| 1. |
- Gatzinsky, Vladimir, 1966, et al.
(författare)
-
Long-term respiratory symptoms following esophageal atresia.
- 2011
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253. ; 100:9, s. 1222-1225
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Oesophageal atresia (OA) is a congenital malformation that can lead to persistent respiratory symptoms in adulthood. Aim: To describe the prevalence of respiratory symptoms in adulthood in a population-based study of patients with repaired OA and to compare this with the prevalence in the general population. Methods: Of 80 patients operated for OA in Gothenburg in 1968–1983, 79 were located. The patients received a questionnaire on respiratory symptoms. Controls were 4979 gender- and age-matched subjects who answered the same questions. Results: The questionnaire was answered by 73 of 79 (92%) patients. Physician-diagnosed asthma was reported by 30% in the OA group vs 10% in the control group (OR 4.1; 95% CI 2.4–6.8), and recurrent wheeze in 29% vs 5.5% (OR 6.9; 4.1–11.6). Also wheeze during the last year, asthma medication, a long-standing cough, cough with sputum production and chronic bronchitis were significantly more common among the patients with OA. In contrast, there was no significant difference regarding risk factors for asthma. The prevalence of respiratory symptoms did not appear to decrease with age. Conclusion: A high prevalence of respiratory symptoms remains among adult patients with repaired OA. Many of the patients had an asthma diagnosis. However, asthma heredity or allergic rhinitis was not overrepresented.
|
|
| 2. |
- Alm, Bernt, 1951, et al.
(författare)
-
Antibiotics in the first week of life is a risk factor for allergic rhinitis at school age.
- 2014
-
Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038. ; 25:5, s. 468-472
-
Tidskriftsartikel (refereegranskat)abstract
- Heredity as well as external factors influences the development of allergic rhinitis. The aim of this study was to analyse early risk factors and protective factors for allergic rhinitis at school age.
|
|
| 3. |
- Alm, Bernt, 1951, et al.
(författare)
-
Breastfeeding and dummy use have a protective effect on sudden infant death syndrome.
- 2016
-
Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 105:1, s. 31-38
-
Tidskriftsartikel (refereegranskat)abstract
- We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From the 4,343 abstracts, we identified 35 relevant studies on breastfeeding and SIDS, 27 on dummy use and SIDS and 59 on dummy use versus breastfeeding CONCLUSION: We found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed. This article is protected by copyright. All rights reserved.
|
|
| 4. |
- Alm, Bernt, 1951, et al.
(författare)
-
Early protective and risk factors for allergic rhinitis at age 4½ yr.
- 2011
-
Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038 .- 0905-6157. ; 22:4, s. 398-404
-
Tidskriftsartikel (refereegranskat)abstract
- Allergic heredity plays a major role in the development of allergic rhinitis. In addition the introduction of food may influence the risk of subsequent allergic disease. The aim of this study was to analyse early risk factors and protective factors for allergic rhinitis at preschool age. Data were obtained from a prospective, longitudinal study of a cohort of children born in the region of western Sweden in 2003 and 8,176 families (50% of the birth cohort) were randomly selected. The parents answered questionnaires at 6 and 12 months and at 4½ yr of age. The response rate at 4½ yr was 4,496, i.e. 83% of the 5,398 questionnaires distributed at 4½ yr. At 4½ yr of age, 5.5% reported symptoms of allergic rhinitis during the last year. In the multivariate analysis, independent risk factors for allergic rhinitis were: allergic sensitisation to food allergens at 4½ yr (OR 10.21; 95% confidence interval 4.22-24.73), recurrent wheeze at 4½ yr (3.33; 1.56-7.10), doctor-diagnosed eczema at 4½ yr (2.72; 1.62-4.55), parental rhinitis (2.21; 1.39-3.53), eczema first year (1.97; 1.19-3.26) and male gender (1.82; 1.13-2.94). The risk was reduced with fish introduction before 9 months (0.49; 0.29-0.82). In conclusion, we found that previous and present allergic disease, heredity and male gender increased the risk of allergic rhinitis at 4½ yr of age. The introduction of fish before the age of 9 months reduced the risk.
|
|
| 5. |
|
|
| 6. |
- Alm, Bernt, 1951, et al.
