uu.seUppsala universitets publikationer
Ändra sökning
Avgränsa sökresultatet
12 1 - 50 av 71
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    Ahmadi, Z.
    et al.
    Lund Univ, Lund, Sweden..
    Sundh, J.
    Univ Orebro, Orebro, Sweden..
    Bornefalk Hermansson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Ekström, M.
    Lund Univ, Lund, Sweden..
    Does Long-Term Oxygen Therapy 24 H/day Improve Survival Compared To 15 H/day In Hypoxemic Chronic Obstructive Pulmonary Disease?2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 2.
    Amin, Kawa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk cellbiologi.
    Lúdvíksdóttir, Dóra
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Nettelbladh, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Björnsson, Eythór
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Roomans, Godfried M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk cellbiologi.
    Boman, Gunnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Sevéus, Lahja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Inflammation and structural changes in the airways of patients with atopicand nonatopic asthma: BHR group2000Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 162, nr 6, s. 2295-2301Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to compare the cellular pattern and structural changes in the airway walls of atopic and nonatopic patients with asthma. Bronchial biopsy specimens were obtained from 13 atopic subjects with asthma, nine nonatopic patients with asthma, and seven healthy control subjects and investigated using immunohistochemical methods. The number of eosinophils increased in both asthma groups, but significantly more in the atopic group. The number of mast cells increased similarly in the two asthma groups, whereas the number of neutrophils increased only in the nonatopic asthma group. The number of T-lymphocytes (CD3-, CD4-, CD8-, CD-25-positive cells) was higher in patients with atopic asthma compared with nonatopic asthma. Interleukin-4 (IL-4) and IL-5-positive cells were more frequently found in the atopic asthma group, whereas cells staining for IL-8 were more frequent in the nonatopic group. The degree of epithelial damage was significantly higher in the atopic asthma group compared with the control subjects and the nonatopic asthmatics. The tenascin and laminin layer was significantly thicker in the atopic group compared with the group of nonatopic asthmatics. In the atopic group, there was a significant negative correlation between epithelial integrity (defined as the relative length of intact epithelium) and the eosinophil count and also between the number of CD25-positive cells and epithelial integrity. The number of mast cells correlated positively with the thickness of tenascin- and laminin-positive layers. In conclusion, we provide evidence of different patterns of involvement of inflammatory cells in atopic and nonatopic patients with asthma. There were also structural differences in the bronchial mucous membrane between atopic asthma and nonatopic asthma. This suggests that there are differences in the extent of the immunopathologic response of these clinically distinct forms of asthma.

  • 3. Bafadhel, Mona
    et al.
    McKenna, Susan
    Terry, Sarah
    Mistry, Vijay
    Pancholi, Mitesh
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Biokemisk struktur och funktion.
    Lomas, David A.
    Barer, Michael R.
    Johnston, Sebastian L.
    Pavord, Ian D.
    Brightling, Christopher E.
    Blood Eosinophils to Direct Corticosteroid Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease A Randomized Placebo-Controlled Trial2012Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 186, nr 1, s. 48-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Exacerbations of chronic obstructive pulmonary disease (COPD) and responses to treatment are heterogeneous. Objectives: Investigate the usefulness of blood eosinophils to direct corticosteroid therapy during exacerbations. Methods: Subjects with COPD exacerbations were entered into a randomized biomarker-directed double-blind corticosteroid versus standard therapy study. Subjects in the standard arm received prednisolone for 2 weeks, whereas in the biomarker-directed arm, prednisolone or matching placebo was given according to the blood eosinophil count biomarker. Both study groups received antibiotics. Blood eosinophils were measured in the biomarker-directed and standard therapy arms to define biomarker-positive and -negative exacerbations (blood eosinophil count > and <= 2%, respectively). The primary outcome was to determine noninferiority in health status using the chronic respiratory questionnaire (CRQ) and in the proportion of exacerbations associated with a treatment failure between subjects allocated to the biomarker-directed and standard therapy arms. Measurements and Main Results: There were 86 and 80 exacerbations in the biomarker-directed and standard treatment groups, respectively. In the biomarker-directed group, 49% of the exacerbations were not treated with prednisolone. CRQ improvement after treatment in the standard and biomarker-directed therapy groups was similar (0.8 vs. 1.1; mean difference, 0.3; 95% confidence interval, 0.0-0.6; P = 0.05). There was a greater improvement in CRQ in biomarker-negative exacerbations given placebo compared with those given prednisolone (mean difference, 0.45; 95% confidence interval, 0.01-0.90; P = 0.04). In biomarker-negative exacerbations, treatment failures occurred in 15% given prednisolone and 2% of those given placebo (P = 0.04). Conclusions: The peripheral blood eosinophil count is a promising biomarker to direct corticosteroid therapy during COPD exacerbations, but larger studies are required.

  • 4. Bafadhel, Mona
    et al.
    McKenna, Susan
    Terry, Sarah
    Mistry, Vijay
    Reid, Carlene
    Haldar, Pranabashis
    McCormick, Margaret
    Haldar, Koirobi
    Kebadze, Tatiana
    Duvoix, Annelyse
    Lindblad, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Patel, Hemu
    Rugman, Paul
    Dodson, Paul
    Jenkins, Martin
    Saunders, Michael
    Newbold, Paul
    Green, Ruth H.
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Lomas, David A.
    Barer, Michael R.
    Johnston, Sebastian L.
    Pavord, Ian D.
    Brightling, Christopher E.
    Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Identification of Biologic Clusters and Their Biomarkers2011Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 184, nr 6, s. 662-671Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Exacerbations of chronic obstructive pulmonary disease (COPD) are heterogeneous with respect to inflammation and etiology. Objectives: Investigate biomarker expression in COPD exacerbations to identify biologic clusters and determine biomarkers that recognize clinical COPD exacerbation phenotypes, namely those associated with bacteria, viruses, or eosinophilic airway inflammation. Methods: Patients with COPD were observed for 1 year at stable and exacerbation visits. Biomarkers were measured in sputum and serum. Viruses and selected bacteria were assessed in sputum by polymerase chain reaction and routine diagnostic bacterial culture. Biologic phenotypes were explored using unbiased cluster analysis and biomarkers that differentiated clinical exacerbation phenotypes were investigated. Measurements and Main Results: A total of 145 patients (101 men and 44 women) entered the study. A total of 182 exacerbations were captured from 86 patients. Four distinct biologic exacerbation clusters were identified. These were bacterial-, viral-, or eosinophilic-predominant, and a fourth associated with limited changes in the inflammatory profile termed "pauciinflammatory." Of all exacerbations, 55%, 29%, and 28% were associated with bacteria, virus, or a sputum eosinophilia. The biomarkers that best identified these clinical phenotypes were sputum IL-1 beta, 0.89 (area under receiver operating characteristic curve) (95% confidence interval [CI], 0.83-0.95); serum CXCL10, 0.83 (95% CI, 0.70-0.96); and percentage peripheral eosinophils, 0.85 (95% CI, 0.78-0.93), respectively. Conclusions: The heterogeneity of the biologic response of COPD exacerbations can be defined. Sputum IL-1 beta, serum CXCL10, and peripheral eosinophils are biomarkers of bacteria-, virus-, or eosinophil-associated exacerbations of COPD. Whether phenotype-specific biomarkers can be applied to direct therapy warrants further investigation.

