uu.seUppsala University Publications
Change search
Refine search result
1 - 23 of 23
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the 'Create feeds' function.
  • 1.
    Almgren, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology.
    Wickerts, Carl-Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology.
    Heinonen, Erkki
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology.
    Högman, Marieann
    Side effects of endotracheal suction in pressure and volume controlled ventilation2004In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 125, no 3, p. 1077-1080Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVES:

    To investigate the effects of endotracheal suction in volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) with an open suction system (OSS) or a closed suction system (CSS).

    DESIGN:

    Randomized comparison.

    SETTING:

    Animal research laboratory.

    PATIENTS:

    Twelve healthy anesthetized pigs.

    INTERVENTIONS:

    The effects of endotracheal suction during VCV and PCV with tidal volume (VT) of 14 mL/kg were compared. A 60-mm inner-diameter endotracheal tube was used. Ten-second suction was performed using OSS and CSS with 12F and 14F catheters connected to - 14 kPa vacuum.

    MEASUREMENTS AND RESULTS:

    Thirty minutes after suction in PCV, VT was still decreased by 27% (p < 0.001), compliance (Crs) by 28% (p < 0.001), and PaO(2) by 26% (p < 0.001); PaCO(2) was increased by 42% (p < 0.0001) and venous admixture by 158% (p = 0.003). Suction in VCV affected only Crs (decreased by 23%, p < 0.001) and plateau pressure (increased by 24%, p < 0.001). The initial impairment of gas exchange following suction in VCV was no longer statistically significant after 30 min.

    CONCLUSIONS:

    In conclusion, endotracheal suction causes lung collapse leading to impaired gas exchange, an effect that is more severe and persistent in PCV than in VCV.

  • 2.
    Appelberg, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Pavlenko, Tatjana
    Bergman, Henrik
    Rothen, Hans Ulrich
    Hedenstierna, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Lung aeration during sleep2007In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 131, no 1, p. 122-129Article in journal (Refereed)
    Abstract [en]

    Background: During sleep, ventilation and functional residual capacity (FRC) decrease slightly. This study addresses regional lung aeration during wakefulness and sleep. Methods: Ten healthy subjects underwent spirometry awake and with polysomnography, including pulse oximetry, and also CT when awake and during sleep. Lung aeration in different lung regions was analyzed. Another three subjects were studied awake to develop a protocol for dynamic CT scanning during breathing. Results: Aeration in the dorsal, dependent lung region decreased from a mean of 1.14 ± 0.34 mL (± SD) of gas per gram of lung tissue during wakefulness to 1.04 ± 0.29 mL/g during non-rapid eye movement (NREM) sleep (- 9%) [p = 0.034]. In contrast, aeration increased in the most ventral, nondependent lung region, from 3.52 ± 0.77 to 3.73 ± 0.83 mL/g (+ 6%) [p = 0.007]. In one subject studied during rapid eye movement (REM) sleep, aeration decreased from 0.84 to 0.65 mL/g (- 23%). The fall in dorsal lung aeration during sleep correlated to awake FRC (R2 = 0.60; p = 0.008). Airway closure, measured awake, occurred near and sometimes above the FRC level. Ventilation tended to be larger in dependent, dorsal lung regions, both awake and during sleep (upper region vs lower region, 3.8% vs 4.9% awake, p = 0.16, and 4.5% vs 5.5% asleep, p = 0.09, respectively). Conclusions: Aeration is reduced in dependent lung regions and increased in ventral regions during NREM and REM sleep. Ventilation was more uniformly distributed between upper and lower lung regions than has previously been reported in awake, upright subjects. Reduced respiratory muscle tone and airway closure are likely causative factors.

  • 3.
    Benedict, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Link Between Short Sleep and Obesity in Humans A Matter of Age?2013In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 144, no 2, p. 711-711Article in journal (Refereed)
  • 4. Betsuyaku, Tomoko
    et al.
    Nishimura, Masaharu
    Takeyabu, Kimihiro
    Tanino, Mishie
    Venge, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Xu, S
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Kawakami, Yoshikazu
    Evidence for neutrophil involvement in the development of subclinical emphysema2000In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 117, no 5 Suppl 1, p. 302S-303SArticle in journal (Refereed)
  • 5. Ehrs, Per-Olof
    et al.
    Nokela, Mika
    Ställberg, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
    Hjemdahl, Paul
    Wikström Jonsson, Eva
    Brief questionnaires for patient-reported outcomes in asthma: validation and usefulness in a primary care setting2006In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 129, no 4, p. 925-932Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES AND DESIGN: Health-related quality of life (QoL) instruments are generally used for studies of asthma in specialized settings. For primary care use, there is a need for brief and simple questionnaires for structured patient-reported outcomes. We validated the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), using the Asthma Quality of Life Questionnaire with standardized activities (AQLQ[S]) as the "gold standard." The Asthma Control Questionnaire (ACQ) was validated against the symptoms domain of the AQLQ(S). Patients were characterized by the Short Form-36 Health Survey (SF-36).