(författare)
-
PD12 - Living on a farm protects from allergic rhinitis at school age.
- 2014
-
Ingår i: Clinical and translational allergy. - 2045-7022. ; 4:Suppl 1 3rd Pediatric Allergy and Asthma Meeting
-
Tidskriftsartikel (refereegranskat)abstract
- Background Family history plays a major role in the development of allergic rhinitis. External influences, such as a farm childhood and fish introduction have been suggested to play a protective role. The aim was to analyse early risk factors and protective factors for allergic rhinitis at school age. Methods The material is a prospective, longitudinal study of a cohort of children born in the region of western Sweden in 2003 where 8,176 families (50% of the birth cohort) were randomly selected. The parents answered questionnaires at 6 months, 12 months, 4½ years and 8 years of age. The response rate at eight years was 80% (4,051 of 5,044 questionnaires distributed). Results At eight years of age, 441 children (11.3%) had used medicines for allergic rhinitis the past twelve months. The mean onset age was 5.1 year and 61.9% were boys. In a multivariate analysis of factors associated with allergic rhinitis with p<0.1, we found that living on a farm at 4½ years was inversely associated with allergic rhinitis treated with medicines at 8 years (adjusted odds ratio 0.31, 95% confidence interval (0.13, 0.78)). Positive associations were seen with parental allergic rhinitis (2.73 (2.12, 3.52)), food allergy first year (2.45 (1.61, 3.73)), eczema first year (1.97 (1.50, 2.59)), neonatal antibiotics (1.75 (1.03, 2.97)) and male gender (1.35 (1.05, 1.74)). Conclusion In conclusion, we found that a family history of rhinitis, early food allergy, early eczema and male gender increased the risk of rhinitis at school age. Furthermore, we found a protective effect of living on a farm at preschool age, and that antibiotics neonatally increased the risk. Both findings are compatible with the hygiene hypothesis.
|
|
| 7. |
|
|
| 8. |
- Alm, Bernt, 1951, et al.
(författare)
-
Plötslig oväntad död hos spädbarn. Kunskapsstöd med nationella rekommendationer till hälso- och sjukvården
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I detta kunskapsstöd presenteras rekommendationer till hälso- och sjukvår-den för rutiner vid plötslig oväntad död hos spädbarn. Vid plötslig oväntad död hos spädbarn bör hälso- och sjukvården använda Socialstyrelsens checklista för anamnesuppgifter använda Socialstyrelsens checklista för statusuppgifter använda Socialstyrelsens checklista för provtagningar och röntgenundersökning. Utredning av plötslig oväntad död hos spädbarn innefattar samverkan mellan tre aktörer med olika uppgifter, nämligen hälso- och sjukvården, Polismyndigheten och Rättsmedicinalverket. Rekommendationerna är avsedda som ett stöd till hälso- och sjukvårdspersonal vid omhändertagandet av det döda barnet och familjen. Rekommendationerna utgör även en grund för utveckling av lokala vårdprogram och de förväntas dessutom bidra till jämlikhet över landet när det gäller utredning samt till att förebygga plötslig oväntad död hos spädbarn. Eftersom det delvis saknas vetenskapliga studier med tillräcklig relevans och kvalitet om utredning av plötslig oväntad död hos spädbarn har Social-styrelsen genomfört en konsensusprocess för att formulera rekommendationerna. Att som förälder påträffa sitt spädbarn livlöst, eller att informeras om att barnet dött, innebär en extrem känslomässig påfrestning. I ett kapitel ger Socialstyrelsen stöd till hälso- och sjukvården med syfte att underlätta informationen till familjen om dödsorsaksutredningen och dödsorsaksdia-gnosen. I ett sista kapitel om stöd till föräldrar under utredningsprocessen ges vägledning om vad som är viktigt att tänka på i mötet med föräldrarna och andra närstående samt vad som bör göras för att utredningen ska bli så komplett som möjligt. I bilagan till kunskapsstödet finns också en beskrivning av de rättsliga förutsättningarna för utredning av plötslig oväntad död hos spädbarn.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Bjerg, Anders, 1982, et al.
(författare)
-
Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006.