  • 5.
    Batista Borges, João
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Univ Sao Paulo, Sao Paulo, Brazil.
    The Plausibility of "Bronchiolotrauma"2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197, nr 8, s. 1086-1087Artikel i tidskrift (Refereegranskat)
  • 6.
    Batista Borges, João
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Bergman, J. S.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet.
    Dussault, C.
    Armed Forces Biomed Res Inst, Bretigny Sur Orge, France..
    Amato, M. B. P.
    Univ Sao Paulo, Sch Med, Sao Paulo, Brazil..
    Montmerle-Borgdorff, S.
    Armed Forces Biomed Res Inst, Bretigny Sur Orge, France..
    First-Time Monitoring Of Simultaneous Effects Of Hypergravity On Heart And Lung By Electrical Impedance Tomography2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 7.
    Batista Borges, João
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Santos, Arnoldo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Lucchetta, L.
    Hosp San Matteo, Pavia, Italy..
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Suarez-Sipmann, Fernando
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Redistribution Of Regional Lung Perfusion During Mechanical Ventilation With An Open Lung Approach Impacts Pulmonary Vascular Mechanics2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, artikel-id A3751Artikel i tidskrift (Övrigt vetenskapligt)
  • 8.
    Bayat, S.
    et al.
    Grenoble Univ Hosp, Clin Physiol Sommeil & Exercice, Grenoble, France; Grenoble Univ Hosp, RSRM EA 7442, Grenoble, France; Univ Grenoble Alpes, Grenoble, France.
    Fardin, L.
    European Synchrotron Radiat Facil, Biomed Beamline ID17, Grenoble, France.
    Broche, L.
    European Synchrotron Radiat Facil, Biomed Beamline ID17, Grenoble, France.
    Lovric, G.
    Paul Scherrer Inst, Swiss Light Source, Villigen, Switzerland.
    Larsson, Anders S.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Bravin, A.
    European Synchrotron Radiat Facil, Biomed Beamline ID17, Grenoble, France.
    High-Resolution Time-Resolved Phase-Contrast Synchrotron CT for Mapping Cardiac-Induced Lung Motion2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197Artikel i tidskrift (Övrigt vetenskapligt)
  • 9. Beeh, Kai M
    et al.
    Burgel, Pierre-Regis
    Franssen, Frits M E
    Lopez-Campos, Jose Luis
    Loukides, Stelios
    Hurst, John R
    Fležar, Matjaž
    Ulrik, Charlotte Suppli
    Di Marco, Fabiano
    Stolz, Daiana
    Valipour, Arschang
    Casserly, Brian
    Ställberg, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Kostikas, Konstantinos
    Wedzicha, Jadwiga A
    How Do Dual Long-acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 196, nr 2, s. 139-149Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Decreasing the frequency and severity of exacerbations is one of the main goals of treatment for patients with chronic obstructive pulmonary disease (COPD). Several studies have documented that long-acting bronchodilators (LABDs) can reduce exacerbation rate and/or severity, and others have shown that combinations of long-acting β2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroids (LABA/ICS) combinations in patients at low and high risk for these events. In this review, small groups of experts critically evaluated mechanisms potentially responsible for the increased benefit of LABA/LAMA combinations over single LABDs or LABA/ICS in decreasing exacerbation. These included effects on lung hyperinflation and mechanical stress, inflammation, excessive mucus production with impaired mucociliary clearance, and symptom severity. The data assembled and analyzed by each group were reviewed by all authors and combined into this manuscript. Available clinical results support the possibility that effects of LABA/LAMA combinations on hyperinflation, mucociliary clearance, and symptom severity may all contribute to decreasing exacerbations. While preclinical studies suggest LABAs and LAMAs have anti-inflammatory effects, such effects have not been demonstrated yet in patients with COPD.

  • 10. Bellani, Giacomo
    et al.
    Laffey, John G
    Pham, Tài
    Madotto, Fabiana
    Fan, Eddy
    Brochard, Laurent
    Esteban, Andres
    Gattinoni, Luciano
    Bumbasirevic, Vesna
    Piquilloud, Lise
    van Haren, Frank
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    McAuley, Daniel F
    Bauer, Philippe R
    Arabi, Yaseen M
    Ranieri, Marco
    Antonelli, Massimo
    Rubenfeld, Gordon D
    Thompson, B Taylor
    Wrigge, Hermann
    Slutsky, Arthur S
    Pesenti, Antonio
    Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study.2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, nr 1, s. 67-77Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse.

    Objectives: To determine whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful.

    Methods: The LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study described the management of patients with ARDS. This substudy examines the current practice of NIV use in ARDS, the utility of the PaO2/FiO2 ratio in classifying patients receiving NIV, and the impact of NIV on outcome.

    Measurements and Main Results: Of 2,813 patients with ARDS, 436 (15.5%) were managed with NIV on Days 1 and 2 following fulfillment of diagnostic criteria. Classification of ARDS severity based on PaO2/FiO2 ratio was associated with an increase in intensity of ventilatory support, NIV failure, and intensive care unit (ICU) mortality. NIV failure occurred in 22.2% of mild, 42.3% of moderate, and 47.1% of patients with severe ARDS. Hospital mortality in patients with NIV success and failure was 16.1% and 45.4%, respectively. NIV use was independently associated with increased ICU (hazard ratio, 1.446 [95% confidence interval, 1.159–1.805]), but not hospital, mortality. In a propensity matched analysis, ICU mortality was higher in NIV than invasively ventilated patients with a PaO2/FiO2 lower than 150 mm Hg.

    Conclusions: NIV was used in 15% of patients with ARDS, irrespective of severity category. NIV seems to be associated with higher ICU mortality in patients with a PaO2/FiO2 lower than 150 mm Hg.

  • 11. Betsuyaku, Tomoko
    et al.
    Nishimura, Masaharu
    Takeyabu, Kimihiro
    Tanino, Mishie
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Xu, Shengyuan
    Kawakami, Yoshikazu
    Neutrophil granule proteins in bronchoalveolar lavage fluid from subjects with subclinical emphysema1999Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 159, nr 6, s. 1985-1991Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Evidence for the contribution of neutrophils to the pathogenesis of pulmonary emphysema is not convincing. We evaluated neutrophil involvement in subclinical pulmonary emphysema by measuring human neutrophil lipocalin (HNL) and two matrix metalloproteinases, gelatinase B (MMP-9) and neutrophil collagenase (MMP-8), in bronchoalveolar lavage fluid (BALF) from 65 community-based older volunteers. HNL is a recently isolated 24-kD protein secreted from secondary granules of activated neutrophils. Despite no appreciable increase in the number of neutrophils, the level of HNL was significantly increased in BALF from subjects with emphysema evidenced by computed tomography regardless of current smoking, as compared with smokers without emphysema. The levels of MMP-9 and MMP-8 were also significantly higher in current smokers with emphysema than in those without emphysema. The appearance of a 130-kD HNL/MMP-9 complex on gelatin zymography and HNL immunoblot indicated neutrophils to be a significant source of MMP-9 in the subjects' BALF. In a 24-h culture medium of alveolar macrophages, only a latent form of MMP-9 was detected, and there was no difference in the level of MMP-9 between the groups. These data provide further evidence for neutrophil involvement in subclinical pulmonary emphysema.

  • 12. Boner, A. L.
    et al.
    Comis, A.
    Schiassi, M.
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Piacentini, G. L.
    Bronchial reactivity in asthmatic children at high and low altitude: Effect of budesonide1995Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 151, nr 4, s. 1194-1200Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Inhaled steroids may control bronchial inflammation in asthmatics exposed to allergens. In this study we evaluated whether prophylactic budesonide would prevent relapse of asthma in children re-exposed to offending allergens at sea level, after a period of antigen avoidance at high altitude. Thirty children received either budesonide (200 micrograms b.i.d.) or placebo (double-blind). Following a 4-wk baseline period and 2 wk of treatment at high altitude, children were treated for 3 mo at sea level. Methacholine challenge and pulmonary function studies were performed before and after baseline period, after the 2 wk of treatment in the mountain environment, and at the end of treatment. ECP serum levels were evaluated after the baseline period and at the end of treatment. PEFR and symptoms were recorded in a diary card during the study. The increase in methacholine provocative dosage was greater, although not significant (p = 0.096), in the budesonide than in the placebo group after the treatment at high altitude and remained higher at the end of the treatment (p = 0.04). ECP levels increased in both the groups with no significant difference. Our results confirm that budesonide, in addition to its efficacy in treating pre-existent airway inflammation, is effective in preventing the increase of reactivity in asthmatic children re-exposed to allergens.

