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Article ; Online: Arterial Stiffness and Carotid Intima-Media Thickness in Children Exposed to Smokeless Tobacco in Fetal Life.

Nordenstam, Felicia / Norman, Mikael / Caidahl, Kenneth / Wickström, Ronny

Journal of the American Heart Association

2024 Volume 13, Issue 2, Page(s) e9128

Abstract: Background: Arterial stiffening and increased intima-media thickness can be seen as early as childhood and are associated with increased risk of cardiovascular events in adult life. The authors hypothesized that exposure to prenatal smokeless tobacco ( ... ...

Abstract	Background: Arterial stiffening and increased intima-media thickness can be seen as early as childhood and are associated with increased risk of cardiovascular events in adult life. The authors hypothesized that exposure to prenatal smokeless tobacco (Swedish snus) without additional nicotine exposure after the breastfeeding period would be associated with increased arterial stiffness and intima-media thickening in preschool children. Methods and results: This was a longitudinal follow-up cohort study of children aged 5 to 6 years exposed to high doses of nicotine in utero. Women exclusively using snus and unexposed controls were enrolled in early pregnancy (gestational age range, 6-12 weeks). Exposure data were collected during and after pregnancy with questionnaires from both groups. For this study, only children of women using >48 mg nicotine per day during their entire pregnancy were included in the exposure group. Outcomes were determined in 40 healthy children (21 exposed to snus in utero). Ultrasonography of the common carotid artery was used to determine carotid intima-media thickness and calculate arterial stiffness index from the relationship between pulsatile changes in arterial diameter and arterial pressure. Children exposed to snus in fetal life had higher carotid stiffness (median 4.1 [interquartile range (IQR), 2.4-5] versus 2.9 [IQR, 2.1-3.5]; Conclusions: Exposure to snus during fetal life was associated with a stiffer carotid artery in preschool children.
MeSH term(s)	Adult ; Pregnancy ; Child, Preschool ; Humans ; Female ; Child ; Infant ; Carotid Intima-Media Thickness ; Tobacco, Smokeless/adverse effects ; Nicotine/adverse effects ; Follow-Up Studies ; Vascular Stiffness ; Carotid Arteries/diagnostic imaging
Chemical Substances	Nicotine (6M3C89ZY6R)
Language	English
Publishing date	2024-01-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.032384
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Article ; Online: Strategies for extinguishing FIRES.

Wickström, Ronny

European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society

2019 Volume 23, Issue 5, Page(s) 669

MeSH term(s)	Deep Brain Stimulation ; Humans ; Interleukin 1 Receptor Antagonist Protein ; Thalamic Nuclei
Chemical Substances	Interleukin 1 Receptor Antagonist Protein
Language	English
Publishing date	2019-09-04
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1397146-3
ISSN	1532-2130 ; 1090-3798
ISSN (online)	1532-2130
ISSN	1090-3798
DOI	10.1016/j.ejpn.2019.09.001
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Zs.A 4867: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Neurological outcomes and mortality after neonatal seizures with electroencephalographical verification. A systematic review.

Westergren, Hanna / Finder, Mikael / Marell-Hesla, Helena / Wickström, Ronny

European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society

2024 Volume 49, Page(s) 45–54

Abstract: Aim: To conduct a systematic review of post-neonatal neurological outcomes and mortality following neonatal seizures with electroencephalographical verification.: Methods: The databases Medline, Embase and Web of Science were searched for eligible ... ...

