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Biomedical subjects

J Karlberg

Publications and source records attributed to J Karlberg.

At least 109 records · Page 6Linked to original sources
PubMed1993

Pubertal linear growth of Indian girls adopted in Sweden.

Pubertal linear growth in 66 adopted Indian girls was studied. The infancy-childhood-puberty standard was used, since it is applicable to Indian girls, and enables determination of the onset and height gain of the pubertal growth phase in an individual. At arrival in Sweden, mean height was -2.8 SDS. Despite rapid catch-up growth, the girls were still below the reference mean (-0.8 SDS) at the onset of the pubertal growth spurt, which occurred approximately 1.5 years earlier than in Swedish girls and also earlier than in Indian girls. The pubertal height gain, however, was equivalent to that in Swedish girls with similar timing of puberty. The short final height found in some of these girls appears to be related to shortness prior to puberty and to very early onset of an otherwise normal pubertal growth component.

Adolescent↗
PubMed1993

A Swedish version of the Women's Health Questionnaire. A measure of postmenopausal complaints.

We wanted to provide details on the psychometric documentation of the Swedish version of the Women's Health Questionnaire (WHQ), a patient based measure of postmenopausal complaints. The results of two clinical trials in Sweden in which the WHQ had been used as one out of several measurement tools were used to document the reliability, the validity and the responsiveness to change of the WHQ. More than 350 women suffering from postmenopausal complaints were included in the two trials. A factor analysis, using the baseline values of all women in each study, showed that the Swedish version of the WHQ was very close to the English original. The internal consistency reliability was excellent. The clinical validity was confirmed by a significant correlation between change in E2 levels and change in the WHQ during estrogen therapy. A high construct validity was established by the agreement between the WHQ and other quality of life scales. For use in clinical trials the WHQ was sensitive to treatment-induced changes, and added important information to the clinical effect variables.

England↗
PubMed1992

Determination of neutralizing antibodies and specific immunoglobulin isotype levels in infants after vaccination against diphtheria.

Serum samples were obtained from 44 infants vaccinated against diphtheria at the ages of 3, 5 and 12 months with an aluminium-adsorbed diphtheria-tetanus toxoid vaccine containing 15 Lf units of diphtheria toxoid. Toxin-neutralizing antibodies (antitoxin) were measured by the Vero cell assay and IgG, IgM and IgA antibodies against diphtheria toxoid by enzyme-linked immunosorbent assay. A neutralizing antibody titer of 10 corresponded to 0.01 IU/ml, the level considered necessary for short-term protection. Geometric mean neutralizing antibody titers at 3, 5, 6, 12, 13 and 30 months were 28, 21, 173, 61, 1076 and 61. All children had titers of greater than or equal to 10 (greater than or equal to 0.01 IU/ml) between 6 and 30 months of age. At 30 months only 48% had titers of greater than or equal to 100 (greater than or equal to 0.01 IU/ml), the level considered necessary for long-term protection. Geometric mean IgG antibody levels were 13, 36, 216, 64, 649 and 57. IgG antibodies significantly correlated with neutralizing titers and predicted neutralizing antibodies above or below 10 and 100 with an accuracy of 96 and 82%, respectively. IgG antibodies could not, however, be used to predict individual neutralizing antibody titers with great accuracy. IgM antibodies were only detected after the third vaccination. IgA antibodies were not detected in any serum sample from ten infants tested. In conclusion, the Swedish vaccination schedule results in protective antibody levels in infants until at least 30 months of age. The decline of the antibody titers indicates a need for further studies to establish the duration of protection.

Animals↗
PubMed1992

A new methodological approach to the evaluation of quality of life in postmenopausal women.

