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A Gulsvik

Publications and source records attributed to A Gulsvik.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1999

Higher dosage nicotine patches increase one-year smoking cessation rates: results from the European CEASE trial. Collaborative European Anti-Smoking Evaluation. European Respiratory Society.

The Collaborative European Anti-Smoking Evaluation (CEASE) was a European multicentre, randomized, double-blind placebo controlled smoking cessation study. The objectives were to determine whether higher dosage and longer duration of nicotine patch therapy would increase the success rate. Thirty-six chest clinics enrolled a total of 3,575 smokers. Subjects were allocated to one of five treatment arms: placebo and either standard or higher dose nicotine patches (15 mg and 25 mg daily) each given for 8 or 22 weeks with adjunctive moderately intensive support. The 12 month sustained success rates were: 25 mg patch for 22 weeks (L-25), 15.4%; 25 mg patch for 8 weeks (S-25), 15.9%; 15 mg patch for 22 weeks (L-15), 13.7%; 15 mg patch for 8 weeks (S-15), 11.7%; and placebo (P-0) 9.9% (placebo versus 15 mg, p<0.05; 25 mg versus 15 mg, p<0.03; 25 mg versus placebo, p<0.001, Chi-squared test). There was no significant difference in success rate between the two active treatment durations. Of the first week abstainers (n=1,698), 25.1% achieved success at 12 months as opposed to first week smokers, 2.7% of 1,877 subjects (p< 0.001). In summary, a higher than standard dose of nicotine patch was associated with an increase in the long-term success in smoking cessation but continuation of treatment beyond 8-12 weeks did not increase the success rates.

Administration, Cutaneous↗
PubMed1999

Reproducibility of indoor environment characteristics obtained in a walk through questionnaire. A pilot study.

Walk through questionnaires may be feasible tools to obtain data on the indoor environment in community studies. However, limited information is available regarding the reproducibility of the data obtained through these questionnaires. In this pilot study, two construction engineering students inspected ten dwellings twice by means of a standardized walk through questionnaire. The two engineering students inspected the dwellings independent of each other within two months. Time between the two visits varied between 14 and 40 days. The variables presented were based on information from the residents and inspection. The continuous variables recorded included number of rooms in the dwellings, room volume, length of filled shelves and textile area. The inter- and intra-observed variabilities were poorer for number of rooms and shelf factor than for the other variables. For the 3 of the 9 categorical variables based on inspection, the inter-observer comparison showed complete agreement with a kappa statistics of 1.0, these variables being condition of the window frames and construction of outside walls and roof. One of the categorical variables showed a kappa statistics of < 0.5, these variables being presence of basement and presence of condensation at windows. This study indicates a wide variation in observer variability between various items of a walk through questionnaire. Clear definitions of all the parts of the questionnaire are needed, as well as thorough training of observers.

Air Pollution, Indoor↗
PubMed1999

The single-breath transfer factor for carbon monoxide and respiratory symptoms in a Norwegian community sample.

Reduced single-breath transfer factors of the lung for carbon monoxide are seen in a number of conditions. The hypothesis of the present study was that self-reported respiratory symptoms differ in their prediction of TL,CO level in a general population in Norway. A cross-sectional survey of a general population sample in Norway, made up of 1,275 subjects aged 18-73 yrs, was conducted in 1987-1988. The attendees (84% response rate) filled in a questionnaire on respiratory symptoms and underwent standardized spirometric and TL,CO measurements and clinical examination. Associations between TL,CO and respiratory symptoms were assessed using multiple regression models. Tests for interaction were used to examine whether these associations varied with sex, age and smoking habits. Data from 1,221 subjects were analysed. Both males and females who reported respiratory symptoms had significantly lower TL,CO after adjusting for age and height. In a multiple linear regression analysis of TL,CO, adjusting for sex, age, height and smoking habits, the symptoms for which statistical significance was attained, were morning cough, chronic cough and breathlessness. However, only the breathlessness score was independently associated with the TL,CO (-0.42 mmol x min(-1) x kPa(-1) per breathlessness score unit) after adjusting for other respiratory symptoms, and the relationship was stronger in males than in females. In this study, the strongest predictor for a decreased single-breath transfer factor of the lung for carbon monoxide was the presence of self-reported breathlessness, regardless of age, smoking habits and height.