Abstract	Aim: To conduct a systematic review of post-neonatal neurological outcomes and mortality following neonatal seizures with electroencephalographical verification. Methods: The databases Medline, Embase and Web of Science were searched for eligible studies. All abstracts were screened in a blinded fashion between research team members and reports found eligible were obtained and screened in full text by two members each. From studies included, outcome results for post-neonatal epilepsy, cerebral palsy, intellectual disability, developmental delay, mortality during and after the neonatal period and composite outcomes were extracted. A quality assessment of each study was performed. Results: In total, 5518 records were screened and 260 read in full text. Subsequently, 31 studies were included, containing cohorts of either mixed or homogenous etiologies. Follow-up time and gestational ages varied between studies. No meta-analysis could be performed due to the low number of studies with comparable outcomes and effect measures. Reported cumulative incidences of outcomes varied greatly between studies. For post-neonatal epilepsy the reported incidence was 5-84%, for cerebral palsy 9-78%, for intellectual disability 24-67%, for developmental delay 10-67% and for mortality 1-62%. Subgroup analysis had more coherent results and in cohorts with status epilepticus a higher incidence of post-neonatal epilepsy from 46 to 84% was shown. Conclusion: The large variation of reported incidences for neurological outcomes and mortality found even when restricting to cohorts with electroencephalographically verified neonatal seizures indicates selection bias as a significant confounder in existing studies. Population-based approaches are thus warranted to correctly predict outcomes in this group.
MeSH term(s)	Humans ; Electroencephalography ; Infant, Newborn ; Seizures/mortality ; Cerebral Palsy/mortality ; Cerebral Palsy/complications ; Cerebral Palsy/physiopathology ; Developmental Disabilities/etiology
Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1397146-3
ISSN	1532-2130 ; 1090-3798
ISSN (online)	1532-2130
ISSN	1090-3798
DOI	10.1016/j.ejpn.2024.02.005
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Zs.A 4867: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: What is changing, and what is not, in childhood encephalitis.

Wickström, Ronny

The Lancet. Infectious diseases

2017 Volume 17, Issue 4, Page(s) 354–355

MeSH term(s)	Child ; Encephalitis ; Humans
Language	English
Publishing date	2017-03-02
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(17)30115-9
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Zs.A 5743: Show issues

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Article ; Online: Selection and Continuation of Antiseizure Medication in Children With Epilepsy in Sweden From 2007 to 2020.

Håkansson, Samuel / Wickström, Ronny / Zelano, Johan

Pediatric neurology

2023 Volume 144, Page(s) 19–25

Abstract: Background: Knowledge on antiseizure medication (ASM) use and retention for children with epilepsy is limited, partly because of extensive off-label use of newer drugs with limited registration. We used prescription data to study prescription patterns ... ...

Abstract	Background: Knowledge on antiseizure medication (ASM) use and retention for children with epilepsy is limited, partly because of extensive off-label use of newer drugs with limited registration. We used prescription data to study prescription patterns on a population-wide scale and compared the proportion of patients remaining on monotherapy of ASMs with and without formal indication for different age groups. Methods: A total of 14,681 individuals aged <18 years were included, using cross-referenced Swedish registers from 2007 to 2020. Kaplan-Meier retention rates were calculated for all ASMs. The most common pathways of the first three medications per patient were analyzed. Results: In children older than one month and up to age one year, monotherapy retention rates were the highest for oxcarbazepine, valproic acid, and carbamazepine. Among children aged one to five years, oxcarbazepine and levetiracetam were among ASMs that do not have a monotherapy indication in Sweden but still had high retention rates. In the age group five to 12 years, lamotrigine and oxcarbazepine had the highest retention rate. In males aged 12 to 18 years, valproic acid was the most common choice followed by lamotrigine, whereas lamotrigine was the first choice of ASM for females, exceeding the second and third most common options levetiracetam and oxcarbazepine by a factor of two and three, respectively. Conclusion: Off-label medication is common in children with epilepsy but does not seem to be associated with lower retention. The restrictions regarding valproic acid for females of childbearing age seem to have been well implemented in Swedish neuropediatric care.
MeSH term(s)	Male ; Female ; Humans ; Child ; Infant ; Child, Preschool ; Lamotrigine/therapeutic use ; Oxcarbazepine/therapeutic use ; Levetiracetam/therapeutic use ; Sweden/epidemiology ; Valproic Acid ; Triazines/adverse effects ; Epilepsy/drug therapy ; Epilepsy/epidemiology ; Anticonvulsants/therapeutic use
Chemical Substances	Lamotrigine (U3H27498KS) ; Oxcarbazepine (VZI5B1W380) ; Levetiracetam (44YRR34555) ; Valproic Acid (614OI1Z5WI) ; Triazines ; Anticonvulsants
Language	English
Publishing date	2023-03-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/j.pediatrneurol.2023.03.016
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Zs.A 2260: Show issues

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Article ; Online: Corrigendum to "Selection and Continuation of Antiseizure Medication in Children With Epilepsy in Sweden From 2007 to 2020" Pediatric Neurology 144 (2023)(19-25).

