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  • 1.
    Diamant, Zuzana
    et al.
    Skane Univ Hosp, Inst Clin Sci, Dept Resp Med & Allergol, Lund, Sweden; Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands; QPS NL, Groningen, Netherlands; Charles Univ Prague, Fac Med 1, Dept Resp Med, Prague, Czech Republic; Thomayer Hosp, Prague, Czech Republic.
    Vijverberg, Susanne
    Univ Amsterdam, Amsterdam UMC, Dept Resp Med, Amsterdam, Netherlands.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Bakirtas, Arzu
    Gazi Univ, Sch Med, Div Pediat Allergy & Asthma, Dept Pediat, Ankara, Turkey.
    Bjermer, Leif
    Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands; QPS NL, Groningen, Netherlands.
    Custovic, Adnan
    Imperial Coll London, Dept Med, Sect Paediat, London, England.
    Dahlen, Sven-Erik
    Karolinska Inst, Inst Environm Med, Expt Asthma & Allergy Res, Stockholm, Sweden.
    Gaga, Mina
    Athens Chest Hosp, Resp Med Dept 7, Athens, Greece; Athens Chest Hosp, Asthma Ctr, Athens, Greece.
    van Wijk, Roy Gerth
    Erasmus MC, Dept Internal Med, Sect Allergol, Rotterdam, Netherlands.
    Del Giacco, Stefano
    Univ Cagliari, Dept Med Sci & Publ Hlth, Cagliari, Italy.
    Hamelmann, Eckard
    Protestant Hosp Bethel, Childrens Ctr, Bielefeld, Germany; Ruhr Univ Bochum, Allergy Ctr, Bochum, Germany.
    Heaney, Liam G.
    Queens Univ Belfast, Sch Med Dent & Biomed Sci, Ctr Expt Med, Belfast, Antrim, North Ireland.
    Heffler, Enrico
    Humanitas Univ, Dept Biomed Sci, Milan, Italy; Humanitas Res Hosp, Personalized Med Asthma & Allergy, Milan, Italy.
    Kalayci, Omer
    Hacettepe Univ, Fac Med, Div Pediat Allergy, Ankara, Turkey.
    Kostikas, Konstantinos
    Univ Ioannina, Med Sch, Resp Med Dept, Ioannina, Greece.
    Lutter, Rene
    Univ Amsterdam, Amsterdam UMC, Dept Resp Med, Amsterdam, Netherlands.
    Olin, Anna-Carin
    Univ Gothenburg, Sahlgrenska Acad, Sect Occupat & Environm Med, Gothenburg, Sweden.
    Sergejeva, Svetlana
    Univ Tartu, Inst Technol, Tartu, Estonia.
    Simpson, Angela
    Univ Manchester, Manchester Acad Hlth Sci Ctr, Fac Biol Med & Hlth, Div Infect Immun & Resp Med, Manchester, Lancs, England; South Manchester NHS Fdn Trust, Univ Hosp, Manchester, Lancs, England.
    Sterk, Peter J.
    Univ Amsterdam, Amsterdam UMC, Dept Resp Med, Amsterdam, Netherlands.
    Tufvesson, Ellen
    Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands; QPS NL, Groningen, Netherlands.
    Agache, Ioana
    Transylvania Univ Brasov, Fac Med, Dept Allergy & Clin Immunol, Brasov, Romania.
    Seys, Sven F.
    Katholieke Univ Leuven, Dept Microbiol Immunol & Transplantat, Allergy & Clin Immunol Res Grp, Leuven, Belgium.
    Toward clinically applicable biomarkers for asthma: An EAACI position paper2019In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 74, no 10, p. 1835-1851Article in journal (Refereed)
    Abstract [en]

