Search PubMed⌕ Search

Biomedical subjects

A Gulsvik

Publications and source records attributed to A Gulsvik.

At least 19 recordsLinked to original sources
PubMed2002

Absence of relationship between tuberculin reactivity and asthmatic symptoms, level of FEV1 and bronchial hyperresponsiveness in BCG vaccinated young adults.

BACKGROUND: Some recent studies have suggested that bacillus Calmette-Guérin (BCG) vaccination or mycobacterial infection early in life is inversely related to asthma. We wondered if an increase in tuberculin reactivity was inversely related to commonly used indices of asthma in a population of young adults who were BCG vaccinated at age 14. METHODS: Men and women aged 20-44 years, randomly selected from the general population, were tuberculin tested with the epinephrine-Pirquet method with Norwegian-produced synthetic medium tuberculin (n = 588). In addition they were interviewed using eight questions on asthma symptoms and medication. Lung function and bronchial responsiveness were also tested. RESULTS: Altogether 95% of those studied had been BCG vaccinated at age 14 (n = 558). In the 386 subjects with complete examinations, there was no relationship between a positive tuberculin reaction (> or = 4 mm) and asthma symptoms or use of asthma medication. Furthermore we did not observe any relationship between a positive tuberculin reaction and the level of forced expiratory volume (FEV1) or a positive bronchial responsiveness test, assessed as the percent of predicted of FEV1 and PD20 < 2 mg methacholine, respectively. In multiple logistic regression analyses neither respiratory symptoms, level of FEV1, nor bronchial hyperresponsiveness were related to tuberculin reactivity after adjustment for age, gender and smoking habits. CONCLUSIONS: In this young adult population who were BCG vaccinated at the age of 14 no significant relationship existed between tuberculin reactivity and asthmatic symptoms, level of FEV1 or bronchial hyperresponsiveness. Our data does not support the hypothesis that BCG immunization is beneficial in reducing asthmatic symptoms and disease in young adults.

Adult↗
PubMed2001

Relation of occupational exposure to respiratory symptoms and asthma in a general population sample: self-reported versus interview-based exposure data.

The objective of this study was to examine how the consistency of self-reported exposure to dust or gas, asbestos, and quartz varied between subjects with and those without respiratory symptoms and asthma in a Norwegian community sample () in 1987-1988. Exposure characterization obtained in a structured work history interview was used as the "gold standard." The authors also wanted to assess how the exposure-disease relation differed when the exposure was based on self-reported versus interview-obtained data. The prevalence of self-reported exposure to dust or gas, asbestos, and quartz was 28%, 5%, and 4%, respectively. The sensitivity of the self-reported exposure data varied from 21% to 64% and was higher in those with than in those without the respiratory disorders. The specificity varied from 78% to 100% and was lower in those with than in those without the respiratory disorders. The sex-, age-, and smoking-adjusted odds ratios of the respiratory disorders in those with exposure to dust or gas and to asbestos were only slightly reduced when misclassification was taken into account. The corresponding numbers for exposure to quartz were halved and lost their statistical significance when the misclassification was allowed for. In this general population sample, the self-reported occupational, airborne exposure data were differentially misclassified by disease status.

Adult↗
PubMed2001

[Immediate drug therapy of obstructive lung disease in hospital].

BACKGROUND: We have studied how patients with obstructive lung disease are treated in Norwegian hospitals and whether the treatment is in accordance with international guidelines. MATERIAL AND METHODS: During 76 days from 1 April 1997 we registered all 176 patients (110 women) admitted for obstructive lung disease in two hospital catchment areas in western Norway. The medical treatment given the first three hours after admission was recorded by the doctors on call. RESULTS: 106 patients (60%) were above 65 years of age; 21 (12%) below 35.31% of the patients had a mild form of the disease, 42% a moderate, 21% a severe, and 6% a life-threatening condition. Almost all patients with moderate and severe disease were treated with beta 2 agonists on admission. Among the patients with moderate disease, 25% did not receive glucocorticoids during the first three hours in hospital. The proportion of patients treated with theophylline was lower among those with mild disease than among those with moderate disease (15% and 65% respectively). INTERPRETATION: Guidelines are followed to a high degree in patients with severe or life threatening obstructive lung disease, but only party in those with mild or moderate disease.

Adrenal Cortex Hormones↗
PubMed2001

[Consumer surveys among hospitalized patients with lung disease].

BACKGROUND: The aim of our survey was to record the experiences of hospitalised patients with respiratory diseases in order to create a more patient-friendly department. MATERIAL AND METHODS: Our study included 609 patients (response rate 70%) with a median age of 64 years (range 13-91) who were discharged from the Department of Thoracic Medicine, Haukeland University Hospital in October 1991, 1992, 1994, 1995 and 1996. 268 patients had obstructive lung disease, 82 had lung cancer. They answered a questionnaire with 24 questions. RESULTS: Patient reception to the ward and staff knowledge of the patients' illnesses, were for the physicians rated as good or better by 92% and 79% and for the nurses by 94% and 70% respectively. 16% of the patients experienced insecurity, 17% anxiety, 12% helplessness, 9% loneliness and 12% little say in the decision making process. Trend factors for these emotional experiences were female sex, old age, obstructive lung disease and long stay in hospital. Patients aged 50 to 69 years and patients with lung cancer had the lowest rate of negative emotional experiences. Despite staff awareness of the prevalence and of the patients' emotional experiences and the risk factors involved, there was no clear reduction of negative experiences in the later surveys compared to the first survey. INTERPRETATION: Patients in a university hospital with respiratory diseases showed unchanged experiences of health care and personal emotions in repeated surveys over a period of five years.

Adolescent↗
PubMed2001

Standardized submaximal exercise testing in never smokers: a normative study.

In a population survey on the south-western coast of Norway, 373 never smokers aged 18-73 years (230 women) without respiratory symptoms performed a standardized, progressive, incremental submaximal bicycle exercise test. All individuals were able to do an exercise involving oxygen uptake of 1.0 l min(-1), 80% of the subjects reached 1.5 l min(-1) and 50% of the subjects reached 2.0 l min(-1). The respiratory frequency (RF), ventilation (VE) and heart rate (HR) for a given oxygen uptake were all higher in women than in men. Significant predictors of failure to reach oxygen uptake of 1.5 and 2.0 l min(-1) were sex, age, body height and weight. Prediction equations are given for respiratory frequency, heart rate and ventilation for an oxygen uptake of 1.0 l min(-1) in women and 1.5 l min(-1) in men; and body height is a strong predictor for all dependent variables. A multiple linear regression analysis in women showed that age was a significant predictor of respiratory frequency (P<0.05), ventilation (P<0.001) and heart rate (P<0.001), while in men age was a significant predictor only of ventilation (P<0.001) during the bicycle exercise protocol.

Adolescent↗
PubMed2001

Expiratory and inspiratory forced vital capacity and one-second forced volume in asymptomatic never-smokers in Norway.

The objectives of this study were to examine within and between individual variation detected during forced expiratory (FE) and forced inspiratory (FI) manoeuvers in a general population and to investigate the dependence of these variables on age, body size, and gender. A random sample of asymptomatic never smokers who had never been exposed occupationally to quartz or asbestos and who were living on the south-western coast of Norway were examined by spirometry; 81% of the individuals invited to attend did so. Of the 488 subjects between 18 and 73 years of age, 98% contributed three acceptable recordings for forced expiratory vital capacity (FVC) and one-second forced expiratory volume (FEV1), 94% contributed three acceptable recordings for forced inspiratory vital capacity (FIVC) and 85% contributed three acceptable recordings for one-second forced inspiratory volume (FIV(1)). The within-subject variation increased with body height and was considerably larger for FIV(1) than for FVC, FEV(1) or FIVC. A four-parameter model of pulmonary function measurement divided by height squared, including a gender term and a linear and quadratic term of age, fit the median of the observed values well. The residuals had a close-to-normal distribution, and the fifth-percentile values were estimated as the lower limit of normal. The peak value of dynamic lung volumes was observed into the middle of the fourth decade of life, and the decline thereafter did not differ greatly between the genders or among the different indices. The forced inspiratory volumes are the first reported in any reference population.