Håkansson, Samuel / Wickström, Ronny / Zelano, Johan

Pediatric neurology

2023 Volume 148, Page(s) 223

Language	English
Publishing date	2023-09-13
Publishing country	United States
Document type	Published Erratum
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/j.pediatrneurol.2023.08.030
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Article ; Online: Neurocognitive outcome in children and adolescents following infectious encephalitis.

Bergman, Kristian / Fowler, Åsa / Ygberg, Sofia / Lovio, Riikka / Wickström, Ronny

Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence

2023 , Page(s) 1–18

Abstract: Infectious encephalitis in children is fairly uncommon, but unfavorable outcomes are seen in many survivors. The aim of this study was to prospectively describe the long-term neurocognitive consequences following infectious encephalitis in childhood. ... ...

Abstract	Infectious encephalitis in children is fairly uncommon, but unfavorable outcomes are seen in many survivors. The aim of this study was to prospectively describe the long-term neurocognitive consequences following infectious encephalitis in childhood. Children admitted to a primary and tertiary hospital in Sweden between 2011 and 2016 were asked to participate. Fifty-nine children were assessed at a median time of 18 months (IQR 18-20) after hospitalization. Follow-up included measures of intellectual functioning, attention, working memory, and executive functions. Caregiver ratings of executive functioning and behavioral - emotional symptoms were assessed with standardized questionnaires. Neurocognitive outcome and measures of executive functions and behavioral-emotional symptoms varied greatly among participants. Basic auditory attention, working memory, and mental processing speed were affected and significantly lower compared to a standardized mean. Other domains identified as areas of vulnerability included executive functions, sustained attention, and the exert of self-control. Behavioral-emotional symptoms were less common; however, somatic complaints and behaviors related to conduct problems were seen in about one-third of individuals. This study highlights the importance of a comprehensive neurocognitive examination to identify children with unfavorable outcomes.
Language	English
Publishing date	2023-11-16
Publishing country	England
Document type	Journal Article
ZDB-ID	1262599-1
ISSN	1744-4136 ; 0929-7049
ISSN (online)	1744-4136
ISSN	0929-7049
DOI	10.1080/09297049.2023.2281688
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Zs.A 5753: Show issues

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Article: Editorial: Advances in diagnosing and treating new-onset refractory status epilepticus (NORSE).

Thomschewski, Aljoscha / Giovannini, Giada / Gaspard, Nicolas / Steinbrenner, Mirja / Wickström, Ronny / Jacobs, Julia

Frontiers in neurology

2023 Volume 14, Page(s) 1270702

Language	English
Publishing date	2023-08-30
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1270702
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Article ; Online: Seizures in hospitalised paediatric patients with SARS-CoV-2 and comparison of severity with seizures in hospitalised paediatric patients with other respiratory viruses during the COVID-19 pandemic: a population-based cohort study.

Anastasopoulou, Stavroula / Svensson, Eva / Wickström, Ronny / Hertting, Olof / Rinder, Malin Ryd / Bennet, Rutger / Eriksson, Margareta

Archives of disease in childhood

2024 Volume 109, Issue 2, Page(s) 152–157

Abstract: Objective: To study seizures in patients hospitalised due to SARS-CoV-2 infection, and compare their severity with seizures in patients hospitalised due to other viral respiratory tract infections (RTIs).: Design: Observational population-based ... ...

