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- Lisspers, Karin, Docent, 1954-, et al.
(författare)
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Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study
- 2019
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Ingår i: NPJ primary care respiratory medicine. - : Springer Science and Business Media LLC. - 2055-1010. ; 29:1, s. 45-
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Tidskriftsartikel (refereegranskat)abstract
- The present study aimed to generate real-world evidence regarding gender differences among chronic obstructive pulmonary disease (COPD) patients, especially as regards the diagnosis and outcomes in order to identify areas for improvement and management and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients and a matched reference population from 52 primary care centers in 2000–2014. The incidence of COPD, prevalence of asthma and other comorbidities, risk of exacerbations, mortality rate, COPD drug prescriptions, and healthcare resource utilization were analyzed. In total, 17,479 patients with COPD were included in the study. During the study period, COPD was more frequent among women (53.8%) and women with COPD experienced more exacerbations vs. men (6.66 vs. 4.66). However, the overall mortality rate was higher in men compared with women (45% vs. 38%), but no difference for mortality due to COPD was seen between genders over the study period. Women seemed to have a greater susceptibility to asthma, fractures, osteoporosis, rheumatoid arthritis, rhinitis, depression, and anxiety, but appeared less likely to have diabetes, kidney diseases, and cardiovascular diseases. Furthermore, women had a greater risk of COPD-related hospitalization and were likely to receive a significantly higher number of COPD drug prescriptions compared with men. These results support the need to reduce disease burden among women with COPD and highlight the role of healthcare professionals in primary care who should consider all these parameters in order to properly diagnose and treat women with COPD.
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- Abdel-Aal, Arwa, et al.
(författare)
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Prioritising primary care respiratory research needs : results from the 2020 International Primary Care Respiratory Group (IPCRG) global e-Delphi exercise
- 2022
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Ingår i: npj Primary Care Respiratory Medicine. - : Springer Nature. - 2055-1010. ; 32:1
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Tidskriftsartikel (refereegranskat)abstract
- Respiratory diseases remain a significant cause of global morbidity and mortality and primary care plays a central role in their prevention, diagnosis and management. An e-Delphi process was employed to identify and prioritise the current respiratory research needs of primary care health professionals worldwide. One hundred and twelve community-based physicians, nurses and other healthcare professionals from 27 high-, middle- and low-income countries suggested 608 initial research questions, reduced after evidence review by 27 academic experts to 176 questions covering diagnosis, management, monitoring, self-management and prognosis of asthma, COPD and other respiratory conditions (including infections, lung cancer, tobacco control, sleep apnoea). Forty-nine questions reached 80% consensus for importance. Cross-cutting themes identified were: a need for more effective training of primary care clinicians; evidence and guidelines specifically relevant to primary care, adaption for local and low-resource settings; empowerment of patients to improve self-management; and the role of the multidisciplinary healthcare team.
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- Eriksson, Lina J. K., et al.
(författare)
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The interactive effect of the Behavioral Inhibition System (BIS) and response inhibition on accuracy in a modified stop-signal task
- 2016
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Ingår i: Personality and Individual Differences. - : Elsevier BV. - 0191-8869 .- 1873-3549. ; 97, s. 198-202
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Tidskriftsartikel (refereegranskat)abstract
- The ability to adjust to a changing environment is an important aspect of every-day life and successful goal directed behavior requires the ability to suppress responses that are no longer appropriate. The main purpose of the present study was to examine if the relationship between inhibitory control (as indexed by stop-signal reaction time, SSRT) and behavioral precision is dependent on levels of Gray and McNaughton's Behavioral Inhibition System (BIS). Additionally, the relationship between BIS and electrodermal activity, and the Behavioral Approach System (BAS) and heart rate activity was investigated. A modified stop-signal task was used. The results showed that there was an interaction effect of BIS and SSRT on accuracy, suggesting that among individuals with higher levels of BIS, longer SSRT (i.e. poorer inhibitory ability) was associated with decreased accuracy. There were no significant correlations between trait variables and physiological variables. The results were discussed in terms of higher levels of BIS being a vulnerability factor when the individual's inhibitory ability simultaneously is poor in situations where the ability to inhibit inappropriate behavioral routines is important for task performance.
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- Larsson, K., et al.
