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- Riikjarv, M.-A., et al.
(författare)
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Similar prevalence of respiratory symptoms and atopy in estonian schoolchildren with changing lifestyle over 4 yrs
- 2000
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 16:1, s. 86-90
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of allergic sensitization and clinical manifestations is low in Eastern Europe, despite a continuous increase in industrialized countries with a market economy. The aim of the present study was to study changes in the prevalence of respiratory symptoms and atopic sensitization over time among schoolchildren in Estonia, in relation to environmental changes as the country transformed into a market economy. A cross-sectional study of 10-yr-old children was carried out between October 1996 and April 1997, employing a questionnaire regarding the prevalence of wheezing, rhinitis and itching rash (n=979) and skin-prick tests with seven inhalant allergens (n=640). The results were compared with those of a similar study performed in 19921993. The 12-month prevalence of wheeze was 8.3%, as compared to 9.4% in 1992-1993 (NS) and of asthma was 2.5 versus 3.2% (NS). The prevalence of a positive skin-prick test result was 14.3% in both studies. Furthermore, the prevalence of sensitivity to the individual allergens was similar, except for a significantly higher prevalence of dog sensitivity in 1996-1997 (4.7 versus 2.0%). The prevalence of respiratory and other potentially allergic symptoms, as well as the prevalence of atopic sensitization, remains low in Estonian 10-yr-old children, despite a changing lifestyle over the past 4 yrs. This could indicate that the time period was too short for environmental changes to affect the prevalence of allergy, or alternatively that risk factors associated with a 'western lifestyle' are of particular significance earlier in life. (C)ERS Journals Ltd 2000.
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| 3. |
- Butler, C.C., et al.
(författare)
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Antibiotic prescribing for discoloured sputum in acute cough/lower respiratory tract infection
- 2011
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 38:1, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- We investigated whether discoloured sputum and feeling unwell were associated with antibiotic prescription and benefit from antibiotic treatment for acute cough/lower respiratory tract infection (LTRI) in a prospective study of 3,402 adults in 13 countries. A two-level model investigated the association between producing discoloured sputum or feeling generally unwell and an antibiotic prescription. A three-level model investigated the association between an antibiotic prescription and symptom resolution. Patients producing discoloured sputum were prescribed antibiotics more frequently than those not producing sputum (OR 3.2, 95% CI 2.1-5.0), unlike those producing clear/white sputum (OR 0.95, 95% CI 0.61-1.48). Antibiotic prescription was not associated with a greater rate or magnitude of symptom score resolution (as measured by a 13-item questionnaire completed by patients each day) among those who: produced yellow (coefficient 0.00; p=0.68) or green (coefficient -0.01; p=0.11) sputum; reported any of three categories of feeling unwell; or produced discoloured sputum and felt generally unwell (coefficient -0.01; p=0.19). Adults with acute cough/LRTI presenting in primary care settings with discoloured sputum were prescribed antibiotics more often compared to those not producing sputum. Sputum colour, alone or together with feeling generally unwell, was not associated with recovery or benefit from antibiotic treatment.
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| 5. |
- Cohen, Adam, et al.
(författare)
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The global prevalence of latent tuberculosis: a systematic review and meta-analysis
- 2019
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Ingår i: European Respiratory Journal. - : EUROPEAN RESPIRATORY SOC JOURNALS LTD. - 0903-1936 .- 1399-3003. ; 54:3
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Forskningsöversikt (refereegranskat)abstract
- In 1999, the World Health Organization (WHO) estimated that one-third of the worlds population had latent tuberculosis infection (LTBI), which was recently updated to one-fourth. However, this is still based on controversial assumptions in combination with tuberculin skin test (TST) surveys. Interferon-gamma release assays (IGRAs) with a higher specificity than TST have since been widely implemented, but never used to estimate the global LTBI prevalence. We conducted a systematic review and meta-analysis of LTBI estimates based on both IGRA and TST results published between 2005 and 2018. Regional and global estimates of LTBI prevalence were calculated. Stratification was performed for low, intermediate and high TB incidence countries and a pooled estimate for each area was calculated using a random effects model. Among 3280 studies screened, we included 88 studies from 36 countries with 41 IGRA (n=67 167) and 67 TST estimates (n=284 644). The global prevalence of LTBI was 24.8% (95% CI 19.7-30.0%) and 21.2% (95% CI 17.9-24.4%), based on IGRA and a 10-mm TST cut-off, respectively. The prevalence estimates correlated well to WHO incidence rates (Rs=0.70, pamp;lt;0.001). In the first study of the global prevalence of LTBI derived from both IGRA and TST surveys, we found that one-fourth of the worlds population is infected. This is of relevance, as both tests, although imperfect, are used to identify individuals eligible for preventive therapy. Enhanced efforts are needed targeting the large pool of latently infected individuals, as this constitutes an enormous source of potential active tuberculosis.
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| 10. |
- Haahtela, T, et al.
(författare)
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Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air : A SOMA study
- 2006
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 28:4, s. 748-755
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Tidskriftsartikel (refereegranskat)abstract
- Patients with mild intermittent asthma sometimes show signs of inflammation, and guidelines suggesting bronchodilator therapy alone as needed may be questioned. The current study compared as-needed use of a rapid-acting β2-agonist with as-needed use of a β2-agonist and corticosterold combination as the only medication in asthma patients with intermittent symptoms. A total of 92 nonsmoking asthma patients (of 187 screened) using only an inhaled β2-agonist as needed (28 males, 64 females, mean age 37 yrs, mean forced expiratory volume in one second (FEV1) 101% predicted, mean reversibility 6.5% pred and fractional exhaled nitric oxide (FeNO) ≥20 parts per billion (ppb)) were randomised to treatment with formoterol (Oxis® Turbuhaler®) 4.5 μg as needed (n=47) or budesonide/formoterol (Symbicort® Turbuhaler®) 160/4.5 pg as needed (n=45) in a double-blind, parallel-group 24-week study. The primary variable of efficacy was change in FeNO. Baseline FeNO was 60 ppb and 59 ppb in the budesonide/formoterol and formoterol groups, respectively. Mean reductions in FeNO in the budesonide/formoterol and formoterol groups were 18.2 ppb and 2.8 ppb, respectively (95% confidence interval (CI) 7.5-23.5 ppb). The reduction in the budesonide/formoterol group occurred during the first 4 weeks of treatment and remained at this low level. Mean FEV1 increased by 1.8% pred normal value in the budesonide/formoterol group and decreased by 0.9% pred normal value in the formoterol group (95% Cl -4.7 - -0.7). In the budesonide/formoterol group, use of ≥4 inhalations-day-1 of study medication was seen on 21 treatment days compared with 74 in the formoterol group. In conclusion, as-needed use of an inhaled corticosteroid together with a rapid-acting bronchodilator may be more beneficial than a β2-agonist alone in patients with intermittent asthma and signs of airway inflammation. The long-term benefits are unknown. Copyright © ERS Journals Ltd 2006.
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