| 1. |
- Midgren, Bengt, et al.
(författare)
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Cheyne-Stokes respiration is not related to quality of life or sleepiness in heart failure
- 2010
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Ingår i: Clinical Respiratory Journal. - : Wiley. - 1752-6981 .- 1752-699X. ; 4:1, s. 30-36
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: The effects of central sleep apnea in Cheyne-Stokes respiration on sleep-related symptoms and quality of life are not very well established. We aimed to investigate whether Cheyne-Stokes respiration is related to health-related quality of life. We also studied the impact on daytime sleepiness and nocturnal dyspnea. Methods: Included were 203 consecutive patients, stabilized following in-hospital treatment for decompensated congestive heart failure. They underwent overnight cardiorespiratory sleep apnea recordings in hospital and answered a set of questions on symptoms and health-related quality of life questionnaires in the form of the Nottingham Health Profile and the Minnesota Living with Heart Failure Questionnaire. After excluding seven patients with predominantly obstructive apneas and 14 with insufficient recordings, 182 patients were included in the final analysis. Results: One third of the patients had an apnea-hypopnea index (AHI) of > 30. Falling asleep in front of the television was the only symptom related to (AHI). Nocturnal dyspnea, daytime sleepiness, generic quality of life or disease-specific quality of life were not related to AHI. Conclusions: Cheyne-Stokes respiration was not associated with health-related quality of life, daytime sleepiness or nocturnal dyspnea among patients stabilized following treatment for congestive heart failure. Please cite this paper as: Midgren B, Mared L, Franklin KA, Berg S, Erhardt L and Cline C. Cheyne-Stokes respiration is not related to quality of life or sleepiness in heart failure. The Clinical Respiratory Journal 2009; DOI:10.1111/j.1752-699X.2009.00139.x.
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| 2. |
- Sundell, Kerstin, et al.
(författare)
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Quality of life in adolescents with asthma, during the transition period from child to adult.
- 2011
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Ingår i: Clinical Respiratory Journal. - 1752-6981. ; 5:4, s. 195-202
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The present investigation was designed to evaluate the health-related quality of life (HRQOL) of adolescents with asthma between the age of 16 and 21, when they are transferred from paediatric to adult care. Methods: In this prospective study, 156 teenagers (69 females) with asthma were screened employing spirometry, a histamine challenge, skin prick test for allergy and filled out the 'Living with Asthma Questionnaire' both at the time of entry into the study and after 2 and 5 years of follow-up. An exercise test and questions concerning regular performed exercise were carried out at baseline and 5 years later. Results: At all three time-points, the HRQOL of the men was generally better than that of the women. At the same time, the HRQOL of both genders was significantly better, both in terms of the overall scores (P < 0.001) as well as the scores for most of the individual domains, in connection with the 5-year follow-up. The young women who exercised regularly at the time of their entry exhibited better HRQOL at this time than those who did not (P < 0.001), whereas regular exercise had no impact on the HRQOL of the young men. The women with severe asthma demonstrated a poorer HRQOL than those suffering from mild-to-moderate asthma. Conclusion: The HRQOL of adolescents with asthma improves with age. The pronounced positive correlation between regular exercise and HRQOL in female adolescents with asthma revealed here deserves special attention in the care of young women and deserves further exploration.
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| 3. |
- Danielsson, Patrik, et al.