    Inflammation, structural, and functional abnormalities within the airways are key features of asthma. Although these processes are well documented, their expression varies across the heterogeneous spectrum of asthma. Type 2 inflammatory responses are characterized by increased levels of eosinophils, FeNO, and type 2 cytokines in blood and/or airways. Presently, type 2 asthma is the best-defined endotype, typically found in patients with allergic asthma, but surprisingly also in nonallergic patients with (severe) asthma. The etiology of asthma with non-type 2 inflammation is less clear. During the past decade, targeted therapies, including biologicals and small molecules, have been increasingly integrated into treatment strategies of severe asthma. These treatments block specific inflammatory pathways or single mediators. Single or composite biomarkers help to identify patients who will benefit from these treatments. So far, only a few inflammatory biomarkers have been validated for clinical application. The European Academy of Allergy & Clinical Immunology Task Force on Biomarkers in Asthma was initiated to review different biomarker sampling methods and to investigate clinical applicability of new and existing inflammatory biomarkers (point-of-care) to support diagnosis, targeted treatment, and monitoring of severe asthma. Subsequently, we discuss existing and novel targeted therapies for asthma as well as applicable biomarkers.

  • 2.
    Glerup, Mia
    et al.
    Aarhus Univ Hosp, Dept Pediat, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark.
    Thiel, Steffen
    Aarhus Univ, Dept Biomed, Aarhus, Denmark.
    Rypdal, Veronika
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Arnstad, Ellen Dalen
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;Nord Trondelag Hosp Trust, Levanger Hosp, Dept Pediat, Levanger, Norway.
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden.
    Peltoniemi, Suvi
    Univ Helsinki, Helsinki Univ Cent Hosp, New Childrens Hosp, Pediat Res Ctr, Helsinki, Finland.
    Aalto, Kristiina
    Univ Helsinki, Helsinki Univ Cent Hosp, New Childrens Hosp, Pediat Res Ctr, Helsinki, Finland.
    Rygg, Marite
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;St Olavs Hosp, Dept Pediat, Trondheim, Norway.
    Nielsen, Susan
    Copenhagen Univ Hosp, Rigshosp, Dept Pediat, Copenhagen, Denmark.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark.
    Complement lectin pathway protein levels reflect disease activity in juvenile idiopathic arthritis: a longitudinal study of the Nordic JIA cohort2019In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 17, no 1, article id 63Article in journal (Refereed)
    Abstract [en]

    Background

    To determine the serum levels of the lectin pathway proteins early in the disease course and 17 years after disease onset and to correlate the protein levels to markers of disease activity in participants from a population-based Nordic juvenile idiopathic arthritis (JIA) cohort. Additionally, to assess the predictive value of lectin pathway proteins with respect to remission status.

    Methods

    A population-based cohort study of consecutive cases of JIA with a disease onset from 1997 to 2000 from defined geographical areas of Finland, Sweden, Norway and Denmark with 17 years of follow-up was performed. Clinical characteristics were registered and H-ficolin, M-ficolin, MASP-1, MASP-3, MBL and CL-K1 levels in serum were analyzed.

    Results

    In total, 293 patients with JIA were included (mean age 23.7 ± 4.4 years; mean follow-up 17.2 ± 1.7 years). Concentrations of the lectin protein levels in serum were higher at baseline compared to the levels 17 years after disease onset (p ≤ 0.006, n = 164). At baseline, the highest level of M-ficolin was observed in systemic JIA. Further, high M-ficolin levels at baseline and at 17-year follow-up were correlated to high levels of ESR. In contrast, high MASP-1 and MASP-3 tended to correlate to low ESR. CL-K1 showed a negative correlation to JADAS71 at baseline.

    None of the protein levels had prognostic abilities for remission status 17 years after disease onset.

    Conclusion

    We hypothesize that increased serum M-ficolin levels are associated with higher disease activity in JIA and further, the results indicate that MASP-1, MASP-3 and CL-K1 are markers of inflammation.