  • 13. Borges, João Batista
    Enlarging and protecting an aerated lung2008Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 177, nr 4, s. 463; author reply 463-464Artikel i tidskrift (Refereegranskat)
  • 14.
    Borges, João Batista
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Ribeiro Carvalho, Carlos Roberto
    The Quest for the Holy Grail: A Dead Lock2010Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 182, nr 4, s. 579-580Artikel i tidskrift (Refereegranskat)
  • 15. Boudier, Anne
    et al.
    Curjuric, Ivan
    Basagana, Xavier
    Hazgui, Hana
    Anto, Josep M.
    Bousquet, Jean
    Bridevaux, Pierre O.
    Dupuis-Lozeron, Elise
    Garcia-Aymerich, Judith
    Heinrich, Joachim
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Kuenzli, Nino
    Leynaert, Benedicte
    de Marco, Roberto
    Rochat, Thierry
    Schindler, Christian
    Varraso, Raphaelle
    Pin, Isabelle
    Probst-Hensch, Nicole
    Sunyer, Jordi
    Kauffmann, Francine
    Siroux, Valerie
    Ten-Year Follow-up of Cluster-based Asthma Phenotypes in Adults A Pooled Analysis of Three Cohorts2013Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 188, nr 5, s. 550-560Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: The temporal stability of adult asthma phenotypes identified using clustering methods has never been addressed. Longitudinal cluster-based methods may provide novel insights in the study of the natural history of asthma. Objectives: To compare the stability of cluster-based asthma phenotype structures a decade apart in adults and to address the individuals' phenotypic transition across these asthma phenotypes. Methods: The latent transition analysis was applied on longitudinal data (twice, 10 yr apart) from 3,320 adults with asthma who took part in the European Community Respiratory Health Survey, the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults, or the Epidemiological Study on Genetics and Environment of Asthma. Nine variables covering personal and phenotypic characteristics measured twice, 10 years apart, were simultaneously considered. Measurements and Main Results: Latent transition analysis identifies seven asthma phenotypes (prevalence range, 8.4-20.8%), mainly [GRAPHICS] characterized by the level of asthma symptoms ( low, moderate, high), the allergic status, and pulmonary function. Phenotypes observed 10 years apart showed strong similarities. The probability of membership in the same asthma phenotype at both times varied across phenotypes from 54 to 88%. Different transition patterns were observed across phenotypes. Transitions toward increased asthma symptoms were more frequently observed among nonallergic phenotypes as compared with allergic phenotypes. Results showed a strong stability of the allergic status over time. Conclusions: Adult asthma phenotypes identified by a clustering approach, 10 years apart, were highly consistent. This study is the first to model the probabilities of transitioning over time between comprehensive asthma phenotypes.

  • 16.
    Broche, L.
    et al.
    ESRF, Grenoble, France.;Univ Bari, Bari, Italy..
    Tannoia, A.
    Pellegrini, Mariangela
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Derosa, S.
    Sindaco, A.
    Borges, João Batista
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Porra, L.
    Univ Helsinki, Helsinki, Finland..
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Bravin, A.
    ESRF, Grenoble, France..
    Perchiazzi, G.
    Wexler, A. S.
    Univ Calif Davis, Davis, CA 95616 USA..
    Verbanck, S.
    UZ Brussel, Brussels, Belgium..
    Bates, J. H. T.
    Univ Vermont, Burlington, VT USA..
    Bayat, S.
    Univ Picardie Med Sch CHU Amiens, Amiens, France..
    Role Of Parenchymal Interdependence In The Short-Term Dynamics Of Recruitment/derecruitment In Injured Lung: A Modelling Study2015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 17. Chinn, Susan
    et al.
    Heinrich, Joachim
    Antó, Josep M
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Olivieri, Mario
    Svanes, Cecilie
    Sunyer, Jordi
    Verlato, Giuseppe
    Wjst, Matthias
    Zock, Jan-Paul
    Burney, Peter G
    Jarvis, Deborah L
    Bronchial responsiveness in atopic adults increases with exposure to cat allergen2007Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 176, nr 1, s. 20-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: The association of asthma with sensitization and allergen exposure is known to be complex. There have been few studies of bronchial responsiveness in relation to both risk factors in adults.

    Objectives: To determine the relation of bronchial responsiveness to allergen exposure and IgE sensitization in a community study taking into account the major determinants of bronchial responsiveness in adulthood.

    Methods: Cross-sectional data were drawn from 1,884 participants in 20 centers in the European Community Respiratory Health Survey follow-up, which included measurement of house dust mite and cat allergen in mattress dust samples, and IgE sensitization to four allergens. Bronchial responsiveness to methacholine was expressed as a continuous variable, and analyzed by multiple regression.

    Measurements and Main Results: The trend toward greater bronchial responsiveness with increasing exposure to cat allergen was greater in those sensitized to any of the four allergens than those not sensitized (p = 0.001); there was no significant interaction between cat sensitization and Fel d 1 exposure. No trend was found with house dust mite allergen exposure. The difference in bronchial responsiveness between those exposed to the highest levels compared with the lowest was approximately –2.02 doubling doses of PD20 (95% confidence interval, –3.06 to –0.97), and nearly as great in those exposed to more moderate levels.

    Conclusions: Cat allergen exposure at moderate levels may be harmful to all atopic adults. The clinical implication is that it is insufficient to test patients with asthma for cat sensitization; all atopic individuals may benefit from reduced cat exposure.

  • 18. de Marco, Roberto
    et al.
    Accordini, Simone
    Antò, Josep M
    Gislason, Thorarinn
    Heinrich, Joachim
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Jarvis, Deborah
    Künzli, Nino
    Leynaert, Bénédicte
    Marcon, Alessandro
    Sunyer, Jordi
    Svanes, Cecilie
    Wjst, Matthias
    Burney, Peter
    Long-term outcomes in mild/moderate chronic obstructive pulmonary disease in the European community respiratory health survey2009Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 180, nr 10, s. 956-963Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    RATIONALE: Little is known about the long-term outcomes of individuals with mild/moderate chronic obstructive pulmonary disease (COPD) according to spirometric criteria. OBJECTIVES: To test whether nonsmokers and asymptomatic subjects with a spirometric diagnosis of COPD have a steeper decrease in lung function and higher hospitalization rates than subjects without airway obstruction. METHODS: A total of 5,205 subjects without asthma (20-44 years of age) from the general population, with FEV(1) >or= 50% predicted at baseline, were followed for 9 years in the frame of an international cohort study. Percent decrease in FEV(1) (DeltaFEV(1)%) and the annual hospitalization rate for respiratory causes during the follow-up were assessed for each subject. MEASUREMENTS AND MAIN RESULTS: At baseline, 324 (6.2%) subjects had the prebronchodilator FEV(1)/FVC ratio less than the lower limit of normal (LLN-COPD), and 105 (2.0%) subjects had the same ratio less than 0.70 (modified GOLD-COPD). At follow-up, smokers with LLN-COPD (n = 205) had a greater mean DeltaFEV(1)% (1.7%; 95% confidence interval [CI], 0.8-2.7) and a higher hospitalization rate (rate ratio [RR], 2.52; 95% CI, 1.65-3.86) than normal subjects. Similarly, symptomatic subjects with LLN-COPD (n = 104) had DeltaFEV(1)% (2.0%; 95% CI, 0.8-3.3) and the hospitalization rate (RR, 4.18; 95% CI, 2.43-7.21) higher than the reference group. By contrast, nonsmokers and asymptomatic subjects with LLN-COPD had outcomes that were similar or even better than normal subjects. Among subjects with LLN-COPD, the association of symptoms with DeltaFEV(1)% varied according to smoking habits (P = 0.007); it was particularly strong in symptomatic smokers and disappeared in symptomatic nonsmokers. Similar results were found with the modified GOLD classification. CONCLUSIONS: In relatively young populations, COPD is associated with poor long-term outcomes in smokers and in symptomatic subjects only.

  • 19. de Marco, Roberto
    et al.
    Accordini, Simone
    Cerveri, Isa
    Corsico, Angelo
    Antó, Josep M.
    Künzli, Nino
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Sunyer, Jordi
    Jarvis, Deborah
    Chinn, Susan
    Vermeire, Paul
    Svanes, Cecilie
    Ackermann-Liebrich, Ursula
    Gislason, Thorarinn
    Heinrich, Joachim
    Leynaert, B.
    Neukirch, F.
    Schouten, Jan P.
    Wjst, Matthias
    Burney, Peter
    Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm2007Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 175, nr 1, s. 32-39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results. Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether chronic cough/phlegm and dyspnea are independent predictors of COPD. Methods: An international cohort of 5,002 subjects without asthma (ages 20-44 yr) with normal lung function (FEV1/FVC ratio ≥ 70%) from 12 countries was followed from 1991-2002 in the frame of the European Community Respiratory Health Survey II. Incident cases of COPD were those who had an FEV 1/FVC ratio less than 70% at the end of the follow-up, but did not report having had a doctor diagnose asthma during the follow-up. Main Results: The incidence rate of COPD was 2.8 cases/1,000/yr (95% confidence interval [CI], 2.3-3.3). Chronic cough/phlegm was an independent and statistically significant predictor of COPD (incidence rate ratio [IRR], 1.85; 95% CI, 1.17-2.93) after adjusting for smoking habits and other potential confounders, whereas dyspnea was not associated with the disease (IRR = 0.98; 95% CI, 0.64-1.50). Subjects who reported chronic cough/phlegm both at baseline and at the follow-up had a nearly threefold-increased risk of developing COPD with respect to asymptomatic subjects (IRR = 2.88; 95% CI, 1.44-5.79). Conclusions: The incidence of COPD is substantial even in young adults. The presence of chronic cough/phlegm identifies a subgroup of subjects with a high risk of developing COPD, independently of smoking habits.