    SUBJECTS: One hundred eight patients (68 women) with asthma diagnosed by their physicians from 24 primary care centers completed two visits (2 to 3 months apart). Their mean SF-36 scores were lower than the national norm for all domains.

    RESULTS: The Mini-AQLQ and ACQ correlated well with the AQLQ(S). Reliability, determined in 57 patients with stable AQLQ(S) scores, was good. Both brief questionnaires detected improvement or deterioration of patients at the group level. Global ratings of disease severity by patients or clinicians correlated poorly with disease-specific QoL scores.

    CONCLUSIONS: The Mini-AQLQ and ACQ instruments are sufficiently simple and robust to be suitable for research and quality of care monitoring in primary care at the group level. They may, after further validation, even be useful in the management of individual patients.

  • 6. Engström, Gunnar
    et al.
    Gerhardsson de Verdier, Maria
    Dahlbäck, Magnus
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    BP Variability and Cardiovascular Autonomic Function in Relation to Forced Expiratory Volume: A Population-Based Study2009In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 136, no 1, p. 177-183Article in journal (Refereed)
    Abstract [en]

    Background Cardiovascular autonomic dysfunction is associated with increased incidence of cardiovascular diseases (CVD). This population-based study explored whether low FEV(1) or low vital capacity (VC) is associated with autonomic dysfunction, as measured by the spontaneous heart rate variability (HRV) and systolic BP variability (SBPV). Methods SBPV and HRV were recorded during 5 min of controlled breathing in men and women, aged 70 years. FEV(1) and VC were recorded in 901 subjects. Of them, information on HRV and SBPV was available in 820 and 736 subjects, respectively. Measures of autonomic function, ie, SBPV in the low-frequency (LF) and high-frequency (HF) domains, HRV and baroreceptor sensitivity (BRS), were studied in sex-specific quartiles of FEV1 and VC. Results Low FEV(1) was associated with high SBPV in the HF domain. Mean SBPV-HF was 5.2, 4.5, 4.1 and 3.8 mm Hg, respectively, in subjects with FEV(1) in the first (low), second, third and fourth quartile (trend: p < 0.001). This relationship persisted after adjustments for potential confounding factors. Low VC was significantly associated with high SBPV-HF in the crude analysis, but not after adjustment for confounding factors. Neither FEV(1) nor VC showed any significant relationship with BRS, HRV or SBPV in the LF domain. Conclusion In this population-based study, low FEV(1) was associated with high systolic BP variability in the HF domain. It is suggested that high beat-to-beat variability in BP could contribute to the increased cardiovascular risk in subjects with moderately reduced FEV(1).

  • 7. Fazio, Nicola
    et al.
    Granberg, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrine Oncology.
    Grossman, Ashley
    Saletan, Stephen
    Klimovsky, Judith
    Panneerselvam, Ashok
    Wolin, Edward M.
    Everolimus Plus Octreotide Long-Acting Repeatable in Patients With Advanced Lung Neuroendocrine Tumors Analysis of the Phase 3, Randomized, Placebo-Controlled RADIANT-2 Study2013In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 143, no 4, p. 955-962Article in journal (Refereed)
    Abstract [en]