- 2015
-
Ingår i: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 1365-2222 .- 0954-7894. ; 45:1, s. 146-153
-
Tidskriftsartikel (refereegranskat)abstract
- The large increase in asthma prevalence continues in several, but not all areas. Despite the individual risk factors that have been identified, the reasons for the observed trends in prevalence are largely unknown.
|
|
| 12. |
- Bjerg, Anders, 1982, et al.
(författare)
-
Gas, dust, and fumes exposure is associated with mite sensitization and with asthma in mite-sensitized adults
- 2015
-
Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 70:5, s. 604-607
-
Tidskriftsartikel (refereegranskat)abstract
- Occupational exposure to gas, dust, and fumes (GDF) increases the risk of asthma and eczema. We investigated the role of sensitization in the association between GDF and allergic conditions. A population-based sample of 788 adults from the West Sweden Asthma Study completed questionnaires and skin prick tests. After adjustment for confounders, GDF exposure was associated with a doubled risk of sensitization to mites, but not with other allergens. Mite sensitization also modified the effect of GDF on asthma. In mite-sensitized subjects, GDF was associated with physician-diagnosed asthma, adjusted OR 2.9 (1.2-7.2), and with wheeze, OR 2.4 (1.1-5.3). In non-mite-sensitized subjects, the corresponding ORs were 1.1 (0.5-2.6) and 0.6 (0.3-1.3). GDF was independently associated with eczema regardless of mite sensitization, but not with rhinitis. These novel findings suggest that components of GDF may act as adjuvants that facilitate sensitization to mites and that mite-sensitized individuals may be especially susceptible to inhalant occupational exposures.
|
|
| 13. |
- Bjerg, Anders, 1982, et al.
(författare)
-
Increase in pollen sensitization in Swedish adults and protective effect of keeping animals in childhood
- 2016
-
Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 46:10, s. 1328-1336
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To date, most studies of the "allergy epidemic" have been based on self-reported data. There is still limited knowledge on time trends in allergic sensitization, especially among adults.OBJECTIVE: To study allergic sensitization, its risk factors, and time trends in prevalence.METHODS: Within West Sweden Asthma Study (WSAS) a population-based sample of 788 adults (17-60y) underwent skin prick tests (SPT) for 11 aeroallergens 2009-2012. Specific IgE was analyzed in 750 of the participants. Those aged 20-46y (n=379) were compared with the European Community Respiratory Health Survey sample aged 20-46y from the same area (n=591) in 1991-1992.RESULTS: Among those aged 20-46y the prevalence of positive SPT to pollen increased; timothy from 17.1% to 29.0% (p<0.001) and birch from 15.6% to 23.7% (p=0.002) between 1991-1992 and 2009-2012. Measurements of specific IgE confirmed these increases. Prevalence of sensitization to all other tested allergens was unchanged. In the full WSAS sample aged 17-60y any positive SPT was seen in 41.9%, and the dominating sensitizers were pollen (34.3%), animals (22.8%) and mites (12.6%). Pollen sensitization was strongly associated with rhinitis, whereas indoor allergens were more associated with asthma. Growing up with livestock or furred pets decreased the risk of sensitization, adjusted odds ratio 0.53 (0.28-0.995) and 0.68 (0.47-0.98) respectively.CONCLUSION: Pollen sensitization has increased in Swedish adults since the early 1990's, while the prevalence of sensitization to other allergens has remained unchanged. This is one plausible explanation for the increase in rhinitis 1990-2008 in Swedish adults, during which time the prevalence of asthma, which is more associated with perennial allergens, was stable. Contact with animals in childhood seems to reduce the risk of sensitization well into adulthood. One major factor contributing to the rise in pollen allergy is a significant increase in levels of birch and grass pollen over the past three decades.
|
|
| 14. |
|
|
| 15. |
- Bjermer, L, et al.
(författare)
-
Rinitastma : en sjukdom i hela luftvägen
- 2014
-
Ingår i: Rinitastma : en sjukdom i hela luftvägen / [redaktör Hanna Vihavainen]. - Stockholm : Stiftelsen astma och allergiförbundets forskningsfond. - 9789163770425
-
Bokkapitel (refereegranskat)
|
|
| 16. |
- Björkander, Janne, 1946, et al.
(författare)
-
Sublingual immunterapi: Varför och för vem?
