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  • 1.
    Ahlm, Clas
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Settergren, Bo
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Juto, Per
    Nephropathia epidemica (hemorrhagic fever with renal syndrome) in children: clinical characteristics.1994In: The Pediatric Infectious Disease Journal, ISSN 0891-3668, E-ISSN 1532-0987, Vol. 13, no 1, p. 45-9Article in journal (Refereed)
    Abstract [en]

    The clinical characteristics of serologically verified nephropathia epidemica, the Scandinavian form of hemorrhagic fever with renal syndrome, were studied in Swedish children who were < 15 years of age. In 1990 to 1992, 14 cases were prospectively followed. A retrospective survey during 1984 to 1990 disclosed another 18 cases. Among the 32 cases (20 boys, 12 girls, 3 to 15 years of age; median age, 11 years), the most common symptoms were fever (100%), headache (100%), abdominal pain (93%), vomiting (91%) and back pain (76%). Laboratory findings included elevated serum creatinine concentration (19 of 28) and thrombocytopenia (7 of 22). Urinalysis showed proteinuria (31 of 31 patients) and hematuria (24 of 30). Six children had mild hemorrhagic manifestations (epistaxis, metrorrhagia, and petechiae). No severe complications occurred. The clinical symptoms of children with nephropathia epidemica seem to be similar to those found among adult nephropathia epidemica cases.

  • 2. Ahrén, C M
    et al.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stoll, B J
    Salek, M A
    Svennerholm, A M
    Comparison of methods for detection of colonization factor antigens on enterotoxigenic Escherichia coli.1986In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 23, no 3, p. 586-91Article in journal (Refereed)
    Abstract [en]

    Fecal Escherichia coli isolates from 196 patients with watery diarrhea and 68 healthy individuals (controls) were analyzed in Bangladesh immediately after isolation for the presence of colonization factor antigen (CFA) I or II (CFA/I or CFA/II, respectively) by a mannose-resistant hemagglutination (MRHA) test with six species of erythrocytes and by a slide agglutination test with absorbed CFA/I or CFA/II antisera. The presence of CFAs was confirmed by immunodiffusion analyses done in Sweden. By these methods, it was found that 49 of 69 enterotoxin-producing E. coli strains isolated from patients carried CFA/I or CFA/II, whereas none of the nonenterotoxigenic E. coli isolates or the three toxin-positive strains isolated from healthy individuals carried these adhesins. All E. coli strains retained their MRHA ability after transportation to Sweden followed by one subculture and after storage at -70 degrees C (but not at room temperature) for 1 to 2 years without further subculturing. After 5 to 10 subcultures of the fresh isolates, however, 70% of the initially CFA/I- and 80% of the initially CFA/II-carrying strains analyzed did not hemagglutinate. The efficacy of different methods for detecting CFAs on the fresh isolates was compared with that of immunodiffusion. The sensitivity of MRHA with human blood group A erythrocytes for the detection of CFA/I was high (97%), but the specificity was only 69%. The sensitivity of MRHA with bovine erythrocytes for the detection of CFA/II in Bangladesh was very low but increased considerably when chicken erythrocytes were also used. Whereas both false-positive and false-negative reactions were obtained when absorbed CFA antisera were used for agglutination, antisera against purified CFAs were equally effective as immunodiffusion in identifying CFA/I and CFA/II-carrying strains.

  • 3. Belshe, Robert B
    et al.
    Edwards, Kathryn M
    Vesikari, Timo
    Black, Steven V
    Walker, Robert E
    Hultquist, Micki
    Kemble, George
    Connor, Edward M
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Live attenuated versus inactivated influenza vaccine in infants and young children.2007In: N Engl J Med, ISSN 1533-4406, Vol. 356, no 7, p. 685-96Article in journal (Other academic)
    Abstract [en]