An approach employing a range of standardized questionnaires, which included the Nottingham Health Profile (NHP), the Psychological General Well-Being (PGWB) index and the Mood Adjective Check List (MACL), was used to assess health-related quality of life (QoL) in conjunction with a study comparing two doses of transdermal oestrogen (50 or 100 micrograms/24 h) combined with an oral progestogen (5 mg medroxyprogesterone acetate for 14 days each cycle). In addition to the QoL measures, climacteric symptoms were self-rated and also summarized by means of the Kupperman index. In all, 59 women, median age 52 (39-71) years, who completed 4 months of therapy were evaluated. The use of a battery of standardized questionnaires enabled a comprehensive evaluation to be made of perceived health, well-being and day-to-day functioning. Not only was symptomatic relief, e.g. reduced frequency of sweating episodes, sleep disturbance and hot flushes, observed during treatment, but there were also improvements in terms of sleep, energy and emotions. The frequency of health-related problems associated with paid employment, housework, social life, home life and sex life decreased, indicating enhanced ability to take part in daily activities. The PGWB index showed improvement in the subscales representing well-being, anxiety, depression, vitality, health and self-control, while the mood scales indicated that the women experienced less tension and more satisfaction. Although the results of this study need to be further documented on the basis of a placebo-controlled trial, the findings nevertheless imply that the use of a battery of standardized questionnaires optimizes the possibility of evaluating climacteric complaints reliably before and after treatment.

Administration, Cutaneous↗
PubMed1992

Long-term effect of transdermal hormonal therapy on aspects of quality of life in postmenopausal women.

The long-term effect on aspects of quality of life (QoL) of treatment with transdermal oestrogen for 2 weeks followed by transdermal oestrogen/progestogen norethisterone acetate/oestradiol TTS 0.25/0.05 mg/day for the next 2 weeks was investigated in postmenopausal women within the framework of a 1-year seven-centre trial. Of the 136 women who were included (mean age 53 +/- 4.8 years), 110 completed the study. Aspects of QoL that are of relevance in the perimenopause and postmenopause were evaluated using the Psychological General Well-Being (PGWB) index, the Women's Health Questionnaire (WHQ) and the Sleep Dysfunction Scale before and after 3 and 9 months of therapy in the oestrogen phase. Climacteric complaints were also assessed by means of the Kupperman Index. Improved well-being, i.e. less anxiety and depression, increased vitality and better self-control (P less than 0.0001) were observed, as well as reduced sleep disturbance (P less than 0.0001). The WHQ showed decreased vasomotor and somatic symptoms, and improved sex life, emotions and cognitive function (P less than 0.0001). Improvement was the same at 3 and 9 months. According to the Kupperman Index, climacteric symptoms were alleviated (P less than 0.0001). Relief of vasomotor symptoms was correlated with improvement in the WHQ (r = 0.82), the PGWB index (r = 0.58, P less than 0.0001) and sleep (r = 0.51, P less than 0.0001). Because of the absence of a placebo control group, the results must be regarded with caution until confirmed in a placebo-controlled trial.

Administration, Cutaneous↗
PubMed1992

Growth in girls with adolescent idiopathic scoliosis.

The height development during childhood and puberty was analyzed in 54 girls with adolescent idiopathic scoliosis by the use of the Infancy Childhood Puberty growth model, which is based on healthy Swedish children. This model adjusts adolescent reference values for height for individual age at pubertal maturation. The scoliotic girls had an above-average height 2 years before the onset of the pubertal growth spurt. However, because they displayed an early pubertal maturation as well as a low pubertal gain in height, their values were only slightly higher than the reference mean values at maturity. The results indicate an increased growth hormone activity in childhood in girls with adolescent idiopathic scoliosis.

Adolescent↗
PubMed1991

Longitudinal growth in children with non-Hodgkin's lymphoma and children with acute lymphoblastic leukemia: comparison between unirradiated and irradiated patients.

