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Sökning: WFRF:(Rönmark Eva) > Karolinska Institutet

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1.
  • Backman, Helena, et al. (författare)
  • Evaluation of the global lung function initiative 2012 reference values for spirometry in a Swedish population sample
  • 2015
  • Ingår i: Bmc Pulmonary Medicine. - : Springer Science and Business Media LLC. - 1471-2466. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The Global Lung Function Initiative 2012 (GLI) reference values are currently endorsed by several respiratory societies but evaluations of applicability for adults resident in European countries are lacking. The aim of this study was to evaluate if the GLI reference values are appropriate for an adult Caucasian Swedish population. Methods: During 2008-2013, clinical examinations including spirometry were performed on general population samples in northern Sweden, in which 501 healthy Caucasian non-smokers were identified. Predicted GLI reference values and Z-scores were calculated for each healthy non-smoking subject and the distributions and mean values for FEV1, FVC and the FEV1/FVC ratio were examined. The prevalence of airway obstruction among these healthy non-smokers was calculated based on the Lower Limit of normal (LLN) criterion (lower fifth percentile) for the FEV1/FVC ratio. Thus, by definition, a prevalence of 5% was expected. Results: The Z-scores for FEV1, FVC and FEV1/FVC were reasonably, although not perfectly, normally distributed, but not centred on zero. Both predicted FEV1 and, in particular, FVC were lower compared to the observed values in the sample. The deviations were greater among women compared to men. The prevalence of airway obstruction based on the LLN criterion for the FEV1/FVC ratio was 9.4% among women and 2.7% among men. Conclusions: The use of the GLI reference values may produce biased prevalence estimates of airway obstruction in Sweden, especially among women. These results demonstrate the importance of validating the GLI reference values in different countries.
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2.
  • Backman, Helena, et al. (författare)
  • The interplay between obesity and blood neutrophils in adult-onset asthma
  • 2024
  • Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 222
  • Tidskriftsartikel (refereegranskat)abstract
    • Highlights:Severe obesity strongly associates to blood neutrophils in adult-onset asthma.B-neutrophils may partly mediate associations between obesity and asthma control.Clinical evaluation of adult-onset asthma should include assessing B-neutrophils.
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3.
  • Bjerg, Anders, 1982, et al. (författare)
  • Family history of asthma and atopy: in-depth analyses of the impact on asthma and wheeze in 7- to 8-year-old children.
  • 2007
  • Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 120:4, s. 741-8
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Development of asthma in children is influenced by interactions between genetic and environmental factors. It is unclear whether paternal or maternal histories of disease confer different risks. Previous population-based studies have not stratified analyses by child gender and sensitization status. Our aim was to study in detail the hereditary component of childhood asthma. METHODS: A population-based cohort of 3430 (97% of invited) 7- to 8-year-old school children participated in an expanded International Study of Asthma and Allergy in Childhood survey, and two thirds were skin-prick tested. Heredity was defined as a family history of (1) asthma and (2) atopy (allergic rhinitis or eczema). Multivariate analyses corrected for known risk factors for asthma. RESULTS: At ages 7 to 8, prevalence of asthma was 5.3% among the children and 9.0% among the parents. In children without parental asthma or parental atopy, the prevalence of asthma was 2.8%. Corrected for parental asthma, parental atopy was a weak but significant risk factor. There were minor differences in the impact of parental disease between sensitized and nonsensitized children and between boys and girls. CONCLUSIONS: As risk factors for childhood asthma, there were major differences between parental asthma and parental atopy. Sibling asthma was only a marker of parental disease. Interactions between parental disease and the child's allergic sensitization or gender were not statistically significant. Asthma in both parents conferred a multiplicative risk, whereas the effect of parental atopy was additive, however limited. Asthma and atopy, despite their causal relationship, are separate entities and could be inherited differently. This large, population-based, and well-characterized cohort study does not confirm parent-of-origin effects found in previous studies.
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6.
  • Bunne, Joakim, et al. (författare)
  • Increase in allergic sensitization in schoolchildren : two cohorts compared 10 years apart
  • 2017
  • Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 2213-2198 .- 2213-2201. ; 5:2, s. 457-463
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Time trends of incidence of allergic sensitization are unknown and recent trends of prevalence and risk factors are lacking.OBJECTIVE: To estimate the incidence, prevalence, remission, risk factors, and time trends for allergic sensitization among schoolchildren followed from age 7 to 8 years to age 11 to 12 years.METHODS: In 2006, all children in grades 1 and 2 aged 7 to 8 years in 2 municipalities in northern Sweden were invited to a questionnaire survey and to skin prick testing to 10 common airborne allergens. The cohort was reexamined in 2010, with additional blood sampling for specific IgE. Participation rates were 90% (n = 1700) at age 7 to 8 years and 85% (n = 1657) at age 11 to 12 years. The results were compared with a cohort examined by identical methods 10 years earlier.RESULTS: The prevalence of positive skin prick test result to any allergen increased from 30% at age 7 to 8 years to 41% at age 11 to 12 years (P < .001). The cumulative 4-year incidence was 18%, while remission was low. Sensitization to pollen and furred animals was most common. A family history of allergy was significantly associated with incident sensitization, whereas the presence of furred animals at home was negatively associated. The prevalence at age 7 to 8 years and at age 11 to 12 years and the 4-year incidence were all significantly higher compared with the cohort examined 10 years earlier.CONCLUSIONS: The prevalence of allergic sensitization increased by age as a consequence of a high incidence and a low remission. The trends of increasing incidence and prevalence among schoolchildren imply future increases in the prevalence of allergic diseases.
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7.
  • Bunne, Joakim, et al. (författare)
  • The Majority of Children Sensitized Before School-Age Develop Allergic Disease Before Adulthood: A Longitudinal Population-Based Study
  • 2022
  • Ingår i: Journal of Allergy and Clinical Immunology: In Practice. - : Elsevier BV. - 2213-2198 .- 2213-2201. ; 10:2, s. 577-585.e3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Allergic sensitization increases the risk of asthma and allergic rhinitis, but the impact of age at onset of sensitization is less studied. Objective: To examine the cumulative incidence of asthma and rhinitis up to age 19 years in relation to age at onset of sensitization to airborne allergens. Method: All children in grade 1 and 2 (median age, 8 years) in 2 municipalities in Northern Sweden were invited to undergo skin prick tests and answer a questionnaire about allergic diseases, and 88% participated. At ages 12 and 19 years, the protocol was repeated, and 1510 individuals participated in all 3 examinations. Specific IgE data were collected in a random sample at age 19 years (n = 770). Onset of sensitization was defined: 8 years or less, 8 to 12 years, 12 to 19 years, and never sensitized. Adjusted Poisson regression was used to calculate risk ratios (RRs). Results: At 19 years, those sensitized at 8 years of age or earlier had the highest risk of asthma (RR, 4.68; 95% CI, 3.15-6.97) and rhinitis (RR, 22.3; 95% CI, 13.3-37.6), and 84% had developed either asthma or rhinitis. The combination of sensitization at age 8 years or earlier and family history of allergic diseases rendered high risks for asthma (RR, 10.6; 95% CI, 6.71-16.7) and rhinitis (RR, 36.3; 95% CI, 18.9-69.7). Individuals sensitized at age 8 years or earlier showed significantly highest level of sensitization, as judged by number of positive skin test results and titers of specific IgE. Conclusions: Most individuals with sensitization at age 8 years or earlier developed asthma or rhinitis before young adulthood. The high level of sensitization in those sensitized early contributes to the high incidence of allergic airway conditions. © 2021 The Authors
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8.
  • Ekerljung, Linda, 1979, et al. (författare)
  • Has the increase in the prevalence of asthma and respiratory symptoms reached a plateau in Stockholm, Sweden?
  • 2010
  • Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 14:6, s. 764-771
  • Tidskriftsartikel (refereegranskat)abstract
    • SETTING: An increase in the prevalence of asthma has previously been reported worldwide. However, the current trend is debatable. OBJECTIVE: To assess changes in the prevalence of asthma and respiratory symptoms in a defined study area in Stockholm, Sweden, using identical methods. DESIGN: A questionnaire was sent by mail in 1996 and 2007 to randomly selected subjects aged 20-69 years. On both occasions, 8000 subjects received the questionnaire, with response rates of 72% and 68%, respectively. Questions on asthma, respiratory symptoms, asthma medication and possible determinants were included. Logistic regression analysis was used to assess determinants. RESULTS: Ever asthma increased from 8.7% in 1996 to 11.0% in 2007 and physician-diagnosed asthma from 7.6% to 9.3%. The proportion of asthma patients reporting one to two symptoms increased by 14% during the study period. There were few significant changes in the prevalence of respiratory symptoms: wheeze in the previous 12 months (15.9-17.3%), wheezing with breathlessness apart from cold (3.2-4.1%) and recurrent wheeze (8.3-6.8%). There was no major difference in the risk factor pattern between the surveys. CONCLUSION: An increase in the prevalence of asthma with few symptoms as well as an unchanged prevalence of symptoms was demonstrated, which may indicate a change in diagnostic practices.
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9.
  • Ekerljung, Linda, 1979, et al. (författare)
  • Incidence and prevalence of adult asthma is associated with low socio-economic status
  • 2010
  • Ingår i: The Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 4:3, s. 147-56
  • 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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