  • 20. de Marco, Roberto
    et al.
    Accordini, Simone
    Marcon, Alessandro
    Cerveri, Isa
    Anto, Josep M.
    Gislason, Thorarinn
    Heinrich, Joachim
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Jarvis, Deborah
    Kuenzli, Nino
    Leynaert, Benedicte
    Sunyer, Jordi
    Svanes, Cecilie
    Wjst, Matthias
    Burney, Peter
    Risk Factors for Chronic Obstructive Pulmonary Disease in a European Cohort of Young Adults2011Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 183, nr 7, s. 891-897Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Few studies have investigated the factors associated with the early inception of chronic obstructive pulmonary disease (COPD). Objectives: We investigated COPD risk factors in an international cohort of young adults using different spirometric definitions of the disease. Methods. We studied 4,636 subjects without asthma who had prebronchodilator FEV1/FVC measured in the European Community Respiratory Health Survey both in 1991 to 1993 (when they were 20-44 yr old) and in 1999 to 2002. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease fixed cut-off criterion (FEV1/FVC < 0.70), and two criteria based on the Quanjer and LuftiBus reference equations (FEV1/FVC less than lower limit of normal). COPD determinants were studied using two-level Poisson regression models. Measurements and Main Results: COPD incidence ranged from 1.85 (lower limit of normal [Quanjer]) to 2.88 (Global Initiative for Chronic Obstructive Lung Disease) cases/1,000/yr. Although about half of the cases had smoked less than 20 pack-years, smoking was the main risk factor for COPD, and it accounted for 29 to 39% of the new cases during the follow-up. Airway hyperresponsiveness was the second strongest risk factor (15-17% of new cases). Other determinants were respiratory infections in childhood and a family history of asthma, whereas the role of sex, age, and of being underweight largely depended on the definition of COPD used. Conclusions: COPD may start early in life. Smoking prevention should be given the highest priority to reduce COPD occurrence. Airway hyperresponsiveness, a family history of asthma, and respiratory infections in childhood are other important determinants of COPD. We suggest the need for a definition of COPD that is not exclusively based on spirometry.

  • 21. Ekstrom, Magnus P.
    et al.
    Bornefalk Hermansson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Strom, Kerstin E.
    Effects of Cardiovascular Drugs on Mortality in Severe Chronic Obstructive Pulmonary Disease: A Time-Dependent Analysis2013Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 187, nr 7, s. 715-720Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale:

    Cardiovascular drugs may improve survival in chronic obstructive pulmonary disease (COPD). However, previous studies did not account for major sources of bias, and drug effects have not been evaluated in severe COPD.

    Objectives:

    To estimate the time-dependent effects of cardiovascular drugs on survival in oxygen-dependent COPD, accounting for immortal and immeasurable time bias.

    Methods:

    Prospective national study of patients starting long-term oxygen therapy for COPD in Sweden between 1 October 2005 and 30 June 2009. Effects on mortality were estimated using extended Cox regression adjusted for age, sex, Pa-O2, Pa-CO2, World Health Organization performance status, body mass index, comorbidity, and concomitant medications. Immortal and immeasurable time bias was addressed by analyzing all medications as time-dependent variables and accounting for hospitalized time, respectively.

    Measurements and Main Results:

    Time-dependent effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, antiplatelet drugs, beta-blockers, and statins on all-cause mortality were measured. Of the 2,249 included patients, 1,129 (50%) died under observation. No patient was lost to follow-up. The adjusted time-dependent model was compatible with reduced mortality for antiplatelet drugs (hazard ratio [HR], 0.86; 95% CI, 0.75-0.99; P = 0.030) and trends for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (HR, 0.90; 95% CI, 0.79-1.04; P = 0.166) and statins (HR, 0.86; 95% CI, 0.72-1.03; P = 0.105), whereas beta-blockers increased mortality (HR, 1.19; 95% CI, 1.04-1.37; P = 0.010). Conclusions: This study supports that antiplatelet drugs improve survival

  • 22. Ekstrom, Magnus P.
    et al.
    Hermansson, Anna Bornefalk
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Strom, Kerstin E.
    Effects of Cardiovascular rugs on Mortality in Severe Chronic Obstructive Pulmonary Disease A Time-Dependent Analysis2013Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 187, nr 7, s. 715-720Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Cardiovascular drugs may improve survival in chronic obstructive pulmonary disease (COPD). However, previous studies did not account for major sources of bias, and drug effects have not been evaluated in severe COPD. Objectives: To estimate the time-dependent effects of cardiovascular drugs on survival in oxygen-dependent COPD, accounting for immortal and immeasurable time bias. Methods: Prospective national study of patients starting long-term oxygen therapy for COPD in Sweden between 1 October 2005 and 30 June 2009. Effects on mortality were estimated using extended Cox regression adjusted for age, sex, Pa-O2, Pa-CO2, World Health Organization performance status, body mass index, comorbidity, and concomitant medications. Immortal and immeasurable time bias was addressed by analyzing all medications as time-dependent variables and accounting for hospitalized time, respectively. Measurements and Main Results: Time-dependent effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, antiplatelet drugs, beta-blockers, and statins on all-cause mortality were measured. Of the 2,249 included patients, 1,129 (50%) died under observation. No patient was lost to follow-up. The adjusted time-dependent model was compatible with reduced mortality for antiplatelet drugs (hazard ratio [HR], 0.86; 95% CI, 0.75-0.99; P = 0.030) and trends for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (HR, 0.90; 95% CI, 0.79-1.04; P = 0.166) and statins (HR, 0.86; 95% CI, 0.72-1.03; P = 0.105), whereas beta-blockers increased mortality (HR, 1.19; 95% CI, 1.04-1.37; P = 0.010). Conclusions: This study supports that antiplatelet drugs improve survival