Adolescent↗
PubMed1999

Tuberculin test variability: using the Norwegian Adrenaline-Pirquet method.

SETTING: Chest Unit, Bergen, Norway. OBJECTIVES: To study the agreement between two Adrenaline-Pirquet tuberculin tests and compare reactivity in groups read after 2, 3 and 4 days. DESIGN: Responders from a random sample of 1200 men and women 20-44 years of age in 1991 were tested with dual Adrenaline-Pirquet skin scratch tests with Norwegian-produced synthetic medium tuberculin and read after 2-7 days. RESULTS: Of 588 subjects dually tuberculin tested, complete agreement existed in 220 (37.4%). A difference of 1 mm one way or the other was observed in 239 (40.6%), whereas a difference of less than 3 mm was found in 567 (96.5%). Using the larger of the two reactions increased the rate of tuberculin positivity (> or =4 mm) by up to 8.4% compared with reading only one of the tests. No statistically significant differences were observed between subjects whose reactions were read after 2, 3 and 4 days. CONCLUSION: Under the non-blinded conditions of this study the dual Adrenaline-Pirquet tuberculin tests demonstrated reproducibility equivalent to the internationally recommended Mantoux test, and appeared to be independent of time of reading within four days.

Adult↗
PubMed1999

Mortality in and prevalence of chronic obstructive pulmonary disease in different parts of Europe.

A prerequisite for acquiring data on death and illness in chronic obstructive pulmonary disease is the application of agreed operational definitions. The International Union against Tuberculosis and Lung Diseases recommended that International Classification of Diseases 490-496 be grouped together for mortality statistics. A task force of the European Respiratory Society have given operative criteria for chronic obstructive pulmonary disease which depend very much on spirometric reference values collected 25 years ago. The mortality rates in chronic obstructive disease vary more than 5-fold among the European countries. Deaths due to chronic obstructive pulmonary disease as a proportion of all deaths increase greatly with age and are considerably lower in females than in males. Community surveys in countries of both northern and southern Europe indicate that 4-6% of the adult population suffer from clinically relevant chronic obstructive pulmonary disease. The prevalence increases greatly with age; however two-thirds have only a mild reduction in lung function.

Adult↗
PubMed1998

[Medication practice and personal knowledge of the disease among patients with obstructive lung disease].

250 patients with obstructive lung disease who had attended an out-patient clinic were assessed after reporting on individual medication practices and their personal knowledge of the disease. 56% of the patients reported using two types of asthma medicine. The use of three, four, and five or more antasthmatica was reported by 26%, 9% and 5%, respectively. 90% had been prescribed an inhalation corticosteroid. Of these, one in five reported using it only when required, whereas in the age group 18-34 years the corresponding figure was one in three (34%). Regardless of what medication the patients were using, 20% reported that they often forgot to take it, 20% that they stopped taking it when their asthma improved, and 38% that they did not think about what time of the day they took their medicine. These practices of taking medication occurred more frequently in the young than in older patients. Practices did not vary with either a person's sex, duration of disease, or the patient's personal assessment of the seriousness of the disease. Patients with a higher level of education seemed to have greater knowledge of their disease than those with only secondary education, as was also the case with nonsmokers compared to smokers.

Adrenal Cortex Hormones↗
PubMed1998

[Immunoglobulin E, viral antibodies and obstructive lung disease in adults. The relation between antibody level in serum, lung function and non-specific bronchial reactivity].

We have measured immunoglobulin E levels and respiratory virus antibodies and examined their possible role as risk factors for obstructive lung disease in adults. We observed that increased total serum IgE levels were associated with reduced lung function in subjects with obstructive lung disease, but not in asymptomatic subjects. Subjects sensitised to indoor allergens (house dust mites, cats and mould) had reduced lung function and increased, non-specific, bronchial responsiveness compared with individuals who were not sensitised to indoor allergens. Similar relationships were not observed for subjects sensitised to outdoor allergens (birch and timothy). The presence of respiratory virus antibodies was vaguely associated with reduced lung function, but was not related to increased, non-specific, bronchial responsiveness. In adults in this community sensitisation to indoor allergens is a strong predictor of reduced lung function and increased, non-specific, bronchial responsiveness, which are again closely associated with obstructive lung disease.

Adolescent↗
PubMed1998

Hospitalization for lung disease in early childhood and asthma symptoms in young adulthood.