- 2014
-
Ingår i: Allergi i praxis. - 0806-5462. ; :2, s. 30-35
-
Tidskriftsartikel (refereegranskat)abstract
- Sublingual immunterapi (SLIT) är en ny form av immunterapi som utvecklats under 1980-talet och det första alternativet sedan Noon introducerade subkutan immunterapi 1911 (SCIT). I Sverige finns SLIT för närvarande tillgängligt endast för behandling av gräsallergi. Trots upprepade placebokontrollerade studier, upprepade konsensusrapporter från WHO och ARIA samt Cochrane-rapporter har en vidare användning av behandlingen i Sverige försvårats av formella hinder. Behandlingen är säkrare, enklare och billigare än SCIT och i många fall finns, på grund av bristande sjukvårdsresurser, inte de möjligheter till SCIT som läkemedelsverket rekommenderar som alternativ. Vi allergologer behöver ställa upp för våra patienter för att kunna ge dem en behandling som inte bara lindrar för stunden utan också har immunologiska effekter, som kan förhindra både nya sjukdomar och nya sensibiliseringar. Typfallet är en ungdom med björksnuva. Vi kan med immunterapi minska risken för björkastma genom behandling, liksom vidare insjuknade för andra pollen och kanske även för djur. Detta gäller både för SCIT liksom för SLIT, men om vi har hinder för den ena behandlingsformen, SCIT, så måste vi väl ändå få tillstånd av Läkemedelsverket att använda den andra, säkrare behandlingsformen, SLIT?
|
|
| 17. |
- Bousquet, Jean, et al.
(författare)
-
Pooling birth cohorts in allergy and asthma: European Union-funded initiatives - a MeDALL, CHICOS, ENRIECO, and GA²LEN joint paper.
- 2013
-
Ingår i: International archives of allergy and immunology. - : S. Karger AG. - 1423-0097 .- 1018-2438. ; 161:1, s. 1-10
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Long-term birth cohort studies are essential to understanding the life course and childhood predictors of allergy and the complex interplay between genes and the environment (including lifestyle and socioeconomic determinants). Over 100 cohorts focusing on asthma and allergy have been initiated in the world over the past 30 years. Since 2004, several research initiatives funded under the EU Framework Program for Research and Technological Development FP6-FP7 have attempted to identify, compare, and evaluate pooling data from existing European birth cohorts (GA(2)LEN: Global Allergy and European Network, FP6; ENRIECO: Environmental Health Risks in European Birth Cohorts, FP7; CHICOS: Developing a Child Cohort Research Strategy for Europe, FP7; MeDALL: Mechanisms of the Development of ALLergy, FP7). However, there is a general lack of knowledge about these initiatives and their potentials. The aim of this paper is to review current and past EU-funded projects in order to make a summary of their goals and achievements and to suggest future research needs of these European birth cohort networks.
|
|
| 18. |
- Brand, Paul L P, et al.
(författare)
-
Classification and pharmacological treatment of preschool wheezing: changes since 2008.
- 2014
-
Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 43:4, s. 1172-1177
-
Tidskriftsartikel (refereegranskat)abstract
- Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some modifications to the recommendations made in 2008. Specifically, the consensus group acknowledges that wheeze patterns in young children vary over time and with treatment, rendering the distinction between episodic viral wheeze and multiple-trigger wheeze unclear in many patients. Inhaled corticosteroids remain first-line treatment for multiple-trigger wheeze, but may also be considered in patients with episodic viral wheeze with frequent or severe episodes, or when the clinician suspects that interval symptoms are being under reported. Any controller therapy should be viewed as a treatment trial, with scheduled close follow-up to monitor treatment effect. The group recommends discontinuing treatment if there is no benefit and taking favourable natural history into account when making decisions about long-term therapy. Oral corticosteroids are not indicated in mild-to-moderate acute wheeze episodes and should be reserved for severe exacerbations in hospitalised patients. Future research should focus on better clinical and genetic markers, as well as biomarkers, of disease severity.
|
|
| 19. |
|
|
| 20. |
|
|
| 21. |
- Ekerljung, Linda, 1979, et al.
(författare)
-
Five-fold increase in use of inhaled corticosteroids over 18 years in the general adult population in West Sweden.