  • 23.
    Ekström, M.
    et al.
    Lund Univ, Div Resp Med & Allergol, Dept Clin Sci, Lund, Sweden..
    Ahmadi, Z.
    Lund Univ, Div Resp Med & Allergol, Dept Clin Sci, Lund, Sweden..
    Bornefalk Hermansson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR). Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Statistiska institutionen.
    Currow, D.
    Flinders Univ S Australia, Adelaide, SA, Australia..
    Oxygen For Breathlessness In Patients With COPD Who Do Not Qualify For Home Oxygen Therapy: An Updated Cochrane Analysis2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, artikel-id A5450Artikel i tidskrift (Övrigt vetenskapligt)
  • 24.
    Ekström, M.
    et al.
    Lund Univ, Lund, Sweden..
    Schioler, L.
    Gothenburg Univ, Gothenburg, Sweden..
    Gronseth, R.
    Haukeland Hosp, Bergen, Norway..
    Johannessen, A.
    Haukeland Hosp, Bergen, Norway..
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Svanes, C.
    Univ Bergen, Bergen, Norway..
    Leynaert, B.
    Univ Paris Diderot, Paris, France..
    Jarvis, D.
    Imperial Coll London, London, England..
    Torén, K.
    Absolute Lung Volume And Breathlessness In Men And Women In The General Population2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 25. Ekström, Magnus
    et al.
    Bornefalk Hermansson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Wysham, Nicholas
    Currow, David C
    MacIntyre, Neil
    Spirometric Volumes and Breathlessness Across Levels of Airflow Limitation: The COPDGene Study.2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 198, nr 5, s. 678-681Artikel i tidskrift (Refereegranskat)
  • 26.
    Fardin, L.
    et al.
    European Synchrotron Radiat Facil, Grenoble, France..
    Broche, Ludovic
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Coll, J. -L
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Bayat, S.
    Grenoble Univ Hosp, Grenoble, France..
    Bravin, A.
    European Synchrotron Radiat Facil, Grenoble, France..
    Enhancing Lung Tumor Visibility Using In-Vivo Analyzer-Based X-Ray Phase Contrast Imaging In Mouse: A Feasibility Study2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, artikel-id A6514Artikel i tidskrift (Övrigt vetenskapligt)
  • 27.
    Franzen, S.
    et al.
    Registercentrum, Gothenburg, Sweden..
    Magnusson, G.
    AstraZeneca, Gothenburg, Sweden..
    Telg, G.
    AstraZeneca Nord Balt, Sodertalje, Sweden..
    Olsson, U.
    Statisticon, Uppsala, Sweden..
    Jansson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Larsson, K.
    Karolinska Inst, Stockholm, Sweden..
    Petzold, M.
    Ctr Appl Biostat, Gothenburg, Sweden..
    Sundgren, M.
    AstraZeneca Gothenburgh, SE-43183 Gothenburg, Sweden..
    Evaluation Of Swedish Integrated Electronic Health Records And Register Health Care Data To Support Interpretation Of A Reference Population In Asthma Clinical Trials (pacehr)2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 28.
    Frodella, C. M.
    et al.
    Univ Vermont, Burlington, VT USA..
    Smith, B. J.
    Univ Vermont, Burlington, VT USA..
    Hellman, Lars T.
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Biologiska sektionen, Institutionen för cell- och molekylärbiologi.
    Poynter, M. E.
    Univ Vermont, Burlington, VT USA..
    Van Der Vliet, A.
    Univ Vermont, Burlington, VT USA..
    Aliyeva, M.
    Univ Vermont, Burlington, VT USA..
    Daphtary, N.
    Univ Vermont, Burlington, VT USA..
    Hristova, M.
    Univ Vermont, Burlington, VT USA..
    Lundblad, L. K. A.
    Univ Vermont, Burlington, VT USA..
    Elimination Of Il-33 Inhibits Airways Hyperresponsiveness2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 29.
    Graf, J.
    et al.
    Univ Desarrollo, Fac Med, Clin Alemana, Santiago, Chile..
    Santos, Arnoldo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Silva, C.
    Clin Alemana Santiago, Santiago, Chile..
    Salazar, A.
    Clin Alemana Santiago, Santiago, Chile..
    Formenti, P.
    Polo Univ, Azienda Osped San Paolo, Milan, Italy..
    Marini, J. J.
    Univ Minnesota, St Paul, MN 55108 USA..
    Rapid Quantification Of Lung Inflation And Recruitment With Automatic Lung Segmentation Of Chest Computed Tomography In A Variable Lung Collapse Model2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 30. Haggmark, Anna
    et al.
    Hamsten, Carl
    Wiklundh, Emil
    Lindskog, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Mattsson, Cecilia
    Andersson, Eni
    Lundberg, Ingrid E.
    Gronlund, Hans
    Schwenk, Jochen M.
    Eklund, Anders
    Grunewald, Johan
    Nilsson, Peter
    Proteomic Profiling Reveals Autoimmune Targets in Sarcoidosis2015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191, nr 5, s. 574-583Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: There is a need to further characterize the antibody repertoire in relation to sarcoidosis and potentially related autoantigens. Objectives: We investigated bronchoalveolar lavage (BAL) and serum samples from patients with sarcoidosis and healthy and diseased control subjects to discover sarcoidosis-associated autoantigens. Methods: Antigen microarrays built on 3,072 protein fragments were used to screen for IgG reactivity in 73 BAL samples from subjects with sarcoidosis, subjects with asthma, and healthy subjects. A set of 131 targets were selected for subsequent verification on suspension bead arrays using 272 additional BAL samples and 141 paired sera. Reactivity to four antigens was furthermore analyzed in 22 unprocessed BAL samples from patients with fibrosis and 269 plasma samples from patients diagnosed with myositis. Measurements and Main Results: Reactivity toward zinc finger protein 688 and mitochondrial ribosomal protein L43 were discovered with higher frequencies in patients with sarcoidosis, for mitochondrial ribosomal protein L43 especially in patients with non-Lofgren syndrome. Increased reactivity toward nuclear receptor coactivator 2 was also observed in patients with non-Lofgren syndrome as compared with patients with Lofgren syndrome. The antigen representing adenosine diphosphate-ribosylation factor GTPase activating protein 1 revealed high reactivity frequency in all sample groups but with significantly higher level of IgG reactivities in patients with sarcoidosis. Conclusions: Autoantigen reactivity was present in most BAL and serum samples analyzed, and the results revealed high interindividual heterogeneity, with most of the reactivities observed in single individuals only. Four proteins are here proposed as sarcoidosis-associated autoimmune targets and of interest for further validation in independent cohorts.

  • 31.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Unstable Inflation Is Harmful and More Common Supine Than Prone2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 198, nr 2, s. 146-147Artikel i tidskrift (Refereegranskat)
  • 32.
    Hedenstierna, Göran
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Univ Hosp, Med Sci, Uppsala, Sweden.
    Lundin, S.
    Univ Hosp, Anesthesia & Intens Care, Gothenburg, Sweden.
    Pesenti, A.
    Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy.
    Chiumello, D.
    Università degli Studi di Milano, Anesthesia and Intensive Care, Milan, Italy.
    Larsson, Anders S.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Stenqvist, O.
    Sahlgrens Univ Hosp, Anaesthesiol & Intens Care, Gothenburg, Sweden.
    Chest Wall Elastance During Passive Mechanical Ventilation: An Alternative Hypothesis2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197Artikel i tidskrift (Övrigt vetenskapligt)
  • 33.
    Kemp, S. V.
    et al.
    Royal Brompton & Harefield NHS Fdn Trust, London, England..
    Slebos, D. -J
    Kirk, A.
    Golden Jubilee Natl Hosp, Glasgow, Lanark, Scotland..
    Kornaszewska, M.
    Univ Hosp Wales, Cardiff, S Glam, Wales..
    Carron, K.
    AZ Delta, Menen, Belgium..
    Ek, L.
    Skane Univ Hosp, Lund, Sweden..
    Mal, H.
    Bight Hosp, Paris, France..
    Pison, C.
    CHU Grenoble, Grenoble, France..
    Downer, N. J.
    Sherwood Forest Hosp NHS Fdn Trust, Sutton, Surrey, England..
    Broman, Gustav
    Uppsala Univ Hosp, Uppsala, Sweden..
    Darwiche, K.
    Univ Duisburg Essen, Ruhrlandklin, West German Lung Ctr, Univ Hosp, Essen, Germany..
    Rao, J.
    Northern Gen Hosp, Sheffield, S Yorkshire, England..
    Hubner, R. -H
    Trosini-Desert, V.
    Grp Hosp Pitie Salpetriere, Paris, France..
    Eberhardt, R.
    Heidelberg Univ, Thoraxklin, Heidelberg, Germany.;German Ctr Lung Res DZL, TLRCH, Heidelberg, Germany..
    Herth, F. J. F.
    Heidelberg Univ, Thoraxklin, Heidelberg, Germany.;German Ctr Lung Res DZL, TLRCH, Heidelberg, Germany..
    Derom, E.
    Ghent Univ Hosp, Ghent, Belgium..
    Marquette, C. H.
    Hop Louis Pasteur, CHU, Nice, France..
    A Multicenter, Prospective, Randomized, Controlled Trial Of Endobronchial Valve Treatment Vs Standard Of Care In Heterogeneous Emphysema (transform)2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, artikel-id A6740Artikel i tidskrift (Övrigt vetenskapligt)
  • 34.
    Kemp, Samuel V.
    et al.
    Royal Brompton Hosp, London; Imperial Coll London; Sherwood Forest Hosp NHS Fdn Trust, AshfieldAshfield.
    Slebos, Dirk-Jan
    Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Dis.
    Kirk, Alan
    Golden Jubilee Natl Hosp, West Scotland Reg Heart & Lung Ctr, Dept Thorac Surg, West Dunbartonshire.
    Kornaszewska, Malgorzata
    Univ Hosp Wales, Dept Cardiothorac Surg, Cardiff.
    Carron, Kris
    AZ Delta, Dept Pulmonol, Menen.
    Ek, Lars
    Skåne Univ Hosp, Dept Pulm Dis, Lund.
    Broman, Gustav
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning. Uppsala Univ Hosp, Dept Pulm Dis, Uppsala.
    Hillerdal, Gunnar
    Uppsala Univ Hosp, Dept Pulm Dis, Uppsala.
    Mal, Herve
    Hop Bichat Claude Bernard, Serv Pneumol A, Paris.
    Pison, Christophe
    CHU Grenoble Alpes, Clin Univ Pneumol, Pole Thorax & Vaisseaux, Grenoble.
    Briault, Amandine
    CHU Grenoble Alpes, Clin Univ Pneumol, Pole Thorax & Vaisseaux, Grenoble.
    Downer, Nicola
    Sherwood Forest Hosp NHS Fdn Trust, Ashfield.
    Darwiche, Kaid
    Univ Clin Essen, Dept Intervent Pneumol, West German Lung Ctr, Ruhrlandklin, Essen.
    Rao, Jagan
    Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire.
    Huebner, Ralf-Harto
    Charite, Medi Klin M Schw Infektiol & Pneumol, Campus Virchow, Berlin.
    Ruwwe-Glosenkamp, Christof
    Charite, Medi Klin M Schw Infektiol & Pneumol, Campus Virchow, Berlin.
    Trosini-Desert, Valery
    Grp Hosp Pitie Salpetriere, Unite Endoscopie Bronch, Serv Pneumol & Reanimat, Paris.
    Eberhardt, Ralf
    Heidelberg Univ, Dept Pneumol & Crit Care Med, Thoraxklin, Heidelberg; Translat Lung Res Ctr Heidelberg, Heidelberg.
    Herth, Felix J.
    Heidelberg Univ, Dept Pneumol & Crit Care Med, Thoraxklin, Heidelberg; Translat Lung Res Ctr Heidelberg, Heidelberg.
    Derom, Eric
    Ghent Univ Hosp, Dept Pulm Dis, Ghent.
    Malfait, Thomas
    Ghent Univ Hosp, Dept Pulm Dis, Ghent.
    Shah, Pallav L.
    Royal Brompton Hosp, London; Imperial Coll London.
    Garner, Justin L.
    Royal Brompton Hosp, London; Imperial Coll London.
    ten Hacken, Nick H.
    Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Dis.
    Fallouh, Hazem
    Univ Hosp Wales, Dept Cardiothorac Surg, Cardiff.
    Leroy, Sylvie
    Univ Cote Azur, CHU Nice, Serv Pneumol, FHU OncoAge, Nice.
    Marquette, Charles H.
    Univ Cote Azur, CHU Nice, Serv Pneumol, FHU OncoAge, Nice.
    A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (TRANSFORM)2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 196, nr 12, s. 1535-1543Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Single-center randomized controlled trials of the Zephyr endobronchial valve (EBV) treatment have demonstrated benefit in severe heterogeneous emphysema. This is the first multicenter study evaluating this treatment approach. Objectives: To evaluate the efficacy and safety of Zephyr EBVs in patients with heterogeneous emphysema and absence of collateral ventilation.