Adolescent↗
PubMed2001

Comparing the adrenaline-Pirquet test with international PPD tuberculin tests.

Several tuberculins, strengths and setting methods are in everyday use. We wanted to compare the Norwegian reference adrenaline Pirquet test with the internationally recommended Mantoux PPD test and Rhoditest. In responders of a random sample of young adults, with randomization of test subjects, we intra-individually compared the adrenaline-Pirquet (aP) test with Norwegian-produced synthetic medium tuberculin (SMT) with either the Mantoux test with PPD 2 tuberculin units (TU) (M2), the Mantoux-PPD 5 TU (M5) or the PPD 2 TU-Rhoditest (Rh). The criteria for a positive reaction were > or = 4mm for the aP test, > or = 10 mm for the M2 test, > or = 6 mm for the M5 test and > or = 2 mm for the Rh test. Strongly positive reactions were defined as aP test > or = 10 mm and M2/M5 test > or = 15 mm. One of the tuberculin tests was positive while the comparison test was negative in 14% of the M2 test group (n = 236), 15% in the M5 test group (n = 162) and 20% in the Rh test group (n = 187). The three PPD tests had positive reactions 3-10 times as often, with a simultaneous negative aP test, than vice versa. Strongly positive reactions occurred in 7% of the aP tests (> or = 10 mm), 32% of the M2 tests (> or = 15 mm) and in 41% of the M5 tests (> or = 15 mm). Receiver operating characteristic (ROC) curves gave the best agreement, with aP test >3mm compared with the M2 and the Rh tests. Regression equations are presented for transformations of the Norwegian reference method of adrenaline-Pirquet results to internationally recommended PPD tests. The international recommendations, globalization in general and the skill of Norwegian public health nurses in performing intra-dermal BCG suggest a future shift to the PPD 2 TU Mantoux test in Norway. Due to the lack of sensitivity and specificity of all tuberculin tests they might be used in targeted tuberculin testing and not as a general screening procedure in a low-incidence tuberculosis area with BCG-vaccinated inhabitants.

Adult↗
PubMed2001

Increased circulating levels of alpha1-antitrypsin and calprotectin are associated with reduced gas diffusion in the lungs.

The aim was to examine the relationship of serum inflammatory markers to the level of single-breath diffusing capacity of carbon monoxide (TL,CO). A stratified sample (n = 1,121) of a Norwegian general population aged 18-73 yrs was examined. The inflammatory markers measured were calprotectin, a prominent protein in the cytosol fraction of neutrophil granulocytes, and alpha1-antitrypsin (alpha1-AT), the major inhibitor of neutrophil elastase in the lower respiratory system. Both markers have increased circulating levels in the course of an acute inflammatory reaction. Subjects with a TL,CO < 80% of predicted value had a higher level of both alpha1-AT (p = 0.003) and calprotectin (p < 0.03) than those with a TL,CO > 100%. In multiple linear regression analyses, alpha1-AT was still significantly associated with TL,CO after adjusting for sex, age, smoking habits, haemoglobin, carboxyhaemoglobin, forced expiratory volume in one second and alveolar volume. In a similar analysis, no significant overall association was found between calprotectin and TL,CO, but in a stratified analysis, calprotectin was significantly related to TL,CO in females. However, no significant sex interaction in the relationship between the inflammatory markers and TL,COo was found. The findings suggest that increased levels of alpha1-antitrypsin and of calprotectin are risk factors for decreased diffusing capacity of carbon monoxide.

Adolescent↗
PubMed2001

Forced spirometry reference values for Norwegian adults: the Bronchial Obstruction in Nord-Trøndelag Study.

The purpose of this study was to develop new prediction equations for flow/volume spirometry parameters in asymptomatic, never-smoking adults in Norway, and to assess any differences of these parameters when applying the new and most commonly used equation sets. Flow/volume spirometry was measured according to the American Thoracic Society criteria in 2,792 subjects aged > or = 20 yrs, randomly selected from participants in the Nord-Trøndelag Health Study. Ever-smokers and subjects with respiratory symptoms and/or diseases reported in this questionnaire were excluded. A total of 546 females and 362 males met the inclusion criteria and were included in the analyses. Most lung function variables were nonlinear by age and had to be transformed. After a plateau in younger adults, the variables declined by age. The reference values for forced expiratory volume in one second and forced vital capacity from the present study, were higher than those given by prediction equations from the European Community for Coal and Steel, but in closer agreement with later studies from Europe, Australia and the USA. Healthcare providers should be encouraged to reconsider their choice of prediction equations of spirometry in order to improve management of obstructive lung diseases.

Adult↗
PubMed2001

The global burden and impact of chronic obstructive pulmonary disease worldwide.

A prerequisite for fighting chronic obstructive pulmonary disease (COPD) world-wide is accurate data on death and illness. Such data are not available in many countries and surveys with spirometry of forced expiratory volumes should be performed world-wide. Severe COPD, with one second FEV1 below 40% of predicted value, has been estimated to be below 1% in the general population. Mild to moderate COPD can be 10 times more frequent. The prevalence of COPD increases heavily with age. The Global Burden of Disease study, undertaken by the World Bank and World Health Organisation, concluded that COPD worldwide will increase from 1990 to 2020 its rank number of death from rank 6 to rank 3, and its rank number of disability-adjusted life years lost from rank 12 to rank 5. Reduction of total personal exposure to tobacco smoke and occupational and other indoor or outdoor dusts are important goals to prevent the onset and progression of COPD.

Age Distribution↗
PubMed2000

Smoking status, disease duration, and educational level in females, are related to asthma school participation.

Limited data is available on those who do not want to attend an asthma school. Two hundred and forty-five asthmatics aged 18-65 yrs with an FEV1 >50% predicted who had been seen at our outpatient asthma clinic within the last 3 yrs were invited to participate in an asthma school. The patients were contacted by phone by a nurse, offered a 2 day asthma school without personal costs. Altogether 78% of those contacted answered positively. In a logistic regression analysis including sex, age, smoking status, educational level, asthma duration and own opinion of the disease, the-adjusted odds ratio (OR) for nonsmokers wanting to participate versus smokers was 4.0 (95% confidence interval (CI): 1.8-8.3). The corresponding figure for patients with a recent asthma attack was 3.4 (95% CI: 1.5-7.6) compared to those without. For every 10 yr duration of disease the OR for wanting to take part in the asthma school increased by 1.6 (95% CI: 1.0-2.3). When analysing males and females separately, highly educated females were less willing to take part, while an opposite tendency was present in males. In conclusion those interested in taking part in an asthma school were characterized by highly motivated nonsmokers with long duration of disease and with a recent asthma attack, and not being highly educated females.

Adolescent↗
PubMed2000

Cigarette smoking gives more respiratory symptoms among women than among men. The Nord-Trondelag Health Study (HUNT).

STUDY OBJECTIVE: Studies have indicated that women are more vulnerable to the effect of tobacco smoking compared with men. The aim of this study was to explore the prevalence of reported respiratory symptoms and diseases according to smoking burden, age and sex. DESIGN: Questionnaire in a cross sectional population based study. SETTING: The BONT (Bronchial obstruction in Nord-Trondelag) study is part of a comprehensive health survey of all inhabitants aged above 19 years in the county of Nord-Trondelag, Norway, which was carried out from 1995 to 1997. PARTICIPANTS: A total of 65 717 subjects, 71.3% of the total population aged 20-100, answered the main questionnaire. MAIN RESULTS: In all, 12.7% men and 12.1% women reported episodes of wheezing or breathlessness during the past 12 months, 8.8% men and 8.4% women reported that they had or had had asthma, 7.5% men and 8.2% women had ever used asthma medication, and 4.0% men and 3.0% women reported chronic bronchitis. Thirty per cent of men and 31% of women were smokers, and average pack years of smoking were 15.9 and 10.3, respectively. Among previous and current smokers, significant more women reported episodes of wheezing or breathlessness, current asthma and persistent coughing compared with men with the same smoke burden (pack years) and daily number of cigarettes. CONCLUSION: The prevalence of reported asthma and use of asthma medication was higher than reported in previous Scandinavian studies. Respiratory symptoms increased by smoking burden. Comparing the prevalence of symptoms and current asthma among women and men with the same smoke burden or daily cigarette consumption, women seemed to be more susceptible to the effect of tobacco smoking than men.

Adult↗
PubMed2000

Absence of relationship between tuberculin reactivity and atopy in BCG vaccinated young adults.

BACKGROUND: An inverse association between tuberculin responses and atopy has been observed in Japanese children, indicating that BCG immunisation, subclinical exposure to Mycobacterium tuberculosis without clinical disease, or host characteristics may influence the T helper (Th) lymphocyte balance with decreased atopy as a result. This study was undertaken to determine whether tuberculin reactivity is inversely related to atopy in young adults vaccinated with BCG at the age of 14. METHODS: Men and women aged 20-44 years were tested using the adrenaline-Pirquet test with Norwegian produced synthetic medium tuberculin (n = 891). In addition, their serum total and specific IgE antibodies against mite, cat, timothy grass, mould and birch were measured. RESULTS: Of the 574 subjects with complete examinations, 64% had a positive adrenaline-Pirquet tuberculin test (> or =4 mm) and 27% exhibited IgE antibodies (> or =0.35 kU/l) to one or more of the five specific allergens. The geometric mean of total serum IgE in the population was 30.2 kU/l. Tuberculin reactivity and log IgE were not correlated (r = 0.043, p = 0.30). The mean tuberculin reactivity was 4.6 mm, 4.9 mm, and 5.0 mm in the lower, middle and upper tertile of IgE distribution (<14 kU/l, 14-61 kU/l, >61 kU/l). The prevalence of atopy, as assessed by either the presence of any of the five specific IgE antibodies or by each specific IgE antibody separately, did not differ between subjects with a positive and those with a negative tuberculin test. These results persisted after adjustment for age, sex, and smoking status in multivariate logistic regression analyses. CONCLUSIONS: In this young adult population, BCG vaccinated at the age of 14, no significant relationship between a positive tuberculin reaction and atopy was observed. If a true relationship had been found, our study suggests that it may be limited to populations immunised in early childhood when a substantial modulation of the immune system can occur.

Adult↗
PubMed2000

Comparison of respiratory symptoms questionnaires.

SETTING: Comparisons in performance of questionnaires are of interest in international comparisons of prevalences and risk factors, after translation and development of new questionnaires. Factors such as sex, age, educational level and smoking habits may influence the performance of questionnaires. OBJECTIVE: 1) To discuss questionnaire comparisons in general, using as an example a Norwegian respiratory symptoms questionnaire compared with a translation of the British Medical Research Council questionnaire on chronic bronchitis; and 2) to examine whether reliability differs in subgroups. DESIGN: A population sample of 935 residents of Hordaland County, Norway, completed two questionnaires in a short interval of time. Agreement and Cohen's kappa were calculated. RESULTS: Prevalences were significantly different between the two questionnaires for most symptoms. Agreement decreased from non-smokers through ex-smokers to smokers, whereas the kappa statistic increased. Agreement increased as the educational level increased, whereas the kappa statistic declined. No significant age and sex effects on agreement and kappa were observed. CONCLUSION: Small changes in the phrasing of a question can have considerable effect on prevalence estimates. Reliability statistics are prevalence dependent. Reliability may differ according to smoking habit and educational level. Questionnaires should be tested in the population that they are to be used in.

Adult↗
PubMed2000

Work-related asthma: prevalence estimates by sex, age and smoking habits in a community sample.

SETTING: Two-phased study of a general population sample in Norway. OBJECTIVE: To assess the prevalence of work-related asthma by sex, age and smoking habits. DESIGN: The first phase, a mail questionnaire on asthma to a random sample of the general population of Hordaland County, Norway, gave a 90% response. A stratified sample of the responders (n = 1512) was invited to complete an occupational history questionnaire and performing spirometry and bronchial hyperresponsiveness. The attendance rate was 84%. Asthmatics were defined as having work-related asthma if they answered positively the questions: "Have you ever had respiratory symptoms in relation to your work? Did the symptoms improve on absence from work?" RESULTS: The prevalence of work-related asthma was 0.9% in this population, constituting 28% of all asthmatics (95% confidence interval 25-31). The prevalence of work-related asthma was twice as high in men as in women, and did not differ significantly with age or between smoking groups. CONCLUSION: Work-related asthma amounts to a significant proportion of total asthma in this population. This should be taken into account by health planners as it is by definition a preventable disorder.

Adult↗
PubMed1999

[Hospital admissions due to obstructive lung diseases and pneumonia in two hospital districts].

Admission rates for specific diseases in a defined district can be used as a coarse estimate of the need for health services. Such registration has not previously been conducted in the hospital districts of Bergen and Haugesund. We recorded all patients 16 years and older admitted to three hospitals for obstructive lung disease or pneumonia in the two hospital districts of Bergen and Haugesund in April to June 1997. A total of 438 patients were included in both districts, 246 with obstructive lung disease and 192 with pneumonia. The admission rate for obstructive lung disease was 359 per 100,000 inhabitants per year, for pneumonia 280 per 100,000 inhabitants per year. Median age was between 71 and 75 years for men and women for both diseases. 13% of patients with obstructive lung disease were readmitted to the hospital within 30 days. Obstructive lung disease and pneumonia are common causes of hospital admission, especially among older persons. The admission rates for both diseases combined were 639 per 100,000 adults per year in the hospital districts of Bergen and Haugesund.

Adolescent↗
PubMed1999

[Tuberculosis in Bergen 1996].

In 1996, 30 patients with tuberculosis were reported from Haukeland University Hospital to the Norwegian Tuberculosis Registry. Culturing proved 63% with mycobacterium tuberculosis (M. tuberculosis). 13 of the patients, eight adults and five children, all natives, were identified as close relatives or friends (cluster). M. tuberculosis with identical restriction fragment length polymorphism pattern (RFLP) were found in all the adults, indicating that they carried the same bacteria strain. We have compared the clinical findings, bacteriology and treatment among the adults in the cluster with other patients with pulmonary tuberculosis identified the same year at the Department of Thoracic Medicine at Haukeland University Hospital. The patients in the cluster were young adults without any previous chest X-ray changes. The other natives with tuberculosis were older, two showing chest X-ray changes indicating former tuberculosis. No difference was seen in sex, BCG status, tuberculin sensitivity, symptoms, physical findings or chest X-ray between the two groups. In the cluster, four patients proved sputum smear positive, as compared to four in the other group. Spread of infection and new cases of M. tuberculosis with identical RFLP were found only in the cluster. Since RFLP analyses of M. tuberculosis started in Norway in 1993, this cluster in Bergen is the largest cluster observed with identical RFLP pattern.

Adolescent↗