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  • 1.
    Backman, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Sawalha, Sami
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Nilsson, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Hedman, Linnea
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Stridsman, Caroline
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Vanfleteren, Lowie E. G. W.
    Nwaru, Bright I.
    Stenfors, Nikolai
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Rönmark, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Lindberg, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Cause-specific Death in Chronic Airway Obstruction and Restrictive Spirometric Pattern2022In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 19, no 10, p. 1783-1787Article in journal (Refereed)
  • 2. Becher, Tobias H
    et al.
    Miedema, Martijn
    Kallio, Merja
    Papadouri, Thalia
    Karaoli, Christina
    Sophocleous, Louiza
    Rahtu, Marika
    van Leuteren, Ruud W
    Waldmann, Andreas D
    Strodthoff, Claas
    Yerworth, Rebecca
    Dupré, Antoine
    Benissa, Mohamed-Rida
    Nordebo, Sven
    Khodadad, Davood
    Department of Physics and Electrical Engineering, Linnaeus University, Vaxjö, Sweden.
    Bayford, Richard
    Vliegenthart, Roseanne
    Rimensberger, Peter C
    van Kaam, Anton H
    Frerichs, Inéz
    Prolonged Continuous Monitoring of Regional Lung Function in Infants with Respiratory Failure2022In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 19, no 6, p. 991-999Article in journal (Refereed)
    Abstract [en]

    Rationale: Electrical impedance tomography (EIT) allows instantaneous and continuous visualization of regional ventilation and changes in end-expiratory lung volume at the bedside. There is particular interest in using EIT for monitoring in critically ill neonates and young children with respiratory failure. Previous studies have focused only on short-term monitoring in small populations. The feasibility and safety of prolonged monitoring with EIT in neonates and young children have not been demonstrated yet. Objectives: To evaluate the feasibility and safety of long-term EIT monitoring in a routine clinical setting and to describe changes in ventilation distribution and homogeneity over time and with positioning in a multicenter cohort of neonates and young children with respiratory failure. Methods: At four European University hospitals, we conducted an observational study (NCT02962505) on 200 patients with postmenstrual ages (PMA) between 25 weeks and 36 months, at risk for or suffering from respiratory failure. Continuous EIT data were obtained using a novel textile 32-electrode interface and recorded at 48 images/s for up to 72 hours. Clinicians were blinded to EIT images during the recording. EIT parameters and the effects of body position on ventilation distribution were analyzed offline. Results: The average duration of EIT measurements was 53 ± 20 hours. Skin contact impedance was sufficient to allow image reconstruction for valid ventilation analysis during a median of 92% (interquartile range, 77-98%) of examination time. EIT examinations were well tolerated, with minor skin irritations (temporary redness or imprint) occurring in 10% of patients and no moderate or severe adverse events. Higher ventilation amplitude was found in the dorsal and right lung areas when compared with the ventral and left regions, respectively. Prone positioning resulted in an increase in the ventilation-related EIT signal in the dorsal hemithorax, indicating increased ventilation of the dorsal lung areas. Lateral positioning led to a redistribution of ventilation toward the dependent lung in preterm infants and to the nondependent lung in patients with PMA > 37 weeks. Conclusions: EIT allows continuous long-term monitoring of regional lung function in neonates and young children for up to 72 hours with minimal adverse effects. Our study confirmed the presence of posture-dependent changes in ventilation distribution and their dependency on PMA in a large patient cohort. Clinical trial registered with www.clinicaltrials.gov (NCT02962505).

  • 3. Bui, Kim-Ly
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 1: clinical relevance and links to the International classification of functioning, disability and health2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 778-784Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability. A thorough patient-centered outcome assessment, including not only measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity and performance in activities of daily life, is imperative for a comprehensive management of chronic obstructive pulmonary disease. This American Thoracic Society Seminar Series is devoted to help clinicians substantiate their choice of functional outcome measures in this population. In Part 1 of this two-part Seminar Series, we aim to describe the various domains of functional status, to elucidate terms and key concepts intertwined with functioning, and to demonstrate the clinical relevance of assessing functional capacity in the context of activities of daily living, in agreement with the International Classification of Functioning, Disability and Health. We hope that a better understanding of the various defining components of functional status will be instrumental to healthcare providers to optimize chronic obstructive pulmonary disease evaluation and management, ultimately leading to improved quality of life of patients afflicted by this condition. This first paper also serves as an introduction to Part 2 of this Seminar Series, where the main functional tests available to assess upper and lower body functional capacity of these patients will be discussed.

  • 4. Bui, Kim-Ly
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 2: measurement properties2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 785-794Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability and handicap. For a thorough patient-centered outcome assessment and comprehensive management of the disease, measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity in activities of daily life are necessary. In Part 2 of this Seminar Series, we will discuss the main functional tests to assess upper and lower body functional capacity in patients with COPD, to help clinicians substantiate their choice of functional outcome measures in COPD. In agreement with the International Classification of Functioning, Disability and Health to assess functional capacity representative of daily life activities, this review focuses on functional tests that include components such as changing and maintaining body positions, walking, moving and climbing, as well as carrying, moving and handling objects. We will review the validity, reliability and responsiveness of these tests. With 11 links to the International Classification of Functioning, Disability and Health framework addressing several upper and lower body components of functional activities, the Glittre Activities of Daily Life test seems to be the most promising and comprehensive test to evaluate functional capacity in activities of daily life. The links between functional capacity tests and real participation in daily life, as well as with important clinical outcomes such as morbidity and mortality, need further investigation. More studies are also recommended to document minimal detectable changes, minimal clinically important differences and normative values for these functional tests.

  • 5.
    Ljunggren, Mirjam
    et al.
    Uppsala University, Uppsala, Sweden.
    Zhou, Xingwu
    Uppsala University, Uppsala, Sweden.
    Theorell-Haglöw, Jenny
    Uppsala University, Uppsala, Sweden.
    Janson, Christer
    Uppsala University, Uppsala, Sweden.
    Franklin, Karl A.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Emilsson, Össur
    Uppsala University, Uppsala, Sweden.
    Lindberg, Eva
    Uppsala University, Uppsala, Sweden.
    Sleep apnea indices associated with markers of inflammation and cardiovascular disease: a proteomic study in the MUSTACHE cohort2024In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 21, no 1, p. 165-169Article in journal (Other academic)
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  • 6. Lytras, Theodore
    et al.
    Beckmeyer-Borowko, Anna
    Kogevinas, Manolis
    Kromhout, Hans
    Carsin, Anne-Elie
    Antó, Josep Maria
    Bentouhami, Hayat
    Weyler, Joost
    Heinrich, Joachim
    Nowak, Dennis
    Urrutia, Isabel
    Martínez-Moratalla, Jesús
    Gullón, José Antonio
    Pereira Vega, Antonio
    Raherison Semjen, Chantal
    Pin, Isabelle
    Demoly, Pascal
    Leynaert, Bénédicte
    Villani, Simona
    Gislason, Thorarinn
    Svanes, Øistein
    Holm, Mathias
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Norbäck, Dan
    Mehta, Amar J.
    Keidel, Dirk
    Vernez, David
    Benke, Geza
    Jõgi, Rain
    Torén, Kjell
    Sigsgaard, Torben
    Schlünssen, Vivi
    Olivieri, Mario
    Blanc, Paul D.
    Watkins, John
    Bono, Roberto
    Squillacioti, Giulia
    Buist, A. Sonia
    Vermeulen, Roel
    Jarvis, Deborah
    Probst-Hensch, Nicole
    Zock, Jan-Paul
    Cumulative Occupational Exposures and Lung-Function Decline in Two Large General-Population Cohorts2021In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 18, no 2, p. 238-246Article in journal (Refereed)
    Abstract [en]

    RATIONALE: Few longitudinal studies have assessed the relationship between occupational exposures and lung function decline in the general population, with sufficiently long follow-up.

    OBJECTIVES: Our objective was to examine this potential association in two large cohorts (ECRHS and SAPALDIA).

    METHODS: General population samples aged 18 to 62 were randomly selected in 1991-1993, and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a Job-Exposure Matrix, generating cumulative exposure estimates for 12 occupational exposures. FEV1 and FVC were jointly modelled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.

    RESULTS: A total of 40,024 lung function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust and metals (FEV1 -15.1ml, -14.4ml and -18.7ml respectively, and FEV1/FVC -0.52%, -0.43% and -0.36% respectively, per 25 intensity-years of exposure). These declines were comparable in magnitude to those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and SAPALDIA cohorts.

    CONCLUSIONS: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung function decline. This highlights the need to prevent or control these exposures in the workplace.

  • 7.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Québec, Canada.
    Saey, Didier
    Maltais, François
    Why and How Limb Muscle Mass and Function Should Be Measured in Patients with COPD2015In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 12, no 9, p. 1269-1277Article in journal (Refereed)
    Abstract [en]

    Impaired limb muscle function is a common occurrence in patients with chronic obstructive pulmonary disease (COPD) and it negatively influences exercise tolerance, quality of life and even survival. Assessment of limb muscle mass and function in COPD is highly encouraged; it should include the quadriceps muscle, but other lower and upper limb muscles may be evaluated to provide valuable information. Quantification of muscle mass as well as assessment of muscle strength and endurance are suggested. Bioelectrical impedance and dual-energy X-ray absorption can be realistically used in the clinical environment to monitor body composition. Although sophisticated computerized dynamometers provide the most accurate assessment, simple exercise and testing equipment are valid alternatives and they should help implementing limb muscle function assessment in clinical settings. Isometric measurements using strain-gauges or hand-held dynamometers should be favored for their simplicity, availability and quality of information provided. This perspective provides a rationale for the evaluation of limb muscle mass and function in COPD in routine clinical practice. Additionally, measurement techniques used to assess limb muscle mass, strength, endurance and fatigue in various clinical settings are discussed.

1 - 7 of 7
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