| 1. |
- Bjermer, L, et al.
(författare)
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Rinitastma : en sjukdom i hela luftvägen
- 2014
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Ingår i: Rinitastma : en sjukdom i hela luftvägen / [redaktör Hanna Vihavainen]. - Stockholm : Stiftelsen astma och allergiförbundets forskningsfond. - 9789163770425
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Bokkapitel (refereegranskat)
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| 2. |
- Eriksson, Göran, et al.
(författare)
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A new maximal bicycle test using a prediction algorithm developed from four large COPD studies
- 2020
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Ingår i: European clinical respiratory journal. - : Informa UK Limited. - 2001-8525. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Maximum exercise workload (WMAX) is today assessed as the first part of Cardiopulmonary Exercise testing. The WMAX test exposes patients with COPD, often having cardiovascular comorbidity, to risks. Our research project was initiated with the final aim to eliminate the WMAX test and replace this test with a predicted value of WMAX, based on a prediction algorithm of WMAX derived from multicentre studies. Methods: Baseline data (WMAX, demography, lung function parameters) from 850 COPD patients from four multicentre studies were collected and standardized. A prediction algorithm was prepared using Random Forest modelling. Predicted values of WMAX were used in a new WMAX test, which used a linear increase in order to reach the predicted WMAX within 8 min. The new WMAX test was compared with the standard stepwise WMAX test in a pilot study including 15 patients with mild/moderate COPD. Results: The best prediction algorithm of WMAX included age, sex, height, weight, and six lung function parameters. FEV1 and DLCO were the most important predictors. The new WMAX test had a better correlation (R2 = 0.84) between predicted and measured WMAX than the standard WMAX test (R2 = 0.66), with slopes of 0.50 and 0.46, respectively. The results from the new WMAX test and the standard WMAX test correlated well. Conclusion: A prediction algorithm based on data from four large multicentre studies was used in a new WMAX test. The prediction algorithm provided reliable values of predicted WMAX. In comparison with the standard WMAX test, the new WMAX test provided similar overall results.
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| 3. |
- Hagman, Carina
(författare)
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Dysfunctional breathing : Clinical characteristics and treatment
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Dysfunctional breathing (DB) is a respiratory disorder involving an upper chest breathing pattern and respiratory symptoms that cannot be attributed to a medical diagnosis.Aim: The overall aim of this thesis was to describe patients with DB and investigate clinical outcomes after physiotherapy treatment.Methods: Study I was descriptive and comparative, that included 25 patients with DB and 25 age- and sex-matched patients with asthma. Health-related quality of life (HRQoL), anxiety, depression, sense of coherence, influence on daily life due to breathing problems, respiratory symptoms, emergency room visits and asthma medication were investigated. Study II, a 5-year follow-up study based on the same sample as study I (22 patients with DB, 23 patients with asthma), studied treatment outcomes after information and breathing retraining. Study III was descriptive and correlational (20 healthy subjects), investigating whether the Respiratory Movement Measuring Instrument (RMMI) can discriminate between different breathing patterns in varying body positions. Study III also studied correlations between respiratory movements and breathing volumes (12 healthy subjects). Study IV was a single-subject AB design with follow-ups. Self-registered patient-specific respiratory symptoms and respiratory-related activity limitations and breathing pattern (measured with the RMMI) were evaluated after an intervention consisting of information and breathing retraining in five patients with DB.Results: Patients with DB had lower HRQoL (SF-36): vitality (mean 47 vs. 62), social functioning (70 vs. 94) and role emotional (64 vs. 94) (p<0.05) than patients with asthma. The DB group had a higher prevalence of anxiety (56% vs. 24%) and experienced more breathing problems than the asthma group. Patients with DB had made several emergency room visits and had been treated with asthma medication. At the 5-year follow-up, patients with DB showed improved HRQoL (SF-36): physical function 77 to 87 (p=0.04), decreased breathing problems and emergency room visits, and they were not treated with asthma medication. The RMMI can differentiate between different breathing patterns in different body positions. Strong correlations between respiratory movements and breathing volumes were observed (rs 0.86-1.00). The results in study IV indicate that patients with DB benefit from information and breathing retraining regarding decreased respiratory symptoms and activity limitations and improved breathing pattern.
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| 4. |
- Hellgren, Johan, 1965, et al.