    BACKGROUND: Universal vaccination of children 6 to 59 months of age with trivalent inactivated influenza vaccine has recently been recommended by U.S. advisory bodies. To evaluate alternative vaccine approaches, we compared the safety and efficacy of intranasally administered live attenuated influenza vaccine with those of inactivated vaccine in infants and young children. METHODS: Children 6 to 59 months of age, without a recent episode of wheezing illness or severe asthma, were randomly assigned in a 1:1 ratio to receive either cold-adapted trivalent live attenuated influenza vaccine (a refrigeration-stable formulation of live attenuated intranasally administered influenza vaccine) or trivalent inactivated vaccine in a double-blind manner. Influenza-like illness was monitored with cultures throughout the 2004-2005 influenza season. RESULTS: Safety data were available for 8352 children, and 7852 children completed the study according to the protocol. There were 54.9% fewer cases of cultured-confirmed influenza in the group that received live attenuated vaccine than in the group that received inactivated vaccine (153 vs. 338 cases, P<0.001). The superior efficacy of live attenuated vaccine, as compared with inactivated vaccine, was observed for both antigenically well-matched and drifted viruses. Among previously unvaccinated children, wheezing within 42 days after the administration of dose 1 was more common with live attenuated vaccine than with inactivated vaccine, primarily among children 6 to 11 months of age; in this age group, 12 more episodes of wheezing were noted within 42 days after receipt of dose 1 among recipients of live attenuated vaccine (3.8%) than among recipients of inactivated vaccine (2.1%, P=0.076). Rates of hospitalization for any cause during the 180 days after vaccination were higher among the recipients of live attenuated vaccine who were 6 to 11 months of age (6.1%) than among the recipients of inactivated vaccine in this age group (2.6%, P=0.002). CONCLUSIONS: Among young children, live attenuated vaccine had significantly better efficacy than inactivated vaccine. An evaluation of the risks and benefits indicates that live attenuated vaccine should be a highly effective, safe vaccine for children 12 to 59 months of age who do not have a history of asthma or wheezing. (ClinicalTrials.gov number, NCT00128167 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.

  • 4. Berg, S
    et al.
    Trollfors, B
    Claesson, B A
    Alestig, K
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hugosson, S
    Lindquist, L
    Olcén, P
    Romanus, V
    Strangert, K
    Incidence and prognosis of meningitis due to Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis in Sweden.1996In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 28, no 3, p. 247-52Article in journal (Refereed)
    Abstract [en]

    The incidence, concomitant conditions and case fatality rate of Haemophilus influenzae (Hi) and pneumococcal meningitis and of invasive meningococcal infections were studied retrospectively in Sweden (population 8.4 million) for the years 1987-89, the period before vaccination against Hi type b started. A total of 1,019 cases with culture-verified infection were found. The incidence rates per 100,000 per year were 1.8 for Hi meningitis, 1.2 for pneumococcal meningitis and 1.0 for invasive meningococcal infections. The age-specific incidence was highest in the 3-23 months age group for the 3 bacterial species. Pneumococcal meningitis was common in individuals > or = 60 years and meningococcal infections in the age-group 10-24 years. A serious concomitant condition was known in 57% of all patients with pneumococcal meningitis while this was uncommon for the other organisms. The case fatality rate was 2% for Hi meningitis, 24% for pneumococcal meningitis and 10% for meningococcal infections. All 81 pneumococcal isolates which had been serotyped belonged to serotypes in the 23-valent pneumococcal vaccine. Of the meningococcal isolates, 65% belonged to serogroup B. In conclusion, the high incidence of Hib meningitis justifies general Hib vaccination. Development of a vaccine against N. meningitidis group B should have high priority. Furthermore, improved pneumococcal vaccines are needed for patients with predisposing conditions. The currently available pneumococcal polysaccharide vaccine seems to be underused.

  • 5. Berglund, L
    et al.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Tärnvik, A
    [Treatment of tularemia in children].1998In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 95, no 36, p. 3758-Article in journal (Refereed)
  • 6. Bergman, Annika
    et al.
    Young, Cecilia
    Miadi-Fargier, Houda
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Sjukvård och samhälle får betala högt pris för rotavirusinfektioner hos barn: Svensk deskriptiv kostnadsstudieger prisuppgifter2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 16, p. 1186-1191Article in journal (Other academic)
    Abstract [en]

    Rotavirus gastroenterit is the most frequent cause of severe diarrhoea in children <5 years of age. Morbidity and resource use due to rotavirus are substantial, though comprehensive data on the economic impact of the disease in Sweden are lacking. The objective of this study was to estimate the average cost per episode of confirmed rotavirus gastroenteritis in primary care, emergency department and hospital settings in Sweden. The total societal cost (including direct medical, direct nonmedical and indirect cost) per episode was estimated to SEK4307 in the primary care setting, SEK5837 in the emergency department setting and to SEK19 456 in the hospital setting. Loss of productivity due to work absenteeism among parents was one of the major costs from a societal perspective. The result shows that rotavirus incurs considerable resource utilisation in all health care settings and substantial costs for the health care sector and the society.