    Methods: This was a prospective, multicenter 2:1 randomized controlled trial of EBVs plus standard of care or standard of care alone (SoC). Primary outcome at 3 months post-procedure was the percentage of subjects with FEV1 improvement from baseline of 12% or greater. Changes in FEV1, residual volume, 6-minute-walk distance, St. George's Respiratory Questionnaire score, and modified Medical Research Council score were assessed at 3 and 6 months, and target lobe volume reduction on chest computed tomography at 3 months.

    Measurements and Main Results: Ninety seven subjects were randomized toEBV(n = 65) or SoC(n = 32). At 3 months, 55.4% of EBV and 6.5% of SoC subjects had an FEV1 improvement of 12% or more (P < 0.001). Improvements were maintained at 6 months: EBV 56.3% versus SoC 3.2% (P < 0.001), with a mean +/- SD change in FEV1 at 6 months of 20.7 +/- 29.6% and -8.6 +/- 13.0%, respectively. A total of 89.8% of EBV subjects had target lobe volume reduction greater than or equal to 350 ml, mean 1.09 +/- 0.62 L (P < 0.001). Between-group differences for changes at 6 months were statistically and clinically significant: Delta EBV-SoC for residual volume, -700 ml; 6-minute-walk distance, +78.7 m; St. George's Respiratory Questionnaire score, -6.5 points; modified Medical Research Council dyspnea score, -0.6 points; and BODE(body mass index, airflow obstruction, dyspnea, and exercise capacity) index, 21.8 points (all P < 0.05). Pneumothorax was the most common adverse event, occurring in 19 of 65 (29.2%) of EBV subjects.

    Conclusions: EBV treatment in hyperinflated patients with heterogeneous emphysema without collateral ventilation resulted in clinically meaningful benefits in lung function, dyspnea, exercise tolerance, and quality of life, with an acceptable safety profile.

  • 35.
    Khalid, J. M.
    et al.
    Takeda Dev Ctr Europe, London, England..
    Mushnikov, V.
    EPID Res, Espoo, Finland..
    Johansson, Gunnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Backström, T.
    Takeda Pharma AB, Stockholm, Sweden..
    Korhonen, P.
    EPID Res, Espoo, Finland..
    Hoti, F.
    EPID Res, Espoo, Finland..
    Exacerbation Rates Among Severe COPD Patients Prescribed Roflumilast In Sweden During Year 20112015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 36.
    Larsson, A.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Johansson, T.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Lundin, S.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    Stenqvist, O.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    Can Lung Elastance Be Estimated Without The Use Of Esophageal Catheter?2015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 37.
    Larsson, Anders
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Johansson, T.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Stenqvist, O.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    Lundin, S.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    Different Estimates Of Respiratory Elastance. How Do They Relate?2015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 38.
    Larsson, Anders
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Johansson, T.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Stenqvist, O.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    Lundin, S.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    The Chest Wall Has Minimal Protecting Effect On The Lungs In Situations With High Airway Pressures2015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 39.
    Lisspers, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Larsson, K.
    Karolinska Inst, Solna, Sweden..
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Ställberg, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Gutzwiller, F. S.
    Novartis Pharma AG, Basel, Switzerland..
    Mezzi, K.
    Novartis Pharma AG, Basel, Switzerland..
    Uhde, M.
    QuintilesIMS, Stockholm, Sweden..
    Jorgensen, L.
    QuintilesIMS, Copenhagen, Denmark..
    Johansson, Gunnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Extent And Impact Of Late Versus Early COPD Diagnosis In Women In The Swedish Arctic Study2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, artikel-id A4705Artikel i tidskrift (Övrigt vetenskapligt)
  • 40.
    Lovric, G.
    et al.
    Paul Scherrer Inst, Swiss Light Source, Villigen, Switzerland.
    Broche, L.
    ESRF, Xray Imaging, Grenoble, France.
    Schleputz, C. M.
    Paul Scherrer Inst, Swiss Light Source, Villigen, Switzerland.
    Fardin, L.
    European Synchrotron Radiat Facil, Biomed Beamline ID17, Grenoble, France.
    Schittny, J. C.
    Univ Bern, Bern, Switzerland.
    Larsson, Anders S.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Bayat, S.
    Grenoble Univ Hosp Ctr, Dept Clin Physiol, Grenoble, France.
    Spatial Distribution of Ventilator Induced Lung Injury at the µm-Scale. An In-Vivo Synchrotron Phase-Contrast Microscopy Study in BALB/c Mic2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197Artikel i tidskrift (Övrigt vetenskapligt)
  • 41. Macsali, Ferenc
    et al.
    Real, Francisco Gomez
    Plana, Estel
    Sunyer, Jordi
    Anto, Josep
    Dratve, Julia
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Jarvis, Deborah
    Omenaas, Ernst Reidar
    Zemp, Elisabeth
    Wjst, Matthias
    Leynaert, Benedicte
    Svanes, Cecilie
    Early Age at Menarche, Lung Function, and Adult Asthma2011Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 183, nr 1, s. 8-14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Hormonal and metabolic status appears to influence lung health in women, and there are findings suggesting that early menarche may be related to asthma, cardiovascular disease, diabetes, and breast cancer. Objectives: This study investigates whether age at menarche is related to adult lung function and asthma. Methods: Among participants in the European Community Respiratory Health Survey II, 3,354 women aged 27-57 years from random population samples in 21 centers responded to a questionnaire concerning women's health (1998-2002). Of these women, 2,873 had lung function measurements, 2,136 had measurements of bronchial hyperreactivity, and 2,743 had IgE measurements. Logistic, linear, and negative binomial regression analyses included adjustment for age, height, body mass index, education, smoking, family size, and center. Measurements and Main Results: FEV1 and FVC were lower and asthma was more common in women with early menarche. Women reporting menarche at age 10 years or less, as compared with women with menarche at age 13 years (reference category), had lower FEV1 (adjusted difference, -113 ml; 95% confidence interval [CI], -196 to -33 ml) and FVC (-126 ml; 95% CI, -223 to -28 ml); also lower FEV1 expressed as a percentage of the predicted value (-3.28%; 95% CI, -6.25 to -0.30%) and FVC expressed as a percentage of the predicted value (-3.63%; 95% CI, -6.64 to -0.62%). Women with early menarche more often had asthma symptoms (odds ratio, 1.80; 95% CI, 1.09-2.97), asthma with bronchial hyperreactivity (odds ratio, 2.79; 95% CI, 1.06-7.34), and higher asthma symptom score (mean ratio, 1.58; 95% CI, 1.12-2.21). Conclusions: Women with early menarche had lower lung function and more asthma in adulthood. This supports a role for metabolic and hormonal factors in women's respiratory health.