  • 3.
    Grandahl, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Dalianis, Tina
    Karolinska Inst, Karolinska Univ Hosp, Dept Oncol Pathol, Stockholm, Sweden.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Stenhammar, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    ‘I also want to be vaccinated!’ – adolescent boys’ awareness and thoughts, perceived benefits, information sources, and intention to be vaccinated against Human papillomavirus (HPV)2019In: Human Vaccines & Immunotherapeutics, ISSN 2164-5515, E-ISSN 2164-554X, Vol. 15, no 7-8, p. 1794-1802Article in journal (Refereed)
    Abstract [en]

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

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

  • 4.
    Jönson Ring, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research. Reg Uppsala Cty, Publ Dent Serv, Dept Orthodont, Uppsala, Sweden.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Markström, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Magnuson, Anders
    Orebro Univ, Sch Med Sci, Clin Epidemiol & Biostat, Orebro, Sweden.
    Bazargani, Farhan
    Region Orebro Cty, Publ Dent Serv, Dept Orthodont, Postgrad Dent Educ Ctr, Orebro, Sweden;Orebro Univ, Sch Hlth & Med Sci, Orebro, Sweden.
    Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial2020In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 90, no 1, p. 31-38Article in journal (Refereed)
    Abstract [en]

    Objective:

    To investigate whether rapid maxillary expansion (RME) is a useful treatment method for nocturnal enuresis (NE) and whether the treatment effect is due to placebo. The study also aimed to identify prognostic variables in patients responding to treatment.

    Materials and Methods:

    Thirty-eight children with therapy-resistant NE were recruited and randomized into two groups: the intervention group or placebo group. Both groups were treated with RME, but the placebo group received treatment with a sham appliance for 2 weeks before having the actual treatment. A medical history focused on micturition habits, previous treatment, heredity, and sleep disorders was taken. Daytime voided volumes and nocturnal urine production during wet nights were recorded before the intervention.

    Results:

    Of the 38 patients recruited, two dropped out as one patient was unable to take dental impressions and one refused to have the appliance fitted. There was a statistically significant reduction of wet nights after the RME treatment (P<.001). No significant reduction was found after the placebo treatment (P<.40). Eleven patients (35%) had their enuresis frequency reduced by >50%. Large voiding volume and a wide maxilla at baseline had a strong association with positive treatment outcome.

    Conclusions:

    RME has a modest effect on children with therapy-resistant NE. The treatment outcome does not seem to be due to a placebo effect of the appliance. A wide maxillary width and large voiding volume at baseline seem to be positive predictors regarding response to treatment.

  • 5.
    Lundström, Elin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Ljungberg, Joy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Andersson, Jonathan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Manell, Hannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Strand, Robin
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Forslund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Bergsten, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Weghuber, Daniel
    Mörwald, Katharina
    Zsoldos, Fanni
    Widhalm, Kurt
    Meissnitzer, Matthias
    Ahlström, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Antaros Medical.
    Kullberg, Joel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Antaros Medical.
    Brown adipose tissue estimated with the magnetic resonance imaging fat fraction is associated with glucose metabolism in adolescents2019In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 14, no 9, article id e12531Article in journal (Refereed)
    Abstract [en]

    Background

    Despite therapeutic potential against obesity and diabetes, the associations of brown adipose tissue (BAT) with glucose metabolism in young humans are relatively unexplored.

    Objectives

    To investigate possible associations between magnetic resonance imaging (MRI) estimates of BAT and glucose metabolism, whilst considering sex, age, and adiposity, in adolescents with normal and overweight/obese phenotypes.

    Methods

    In 143 subjects (10‐20 years), MRI estimates of BAT were assessed as cervical‐supraclavicular adipose tissue (sBAT) fat fraction (FF) and T*2 from water‐fat MRI. FF and T*2 of neighbouring subcutaneous adipose tissue (SAT) were also assessed. Adiposity was estimated with a standardized body mass index, the waist‐to‐height ratio, and abdominal visceral and subcutaneous adipose tissue volumes. Glucose metabolism was represented by the 2h plasma glucose concentration, the Matsuda index, the homeostatic model assessment of insulin resistance, and the oral disposition index; obtained from oral glucose tolerance tests.