  • 7.
    Bergström, Sven
    et al.
    Umeå University, Faculty of Medicine, Microbiology.
    Olsén, Björn
    Umeå University, Faculty of Medicine, Microbiology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Burman, Nils
    Umeå University, Faculty of Medicine, Microbiology.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Jaenson, Thomas G.T.
    University of Uppsala.
    Jonsson, Maria
    Umeå University, Faculty of Medicine, Microbiology.
    Mejlon, Hans A
    University of Uppsala.
    Molecular characterization of Borrelia burgdorferi isolated from Ixodes ricinus in northern Sweden1992In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 24, no 2, p. 181-188Article in journal (Refereed)
    Abstract [en]

    Ixodes ricinus ticks, harbouring Borrelia burgdorferi, were found in an area in northern Sweden, not thought to be endemic for Lyme borreliosis. This investigation took place at Norrbyskär, an island situated in the Bothnian Gulf, 63 degrees 33'N/19 degrees 52'E. One of 42 nymphal and 8/43 adult I. ricinus ticks collected carried spirochetes as seen by phase contrast microscopy. Pure bacterial cultures were obtained from 2 of the ticks. Western blot analysis using species-specific monoclonal antibodies showed that the isolated spirochetes were B. burgdorferi. The identity of the isolated spirochetes was confirmed by DNA amplification using B. burgdorferi OspA and flagellin gene specific oligonucleotides as well as partial DNA sequencing of the respective OspA and flagellin genes. The 2 isolated spirochaete populations were different as shown by their protein profiles in sodium dodecyl sulphate polyacrylamide gels. Moreover, the demonstration of Lyme borreliosis in a patient from the island of Norrbyskär indicates the need for clinical consideration of this disease in northern Sweden.

  • 8. Berntson, L
    et al.
    Steen, L
    Stenling, R
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [Ménétrier disease as an unusual cause of hypoalbuminemia in children].1990In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 87, no 26-27, p. 2259-60Article in journal (Refereed)
  • 9. Björkstén, B
    et al.
    Bortolussi, R
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Quie, P G
    Interaction of E. coli strains with human serum: lack of relationship to K1 antigen.1976In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 89, no 6, p. 892-7Article in journal (Refereed)
    Abstract [en]

    Twenty-eight strains of E. coli isolated from infants were compared with respect to opsonic requirements, sensitivity to serum, and ability to activate serum chemotactic factors. Six of the strains were isolated from stools of healthy newborn infants; 22 were isolated from the cerebrospinal fluid or blood of infants with meningitis and/or septicemia. Eighteen of the strains had K1 polysaccharide antigen. Fourteen of the strains (seven with K1 antigen) activated complement via the alternative pathway and all of these strains were well opsonized in 4% pooled human serum. A higher concentration of serum was necessary to opsonize 12 of the 14 strains that did not activate the alternative pathway. A wide variation was also found in opsonic requirements of E. coli strains isolated from healthy and sick infants. There was no relationship of the K1 antigen to opsonic requirements, to capacity to activate complement via the alternative pathway, to generation of chemotactic factors, or to sensitivity to serum cidal activity. Therefore, the association of E. coli with K1 antigen and neonatal meningitis did not appear to be related to these bacteria-serum interactions.

  • 10. Björkstén, B
    et al.
    Burman, L G
    De Château, P
    Fredrikzon, B
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Collecting and banking human milk: to heat or not to heat?1980In: British medical journal, ISSN 0007-1447, Vol. 281, no 6243, p. 765-9Article in journal (Refereed)
    Abstract [en]

    Data on human breast milk and its handling when fed to babies who cannot be breast-fed were reviewed to determine whether the method of processing and storage affected the properties of the milk. Breast milk is normally contaminated by potential pathogens, which seem to produce no ill effects, but it also contains antimicrobial properties which protect against infection. The evidence suggests that pasteurisation not only eliminates pathogenic bacteria but also damages bacteriostatic mechanisms, so making the milk more susceptible to later contamination. Pasteurisation also affects the nutritional properties of milk. Freezing has little effect on milk proteins, while a study on the effect of refrigeration showed that there was little bacterial growth at temperatures below 8 degrees C. Several years' experience of feeding donated raw milk to newborn infants has confirmed that it produces no ill effects. These findings suggest that pasteurisation of donated breastmilk is unnecessary, and it is not recommended, while the decision whether or not to freeze the milk may be made on practical grounds. Raw breast milk can be safely stored at 4-6 degrees C for 72 hours.

  • 11. Björkstén, B
    et al.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Sidenvall, R
    The effect of human colostrum on neutrophil function.1979In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 13, no 6, p. 737-41Article in journal (Refereed)
    Abstract [en]

    Strains of Escherichia coli were opsonized in human colostrum via heat stable opsonins and the classic complement pathway, but colostrum lacked capacity to opsonize E. coli via the alternative pathway. There was no bacteriostatic activity against serum sensitive E. coli strains, although specific antibodies against the strains were present. Neutrophils suspended in colostrum had normal chemotaxis and this was not altered by treating the colostrum with HCl.

