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Axelsson, Inge
Alternative names
Publications (10 of 100) Show all publications
Axelsson, I. (2019). Bone maturation cannot be used to estimate chronological age in asylum-seeking adolescents. Acta Paediatrica, 108(4), 590-592
Open this publication in new window or tab >>Bone maturation cannot be used to estimate chronological age in asylum-seeking adolescents
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 4, p. 590-592Article in journal, Editorial material (Other academic) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-36104 (URN)10.1111/apa.14645 (DOI)000461014600003 ()30428141 (PubMedID)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-07Bibliographically approved
Axelsson, I., Naumburg, E., Prietsch, S. O. M. & Zhang, L. (2019). Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth (review). Cochrane Database of Systematic Reviews (6), Article ID CD010126.
Open this publication in new window or tab >>Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth (review)
2019 (English)In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 6, article id CD010126Article, review/survey (Refereed) Published
Abstract [en]

Background Inhaled corticosteroids (ICS) are the most effective treatment for children with persistent asthma. Although treatment with ICS is generally considered to be safe in children, the potential adverse effects of these drugs on growth remains a matter of concern for parents and physicians. Objectives To assess the impact of different inhaled corticosteroid drugs and delivery devices on the linear growth of children with persistent asthma. Search methods We searched the Cochrane Airways Trials Register, which is derived from systematic searches of bibliographic databases including CENTRAL, MEDLINE, Embase, CINAHL, AMED and PsycINFO. We handsearched respiratory journals and meeting abstracts. We also conducted a search of ClinicalTrials. gov and manufacturers' clinical trial databases, or contacted the manufacturer, to search for potential relevant unpublished studies. The literature search was initially conducted in September 2014, and updated in November 2015, September 2018, and April 2019. Selection criteria We selected parallel-group randomized controlled trials of at least three months' duration. To be included, trials had to compare linear growth between different inhaled corticosteroid molecules at equivalent doses, delivered by the same type of device, or between different devices used to deliver the same inhaled corticosteroid molecule at the same dose, in children up to 18 years of age with persistent asthma. Data collection and analysis At least two review authors independently selected studies and assessed risk of bias in included studies. The data were extracted by one author and checked by another. The primary outcome was linear growth velocity. We conducted meta-analyses using Review Manager 5.3 software. We used mean differences (MDs) and 95% confidence intervals (CIs) as the metrics for treatment effects, and the random-effects model for meta-analyses. We did not perform planned subgroup analyses due to there being too few included trials. Main results We included six randomized trials involving 1199 children aged from 4 to 12 years (per-protocol population: 1008), with mild-to-moderate persistent asthma. Two trials were from single hospitals, and the remaining four trials were multicentre studies. The duration of trials varied from six to 20 months. One trial with 23 participants compared fluticasone with beclomethasone, and showed that fluticasone given at an equivalent dose was associated with a significant greater linear growth velocity (MD 0.81 cm/year, 95% CI 0.46 to 1.16, low certainty evidence). Three trials compared fluticasone with budesonide. Fluticasone given at an equivalent dose had a less suppressive effect than budesonide on growth, as measured by change in height over a period from 20 weeks to 12 months (MD 0.97 cm, 95% CI 0.62 to 1.32; 2 trials, 359 participants; moderate certainty evidence). However, we observed no significant difference in linear growth velocity between fluticasone and budesonide at equivalent doses (MD 0.39 cm/year, 95% CI -0.94 to 1.73; 2 trials, 236 participants; very low certainty evidence). Two trials compared inhalation devices. One trial with 212 participants revealed a comparable linear growth velocity between beclomethasone administered via hydrofluoroalkane-metered dose inhaler (HFA-MDI) and beclomethasone administered via chlorofluorocarbon- metered dose inhaler (CFC-MDI) at an equivalent dose (MD-0.44 cm/year, 95% CI -1.00 to 0.12; low certainty evidence). Another trial with 229 participants showed a small but statistically significant greater increase in height over a period of six months in favour of budesonide via Easyhaler, compared to budesonide given at the same dose via Turbuhaler (MD 0.37 cm, 95% CI 0.12 to 0.62; low certainty evidence). Authors' conclusions This review suggests that the drug molecule and delivery device may impact the effect size of ICS on growth in children with persistent asthma. Fluticasone at an equivalent dose seems to inhibit growth less than beclomethasone and budesonide. Easyhaler is likely to have less adverse effect on growth than Turbuhaler when used for delivery of budesonide. However, the evidence from this systematic review of head-to-head trials is not certain enough to inform the selection of inhaled corticosteroid or inhalation device for the treatment of children with persistent asthma. Further studies are needed, and pragmatic trials and real-life observational studies seem more attractive and feasible.