(författare)
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The prevalence of chronic obstructive pulmonary disease in Uppsala, Sweden - the Burden of Obstructive Lung Disease (BOLD) study : cross-sectional population-based study
- 2012
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Ingår i: Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 6:2, s. 120-127
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate chronic obstructive pulmonary disease (COPD) prevalence in Uppsala and the impact of risk factors on disease prevalence using the standardised methods of the Burden of Obstructive Lung Disease (BOLD) study initiative. Methods: Randomly selected participants, aged 40 years or more (n = 548) responded to a questionnaire regarding smoking habits, respiratory symptoms, medical history, and exposure to airway irritants. Spirometry, with a post-bronchodilator test, was performed and COPD defined as post-bronchodilatory forced expiratory volume in 1 s (FEV(1) )/forced vital capacity (FVC) < 0.70 or FEV(1) /FVC < lower limit of normality (LLN). Circulatory inflammatory markers were measured. Results: COPD prevalence was 16.2%, which was the fourth lowest prevalence of COPD, compared with 12 other BOLD centres. Main risk factors for COPD were increasing age [odds ratio (OR) = 2.08 per 10 years] and smoking (OR = 1.33 per 10 pack years). Higher education was protective (OR = 0.70 per 5 years). Previous tuberculosis was an almost significant risk factor for COPD (P = 0.08). Subjects with COPD reported more respiratory symptoms but only 29% had previous doctor diagnosed COPD, asthma, chronic bronchitis or emphysema. Participants with COPD had higher levels of C-reactive protein (P = 0.01), but no difference was observed in interleukin 6 (IL-6) levels. Using LLN instead of the fixed FEV(1) /FVC ratio reduced the prevalence of COPD to 10%. Conclusion: COPD prevalence in Uppsala was similar to other BOLD centres in high-income countries. Apart from known COPD risk factors (age, smoking, lower educational level), a history of tuberculosis may be associated with COPD even in high-income countries. COPD remains under-diagnosed, as only 29% of subjects with COPD had a previously diagnosed lung disorder.
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| 4. |
- Ekerljung, Linda, 1979, et al.
(författare)
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Incidence and prevalence of adult asthma is associated with low socio-economic status
- 2010
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Ingår i: The Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 4:3, s. 147-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low socio-economic status is often related to health problems; however, previous studies on asthma, usually cross-sectional, yield inconsistent results. In this study, longitudinal and cross-sectional data on the association between socio-economic status and asthma as well as respiratory symptoms among adults are presented. Methods: A postal questionnaire was sent on two occasions, 1996 and 2006, to a randomly selected sample of subjects aged 20–69 years in 1996. In total, 4479 subjects participated in both surveys. The questionnaire included questions on asthma, respiratory symptoms and possible determinants. Logistic regression analysis, adjusted for potential confounders, was used to study the association between asthma, respiratory symptoms and socio-economic status. Results: Manual workers in service had the highest prevalence and cumulative incidence for all investigated symptoms and asthma. Despite a large decrease in smokers, the increase in incident bronchitic symptoms was higher than the increase of incident asthma and incident asthmatic symptoms. Low socio-economic status, rhinitis and a family history of asthma were risk factors for having and developing asthma and respiratory symptoms. Conclusion: Low socio-economic status is significantly associated with an increased risk for prevalent and incident asthma and respiratory symptoms in this longitudinal population-based survey. The increase in risk was most pronounced in manual workers. Several studies have recently shown an association between low socio-economic status and respiratory symptoms and we conclude that asthma can not be considered as a disease that mainly affects the middle and upper socio-economic classes.
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| 5. |
- Ekerljung, Linda, 1979, et al.
(författare)
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Questionnaire layout and wording influence prevalence and risk estimates of respiratory symptoms in a population cohort
- 2013
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Ingår i: Clinical Respiratory Journal. - : Blackwell Publishing. - 1752-6981 .- 1752-699X. ; 7:1, s. 53-63
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Results of epidemiological studies are greatly influenced by the chosen methodology. The study aims to investigate how two frequently used questionnaires (Qs), with partly different layout, influence the prevalence of respiratory symptoms.Study Design and Setting: A booklet containing two Qs, the Global Allergy and Asthma European Network Q and the Obstructive Lung Disease in Northern Sweden Q, was mailed to 30 000 subjects aged 16-75 years in West Sweden; 62% responded. Sixteen questions were included in the analysis: seven identical between the Qs, four different in set-up and five with the same layout but different wording. Comparisons were made using differences in proportions, observed agreement and Kappa statistics.Results: Identical questions yielded similar prevalences with high observed agreement and kappa values. Questions with different set-up or differences in wording resulted in significantly different prevalences with lower observed agreement and kappa values. In general, the use of follow-up questions, excluding subjects answering no to the initial question, resulted in 2.9-6.7% units lower prevalence.Conclusion: The question set-up has great influences on epidemiological results, and specifically questions that are set up to be excluded based on a previous no answer leads to lower prevalence compared with detached questions. Therefore, Q layout and exact wording of questions has to be carefully considered when comparing studies.