    Results

    sBAT FF and T*2 correlated positively with adiposity before and after adjustment for sex and age. sBAT FF, but not T*2, correlated with 2h glucose and Matsuda index, also after adjustment for sex, age, and adiposity. The association with 2h glucose persisted after additional adjustment for SAT FF.

    Conclusions

    The association between sBAT FF and 2h glucose, observed independently of sex, age, adiposity, and SAT FF, indicates a role for BAT in glucose metabolism, which potentially could influence the risk of developing diabetes. The lacking association with sBAT T*2 might be due to FF being a superior biomarker for BAT and/or to methodological limitations in the T*2 quantification.

  • 6.
    Mogensen, Ida
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Jacinto, Tiago
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Fonseca, João A.
    Jansson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Inflammatory patterns in fixed airflow obstruction are dependent on the presence of asthmaManuscript (preprint) (Other (popular science, discussion, etc.))
    Abstract [en]

    Background: Fixed airflow obstruction (FAO) can complicate asthma. Inflammation is a proposed underlying mechanism. The aim with this cross-sectional study was to evaluate the blood leucocyte pattern and level of exhaled nitric oxide in asthmatics and non-asthmatics with or without FAO.

    Methods: A total of 11,579 individuals aged ≥20 years from the US National Health and Nutrition Examination Survey were included. They were grouped as: controls without asthma and FAO (n=9,935), asthmatics without FAO (n=674), asthmatics with FAO (n=180) and non-asthmatics with FAO (n=790). FAO was defined as post-bronchodilator FEV1/FVC < lower limit of normal. Exhaled nitric oxide ≥ 25ppb, blood eosinophil levels ≥300 cells/μL, and blood neutrophil levels ≥5100 cells/μL were defined as elevated.

    Results: Elevated blood eosinophil levels were more common in all groups compared to the controls, and the group with asthma and fixed airflow obstruction had the highest prevalence of all groups (p<0.01). In a multiple logistic regression model adjusted for potential confounders including smoking, the asthma groups had significantly higher odds ratios for elevated B-Eos levels compared to the control group (odds ratio 1.4, (confidence interval: 1.1-1.7) for the asthma group without fixed airflow obstruction and 2.5 (1.4-4.2) for the asthma group with fixed airflow obstruction). The group with fixed airflow obstruction without asthma had higher odds ratio for elevated blood neutrophil levels compared to the controls: 1.4 (1.1-1.8).

    Conclusion: Fixed airflow obstruction in asthma was associated with elevated blood eosinophil levels, whereas fixed airflow obstruction without asthma was associated with elevated blood neutrophil levels.

  • 7.
    Nayeb, Laleh
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Lagerberg, Dagmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Westerlund, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Eriksson, Mårten
    Univ Gavle, Fac Hlth & Occupat Studies, Dept Social Work & Psychol, Gavle, Sweden.
    Modifying a language screening tool for three-year-old children identified severe language disorders six months earlier2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 9, p. 1642-1648Article in journal (Refereed)
    Abstract [en]

    Aim We examined if routine Swedish language screening for developmental language disorder (DLD) carried out at three years of age could be performed as effectively six months earlier. Methods This study observed 105 monolingual Swedish-speaking children (53% boys) aged 29-31 months at three Swedish child health centres. We compared their ability to combine three words, as per the existing protocol, and two words. They also underwent a comprehension task. Speech and language pathologists clinically assessed the children for DLD and their results were compared with the nurse-led screening. Results The results for the three-word and two-word criterion were the following: sensitivity (100% versus 91%) specificity (81% versus 91%), positive predictive (38% versus 56%) and negative predictive value (100% versus 99%). The three-word criterion identified 29 children with possible DLD, including 11 cases later confirmed, and the two-word criterion identified 18 possible cases, including 10 confirmed cases. DLD was overrepresented in the 10% of children who did not cooperate with the nurse-led screening. Conclusion Changing the required word combinations from three to two words worked well. The three-word test identified one extra confirmed case, but resulted in 10 more false positives. Lack of cooperation during screening constituted an increased risk for DLD.