(författare)
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Quality of life in non-infectious rhinitis and asthma
- 2004
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Ingår i: Rhinology. ; 42:4
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Tidskriftsartikel (refereegranskat)abstract
- In this study we evaluated how the quality of life in subjects with asthma was affected by a history of non-infectious rhinitis. The study comprised 180 persons with asthma and 156 controls, who answered the Short Form 36 quality of life questionnaire. Both the asthma subjects and the controls were stratified according to a history of non-infectious rhinitis (NIR). The global physical quality of life score (PCS) was significantly lower for all the asthma subjects regardless of their previous history of NIR compared to controls (NIR positive asthma, -8, p=O,001, NIR negative asthma, -9, p=0, 001). The subjects with asthma and a positive history of NIR obtained significantly lower scores for their global mental quality of life (MCS) than the controls (46 vs 51, p=0.004). The subjects with asthma and a negative history of NIR obtained MCS scores that were similar to those of the controls (50 and 51, p=0.9). In this population based study, the physical Qol of the subjects with asthma was lower regardless of a previous history of NIR compared to controls. A positive history of NIR in asthma was however associated with a poorer mental Qol.
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| 5. |
- Karlsson Sundbaum, Johanna, et al.
(författare)
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Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register.
- 2022
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Ingår i: Therapeutic advances in respiratory disease. - : SAGE Publications. - 1753-4666 .- 1753-4658. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Severe asthma increases the risk of severe COVID-19 outcomes such as hospitalization and death. However, more studies are needed to understand the association between asthma and severe COVID-19.A cohort of 150,430 adult asthma patients were identified in the Swedish National Airway Register (SNAR) from 2013 to December 2020. Data on body mass index, smoking habits, lung function, and asthma control test (ACT) were obtained from SNAR, and uncontrolled asthma was defined as ACT ⩽19. Patients with severe COVID-19 were identified following hospitalization or in death certificates based on ICD-10 codes U07.1 and U07.2. The Swedish Prescribed Drug register was used to identify comorbidities and data from Statistics Sweden for educational level. Multivariate logistic regression analyses were used to estimate associations with severe COVID-19.Severe COVID-19 was identified in 1067 patients (0.7%). Older age (OR=1.04, 95% CI=1.03-1.04), male sex (1.42, 1.25-1.61), overweight (1.56, 1.27-1.91), obesity (2.12, 1.73-2.60), high-dose inhaled corticosteroids in combination with long-acting β-agonists (1.40, 1.22-1.60), dispensed oral corticosteroids ⩾2 (1.48, 1.25-1.75), uncontrolled asthma (1.64, 1.35-2.00), cardiovascular disease (1.20, 1.03-1.40), depression (1.47, 1.28-1.68), and diabetes (1.52, 1.29-1.78) were associated with severe COVID-19, while current smoking was inversely associated (0.63, 0.47-0.85). When comparing patients who died from COVID-19 with those discharged alive from hospital until 31 December 2020, older age, male sex, and current smoking were associated with COVID-19 death.Patients with uncontrolled asthma and high disease burden, including increased asthma medication intensity, should be identified as risk patients for severe COVID-19. Furthermore, current smoking is strongly associated with COVID-19 death in asthma.
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| 6. |
- Kiotseridis, Hampus, et al.
(författare)
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Adherence and quality of life in adults and children during 3-years of SLIT treatment with Grazax-a real life study
- 2018
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Ingår i: npj Primary Care Respiratory Medicine. - : Springer Science and Business Media LLC. - 2055-1010. ; 28:1
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Tidskriftsartikel (refereegranskat)abstract
- Respiratory allergic disease represents a global health problem, 30% of the population suffers from allergic rhinoconjunctivitis and 20% suffer from asthma. Allergy immunotherapy induce immunological tolerance and thereby modify the response to allergens and sublingual immunotherapy (SLIT) offers the possibility of home administration of allergen therapy, but adherence is more uncertain. The aim of the study was to investigate the adherence with GRAZAX in adults and children ≥ 5 years during three consecutive years of treatment. This was a non-interventional, prospective, observational, multi-center, open-label study to investigate adherence, quality of life, safety and tolerability of GRAZAX in adult and pediatric patients in a real-life setting. During the 3-years study period estimation of adherence was done regularly. Quality of life as well as symptom score was also assessed. In total, 399 patients (236 adults and 163 children) were included in the study. At baseline, 100% suffered from moderate-severe eyes and nose symptoms, and 31% had asthma in the grass pollen season. Overall, 55% completed a 3-years treatment period, whereas 37% stopped before end of study and 8% were lost to follow up. After 3 years, the adherence rate decreased from 98.2% (first month), 93.7% (first year), 93.2% (second year) and 88.9% (third year) and adverse events were the main reason for pre-term termination. The study suggests a good adherence to treatment in a real life setting among the patients finalizing 3-years SLIT therapy. The treatment was effective both on symptoms and HRQL.
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| 7. |
- Kiotseridis, Hampus, et al.
(författare)
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ALMA, a new tool for the management of asthma patients in clinical practice: development, validation and initial clinical findings.
- 2012
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Ingår i: Primary Care Respiratory Journal. - : Springer Science and Business Media LLC. - 1475-1534 .- 1471-4418. ; 21:2, s. 139-144
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several instruments have been developed for measuring asthma control, but there is still a need to provide a structure for primary care asthma reviews. AIMS: The Active Life with Asthma (ALMA) tool was developed with the aim of structuring patient visits and assessing asthma treatment in primary care. The ability of ALMA to map out the care of asthma patients was evaluated and validated. METHODS: ALMA was developed with patient and clinical expert input. Questions were generated in focus groups and the resulting tool was subsequently validated by factor analysis in 1779 patients (1116 females) of mean age 51 years (range 18-89) in primary care. RESULTS: The ALMA tool includes 19 questions, 14 of which belong to a subset assessing asthma control. In this subset, factor analysis revealed three domains (factors): physical, psychological, and environmental triggers. Correlation with the Asthma Control Questionnaire was 0.72 and the Cronbach's alpha was 0.88. The test-retest reliability was 0.93. Of the 1779 patients tested with ALMA in primary care, 62% reported chest tightness, 30% nightly awakenings and 45% asthma breakthrough despite medication. CONCLUSIONS: The ALMA tool is useful as a follow-up instrument in clinical practice to structure patient visits and assess asthma treatment in primary care. The breadth of the questions and the pragmatic use in clinical practice also make it useful as an outcome measure.
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| 8. |
- Kiotseridis, Hampus, et al.
(författare)
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Grass pollen allergy in children and adolescents-symptoms, health related quality of life and the value of pollen prognosis
- 2013
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Ingår i: Clinical and Transnational Allergy. - 2045-7022. ; 3:19
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Introduction An association between pollen count (Poaceae) and symptoms is well known, but to a lesser degree the importance of priming and lag effects. Also, threshold levels for changes in symptom severity need to be validated. The present study aims to investigate the relationship between pollen counts, symptoms and health related quality of life (HRQL), and to validate thresholds levels, useful in public pollen warnings. Material and methods Children aged 7–18 with grass pollen allergy filled out a symptom diary during the pollen season for nose, eyes and lung symptoms, as well as a HRQL questionnaire every week. Pollen counts were monitored using a volumetric spore trap. Results 89 (91%) of the included 98 children completed the study. There was a clear association between pollen count, symptom severity and HRQL during the whole pollen season, but no difference in this respect between early and late pollen season. There was a lag effect of 1–3 days after pollen exposure except for lung symptoms. We found only two threshold levels, at 30 and 80 pollen grains/m3 for the total symptom score, not three as is used today. The nose and eyes reacted to low doses, but for the lung symptoms, symptom strength did hardly change until 50 pollen grains/m3. Conclusion Grass pollen has an effect on symptoms and HRQL, lasting up to 5 days after exposure. Symptoms from the lungs appear to have higher threshold levels than the eyes and the nose. Overall symptom severity does not appear to change during the course of season. Threshold levels need to be revised. We suggest a traffic light model for public pollen warnings directed to children, where green signifies “no problem”, yellow signifies “can be problems, especially if you are highly sensitive” and red signifies “alert – take action”.
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| 9. |
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| 10. |
- Kiotseridis, Hampus, et al.
(författare)
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Quality of life in children and adolescents with respiratory allergy, assessed with a generic and disease-specific instrument
- 2013
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Ingår i: Clinical Respiratory Journal. - 1752-6981. ; 7:2, s. 168-175
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Respiratory allergic disorders like rhinitis and asthma are common conditions that not only affect target organs, but complicate the daily life of affected children and adolescents. Objectives: The aim of this study was to investigate the QoL (quality of life) in children with grass pollen allergy in and out of grass pollen season. Methods: We used the Pediatric Allergic Disease Quality of Life Questionnaire (PADQLQ), a disease-specific questionnaire including both asthma and rhinitis symptoms. We also used the DISABKIDS (a European project which aims at enhancing the quality of life and the independence of children with chronic health conditions and their families) questionnaire, a generic questionnaire covering non-organ-specific effects of disease. Results: Ninety-eight children 718 years old with grass pollen allergy were included. Eighty-nine children (91%) completed the study. The QoL was significantly decreased during pollen season assessed both with DISABKIDS and PADQLQ. The correlation between the questionnaires was 0.73. Not only the physical domain score (P=0.00093) but also the emotional domain score (P=0.034) was significantly lowered. Children with multiple manifestations (asthma and rhinitis) had lower QoL than children with rhinitis alone (P=0.01). Multiple regression analysis showed a highly significant impact on QoL for symptoms from nose, eyes and lungs. They were equally important (standardized coefficient 047, 0.47 and 0.46, respectively). Conclusion: The QoL in children and adolescents with respiratory allergy deteriorates during pollen season. This was shown both with generic (DISABKIDS) and disease-specific instrument (PADQLQ). Please cite this paper as: Kiotseridis H, Cilio CM, Bjermer L, Aurivillius M, Jacobsson H, Dahl angstrom and Tunsater A. Quality of life in children and adolescents with respiratory allergy, assessed with a generic and disease-specific instrument. Clin Respir J 2013; 7: 168175.
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