PubMed Health⌕ Search

Biomedical subjects

J Schollin

Publications and source records attributed to J Schollin.

At least 19 recordsLinked to original sources
PubMed2000

Intervention models on psycho-social health in families with an asthmatic child.

Despite an increase in the prevalence of asthma during the last few decades, the need for hospital treatment of children with asthma has become less. One reason for this is that children and their parents are now more involved in the treatment of the disease, and responsibility has been shifted from the medical care system to the family. This new responsibility may cause increased psycho-social tension within the family. We conducted a pilot study on three limited methods of intervention to find the best way to help families in this respect. All three methods (individual family meetings, family group meetings, and evaluation of the child's environment in school) reduced the psychosocial burden of having a child with asthma. This indicates that families should be supported by being given the opportunity to participate in meetings to discuss the disease or to have the environment in the child's school evaluated, in addition to receiving regular medical care.

Asthma↗
PubMed2000

Pilot study of nebulized surfactant therapy for neonatal respiratory distress syndrome.

Thirty-four spontaneously breathing newborns with respiratory distress syndrome (RDS) requiring nasal continuous positive airway pressure (CPAP) and an arterial-to-alveolar oxygen tension ratio (a/A PO2) of 0.15-0.22 were randomized to treatment with nebulized surfactant (Curosurf) or to serve as controls. All children were first supported by nasal CPAP according to normal clinical routines. Surfactant was administered using a modified Aiolos nebulizer, and a total of 480 mg was aerosolized in each case. The control group received no nebulized material, but had the same CPAP support. Acid-base status and a/A PO2 were determined at regular intervals before, during and after surfactant administration. Both groups included in the study were similar with regard to gestational age, birthweight, steroids given before birth, sex and Apgar scores as well as a/A PO2 when entering the study. There were no significant differences between the groups in a/A PO2 1-12 h after randomization, number of infants needing mechanical ventilation, time on ventilator or CPAP. Two children in the treated group developed bronchopulmonary dysplasia. No side effects of the surfactant therapy were noted. No beneficial effects of aerosolized surfactant were demonstrated in our trial, contrary to data from animal experiments. This finding probably reflects differences in administration techniques. Our findings do not justify large clinical trials with the same protocol. Further work is needed to optimize delivery of aerosolized surfactant to the neonatal lung in clinical practice.

Aerosols↗
PubMed1999

Oral glucose and venepuncture reduce blood sampling pain in newborns.

The objectives of this study were to measure pain symptoms in healthy fullterm newborns undergoing routine blood sampling with different methods. The 120 study subjects were randomly allocated to one of four groups with 30 babies in each, namely venepuncture or heel stick, with or without oral glucose administration. Pain was assessed from the duration of crying within the first 3 min, the Premature Infant Pain Profile (PIPP) and changes in heart rate. When the babies received 1 ml 30% glucose prior to skin puncture there was no significant difference between the heel stick and venepuncture group either in mean crying time (12.9 and 11.6 s, respectively) or in PIPP score (3.9 and 3.3). When no glucose was given crying time was 57.3 s in the heel stick group and 26.8 s in the venepuncture group (P = 0.0041) and the mean PIPP scores were 8.4 and 6.0, respectively (P = 0.0458). This study suggests that if oral glucose is given prior to skin puncture the choice of blood sampling method has no impact on the pain symptoms.

Administration, Oral↗
PubMed1999

Contribution of interleukin-6 in distinguishing between mild respiratory disease and neonatal sepsis in the newborn infant.

The purpose of this study was to investigate if early samples of interleukin-6 (IL-6) could distinguish early bacterial sepsis from respiratory diseases in the newborn. IL-6 and C-reactive protein (CRP) were measured at onset of symptoms in newborns evaluated for sepsis during the first week of life. Five groups of children were investigated: proven sepsis, clinical sepsis, respiratory distress syndrome (RDS), transient tachypnoea of the newborn (TTN) and controls. IL-6 was also analysed at the time when CRP was at its maximum level. The results showed that initial IL-6 distinguished proven and clinical sepsis from TTN, but not from RDS. Initial CRP was of no value for diagnosis. Our conclusion is that early IL-6 makes it possible to avoid antibiotics in children with TTN and contributes to the diagnosis of sepsis faster than CRP.