Longitudinal studies have reported an association between early childhood lung disease and adult respiratory disease. This issue has not been addressed in the Nordic countries. We studied the association between hospitalization for lung disease in early childhood and asthma in young adulthood in a Norwegian population sample, while estimating the attributable fraction of childhood hospitalization. A population-based survey in Bergen, Norway included a random sample of 4300 subjects aged 20-44 years, of whom 80% responded. The effect of hospitalization for lung disease before the age of 2 years on asthma in adulthood was analysed by logistic and polytomous logistic regressions, adjusting for related variables. Adjusted attributable fractions were estimated from these models. The risk for different measures of asthma was significantly increased in the 103 persons reporting childhood hospitalization (airways symptoms: OR from 1.9 to 2.9; asthma medication: OR = 2.8). The associations with airways symptoms were stronger in women (OR from 2.6 to 5.3) than in men (OR from 1.4 to 2.4). Given a causal association, adjusted attributable fractions showed that childhood lung disease causing hospitalization explained 4% of asthma symptoms. Early childhood hospitalization for lung disease was related to asthma symptoms in young Norwegian adults, more strongly in women than in men. Only a minor proportion of asthma symptoms in this age group could be related to hospitalization for lung disease in early childhood.

Adult↗
PubMed1998

Increasing risk of asthma without other atopic diseases in school children: a repeated cross-sectional study after 13 years.

Some children develop asthma and other atopic diseases, others asthma without atopic diseases. To better understand secular trends, we estimated the relative increase in asthma in children with (atopy related asthma) and without (non-atopy related asthma) other atopic diseases (eczema or hay fever) in two samples of school children born, 1965-1975 (n = 1674) and 1978-1988 (n = 2188). By analysing the samples as historical cohorts, age-specific prevalence rates were estimated and incidence rates were calculated (number of new cases by 1000 person years under risk). Cox regression was used to estimate the relative risk (RR) of asthma by year of birth. The point prevalence of asthma was 1.9% (95% CI: 1.4-2.4) in the 1965-1975 cohort and 4.6% (95% CI: 3.8-5.4) in the 1978-1988 cohort for three-year old children, and remained fairly constant throughout childhood. The age-specific prevalence of non-atopy related asthma increased relatively more from 1965-1975 to 1978-1988 compared to atopy related asthma. The age-specific incidence rates of asthma showed that the RRs comparing the two cohorts tended at all ages to be highest for non-atopy related asthma. The relative risks of non-atopy related asthma by gender and birth cohort, showed that the effect of cohort was higher for non-atopy related asthma, aRR: 4.0 (95 % CI: 2.5-6.5), than for atopy-related asthma aRR: 2.0 (95% CI: 1.3-3.2). Children without other atopic diseases have a higher relative risk of being diagnosed with asthma than children with other atopic diseases across all ages comparing two samples of school children born 1965-1975 and 1978-1988.

Adolescent↗
PubMed1998

Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) variability in asymptomatic never-smoking men.

We examined the effects from subjects, technicians and spirometers on within-session variability in successful recordings of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) in 4989 asymptomatic never-smoking men. All eligible men aged 30-46 years living in western Norway (n = 45,380) were invited to a cross-sectional community survey. Information on respiratory symptoms, smoking habits and occupational exposures was obtained from a self-administered questionnaire. Three successful FEV1 and FVC recordings were obtained in 26,368 attendants using three dry-wedge bellow spirometers operated by 10 different technicians. Within-subject standard deviation (SD) from three recordings of FEV1 and FVC was on average 102 and 106 ml, respectively, and increased with height (14 and 17 ml, respectively, per 10 cm) and body mass index (BMI) (11 and 14 ml, respectively, per 5 kg m-2). Between-subject SD of the mean of three FEV1 and FVC recordings was 591 and 754 ml, respectively, and increased in groups of increasing height (43 and 40 ml, respectively, per 10 cm). Small, but significant, differences were observed between technicians in within-subject SD and in levels of FEV1 and FVC. Homogeneity of between-subject variability, necessary for linear regression analysis, was obtained using FEV1 and FVC divided by height squared. In conclusion, within-subject variability in three successful spirometric recordings was small, but dependent on height and BMI of the subjects as well as technician performance. The observed heterogeneity in between-subject variation in FEV1 and FVC levels disappeared when each variable was divided by height squared. Novel multiple linear regression equations for FEV1/height2 and FVC/height2 were developed to be used in evaluating the effects from occupational airborne exposures in Nordic men aged 30-46 years.

