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Biomedical subjects

A Gulsvik

Publications and source records attributed to A Gulsvik.

At least 91 records · Page 5Linked to original sources

Serum house-dust-mite antibodies and reduced FEV1 in adults of a Norwegian community.

In this cross-sectional study we investigated whether the presence of specific serum IgE antibodies to house dust mite, timothy, birch, cat, and mold was associated with a reduced FEV1 in adults. We performed complete examinations on 82% of a stratified random sample of 18 to 73-yr-old adults (n = 1,239). Subjects with house-dust-mite antibodies had lower (p = 0.002) sex, age, and height standardized residuals of FEV1 (SFEV1) than those without any specific IgE antibody. This relationship did not differ significantly by sex, age, smoking habit, total serum IgE level, or season, and remained significant after excluding subjects with obstructive lung disease. For house-dust-mite antibodies we also observed a dose-response relationship between antibody levels and impaired lung function. In a final multiple linear regression analysis the presence of house-dust-mite antibodies was the only significant predictor (regression coefficient: -0.425; SE = 0.189; p = 0.02) of reduced SFEV1 after adjusting for smoking habit and lifetime tobacco consumption, season, total serum IgE level, and respiratory-symptom and disease status. Thus, house-dust-mite allergy is an independent predictor of reduced lung function in adults of a wide age range.

Adult↗

The efficacy and tolerability of inhaled salmeterol and individually dose-titrated, sustained-release theophylline in patients with reversible airways disease.

In a double-blind, double-dummy, cross-over, multicentre study, 141 patients with moderate reversible airways disease were randomized to receive either 50 micrograms salmeterol via a metered dose inhaler or individually dose-titrated oral theophylline, both twice daily for a 2-week period. Just over half (n = 77) the patients had received theophylline before, but 64 patients were new to theophylline therapy. Efficacy was based on lung function data and symptom scores. Salmeterol produced significantly higher increase in mean morning peak expiratory flow (PEF) of 161 min-1 (P < 0.001; 95% Confidence Interval (CI); 8-241 min-1) and mean evening PEF of 151 min-1 (p < 0.001; 95% CI; 7-221 min-1) compared with theophylline therapy. Further analysis of the data revealed that the increase in PEF with salmeterol compared with theophylline was highest in a sub-group of patients new to theophylline therapy. Patients on salmeterol had significantly less night-time awakenings than those on theophylline (P = 0.011) and significantly less daytime symptoms (P = 0.017). There was also a significant increase in the number of nights (P = 0.013) and days (P < 0.001) on salmeterol when no additional salbutamol was required compared with theophylline. Theophylline produced a higher incidence of adverse events compared with salmeterol. The results of this study show that inhaled salmeterol is more effective and better tolerated than individually dose-titrated oral theophylline over a 2-week study period in patients with moderate asthma.

Administration, Inhalation↗

Total and specific serum IgE levels in adults: relationship to sex, age and environmental factors.

We studied total and specific serum IgE levels cross-sectionally, potential predictors of obstructive lung disease, in a stratified random sample of 18-73-year-old adults (n = 1512). The attendance rate was 84%. The total IgE level and prevalences of specific IgE antibodies against house dust mite and cat were higher for men than for women. Specific IgE levels decreased by increasing age, while total IgE decreased in women only. Smokers had a higher IgE level than non-smokers, while non-smokers had more often specific IgE antibodies against timothy and birch than smokers. Subjects with occupational dust or gas exposure had a higher total IgE level than unexposed. The general population prevalences were for specific IgE antibodies against timothy 4.5%, house dust mite 3.2%, birch 2.6%, cat dander 1.6% mould 0.2% and against any of these 7.6%. In a multivariate analysis age, occupational dust or gas exposure as well as the interaction terms between sex and age and between smoking and pack-years were independent predictors for total IgE levels. Male sex, young age, never having smoked and the season of the year were independent predictors for having one or more of the five specific IgE antibodies. Subjects with total serum IgE in the highest quintile (> or = 66 kU/l) had an adjusted odds ratio of 37 (95% confidence interval: 11-120) for having one or more of the specific IgE antibodies examined, compared with those in the lowest quintile (< 5 kU/l). Demographic and environmental factors were thus predictors of total and specific IgE levels in this adult community.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

High-dose inhaled steroids in asthmatics: moderate efficacy gain and suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Research Council of the Norwegian Thoracic Society.

