| 1. |
- Dellborg, Catharina, 1956, et al.
(författare)
-
Impact of home mechanical ventilation on health-related quality of life in patients with chronic alveolar hypoventilation: a prospective study.
- 2008
-
Ingår i: Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 2:1, s. 26-35
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Nocturnal ventilatory support by nasal positive pressure ventilation (NPPV) is an established treatment method in patients with chronic alveolar hypoventilation (CAH). The knowledge about its long-term effects on health-related quality of life (HRQL) is limited. Methods: In a prospective, longitudinal, single-strand study, patients with CAH caused by non-COPD conditions, consecutively recruited among referral patients in three Swedish university hospital pulmonary departments, were examined at baseline and after 9 months (n = 35) and 8 years (n = 11) on NPPV treatment. Both volume pre-set and pressure pre-set ventilators were used. Patients completed a battery of condition-specific and generic HRQL questionnaires at baseline and follow-up. Spirometry and blood gases were measured. Compliance with treatment, side effects and patient satisfaction were evaluated. Results: After 9 months of NPPV, improvements were seen primarily not only in sleep-related domains, but also in emotional behaviour, ambulation and sleep/rest functioning as measured with the Sickness Impact Profile (SIP). Improvements in sleep-related symptoms were related to effectiveness in ventilation, evaluated by morning PaCO2, and remained by 8 years. Mental well-being was stable over time, while emotional distress improved by 8 years. Satisfaction with treatment was high in spite of frequent side effects. Conclusion: NPPV improves HRQL, particularly in condition-specific areas. Improvements are related to effectiveness in ventilation. Side effects are common, but compliance is good And patient satisfaction is high.
|
|
| 2. |
- Löfdahl, Claes-Göran
(författare)
-
COPD and co-morbidities, with special emphasis on cardiovascular conditions
- 2008
-
Ingår i: CLINICAL RESPIRATORY JOURNAL. - 1752-6981 .- 1752-699X. ; 2, s. 59-63
-
Konferensbidrag (refereegranskat)abstract
- The concept of COPD as a systemic disease has been widely accepted in the past several years. In parallel, it has been emphasised that COPD morbidity and mortality is strongly related to co-morbid conditions. This review summarises some recent studies showing that in patients with COPID, the prevalence of cardiac failure is manifested in 10%-46% of the patients, and that up to 40% of patients with cardiac failure show evidence of COPD, about half of them not earlier diagnosed. Recent data also show an increased risk for arteriosclerotic manifestations in COPD patients, and cardiac complications are common causes of death in COPD patients. Other manifestations of the metabolic syndrome, as diabetes, are also over-represented in patients. It is also a well-established fact that a low FEV1 is a risk factor for cardiovascular diseases and events. Mechanistically, a systemic inflammation in COPD could be a link to cardiovascular events. COPD raises inflammatory parameters and local anti-inflammatory treatment seems to have a potential to decrease the systemic inflammation and also to decrease cardiovascular events.
|
|
| 3. |
- Andersson, Ingalill, et al.
(författare)
-
Vitamin and mineral status in elderly patients with chronic obstructive pulmonary disease
- 2007
-
Ingår i: Clinical Respiratory Journal. - : Blackwell Publishing. - 1752-6981 .- 1752-699X. ; 1:1, s. 23-29
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Eating problems are common in patients with chronic obstructive pulmonary disease (COPD), and intake of micronutrients might be lower than recommended. Objective: To study dietary intake, serum and urinary concentration of trace elements and vitamins in elderly underweight patients with established severe COPD. Methods: Outpatients at a university clinic for lung medicine, with COPD, 70-85 years old, with no other serious disease, and with a body mass index (BMI) of similar to 20 kg/m(2) and an FEV(1) of < 50 % predicted were recruited. Body composition and bone density were evaluated with dual energy X-ray absorptiometry. Dietary intake was studied by a trained dietitian using diet-history interview. Blood and urine samples were analysed for various vitamins and trace elements. Results: Seventeen of 30 recruited patients took part. Osteoporosis or osteopaenia was found in 16 patients. Dietary intake of energy and macronutrients was in line with recommendations for healthy individuals. Intake of protein did not meet recommendations for COPD patients. Intake of polyunsaturated fatty acids was lower than recommended and intake of saturated fatty acids was higher than recommended. Mean intake of vitamin D and folic acid was far below recommendations. Serum concentrations for folic acid and methylmalonate and plasma concentrations for homocysteine were below normal in several patients. Conclusion: Intake of vitamin D and calcium is often low in older COPD patients, which might contribute to osteoporosis. Low intake of folic acid might also be a problem. The results support prophylaxis with calcium, vitamin D and folic acid.
|
|
| 4. |
- Bjerg, Anders, et al.