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| 6. |
- Eriksson, Jonas, 1984, et al.
(författare)
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Update of prevalence of self-reported allergic rhinitis and chronic nasal symptoms among adults in Sweden
- 2012
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Ingår i: The Clinical Respiratory Journal. - 1752-699X .- 1752-6981. ; 6:3, s. 159-168
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Tidskriftsartikel (refereegranskat)abstract
- Background: Allergic rhinitis (AR) is the most common immunologic disease, and it renders a considerable burden on both sufferers and society. The prevalence of AR has been increasing worldwide over the past century. The aim of this study was to assess the present prevalence, risk factor patterns and comorbidity of self-reported AR and chronic nasal symptoms in different age groups in Stockholm, Sweden. Methods: A postal questionnaire was sent on two occasions, in 2006 to a population aged 30-80 years, randomly selected 10 years previously, and in 2007 to a randomly selected sample of subjects aged 20-69 years. The response rates were 83% and 68%, respectively, and in total, 9792 subjects participated. The questionnaire included questions on self-reported AR, asthma, respiratory and nasal symptoms and possible determinants. Results: The prevalence of self-reported AR was 28.0% (men 26.6%, women 29.1%, P<0.01) similar to 10 years previously and 33.6% in ages 30-40 years. Allergic heredity [odds ratio (OR) 4.76, confidence interval (CI) 95% 4.25-5.33], physician-diagnosed asthma (OR 5.29, CI 95% 4.49-6.24) and occupational exposure to dust, gases and fumes (OR 1.49, CI 95% 1.30-1.72) were determinants for AR. Prevalence of chronic nasal congestion was 16.1% and of chronic rhinorrhea 14.1%. Conclusions: As a basis for understanding the disease, as well as in planning and prioritising health-care resources, the study provides information about the current prevalence and determinants of self-reported AR and chronic nasal symptoms. Further, comparing with previous studies, the present study suggests that a plateau in the prevalence of AR may have been reached in Sweden. Please cite this paper as: Eriksson J, Ekerljung L, Rönmark E, Dahlén B, Ahlstedt S, Dahlén S-E and Lundbäck B. Update of prevalence of self-reported allergic rhinitis and chronic nasal symptoms among adults in Sweden
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| 7. |
- Hallin, Runa, et al.
(författare)
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Relation between physical capacity, nutritional status and systemic inflammation in COPD
- 2011
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Ingår i: Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 5:3, s. 136-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Decreased physical capacity, weight loss, fat-free mass depletion and systemic inflammation are frequently observed in patients with chronic obstructive pulmonary disease (COPD).Objective: Our aim was to examine relations between physical capacity, nutritional status, systemic inflammation and disease severity in COPD.Method: Forty nine patients with moderate to severe COPD were included in the study. Spirometry was preformed. Physical capacity was determined by a progressive symptom limited cycle ergo meter test, incremental shuttle walking test, 12-minute walk distance and hand grip strength test. Nutritional status was investigated by anthropometric measurements, (weight, height, arm and leg circumferences and skinfold thickness) and bioelectrical impedance assessment was performed. Blood samples were analyzed for C-reactive protein (CRP) and fibrinogen.Result: Working capacity was positively related to forced expiratory volume in 1 s (FEV(1)) (p < 0.001), body mass index and fat free mass index (p = 0.01) and negatively related to CRP (p = 0.02) and fibrinogen (p = 0.03). Incremental shuttle walk test was positively related to FEV(1) (p < 0.001) and negatively to CRP (p = 0.048). Hand grip strength was positively related to fat free mass index, and arm and leg circumferences. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV(1), fat free mass index and CRP were combined in a multiple regression model.Conclusion: Physical capacity in chronic obstructive pulmonary disease is related to lung function, body composition and systemic inflammation. A depiction of all three aspects of the disease might be important when targeting interventions in chronic obstructive pulmonary disease.
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| 8. |
- Jacinto, Tiago, et al.
