| 1. |
- Ahmadi, Zainab, et al.
(författare)
-
Smoking and home oxygen therapy : a review and consensus statement from a multidisciplinary Swedish taskforce
- 2024
-
Ingår i: European Respiratory Review. - : European Respiratory Society. - 0905-9180 .- 1600-0617. ; 33:171
-
Forskningsöversikt (refereegranskat)abstract
- Background: Home oxygen therapy (HOT) improves survival in patients with hypoxaemic chronic respiratory disease. Most patients evaluated for HOT are former or active smokers. Oxygen accelerates combustion and smoking may increase the risk of burn injuries and fire hazards; therefore, it is considered a contraindication for HOT in many countries. However, there is variability in the practices and policies regarding this matter. This multidisciplinary Swedish taskforce aimed to review the potential benefits and risks of smoking in relation to HOT, including medical, practical, legal and ethical considerations.Methods: The taskforce of the Swedish Respiratory Society comprises 15 members across respiratory medicine, nursing, medical law and ethics. HOT effectiveness and adverse risks related to smoking, as well as practical, legal and ethical considerations, were reviewed, resulting in five general questions and four PICO (population–intervention–comparator–outcome) questions. The strength of each recommendation was rated according to the GRADE (grading of recommendation assessment, development and evaluation) methodology.Results: General questions about the practical, legal and ethical aspects of HOT were discussed and summarised in the document. The PICO questions resulted in recommendations about assessment, management and follow-up of smoking when considering HOT, if HOT should be offered to people that meet the eligibility criteria but who continue to smoke, if a specific length of time of smoking cessation should be considered before assessing eligibility for HOT, and identification of areas for further research.Conclusions: Multiple factors need to be considered in the benefit/risk evaluation of HOT in active smokers. A systematic approach is suggested to guide healthcare professionals in evaluating HOT in relation to smoking.
|
|
| 2. |
- Andréasson, Sven, et al.
(författare)
-
Att förebygga sjukdom - en ledarskapsfråga
- 2010
-
Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 107:48, s. 3070-3071
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 3. |
- Dellgren, Göran, 1961, et al.
(författare)
-
Extracorporeal membrane oxygenation as a bridge to lung transplantation: a long-term study
- 2015
-
Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 47:1
-
Tidskriftsartikel (refereegranskat)abstract
- We investigated early outcomes in patients with end-stage pulmonary disease bridged with extracorporeal membrane oxygenation (ECMO) with the intention to perform lung transplantation (LTx).
|
|
| 4. |
- Gilljam, Thomas, et al.
(författare)
-
Heart transplantation in arrhythmogenic right ventricular cardiomyopathy - Experience from the Nordic ARVC Registry
- 2018
-
Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 250, s. 201-206
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: There is a paucity of data on heart transplantation (HTx) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), and specific recommendations on indications for listing ARVC patients for HTx are lacking. In order to delineate features pertinent to HTx assessment, we explored the pre-HTx characteristics and clinical history in a cohort of ARVC patients who received heart transplants. Methods: Data from 31 ARVC/HTx patients enrolled in the Nordic ARVC Registry, transplanted between 1988 and 2014 at a median age of 46. years (14-65), were compared with data from 152 non-transplanted probands with Definite ARVC according to 2010 Task Force Criteria from the same registry. Results: The HTx patients were younger at presentation, median 31 vs. 38. years (p = 0.001). There was no difference in arrhythmia-related events. The indication for HTx was heart failure in 28 patients (90%) and ventricular arrhythmias in 3 patients (10%). During median follow-up of 4.9. years (0.04-28), there was one early death and two late deaths. Survival was 91% at 5. years after HTx. Age at first symptoms under 35. years independently predicted HTx in our cohort (OR = 7.59, 95% CI 2.69-21.39, p <. 0.001). Conclusion: HTx in patients with ARVC is performed predominantly due to heart failure. This suggests that current 2016 International Society for Heart and Lung Transplantation heart transplant listing recommendations for other cardiomyopathies could be applicable in many cases when taking into account the haemodynamic consequences of right ventricular failure in conjunction with ventricular arrhythmia.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Norberg, Margareta, et al.
(författare)
-
Changing patterns of tobacco use in a middle-aged population : the role of snus, gender, age, and education
- 2011
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 4, s. 5613-
-
Tidskriftsartikel (refereegranskat)abstract
- Background In Sweden, the smoking prevalence has declined. In 2007, it was among the lowest in the industrialized world. A steady increase in the use of Swedish oral moist snuff, snus, has occurred in parallel. This development is neither solicited by authorities nor the medical establishment, but rather has occurred along with increased awareness of the dangers of smoking, and has been promoted by product development and marketing of snus.Objective To evaluate time trends in patterns of tobacco use in northern Sweden during 1990–2007.Design Cross-sectional (99,381 subjects) and longitudinal (26,867 subjects) data from the Västerbotten Intervention Programme (VIP) 1990–2007 were analyzed. All adults in Västerbotten County are invited to a VIP health examination at ages 40, 50, and 60 years, and until 1995 also 30 years. Smoking and use of snus were evaluated by gender, age and educational groups. Intermittent smoking was categorized as smoking.Results From the period 1990–1995 to the period 2002–2007, smoking prevalence decreased from 26 to 16% among men and from 27 to 18% among women. The differences in prevalence increased between educational groups. The decline in smoking was less and the increase of snus use was greater among those with basic education. The use of snus among basic-educated 40-year-olds reached 35% among men and 14% among women during 2002–2007. Dual smoking and snus use increased among men and women with basic education. Smoking without snus use was more prevalent among women. Gender differences in total smoking prevalence (smoking only plus dual use) were small in all age groups, but increased among those with basic education reaching 7.3% during 2002–2007, with women being more frequent smokers. Smoking prevalences were similar among never, former and current snus users. Among the 30,000 former smokers, 38% of men and 64% of women had never used snus. Longitudinal data showed a decline in total tobacco use from baseline until follow-up and this was mainly due to a smoking cessation rate of<1% a year. Snus use was started by 6.2% of the 30-year-old women (age at baseline), and this contributed to a stable prevalence of total tobacco use in this group. Seventy percent of baseline snus users still used snus at follow-up. Among smokers, 55% continued smoking, 12% of men and 7% of women switched to snus. Among those with dual tobacco use at baseline, a third of men and a fourth of women remained dual users 10 years later.Conclusion There are increasing differences in tobacco use between educational groups. Higher smoking and snus use prevalence are found among those with basic education, and this is most pronounced in the younger group of this middle-aged population. In spite of a higher prevalence of smoking without snus use among women, total smoking prevalence is similar in men and women due to a higher prevalence of dual tobacco use, i.e. snus and cigarettes, among men. The increase in snus use is being paralleled by a slight increase in dual use and the smoking prevalence does not seem to be influenced by snus. This should be the subject of further studies and also have implications for tobacco control policies.