    Background: The incidence of neuroendocrine tumors (NETs) has increased approximately fivefold since the 1980s. A similar increase in the incidence of lung NETs has been reported, but therapy has not been optimized. Methods: This exploratory subanalysis evaluated the efficacy and safety of everolimus plus octreotide long-acting repeatable (LAIR) in a cohort of patients with low- to intermediate-grade advanced lung NET from the phase 3, randomized, placebo-controlled RADIANT-2 (RAD001 in Advanced Neuroendocrine Tumors) study. The primary end point was progression-free survival (PFS). Secondary end points included objective response rate, overall survival, change from baseline in biomarker levels, and safety outcomes. Results: Patients were randomly assigned to everolimus plus octreotide LAIR (n = 33) or placebo plus octreotide LAIR (n = 11). Median PFS was 13.63 months in the everolimus plus octreotide LAIR arm compared with 5.59, months in the placebo plus octreotide LAIR arm (relative risk for progression: HR, 0.72; 95% CI, 0.31-1.68; P = .228). More patients receiving everolimus plus octreotide LAR (67%) experienced minor tumor shrinkage (not partial response as per RECIST [Response Evaluation Criteria in Solid Tumors]) than those receiving placebo plus octreotide LAIR (27%). Most frequently reported adverse events (AEs) included stomatitis, rash, diarrhea, and asthenia. This was consistent with the overall RADIANT-2 trial and the safety profile of everolimus. Conclusions: This exploratory subgroup analysis of the RADIANT-2 trial indicates that in patients with advanced lung NET, the addition of everolimus to octreotide LAIR improves median PFS by 2.4-fold compared with placebo plus octreotide LAIR. These clinically significant observations support the continued evaluation of everolimus treatment regimens in this patient population. Trial registry: ClinicalTrials.gov; No.: NCT00412061; PRL: www.clinicaltrials.gov CHEST 2013; 143(4):955-962

  • 8. García Rodríguez, Luis A
    et al.
    Ruigómez, Ana
    Martín-Merino, Elisa
    Johansson, Saga
    Wallander, Mari-Ann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Relationship between gastroesophageal reflux disease and COPD in UK primary care2008In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 134, no 6, p. 1223-1230Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gastroesophageal reflux symptoms may be more common in patients with COPD than in control subjects. The aim of this study was to investigate the relationship between diagnoses of COPD and gastroesophageal reflux disease (GERD) in primary care. METHODS: We used the UK General Practice Research Database to identify a cohort of patients with a first diagnosis of GERD (n = 4,391) and another cohort of patients with a first diagnosis of COPD (n = 1,628) during 1996, which we compared with age-matched and sex-matched comparison cohorts without either diagnosis. We calculated the incidence of a GERD diagnosis among the patients with COPD and control subjects, and of a COPD diagnosis among the patients with GERD and control subjects. We also calculated the relative risk (RR) estimates of these diagnoses using the Mantel-Haenszel test. Risks associated with medication use, comorbidities, and demographic and lifestyle factors were examined using a nested case-control analysis. RESULTS: During the 5-year follow-up, the RR of an incident COPD diagnosis in patients with a diagnosis of GERD was 1.17 (95% confidence interval [CI], 0.91 to 1.49), while the RR of an incident GERD diagnosis among patients with a diagnosis of COPD was 1.46 (95% CI, 1.19 to 1.78). A COPD diagnosis was associated with current or former smoking, prior diagnosis of asthma, or the use of asthma medication. A GERD diagnosis was associated with a prior diagnosis of ischemic heart disease. CONCLUSIONS: Patients with a diagnosis of COPD are at a significantly increased risk of a diagnosis of GERD compared with individuals with no COPD diagnosis.

  • 9. Geerts, William H.
    et al.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Pineo, Graham F.
    Heit, John A.
    Samama, Charles M.
    Lassen, Michael R.
    Colwell, Clifford W.
    Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)2008In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 133, no 6 Suppl, p. 381S-453SArticle, review/survey (Refereed)
    Abstract [en]

