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Stefan Johansson

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Blog Entries posted by Stefan Johansson

  1. We had an unpleasant experience last week.
    Our account at the web host was hacked. Even, badly hacked!

    This is what probably happened: I added a subdomain years ago and played around with a Wordpress installation (that's the kind of thing you can do just for fun, or do I need to see someone ) . I left this wp-installation and thought it was resting in peace, not aware of the bomb our account was keeping within its boundaries.

    Apparently, hackers sniffed this installation and manage to break into it and install spam-scripts and other not-so-friendly-executable-files. When hackers (in GERMANY, we KNOW that, the IP address was 77.237.242.241) activated the spam-script, bells were ringing really hard at our web hosting company and our account was shut down. Thanks 77.237.242.241!

    Thanks to immediate help from staff at our webhost (www.ODERLAND.se, if you ever need a web host in Sweden) 99nicu was up and running again within a few hours.

    Unfortunately, our own IP-address will be blacklisted for some time. Therefore we may have some problems with our own, legitimate emails going out from us.

    Thanks to ALL participating in the rescue mission of 99nicu!
  6. I would just like to leak some 99nicu info...

    the software that we use for this site has been realized in a new version that looks and behaves quite differently compared to the current version.

    This means that the outlook of 99nicu will/may change in the future (early next year).

    More good news... a professional webmaster has volonteered to help us with 99nicu.org.
  7. I would just like to share a unusual collaboration, Sweden-Australia.

    There's a Swedish radiologist working in Australia. Due to the shortage of pediatric radiologists in Stockholm, this person in Australia is "on call" sometimes, i.e. x-rays images are sent by wire (Internet) to Australia, and we get the response back.

    It's quite a good idea I think. I mean, night time in Sweden is day time in Australia.

    I wished I could be doing night shift in the day time.
    Preferably in Australia!

  9. I got a new Job!

    · Stefan Johansson · 12/28/2008 07:14 PM

    I have got a new job ,
    from the 16th of March I will be the medical editor-in-chief at the Swedish Medical Journal (Läkartidningen).

    It may seem as the greatest of surprises, but those who know me are not surprised. Since my late teens, I have been involved in various info/media projects (local newspapers, student papers, free-lance writing, 99nicu...). And, I am really looking forward to this new challenge!

    During the recruitment process I questioned myself many times how I would feel about not working clinically, caring for infants and parents. Some of my colleagues have argued that I am trained to live on the edge of neonatal medicine (take-home message - do not leave us!). And to be honest, this is something I still wonder about. Neonatal care is a fantastic medical field! As a compromise, I will work 80% (i.e. Mon-Thurs) for the Journal, and keep 20% of work for clinical commitments / research. Time will tell whether this combo will work out, but that's my way staying in touch with the rewarding work in the NICU.

    This new job will affect my work for the 99nicu community. The editorial board felt there's a risk of conflict-of-interest between the Swedish Medical Journal - 99nicu. Although I am pretty sure these two publication platforms would not interfere/compete etc, I need to be loyal to my new employer. I will still be around as a resource for the 99nicu Team, but I will leave the administration/moderation to the other members of the 99nicu Team. My colleague and friend Alexander Rakow, one of the founders of the 99nicu, will be coming back to chair the Team instead of myself.

  11. Hot Topics 2008!

    · Stefan Johansson · 12/09/2008 01:02 AM

    I am at the Hot Topics congress. Despite my severe jet-lag... it's a great congress, on clinically relevant aspects of neonatal care. If you have the opportunity... come here next year!

    For example; hypothermia - it's here to stay, I am sure. And, I must admit I have been a sceptic, but taking the TOBY trial together with the older trials... it's no doubt of the improved outcome in terms of increased survival, free of disability. Still, many of treated infants will have to live with sequels of perinatal asphyxia. The numbers-needed-to-treat seems to be in the range of 5-10, i.e. for every 5-10 treated infants, there will be one without disability. Whether this is good enough or not may be up to debate, I would say it is good enough!

    The best lecture today was about a commonly used therapy; buffering with bicarbonate. Take-home message - bicarbonate is a completely useless therapy. Do not use it!
    And read the recent article by Judy Aschner and Ronald Poland, in Pediatrics 2008;122:831-5.

    Best wishes from Washington DC!

  12. Rationality vs empathy

    · Stefan Johansson · 12/04/2007 11:08 PM

    When speaking to people in non-medical professions about daily life in neonatal care, many people wonder how we cope with everything.
    This remarkable mix of well-baby-nursery problems, medical and ethical issues in the NICU... and all parents... and their fear, anger and happiness.

    I do not really know what to respond to such questions, but a bit of the answer might be related to how we combine a rational mind with empathic capabilities. I mean, when standing in front of a newly delivered 25-weeker, immediate care is much driven by rational decision-making. But we (should…) also consider comfort issues already in the delivery room, and such strategies are probably based on what we believe the infant is really experiencing. Right there on the resuscitation table, medicated, intubated and on the ventilator.

    How we manage to cope with everything in our daily service in neonatal care may be related to how well we create a succesful synthesis of rationality and empathy. Not an easy task.
  14. A friend of mine went into journalism after his medical studies, and he is now editor-in-chief of a large newspaper.

    We had sushi a few weeks ago, and among other things we discussed my favourite spare-time project... the 99nicu community.

    One issue is what I believe is a conflict how we run 99nicu: the idea of true independence (from the market) and the fact the funding is needed to maintain the community.

    My friend enlightened me how the media world works: although information wants to be free and independent, someone has to pay for it. And, noone questions the validity and independence of der Spiegel, le Monde, the Guardian or the New York Times, for the fact that they are all funded by adverts. To accomplish to their publicistic missions, they have big market departments trading ad space for money.

    I do not intend to compare New Your Times and 99nicu, but my friend has a point, we need funding too.

    I promise that 99nicu will not drown in adverts, but I feel more confident about the necessity of selling ad space in our newsletter 99nicu News and make sponsors sign up for display of their logos here at the web site. Today, 99nicu has more than 100 unique visitors per day, and the possibility to reach the highly specific audience we represent should be attractive for companies marketing products in neonatal medicine.

    Bottomline: it is true - there is no such thing as a free lunch.

  16. I am a "project-oriented" person, i.e. I get a lot of "brilliant ideas", and try to realize some of them. With variable success/failure. Another side of this personality trait is that I get bored quite easily, if things get... boring

    The latest project I took the initiative is... a large Swedish charity foundation for peri-/neonatal research: Lilla barnets fond (Small child foundation). We (me, five other neonatologists, and one premie-parent) are just about to finish the formal paperwork and we plan for an official launch in a few months.

    Swedes are donating increasing amounts of money to charity foundations. For example - last year the Child cancer foundation recieved 14 million euro. Since research in neonatal medicine lacks funding from a large-scale fund-raising organisation, I thought we should start one. With the ultimate aim to marginalise the (generally accepted) idea that research is something that can be done with embarrasingly low scholarships, or during free time (evenings, weekends). There's no natural law that neonatal research in Sweden should not paid by salaries.

    "kamikaze" project?! Well, similar to other projects, there's a great risk this project will drive me to the rim of work-overload. If I had been in therapy, someone would have told me that it is part of the "pattern".

  17. I recently read an article about Haruki Murakami, a Japanese novelist. I had never heard of him before but this man is a literature "Mega-star"!
    (Which tells more about me than about the fame of Murakami)

    While reading about Murakami, I felt this is a good person. We had things in common! Integrity. Sense of humour. Wife's always right. Likes jogging and vinyl records. And Twin Peaks.

    So, I bought his book "Kafka on the Shore" to bring on our summer holiday trip. I have only read the first 50 pages, but I can really recommend this novel! This is original, mind-breaking and sophisticated literature.

    This summer, I will be stuck with this Japanese mystery!
  18. Our latest research paper, about low birth weight and later risk of developing type 2 diabetes, was recently published in Epidemiology. (Abstract - click here!) I feel relieved, it was a lot of hard work to do the study, and not the least, to get it published.
    Therefore, I got happy when Reuters News Agency wrote about it (click here or here to read the article!)

    There are many reports showing a link between low birth weight and type 2 diabetes; the lower the birth weight, the higher the risk. However, as discussed in Lancet already in 1999 (Hattersley, Lancet 1999;353:1789-92), there may be no causal link between low birth weight and type 2 diabetes. Instead, the two problems could be explained by a common genetic background, i.e. the same genes may increase the risk for both low birth weight and type2 diabetes. And, by using a large twin cohort, we could demonstrate that the association between LBW and type 2 diabetes seems to subjected to such "genetic confounding".

    Our findings contrast to the current paradigm (that poor fetal nutrition would leading to low birth weight would "program" the fetus to develop diabetes later in life). I think we experienced a bit of negative publication bias before the paper was finally (and easily) accepted in Epidemiology. Reviewers in the "Big-Medical-Journals-With-Wellknown-Abbreviations" were a bit unfair in their judgements. (It seemed that they 1) did not understand twin study methodology as such, and 2) did not believe our findings could be true).

    With this in mind, I was glad and surprised that a medical writer from Reuters News Agency got in touch once the paper was published. Joene Hendry wrote a very nice article about the study. Unfortunately I am not allowed to share this article with you here. Reproduction of Reuter's material is strictly prohibited, and a permission would be (at least) 800USD! But if you're curious, click on the links above to read it at the Reuters web site or at MedlinePlus.

  19. Neonatal Olympics

    · Stefan Johansson · 08/28/2008 05:27 PM

    The Olympic games are over, and I am leaving the TV sofa. In spite of the politicopropagandistic extravaganzas, I think the games were great: lots of fighting spirit, fantastic achievements, the chaotic mix of emotions. Some people were winners (probably not only those who travelled home with gold medals), and some people felt like losers (also some with medals in their luggage, I'm sure).

    Although sports is only a small part of life (for most of us) I think sports contains most bits and pieces what Life is all about. We try, train, perform, and achieve. Then we reflect and react. Finally, most of us need to try all over again.

    Neonatal medicine is much about individuals fighting for finishing lines too. Most will be winners and some will be losers. And, I am not thinking about you. But the babies we care for.

  20. Babies online!

    · Stefan Johansson · 07/02/2008 05:25 PM

    "Get real - get online" - that seems to apply also to newborn infants!

    Our hospital (with the largest number of newborns/year, in Sweden at least) as adopted an increasingly popular feature - web-babies!

    There's a camera installed below the roof in the waiting room for the doctors health check - parents can just put their newborn baby below it, press the "click" button and then the "get online" button.

    Good or bad... I guess, not too bad anyway

    http://www.ds.se/Web/NormalPage____4225.aspx
  21. While biking home from work tonight I thought about my blogging habit, or, the lack of a blogging habit!
    I figured... blogging is the art of being present.

    And there has not been much time for x-tras the last few weeks. I have been heavily involved in the update of the forum software (as you may have noticed... soon we will officially announce a lot of new features...), and clinical work has been demanding. But, as the summer is here, things tend to slow down and I hope to be more present.

    But now... time to switch on the TV at the 99nicu HQs... Sweden-Russia in the UEFA 2008 Championships (football!) We must win to qualify for the quarter final.

  22. MD, PhD...

    · Stefan Johansson · 04/27/2008 02:04 PM

    I live through a kind of refractory post-doc phase.
    I defended my thesis last Friday (080418), managed pretty well , the party in the evening was wild and crazy , and I am about to adapt to the new life of being 'MD PhD'.

    I think I need to 'digest' what has happened. The last few nights, I have had some really strange dreams about things that did (and did not) happen that day. I guess Freud would be delighted to hear about this...

    It feels good to be back in business again. I am sure some regular clinical commitments will help to get back to reality again. Babies don't really care about PhD's. And I am still me!
  23. Yesterday I approved the final proof for my thesis book "Very preterm birth - etiological aspects and short and long term outcomes". It is being printed right NOW and I will have a LARGE stack of books by next week. Will post a photograph.

    My latest years of hard work and psychological tension will have the ISBN nb 978-91-7357-498-3

    If you spend a day in Stockholm on the 18th of April, welcome to my dissertation in Leksellsalen, Karolinska University Hospital. Grand thesis defence in the morning, big party in the evening
    (just send me a mail and I will return an invitation!)

    UPDATE 080319... pile of books!

  24. This is my list for 2007...

    Best research experience...
    our brilliant study on twins, their birth weights and later risk of type-2 diabetes

    Worst research experience...
    four rejections of the manuscript of the brilliant study above... (NEJM, Lancet, JAMA, Diabetes...)

    Best neonatal gossip...
    how the family Zlatan Ibrahimovic escaped the paparazzi photographers from the maternity ward... (well, this is from 2006, but I heard the story just recently)

    Most fascinating journey...
    Turkey, no doubt!

    Best gastronomic surprise...
    Dennis pizzeria in Turku (awarded "Best pizzeria in Finland")

    Best cultural event...
    (Dweezil) Zappa plays (Frank) Zappa: not a usual within-family show-biz event, but a fantastic consert!

    Most overrated family life happening...
    the introduction of Cable TV in our house

    Best sport event...
    the Wimbledon thriller/final: Federer-Nadal
    (on TV...)
  25. Heard from a colleague of a rough weekend on-call, in a unit somewhere out there.

    Generally, for myself I like working really hard... I feel good after a bit of mental flow and manual work

    But the weekend I was told about must have been hard, as indicated by the number of pediatric subspecialties and units that were also involved:

    oncology
    surgery
    anestesiology
    nephrology
    radiology
    transfusion medicine
    infectious diseases
    ECMO...

    Reflections...

    professional networks are nothing but very important (no Network = no Care)
    team work around the patient is essential for success (no Team = no Life)

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