| 2731. |
- Li, Tian, et al.
(författare)
-
Onset of respiratory symptoms among Chinese students : associations with dampness and redecoration, PM10, NO2, SO2 and inadequate ventilation in the school
- 2020
-
Ingår i: Journal of Asthma. - : Informa UK Limited. - 0277-0903 .- 1532-4303. ; 57:5, s. 495-504
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study onset of respiratory symptoms among students in China in relation to the school and the home environment.METHODS: A two-year prospective cohort study among 1325 students in eight schools. Air pollution was measured at baseline in the schools. Respiratory symptoms and the home environment were assessed by a questionnaire.RESULTS: The 2-year onset was 14.3%, 23.2%, 15.4%, 4.7% and 37.3% for wheeze, daytime attacks of breathlessness, nocturnal cough, nocturnal wheeze/breathlessness and respiratory infections, respectively. The mean concentrations of PM10, SO2, NO2, ozone and CO2 in the classrooms were 129 µg/m3, 68.0 µg/m3, 43.2 µg/m3, 8.6 µg/m3 and 1208 ppm, respectively. Environmental tobacco smoke (ETS), dampness/mold at home and ozone in the classroom were associated with onset of wheeze. Onset of daytime breathlessness was associated with redecoration and dampness/mold at home and CO2 and relative air humidity (RH) in the classrooms. Dampness/mold at home, PM10, CO2 and RH in the classrooms and outdoor PM10, SO2 and NO2 were associated with onset of nocturnal cough. Onset of nocturnal wheeze/breathlessness was associated with dampness/mold at home and RH and PM10 in the classrooms. Respiratory infections were more common at higher levels of outdoor PM10.CONCLUSIONS: Air pollution (PM10, ozone, SO2 and NO2) and inadequate ventilation flow in the classrooms (indicated by CO2 > 1000 ppm) and ETS, dampness or mold and chemical emissions from redecoration at home can increase onset of respiratory symptoms.
|
|
| 2732. |
- Lieberman, Jay A., et al.
(författare)
-
The Utility of Peanut Components in the Diagnosis of IgE-Mediated Peanut Allergy Among Distinct Populations
- 2013
-
Ingår i: Journal of Allergy and Clinical Immunology: In Practice. - : Elsevier BV. - 2213-2198. ; 1, s. 75-82
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Increasing data suggest that analysis of IgE to peanut components can be clinically helpful and possibly more accurate than IgE to whole peanut. Not all studies examining this topic, however, have used prospective samples, multiple components, and peanut challenges. Objective: We sought to determine the utility of peanut component testing, using a standardized, commercially available test done before oral peanut challenge in various populations of patients with suspected peanut allergy from 2 different countries. Methods: IgE to whole peanut and the recombinant allergen components Ara h 1, 2, 3, and 8 were analyzed from serum samples drawn before double-blind peanut challenge from 4 distinct cohorts of patients with suspected peanut allergy from 2 nations (United States and Sweden). Results: Patients (n = 167; median age, 11.7 years; interquartile range, 7.0-15.0 years) had serum analyzed for peanut components and completed an oral food challenge to peanut. Although IgE to peanut was the most sensitive test (0.93), Ara h 2 was the most specific (0.92) and provided the best positive predictive value (0.94) of all the tests. Ara h 2 was also the best overall diagnostic test by receiver operating characteristic analysis (area under the curve, 0.84; P < .05). Conclusions: In patients with suspected peanut allergy, IgE to peanut is a sensitive test but is not specific. IgE to Ara h 2 is a more specific and more accurate diagnostic test in this sampling of patients with suspected peanut allergy. Given each tests attributes, a stepwise approach to testing may provide clinicians with a way to minimize the need for peanut challenges. © 2013 American Academy of Allergy, Asthma & Immunology.
|
|
| 2733. |
- Liesker, JJW, et al.
(författare)
-
Effects of formoterol (Oxis (R) Turbuhaler (R)) and ipratropium on exercise capacity in patients with COPD
- 2002
-
Ingår i: Respiratory Medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 96:8, s. 559-566
-
Tidskriftsartikel (refereegranskat)abstract
- Although long-acting inhaled beta(2)-agonists improve various outcome measures in COPD, no double-blind study has yet shown a significant effect of these drugs on exercise capacity. In a randomized, double-blind, placebo-controlled, crossover study, patients received formoterol (4.5,9, or 18 mug b.i.d via Turbuhaler(R)), ipratroplum bromide (80 mug t.i.d via pMDI with spacer), or placebo for I week. Main endpoint was time to exhaustion (TTE) in an incremental cycle ergometer test. Secondary endpoints were Borg dyspnoea score during exercise, lung function, and adverse events. Thirty-four patients with COPD were included, mean age 64.8 years, FEV(1)55.6% predicted, reversibility 6.1% predicted. All doses of formoterol, and ipratropium significantly improved TTE, FEV1, FEF25-75%, FRC, IVC, RV and sGAW compared with placebo. A negative dose-response relationship was observed with formoterol. Ipratropium increased time to exhaustion more compared with formoterol, 18 mug, but not with formoterol, 4.5 and 9 mug. No changes in Borg score were found. There was no difference in the adverse event profile between treatments. In conclusion, I week of treatment with formoterol and ipratropium significantly improved exercise capacity and lung function compared with placebo. However, a negative dose-response relation for formoterol was unexpected and needs further investigation.
|
|
| 2734. |
- Lillienberg, Linnea, 1942, et al.
(författare)
-
A population-based study on welding exposures at work and respiratory symptoms.
- 2008
-
Ingår i: The Annals of occupational hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 52:2, s. 107-15
-
Tidskriftsartikel (refereegranskat)abstract
- In the first European Community Respiratory Health Survey (ECRHS I), an excess asthma risk was associated with high exposure to gases and fumes, mineral and biological dusts. In a 9-year follow-up study (ECRHS II), the aim was to study if welding at work increases the risk of asthma symptoms, wheeze and chronic bronchitis symptoms. The study also aimed to identify specific welding risk factors. In a random population sample of individuals from 22 European centres in 10 countries, 316 males reported welding at work during the follow-up period. These individuals responded to a supplemental questionnaire about frequency of welding, use of different methods and materials, welding environment and respiratory protection. Cumulative exposure to welding fumes for the follow-up period was estimated by using a database on welding fume exposures. Log-binomial regression models were used to estimate prevalence ratios (PR) with 95% confidence intervals (CIs) for prevalence of asthma symptoms or asthma medication, wheeze and chronic bronchitis symptoms in relation to welding methods and welded materials as well as estimated cumulative welding fume exposure compared to an external reference group. In the study population of 316 males, 62% performed welding <1 h day(-1), 23% 1-3 h day(-1) and 15% >4 h day(-1). Welding was a common task in many occupations and only 7% of the individuals actually called themselves welders and flame cutters, while the largest groups doing welding worked in construction or were motor, agricultural and industrial mechanics and fitters. Welding at work was not associated with an increased prevalence of asthma symptoms or wheeze but there was an association with chronic bronchitis symptoms (PR = 1.33, 1.00-1.76). Using assigned cumulative exposure in tertiles showed that the lowest exposed tertile had the highest PR of bronchitis symptoms. Chronic bronchitis symptoms was significantly higher in those frequently welding in galvanized steel or iron (PR = 2.14, 1.24-3.68) and in those frequently manual welding stainless steel (PR = 1.92, 1.00-3.66). There was also an increase in the prevalence of wheeze in individuals welding painted metal (PR = 1.66, 0.99-2.78; PR = 1.83, 0.90-3.71). Welding with manual metal arc technique <1 day week(-1) showed a prevalence risk of 1.69 for wheeze (CI = 1.16-2.46). In conclusion, the present study shows an association between welding in galvanized material and stainless steel and chronic bronchitis symptoms. There was also an increased prevalence of wheeze and welding in painted metal. The results support that welding in coated material is a respiratory hazard underscoring the importance of preventive actions.
|
|
| 2735. |
- Lim, F. L., et al.
(författare)
-
Respiratory health among office workers in Malaysia and endotoxin and (1,3)-beta-glucan in office dust
- 2019
-
Ingår i: The International Journal of Tuberculosis and Lung Disease. - : INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D). - 1027-3719 .- 1815-7920. ; 23:11, s. 1171-1177
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE : To examine the associations between endotoxin and (1,3)-beta-glucan concentrations in office dust and respiratory symptoms and airway inflammation among 695 office workers in Malaysia. METHODS : Health data were collected using a questionnaire, sensitisation testing and measurement of fractional exhaled nitric oxide (FeNO). Indoor temperature, relative air humidity (RH) and carbon dioxide (CO2) were measured in the offices and settled dust was vacuumed and analysed for endotoxin and (1,3)-beta-glucan concentrations. Associations were analysed by two level multiple logistic regression. RESULTS : Overall, 9.6% of the workers had doctor-diagnosed asthma, 15.5% had wheeze, 18.4% had daytime attacks of breathlessness and 25.8% had elevated FeNO (>= 25 ppb). The median levels in office dust were 11.3 EU/mg endotoxin and 62.9 ng/g (1,3)-beta-glucan. After adjusting for personal and home environment factors, endotoxin concentration in dust was associated with wheeze (P = 0.02) and rhinoconjunctivitis (P = 0.007). The amount of surface dust (P = 0.04) and (1,3)-beta-glucan concentration dust (P = 0.03) were associated with elevated FeNO. CONCLUSION: Endotoxin in office dust could be a risk factor for wheeze and rhinoconjunctivitis among office workers in mechanically ventilated offices in a tropical country. The amount of dust and (1,3)-beta-glucan (a marker of indoor mould exposure) were associated with Th2 driven airway inflammation.
|
|
| 2736. |
- Lin, Zhijing, et al.
(författare)
-
Home Dampness Signs in Association with Asthma and Allergic Diseases in 4618 Preschool Children in Urumqi, China-The Influence of Ventilation/Cleaning Habits
- 2015
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:7
-
Tidskriftsartikel (refereegranskat)abstract
- There is an increasing prevalence of childhood asthma and allergic diseases in mainland of China. Few studies investigated the indoor dampness, ventilation and cleaning habits and their interrelationship with childhood asthma and allergic diseases. A large-scale cross-sectional study was performed in preschool children in Urumqi, China. Questionnaire was used to collect information on children's health, home dampness and ventilation/cleaning (V/C) habits. Multiple logistic regressions were applied to analyze the associations between childhood asthma/allergic diseases and each sign of home dampness, dampness levels, each V/C habit and total V/C scores. The associations between dampness and health were further performed by strata analyses in two groups with low and high V/C scores. Totally 4618 (81.7%) of 5650 children returned the questionnaire. Reports on home dampness were most common for water condensation on windows (20.8%) followed by damp beddings (18.0%). The most common ventilation measure was the use of exhaust fan in bathroom (59.3%), followed by daily home cleaning (48.3%), frequently putting beddings to sunshine (29.9%) and frequently opening windows in winter (8.4%). There were positive associations between the 6 signs of home dampness and children's health particularly the symptoms last 12 months. By comparing with the reference dampness level (dampness scored 0), both the low dampness (scored 1 similar to 2) level and the high dampness level (scored 3 similar to 6) showed significantly increasing associations with childhood symptoms. There were crude negative associations between V/C habits and childhood health but not significant adjusting for home dampness levels. The risks of home dampness on children's health were lower in the group with higher V/C score but the differences were not statistically significant. Home dampness is a potential risk factor for childhood asthma and allergic symptoms in preschool children in Urumqi, China. No significant effects were observed for ordinary home ventilation and cleaning habits in reducing the risks of home dampness on childhood asthma and allergic diseases in Urumqi, China.
|
|
| 2737. |
- Lind, Leili, 1954-, et al.
(författare)
-
COPD patients require more health care than heart failure patients
- 2018
-
Ingår i: ERS International Congress 2018.
-
Konferensbidrag (refereegranskat)abstract
- Background: Populations of elderly patients with advanced stages of chronic obstructive pulmonary disease (COPD) or heart failure (HF) are growing, urging the need for specialized health care in the patients’ home. A 4 year (2013-2017) telehealth intervention single-centre clinical study has been completed. We hypothesized that the two groups of patients, advanced COPD or HF, would exhibit differences regarding exacerbations and the need of health care.Objective: To study exacerbations of COPD or HF, and patients’ need of health care.Methods: A telemonitoring system, the Health Diary, which is based on digital pen technology, was employed. Patients with at least 2 hospital admissions the previous year were included. Responsible nurses and physicians at a specialized home care unit at a university hospital checked all daily patient reports. Physicians identified exacerbations using information provided through the telemonitoring system and patient contacts. Consumed health care was assessed as the number of patient contacts (home visits or telephone consultations).Results: Totally, 94 patients with advanced disease were enrolled (36 COPD and 58 HF patients) of which 53 patients (19 COPD and 34 HF patients) completed the 1-yr study period. The major reason for not completing the study was death (13 COPD, 15 HF patients). Average numbers of exacerbations were 3.1 and 0.8 and patient contacts were 94 and 67 per COPD and HF patient, respectively.Conclusions: Compared to HF patients, COPD patients exhibit exacerbations more frequently and demand much more home health care. This difference of health care consumption is mainly due to disease characteristics.
|
|
| 2738. |
- Lindberg, Anne, et al.
(författare)
-
Co-morbidity in Mild-to-Moderate COPD : comparison to normal and restrictive lung function
- 2011
-
Ingår i: COPD. - : Informa UK Limited. - 1541-2555 .- 1541-2563. ; 8:6, s. 421-428
-
Tidskriftsartikel (refereegranskat)abstract
- Background: A relationship between local and systemic inflammation and different co-morbidities, such as cardiovascular, has been discussed in relation to disease process and prognosis in COPD. Aim: To evaluate if conditions as cardiovascular diseases, diabetes, chronic rhinitis and gastroesophageal reflux are overrepresented in COPD. Methods: All subjects with COPD according to GOLD, FEV(1)/FVC<0.70, were identified (n = 993) from the clinical follow-up in 2002-04 of the OLIN (Obstructive Lung Disease in Northern Sweden) studies' cohorts together with 993 gender- and age-matched reference subjects without COPD (non-COPD, further divided into normal and restrictive lung function). Interview data on co-morbidity and symptoms were used. Results: Cardiovascular co-morbidity, taken together heart disease, hypertension, stroke and intermittent claudication, was the most common and higher in COPD compared to in normal lung function (Nlf) 50.1% vs 41.0% (p<0.001). The prevalence of chronic rhinitis and gastroesophageal reflux (GERD) was higher in COPD compared to in Nlf (43.1% vs 32.3%, p<0.001 and 16.7% vs 12.0%, p = 0.011). In restrictive lung function the prevalence of chronic rhinitis, cardiovascular disease, hyperlipemia and diabetes was higher compared to in Nlf (41.0% vs 32.3%, p = 0.017, 59.0% vs 41.0%, p<0.001, 29.2% vs.12.9%, p = 0.033, 20.9% vs 8.6%, p <0.001). In COPD and heart disease, 62.5% had chronic rhinitis and/or GERD, while in Nlf the corresponding proportion was 42.5%. Conclusion: Co-morbid conditions such as cardiovascular disease, chronic rhinitis and gastroesophageal reflux were common in COPD. The overlap between heart disease, chronic rhinitis and GERD was large in COPD. Restrictive lung function did also identify a population with increased disease burden.
|
|
| 2739. |
- Lindberg, Anne, et al.
(författare)
-
Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction.
- 2007
-
Ingår i: Respirology (Carlton, Vic.). - : Wiley. - 1323-7799 .- 1440-1843. ; 12:5, s. 732-9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVES: Data on the onset of action of COPD medications are lacking. This study compared the onset of bronchodilation following different inhaled therapies in patients with moderate-to-severe COPD and reversible airway obstruction. METHODS: In this double-blind, double-dummy, crossover study, 90 patients (aged >or=40 years; FEV(1) 30-70% predicted) were randomized to a single dose (two inhalations) of budesonide/formoterol 160/4.5 microg, salmeterol/fluticasone 25/250 microg, salbutamol 100 microg or placebo (via pressurized metered-dose inhalers) on four visits. The primary end-point was change in FEV(1) 5 min after drug inhalation; secondary end-points included inspiratory capacity (IC) and perception of onset of effect. RESULTS: Budesonide/formoterol significantly improved FEV(1) at 5 min compared with placebo (P < 0.0001) and salmeterol/fluticasone (P = 0.0001). Significant differences were first observed at 3 min. Onset of effect was similar with budesonide/formoterol and salbutamol. Improvements in FEV(1) following active treatments were superior to placebo after 180 min (all P < 0.0001); both combinations were better than salbutamol at maintaining FEV(1) improvements (P
|
|
| 2740. |
- Lindberg, Anne, et al.
(författare)
-
From COPD epidemiology to studies of pathophysiological disease mechanisms : challenges with regard to study design and recruitment process
- 2017
-
Ingår i: European Clinical Respiratory Journal. - : Taylor & Francis. - 2001-8525. ; 4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic obstructive pulmonary disease (COPD) is a largely underdiagnosed disease including several phenotypes. In this report, the design of a study intending to evaluate the pathophysiological mechanism in COPD in relation to the specific phenotypes non-rapid and rapid decline in lung function is described together with the recruitment process of the study population derived from a population based study.Method: The OLIN COPD study includes a population-based COPD cohort and referents without COPD identified in 2002–04 (n = 1986), and thereafter followed annually since 2005. Lung function decline was estimated from baseline in 2002–2004 to 2010 (first recruitment phase) or to 2012/2013 (second recruitment phase). Individuals who met the predefined criteria for the following four groups were identified; group A) COPD grade 2–3 with rapid decline in FEV1 and group B) COPD grade 2–3 without rapid decline in FEV1 (≥60 and ≤30 ml/year, respectively), group C) ever-smokers, and group D) non-smokers with normal lung function. Groups A–C included ever-smokers with >10 pack years. The intention was to recruit 15 subjects in each of the groups A-D.Results: From the database groups A–D were identified; group A n = 37, group B n = 29, group C n = 41, and group D n = 55. Fifteen subjects were recruited from groups C and D, while this goal was not reached in the groups A (n = 12) and B (n = 10). The most common reasons for excluding individuals identified as A or B were comorbidities contraindicating bronchoscopy, or inflammatory diseases/immune suppressive medication expected to affect the outcome.Conclusion: The study is expected to generate important results regarding pathophysiological mechanisms associated with rate of decline in lung function among subjects with COPD and the in-detail described recruitment process, including reasons for non-participation, is a strength when interpreting the results in forthcoming studies.
|
|