- 2014
-
Ingår i: Respiratory medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 108:5, s. 685-693
-
Tidskriftsartikel (refereegranskat)abstract
- Asthma medication was increasingly used during the second part of the past century. There are few detailed data from population studies on use of asthma medication. The current study aimed to determine the use and determinants of asthma medication in West Sweden and to assess changes during the last two decades.
|
|
| 22. |
|
|
| 23. |
- Ekerljung, Linda, 1979, et al.
(författare)
-
Multi-symptom asthma as an indication of disease severity in epidemiology
- 2011
-
Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 38:4, s. 825-832
-
Tidskriftsartikel (refereegranskat)abstract
- Epidemiological questionnaires have failed to identify individuals with severe asthma. The extent of symptoms of asthma can, however, be easily established in epidemiology, by identification of multiple symptoms. We hypothesise that reporting of multiple symptoms of asthma reflects uncontrolled disease and is a sign of more severe asthma. The aims of the current study were, therefore, to determine the prevalence and determinants of multi-symptom asthma. A postal questionnaire was sent to 30,000 randomly selected individuals aged 16–75 yrs. A subgroup underwent clinical examinations. Multi-symptom asthma was defined as reported physician-diagnosed asthma, use of asthma medication, recurrent wheeze, attacks of shortness of breath and at least one additional respiratory symptom. The prevalence of multi-symptom asthma was 2.0%, and it was more common among females (2.4 versus 1.5%; p<0.001) and those with a body mass index >30 kg·m-2. Multi-symptom asthmatics had lower forced expiratory volume in 1 s, higher exhaled nitric oxide fraction and more pronounced hyperresponsiveness. Family history of both asthma and allergy (OR 7.3), and occupational exposure to gas dust or fumes (OR 2.0) were also significant risk factors. Multi-symptom asthmatics comprise 2% of the general population; multi-symptom asthma is related to signs of more severe disease and could be used as an epidemiological marker of disease severity.
|
|
| 24. |
- Ekerljung, Linda, 1979, et al.
(författare)
-
Questionnaire layout and wording influence prevalence and risk estimates of respiratory symptoms in a population cohort
- 2013
-
Ingår i: Clinical Respiratory Journal. - : Blackwell Publishing. - 1752-6981 .- 1752-699X. ; 7:1, s. 53-63
-
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.
|
|
| 25. |
- Eriksson, Jonas, et al.
(författare)
-
Aspirin-intolerant asthma in the population : prevalence and important determinants
- 2015
-
Ingår i: Clinical and Experimental Allergy. - : John Wiley & Sons. - 0954-7894 .- 1365-2222. ; 45:1, s. 211-219
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Population-based studies on aspirin-intolerant asthma are very few and no previous population study has investigated risk factors for the condition.OBJECTIVE: To investigate the prevalence and risk factors of aspirin-intolerant asthma in the general population.METHODS: A questionnaire on respiratory health was mailed to 30 000 randomly selected subjects aged 16-75 years in West Sweden, 29 218 could be traced and 18 087 (62%) responded. The questionnaire included questions on asthma, respiratory symptoms, aspirin-induced dyspnea and possible determinants.RESULTS: The prevalence of aspirin-intolerant asthma was 0.5%, 0.3% in men and 0.6% in women (p=0.014). Sick leave, emergency visits due to asthma and all investigated lower respiratory symptoms were more common in aspirin-intolerant asthma than in aspirin-tolerant asthma. Obesity was a strong risk factor for aspirin-intolerant asthma (BMI>35: OR 12.1; 95% CI 2.49-58.5) and there was a dose-response relationship between increasing body mass index and risk of aspirin-intolerant asthma. Obesity, airborne occupational exposure and visible mold at home were considerably stronger risk factors for aspirin-intolerant asthma than for aspirin-tolerant asthma. Current smoking was a risk factor for aspirin-intolerant asthma (OR 2.55; 95% CI 1.47-4.42), but not aspirin-tolerant asthma.CONCLUSION: Aspirin-intolerant asthma identified in the general population was associated with a high burden of symptoms, uncontrolled disease and a high morbidity. Increasing body mass index increased the risk of aspirin-intolerant asthma in a dose-response manner. A number of risk factors, including obesity and current smoking, were considerably stronger for aspirin-intolerant asthma than for aspirin-tolerant asthma.
|
|