We wanted to evaluate the improvement in efficacy when increasing the daily dose of inhaled steroids and to compare the efficacy, safety, and tolerance of 1.6 mg beclomethasone dipropionate (BDP) with that of 2.0 mg fluticasone propionate (FP). The study was a randomized, double-blind, 3 month, multicentre study. One hundred and thirty four asthmatics currently using inhaled steroids (0.4-1.6 mg BDP or budesonide (BUD)) were stratified according to pretrial daily steroid use. Within each stratum they were randomized to either 1.6 mg BDP or 2.0 mg FP. A significant increase in the primary efficacy variables, i.e. mean morning and evening peak expiratory flow (PEF) (approximately 20 l.min-1) during the treatment period, was found for both treatments. No significant differences between the drugs were revealed for these primary or any other secondary efficacy variables (use of beta 2-agonists, symptom scores, and PEF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) recorded at the clinical visits). However, significant differences between treatments occurred regarding decrease of serum cortisol and adrenocorticotropic hormone. We conclude that, although both treatments gave statistically significant increases in efficacy parameters when compared with baseline, the increases were so small that they can be regarded as being clinically unimportant. Daily doses of BDP, 1.6 mg, and FP, 2.0 mg, had comparable effects on lung function. A suppression of the hypothalamic pituitary adrenal (HPA) axis was only found with a daily dose of 2 mg FP.

Administration, Inhalation↗

Contribution of hyperoxia to reduced pulmonary function after deep saturation dives.

Pulmonary function was measured before and after a 28-day saturation dive to a pressure of 0.25 MPa in eight subjects. PO2 was 40 kPa, with periods of 75 kPa for 2 h every 2nd day during the first 14 days, 50 kPa for the next 12 days, and a gradual fall to 21 kPa over the last 2 days in decompression. A 28-day saturation dive with six subjects to a pressure of 0.15 MPa and a PO2 of 21 kPa was used as control. The measurements included static and dynamic lung volumes and flows, transfer factor for carbon monoxide (TLCO), and a cycle ergometer exercise test. There was a significant reduction in TLCO of 9.8 +/- 6.0% (P < 0.001) after the dive when values were corrected for hemoglobin concentration changes. Effective alveolar volume was unchanged. There was a reduction in forced midexpiratory flow rate of 9.8 +/- 7.0% (P < 0.01), but forced vital capacity and forced expired volume in 1 s were unchanged. Peak oxygen uptake was reduced by 10.1 +/- 5.3% (P < 0.001). There were no significant changes in any of the lung function variables after the control dive. Exposure to raised PO2 contributes significantly to the changes in pulmonary function that have been reported after deep saturation dives to pressures of 3.1-4.6 MPa with a similar profile of oxygen exposure. TLCO is apparently a more sensitive index than vital capacity for oxygen toxicity.

Adult↗

Pulmonary function one and four years after a deep saturation dive.

The pulmonary function of 24 Norwegian divers who had participated in a deep saturation dive to pressures of 3.1-4.6 MPa was reevaluated one and four years later. Twenty-eight divers performing ordinary saturation diving to pressures of 0.8-1.6 MPa and followed over a three-year period served as referents. A significant reduction in forced expiratory volume in 1 s (FEV1.0) of 210 (SD 84) ml (P < 0.001) occurred the first year after the dive. Thereafter the annual reduction in FEV1.0 was 28 (SD 62) ml.year-1; this value did not differ from the 35 (SD 80) ml.year-1 of the referents. The forced midexpiratory flow rate and forced expiratory flow rates at low lung volumes were also significantly reduced one year after the deep dive, and the closing volume was increased. No significant changes occurred in forced vital capacity. The results agree with those of cross-sectional studies on divers' lung function and indicate the development of airflow limitation in relation to diving exposure.

Adult↗

Decline in FEV1 and airflow limitation related to occupational exposures in men of an urban community.

The purpose of this survey was to evaluate the effects of smoking and occupational exposures on the decline in forced expiratory volume in one second (FEV1), and the presence of airflow limitation (FEV1 x100/forced vital capacity (FVC) being < 65) at follow-up. A random sample of 1,933 men aged 22-54 years in Bergen, Norway, were invited into the survey. Smoking habits and measurements of FEV1 were recorded at the initial survey in 1965-1970 (n = 1,591) and at follow-up in 1988-1990 (n = 951). Past or present self-reported occupational exposures to eleven airborne agents (dusts, gases, vapours and fumes) and measurements of FVC were recorded at follow-up only. The decline in FEV1 was associated (p < 0.001) with age, body height and smoking. Smoking cessation reduced the decline to the level of lifetime nonsmokers. Accelerated decline in FEV1 was observed in subjects exposed to sulphur dioxide gas and to metal fumes. The adjusted decline in FEV1 increased progressively in subjects exposed to increasing numbers of occupational agents (test for trend: p < 0.01). Airflow limitation was observed in 9.5% at follow-up, and increased with age and cigarette consumption. In this community follow-up survey in men, smoking and occupational exposures to sulphur dioxide gas, metal fumes and the numbers of specific agents were found to be important predictors for accelerated decline in FEV1.