(författare)
-
Asthma in school age : prevalence and risk factors by time and by age
- 2008
-
Ingår i: Clinical Respiratory Journal. - Oxford : Blackwell Publishing. - 1752-6981 .- 1752-699X. ; 2:Suppl 1, s. 123-126
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood is the most important age for asthma development. Recent reports indicate that the prevalence of asthma. in children has plateaued after having increased for decades.Aims: To study prevalence and risk factor patterns of asthma by age and by time.Methods: In 1996, all children in grade 1-2 (age 7-8) in three cities ill Northern Sweden were invited to an expanded International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. A total of 3430 children (97%) participated yearly until 2000 (age 11-12). A subset (n = 2454) was invited to skill-prick testing in 1996 and 2000 with 88% and 90% participation. In 2006, another cohort (n = 2704) was identified and studied by identical methods with 96% participation. A total of 1700 children (90% of invited) were skin-prick tested.Results and comments: From age 7-8 to 11-12, the prevalence of physician-diagnosed asthma increased, 5.7%-7.7% (P<0.01) while current wheeze decreased, 11.7%-9.4% (P < 0.01), indicating a less diverse spectrum of symptoms with age. The yearly remission from asthma was 10% (lasting remission 5%), largely determined by allergic sensitisation. Allergic sensitisation (OR 5) and a family history of asthma (OR 3) were important risk factors for asthma at age 7-8 and 11-12. However, several other significant risk factors at age 7-8 (low birth weight, respiratory infections and house dampness) lost importance until age 11-12. Maternal and paternal asthma were equally important risk factors (OR 3-4) at age 7-8. Sibling asthma was only a marker of parental disease.Future perspectives: Through comparison with the 2006 cohort, trends in prevalence and in risk factors from 1996 to 2006 will be studied.
|
|
| 5. |
- Ekerljung, Linda, 1979, et al.
(författare)
-
FinEsS-Stockholm and the Stockholm adult asthma study
- 2008
-
Ingår i: The clinical respiratory journal. - 1752-6981. ; 22 Suppl 1, s. 127-128
-
Forskningsöversikt (refereegranskat)abstract
- Abstract Two major studies on asthma and respiratory symptoms are presently in progress in Stockholm. The FinEsS-studies has been ongoing since 1996, with a follow-up study preformed in 2006 and a new cohort selected in 2007. The FinEsS studies focus on prevalence and incidence of asthma and respiratory symptoms in a general population. Clinical follow-up surveys will also target COPD. Further aims include remission and relapse of disease and symptoms and their determinants. The Stockholm adult Asthma Study (SaAS) began in the spring of 2007 and data is being collected presently. The SaAS study focus on the medical care and medication given to asthmatics in Stockholm, and the study population consists of asthmatics found in the two Swedish cohort studies.
|
|
| 6. |
|
|
| 7. |
- Hillerdal, Gunnar, et al.
(författare)
-
Treatment of malignant pleural mesothelioma with liposomized doxorubicine : prolonged time to progression and good survival. A Nordic study
- 2008
-
Ingår i: The Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 2:2, s. 80-85
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Malignant pleural mesothelioma (MPM) has a poor prognosis and there is limited effect of treatment. Lately, pemetrexed and cisplatin have been established as the standard treatment. Objectives: The present study was planned in 1998, when there was no standard treatment. Single-dose doxorubicine had, in small studies, accomplished remissions, and the Scandinavian Mesothelioma Groups therefore decided to test a liposomized form of this drug, which had shown limited toxicity but good efficacy in a few small studies. Methods: Fifty-four evaluable patients with histologically verified and inoperable MPM were treated with liposomized doxorubicine 40 mg/m2, every 4 weeks for six cycles. Results: In all, 29 patients (54%) received at least six treatments. The quality of life remained good during the study. Hematologic toxicity was very low. Palmo–plantar erythema occurred in 11 patients (20%), thereof 7 grade II but none was severe and none was dose-limiting. There were four partial responses (7%). The median time to progression (TTP) was 5 months, the median survival was 12 months, and at 24 months, 22% were still alive. Conclusion: Liposomized doxorubicine has a low toxicity and is well tolerated; there were a remarkably long TTP and a good survival. Thus, despite the low response rate, liposomized doxorubicine remains an interesting drug for the treatment of malignant mesothelioma.
|
|
| 8. |
- Janson, Christer, et al.