  • 12. Blennow, M
    et al.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Storsaeter, J
    [A new vaccination campaign for better protection against whooping cough of infants].1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, no 30-31, p. 3320-Article in journal (Refereed)
  • 13. Carlsson, B
    et al.
    Kaijser, B
    Ahlstedt, S
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hansson, L A
    Antibodies against Escherichia coli capsular (K) antigens in human milk and serum. Their relation on the E. coli gut flora of the mother and neonate.1982In: Acta paediatrica Scandinavica, ISSN 0001-656X, Vol. 71, no 2, p. 313-8Article in journal (Refereed)
  • 14.
    Carlsson, R. M.
    et al.
    Göteborg, Sweden; Public Health Agency of Sweden, Sweden.
    Gustafsson, L.
    Public Health Agency of Sweden, Sweden.
    Hallander, H. O.
    Public Health Agency of Sweden, Sweden.
    Ljungman, M.
    Public Health Agency of Sweden, Sweden.
    Olin, P.
    Public Health Agency of Sweden, Sweden.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Public Health Agency of Sweden, Sweden.
    Nilsson, L.
    Public Health Agency of Sweden, Sweden; Linköping, Sweden.
    Netterlid, E.
    Public Health Agency of Sweden, Sweden; Malmö, Sweden.
    Two consecutive randomized controlled pertussis booster trials in children initially vaccinated in infancy with an acellular vaccine: The first with a five-component Tdap vaccine to 5-year olds and the second with five- or monocomponent Tdap vaccines at age 14-15 years2015In: Vaccine, ISSN 0264-410X, E-ISSN 1873-2518, Vol. 33, no 31, p. 3717-3725Article in journal (Refereed)
    Abstract [en]

    Prior study children from a DTaP efficacy trial were recruited at ages 5 and 15 years to randomized booster trials addressing immunogenicity and reactogenicity; 475 preschool children received mixed or separate injections of a reduced antigen vaccine (Tdap5, Sanofi Pasteur MSD) and an inactivated polio vaccine, and 230 adolescents received the same or another booster vaccine (Tdap1, SSI, Denmark). Pre-vaccination antibody concentrations against pertussis antigens were significantly higher at 15 than 5 years of age, probably due to natural boosting between the studies. Tdap5 induced comparable anti-PT concentrations at both ages, but antibody responses were significantly higher to filamentous haemagglutinin, pertactin and fimbriae 2/3 in adolescents. As expected, a higher amount of PT (Tdap1, 20 mu g) induced a stronger anti-PT response than a lower amount (Tdap5, 2.5 mu g). The frequency of adverse events was low and there were no serious adverse reactions. All local reactions had an early onset and a short duration. A large swelling or redness of more than half of the upper arm circumference was reported in 8/475 5-year-olds and in 6/230 15-year-olds. Children vaccinated with Tdap5 reported more moderate pain in adolescence than at preschool age, whereas itching was only reported in preschool children. Sweden introduced DTaP vaccines in 1996 after a 17-year hiatus with no general pertussis vaccination and pertussis was still endemic at the time of the studies. The frequency of adverse events was nevertheless low in both preschool children and adolescents and antibody responses were adequate. These studies document immunogenicity and reactogenicity in a trial cohort consecutively vaccinated with acellular pertussis vaccines from infancy to adolescence. (C) 2015 Elsevier Ltd. All rights reserved.

  • 15. Carlsson, R M
    et al.
    Trollfors, B
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Taranger, J
    [National cooperation in mass vaccination of infants is important].1993In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 90, no 44, p. 3846-Article in journal (Refereed)
  • 16. Carlsson, Rose-Marie
    et al.
    Blennow, Margareta
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Vaccination av barn och ungdomar (ingår i Läkemedelsboken 2011-2012)2011In: Läkemedelsboken 2011-2012 / [ed] Odeberg H et al (red), Uppsala: Läkemedelsverket , 2011, p. 177-191Chapter in book (Refereed)
  • 17. Carlsson, Rose-Marie
    et al.
    Ekholm, Leif
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Granström, Marta
    Trolin, Ingrid
    Tegnell, Anders
    [Time for booster doses against whooping cough for 10-year-old children]2005In: Lakartidningen, ISSN 0023-7205, Vol. 102, no 35, p. 2394-8Article in journal (Other academic)
    Abstract [sv]

    Acellular pertussis vaccine was introduced in Sweden in 1996 at the age of 3, 5 and 12 months, after a 17 year period without general vaccination against pertussis. At present, the incidence of notified pertussis has decreased to 1/10 of what was seen 10 years ago. In spite of the dramatic decrease, the disease is not eliminated. In accordance with the experience of other countries, most cases in Sweden are reported among older children and adults, while the highest risk of severe disease is still seen in infants. Many industrialized countries have introduced booster dose(s) in order to control the spread of pertussis. The Swedish National Board of Health and Welfare has recently initiated a major revision of the vaccines used and the schedule of the national vaccination program. Until the final proposal and in order not to miss the opportunity to boost pertussis immunity in children who were vaccinated as infants at the reintroduction of pertussis vaccination, the Board now recommends the Swedish municipalities as an interim measure to include pertussis in the current school booster against diphtheria and tetanus at 10 years of age with a full dose vaccine.

