Search PubMed⌕ Search

Biomedical subjects

A Gulsvik

Publications and source records attributed to A Gulsvik.

At least 55 records · Page 3Linked to original sources
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↗
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↗