  • 8.
    Norlander, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Johansson, Henrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Jansson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Nordvall, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Nordang, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Differences in laryngeal movements during exercise in healthy and dyspnoeic adolescents.2020In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 129, article id 109765Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To compare glottic and supraglottic movements in healthy adolescents and adolescents experiencing dyspnoea during strenuous exercise.

    METHODS: Using the continuous laryngoscopy exercise (CLE)-test laryngeal movements during exercise were analysed in healthy controls (n = 28) and compared to subjects with exercise induced bronchoconstriction (EIB) (n = 10), exercise induced laryngeal obstruction (EILO) (n = 10) and subjects experiencing exercise-induced dyspnoea without having any of these diagnoses (n = 31). Images from the video recordings were assessed regarding glottic angle, glottic area and supraglottic area using the software measuring tool EILOMEA.

    RESULTS: No significant differences were detected between controls, the dyspnoea group without a diagnosis of EIB or EILO and the EIB group regarding glottis angle, glottis area or supraglottic area at maximum effort. All three parameters differed significantly in the EILO group compared to the other groups (p=<0.001). In the group with EILO all but one had supraglottic obstruction (corresponding to a CLE-test score ≥2). Movement of the laryngeal structures, corresponding to a CLE-test score of 1, at glottic and/or supraglottic level was seen in 26 of 35 (74%) of controls, 34 out of 41 (83%) of patients in the dyspnoea group, and in 25 of 38 (66%) of EIB-subjects.

    CONCLUSION: Minor movements at both glottic and supraglottic level are equally common in healthy controls as among adolescents with exercise induced dyspnoea without EIB or EILO and adolescents with EIB. Adolescents with EILO had a statistically significant more pronounced supraglottic obstruction than the other groups.

  • 9.
    Rypdal, Veronika
    et al.
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Guzman, Jaime
    BC Childrens Hosp, Dept Pediat, Vancouver, BC, Canada;Univ British Columbia, Vancouver, BC, Canada.
    Henrey, Andrew
    Simon Fraser Univ, Dept Stat & Actuarial Sci, Burnaby, BC, Canada.
    Loughin, Thomas
    Simon Fraser Univ, Dept Stat & Actuarial Sci, Burnaby, BC, Canada.
    Glerup, Mia
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark.
    Arnstad, Ellen Dalen
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;Nord Trondelag Hosp Trust, Levanger Hosp, Dept Pediat, Levanger, Norway.
    Aalto, Kristiina
    Univ Helsinki, Helsinki Univ Hosp, Dept Pediat, Helsinki, Finland.
    Rygg, Marite
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;St Olavs Hosp, Dept Pediat, Trondheim, Norway.
    Nielsen, Susan
    Copenhagen Univ Hosp, Dept Pediat, Rigshosp, Copenhagen, Denmark.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Rypdal, Martin
    UIT Arctic Univ Norway, Dept Math & Stat, Tromso, Norway.
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway.
    Validation of prediction models of severe disease course and non-achievement of remission in juvenile idiopathic arthritis: part 1-results of the Canadian model in the Nordic cohort2019In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 21, article id 270Article in journal (Refereed)
    Abstract [en]

    Background: Models to predict disease course and long-term outcome based on clinical characteristics at disease onset may guide early treatment strategies in juvenile idiopathic arthritis (JIA). Before a prediction model can be recommended for use in clinical practice, it needs to be validated in a different cohort than the one used for building the model. The aim of the current study was to validate the predictive performance of the Canadian prediction model developed by Guzman et al. and the Nordic model derived from Rypdal et al. to predict severe disease course and non-achievement of remission in Nordic patients with JIA.

    Methods: The Canadian and Nordic multivariable logistic regression models were evaluated in the Nordic JIA cohort for prediction of non-achievement of remission, and the data-driven outcome denoted severe disease course. A total of 440 patients in the Nordic cohort with a baseline visit and an 8-year visit were included. The Canadian prediction model was first externally validated exactly as published. Both the Nordic and Canadian models were subsequently evaluated with repeated fine-tuning of model coefficients in training sets and testing in disjoint validation sets. The predictive performances of the models were assessed with receiver operating characteristic curves and C-indices. A model with a C-index above 0.7 was considered useful for clinical prediction.

    Results: The Canadian prediction model had excellent predictive ability and was comparable in performance to the Nordic model in predicting severe disease course in the Nordic JIA cohort. The Canadian model yielded a C-index of 0.85 (IQR 0.83-0.87) for prediction of severe disease course and a C-index of 0.66 (0.63-0.68) for prediction of non-achievement of remission when applied directly. The median C-indices after fine-tuning were 0.85 (0.80-0.89) and 0.69 (0.65-0.73), respectively. Internal validation of the Nordic model for prediction of severe disease course resulted in a median C-index of 0.90 (0.86-0.92).

    Conclusions: External validation of the Canadian model and internal validation of the Nordic model with severe disease course as outcome confirm their predictive abilities. Our findings suggest that predicting long-term remission is more challenging than predicting severe disease course.

  • 10.
    Salomonsson, Maya
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Kalm-Stephens, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Dahlin, Joakim S.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Hallgren, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Circulating mast cell progenitors correlate with reduced lung function in allergic asthma2019In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 6, p. 874-882Article in journal (Refereed)
    Abstract [en]

    Background

    Studies using mouse models have revealed that mast cell progenitors are recruited from the blood circulation to the lung during acute allergic airway inflammation. The discovery of a corresponding human mast cell progenitor population in the blood has enabled to study the relation of circulating mast cell progenitors in clinical settings.

    Objectives

    To explore the possible association between the frequency of mast cell progenitors in the blood circulation and allergic asthma, we assessed the relation of this recently identified cell population with asthma outcomes and inflammatory mediators in allergic asthmatic patients and controls.

    Methods

    Blood samples were obtained, and spirometry was performed on 38 well‐controlled allergic asthmatic patients and 29 controls. The frequency of blood mast cell progenitors, total serum IgE and 180 inflammation‐ and immune‐related plasma proteins were quantified.

    Results

    Allergic asthmatic patients and controls had a similar mean frequency of blood mast cell progenitors, but the frequency was higher in allergic asthmatic patients with reduced FEV1 and PEF (% of predicted) as well as in women. The level of fibroblast growth factor 21 (FGF‐21) correlated positively with the frequency of mast cell progenitors, independent of age and gender, and negatively with lung function. The expression of FcεRI on mast cell progenitors was higher in allergic asthmatic patients and correlated positively with the level of total IgE in the controls but not in the asthmatic patients.

    Conclusion

    Elevated levels of circulating mast cell progenitors are related to reduced lung function, female gender and high levels of FGF‐21 in young adults with allergic asthma.

  • 11.
    Sato, Sakura
    et al.
    Natl Hosp Org, Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan;Juntendo Univ, Grad Sch Med, Course Allergy & Clin Immunol, Tokyo, Japan.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, Uppsala, Sweden.
    Ohya, Yukihiro
    Natl Ctr Child Hlth & Dev, Dept Allergy, Tokyo, Japan.
    Ito, Komei
    Aichi Childrens Hlth & Med Ctr, Dept Allergy, Obu, Japan.
    Nagao, Mizuho
    Natl Hosp Org, Mie Natl Hosp, Inst Clin Res, Tsu, Mie, Japan.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research. Thermo Fisher Sci, Uppsala, Sweden.
    Ebisawa, Motohiro
    Natl Hosp Org, Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan;Juntendo Univ, Grad Sch Med, Course Allergy & Clin Immunol, Tokyo, Japan.
    Ana o 3-specific IgE is a predictive marker for cashew oral food challenge failure2019In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 7, no 8, p. 2909-2911.e4Article in journal (Other academic)
  • 12.
    Sütterlin, Susanne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition.
    Myrelid, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Nöjd, Johan
    Kaden, Heike
    [Case Report of Pseudomonas Hot-Foot Syndrome in Uppsala, Sweden].2019In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, article id FSMXArticle in journal (Refereed)
    Abstract [sv]

    During February and March 2019, an accumulation of clinically similar erythematous plantar nodules was observed at the University Children's Hospital and several primary care facilities in Uppsala, Sweden. At least 20 children sought medical advice, and all cases presented with a recurrent plantar hidradenitis after within a day after visiting Uppsala's largest waterpark and arena for swimming. The presented symptoms were identical with a condition called pseudomonas hot-foot syndrome described in the literature. An investigation led by the local public health authorities revealed heavy growth of Pseudomonas aeruginosa in water-filled toys in a children's play area and in samples taken from the floor of a pool where the surface was partly damaged. After closing the affected part of the pool and removal of the contaminated toys, no more people sought medical advice. Pseudomonas hot-foot syndrome is believed to be more frequent than diagnosed today, and increased awareness is essential to avoid unwarranted diagnostic tests and treatments, and to identify and eradicate the source of infection.

  • 13.
    Wahlström Johnsson, Inger
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Ahlsson, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Gustafsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    High birthweight was not associated with altered body composition or impaired glucose tolerance in adulthood2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 12, p. 2208-2213Article in journal (Refereed)
    Abstract [en]

    Aim

    To investigate whether a high birthweight was associated with an increased proportion of body fat or with impaired glucose tolerance in adulthood.

    Methods

    Our cohort comprised 27 subjects with birthweights of 4500 g or more, and 27 controls with birthweights within ±1 standard deviation scores, born at Uppsala University Hospital 1975‐1979. The subjects were 34‐40 years old at the time of study. Anthropometric data was collected, and data on body composition was obtained by air plethysmography and bioimpedance and was estimated with a three‐compartment model. Indirect calorimetry, blood sampling for fasting insulin and glucose as well as a 75 g oral glucose tolerance test were also performed. Insulin sensitivity was assessed using homoeostasis model assessment 2 and Matsuda index.

    Results

    There were no differences in body mass index, body composition or insulin sensitivity between subjects with a high birthweight and controls.

    Conclusion

    In this cohort of adult subjects, although limited in size, those born with a moderately high birthweight did not differ from those with birthweights within ±1 standard deviation scores, regarding body composition or glucose tolerance.

  • 14.
    Warnakulasuriya, Loretta S.
    et al.
    Univ Colombo, Colombo, Sri Lanka.
    Fernando, Manel A. M.
    Colombo North Teaching Hosp, Ragama, Sri Lanka.
    Adikaram, A. V. Nihal
    Bandaranayake Int Airport, Hlth Unit, Katunayake, Sri Lanka.
    Thawfeek, A. R. M.
    Colombo North Teaching Hosp, Ragama, Sri Lanka.
    Anurasiri, W. M. L.
    Dist Gen Hosp, Negombo, Sri Lanka.
    Rytter, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Bergsten, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Silva, K. D. Renuka Ruchira
    Wayamba Univ, Gonawila, Sri Lanka.
    Samaranayake, Dulani L.
    Univ Colombo, Colombo, Sri Lanka.
    Wickramasinghe, Vithanage Pujitha
    Univ Colombo, Colombo, Sri Lanka.
    Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?2019In: Asia-Pacific journal of public health, ISSN 1010-5395, Vol. 31, no 7, p. 633-642Article in journal (Refereed)
    Abstract [en]

    Despite socioeconomic improvement, undernutrition rates stagnate in Sri Lanka, while a slow rise in obesity and noncommunicable diseases (NCD) is seen. Inability to improve undernutrition and detection of NCD could be due to overdiagnosing stunting/wasting and underdiagnosing overweight/obesity. Obesity, being a risk factor for NCDs, needs correct tools for early diagnosis. Although body mass index (BMI) is a commonly used surrogate index, the validity of universal cutoffs is questioned. Evidence shows that body composition varies with ethnic origin and cutoff value reflecting fat mass (FM) varies in different ethnic groups. This study was conducted in 12 788, 5- to 15-year-old children from 8 schools in Negombo, Sri Lanka, to identify the validity of current anthropometric cutoffs. Obesity prevalence identified by body fat content was high. International BMI cutoffs had high specificity but varied sensitivity. Locally developed BMI cutoffs had high sensitivity and specificity. Validity of internationally developed anthropometric cutoffs in South Asian children is unsatisfactory; hence, locally/regionally developed anthropometric tools should be used for screening of obesity.

  • 15.
    Wester Oxelgren, Ulrika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Westerlund, Joakim
    Institutionen för psykologi, Stockholms universitet.
    Myrelid, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Annerén, Göran
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    Johansson, Lotta
    Habiliteringen Uppsala län.
    Åberg, Marie
    Habiliteringen Uppsala län.
    Gustafsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Frenell, Elisabeth
    Gillberg centrum, Institutionen för neurovetenskap och psykologi, Göteborgs universitet.
    An intervention targeting social, communication and daily activity skills in children and adolescents with Down syndrome and autism: a pilot study2019In: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 15, p. 2049-2056Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate whether an intervention, targeting deficits in social communication, interaction and restricted activities in children and adolescents with Down syndrome and autism could lead to enhanced participation in family and school activities.

    Methods: The intervention included education for parents and school staff about autism, and workshops to identify social-communication and daily living activities that would be meaningful for the child to practice at home and at school. Thereafter, a three-month period of training for the child followed. Outcome measures comprised evaluation of goal achievement for each child, the “Family Strain Index” questionnaire and a visual scale pertaining to the parents´ general opinion about the intervention.

    Results: On average, more than 90% of the goals were (to some extent or completely) achieved at home and at school. The mean scores of the “Family Strain Index” were almost identical at the follow-up to those before intervention. The evaluation supported that the use of strategies, intended to facilitate activities and communication, remained largely 18 months after start of the intervention.

    Conclusion: Despite the group involved in this study being comprised of older children and adolescents, most of whom had severe and profound intellectual disability, the goal achievements and parents’ views on the intervention were encouraging.

  • 16.
    Wester Oxelgren, Ulrika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Neuropediatrics/Paediatric oncology.
    Åberg, Marie
    Kungsgardet Ctr, Dept Hlth & Habilitat, Uppsala, Sweden.
    Myrelid, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Annerén, Göran
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    Westerlund, Joakim
    Stockholm Univ, Dept Psychol, Stockholm, Sweden; Gothenburg Univ, Gillberg Neuropsychiat Ctr, Dept Neurosci & Physiol, Gothenburg, Sweden.
    Gustafsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Fernell, Elisabeth
    Gothenburg Univ, Gillberg Neuropsychiat Ctr, Dept Neurosci & Physiol, Gothenburg, Sweden.
    Autism needs to be considered in children with Down syndrome2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 11, p. 2019-2026Article in journal (Refereed)
    Abstract [en]

    Aim: To compare levels and profiles of autistic symptoms in children with Down syndrome (DS) with diagnosed autism spectrum disorder (ASD), with those with DS without ASD and with children with idiopathic autism.

    Methods From a population-based cohort of 60 children with DS (age 5-17 years) with 41 participating, those with ASD were compared to those without ASD using the scores obtained with the Autism Diagnostic Observation Schedule (ADOS) Module-1 algorithm.

    Results: Children with both DS and ASD had significantly higher ADOS scores in all domains compared to those without ASD. When the groups with DS, with and without ASD, were restricted to those with severe intellectual disability (ID), the difference remained. When the children with DS and ASD were compared with a group with idiopathic autism, the ADOS profile was broadly similar.

    Conclusion: A considerable proportion of children with DS, exhibit autism in addition to severe ID. In addition, there is also a group of children with DS and severe ID, but without autism. There is a need to increase awareness of the high prevalence of autism in children with DS. Recognizing the prevalence of autism is important for the appropriate diagnosis and care of children with DS.

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