Adult↗
PubMed1998

Association of years of occupational quartz exposure with spirometric airflow limitation in Norwegian men aged 30-46 years.

BACKGROUND: The association between occupational quartz exposure and ventilatory function was investigated in men in a general population after adjusting for other potential determinants of outcome. METHODS: All eligible men aged 30-46 years living in western Norway (n = 45,380) were invited to a cross sectional community survey. This included a self administered questionnaire (with respiratory symptoms, smoking habits and occupational exposures), spirometric recordings (using dry wedge below spirometers), and a chest radiograph (65% attendance). Measurements of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were obtained in 91% (n = 26,803) of those who participated, 26,106 of whom performed successful spirometric tests and had normal chest radiographs and remained for further analysis. Age, body mass index, and technician standardised residuals ((observed minus predicted value)/residual standard error) of maximum FEV1/height2 and FVC/height2 were used as outcome variables for adjusted lung function levels, respectively. RESULTS: Occupational quartz exposure was reported by 13% (n = 3445) of those who participated in the survey, with a mean duration of seven years. Among those exposed to quartz, significant inverse linear relationships were observed between years of exposure and FEV1 level and the ratio of FEV1/FVC, independent of host characteristics. Multiple linear regression analyses showed that the difference in FEV1 associated with each year of quartz exposure was -4.3 ml (95% CI -1.1 to -7.5 ml; p = 0.01) compared with -6.9 ml (95% CI -4.7 to -9.1 ml; p < 0.01) from smoking 20 cigarettes/day for one year after adjusting for age, atopy, asthma, wheezing, marital status, and other occupational exposures. CONCLUSION: In men aged 30-46 years with occupational quartz exposure and normal chest radiographs the duration of occupational quartz exposure was an independent predictor for spirometric airflow limitation.

Adult↗
PubMed1998

Applicability of the single-breath carbon monoxide diffusing capacity in a Norwegian Community Study.

The test of single-breath diffusing capacity for carbon monoxide (DLCO) has been widely used in population surveys. However, little is known about the effect of meeting or failing to meet the criteria for acceptability of this test. The American Thoracic Society (ATS) recommends a breathholding time of 9 to 11 s, two measurements within +/- 10% or 3 ml CO(STPD)/min/mm Hg of the average DLCO, and an inspiratory vital capacity (IVC) of at least 90% of the largest previously measured forced vital capacity (FVC) as criteria for this test. The objective of the present study was to examine the extent to which these criteria were met in a community study. To do this, a random sample of 3,740 persons, aged 15 to 70 yr, of the general population of the city of Bergen and 11 surrounding municipalities on the southwest coast of Norway were enrolled in a two-phase cross-sectional study. In the second phase, a stratified sample (n = 1,512) of the respondents to the postal questionnaire used for recruitment for the study (n = 3,370) were invited to a clinical and respiratory physiologic examination that included the DLCO test. The attendance rate was 84% (1,275 of 1,512). In the examination, all subjects were able to maintain a breathholding time of 9 to 11 s, and 98% had two DLCO values within +/- 10% or 3 ml CO(STPD)/min/mm Hg of the average DLCO. The criterion of an IVC of at least 90% of FVC in the two tests was met by 68% of the subjects. Younger age was an independent predictor of failure to meet the required criteria. Thus, only two-thirds of the participants fulfilled all of the ATS criteria for the DLCO test, the main reason for failure being an IVC of less than 90% FVC. This should not necessarily lead to the exclusion from further analysis of those failing to meet this criterion.

Adolescent↗
PubMed1998

Effectiveness of postal smoking cessation advice: a randomized controlled trial in young men with reduced FEV1 and asbestos exposure.