  • 42. Macsali, Ferenc
    et al.
    Svanes, Cecilie
    Sothern, Robert B.
    Benediktsdottirs, Bryndis
    Bjorge, Line
    Dratva, Julia
    Franklin, Karl A.
    Holm, Mathias
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Johannessen, Ane
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Omenaas, Ernst R.
    Schlunssen, Vivi
    Zemp, Elizabeth
    Real, Francisco Gomez
    Menstrual Cycle and Respiratory Symptoms in a General Nordic-Baltic Population2013Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 187, nr 4, s. 366-373Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: There is little knowledge of variations in respiratory symptoms during the menstrual cycle in a general population, and potential modifying factors are not investigated. Objectives: To investigate menstrual cycle variation in respiratory symptoms in a large general population, using chronobiology methodology, and stratifying by body mass index (BMI), smoking, and asthma status. Methods: A total of 3,926 women with regular cycles less than or equal to 28 days and not taking exogenous sex hormones answered a postal questionnaire regarding the first day of their last menstruation and respiratory symptoms in the last 3 days. Moving 4-day means were computed to smooth uneven records of daily sampling; best-fitting 28-day composite cosine curves were applied to each time series to describe rhythmicity. Measurements and Main Results: Significant rhythmic variations over the menstrual cycle were found in each symptom for all subjects and subgroups. Wheezing was higher on cycle Days 10-22, with a midcycle dip near the time of putative ovulation (approximately Days 14-16)-in most subgroups. Shortness of breath was higher on days 7-21, with a dip just before midcycle in many subgroups. Cough was higher just after putative ovulation for subjects with asthma, BMI greater than or equal to 23 kg/m(2), and smokers, or just before ovulation and menses onset for low symptomatic subgroups. Conclusions: Respiratory symptoms varied significantly during the menstrual cycle and were most frequent from the midluteal to mid-follicular stages, often with a dip near the time of ovulation. The patterns varied by BMI, smoking, and asthma status. These relations link respiratory symptoms with hormonal changes through the menstrual cycle and imply a potential for individualized chronotherapy for respiratory diseases.

  • 43.
    Marchesi, Silvia
    et al.
    Akad Sjukhuset, Uppsala, Sweden.
    Hata, Aki
    Akad Sjukhuset, Uppsala, Sweden.
    Larsson, Anders
    Akad Sjukhuset, Uppsala, Sweden.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi. Akad Sjukhuset, Uppsala, Sweden.
    Abdominal Edema and Inflammation in a Ventilator-Induced Lung Injury Model: Comparison Between Spontaneous Breathing and Mechanical Ventilation2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193, artikel-id A5224Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    RATIONALE. The amount of abdominal edema and inflammation were investigated in a porcine model of ventilator-induced lung injury,VILI, and potential differences between spontaneously breathing and mechanically ventilated animals were studied.METHODS. Twelve piglets were submitted to a double hit lung injury. Five lung lavages with warm saline were followed by one hour ofinjurious ventilation: peak airway pressure 32 cmH2O, PEEP 0 and oxygen fraction (FIO2) 1. The animals were randomized into two groups:1. Mechanical ventilation (MV) group (tidal volume: 6 ml/kg, PEEP 15, respiratory rate around 40 and FIO2 0,5); 2. Spontaneous breathing(SB) group (CPAP mode with PEEP 15 and FIO2 0,5). Remifentanil infusion was provided in the SB group, to maintain analgesia while stillenabling spontaneous breathing.After six hours, the piglets were sacrificed and samples from intestine, liver and spleen were collected for histopathological analysis ofinflammation and measurement of wet-dry weight ratio to quantitate the degree of edema.RESULTS. No difference in hemodynamic parameters was observed between the groups.Tidal volume was slightly higher in the SB group (7,3 vs 6 ml/kg in the MV group). Respiratory rate was similar in both groups.Arterial oxygen pressure-fraction (P/F) ratio was higher in spontaneously breathing animals 5 hours after creation of VILI (Group 1: 455 ±27; Group 2: 506 ± 34; p < 0,05). The spontaneous breathing group returned to baseline values of P/F on an average of 3,3 hours (only oneanimal did not reach the baseline value). In the mechanical ventilation group only two animals reached the baseline value during theobservation period of 5 hours.Acute inflammation was present in all three studied abdominal organs and tended to be higher in intestine (Fig. 1) in the MV than SBgroup, but with no difference in liver or spleen. The wet-dry weight ratio showed no difference between the groups.CONCLUSION. The difference in P/F ratio may suggest that the animals on SB with high CPAP recovered faster than the MV group from thelung injury.The tendency to less intestinal inflammation in the SB than MV group may suggest reduced spread of inflammation from the lung and/orbetter intestinal immune response during SB.

  • 44.
    Marchesi, Silvia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Larsson, A.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Ahlgren, Kerstin M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Autoimmunitet.
    Lattuada, M.
    Policlin Milano, Milan, Italy..
    Ortiz-Nieto, Francisco
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Enhanced Abdominal Inflammation In Acute Respiratory Failure - Is The Culprit Ventilator Associated Abdominal Edema Or Inadequate Perfusion?: A Magnetic Resonance Imaging Pilot Study2015Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 45.
    Mogensen, Ida
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Alving, Kjell
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Fonseca, J. A.
    CINTESIS, Oporto, Portugal..
    Jacinto, T.
    CINTESIS, Oporto, Portugal..
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Malinovschi, Andrei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Simultaneously Elevated Fraction Of Exhaled Nitric Oxide And Blood Eosinophil Counts Relates To Recent Asthma Events2016Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikel i tidskrift (Refereegranskat)
  • 46.
    Morais, C. C. A.
    et al.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Plens, G.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Tucci, M. R.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Yoshida, T.
    Hosp Sick Children, Toronto, ON, Canada..
    Batista Borges, João
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Ramos, O. P.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Pereira, S. M.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Lima, C. A. S.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Gomes, S.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Melo, M. Vidal
    Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA USA..
    Amato, M. B. P.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Costa, E. L. V.
    Univ Sao Paulo, Fac Med, Hosp Clin, Pulm Div,Heart Inst InCor, Sao Paulo, Brazil..
    Higher Positive End-Expiratory Pressures Affect The Distribution Of Lung Inflammation During Spontaneous Breathing In An Experimental Model Of Severe Acute Respiratory Distress Syndrome2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, artikel-id A7669Artikel i tidskrift (Övrigt vetenskapligt)
  • 47.
    Morais, Caio C. A.
    et al.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Koyama, Yukiko
    Osaka Univ Hosp, Intens Care Unit, Suita, Osaka, Japan.
    Yoshida, Takeshi
    Osaka Univ Hosp, Intens Care Unit, Suita, Osaka, Japan;Univ Toronto, Hosp Sick Children, Dept Crit Care Med & Anesthesia, Translat Med, 686 Bay St, Toronto, ON M5G 0A4, Canada.
    Plens, Glauco M.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Gomes, Susimeire
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Lima, Cristhiano A. S.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Ramos, Ozires P. S.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Pereira, Sergio M.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Kawaguchi, Naomasa
    Osaka Univ, Sch Allied Hlth Sci, Dept Pathol, Grad Sch Med, Suita, Osaka, Japan.
    Yamamoto, Hirofumi
    Osaka Univ, Sch Allied Hlth Sci, Dept Pathol, Grad Sch Med, Suita, Osaka, Japan.
    Uchiyama, Akinori
    Osaka Univ Hosp, Intens Care Unit, Suita, Osaka, Japan.
    Batista Borges, João
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Melo, Marcos F. Vidal
    Harvard Univ, Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA USA.
    Tucci, Mauro R.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Amato, Marcelo B. P.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Kavanagh, Brian P.
    Univ Toronto, Hosp Sick Children, Dept Crit Care Med & Anesthesia, Translat Med, 686 Bay St, Toronto, ON M5G 0A4, Canada.
    Costa, Eduardo L. V.
    Univ Sao Paulo, Fac Med, Hosp Clin, Div Pneumol,Inst Coracao Incor, Sao Paulo, Brazil.
    Fujino, Yuji
    Osaka Univ Hosp, Intens Care Unit, Suita, Osaka, Japan.
    High Positive End-Expiratory Pressure Renders Spontaneous Effort Noninjurious2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197, nr 10, s. 1285-1296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: In acute respiratory distress syndrome (ARDS), atelectatic solid-like lung tissue impairs transmission of negative swings in pleural pressure (Ppl) that result from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions (e.g., nondependent lung [pendelluft]) or from the ventilator. Lowering the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort noninjurious.