Adult↗

Quantitation of biological tumor markers (p53, c-myc, Ki-67 and DNA ploidy) by multiparameter flow cytometry in non-small-cell lung cancer.

Fifteen primary non-small-cell lung carcinomas (8 adenocarcinomas and 7 squamous-cell carcinomas) were analyzed by multiparameter flow cytometry for their expression of p53 and c-myc proteins. In addition, the fraction of cells staining with the proliferation-associated antibody Ki-67 and DNA ploidy was determined. These 4 biological markers were analyzed in parallel samples from a single-cell suspension made from fresh, frozen biopsies. Thus, the internal relationship between these markers within each tumor-cell population was established. Three different anti-p53 antibodies were used: PAb 421, PAb 1801 and PAb 240. All 15 tumors were p53-positive with the antibodies PAb 1801 and PAb 240, whereas only 9 were positive as judged by the antibody PAb 421. This indicates that the choice of p53 antibody is not irrelevant. Ten tumors were c-myc-positive; 7 of these were adenocarcinomas. The c-myc-positive tumors had a significantly higher level of p53 expression, judged by PAb 1801 and PAb 240, than c-myc-negative tumors. For PAb 421, there was no difference. We did not find any correlation between Ki-67 staining and expression of p53 and c-myc proteins, either with DNA ploidy, S-phase fraction or histological type. Our study indicates that there might be an association between accumulation of p53 protein and c-myc over-expression in non-small-cell lung cancer, and that this in particular might apply to adenocarcinomas. Furthermore, we show that multiparameter flow cytometry is a powerful tool in the study of the relationship between different markers in a cell population.

Biomarkers, Tumor↗

[Obstructive lung disease in a Norwegian population group--risk factors and occurrence].

In an ordinary Norwegian population which we studied, one in 13 persons suffered from an obstructive lung disease--bronchial asthma or chronic obstructive lung disease. The prevalence of the disease was the same in both sexes, but increased with age. There was a strong association between smoking and the disease. Occupational airborne pollution was an important risk factor. Taking the longest job held as a basis for the study, the adjusted odds ratio for obstructive lung disease in those exposed to a high degree of airborne pollution was 2.5 relative to those not so exposed. There was no difference between urban and rural areas in the frequency of the disease. Allergy and bronchial hypersensitivity were both associated with obstructive lung disease. Greater efforts should be put than at present into preventing obstructive lung disease.

Adult↗

Single breath transfer factor for carbon monoxide in an asymptomatic population of never smokers.

BACKGROUND: Data on reference values of transfer factor variables in general populations of asymptomatic never smokers are limited. The aim of this study was to examine the relation between test variables and age, height, haemoglobin concentration and carboxyhaemoglobin concentration. METHODS: Measurements of single breath transfer factor for carbon monoxide (TLCO) were obtained for a randomly selected sample of never smokers in north western Europe who were 18-73 years old and had no respiratory symptoms or disorders. Two recordings of TLCO with a ratio of inspiratory vital capacity to forced vital capacity of greater than 0.09 were obtained by standardised techniques for 304 subjects. RESULTS: The measurement errors expressed as a percentage of the common mean value of TLCO, volume adjusted TLCO (KCO), and alveolar volume (VA) were 4.5%, 4.2%, and 2.4% respectively. Multiple linear regressions showed sex specific effects of height and age on TLCO, and, in addition, of haemoglobin and carboxyhaemoglobin concentrations on KCO. VA was associated with height but not with age. The 5th and 95th centiles for TLCO and KCO in men and women were between 78% and 82% and between 120% and 127%, respectively, of predicted values when age and height were taken into account. CONCLUSION: Reference equations and normal values for transfer test variables in a large healthy population of never smokers are described in relation to age, height, and haemoglobin concentrations. To our knowledge, this is the first report of an association between carboxyhaemoglobin concentrations and KCO in a population of never smoking men and women.

Adolescent↗

Occupational airborne exposure of the general population of a Norwegian county.

Occupational airborne exposure was examined for a stratified sample (N = 1275) of the general population aged 18-73 years in Hordaland County, Norway. The subjects identified all jobs of more than six months since leaving school and stated whether they had been occupationally exposed to specific agents and work processes potentially harmful to the lungs. The prevalence in the population ever having been exposed was 18% for asbestos, 9% for quartz, 5% for aluminum dust, 6% for wood dust, 12% for metal gases, 12% for welding, 9% for soldering, and 1% for hairdressing. According to occupational title (last job), 3% of the population had held a job with a high degree of airborne exposure, 26% a job with moderate exposure, and 70% a job with no airborne exposure. During their worklife both the men and the women tended to leave polluted jobs more often than unpolluted jobs. Occupational exposure to airborne pollutants potentially harmful to the lungs is widespread in this Norwegian general population.

Adolescent↗

[Allergic diseases in Norway. Operative definition, occurrence and risk factors].

Cross-sectional surveys of Norwegian populations indicate that 14-17 per cent of the children below the age of 15 years have had an allergic disease. The corresponding figure in adults is 37 per cent. Among children allergic diseases tend to be more frequent in boys than in girls. In adults there is no significant sex-difference regarding the prevalences of hay fever and obstructive lung disease, while eczema and urticaria are more frequent in women than in men. There is an association of smoking, occupational airborne exposure and degree of industrialization to the prevalences of allergic diseases. There are indications of an increase in occurrence of allergic diseases. The need for standardized operative definitions of these diseases is emphasized.

Adolescent↗

Prevalence of obstructive lung disease in a general population: relation to occupational title and exposure to some airborne agents.

BACKGROUND: The importance of occupational exposure to airborne agents in the development of obstructive disease is uncertain. Studying the relation in a community population has the benefit of reducing the healthy worker effect seen in studies of working populations. METHODS: The prevalence of obstructive lung disease was examined in a Norwegian general population aged 18-73 in a two phased cross sectional survey. In the second phase a stratified sample (n = 1512) of those responding in the first phase was invited for clinical and spirometric examination (attendance rate 84%). Attenders were asked to state all jobs lasting greater than 6 months since leaving school and to say whether they had been exposed to any of seven specific agents and work processes potentially harmful to the lungs. RESULTS: The prevalence of asthma and chronic obstructive lung disease was 2.4% and 5.4%, respectively; spirometric airflow limitation (FEV1/FVC less than 0.7 and FEV1 less than 80% of predicted values) was observed in 4.5% of the population. All jobs were categorised into three groups according to the degree of potential airborne exposure. Having a job with a high degree of airborne exposure increased the sex, age, and smoking adjusted odds ratio for obstructive lung disease (asthma and chronic obstructive lung disease) by 3.6 (95% confidence interval 1.3 to 9.9) compared with having a job without airborne exposure; the association with spirometric airflow limitation was 1.4 (0.3 to 5.2). Occupational exposures to quartz, metal gases, aluminium production and processing, and welding were significantly associated with obstructive lung disease after adjusting for sex, age, and smoking habit, the adjusted odds ratios varying between 2.3 and 2.7. Occupational exposure to quartz and asbestos was significantly related to spirometric airflow limitation in people older than 50. CONCLUSION: Occupational title and exposure to specific agents and work processes may be independent markers of obstructive lung disease in the general population.

Adolescent↗

Bronchial responsiveness in a Norwegian community.

Bronchial responsiveness to methacholine was examined in a Norwegian general population sample (n = 490) 18 to 73 yr of age. Altogether, 20 and 6% of the sample had PC20 less than or equal to 32 mg/ml and PC20 less than or equal to 8 mg/ml, respectively. The relationship of bronchial responsiveness to the following potential predictors were examined: sex, age, smoking habits, airway caliber (FEV1), FEV1 percent predicted (%FEV1), urban-rural area of residence, occupational airborne exposure in present job, and total serum IgE. After adjusting for age and FEV1, the odds ratio for PC20 less than or equal to 32 mg/ml was higher for men than for women in smokers and in ex-smokers, but did not vary by sex in nonsmokers, the adjusted odds ratio for PC20 less than or equal to 32 mg/ml in male compared with female smokers being 8.4 (95% Cl: 2.5-37.4). Irrespective of smoking status the sex- and FEV1-adjusted odds ratio for PC20 less than or equal to 32 mg/ml fell with increasing age. For every 10-yr increase in age the adjusted odds ratio for PC20 less than or equal to 32 mg/ml methacholine in nonsmokers decreased by 2.0 (95% Cl: 1.3-3.3). Also FEV1 and %FEV1 were predictors of PC20 less than or equal to 32 mg/ml after adjusting for sex and age irrespective of smoking status. Bronchial responsiveness (PC20 less than or equal to 8 mg/ml) was more prevalent in rural than in urban areas, the adjusted odds ratio being 2.5 (95% Cl: 1.1-5.9) for bronchial responsiveness in rural compared with urban residents after adjusting for sex, age, smoking habits, and FEV1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