Abstract	Objective: To study seizures in patients hospitalised due to SARS-CoV-2 infection, and compare their severity with seizures in patients hospitalised due to other viral respiratory tract infections (RTIs). Design: Observational population-based cohort study. Setting: Northern Stockholm. Patients: Patients aged 1 month-18 years hospitalised due to SARS-CoV-2 with and without seizures, and patients of the same age hospitalised due to other viral RTIs with seizures, between 1 March 2020 and 30 June 2022. Main outcome measures: The prevalence of seizures in hospitalised patients due to SARS-CoV-2, the evaluation of assumed predictors of seizures and the comparison of severity markers in patients with SARS-CoV-2 versus other RTIs. Results: 32 of 239 included patients (13.4%) admitted due to SARS-CoV-2 infection had seizures. Central nervous system (CNS) disease and the omicron period had significantly increased OR for seizures (OR: 5.12; CI: 2.06 to 12.72 and OR: 3.01; CI: 1.15 to 7.88, respectively). Seizures in patients with SARS-CoV-2 were more common in children older than 5 years (p=0.001), even in the absence of fever (p=0.007), as compared with other viral RTIs. The duration of hospitalisation was longer in patients with seizures due to other viral RTIs (p=0.023). There was no significant difference regarding severity markers of seizures between the two groups. Conclusions: CNS disease and the omicron period were risk factors for seizures in patients with SARS-CoV-2, who were older than patients with other RTIs. The severity of seizures was comparable between the two groups; hospitalisation was however longer in patients with other RTIs.
MeSH term(s)	Humans ; Child ; Child, Preschool ; SARS-CoV-2 ; COVID-19/complications ; COVID-19/epidemiology ; Cohort Studies ; Pandemics ; Seizures/epidemiology ; Seizures/etiology ; Respiratory Tract Infections
Language	English
Publishing date	2024-01-22
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2023-325974
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Article ; Online: Altered cytokine levels in cerebrospinal fluid following ketogenic diet of children with refractory epilepsy.

Wickström, Ronny / Ygberg, Sofia / Lindefeldt, Marie / Dahlin, Maria

Epilepsy research

2021 Volume 177, Page(s) 106775

Abstract: Ketogenic diet is an effective treatment which has the potential to achieve a significant seizure reduction in drug-resistant epilepsy. The mechanism behind this effect is unclear, but one hypothesis is that the mechanism is anti-inflammatory. In this ... ...

Abstract	Ketogenic diet is an effective treatment which has the potential to achieve a significant seizure reduction in drug-resistant epilepsy. The mechanism behind this effect is unclear, but one hypothesis is that the mechanism is anti-inflammatory. In this prospective study on pediatric patients we compared levels of cytokines and chemokines in the cerebrospinal fluid before and after three months on treatment to evaluate a possible anti-inflammatory effect. We analyzed 34 cytokines and chemokines in the cerebrospinal fluid of pediatric patients (n = 21) with refractory epilepsy by a multiplex assay. Beta-hydroxybutyric acid was measured in blood and cerebrospinal fluid. Seizure frequency in relation to diet treatment was assessed. For 9 different cytokines (CCL 7, CCL 21, CCL 22, CCL 25, CCL 27, IL-2, IL-10, CX3CL1 and MIF), a significant decrease ranging from 7 to 27% was seen after three months as compared to levels before the diet. In contrast, no cytokine displayed a significant increase during diet. A seizure reduction ≥ 50 % was seen in 15/21 patients (71 %) but no significant differences in cytokine decreases were found between responders and non-responders during treatment. A non-significant trend towards higher initial pre-treatment levels of cytokines was seen in responders, which were reduced following treatment. The levels of betahydroxybutyric acid were not related to seizure response. We conclude that while it is not possible to state a primary anti-inflammatory effect by dietary treatment from these data, an unequivocal immunological effect is seen and may be a part of the mechanism of ketogenic dietary treatment.
MeSH term(s)	Child ; Cytokines ; Diet, Ketogenic ; Drug Resistant Epilepsy ; Humans ; Prospective Studies ; Seizures ; Treatment Outcome
Chemical Substances	Cytokines
Language	English
Publishing date	2021-09-22
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632939-1
ISSN	1872-6844 ; 0920-1211
ISSN (online)	1872-6844
ISSN	0920-1211
DOI	10.1016/j.eplepsyres.2021.106775
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