Longitudinal growth was studied in children treated for non-Hodgkin's lymphoma (NHL). The aim of the study was to compare these children's growth velocity with findings in a previous study we performed on age-matched children with acute lymphoblastic leukemia (ALL) who received cranial irradiation. Nine children with NHL with an onset time of treatment between 4 and 9 years of age (mean 6.5 years) were studied with annual body measurements taken from the time of the diagnosis and thereafter annually during the following 4 years. None of the children received cranial irradiation. During the first treatment year a significantly low mean height velocity was observed (-1.4 standard deviation score [SDS]) for the NHL group. The consecutive two 1 year periods showed a normalization of the mean height velocity. For the group of children with ALL, there was a more prominent negative effect on height during the first 2 years of treatment than for the NHL group in the present study. After the cessation of therapy, the children with NHL showed a reduced catch-up growth compared with the children with ALL. The explanation offered is that cranial irradiation has a heavier impact on growth than chemotherapy during the first 2 years of treatment, but an intense chemotherapy during the maintenance period could have a considerable impact in blunting growth.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Evaluation of quality of life in clinical trials. Selecting quality-of-life measures.

The strategy for evaluating quality of life in clinical trials is an important and complex issue. By comparing the performance of different quality-of-life measures before and after estrogen replacement therapy, it was shown that disease-specific measures had obvious advantages. Although narrow in applicability to the particular patient group, they were the most responsive measures in detecting small, clinically important changes. In clinical trials more attention should be given to how side effects, which often have important implications with regard to quality-of-life, are recorded.

Administration, Cutaneous↗
PubMed1991

Weight-for-height standards in adulthood.

Although there are some Swedish studies giving reference values for height and weight in adulthood, no values of weight for height (W/H) are available. W/H is an essential measurement, as it permits comparison of weight independent of the height of an individual. We here present a method of constructing W/H standards, illustrated by a material sample of 4438 healthy individuals, 20-80 years of age, living in the Uppsala County during the period 1964-1971. In setting standards of W/H, the 'normal' increase in weight during adulthood and the distribution skewness of weight are both shown to be important. This weight gain starts at about 40 years of age, and is completed at approximately 55 years of age. It can be regarded as a 'normal' pattern, but not necessarily the optimum healthy one. Using ordinary growth charts for weight and height, a simple means of expressing W/H in standard deviation scores is outlined. It is difficult to find a representative Swedish sample, owing to geographical and psychosocial differences, and also to the secular trend phenomenon. However, the mean values for weight and height obtained in the present study fall between the mean values of two other recently conducted Swedish studies.

Adult↗
PubMed1991

Growth in infancy and childhood in girls with Turner's syndrome.

We describe spontaneous longitudinal growth in girls with Turner's syndrome (TS), using the infancy-childhood-puberty (ICP) growth model. Length/height during the first 12 years of life was studied in 58 Swedish girls with TS. Their mean length at birth was 47.8 cm (SDS -1.4) and mean height at 12.0 years of age 127.3 cm (SDS -3.0). A clear age-dependent subnormality was observed in the change in length-height SDS (delta SDS). Mean delta SDS values at ages 0.0 to 0.5 and 3.0 to 6.0 years were normal. In contrast, the mean delta SDS at ages 0.5 to 3.0 and 6.0 to 12.0 years were subnormal. The onset of the childhood growth component (normally located between 0.5 and 1.0 year of age) was, on the average, delayed by 0.28 year. This accounts for the subnormality of delta SDS at 0.5 to 3.0 years of age. About 50% of the variation in height at 12.0 years of age, as determined by a multiple linear regression analysis, was significantly explained by length at 0.5 year of age, age at the onset of the childhood component, and delta SDS at 6.0 to 12.0 years of age.

Adolescent↗
PubMed1991

Linear growth in children with cystic fibrosis. I. Birth to 8 years of age.

The linear growth of Swedish children with cystic fibrosis (CF), is described using the infancy-childhood-puberty (ICP) growth model. Length/height was studied in 51 patients during their first 8 years of life. The median age at diagnosis was 0.4 years (range 0.0-6.1 years). At birth, their mean length was close to normal, but the gain in length over the first 0.25 years of life was significantly below normal, resulting in a mean length SDS of -1.3. Length remained subnormal up to 1.0 year of age. Thereafter, catch-up growth occurred, resulting in almost normal height (mean SDS-0.3) at 5.0 years of age. Between 5.0 and 8.0 years of age growth was normal. The mean age at onset of the childhood component was not significantly different from the controls. Hence, the catch-up growth did not occur until after the onset of the childhood component. This study shows that the postnatal linear growth rate is retarded in children with CF during the first months of life. This is almost completely compensated for by a supranormal growth rate that starts at the end of the first year of life.