(författare)
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Setting reference values for exhaled nitric oxide : a systematic review
- 2013
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Ingår i: Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 7:2, s. 113-120
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Forskningsöversikt (refereegranskat)abstract
- Background The values obtained when the fraction of exhaled nitric oxide (FeNO) is measured are affected by several factors that are specific to the individual patient, making interpretation difficult, especially in the initial assessment of patients with respiratory symptoms. Methods Systematic review of studies on FeNO reference values and individual-specific factors that influence them. Results From 3739 references, 15 studies were included. Four studies included children and adolescents. In nine studies, samples were selected from the general population. Most studies reported objective measures for atopy (nine studies), but not for smoking status (one). Significant determinants of FeNO values reported were age and height (seven studies), atopy (six), smoking (four), weight (four), sex (three) and race (three). Additional factors were included in eight studies. R2 was reported in only five studies. The logarithmic transformation of FeNO was inadequately described in seven studies. Conclusion There are several equations for FeNO reference values that may be used in clinical practice, although the factors they include and the statistical methods they use vary considerably. We recommend the development of standard methods for the evaluation of normal FeNO data and that reference equations should be formulated based on a predetermined physiological model.
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| 9. |
- Syk, Jorgen, et al.
(författare)
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Association between self-rated health and asthma : a population-based study
- 2012
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Ingår i: Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 6:3, s. 150-158
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Self-rated health (SRH) is a relevant measure of health as it can predict morbidity, mortality and health-care use. Studies have shown an association between poor SRH and elevated levels of circulating inflammatory cytokines. It is therefore interesting to learn more about the association between asthma, a chronic inflammatory disease with a recognised systemic component and SRH.Objectives: To compare SRH ratings in respondents with and without current asthma. A second aim was to compare SRH with quality-of-life ratings in the same groups.Methods: In 1995, we randomly selected 8200 persons =18 years from the population of Stockholm County, Sweden and mailed them a questionnaire. A total of 5355 persons (67.5%) responded. Respondents were divided in two groups, those with and those without current asthma. The groups were further divided by sex and age (1844 and =45 years). SRH was measured with the question How do you rate your general health status? and quality of life with the Gothenburg Quality of Life Instrument and the Ladder of Life.Results: Respondents with asthma rated their health significantly worse than did those without asthma, except women aged 1844 years. SRH was associated at least as strong as quality of life to asthma with the advantage of being easier to apply (only one item).Conclusion: Information on SRH is easy to obtain and represents an important dimension of health status that potentially can be used as a complement to identify patients who need extra attention to manage their asthma and its consequences.
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| 10. |
- Andreassen, Siw Lillevik, et al.
(författare)
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Impact of pneumonia on hospitalizations due to acute exacerbations of COPD
- 2014
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Ingår i: Clinical Respiratory Journal. - : Wiley. - 1752-6981 .- 1752-699X. ; 8:1, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Pneumonia is often diagnosed among patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The aims of this study were to find the proportion of patients with pneumonia among admissions due to AECOPD and whether pneumonia has impact on the length of stay (LOS), usage of non-invasive ventilation (NIV) or the in-hospital mortality.METHODS: Retrospectively, all hospitalizations in 2005 due to AECOPD in the Departments of Internal and Respiratory Medicine in one Swedish and two Norwegian hospitals were analyzed. A total of 1144 admittances (731 patients) were identified from patient administrative systems. Pneumonic AECOPD (pAECOPD) was defined as pneumonic infiltrates on chest X-ray and C-reactive protein (CRP) value of ≥40 mg/L, and non-pneumonic AECOPD (npAECOPD) was defined as no pneumonic infiltrate on X-ray and CRP value of <40 at admittance.RESULTS: In admissions with pAECOPD (n = 237), LOS was increased (median 9 days vs 5 days, P < 0.001) and usage of NIV was more frequent (18.1% vs 12.5%, P = 0.04), but no significant increase in the in-hospital mortality (3.8% vs 3.6%) was found compared to admissions with npAECOPD. A higher proportion of those with COPD GOLD stage I-II had pAECOPD compared to those with COPD GOLD stage III-IV (28.2% vs 18.7%, P = 0.001).CONCLUSIONS: In-hospital morbidity, but not mortality, was increased among admissions with pAECOPD compared to npAECOPD. This may, in part, be explained by the extensive treatment with antibiotics and NIV in patients with pAECOPD.
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