Bacterial Infections↗
PubMed1998

Impaired phagocytosis and opsonisation towards group B streptococci in preterm neonates.

AIMS: To study the chemiluminescence response in polymorphonuclear leucocytes (PMNL) at different stages of maturity and the opsonic capacity of sera with defined titres of anti-capsular type III antibodies, after exposure to serotype III group B streptococci (GBS). The influence of GBS type III capsule expression on PMNL chemiluminescence response was also investigated. METHODS: Two clinical isolates of serotype III GBS and two serotype III reference strains which form isogenic variants with high and low amounts of capsule substance, respectively, were used. PMNL and sera were obtained from adult healthy blood donors, full term neonates, and preterm neonates. RESULTS: PMNL from premature infants showed a significantly lower chemiluminescence response (p < 0.0001) than the PMNL from adults and neonates, while the chemiluminescence response with adult, neonatal, and preterm sera gradually diminished. In the presence of a serum pool with a standardised complement value, raised (> 10 mg/l), rather than low (< 1.0 mg/l) anti-III antibody titres induced a higher chemiluminescence response to the capsule expressing variant. When GBS were cultured at pH 5.0, the bacteria had a higher buoyant density, reflecting decreased expression of capsule substance compared with bacteria grown at pH 7.4. Concomitantly, there was a substantial increase in chemiluminescence response for all isolates cultured at the lower pH, except for the capsule deficient mutant. CONCLUSIONS: PMNL function and opsonic capacity are significantly impaired in neonates and correlate with maturation of the newborn child. The combined defect in cellular and humoral defences in preterm neonates may contribute to their increased susceptibility to GBS infection. Growth conditions for GBS, simulating different in vivo environments, greatly affect capsule expression and resistance to phagocytosis.

Adult↗
PubMed1997

Analgesia in newborns given oral glucose.

There is evidence that newborn babies feel pain even at the lowest gestational ages when they can survive. Because sweet solutions such as sucrose, given orally, may relieve pain in neonates, we decided to compare the effects of two concentrations of glucose (normally used for intravenous infusions) and of breast milk in a randomized controlled trial in 120 babies requiring heel-prick tests. Glucose solutions and breast milk are readily available in the neonatal department. No other treatment was given. Our results strongly suggest that 1 ml of a 30% glucose solution given orally alleviates mild pain significantly and can be used for this purpose in newborns. Breast milk and 10% glucose did not have a similar effect.

Administration, Oral↗
PubMed1997

Increase of staphylococci in neonatal septicaemia: a fourteen-year study.

All cases of neonatal septicaemia during 1981-94 were studied at Orebro Medical Centre Hospital, Sweden. One hundred and thirty-two children fulfilled laboratory and clinical criteria for neonatal septicaemia and were included. Staphylococcus aureus (n = 41), Group B streptococcus (GBS) (n = 32) and coagulase-negative staphylococci (CoNS) (n = 27) were the dominating aetiologies. The annual incidence of septicaemia increased significantly, from 2.3 cases during the first 7-year period to 3.3 per 1000 live births during 1988-94. This increase was caused by S. aureus and CoNS, which mainly affected premature children and had an onset more than 48 h after delivery. GBS, on the other hand, slightly decreased and affected full-term children within 48 h. The overall mortality was 11%. CoNS isolated during the latter 7-year period were more resistant to antibiotics than those isolated during 1981-87; resistance to methicillin increased from 14 to 45% and to gentamicin from 0 to 20%. These changes in aetiology and antibiotic susceptibility should be considered when selecting antibiotic treatment in neonatal septicaemia.

Academic Medical Centers↗
PubMed1997

Early postnatal hypoglycaemia in newborn infants of diabetic mothers.