  • 18.
    Carlsson, Rose-Marie
    et al.
    Avdelningen för epidemiologi, Smittskyddsinstitutet, Solna.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Granström, Marta
    Mikrobiologiskt och tumörbiologiskt centrum (MTC), Karolinska institutet, Karolinska Universitetssjukhuset, Solna.
    Vaccinscheman inom EU behöver göras mer lika: More equal vaccination schedules in the European Union needed2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 22, p. 1665-1669Article in journal (Other academic)
    Abstract [en]

    The worldwide variation in vaccination schedules often induces questions about complementary vaccinations to children in migrating families. Also the European vaccination programmes seem to differ widely, but there are in fact many similarities. A two or three-dose priming schedule, with 1, 1 ? or 2 months interval within the three-dose schedule, is used for immunisation against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b and in many countries also against hepatitis B. In some countries hepatitis B vaccination is started at birth. An early booster at 10-24 months is also generally implemented, with very few exceptions. At least one additional booster dose against diphtheria and tetanus is recommended within the age intervals 4-7 or 11-18 years of age. Most countries also have scheduled boosters against polio and pertussis within these intervals. Nowadays all countries offer two doses of MMR. The first dose is usually given at 12-18 months of age, while there is a wide age range for the second dose. A majority of countries give the second MMR at 3-9 years of age, five countries at 13-24 months whereas nine countries vaccinate at 9-13 years of age.

  • 19. Carlsson, Rose-Marie
    et al.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Lindberg, Anders
    [Whooping cough is life-threatening for small children. Generous prophylaxis and contact tracing reduce the risks]2005In: Lakartidningen, ISSN 0023-7205, Vol. 102, no 35, p. 2390-2Article in journal (Other academic)
    Abstract [sv]

    The article presents clinical features of pertussis in older children and adults as well as in unvaccinated infants, with the aim to increase the awareness of the disease and to promote implementation of chemoprophylaxis in households with infants. The national routines for reporting according to the Communicable Diseases Act are outlined, contact-tracing around cases of pertussis being mandatory since July 2004.

  • 20. Claesson, B A
    et al.
    Lagergård, T
    Trollfors, B
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Jodal, U
    Serum antibody response to capsular polysaccharide, outer membrane, and lipooligosaccharide in children with invasive Haemophilus influenzae type b infections.1987In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 25, no 12, p. 2339-43Article in journal (Refereed)
    Abstract [en]

    Serum antibodies against capsular polysaccharide (CPS), outer membrane (OM), and lipooligosaccharide (LOS) from Haemophilus influenzae type b were measured by enzyme-linked immunosorbent assay in acute- and convalescent-phase sera from 21 children between 3 months and 4 years of age with invasive H. influenzae type b infections. As expected, the levels of anti-CPS antibodies in the acute-phase serum samples were low or not detectable, as were the levels of antibodies against LOS. In contrast, all children had detectable antibodies against the OM in the acute-phase serum sample, indicating that they are of little or no importance for protection. An antibody response to CPS was noted in 13 of the 21 patients, mainly in the older children. An antibody response to the OM was seen in 16 patients, with no evident relation to age. The antibody response to the OM preparation, which consisted of proteins and LOS, was probably directed mainly against the OM proteins, since only six children showed a response, usually of low magnitude, of antibodies to LOS.

  • 21.
    Dahlquist, Gisela
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    The cumulative incidence of childhood diabetes mellitus in Sweden unaffected by BCG-vaccination.1995In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 38, no 7, p. 873-4Article in journal (Refereed)
  • 22.
    Engberg, S
    et al.
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Gothefors, L
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Infektioner hos nyfödda2006In: Infektionsmedicin 2, 2006Chapter in book (Other academic)
    Abstract [sv]