Place, publisher, year, edition, pages
WILEY, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-36812 (URN)10.1002/14651858.CD010126.pub2 (DOI)000473340700008 ()31194879 (PubMedID)
Available from: 2019-08-09 Created: 2019-08-09 Last updated: 2019-08-09Bibliographically approved
Irevall, T., Axelsson, I. & Naumburg, E. (2017). B12 deficiency is common in infants and is accompanied by serious neurological symptons. Acta Paediatrica, 106(1), 101-104
Open this publication in new window or tab >>B12 deficiency is common in infants and is accompanied by serious neurological symptons
2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 1, p. 101-104Article in journal (Refereed) Published
Abstract [en]

Aim

Adverse neurological symptoms have been linked to vitamin B12 deficiency in infants. This explorative study described the clinical presentation associated with vitamin B12 deficiency in this age group.

Methods

The study comprised infants who were born between 2004 and 2012 and were tested for vitamin B12 levels after they were admitted to a hospital with neurological symptoms at less than one year of age. Vitamin B12 deficiency was defined as low cobalamin in serum and/or increased homocysteine and/or increased methylmalonate. It was diagnosed according to the applicable International Classification of Diseases, 10th revision, and recorded as vitamin B12 deficiency in the medical records. All information was retrieved from medical records and compared to symptomatic infants with normal levels.

Results

Of the 121 infants tested, 35 had vitamin B12 deficiency and 86 had normal levels. Vitamin B12 deficiency was diagnosed at an average age of 1.7 months and was more common among boys. Seizures and apparent life-threatening events were the most common symptoms among infants with B12 deficiency compared to infants with normal levels.

Conclusion

Vitamin B12 deficiency was more common in infants than we expected and presented with severe symptoms, such as seizures and apparent life-threatening events.

National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-29657 (URN)10.1111/apa.13625 (DOI)
Available from: 2016-12-18 Created: 2016-12-18 Last updated: 2017-12-18Bibliographically approved
Axelsson, I. & Lind, J. (2017). Kriminalisera kärnvapen. In: Edith Andresen, Gustav Lidén, Sara Nyhlén (Ed.), Hållbarhetens många ansikten: samtal, forskning och fantasier (pp. 102-107). Sundsvall: Mid Sweden University
Open this publication in new window or tab >>Kriminalisera kärnvapen
2017 (Swedish)In: Hållbarhetens många ansikten: samtal, forskning och fantasier / [ed] Edith Andresen, Gustav Lidén, Sara Nyhlén, Sundsvall: Mid Sweden University , 2017, p. 102-107Chapter in book (Other academic)
Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University, 2017
Series
Genusstudier vid Mittuniversitetet, ISSN 1654-5753 ; 13
National Category
Social Sciences
Identifiers
urn:nbn:se:miun:diva-32318 (URN)978-91-88527-37-0 (ISBN)
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2017-12-07
Naumburg, E., Söderström, L., Huber, D. & Axelsson, I. (2017). Risk factors for pulmonary arterial hypertension in children and young adults. Pediatric Pulmonology, 52(5), 636-641
Open this publication in new window or tab >>Risk factors for pulmonary arterial hypertension in children and young adults
2017 (English)In: Pediatric Pulmonology, ISSN 8755-6863, E-ISSN 1099-0496, Vol. 52, no 5, p. 636-641Article in journal (Refereed) Published
Abstract [en]

Objectives

Pulmonary hypertension (PH) has been linked to preterm birth explained by congenital heart defects and pulmonary diseases.

Working hypothesis

Other factors may influence the risk of PH among adolescences and children born premature.

Study design

This national registry-based study assess risk of PH following premature birth adjusted for known risk factors.

Patient-subject selection and methodology

All cases born 1993–2010, identified by diagnostic codes applicable to PH and retrieved from the Swedish Registry of Congenital Heart Disease (N = 67). Six controls were randomly selected and matched to each case by year of birth and hospital by the Swedish Medical Birth Register (N = 402). Maternal and infant data related to preterm birth, pulmonary diseases, and congenital defects were retrieved. The association between preterm birth and pulmonary hypertension was calculated by conditional logistic regression taking into account potential confounding factors.

Results

One third of the cases and seven percent of the controls were born preterm in our study. Preterm birth was associated with PH, OR = 8.46 (95%CI 2.97–24.10) (P < 0.0001) even after adjusting for confounding factors. Other factors, such as acute pulmonary diseases, congenital heart defects, congenital diaphragm herniation, and chromosomal disorders were also associated with PH in the multivariate analysis.