(författare)
-
Risk factors associated with allergic and non-allergic asthma in adolescents
- 2007
-
Ingår i: Clinical Respiratory Journal. - : Wiley. - 1752-6981 .- 1752-699X. ; 1:1, s. 16-22
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Risk factors for asthma have been investigated in a large number of studies in adults and children, with little progress in the primary and secondary prevention of asthma. The aim of this investigation was to investigate risk factors associated with allergic and non-allergic asthma in adolescents. Methods: In this study, 959 schoolchildren (13-14 years old) answered a questionnaire and performed exhaled nitric oxide ( NO) measurements. All children (n = 238) with reported asthma, asthma-related symptoms and/or increased NO levels were invited to a clinical follow-up which included a physician evaluation and skin-prick testing. Results: Asthma was diagnosed in 96 adolescents, whereof half had allergic and half non-allergic asthma. Children with both allergic and non-allergic asthma had a significantly higher body mass index (BMI) (20.8 and 20.7 vs. 19.8 kg/m(2)) (p < , 0.05) and a higher prevalence of parental asthma (30% and 32% vs. 16%) (p < , 0.05). Early-life infection (otitis and croup) [adjusted odds ratio ( OR) (95% confidence interval (CI)): 1.99(1.02-3.88) and 2.80 (1.44-5.42), respectively], pets during the first year of life [2.17 (1.16-4.04)], window pane condensation [2.45 (1.11-5.40)] and unsatisfactory school cleaning [(2.50 (1.28-4.89)] was associated with non-allergic but not with allergic asthma. Conclusion: This study indicates the importance of distinguishing between subtypes of asthma when assessing the effect of different risk factors. While the risk of both allergic and non-allergic asthma increased with increasing BMI, associations between early-life and current environmental exposure were primarily found in relation to non-allergic asthma.
|
|
| 9. |
- Lindberg, A, et al.
(författare)
-
The Obstructive Lung Disease in Northern Sweden Chronic Obstructive Pulmonary Disease Study: design, the first year participation and mortality
- 2008
-
Ingår i: The clinical respiratory journal. - 1752-6981. ; 22 Suppl 1, s. 64-71
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Most epidemiological data on chronic obstructive pulmonary disease (COPD) are cross-sectional, and the longitudinal course of disease on population bases is incompletely described. AIM: To describe an epidemiological study designed to follow the longitudinal course of disease in chronic obstructive lung disease, COPD, including co-morbidity and mortality and further, to evaluate the impact of COPD on quality of life and health economics. MATERIALS AND METHODS: From the Obstructive Lung Disease in Northern Sweden studies database cohorts I-IV, all subjects with COPD according to the Global Initiative for Chronic Obstructive Lung Disease spirometric criteria, FEV(1)/FVC < 0.70 (n = 993), were identified together with a similar size age- and gender-matched control group. The study population was invited to a yearly examination starting in year 2005. The examinations included structured interview, spirometry with reversibility testing, oxygen saturation and health-related quality of life questionnaires. RESULTS: On the first year, 83% of the population was examined, and the subjects unable to attend the examination were interviewed by telephone. Altogether, 91% of the original study population participated (95% of all subjects were alive at the end of the first year). Mortality was significantly higher among subjects with COPD, 5.1%, compared with controls, 3.0% (P = 0.018). CONCLUSION: The study design including cases of COPD representative of COPD by disease severity in the general population and a similar sized control group, together with a high participation rate in the first study year, creates excellent conditions for evaluating the impact of COPD on population bases, and to follow the longitudinal course of disease in COPD.
|
|
| 10. |
- Lundbäck, Bo, 1948, et al.
(författare)
-
General population-based cohorts for studies of lung health in adults in Sweden
- 2008
-
Ingår i: Clinical Respiratory Journal. - Oxford : Blackwell Publishing. - 1752-6981 .- 1752-699X. ; 2:Suppl 1, s. 2-9
-
Tidskriftsartikel (refereegranskat)abstract
- Epidemiological population-based studies about lung health in Sweden have mostly been focused on obstructive airway diseases. From the 1960s to the 1980s, the epidemiological studies were cross-sectional, aiming at the study of the prevalence of asthma, chronic bronchitis and respiratory symptoms and their associations with mainly demographic data. With the exception of highly stratified samples, for instance the men born on 1913 in Gothenburg and cohorts of occupational groups or work places, general population-based cohorts for studies of lung health in adults are still not very common. Two large-scale studies of lung health have been in progress in Sweden for more than 20 years; the Obstructive Lung Disease in Northern Sweden (OLIN) Studies, which started in 1985, and the Swedish part of European Community Respiratory Health Survey (ECRHS) since 1989 with the follow-Lip survey labelled Respirator), Health in Northern Europe (RHINE). During the 1990s the comparative studies between Finland, Estonia and Sweden (The FinEsS Studies) started. These and other studies will be reviewed in the following exemplifying change of aims and study designs over time as well as change of focus of risk factors under study.
|
|