    No abstract available

  • 23.
    Farooqi, Aijaz
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Sedin, G
    Gothefors, L
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Serenius, F
    Executive functions, language and learning skills in children born at 23-25 weeks' gestation in the 1990s: a Swedish national prospective follow-up studyArticle in journal (Refereed)
  • 24.
    Farooqi, Aijaz
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Sedin, Gunnar
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Serenius, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Chronic conditions, functional limitations, and special health care needs in 10- to 12-year-old children born at 23 to 25 weeks' gestation in the 1990s: a Swedish national prospective follow-up study.2006In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 118, no 5, p. e1466-e1477Article in journal (Refereed)
  • 25.
    Farooqi, Aijaz
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Pediatrik.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry. Barn- och ungdomspsykiatri.
    Sedin, Gunnar
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Pediatrik.
    Serenius, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Pediatrik.
    Growth in 10- to 12-year-old children born at 23 to 25 weeks' gestation in the 1990s: a Swedish national prospective follow-up study.2006In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Pediatrics, ISSN 1098-4275, Vol. 118, no 5, p. e1452-e1465Article in journal (Refereed)
  • 26.
    Farooqi, Aijaz
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Sedin, Gunnar
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Serenius, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Mental health and social competencies of 10- to 12-year-old children born at 23 to 25 weeks of gestation in the 1990s: a Swedish national prospective follow-up study.2007In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 120, no 1, p. 118-133Article in journal (Refereed)
    Abstract [en]

    Abstract

    OBJECTIVE: We investigated a national cohort of extremely immature children with respect to behavioral and emotional problems and social competencies, from the perspectives of parents, teachers, and children themselves.

    METHODS: We examined 11-year-old children who were born before 26 completed weeks of gestation in Sweden between 1990 and 1992. All had been evaluated at a corrected age of 36 months. At 11 years of age, 86 of 89 survivors were studied and compared with an equal number of control subjects, matched with respect to age and gender. Behavioral and emotional problems, social competencies, and adaptive functioning at school were evaluated with standardized, well-validated instruments, including parent and teacher report questionnaires and a child self-report, administered by mail.

    RESULTS: Compared with control subjects, parents of extremely immature children reported significantly more problems with internalizing behaviors (anxiety/depression, withdrawn, and somatic problems) and attention, thought, and social problems. Teachers reported a similar pattern. Reports from children showed a trend toward increased depression symptoms compared with control subjects. Multivariate analysis of covariance of parent-reported behavioral problems revealed no interactions, but significant main effects emerged for group status (extremely immature versus control), family function, social risk, and presence of a chronic medical condition, with all effect sizes being medium and accounting for 8% to 12% of the variance. Multivariate analysis of covariance of teacher-reported behavioral problems showed significant effects for group status and gender but not for the covariates mentioned above. According to the teachers' ratings, extremely immature children were less well adjusted to the school environment than were control subjects. However, a majority of extremely immature children (85%) were functioning in mainstream schools without major adjustment problems.

    CONCLUSIONS: Despite favorable outcomes for many children born at the limit of viability, these children are at risk for mental health problems, with poorer school results.

  • 27. Giaquinto, Carlo
    et al.
    Van Damme, Pierre
    Huet, Frederic
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Maxwell, Melanie
    Todd, Peter
    da Dalt, Liviana
    Clinical consequences of rotavirus acute gastroenteritis in Europe, 2004-2005: the REVEAL study.2007In: J Infect Dis, ISSN 0022-1899, Vol. 195 Suppl 1, p. S26-35Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The availability of comprehensive, up-to-date epidemiologic data would improve the understanding of the disease burden and clinical consequences of rotavirus gastroenteritis (RVGE) in Europe. METHODS: During the 2004-2005 season, a prospective, multicenter, observational study was conducted in children <5 years of age in primary care, emergency department, and hospital settings in selected areas of Belgium, France, Germany, Italy, Spain, Sweden, and the United Kingdom. The clinical consequences of acute gastroenteritis (AGE) and RVGE were estimated. RESULTS: The estimated percentage of children with rotavirus-positive AGE admitted to a hospital was 10.4%-36.0%, compared with 2.1%-23.5% of children with rotavirus-negative AGE. In France, Germany, Italy, Spain, and the United Kingdom, the relative risk of hospitalization was statistically significantly higher for children with rotavirus-positive AGE than for those with rotavirus-negative AGE. Children with rotavirus-positive AGE were more likely to have lethargy, fever, vomiting, and dehydration, and, therefore, more severe disease than were children with rotavirus-negative AGE. Dehydration was up to 5.5 times more likely in children with rotavirus-positive AGE than in those with rotavirus-negative AGE. CONCLUSIONS: Rotavirus-positive AGE is more severe, causes more dehydration, and results in more emergency department consultations and hospitalizations than does rotavirus-negative AGE. Variations in the management of RVGE seen across study areas could be explained by differences in health care systems. Routine rotavirus vaccination of infants could significantly reduce the substantial burden of RVGE and would have major benefits for potential patients, their families, and health care providers.

  • 28. Giaquinto, Carlo
    et al.
    Van Damme, Pierre
    Huet, Frédéric
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Van der Wielen, Marie
    Costs of community-acquired pediatric rotavirus gastroenteritis in 7 European countries: the REVEAL Study.2007In: J Infect Dis, ISSN 0022-1899, Vol. 195 Suppl 1, p. S36-S44Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Morbidity and resource use due to rotavirus gastroenteritis (RVGE) are substantial in Europe, although comprehensive data on the economic impact of the disease are lacking. METHODS: A cost study was conducted to assess health care resource use data collected during a prospective epidemiologic study of acute gastroenteritis in children <5 years of age in selected areas of Belgium, France, Germany, Italy, Spain, Sweden, and the United Kingdom. We calculated the average cost (direct and indirect) per episode of confirmed RVGE in primary care, emergency department, and hospital settings. RESULTS: The total societal cost (including direct medical, direct nonmedical, and indirect costs) per episode of RVGE ranged from 166 euros to 473 euros in the primary care setting, from 334 euros to 770 euros in the emergency department setting, and from 1525 euros to 2101 euros in the hospital setting. The majority of hospital-related costs were reimbursed by national health care payers, but the percentage of reimbursed costs declined progressively in the emergency department and primary care settings. The mean number of workdays lost by parents and other relatives varied between study areas and settings, ranging from 2.3 to 7.5 days, and this represented the major cost not reimbursed by national health care payers. CONCLUSIONS: RVGE incurs considerable resource utilization in all health care settings and substantial costs for national health care payers, families of patients, and employers. Routine rotavirus vaccination in infants could significantly reduce the health and economic burden of pediatric RVGE.

  • 29.
    Gothefors, L
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Infektionssjukdomar2007In: Barnmedicin, 2007Chapter in book (Other academic)
    Abstract [sv]

    Abstract not available

  • 30.
    Gothefors, L
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    The impact of vaccines in low- and high-income countries2008In: Annales Nestlé, ISSN 0517-8606, Vol. 66, no 2, p. 55-69Article in journal (Refereed)
    Abstract [en]

    Vaccination has become the most effective public health measure for the control of infectious diseases after the provision of clean drinking water. The history of vaccination is marked with great hopes and some disappointments. In particular, the second half of the 20th century witnessed the development of remarkable vaccination projects. There is a possibility that polio and measles may be eradicated within a few years, but almost 3 million people - usually children <5 years of age - die each year from diseases that are preventable by vaccines. Developing countries are struggling to get the vaccines to children who desperately need them. However, in Europe and North America, people have become complacent about vaccines: 'these diseases are no longer a threat and the vaccine is more dangerous than the disease'. Those misconceptions have caused outbreaks of measles, diphtheria and pertussis. The international community must continue to devote the necessary resources, money and manpower to fully exploit the promise that vaccines hold for the relief of human misery.

  • 31.
    Gothefors, L
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    The relevance and future role of the international vaccine institute (IVI) 2000-20062007Report (Other academic)
    Abstract [en]

    No abstract available

  • 32.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [Acyclovir in varicella or herpes simplex. Restricted indications for otherwise healthy children].1994In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 91, no 8, p. 707-8Article in journal (Refereed)
  • 33.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [Cefuroxime has a good effect in severe infections in children].1990In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 87, no 37, p. 2849-50Article in journal (Refereed)
  • 34.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [Current aspects in vaccination program for children].1991In: Vårdfacket, ISSN 0347-0911, Vol. 15, no 16, p. X-XIArticle in journal (Refereed)
  • 35.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Effects of diet on intestinal flora.1989In: Acta paediatrica Scandinavica. Supplement, ISSN 0300-8843, Vol. 351, p. 118-21Article in journal (Refereed)
  • 36.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [Information on vaccination against whooping cough will be released in the autumn].1991In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 88, no 37, p. 2968-Article in journal (Refereed)
  • 37.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology.
    Studies of antimicrobial factors in human milk and bacterial colonization of the newborn1975Doctoral thesis, comprehensive summary (Other academic)
  • 38.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Symbiosis between host and microorganisms: neonatal colonization.1980In: Scandinavian Journal of Infectious Diseases. Supplementum, ISSN 0300-8878, E-ISSN 1651-2502, Vol. Suppl 24, p. 68-73Article in journal (Refereed)
  • 39.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [The best health care in the world is inaccessible for still more and more American children].1992In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 89, no 15, p. 1259-60Article in journal (Refereed)
  • 40.
    Gothefors, Leif
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [With optimal diagnosis of enterovirus infections can Sweden be proclaimed free from polio in the long run].2000In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, no 26-27, p. 3217-8Article in journal (Refereed)
  • 41.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Ahrén, C
    Stoll, B
    Barua, D K
    Orskov, F
    Salek, M A
    Svennerholm, A M
    Presence of colonization factor antigens on fresh isolates of fecal Escherichia coli: a prospective study.1985In: Journal of Infectious Diseases, ISSN 0022-1899, E-ISSN 1537-6613, Vol. 152, no 6, p. 1128-33Article in journal (Refereed)
    Abstract [en]

    In Dhaka, Bangladesh, fresh isolates of Escherichia coli from 197 patients with diarrhea were investigated for production of enterotoxin and possession of colonization factor antigen (CFA) I or II. Enterotoxigenic E. coli (ETEC) was isolated from 34% of the patients, and of the 67 enterotoxin-positive strains, 75% carried CFAs. Among 68 healthy control persons no strains positive for both enterotoxin and CFA were found. The CFAs in general were restricted to certain serotypes of E. coli. In a subgroup of patients, part of an ongoing surveillance study, mixed infection was seen in 23% of those from whom recognized pathogens were identified. There was a tendency to more severe dehydration when the two virulence factors, enterotoxin and CFA, were simultaneously present.

  • 42.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Berg, R
    [The new pertussis vaccines are safe and efficient. With only few exceptions should all preschool children be vaccinated].1997In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 94, no 45, p. 4057-61Article in journal (Refereed)
  • 43.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Berg, R
    [Vaccination against whooping cough is being reintroduced].1996In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 93, no 3, p. 129-32Article in journal (Refereed)
  • 44.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Bergström, E
    Backman, M
    Immunogenicity and reactogenicity of a new measles, mumps and rubella vaccine when administered as a second dose at 12 y of age.2001In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, no 7, p. 545-9Article in journal (Refereed)
    Abstract [en]

    An open randomized trial involving 301 subjects was conducted in order to compare the reactogenicity and immunogenicity of a new measles, mumps and rubella (MMR) vaccine, SB MMR, with those of a commercial MMR vaccine, Merck MMR, when given as a second dose to children at 11-12 y of age. All subjects had previously received Merck MMR in the first year of life. In initially seronegative subjects, all subjects receiving the Merck MMR vaccine had seroconverted with respect to measles (10/10 subjects), mumps (38/38) and rubella (4/4). Of the subjects receiving SB MMR, 6/7 seroconverted with respect to measles, 29/31 with respect to mumps and 3/3 with respect to rubella. No difference was seen in seroconversion rates or geometric mean values (GMVs) between groups. In initially seropositive subjects, a higher anti-mumps immune response rate was observed in the SB MMR group (59.3%) compared with the Merck MMR group (24.1%). Higher post-vaccination anti-mumps and anti-rubella GMVs were observed in the group receiving SB MMR (p < 0.007), whereas higher anti-measles GMVs were observed in the Merck MMR group (p = 0.0013). There was a lower (p = 0.013) incidence of pain at the injection site in subjects receiving SB MMR (20.1%) compared with Merck MMR (33.3%). Incidences of systemic reactions were similar between groups.

  • 45.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Blenkharn, I
    Clostridium butyricum and necrotising enterocolitis.1978In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 1, no 8054, p. 52-3Article in journal (Refereed)
  • 46.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Carlsson, Rose-Marie
    [Children become as ill because of influenza as the elderly. They become early infection carriers as well: a vaccine can significantly reduce health problems]2006In: Lakartidningen, ISSN 0023-7205, Vol. 103, no 7, p. 440-1Article in journal (Other academic)
    Abstract [sv]

    Article in Swedish

  • 47.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Diarré och magsjuka – prevention och behandling2011In: Små & stora nyheter, ISSN ISSN 1400-4186, no MajArticle in journal (Other (popular science, discussion, etc.))
  • 48.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    [Lactose intolerance after gastroenteritis. Not the serious clinical problem as supposed earlier].1995In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 92, no 40, p. 3694, 3698-9Article in journal (Refereed)
  • 49.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Storsaeter, J
    [2 vaccine dosages for basic prevention of whooping cough in children over 2 years of age?].1996In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 93, no 28-29, p. 2564-Article in journal (Refereed)
  • 50.
    Gothefors, Leif
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Strangert, K
    Taranger, J
    Trollfors, B
    [General vaccination against Haemophilus influenzae type b--unified decision for the entire country is needed].1992In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 89, no 40, p. 3268-9Article in journal (Refereed)
12 1 - 50 of 87
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