    This article discusses the prevention of venous thromboembolism (VTE) and is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 recommendations are strong and indicate that the benefits do or do not outweigh risks, burden, and costs. Grade 2 suggestions imply that individual patient values may lead to different choices (for a full discussion of the grading, see the "Grades of Recommendation" chapter by Guyatt et al). Among the key recommendations in this chapter are the following: we recommend that every hospital develop a formal strategy that addresses the prevention of VTE (Grade 1A). We recommend against the use of aspirin alone as thromboprophylaxis for any patient group (Grade 1A), and we recommend that mechanical methods of thromboprophylaxis be used primarily for patients at high bleeding risk (Grade 1A) or possibly as an adjunct to anticoagulant thromboprophylaxis (Grade 2A). For patients undergoing major general surgery, we recommend thromboprophylaxis with a low-molecular-weight heparin (LMWH), low-dose unfractionated heparin (LDUH), or fondaparinux (each Grade 1A). We recommend routine thromboprophylaxis for all patients undergoing major gynecologic surgery or major, open urologic procedures (Grade 1A for both groups), with LMWH, LDUH, fondaparinux, or intermittent pneumatic compression (IPC). For patients undergoing elective hip or knee arthroplasty, we recommend one of the following three anticoagulant agents: LMWH, fondaparinux, or a vitamin K antagonist (VKA); international normalized ratio (INR) target, 2.5; range, 2.0 to 3.0 (each Grade 1A). For patients undergoing hip fracture surgery (HFS), we recommend the routine use of fondaparinux (Grade 1A), LMWH (Grade 1B), a VKA (target INR, 2.5; range, 2.0 to 3.0) [Grade 1B], or LDUH (Grade 1B). We recommend that patients undergoing hip or knee arthroplasty or HFS receive thromboprophylaxis for a minimum of 10 days (Grade 1A); for hip arthroplasty and HFS, we recommend continuing thromboprophylaxis > 10 days and up to 35 days (Grade 1A). We recommend that all major trauma and all spinal cord injury (SCI) patients receive thromboprophylaxis (Grade 1A). In patients admitted to hospital with an acute medical illness, we recommend thromboprophylaxis with LMWH, LDUH, or fondaparinux (each Grade 1A). We recommend that, on admission to the ICU, all patients be assessed for their risk of VTE, and that most receive thromboprophylaxis (Grade 1A).

  • 10. Guida, Giuseppe
    et al.
    Rolla, Giovanni
    Badiu, Iuliana
    Marsico, Pietro
    Pizzimenti, Stefano
    Bommarito, Luisa
    De Stefani, Antonella
    Usai, Antonio
    Bugiani, Massimiliano
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Bucca, Caterina
    Heffler, Enrico
    Determinants of Exhaled Nitric Oxide in Chronic Rhinosinusitis2010In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 137, no 3, p. 658-664Article in journal (Refereed)
    Abstract [en]

    Background:

    Chronic rhinosinusitis (CRS) has been reported to be associated with increased values of exhaled nitric oxide (ENO), which could not be entirely explained by the association between CRS and asthma. The aim of this study was to investigate the variables associated with increased ENO in patients with CRS.

    Methods:

    This was a prospective cross-sectional descriptive study of 93 consecutive patients with CRS. The effect on ENO of age, gender, atopy, asthma, respiratory symptoms without bronchial hyperresponsiveness (BHR), and nasal polyps was evaluated by multiple regression analysis.

    Results:

    Nasal polyps (P=.01), asthma (P<.001), and respiratory symptoms without BHR (P=.01) were the only independent variables associated with increased ENO. The prevalence of asthma was significantly higher in subjects with nasal polyps (61% vs 29.4%), P=.005, whereas the prevalence of respiratory symptoms without BHR was higher in those without nasal polyps (44.1% vs 15.3%, P=.003). Respiratory symptoms without BHR were associated with significantly higher ENO and prevalence of sputum eosinophilia (eosinophils>3%) in patients with nasal polyps compared with those without nasal polyps (68.2 vs 24.0 ppb, P=.001; 60% vs 8.3%, P=.03, respectively).

    Conclusions:

    The presence of nasal polyps in patients with CRS was associated with increased asthma prevalence as well as increased ENO levels. Respiratory symptoms without BHR were associated with eosinophilic airway inflammation and increased ENO only in patients with nasal polyps. These findings suggest important clinical and biologic differences between the two types of CRS, with and without nasal polyps.

  • 11.
    Johansson, G
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Ställberg, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Tornling, G
    Andersson, S
    Karlsson, G
    Fält, K
    Berggren, F
    Asthma treatment preference study: a conjoint analysis of preferred drug treatments2004In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 125, p. 916-923Article in journal (Refereed)
  • 12.
    Johansson, Gunnar
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Ställberg, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Tornling, Göran
    Andersson, Stina
    Karlsson, Göran S
    Fält, Krister
    Berggren, Fredrik
    Asthma treatment preference study: a conjoint analysis of preferred drug treatments2004In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 125, no 3, p. 916-923Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    Assessment of patient preferences for attributes of asthma treatments.

    METHODS:

    Two hundred ninety-eight patients (age range, 18 to 60 years) from 15 centers in Sweden completed a questionnaire concerning their asthma, and ranked 18 alternative treatments using conjoint analysis. Patients were receiving treatment with either inhaled corticosteroids (ICS) and short-acting bronchodilator (n = 123) or ICS and long-acting bronchodilator (separate inhalers, n = 87; combination inhaler, n = 88). Attributes analyzed were maintenance treatment, additional reliever, time to onset and duration of reliever, number of symptom-free days (SFDs) per month, and out-of-pocket cost per month.