Conclusions

Children and young adults born preterm are known to have an increased risk of PH, previously explained by congenital heart defects and pulmonary diseases. By adjusting for such factors, our study indicates that new factors may play a role in the risk of developing PH among children born preterm. 

National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-29655 (URN)10.1002/ppul.23633 (DOI)
Available from: 2016-12-18 Created: 2016-12-18 Last updated: 2017-12-14Bibliographically approved
Axelsson, I., Bergström, S.-E., Hermansson, A., Tessin, I., Hellberg, C., Mowafi, F. & Granath, A. A. (2016). Behandling av luftvägsinfektioner hos barn med läkemedel och andra preparat. Stockholm: SBU
Open this publication in new window or tab >>Behandling av luftvägsinfektioner hos barn med läkemedel och andra preparat
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2016 (Swedish)Report (Refereed)
Place, publisher, year, edition, pages
Stockholm: SBU, 2016. p. 80
Series
SBU kartlägger, ISSN 1400-1403 ; 251/2016
National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-29663 (URN)978-91-85413-94-2 (ISBN)
Available from: 2016-12-19 Created: 2016-12-19 Last updated: 2016-12-19Bibliographically approved
Axelsson, I. (2016). Hårdnad konkurrens ger dopad forskning. Stockholm: SvD Kultur
Open this publication in new window or tab >>Hårdnad konkurrens ger dopad forskning
2016 (Swedish)Other (Other (popular science, discussion, etc.))
Place, publisher, year, pages
Stockholm: SvD Kultur, 2016
National Category
Medical Ethics
Identifiers
urn:nbn:se:miun:diva-29664 (URN)
Available from: 2016-12-19 Created: 2016-12-19 Last updated: 2016-12-19Bibliographically approved
Edler, G., Axelsson, I., Barker, G. M., Lie, S. & Naumburg, E. (2016). Serious complications in male infant circumcisions in Scandinavia indicate that this always be performed as a hospital-based procedure. Acta Paediatrica, 105(7), 842-850
Open this publication in new window or tab >>Serious complications in male infant circumcisions in Scandinavia indicate that this always be performed as a hospital-based procedure
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 7, p. 842-850Article in journal (Refereed) Published
Abstract [en]

Aim:More than 7000 male circumcisions are performed in Scandinavia every year. Circumcision is regulated in different ways in Sweden and Denmark and Norway. This study reviewed and described factors associated with complications of circumcision in infant boys in Scandinavia over the last two decades and discussed how these complications could be avoided. Methods: Data on significant complications following circumcision on boys under the age of one in Scandinavia over the last 20 years were collected. Information was retrieved from testimonies of circumcisers, witnesses, medical records and verdicts. A systematic review was performed of fatal cases in the literature. Results: We found that 32 cases had been reported to the health authorities in the three countries, and we identified a total of 74 complications in these cases. These included four boys with severe bleeding and circulatory shock, which ended in the death of one boy.Other less serious complications may have occurred in other boys, but not been reported. Conclusion: Complications following male circumcision in Scandinavia were relatively rare,but serious complications did occur. Based on the analyses of the severe cases, we argue that circumcision should only be performed at hospitals with 24-hour emergency departments.

National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-29658 (URN)10.1111/apa.13402 (DOI)
Available from: 2016-12-18 Created: 2016-12-18 Last updated: 2017-11-29Bibliographically approved
Axelsson, I. (2016). Sverige måste agera för en kärnvapenfri värld 2030. Göteborg: GP
Open this publication in new window or tab >>Sverige måste agera för en kärnvapenfri värld 2030
2016 (Swedish)Other (Other (popular science, discussion, etc.))
Place, publisher, year, pages
Göteborg: GP, 2016
Series
GP Debatt
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-29665 (URN)
Available from: 2016-12-19 Created: 2016-12-19 Last updated: 2016-12-19Bibliographically approved
Edler, G., Axelsson, I., Barker, G. M., Lie, S. & Naumburg, E. (2016). Säkerheten vid omskärelse av pojkar måste bli bättre. Läkartidningen, 113, Article ID D4CC.
Open this publication in new window or tab >>Säkerheten vid omskärelse av pojkar måste bli bättre
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2016 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, article id D4CCArticle in journal (Other academic) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:miun:diva-29659 (URN)
Available from: 2016-12-18 Created: 2016-12-18 Last updated: 2017-08-09Bibliographically approved
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