This study found that early postnatal hypoglycaemia was mainly induced by foetal hyperinsulinaemia, in close relation to maternal hyperglycaemia, even in well-controlled pregnancies of 59 mothers with insulin-treated diabetes mellitus, 29 with insulin-dependent diabetes mellitus and 30 with gestational diabetes mellitus. Ten of the newborn children (17%) had a blood glucose concentration below 1.0 mmol l(-1) at 2 h postnatally. Cord insulin-like growth factor-I or glucagon concentrations were not related to the early decline of blood glucose.

Adult↗
PubMed1994

Severe retinopathy of prematurity in infants from the southern regions of Sweden.

We studied children born in 1986-1989 with severe retinopathy of prematurity (ROP) defined as stage 3 "plus" or more. Sixteen children from the southern and central areas of Sweden were identified and 15 of these were referred to Orebro Medical Center Hospital for surgical treatment of ROP. The incidence of severe ROP was estimated as 0.8 per 10,000 newborns per year. All children were born before 29 weeks' gestation and weighed less than 1310 g; they also needed ventilatory support for a long time. The overall neonatal morbidity was high. A model for eye examination in premature newborns is suggested.

Female↗
PubMed1994

Sequential combined spinal epidural block versus spinal block for cesarean section: effects on maternal hypotension and neurobehavioral function of the newborn.

Sequential combined spinal-epidural (CSE) block was compared with spinal block for elective cesarean section. The quality of surgical analgesia and the effect on maternal blood pressure and neonatal neurobehavioral function were evaluated. Forty-two healthy parturients were randomly divided into a spinal (n = 21) and a sequential CSE (n = 21) group. A T4 sensory block was targeted. In the spinal group, 0.5% hyperbaric bupivacaine, 2.5 mL, was injected into the subarachnoid space through a 26-gauge Quincke needle. In the sequential CSE group, 1.5 mL of 0.5% hyperbaric bupivacaine was injected into the subarachnoid space through a long 26-gauge Quincke needle, which was introduced through an 18-gauge Tuohy needle. An epidural catheter was then inserted. If the block in the sequential CSE group did not reach the T4 level in 15 min, it was extended by fractionated doses of 0.5% bupivacaine administered through the epidural catheter. Ephedrine, 10 mg intravenously (i.v.), was given to treat hypotension (20% decrease from baseline value and/or systolic blood pressure below 100 mmHg). The time intervals from induction of block to start of surgery and to delivery were shorter in the spinal group (P < 0.01). Cephalad spread of block (pinprick) 15 min after induction was T4 [T2-T7] (median [range]) in the spinal group and T7 [T2-L1] in the sequential CSE group (P < 0.05). All patients in the sequential CSE group needed epidural bupivacaine, 53.8 +/- 6.5 mg (mean +/- SEM). The surgical analgesia was good or excellent in both groups before delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Diffuse neonatal haemangiomatosis in a newborn child.

Diffuse neonatal haemangiomatosis is a severe disease with a high mortality. It is characterized by multiple haemangiomas at birth affecting the skin and visceral organs. A case of diffuse neonatal haemangiomatosis in a newborn child with a favourable outcome after steroid treatment is described.

Female↗
PubMed1993

Adherence of group B streptococci to human endothelial cells in vitro.

A model using human umbilical vein endothelial cells was developed to study the adhesion of group B streptococci. Ten clinical isolates of serotypes Ia, Ib and III, including six blood isolates from neonates with early-onset disease, were studied. Isogenic variants with different ability to express capsule substance were also included. Clinical isolates of serotype III adhered significantly better than other serotypes. Strains with high ability to adhere to endothelial cells also had high ability to bind to plastic. Isogenic variants of serotype III with low amounts of capsule substance adhered significantly better to cells than variants expressing high amounts of capsule substance. These results show that the higher adherence of serotype III strains may be a virulence factor and contribute to the finding that this serotype dominates in invasive group B streptococcal disease.

Bacterial Adhesion↗