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  • 1.
    Andreassen, Siw Lillevik
    et al.
    Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
    Liaaen, Erik Dyb
    Department of Internal Medicine, Aalesund Hospital, Aalesund, Norway.
    Stenfors, Nikolai
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Henriksen, Anne H
    Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway ; Department of Thoracic- and Occupational Medicine, Trondheim University Hospital, Trondheim, Norway.
    Impact of pneumonia on hospitalizations due to acute exacerbations of COPD2014Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 8, nr 1, s. 93-99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 2.
    Bjerg, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. The OLIN Studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå.
    Rönmark, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. The OLIN Studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå.
    Asthma in school age: prevalence and risk factors by time and by age2008Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 2, nr Suppl 1, s. 123-126Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 3. Ekerljung, Linda
    et al.
    Rönmark, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Department of Internal Medicine, Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Obstructive Lung Disease In Northern Sweden (OLIN) studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden.
    Lötvall, Jan
    Wennergren, Göran
    Torén, Kjell
    Lundbäck, Bo
    Questionnaire layout and wording influence prevalence and risk estimates of respiratory symptoms in a population cohort2013Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 7, nr 1, s. 53-63Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 4. Eriksson, Jonas
    et al.
    Ekerljung, Linda
    Rönmark, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Dahlen, Barbro
    Ahlstedt, Staffan
    Dahlen, Sven-Erik
    Lundback, Bo
    Update of prevalence of self-reported allergic rhinitis and chronic nasal symptoms among adults in Sweden2012Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 6, nr 3, s. 159-168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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 3040 years. Allergic heredity [odds ratio (OR) 4.76, confidence interval (CI) 95% 4.255.33], physician-diagnosed asthma (OR 5.29, CI 95% 4.496.24) and occupational exposure to dust, gases and fumes (OR 1.49, CI 95% 1.301.72) 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, Ronmark E, Dahlen B, Ahlstedt S, Dahlen S-E and Lundback B. Update of prevalence of self-reported allergic rhinitis and chronic nasal symptoms among adults in Sweden. Clin Respir J 2012; 6: 159168.

  • 5. Lundback, B
    et al.
    Rönmark, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. The OLIN Studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden; Asthma and Allergy Research, National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    General population-based cohorts for studies of lung health in adults in Sweden2008Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 2, nr Suppl 1, s. 2-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 6. Midgren, Bengt
    et al.
    Mared, Lena
    Franklin, Karl Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Berg, Søren
    Erhardt, Leif
    Cline, Charles
    Cheyne-Stokes respiration is not related to quality of life or sleepiness in heart failure2010Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 4, nr 1, s. 30-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 7.
    Nyberg, Andre
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lindström, Britta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Rickenlund, Anette
    Institutionen för klinisk fysiologi, Karolinska universitetssjukhuset, Stockholm; Institutionen för molekylär medicin och kirurgi, Karolinska Institutet, Stockholm.
    Wadell, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Low-load/high-repetition elastic band resistance training in patients with COPD: a randomized, controlled, multicenter trial2015Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 9, nr 3, s. 278-288Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: High-repetitive resistance training is recommended to increase peripheral muscular endurance in healthy adults, however the effects of resistance training with this design on exercise capacity and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD) is unknown.

    Objective: Investigate if low load / high repetition elastic band resistance training (RT) could improve functional capacity, muscular function, endurance cycle capacity or HRQOL in patients with COPD.

    Methods: A prospective, randomized controlled multicentre trial was constructed with concealed allocation, blinded outcome assessment, and intention-to-treat analysis. A total of 44 patients with moderate to very severe COPD (FEV1 44.6% predicted) were included. Patients were randomized to either the experimental group receiving eight weeks of RT (3 sessions/week) in combination with patient education (four occasions) or the control group receiving the patient education alone.

    Results: At post-tests, the between-group differences were in favor of the experimental group on the 6 minute walk test (mean difference (95% confidence interval)): 34 meters (14 to 54) and the 6 minute pegboard and ring test (20 rings (3 to 37). No difference between groups was found on the chronic respiratory disease questionnaire (0.1 (-0.2 to 0.4). On secondary outcomes, results were in favor of the experimental group regarding upper extremity endurance capacity, muscular function and depression but no difference was seen between groups on endurance cycle capacity and HRQOL.

    Conclusion: RT can increase functional capacity and muscular function but not cycle endurance capacity and HRQOL in patients with moderate to severe COPD.

  • 8.
    Rönmark, Eva
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. The OLIN Studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden.
    Bjerg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. The OLIN Studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden.
    Hedman, L
    Perzanowski, M
    Sundberg, S
    Lundbäck, B
    The Obstructive Lung Disease in Northern Sweden (OLIN) longitudinal paediatric study I: the first 10 years2008Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 2, nr Suppl 1, s. 26-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Prospective studies of asthma and allergic conditions based oil the general population are scare.

    Aim: To summarize the methods and main results from a prospective study among school children.

    Methods: In 1996, a cohort of 3525 children aged 7/8 years in Northern Sweden were invited to a questionnaire survey using an expanded ISAAC protocol, and 97% participated. The cohort has been followed up yearly with high participation rate. Skin prick tests were conducted 1996, 2000 and 2006/2007. Allergens in dust from homes and schools have been analyzed. Sub samples have participated in interviews, lung function tests, bronchial hyper reactivity test, and analyses of IgE and IgG antibodies in serum.

    Results: The prevalence of asthma was 6% at age 7-8 years and increased by age. The incidence of physician-diagnosed asthma after the age of 7-8 years was around 1/100/year. The prevalence of positive skin prick test increased from 21% at age 7-8 to 30% at age 11-12 years. Remission of allergic sensitization was rare, while asthma remission was 5% yearly. The main risk factor for asthma and allergic sensitization increased in importance with increasing age. Allergic and non-allergic asthma had different risk factor pattern. Environmental risk factors decreased in impact after the age of 7. Avoidance of pets at home did not protect from asthma or allergic sensitization.

    Conclusion: The study includes important sources of data for further longitudinal analyses that will contribute to the understanding of the development and the nature of asthma and allergic sensitization.

  • 9.
    Stenfors, Nikolai
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Liaaen, Erik Dyb
    Henriksen, Anne H.
    No difference in long term survival in patients hospitalized for pneumonic versus non-pneumonic acute exacerbations of COPD2018Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 12, nr 3, s. 1305-1306Artikel i tidskrift (Refereegranskat)
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