| 1. |
- Sawalha, Sami, et al.
(författare)
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The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study
- 2019
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Ingår i: Therapeutic Advances in Respiratory Disease. - : SAGE Publications. - 1753-4658 .- 1753-4666. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Comorbidities probably contribute to the increased mortality observed among subjects with chronic obstructive pulmonary disease (COPD), but sex differences in the prognostic impact of comorbidities have rarely been evaluated in population-based studies. The aim of this study was to evaluate the impact of common comorbidities, cardiovascular disease (CVD), diabetes mellitus (DM), and anxiety/depression (A/D), on mortality among men and women with and without airway obstruction in a population-based study. Methods: All subjects with airway obstruction [forced expiratory volume in 1 second (FEV1)/(forced) vital capacity ((F)VC) <0.70, n = 993] were, together with age- and sex-matched referents, identified after examinations of population-based cohorts in 2002-2004. Spirometric groups: normal lung function (NLF) and COPD (post-bronchodilator FEV1/(F)VC <0.70) and additionally, LLN-COPD (FEV1/(F)VC
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| 2. |
- Qvist, Linnea, et al.
(författare)
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Central arterial stiffness is increased among subjects with severe and very severe COPD : report from a population-based cohort study
- 2015
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Ingår i: European Clinical Respiratory Journal. - : Taylor & Francis. - 2001-8525. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Cardiovascular disease (CVD) is common in chronic obstructive pulmonary disease (COPD) and is, as productive cough, related to poorer prognosis in COPD. Central arterial stiffness is a marker of early atherosclerosis, but the association between COPD, productive cough, and arterial stiffness as a possible indicator of CVD is unclear.Objectives: To compare both arterial stiffness among subjects with and without COPD and the impact of productive cough in a population-based cohort.Methods: A population-based cohort, including 993 COPD and 993 non-COPD subjects, has been invited to annual examination since 2005. In 2010, 947 subjects, of which 416 had COPD (according to the GOLD spirometric criteria), participated in examinations including structured interview, spirometry, and measurements of central arterial stiffness as pulse wave velocity (PWV).Results: PWV was higher in GOLD 3–4 compared to non-COPD (10.52 vs. 9.13 m/s, p=0.042). CVD and age ≥60 were both associated with significantly higher PWV in COPD as well as in non-COPD. In COPD, those with productive cough had higher PWV than those without, significantly so in GOLD 1 (9.59 vs. 8.92 m/s, p=0.024). In a multivariate model, GOLD 3–4 but not productive cough was associated with higher PWV, when adjusted for sex, age group, smoking habits, blood pressure, CVD, and pulse rate.Conclusions: GOLD 3–4, age ≥60, and CVD were associated with increased arterial stiffness, and also increased in COPD subjects with productive cough compared to those without. Of importance, GOLD 3–4 but not productive cough remained associated with increased central arterial stiffness when adjusted for confounders.
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| 3. |
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| 4. |
- Yousefi-Banaem, Hossein, et al.
(författare)
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An improved spatial FCM algorithm for cardiac image segmentation
- 2013
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Ingår i: 2013 13th Iranian Conference on Fuzzy Systems (IFSC). - Piscataway, NJ : IEEE. - 9781479912285 ; , s. 1-4
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Konferensbidrag (refereegranskat)abstract
- Image segmentation is one of challenging field in medical image processing. Segmentation of cardiac wall is one of challenging work and it is very important step in evaluation of heart functionality by existing methods. For cardiac image analysis, Fuzzy C- Means (FCM) algorithm proved to be superior over the other clustering approaches in segmentation field. However, the nave FCM algorithm is sensitive to noise because of not considering the spatial information in the image. In this paper an improved FCM algorithm is formulated by incorporating the spatial domain neighborhood information into the membership function for clustering (ISFCM). In this paper we applied improved Fuzzy c-Means with spatial information for left ventricular wall segmentation. Obtained results showed that the proposed method can segment cardiac wall automatically with acceptable accuracy. The comparison of proposed method with nave FCM proved that ISFCM can segment with more accuracy than nave FCM.
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| 5. |
- Antoniewicz, Lukasz, et al.
(författare)
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Acute Effects of Electronic Cigarette Inhalation on the Vasculature and the Conducting Airways
- 2019
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Ingår i: Cardiovascular Toxicology. - : Springer. - 1530-7905 .- 1559-0259. ; 19:5, s. 441-450
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Tidskriftsartikel (refereegranskat)abstract
- The use of electronic cigarettes has increased exponentially since its introduction onto the global market in 2006. However, short- and long-term health effects remain largely unknown due to the novelty of this product. The present study examines the acute effects of e-cigarette aerosol inhalation, with and without nicotine, on vascular and pulmonary function in healthy volunteers. Seventeen healthy subjects inhaled electronic cigarette aerosol with and without nicotine on two separate occasions in a double-blinded crossover fashion. Blood pressure, heart rate, and arterial stiffness measured by pulse wave velocity and pulse wave analysis were assessed at baseline, and then at 0 h, 2 h, and 4 h following exposure. Dynamic spirometry and impulse oscillometry were measured following vascular assessments at these time points, as well as at 6 h following exposure. e-Cigarette aerosol with nicotine caused a significant increase in heart rate and arterial stiffness. Furthermore, e-cigarette aerosol-containing nicotine caused a sudden increase in flow resistance as measured by impulse oscillometry, indicating obstruction of the conducting airways. Both aerosols caused an increase in blood pressure. The present study indicates that inhaled e-cigarette aerosol with nicotine has an acute impact on vascular and pulmonary function. Thus, chronic usage may lead to long-term adverse health effects. Further investigation is warranted.
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| 6. |
- Andersson, Mikael, et al.
(författare)
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Physical activity and fatigue in chronic obstructive pulmonary disease - A population based study
- 2015
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 109:8, s. 1048-1057
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Tidskriftsartikel (refereegranskat)abstract
- Background: In subjects with chronic obstructive pulmonary disease (COPD), symptoms of fatigue, concomitant heart disease and low physical activity levels are more frequently described than in subjects without COPD. However, there are no population-based studies addressing the relationship between physical activity, fatigue and heart disease in COPD. The aim was to compare physical activity levels among subjects with and without COPD in a population based study, and to evaluate if concomitant heart disease and fatigue was associated to physical activity. Methods: In this, 470 subjects with COPD and 659 subjects without COPD (non-COPD) participated in examinations including structured interview and spirometry. A ratio of the forced expiratory volume in one second (FEV1)/best of forced vital capacity (FVC) and vital capacity (VC) <0.7 was used to define COPD. Physical activity was assessed with the International Physical Activity Questionnaire (IPAQ), and fatigue with the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F). Results: The prevalence of low physical activity was higher among subjects with FEV1 <80% predicted compared to non-COPD subjects (22.4% vs. 14.6%, p = 0.041). The factors most strongly associated with low physical activity in subjects with COPD were older age, OR 1.52, (95% CI 1.12-2.06), a history of heart disease, OR 2.11 (1.10-4.08), and clinically significant fatigue, OR 2.33 (1.31-4.13); while obesity was the only significant factor among non-COPD subjects, OR 2.26 (1.17-4.35). Conclusion: Physical activity levels are reduced when lung function is decreased below 80% of predicted, and the factors associated with low physical activity are different among subject with and without COPD. We propose that the presence of fatigue and heart disease are useful to evaluate when identifying subjects for pulmonary rehabilitation.
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| 7. |
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| 8. |
- Jansson, Sven-Arne, et al.
(författare)
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Severe asthma is related to high societal costs and decreased health related quality of life
- 2020
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 162
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described. Methods: The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses. Results: Estimated mean annual asthma-related costs per patient with severe asthma amounted to (sic)6,500, of which approximately (sic)2400 and (sic)4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately (sic)1000 and (sic)800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately (sic)4200. The OCS group had significantly lower HRQOL compared to the non-OCS group. Conclusions: The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.
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| 9. |
- Kleyko, Denis, 1990-, et al.
(författare)
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Vector-Based Analysis of the Similarity Between Breathing and Heart Rate During Paced Deep Breathing
- 2018
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Ingår i: Computing in Cardiology 2018. - : IEEE.
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Konferensbidrag (refereegranskat)abstract
- The heart rate (HR) response to paced deep breathing (DB) is a common test of autonomic function, where the scoring is based on indices reflecting the overall heart rate variability (HRV), where high scores are considered as normal findings but can also reflect arrhythmias. This study presents a method based on hyperdimensional computing for assessment of the similarity between feature vectors derived from the HR and breathing signals. The proposed method was used to identify subjects where HR did not follow the paced breathing pattern in recordings from DB tests in 174 healthy subjects and 135 patients with cardiac autonomic neuropathy. Subjects were classified in 4 similarity classes, where the lowest similiarity class included 35 patients and 3 controls. In general, the autonomic function cannot be evaluated in subjects in the lowest similarity class if they also present with high HRV scores, since this combination is a strong indicator of the presence of arrhythmias. Thus, the proposed vector-based similarity analysis is one tool to identify subjects with high HRV but low cardiorespiratory synchronization during the DB test, which falsely can be interpreted as normal autonomic function.
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| 10. |
- Brännström, Margareta, et al.
(författare)
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Meeting in a 'free-zone' : Clinical ethical support in integrated heart-failure and palliative care
- 2019
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 18:7, s. 577-583
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Tidskriftsartikel (refereegranskat)abstract
- Background: Integrating heart-failure and palliative care combines expertise from two cultures, life-saving cardiology and palliative care, and involves ethically difficult situations that have to be considered from various perspectives. We found no studies describing experiences of clinical ethical support (CES) in integrated cardiology and palliative care teams.Objective: Our aim is to describe experiences of CES among professionals after a period of three years working in a multidisciplinary team in integrated heart-failure and palliative homecare.Method: The study design was descriptive qualitative, comprising interviews with seven professionals from one integrated heart-failure and palliative care team who received CES over a three-year period. The interview data were subjected to qualitative content analysis.Results: The CES was found to offer possibilities for meeting in an ethical ‘free-zone’ where the participants could relate to each other beyond their various professional roles and specialties. The trust within the team seemed to increase and the participants were confident enough to express their points of view. Together they developed an integrated understanding, and acquired more knowledge and a comprehensive view of the ethically difficult situation of concern. The CES sessions were considered a means of becoming better prepared to deal with ethical care issues and developing action strategies to apply in practice, from shared standpoints.Conclusion: Participating in CES was experienced as meeting in an ethical ‘free-zone’ and seemed to be a means of facilitating integration of palliative and heart-failure care.
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