|
|
| 8. |
- Tomson, Tanja, et al.
(författare)
-
Are non-responders in a quitline evaluation more likely to be smokers?
- 2005
-
Ingår i: BMC Public Health. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 1471-2458.
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In evaluation of smoking cessation programs including surveys and clinical trials the tradition has been to treat non-responders as smokers. The aim of this paper is to assess smoking behaviour of non-responders in an evaluation of the Swedish national tobacco cessation quitline a nation-wide, free of charge service. METHODS: A telephone interview survey with a sample of people not participating in the original follow-up. The study population comprised callers to the Swedish quitline who had consented to participate in a 12 month follow-up but had failed to respond. A sample of 84 (18% of all non-responders) was included. The main outcome measures were self-reported smoking behaviour at the time of the interview and at the time of the routine follow-up. Also, reasons for not responding to the original follow-up questionnaire were assessed. For statistical comparison between groups we used Fischer's exact test, odds ratios (OR) and 95% confidence intervals (CI) on proportions and OR. RESULTS: Thirty-nine percent reported to have been smoke-free at the time they received the original questionnaire compared with 31% of responders in the original study population. The two most common reasons stated for not having returned the original questionnaire was claiming that they had returned it (35%) and that they had not received the questionnaire (20%). Non-responders were somewhat younger and were to a higher degree smoke-free when they first called the quitline. CONCLUSION: Treating non-responders as smokers in smoking cessation research may underestimate the true effect of cessation treatment.
|
|
| 9. |
- Tomson, Tanja, et al.
(författare)
-
Quitline in smoking cessation : a cost-effectiveness analysis
- 2004
-
Ingår i: International Journal of Technology Assessment in Health Care. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 0266-4623.
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The cost-effectiveness of the Swedish quitline, a nation-wide, free of charge service, is assessed. METHODS: The study was based on data of a sample of 1131 callers enrolled from February 1, 2000 to November 30, 2001. Outcome was measured as cost per quitter and cost per year of life saved. Cost per quitter was based on a calculation of the total cost of the quitline divided by the number of individuals who reported abstinence after 12 months. The cost per life year saved (LYS) was calculated by the use of data from the literature on average life expectancy for smokers versus quitters, the total cost of the quitline, and the cost of pharmacological treatment. RESULTS: The number of smokers who used the quitline and reported abstinence after 1 year was 354 (31 percent). The accumulated number of life years saved in the study population was 2400. The cost per quitter was 1052-1360 USD, and the cost per life year saved was 311-401 USD. A sensitivity analysis showed that, for outcomes down to an abstinence rate of 20 percent, the cost per LYS rose modestly, from 311 to 482 USD. Discounting the cost per LYS showed the cost to be 135 USD for 3 percent and 283 USD for 5 percent. CONCLUSIONS: The Swedish quitline is a cost-effective public health intervention compared with other smoking cessation interventions.
|
|
| 10. |
- Tomson, Tanja, et al.
(författare)
-
Symptoms in smokers trying to quit
- 2006
-
Ingår i: Tobacco Induced Diseases. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 1617-9625.
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS: To describe the prevalence and intensity of different symptoms in relation to tobacco abstinence. To explore latent dimensions between symptoms in smokers trying to quit. DESIGN: A cross sectional study using a questionnaire to retrospectively assess symptoms over a period of 12 months. SETTING: Swedish telephone quitline, a nationwide free of charge service. PARTICIPANTS: All 741 individuals who had called the quitline and signed up for smoking cessation treatment between February 2000 to November 2001 and reported to have been smoke free for at least 24 hours during the previous 12 month period from first contact. MEASUREMENTS: Assessments were made by self-report, and abstinence was defined as "not a single puff of smoke during the last week". A factor analysis approach where individual items aggregate into factors was used to explore the relationship between the different symptoms. FINDINGS: High intensity of symptoms related to unsuccessful quitting attempts and included craving, irritability, apprehension/anxiety, difficulties concentrating, restlessness, depression/depressed mood, and insomnia. The factor loadings of all 17 symptoms resulted in three factors with factor 1, psychological being the most important. High scores on this factor relates to unsuccessful quitting attempts. Using Nicotine Replacement Therapy (NRT) for 5 weeks or longer, reduced symptoms included in factor 1. The other two factors were factor 2 physiological and factor 3 neurological. CONCLUSION: Symptoms that are psychological and/or neurological in nature are interrelated and appear to be the most significant obstacles for successful quitting attempts in a population-based setting. These symptoms may be successfully treated with NRT.
|
|