    RESULTS:

    Conjoint analysis showed that the most important aspect of treatment was SFD. Forty percent of the patients had <or= 15 SFDs per month. Eighty-five percent of the patients preferred another treatment over their current treatment. Treatment preferences were heterogeneous, and in 78% were not covered by current treatment guidelines. A total of 148 patients (50%) preferred a combination inhaler to separate inhalers, and 233 patients (78%) preferred a reliever that is both rapid and long acting. The most preferred treatment was a combination inhaler for maintenance and reliever use. On average, the patients were willing to pay an additional 328 Swedish krona [36 US dollars] per month for the change to the preferred treatment.

    CONCLUSION:

    SFDs were the most important attribute in asthma treatment. Patients were willing to pay for a switch to their preferred treatment. The most favored treatments were a reliever therapy that is both rapid and long acting and a combination inhaler for both maintenance and as-needed use.

  • 13. Lehtimaki, Lauri
    et al.
    Cristescu, Simona M.
    Van Muylem, Alain
    Högman, Marieann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Dinh-Xuan, Anh Tuan
    How to Assess Alveolar Nitric Oxide A Quest of the Grail?2014In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 146, no 6, p. E234-E235Article in journal (Refereed)
  • 14.
    Lindberg, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Theorell-Haglöw, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Svensson, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Gislason, Thorarinn
    Berne, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Sleep apnea and glucose metabolism: a long-term follow-up in a community-based sample2012In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 142, no 4, p. 935-942Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-ups are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after more than 10 years.

    METHODS:

    Men without diabetes (n=141, mean age 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements and blood sampling. Insulin resistance was quantified using the homeostasis model assessment (HOMA). ΔHOMA-IR was calculated as (HOMA-IR(follow-up) - HOMA-IR(baseline)). An oral glucose tolerance test was performed in 113 men to calculate the insulin sensitivity index (ISI).

    RESULTS:

    The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At the follow-up, 23 men had diabetes. An oxygen desaturation index (ODI) of >5 was a predictor of developing diabetes (adj. OR 4.4, 95% CI 1.1-18.1 after adjusting for age, BMI(baseline,) ΔBMI, hypertension and years with CPAP during the period). The ODI was inversely related to the ISI at the follow-up (r= -0.27, p=0.003). A deterioration in HOMA-IR was significantly related to all variables of sleep-disordered breathing (AHI, AHI>5, ODI, ODI>5 and MinSaO2) even when adjusting for confounders. When excluding the variable "years on CPAP" from the multivariate model, all associations weakened.

    CONCLUSIONS:

    SDB is independently related to the development of insulin resistance and thereby the risk of manifest diabetes mellitus.

  • 15. Lubenow, Norbert
    et al.
    Kempf, Reiner
    Eichner, Angelika
    Eichler, Petra
    Carlsson, Lena E
    Greinacher, Andreas
    Heparin-induced thrombocytopenia: temporal pattern of thrombocytopenia in relation to initial use or reexposure to heparin.2002In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 122, no 1, p. 37-42Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVES: Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction associated with a decrease of platelet counts that usually begins after at least 5 days of heparin treatment. Uncertainty exists about the risk of early onset of HIT (ie, < 5 days) in relation to previous heparin exposure. We therefore analyzed the temporal pattern of thrombocytopenia in patients with laboratory-confirmed HIT to assess whether patients with previous heparin exposure have an increased risk of early onset of HIT.

    DESIGN: Platelet count patterns in patients with a laboratory-confirmed diagnosis of HIT were examined in a retrospective chart review of a clinical study database. The onset of thrombocytopenia < 100 x 10(9)/L associated with the current heparin treatment (mainly unfractionated heparin) was analyzed using nonparametric maximum likelihood estimation.

    RESULTS: A total of 119 patients with 125 treatment episodes were assessed: HIT developed in 79 patients during initial exposure to heparin, and in 46 patients during reexposure. Early onset (< 5 days) of thrombocytopenia was associated with very recent heparin exposure. Patients reexposed to heparin within 3 months had an earlier onset of thrombocytopenia as compared to patients reexposed to heparin after 3 months (4.9 +/- 4.4 days vs 11.5 +/- 5.5 days [mean +/- SD], p = 0.001). There was no difference between onset on thrombocytopenia < 100 x 10(9)/L in patients reexposed to heparin within 3 to 12 months and after 1 year (9.7 +/- 6.4 days vs 12.3 +/- 5.2 days, p = 0.41). Whether platelet counts were obtained daily or less regularly did not affect the analysis.

    CONCLUSION: Early onset of thrombocytopenia in HIT is associated with recent heparin treatment (< 3 months). In contrast, for patients who did not receive heparin within the previous 3 months, HIT is an unlikely explanation for thrombocytopenia that occurs within the first 5 days.

  • 16. Nordenstedt, H
    et al.
    Nilsson, M
    Johansson, Saga
    Wallander, Mari-Ann
    AstraZeneca R&D , Mölndal.
    Johnsen, R
    Hveem, K
    Lagergren, J
    The relation between gastroesophageal reflux and respiratory symptoms in a population-based study: the Nord-Tröndelag health survey2006In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 129, no 4, p. 1051-1056Article in journal (Refereed)
    Abstract [en]

    Background

     In spite of numerous investigations, the relation between respiratory symptoms and reflux symptoms in the general population remains unclear, since population-based studies are few.

    Study objectives

     To investigate the relation between respiratory symptoms and reflux symptoms in the population.

    Subject and methods

     In a cohort of 65,363 individuals representing 71.2% of the adult population in the Norwegian county of Nord-Trøndelag, 58,596 individuals (89.6%) responded to questions concerning reflux symptoms. The 3,153 persons (5.4%) with severe and recurrent reflux symptoms constituted the case group, and the 40,210 persons (68.6%) without reflux symptoms served as the control group. Odds ratios (ORs) with 95% confidence intervals (CIs) represented relative risks. Potential confounding was tested in multivariable logistic regression analysis.

    Results

     Persons with asthma had reflux to a 60% greater extent than those without asthma after including adjustment for asthma medication (OR, 1.6; 95% CI, 1.4 to 1.9). There was a statistically significant dose-response association between breathlessness and reflux symptoms (p for trend < 0.0001), and the OR of severe breathlessness was 12.0 (95% CI, 9.5 to 15.2). Persons with heavy and wheezy breathing, daily cough, daily productive cough, or chronic cough showed a twofold to threefold statistically significant increase in risk of reflux symptoms. Adjustment for asthma or use of asthma medication did not substantially influence the risk estimates for any of the studied respiratory disorders.

    Conclusions

     Reflux symptoms commonly coexist with asthma and other respiratory symptoms on a population-based level, seemingly irrespective of asthma medication.

  • 17. Rabe, Klaus F.
    et al.
    Pizzichini, Emilio
    Ställberg, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
    Romero, Santiago
    Balanzat, Ana M.
    Atienza, Tito
    Lier, Per Arve
    Jorup, Carin
    Budesonide/formoterol in a single inhaler for maintenance and relief in mild-to-moderate asthma: a randomized, double-blind trial2006In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 129, no 2, p. 246-256Article in journal (Refereed)
    Abstract [en]

    Study objective: To compare a novel asthma management strategy—budesonide/formoterol in a single inhaler for both maintenance therapy and symptom relief—with a higher dose of budesonide plus as-needed terbutaline.

    Methods: This was a 6-month, randomized, double-blind, parallel-group study in patients with mild-to-moderate asthma (n = 697; mean age, 38 years [range, 11 to 79 years]; mean baseline FEV1, 75% of predicted; mean inhaled corticosteroid [ICS] dosage, 348 μg/d). Following a 2-week run-in period, all patients received two blinded, dry powder inhalers, one containing maintenance medication and one containing medication to be used as needed for the relief of symptoms. Patients were randomized to receive either budesonide/formoterol (80 μg/4.5 μg, two inhalations qd) for maintenance plus additional inhalations as needed for symptom relief, or budesonide (160 μg, two inhalations qd) for maintenance medication plus terbutaline (0.4 mg) as needed. The primary efficacy variable was morning peak expiratory flow (PEF).

    Results: Patients receiving budesonide/formoterol showed greater improvements in morning PEF than patients receiving budesonide (increases of 34.5 L/min vs 9.5 L/min, respectively; p < 0.001). The risk of having a severe exacerbation (hospitalization/emergency department [ED] treatment, oral steroids for asthma, or a ≥ 30% decrease from baseline in morning PEF on 2 consecutive days) was 54% lower with budesonide/formoterol vs budesonide (p = 0.0011). Budesonide/formoterol patients experienced 90% fewer hospitalizations/ED treatments due to asthma than budesonide patients (1 vs 10, respectively; p = 0.026). The increased efficacy with budesonide/formoterol was achieved with less ICS than was used in the budesonide group (mean dose, 240 μg/d vs 320 μg/d, respectively) and with 77% fewer oral steroid treatment days vs budesonide (114 days vs 498 days, respectively). Both treatments were well tolerated.

    Conclusions: Budesonide/formoterol for both maintenance and relief improves asthma control with a lower steroid load compared with a higher dose of budesonide plus terbutaline.

  • 18.
    Svensson, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Excessive Daytime Sleepiness in Women Without OSA Response2009In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 136, no 2, p. 649-649Article in journal (Refereed)
  • 19.
    Svensson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Franklin, Karl A.
    Theorell-Haglöw, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population2008In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 134, no 5, p. 919-924Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to investigate the significance of snoring and sleep apnea on daytime symptoms in a population-based sample of women. METHOD: From the general population, 400 women aged 20 to 70 years were randomly selected, with oversampling of habitually snoring women. The women were investigated using full-night polysomnography and a questionnaire. The apnea-hypopnea index (AHI) was calculated, and women who acknowledged snoring loudly and disturbingly often or very often were considered habitual snorers. RESULTS: Habitual snoring was independently related to excessive daytime sleepiness (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.31 to 3.99), to falling asleep involuntarily during the day (OR, 2.11; 95% CI, 1.06 to 4.21), to waking up unrefreshed (OR, 2.14; 95% CI, 1.30 to 3.52), to daytime fatigue (OR, 2.77; 95% CI, 1.54 to 4.99), and to a dry mouth on awakening (OR, 2.00; 95% CI, 1.22 to 3.27) after adjustment for AHI, age, body mass index (BMI), smoking, total sleep time, percentage of slow-wave sleep, and percentage of rapid eye movement (REM) sleep. An AHI > or = 15/h was only related to a dry mouth on awakening after adjustment for snoring, age, BMI, smoking, total sleep time, percentage of slow-wave sleep, and percentage of REM sleep (OR, 2.24; 95% CI, 1.14 to 4.40). An AHI of 5 to 15/h was not related to any daytime symptom. CONCLUSIONS: Excessive daytime sleepiness and daytime fatigue are related to habitual snoring independent of the apnea-hypopnea frequency, age, obesity, smoking, and sleep parameters in a population-based sample of women, but not to the AHI. This indicates that snoring is an independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea.

  • 20.
    Svensson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Naessen, Tord
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Risk Factors Associated With Snoring in Women With Special Emphasis on Body Mass Index: A Population-Based Study2006In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 129, no 4, p. 933-41Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVES: Habitual snoring may be regarded as an indicator of sleep-disordered breathing, and the health consequences of sleep-disordered breathing are well-known. The aim of this study was to analyze the risk factors associated with habitual snoring in a large sample of women, with special emphasis on the determinants of snoring in women with different body mass index (BMI) levels.Design and setting: A cross-sectional, epidemiologic, population-based study was performed by using a postal questionnaire that was sent to a randomly selected sample of 6,817 women >/= 20 years of age in Uppsala, Sweden. RESULTS: The total prevalence of self-reported habitual snoring was 7.6%. There was a clear age dependence, with the highest prevalence of habitual snoring (14%) occurring between the ages of 50 and 59 years. Self-reported habitual snoring was related to BMI, neck circumference, and smoking >/= 10 cigarettes a day, after adjusting for possible confounders. When analyzing the influence of different risk factors in separate BMI groups, the results varied among the groups. The influence of alcohol dependence on snoring frequency was only significant in women with a BMI of < 20 kg/m(2), while physical inactivity was only associated with habitual snoring in women with a BMI of >/= 30 kg/m(2). CONCLUSIONS: The prevalence of self-reported habitual snoring in women was strongly dependent on age and BMI. The importance of other risk factors differed depending on BMI, with alcohol dependence being associated with self-reported snoring in lean women, whereas physical inactivity was a risk factor for self-reported snoring in women with a high BMI.

  • 21.
    Walker-Engström, Marie-Louise
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Tegelberg, Åke
    Wilhelmsson, Bo
    Ringqvist, Ivar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    4-year follow-up of treatment with dental appliance or uvulopalatopharyngoplasty in patients with obstructive sleep apnea: A randomized study2002In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 121, no 3, p. 739-746Article in journal (Refereed)
    Abstract [en]

    Study objectives: To evaluate the effects of treatment with a dental appliance or uvulopalato-pharyngoplasty, (UPPP) on somnographic variables in patients with mild-to-moderate obstructive sleep apnea (OSA) followed up for 4 years, and compliance,and complementary treatment.

    Design: Randomized study.

    Setting: Central Hospital, Västerås, Uppsala University, Sweden.

    Patients: Ninety-five male patients with confirmed mild-to-moderate OSA (apnea index (AI) > 5 and < 25) were randomized to treatment with a dental appliance or UPPP. Sleep studies were performed before and 1 year and 4 years after intervention. Thirty-two patients in the dental-appliance group and 40 patients in the UPPP group completed the 4-year follow-up.

    Results: The success rate (percentage of patients with at least 50% reduction in AI) in the dental-appliance group was 81%, which was significantly higher than in the UPPP group, 53% (p < 0.05). Normalization (AI < 5 or apnea/hypopnea index < 10) was observed in 63% of the dental-appliance group and 33% of the UPPP group after 4 years. The difference between the groups was significant (p < 0.05). The compliance to use of the dental appliance was 62% at the 4-year follow-up. Thirty patients (75%) in the UPPP group continued without complementary treatment. The dental appliances had few adverse effects on the stomatognathic system, and the number of adjustments and repairs of the appliances over time was moderate. Pronounced complaints of nasopharyngeal regurgitation of fluid and difficulty, with swallowing after UPPP were reported by 8% and 10%, respectively.

    Conclusions: The dental-appliance group showed significantly higher success and normalization rates regarding the somnographic variables compared to the UPPP group, but the effectiveness of the dental appliance was partly invalidated by the compliance of 62% at the 4-year follow-up. However, the appliances had few adverse effects on the stomatognathic system an required only moderate adjustments. Use of a dental appliance with regular follow-up can be recommended for long-term treatment of OSA.

  • 22.
    Westerdahl, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Lindmark, Birgitta
    Eriksson, Tomas
    Friberg, Örjan
    Hedenstierna, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Tenling, Arne
    Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery.2005In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 128, p. 3482-3488Article in journal (Refereed)
  • 23. Zinserling, Jörg
    et al.
    Wrigge, Hermann
    Neumann, Peter
    Muders, Thomas
    Magnusson, Anders
    Hedenstierna, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Putensen, Christian
    Methodologic aspects of attenuation distributions from static and dynamic thoracic CT techniques in experimental acute lung injury2005In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 128, no 4, p. 2963-2970Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In acute lung injury, thoracic CT is used to gain information about lung aeration and consolidation. This can be done either during breath-holding by spiral CT scanning of the entire lung or dynamically by scanning lung slices without interrupting ventilation. We hypothesized that attenuation distribution is dependent on static or dynamic scanning techniques. We also studied whether a variation in the CT cut level, corresponding to the diaphragm movement over a breath, had any effect on the attenuation distribution. METHODS: Twenty-two pigs with oleic acid-induced lung injury were randomly assigned to receive pressure-controlled mechanical ventilation with or without spontaneous breathing. Transversal dynamic CT scans of the chest were performed in apical and juxtadiaphragmatic regions, and end-expiratory and end-inspiratory slices were selected. In addition, after clamping the tube at end-expiration and end-inspiration, respectively, spiral CTs were performed. Guided by morphologic structures, spiral CT slices matching the dynamic scan slice and three additional neighbored slices above the diaphragm were selected. Distributions of CT attenuation were calculated and summarized in ranges for comparison. RESULTS: No significant difference in attenuation distributions between the two scanning methods or an interaction with the factors ventilation mode, ventilation phase, and attenuation range were found. In addition, attenuation distributions of four neighbored juxtadiaphragmatic slices, 8 mm thick, from the spiral CT did not differ statistically. CONCLUSION: In an animal model of oleic acid-induced lung injury, analyses of transverse thoracic slices based on dynamic or static CT scanning showed comparable distributions of attenuation. Variations on the CT cut level of 24 mm had no significant effect on the distribution of Hounsfield unit numbers. CT attenuation distributions of transversal juxtadiaphragmatic slices were not dependent on exact position.

1 - 23 of 23
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf