tongue base is beginning to become an alternative to targeted biopsies in Sweden and Finland. Narrow Band Imaging is used only in Finland.

  • 40.
    Farnebo, Lovisa
    et al.
    Linkoping Univ, Dept Clin & Expt Med, Dept Otorhinolaryngol, Linkoping, Sweden..
    Malila, Nea
    Finnish Canc Registry, FIN-00170 Helsinki, Finland..
    Makitie, Antti
    Karolinska Inst, Div Ear Nose & Throat Dis Intervent & Technol, Dept Clin Sci, Stockholm, Sweden.;Karolinska Hosp, S-10401 Stockholm, Sweden.;Univ Helsinki, Dept Otorhinolaryngol Head & Neck Surg, Helsinki, Finland.;Helsinki Univ Hosp, FI-00029 Helsinki, Hus, Finland..
    Laurell, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Early death among head and neck cancer patients2016In: Current Opinion in Otolaryngology & Head and Neck Surgery, ISSN 1068-9508, E-ISSN 1531-6998, Vol. 24, no 2, 115-120 p.Article, review/survey (Refereed)
    Abstract [en]

    Purpose of reviewManagement of advanced head and neck cancer (HNC) is characterized by high mortality. Furthermore, the treatment involves significant burden to patients and high costs to healthcare systems. Recognizing the risks of early death in patients with a high probability of noncurable disease is important for each individual treatment decision-making. It is thus critical to consider the benefits and side-effects of the planned treatment in relation to the expected survival and to discuss these factors with the patient. However, only few studies have documented early death in HNC patients, that is, during the first posttreatment 6 months. We performed a systematic literature review to find the incidence of this phenomenon and to outline the probable cause.Recent findingsEarly mortality in patients with HNC can be explained either by direct effect of malignant disease, may be related to comorbidities, or secondary to the treatment. These factors act together resulting in expected or unexpected early death.SummaryThe present review provides information on the mechanisms leading to early phase mortality (<6 months) after management of HNC. It also reports the incidence of this phenomenon among Finnish and Swedish patient populations.

  • 41. Frick, Claudia
    et al.
    Müller, Marcus
    Wank, Ute
    Tropitzsch, Anke
    Kramer, Benedikt
    Senn, Pascal
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Wiesmüller, Karl-Heinz
    Löwenheim, Hubert
    Biofunctionalized peptide-based hydrogels provide permissive scaffolds to attract neurite outgrowth from spiral ganglion neurons2017In: Colloids and Surfaces B: Biointerfaces, ISSN 0927-7765, E-ISSN 1873-4367, Vol. 149, 105-114 p.Article in journal (Refereed)
    Abstract [en]

    Cochlear implants (CI) allow for hearing rehabilitation in patients with sensorineural hearing loss or deafness. Restricted CI performance results from the spatial gap between spiral ganglion neurons and the CI, causing current spread that limits spatially restricted stimulation and impairs frequency resolution. This may be substantially improved by guiding peripheral processes of spiral ganglion neurons towards and onto the CI electrode contacts. An injectable, peptide-based hydrogel was developed which may provide a permissive scaffold to facilitate neurite growth towards the CI. To test hydrogel capacity to attract spiral ganglion neurites, neurite outgrowth was quantified in an in vitro model using a custom-designed hydrogel scaffold and PuraMatrix(®). Neurite attachment to native hydrogels is poor, but significantly improved by incorporation of brain-derived neurotrophic factor (BDNF), covalent coupling of the bioactive laminin epitope IKVAV and the incorporation a full length laminin to hydrogel scaffolds. Incorporation of full length laminin protein into a novel custom-designed biofunctionalized hydrogel (IKVAV-GGG-SIINFEKL) allows for neurite outgrowth into the hydrogel scaffold. The study demonstrates that peptide-based hydrogels can be specifically biofunctionalized to provide a permissive scaffold to attract neurite outgrowth from spiral ganglion neurons. Such biomaterials appear suitable to bridge the spatial gap between neurons and the CI.

  • 42.
    Fröman, Charlotta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Henricson, Berit
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Förberedande läpprundning hos personer som stammar: EMG-studier av stamning och flytande tal2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 43.
    Gadeborg, Jennie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Lundgren, Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Hur barn i åldern 4;0-5;11 år presterar på taluppfattningstestet HöraTal: En analys av resultaten från en talperceptions- och entalproduktionsuppgift2008Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Speech perception tests have been developed to receive information about a person’sability to perceive and discriminate between speech sounds. HöraTal Test 1.1 is anextensive analytical computer based speech perception test made for children ages fourand up. The children do not need to be able to read to take the test. The test wasdeveloped for children with hearing disabilities and/or cochlear implants but it can also beused for children with neurological damages, specific language impairments and/or adifferent first language than Swedish. The aim of this study is to receive reference datafrom children of the age 4;0 to 5;11 years with normal hearing and normal speechdevelopment. The study also included a speech production test. The results from theproduction test were compared with the results from the perception test in order to find apossible connection between speech perception difficulties and speech productiondifficulties. 16 four-year-olds and 19 five-year-olds participated in the study. One of theconclusions from this study was that four-year-olds are not able to take the test. The five-year-olds had high mean scores on all the subtests which indicate that a five year old childwith normal hearing should receive high scores on HöraTal Test. This also indicates thatHöraTal Test is suitable for testing speech perception. To be able to generalize to thepopulation more test subjects are needed. No connection between speech perceptiondifficulties and speech production difficulties was found. Only a few of the test subjectshad speech production difficulties in the speech production test and therefore conclusionsabout a possible connection between speech perception difficulties and speech productiondifficulties in the population can not be made.

  • 44. Gao, Chaobing
    et al.
    Li, Xiaohong
    Tong, Busheng
    Wu, Kaile
    Liu, Yehai
    Anniko, Matti
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Duan, Maoli
    Up-regulated expression of Dicer reveals poor prognosis in laryngeal squamous cell carcinoma2014In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 134, no 9, 959-963 p.Article in journal (Refereed)
    Abstract [en]

    Conclusions: Increased expression of Dicer may be a prognostic biomarker for patients with laryngeal squamous cell carcinoma (LSCC). Objectives: Recent studies have shown that many microRNAs (miRNAs) play an important role in the development and progression of human cancers. Dicer, one of the most important enzymes of the miRNA machinery, performs the final step of biogenesis of miRNAs. This study aimed to investigate the impact of Dicer expression on patient survival in human LSCC. Methods: We detected the expression of Dicer in larynx tissue specimens from 76 LSCC samples and 26 polyps by immunohistochemistry. The clinicopathological and prognostic significance of Dicer expression was investigated in LSCC. Results: Our data showed that the expression of Dicer was significantly higher in the LSCC than in the polyp tissue specimens. Moreover, the expression level of Dicer was significantly associated with the pTNM stage and tumor lymph node metastasis. Kaplan-Meier survival analyses revealed a strong association between tumor Dicer expression and the survival of the patients with LSCC.

  • 45.
    Giese, Dina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Carotid Artery Compression Caused by the Cochlea2015In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 36, no 7, 1275-1278 p.Article in journal (Refereed)
    Abstract [en]

    Hypothesis We investigated the possible interference between the human internal carotid artery and the cochlea. Background The cochlea and the internal carotid artery (ICA) are anatomically closely related in the human temporal bone. The intimacy may even result in functional interferences. Methods Here, we analyzed 324 human plastic inner ear corrosion casts including the ICA canal and jugular bulb. Results Results showed that in 23% (14 cases), the cochlea caused physical impression in the carotid canal (CA) with luminal restriction. In one case, there was no separation between the CC and the basal turn of the cochlea. The distance between the CC and the cochlea varied between 0 and 1 mm among these 14 specimens. The lumen restriction of the CC in the pyramid-axial projection varied between 39% and 79%. Conclusion We speculate that the reduction in ICA canal lumen size caused by the cochlea may form a predilection site for intratemporal ICA plaque formation and therefore be clinically relevant.

  • 46. Gisselsson-Solen, Marie
    et al.
    Henriksson, Gunnel
    Hermansson, Ann
    Melhus, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Clinical Bacteriology.
    Effect of pneumococcal conjugate vaccination on nasopharyngeal carriage in children with early onset of acute otitis media - a randomized controlled trial2015In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 135, no 1, 7-13 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: Although children vaccinated with heptavalent pneumococcal conjugate vaccine (PCV) had fewer episodes of acute otitis media (AOM), this trial was unable to prove a simultaneous decrease in nasopharyngeal carriage. Objective: Carriage rates of AOM pathogens in the nasopharynx are high among children, and colonization is the first step towards infection. The possible impact of PCV on carriage is therefore of interest, particularly in children with recurrent AOM. The aims of this study were to examine the effect of heptavalent PCV on carriage of AOM pathogens in children at high risk of developing recurrent disease, and to monitor carriage of resistant pathogens in vaccinated and unvaccinated children. Methods: A total of 109 children with an onset of AOM before 6 months of age, 89 of whom developed recurrent disease, were enrolled in a trial. Fifty-two children were vaccinated and all were closely monitored for 3 years. Results: There was no difference statistically between vaccinated children and controls concerning the carriage of any of the major AOM pathogens. There was evidence of within-child clustering for S. pneumoniae (p = 0.002) and H. influenzae (p < 0.001), indicating that children continued to carry either species over time. Resistance rates were generally low and comparable with national levels.

  • 47. Gisselsson-Solen, Marie
    et al.
    Henriksson, Gunnel
    Hermansson, Ann
    Melhus, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine.
    Risk factors for carriage of AOM pathogens during the first 3 years of life in children with early onset of acute otitis media2014In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 134, no 7, 684-690 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: Risk factors associated with increased carriage rates are the same in children with recurrent acute otitis media (rAOM) as in healthy children. These are also known to be risk factors for the development of AOM itself. Objectives: The aim of this study was to describe risk factors for nasopharyngeal carriage in a cohort of young children at high risk of developing rAOM. Methods: Children with an onset of AOM before 6 months of age, indicating an 80% risk of developing rAOM, were enrolled in a vaccination trial on heptavalent PCV. These children were monitored for 3 years during healthy and AOM periods with nasopharyngeal cultures, physical examinations, and questionnaires. Results: A total of 109 children were included at a mean age of 5 months; 105 were followed for 3 years, 89 (82%) of whom developed rAOM. Risk factors associated with increased carriage of all major AOM pathogens were age < 2 years, concurrent AOM, and fulfilment of rAOM criteria. Having siblings in day care was associated with increased carriage of Streptococcus pneumoniae and Haemophilus influenzae, recent antibiotic treatment was associated with H. influenzae and Moraxella catarrhalis carriage, and winter season was associated with M. catarrhalis carriage alone.

  • 48.
    Gisselsson-Solen, Marie
    et al.
    Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, S-22185 Lund, Sweden..
    Hermansson, Ann
    Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, S-22185 Lund, Sweden..
    Melhus, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infection medicine.
    Individual-level effects of antibiotics on colonizing otitis pathogens in the nasopharynx2016In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 88, 17-21 p.Article in journal (Refereed)
    Abstract [en]

    Background: Although there is evidence of an association between antibiotic consumption and resistant bacteria on a population level, the relationship on an individual level has been less well studied, particularly in terms of nasopharyngeal colonization. We have therefore analysed this association, using data from a closely followed cohort of children taking part in a vaccination trial. Methods: 109 children with early onset of acute otitis media (AOM) were randomised to heptavalent pneumococcal conjugate vaccine (PCV7) or no vaccination. They were followed for three years with scheduled appointments as well as sick visits. Nasopharyngeal cultures were obtained at all visits. Antibiotic treatments were recorded, as were risk factors for AOM, including siblings, short breast-feeding and parental smoking. Data were entered into a Cox regression model, and the findings of Streptococcus pneumoniae and Haemophilus influenzae with reduced susceptibility to the penicillin group were related to the number of previous courses of antibiotics. Results: There was evidence of an association between the amount of previously consumed betalactams and colonization with beta-lactamasenegative ampicillin-resistant (BLNAR) H. influenzae (RR 1.21; 95% CI 1.03-1.43; p = 0.03), and also with the most commonly prescribed drug; amoxicillin (RR 1.39; 95% CI 1.09-1.76; p = 0.01). There was no evidence for an association between antibiotic consumption and betalactamase producing H. influenzae or S. pneumoniae with reduced susceptibility to penicillin. Furthermore, there was no evidence of an association between resistant bacteria and AOM risk factors or PCV7. Conclusion: In this subgroup of children, most of whom were given several courses of antibiotics in early childhood, there was evidence of an association between betalactam/amoxicillin consumption and nasopharyngeal colonization with BLNAR strains, bacteria that have increased in prevalence during the last 10-15 years, and that are notoriously difficult to treat with oral antibiotics.

  • 49. Gisselsson-Solen, Marie
    et al.
    Hermansson, Ann
    Melhus, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine.
    Brodszki, Nicholas
    Immunologic findings in young children with early onset of acute otitis media2014In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 134, no 10, 1022-1028 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: No significant differences in the number of immune aberrations were seen between children with or without severe recurrent acute otitis media (rAOM); however, subnormal values of immunological markers were found more often than expected, and 4 of the 60 children had treatment-requiring immune deficiencies. Objective: Minor immunologic aberrations have been reported to be more frequent in children with rAOM. Immune investigation is recommended in children with severe rAOM, defined as six or more AOM episodes per year. The purpose of this study was to describe immunological findings in young children at high risk of developing rAOM, and to relate these to the number of expected aberrations and to the presence of severe rAOM. Methods: A total of 109 children at risk of developing rAOM were offered immune investigation including complement function, immunoglobulins with subclasses and cellular immunity. Results: Sixty patients were tested, 31 of whom had severe rAOM and 12 of whom did not develop rAOM. Low levels of IgG2 (27%), C1q (31%) and mannan-binding lectin (21%) were found up to eight times as often as expected. Although subnormal values were more frequent among children with severe rAOM, the study was too small to provide reliable evidence of any difference. Four children were diagnosed with immune deficiencies that required treatment.

  • 50.
    Gullberg, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Granholm, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    A PhonicStick Study: Investigating the Effectiveness of a Phonological Awareness Intervention in Children with Down Syndrome.2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Phonological awareness is a set of language manipulation skills such as blending, rhyme, alliteration production and detection. There are disagreements among researchers how phonological awareness is connected to literacy learning and also how and if children with Down syndrome acquire phonological awareness. The specific phenotype of Down syndrome shows deficits in both short term memory and language development. It is therefore of great concern to investigate how children with Down syndrome acquire phonological awareness and later on literacy. The PhonicStick is a joystick that generates speech sounds. In this study, the PhonicStick was used in phonological awareness intervention in children with Down syndrome. It was compared to intervention with Praxis cards – an already existing picture material in Swedish speech and language therapy. The aim of the study was to investigate if children with Down syndrome can improve phonological awareness during a six week period, and if this was the case, was there a difference in effectiveness between the materials. Six children with Down syndrome participated in this cross-over study. The results indicated that some children can acquire phonological awareness during a six week period. However, it was not possible to address the effectiveness to a certain material. The preference among the children to play with PhonicStick, showed that this is a material that motivates the children to participate in intervention. If the PhonicStick is adapted to this population of children with Down syndrome, this material can be used for phonological awareness intervention in children with Down syndrome.

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