There have been few community-based randomized, controlled intervention trials for cessation in high-risk smokers. In such a trial we evaluated the effects of postal smoking cessation advice in smokers with asbestos exposure and/or reduced forced expiratory volume in one second (FEV1). All men aged 30-45 yrs (n=22,392) living in 34 municipalities in western Norway were invited to a cross-sectional community survey. Information on smoking habits and occupational asbestos exposure were obtained from self-administered questionnaires and measurements of FEV1 were performed with dry-wedge bellow spirometers. Among 16,393 participants we identified a group of 2,610 smokers with previous occupational asbestos exposure and/or adjusted FEV1 in the lowest quartile. A random half (n=1,300) received a mailed personal letter from a respiratory physician with a person-specific health advice to quit smoking and a pamphlet on smoking cessation. The remaining smokers (n=1,310) acted as controls and did not receive any information. Twelve months after the intervention, information on smoking habits was re-examined using a postal questionnaire. Among the respondents (n=2,282), smoking cessation was reported altogether by 13.7% in the intervention group versus 9.9% in the control group (p<0.01). The 1 yr sustained quit rate (no smoking at all during the last year) was 5.6 versus 35% (p<0.05), respectively. Measurements of carbon monoxide in expired air (with < or = 10 parts per million) confirmed self-reported nonsmoking in samples of the two groups. In a community this simple postal smoking cessation advice from a respiratory physician based on person-specific risk factors improved the 1 yr sustained success rate by 60% in identified high-risk smokers.

Adult↗
PubMed1998

Fish consumption and respiratory symptoms among young adults in a Norwegian community.

The aim of this study was to investigate the relationship between dietary fish consumption and self-reported respiratory symptoms among young adults. A random sample of 4,300 subjects, aged 20-44 yrs, living in Bergen, Norway, received a postal questionnaire on respiratory symptoms, of whom 80% responded. Mean fish consumption was assessed in a food-frequency questionnaire by asking how often the subject consumed units of fish (150 g) during the last year. Average fish consumption was 1.8 units x week(-1). Fish intake of <1 unit x week(-1) was reported by 24%, 41% reported consumption of 1 unit x week(-1) and 35% intake of >1 unit x week(-1). A high fish intake was significantly associated with increasing age after adjusting for smoking. Adjusted for smoking habits, the prevalence of "cough at night" and "chest tightness" showed a decreasing trend with increasing fish consumption (p<0.05), while such a trend for "wheeze" was demonstrated only in smokers (p=0.008 for interaction). In logistic regression models (adjusting for age, sex, body mass, smoking habits and occupational exposure) fish consumption (three categories) was not significantly associated with "wheeze", "chest tightness", "breathless at night" or "asthma attack", although the odds ratios (OR) were consistently less than 1 (except for "asthma attack"). Fish consumption was of borderline significance as a protective factor of "cough at night", OR = 0.86 (95% confidence interval: 0.76-0.97) but in stratified analyses only in smokers. Subjects reporting very high levels of fish consumption (>14 units x week(-1)) did not have lower prevalences of respiratory symptoms. In conclusion, among young Norwegian adults, with a relatively low prevalence of asthma and an overall high fish intake, fish consumption was not a significant predictor of four out of five respiratory symptoms.

Adult↗
PubMed1998

Birth characteristics and asthma symptoms in young adults: results from a population-based cohort study in Norway.

There is evidence that the origin of obstructive lung disease may be traced back to foetal life. The associations between birth characteristics and asthma symptoms were studied in a random population sample of young Norwegian adults. Respiratory symptoms were recorded in a population-based questionnaire survey. The records of all subjects aged 20-24 yrs were linked with the Medical Birth Registry of Norway. Of 868 subjects born in Norway, there were 690 (79%) responders. The associations between asthma symptoms and birth characteristics were analysed by logistic regression, adjusted for possible confounding factors. Asthma symptoms in young adults were inversely associated with birth weight (odds ratio (OR)wheeze=0.82; 95% confidence interval (CI)=0.69-0.96x500 g increase in birth weight(-1))), and after adjustment for gestational age, birth length, parity and maternal age (ORwheeze=0.69; 95% CI=0.50-0.95x500 g increase in birth weight(-1)). The association did not vary according to adult smoking habits or atopic status and remained when premature and low weight births were excluded (ORwheeze=0.73; 95% CI=0.60-0.90x500 g increase in birth weight(-1)). The association was consistent for all asthma symptoms. Adjusted for birth weight, asthma symptoms were further associated with low gestational age, high birth length and low maternal age. In a random sample of young adults, asthma symptoms were strongly associated with low birth weight, an association driven by the full-term births within the normal birth weight range. The findings show that the risk for adult asthma is partly established early in life and suggest that poor intrauterine growth is involved in the aetiology of asthma.

Adult↗