Age Factors↗
PubMed1991

Breast feeding and protection against neonatal sepsis in a high risk population.

Protection against neonatal sepsis by breast feeding was investigated in a developing community. A case-control study was carried out with 42 cases from a hospital and 270 controls, matched for age and socioeconomic conditions from the community. Exclusive breast feeding was extremely rare, most babies being partially breast fed and a few being given formula feed or animal milk. A highly significant odds ratio of 18 was obtained, showing that even partial breast feeding protects against neonatal sepsis in such a population.

Bacterial Infections↗
PubMed1991

The timing of secondary sex characters and their relationship to the pubertal maximum of linear growth in girls.

The timing and interrelationships between stages of secondary sex characters and the pubertal maximum of growth were studied in a prospective longitudinal study of 90 Swedish girls, followed from birth to adulthood. The results show that there is a close correlation between some of the stages of secondary sex characters and the pubertal maximum of growth in girls.

Acne Vulgaris↗
PubMed1990

Long-term treatment with glucocorticoids/ACTH in asthmatic children. III. Effects on growth and adult height.

The effect on growth of long-term treatment with prednisolone and/or ACTH (tetracosactrin) depot preparation was studied in 40 children with severe bronchial asthma. Height velocity was subnormal before treatment. During treatment the group of 17 children primarily treated with ACTH showed a moderate increase in mean velocity. Their height was not significantly altered, and neither was the age at peak height velocity nor adult height. In the group of 23 children treated with prednisolone the mean velocity decreased, resulting in a relative decrease in height. Peak height velocity was delayed by about 2 years in the boys but occurred at the expected time in the girls, as did menarche. Mean adult height was lower than expected after adjustment for mid-parenteral height. In 10 children ACTH was substituted for prednisolone, and their height velocity increased but not enough to affect adult height, which was just as low as in the patients treated with prednisolone only.

Adrenocorticotropic Hormone↗
PubMed1990

The infancy-childhood growth spurt.

Early normal human linear growth is unstable and oscillates owing to an increase in growth rate between 6 and 12 months of age. This defines the onset of the infancy-childhood growth spurt (IC spurt). The onset is identical with the onset of the childhood component of the infancy-childhood-puberty growth model. The IC spurt is completed when the infancy component of this model has virtually ceased, at around 3 years of age. Additional observations suggest that its onset represents the age at which growth hormone (GH) begins to regulate growth significantly. The negative impact of late onset of the IC spurt on attained height is illustrated and discussed. A delayed spurt is observed in 30-50% of children with growth-related disorders and of infants living in a poor area of a developing country. The IC spurt is absent in children with GH deficiency who receive no hormonal therapy.

Age Factors↗
PubMed1989

On the construction of cross-sectional statistical standards for growth.

Cross-sectional growth studies generally produce standardizing groups which are too small to permit the direct construction of standards. This problem can be circumvented by the introduction of appropriate structural assumptions. The two key papers in the literature which focus on this issue, Healy (1962) and Goldstein (1972), give methodologies which involve somewhat different premises. Healy takes the ages of individuals to be uniformly distributed over a well-defined interval (but their precise levels unknown). Goldstein by comparison supposes age levels to be known exactly. Both authors postulate that the characteristic of interest follows a Gaussian density whose mean and variance are each linear functions of time, a + bt and c + dt, say. In this paper we begin to explore the robustness of the two methods. Our results show that Healy's original moment solution to the estimation of (a, b, c and d) may be quite insensitive to departures from a uniform distribution for ages provided that this distribution remains symmetric about the interval mid-point. Moreover, the distribution of the characteristic of interest may deviate from the Gaussian without too much effect, provided that symmetry about the mean a + bt is retained. However, there is much more doubt about asymmetric departures in both cases especially with regard to the estimation of b and d. Opting for simple 'interpolated' estimates of these two parameters (when possible) rather than Healy's original formula-based versions will strongly aid robustness in general.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