(författare)
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Combination of budesonide/formoterol more effective than fluticasone/salmeterol in preventing exacerbations in chronic obstructive pulmonary disease : the PATHOS study
- 2013
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 273:6, s. 584-594
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Combinations of inhaled corticosteroids (ICSs) and long-acting 2-agonists (LABAs) are recommended for patients with moderate and severe chronic obstructive pulmonary disease (COPD). However, it is not known whether different fixed combinations are equally effective. The aim of this study was to investigate exacerbation rates in primary care patients with COPD treated with budesonide/formoterol compared with fluticasone/salmeterol. Methods Patients with physician-diagnosed COPD and a record of postdiagnosis treatment with a fixed combination of budesonide/formoterol or fluticasone/salmeterol were included. Data from primary care medical records were linked to those from Swedish national hospital, drug and cause of death registers. Pairwise (1:1) propensity score matching was carried out at the index date (first prescription) by prescribed fixed ICS/LABA combination. Exacerbations were defined as hospitalizations, emergency visits and collection of oral steroids or antibiotics for COPD. Yearly event rates were compared using Poisson regression. Results Matching of 9893 patients (7155 budesonide/formoterol and 2738 fluticasone/salmeterol) yielded two cohorts of 2734 patients, comprising 19170 patient-years. The exacerbation rates were 0.80 and 1.09 per patient-year in the budesonide/formoterol and fluticasone/salmeterol groups, respectively (difference of 26.6%; P<0.0001); yearly rates for COPD-related hospitalizations were 0.15 and 0.21, respectively (difference of 29.1%; P<0.0001). All other healthcare outcomes were also significantly reduced with budesonide/formoterol versus fluticasone/salmeterol. Conclusions Long-term treatment with fixed combination budesonide/formoterol was associated with fewer healthcare utilization-defined exacerbations than fluticasone/salmeterol in patients with moderate and severe COPD.
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- Perk, Joep, et al.
(författare)
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Allvarliga brister i rådgivning till koronarsjuka patienter efter ballongvidgning patienter undervärderar levnadsvanors betydelse, visar enkätstudie
- 2014
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 111:42, s. 1835-
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Tidskriftsartikel (refereegranskat)abstract
- In a questionnaire 1073 patients from 29 randomly selected Swedish hospitals who had undergone percutaneous coronary intervention (PCI) were asked what they considered to be the cause of their coronary disease, how they experienced the information given by the medical staff and in which way had they adopted a heart-healthy lifestyle. The main outcomes were; A majority attributed the cause of the disease to non-modifiable factors, i.e. age and heredity. Merely one in four patients had perceived the information in a correct way: they still carried the coronary disease and needed to adapt their lifestyle. Half of the patient population had increased their physical activity and likewise merely half had changed their food habits. Half of the tobacco users had quit after PCI. Thus the results of this study shows that there is ample space for improving the present care of post-PCI patients.
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- Pincikova, Terezia, et al.
(författare)
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MAIT cell counts are associated with the risk of hospitalization in COPD
- 2022
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Ingår i: Respiratory Research. - : BioMed Central (BMC). - 1465-9921 .- 1465-993X. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation associated with chronic inflammation in the airways. Mucosal-associated invariant T (MAIT) cells are unconventional, innate-like T cells highly abundant in mucosal tissues including the lung. We hypothesized that the characteristics of MAIT cells in circulation may be prospectively associated with COPD morbidity.MethodsCOPD subjects (n = 61) from the Tools for Identifying Exacerbations (TIE) study were recruited when in stable condition. At study entry, forced expiratory volume in 1 s (FEV1) was measured and peripheral blood mononuclear cells were cryopreserved for later analysis by flow cytometry. Patients were followed for 3 years to record clinically meaningful outcomes.ResultsPatients who required hospitalization at one or more occasions during the 3-year follow-up (n = 21) had lower MAIT cell counts in peripheral blood at study inclusion, compared with patients who did not get hospitalized (p = 0.036). In contrast, hospitalized and never hospitalized patients did not differ in CD8 or CD4 T cell counts (p = 0.482 and p = 0.221, respectively). Moreover, MAIT cells in hospitalized subjects showed a more activated phenotype with higher CD38 expression (p = 0.014), and there was a trend towards higher LAG-3 expression (p = 0.052). Conventional CD4 and CD8 T cells were similar between the groups. Next we performed multi-variable logistic regression analysis with hospitalizations as dependent variable, and FEV1, GOLD 2017 group, and quantity or activation of MAIT and conventional T cells as independent variables. MAIT cell count, CD38 expression on MAIT cells, and LAG-3 expression on both MAIT and CD8 T cells were all independently associated with the risk of hospitalization.ConclusionsThese findings suggest that MAIT cells might reflect a novel, FEV1-independent immunological dimension in the complexity of COPD. The potential implication of MAIT cells in COPD pathogenesis and MAIT cells’ prognostic potential deserve further investigation.
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