    Objectives: To determine whether spontaneous effort increases dependent lung injury, and whether such injury would be reduced by recruiting atelectatic solid-like lung with positive end-expiratory pressure (PEEP).

    Methods: Established models of severe ARDS (rabbit, pig) were used. Regional histology (rabbit), inflammation (positron emission tomography; pig), regional inspiratory Ppl (intrabronchial balloon manometry), and stretch (electrical impedance tomography; pig) were measured. Respiratory drive was evaluated in 11 patients with ARDS.

    Measurements and Main Results: Although injury during muscle paralysis was predominantly in nondependent and middle lung regions at low (vs. high) PEEP, strong inspiratory effort increased injury (indicated by positron emission tomography and histology) in dependent lung. Stronger effort (vs. muscle paralysis) caused local overstretch and greater tidal recruitment in dependent lung, where more negative Ppl was localized and greater stretch was generated. In contrast, high PEEP minimized lung injury by more uniformly distributing negative Ppl, and lowering the magnitude of spontaneous effort (i.e., deflection in esophageal pressure observed in rabbits, pigs, and patients).

    Conclusions: Strong effort increased dependent lung injury, where higher local lung stress and stretch was generated; effort-dependent lung injury was minimized by high PEEP in severe ARDS, which may offset need for paralysis.

  • 48.
    Neuman, Åsa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik. Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden..
    Hohmann, Cynthia
    Charite Univ Med Ctr, Inst Social Med Epidemiol & Hlth Econ, Berlin, Germany..
    Orsini, Nicola
    Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden..
    Pershagen, Goran
    Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden.;Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden..
    Eller, Esben
    Odense Univ Hosp, Dept Dermatol, DK-5000 Odense, Denmark.;Odense Univ Hosp, Allergy Ctr, DK-5000 Odense, Denmark..
    Kjaer, Henrik Fomsgaard
    Odense Univ Hosp, Hans Christian Andersen Childrens Hosp, DK-5000 Odense, Denmark..
    Gehring, Ulrike
    Univ Utrecht, IRAS, Utrecht, Netherlands..
    Granell, Raquel
    Univ Bristol, Sch Social & Community Med, Bristol, Avon, England..
    Henderson, John
    Univ Bristol, Sch Social & Community Med, Bristol, Avon, England..
    Heinrich, Joachim
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 1, Neuherberg, Germany..
    Lau, Susanne
    Charite Univ Med Ctr, Dept Pediat Pneumol & Immunol, Berlin, Germany..
    Nieuwenhuijsen, Mark
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain.;CIBERESP, Barcelona, Spain.;IMIM Hosp del Mar Inst, Barcelona, Spain..
    Sunyer, Jordi
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain.;CIBERESP, Barcelona, Spain.;IMIM Hosp del Mar Inst, Barcelona, Spain.;UPF, Barcelona, Spain..
    Tischer, Christina
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 1, Neuherberg, Germany..
    Torrent, Maties
    CIBERESP, Barcelona, Spain.;Ib Salut, Area Salut Menorca, Palma De Mallorca, Spain..
    Wahn, Ulrich
    Charite Univ Med Ctr, Dept Pediat Pneumol & Immunol, Berlin, Germany..
    Wijga, Alet H.
    Natl Inst Publ Hlth & Environm RIVM, Ctr Prevent & Hlth Serv Res, Bilthoven, Netherlands..
    Wickman, Magnus
    Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden.;Karolinska Inst, Sachs Childrens Hosp, Dept Paediat, Stockholm, Sweden..
    Keil, Thomas
    Charite Univ Med Ctr, Inst Social Med Epidemiol & Hlth Econ, Berlin, Germany..
    Bergstrom, Anna
    Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden..
    the ENRICO, Consortium
    Maternal Smoking in Pregnancy and Asthma in Preschool Children A Pooled Analysis of Eight Birth Cohorts2012Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 186, nr 10, s. 1037-1043Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Although epidemiological studies suggest that exposure to maternal smoking during fetal and early life increases the risk of childhood wheezing and asthma, previous studies were not able to differentiate the effects of prenatal from postnatal exposure. Objectives: To assess the effect of exposure to maternal smoking only during pregnancy on wheeze and asthma among preschool-age children. Methods: A pooled analysis was performed based on individual participant data from eight European birth cohorts. Cohort-specific effects of maternal smoking during pregnancy, but not during the first year, on wheeze and asthma at 4 to 6 years of age were estimated using logistic regression and then combined using a random effects model. Adjustments were made for sex, parental education, parental asthma, birth weight, and siblings. Measurements and Main Results: Among the 21,600 children included in the analysis, 735 children (3.4%) were exposed to maternal smoking exclusively during pregnancy but not in the first year after birth. In the pooled analysis, maternal smoking only during pregnancy was associated with wheeze and asthma at 4 to 6 years of age, with adjusted odds ratios of 1.39 (95% confidence interval, 1.08-1.77) and 1.65 (95% confidence interval, 1.18-2.31), respectively. The likelihood to develop wheeze and asthma increased statistically significantly in a linear dose-dependent manner in relation to maternal daily cigarette consumption during the first trimester of pregnancy. Conclusions: Maternal smoking during pregnancy appears to increase the risk of wheeze and asthma among children who are not exposed to maternal smoking after birth.

  • 49.
    Pellegrini, Mariangela
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Roneus, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Larsson, Anders S.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Perchiazzi, Gaetano
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Onset and Magnitude of Pendelluft During Spontaneous Breathing Depend on Lung Volume2018Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197Artikel i tidskrift (Övrigt vetenskapligt)
  • 50.
    Pellegrini, Mariangela
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Univ Bari, Dept Emergency & Organ Transplant, Bari, Italy.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Roneus, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Segelsjö, Monica
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Perchiazzi, Gaetano
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Univ Bari, Dept Emergency & Organ Transplant, Bari, Italy.
    The Diaphragm Acts as a Brake During Expiration to Prevent Lung Collapse2017Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, nr 12, s. 1608-1616Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: The diaphragm is the major inspiratory muscle and is assumed to relax during expiration. However, electrical postinspiratory activity has been observed. Whether there is an expiratory diaphragmatic contraction that preserves lung patency has yet to be explored.

    Objectives: We hypothesized the occurrence of an expiratory diaphragmatic contraction directed at stabilizing peripheral airways and preventing or reducing cyclic expiratory lung collapse.

    Methods: Mild acute respiratory distress syndrome was induced in 10 anesthetized, spontaneously breathing pigs. Lung volume was decreased by lowering end-expiratory airway pressure in a stepwise manner. We recorded the diaphragmatic electric activity during expiration, dynamic computed tomographic scans, and respiratory mechanics. In five pigs, the same protocol was repeated during mechanical ventilation after muscle paralysis.

    Measurements and Main Results: Diaphragmatic electric activity during expiration increased by decreasing end-expiratory lung volume during spontaneous breathing. This enhanced the diaphragm muscle force, to a greater extent with lower lung volume, indicating a diaphragmatic electromechanical coupling during spontaneous expiration. In turn, the resulting diaphragmatic contraction delayed and reduced the expiratory collapse and increased lung aeration compared with mechanical ventilation with muscle paralysis and absence of diaphragmatic activity.

    Conclusions: The diaphragm is an important regulator of expiration. Its expiratory activity seems to preserve lung volume and to protect against lung collapse. The loss of diaphragmatic expiratory contraction during mechanical ventilation and muscle paralysis may be a contributing factor to unsuccessful respiratory support.

12 1 - 50 av 71
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf