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Biomedical subjects

C Janson

Publications and source records attributed to C Janson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Autoantibodies in Estonia and Sweden, populations with different responses to allergens.

BACKGROUND: There are substantial differences in immune-mediated disease prevalence between different countries and populations which cannot be explained by genetic variability. AIMS: To compare the prevalence of antinuclear (ANA), antimitochondrial, antireticulin, liver-kidney microsomal, parietal cell, thyroid microsomal and double-stranded DNA (dsDNA) antibodies among adults aged 20-44 years in two towns, i.e. in Tartu, Estonia (n = 448) and in Uppsala, Sweden (n = 532) with a low and a high prevalence of allergy. METHODS: For autoantibody detection, standard indirect immunofluorescence tests on tissue and Chritidia lucilia antigenic preparations were used (sera were diluted starting from 1:10). RESULTS: The prevalence of ANA was lower in Tartu than in Uppsala (3 vs. 10% among males and 11 vs. 16% among females; p<0.01 and p<0.1, respectively). Furthermore, dsDNA antibody-positive cases were only identified in Uppsala. The largest difference between the two populations was revealed for IgM type ANA, both among males (1 vs. 6%; p<0.02) and females (5 vs. 11%; p<0.01). In addition, the antibody titers were lower in Tartu than in Uppsala (p<0.05). The prevalence of other autoantibodies was similar in the two towns. CONCLUSIONS: The findings could support that Th2-like immune responses are commoner in Sweden than in Estonia, as previously suggested by the higher prevalence of allergy.

Adult↗
PubMed1998

Snoring and hypertension: a 10 year follow-up.

In many cross-sectional studies an association has been found between snoring and hypertension. However, differing results have been obtained when confounding factors have been taken into account. To establish whether snoring is a risk factor for developing hypertension, a population-based, prospective survey was performed. In 1984 and 1994, 2,668 males, aged 30-69 yrs at baseline, answered questionnaires concerning sleep disturbances and somatic disease. Of the habitual snorers in 1984, 12.5% reported that they had developed hypertension during the period, compared with 7.4% of the remaining subjects (p<0.001). In a multiple logistic regression model persistent snoring, i.e., reported habitual snoring in both 1984 and 1994, was found to be an independent predictor for the development of hypertension among males aged 30-49 yrs (odds ratio 2.6, 95% confidence interval 1.5-4.5) after adjustments for age, body mass index (BMI), weight gain, smoking, alcohol dependence, and physical inactivity. Among the subjects aged 50-69 yrs in 1984, no association between snoring and development of hypertension was found. Although based only on reported data, the results indicate that persistent snoring is an independent risk factor for the development of hypertension among males aged <50 yrs. Prospective surveys, including whole-night sleep recordings, are needed to establish whether this is due to a higher prevalence of obstructive sleep apnoea syndrome among snorers or whether nonapnoeic snorers with increased upper airway resistance also have an increased risk of developing hypertension.

Adult↗
PubMed1998

Individual use of antiasthmatic drugs in the European Community Respiratory Health Survey.

A previous analysis of drug utilization in the European Community Respiratory Health Survey found that only between 8 and 29% of subjects with asthma-related symptoms were using antiasthmatic medication in the different areas studied. The aim of this analysis was to investigate which variables were related to individual use of antiasthmatic medication in different geographical areas. Thirty-three centres in 14 countries were analysed, in which a total of 16,854 people (52.1% females, mean age 33.8 yrs, range 20-48) underwent a structured interview, measurement of specific immunoglobin E, spirometry and methacholine challenge test. The use of antiasthmatic drugs in individuals was, in most countries, independently related to asthma-related respiratory symptoms, bronchial hyperresponsiveness (BHR) and atopy. In all countries smokers with respiratory symptoms were less likely to be using antiasthmatic drugs than nonsmokers and exsmokers. In four of 14 countries females were significantly more likely to use antiasthmatic medication than males, while age and socioeconomic status were unrelated to medication. The use of inhaled anti-inflammatory drugs was positively related to symptoms, BHR and atopy and negatively related to current smoking. In conclusion, in many countries smokers were less likely to be using antiasthmatic drugs than were nonsmokers with comparable levels of symptoms and bronchial hyperresponsiveness. Age and socioeconomic status were unrelated to medication, while in some countries females were more likely than males to use antiasthmatic medication.

Adult↗
PubMed1998

A 10-year follow-up of snoring in men.

STUDY OBJECTIVES: Little is known about the natural development of snoring, and this survey was conducted to study the development of snoring in men over a 10-year period. DESIGN: Population-based prospective survey. SETTING: The Municipality of Uppsala, Sweden. PARTICIPANTS AND MEASUREMENTS: In 1984, 3,201 randomly selected men aged 30 to 69 years answered a questionnaire on snoring and sleep disturbances. Of the 2,975 survivors in 1994, 2,668 (89.7%) answered a new questionnaire with identical questions to those used at baseline. Questions about smoking habits, alcohol, and physical activity were also added. RESULTS: Habitual snoring was reported by 393 men (15.0%) in 1984 and by 529 (20.4%) 10 years later. In both 1984 and 1994, the prevalence of snoring increased until age 50 to 60 years and then decreased. Risk factors for being a habitual snorer at the follow-up were investigated using multiple logistic regression with adjustments for previous snoring status, age, body mass index (BMI), weight gain, smoking habits, and physical activity. In men aged 30 to 49 years at baseline, the predictors of habitual snoring at the follow-up, in addition to previous snoring status, were as follows: persistent smoking (adjusted odds ratio, 95% confidence interval) (1.4, 1.1 to 1.9), BMI 1984 (1.1, 1.02 to 1.1/kg/m2) and weight gain (1.1, 1.03 to 1.2/kg/m2). Among men aged 50 to 69 years, after adjustments for previous snoring status and age, weight gain was the only significant risk factor for developing habitual snoring (1.2, 1.05 to 1.4/kg/m2). CONCLUSIONS: In men, the prevalence of snoring increases up to the age of 50 to 60 years and is then followed by a decrease. Weight gain is a risk factor for snoring in all age groups, while smoking is mainly associated with snoring in men <60 years of age.

Adult↗
PubMed1998

Symptoms related to the sick building syndrome in a general population sample: associations with atopy, bronchial hyper-responsiveness and anxiety.

OBJECTIVE: The sick building syndrome (SBS) is a term mainly applied to irritative symptoms in the eyes, skin and upper airways that are experienced in certain environments. The aim of this study was to investigate the characteristics of subjects from the general population that report SBS-related symptoms. METHODS: The study comprised a randomly selected population of 418 individuals aged 20-45 years. The subjects underwent a structured interview, skin prick tests, a methacholine provocation test and answered two questionnaires respectively assessing psychiatric status and the presence of SBS symptoms. RESULTS: Eighty-seven subjects (21%) reported one or more SBS symptom weekly. Most common were general symptoms reported by 10% of the population. Female sex (odds ratio [OR] = 2.1), atopy (OR = 2.2) and anxiety (OR = 2.6) were significant independent risk factors for reporting at least one SBS-related symptom. Anxiety (OR = 3.2) and depression (OR = 4.4) were significant predictors for general symptoms, while bronchial hyper-responsiveness was a significant predictor for pharyngeal symptoms (dryness in the throat, sore throat and irritating cough) (OR = 5.4). CONCLUSIONS: Sick building symptoms are common in the general population and among women, while atopy and anxiety increase the risk of reporting such symptoms. Psychological factors are mainly related to general symptoms, while bronchial hyperresponsiveness is connected with pharyngeal symptoms.

Adult↗
PubMed1997

Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty.

OBJECTIVE: To study the long-term outcome after treatment with uvulopalatopharyngoplasty (UPPP). DESIGN: Long-term follow-up (4-8 years) with polysomnography. SETTING: Referral center for patients with sleep-disordered breathing. PATIENTS: Thirty-four consecutive patients of whom 25 (22 men and 3 women; mean age, 49 years) participated in the follow-up. All patients had obstructive sleep apnea syndrome. INTERVENTION: Uvulopalatopharyngoplasty. MAIN OUTCOME MEASURES: Symptoms and apnea-hypopnea index (AHI) before and after UPPP. Response to treatment defined as a 50% or more reduction in AHI and a postoperative AHI of 10 or less. RESULTS: Reduced prevalence of snoring and daytime sleepiness and reduction in AHI (mean [+/-SD], 40 +/- 26 to 21 +/- 21) at follow-up (P < .001). Sixteen patients (64%) were responders after 6 months and 12 (48%) at the long-term follow-up. Responders had a lower preoperative AHI (25 +/- 7) than did nonresponders (48 +/- 29) (P < .05). None of the 7 patients with preoperative AHI of more than 40 were responders (P < .01). No difference was seen in preoperative body mass index, lung function, ventilatory response to carbon dioxide, computed tomography scan of upper airways, or change in body mass index between responders and nonresponders. CONCLUSIONS: Four to 8 years after UPPP, about half of our patients were clinically and objectively improved. Uvulopalatopharyngoplasty should be reserved for patients with mild or moderate obstructive sleep apnea. After UPPP, long-term follow-up is recommended because some initially successfully treated patients will relapse in the long term.

Female↗
PubMed1997

Asthma and the indoor environment: the significance of emission of formaldehyde and volatile organic compounds from newly painted indoor surfaces.

As a part of the worldwide European Community Respiratory Health Survey, possible relations between asthma and emissions from newly painted indoor surfaces were studied. The participants (n = 562) answered a self-administered questionnaire, with questions on symptoms and indoor exposures, including indoor painting, during the last 12 months. The participants also underwent a structured interview, spirometry, peak flow measurements at home (PEF), methacholine provocation test for bronchial hyper-responsiveness (BHR), and skin prick tests. In addition, serum concentration of eosinophilic cationic protein (S-ECP), blood eosinophil count (B-EOS), and total immunoglobulin E (S-IgE) were measured. Current asthma was defined as a combination of BHR and at least one asthma-related symptom (wheezing and attacks of breathlessness). The information gathered on indoor painting was compared with exposure measurements of formaldehyde and volatile organic compounds (VOC) performed in a selected sample of the dwellings (n = 62). Relations between exposures, asthma and clinical signs were calculated by multiple linear or logistic regression, adjusting for possible influence of age, gender and tobacco smoking. The prevalence of asthma was increased among subjects with domestic exposure to newly painted surfaces (OR = 1.5; 95% CI 1.0-2.4), particularly newly painted wood details (OR = 2.3; 95% CI 1.2-4.5) and kitchen painting (OR = 2.2; 95% CI 1.1-4.5). Moreover, blood eosinophil concentrations were significantly elevated among subjects living in newly painted dwellings. A significantly increased prevalence of symptoms related to asthma, but not BHR, was observed in relation to workplace exposure to newly painted surfaces. The indoor concentration of aliphatic compounds (C8-C11), butanols, and 2,2,4-trimethyl 1,3-pentanediol diisobutyrate (TXIB) was significantly elevated in newly painted dwellings. The total indoor VOC was about 100 micrograms/m3 higher in dwellings painted in the last year. A significant increase in formaldehyde concentration was observed in dwellings with newly painted wood details. Our results indicate that exposure to chemical emissions from indoor paint is related to asthma, and that some VOCs may cause inflammatory reactions in the airways. To improve asthma management, and to counteract the increasing frequency of asthma, the significance of the indoor environment should not be neglected. Our study suggests that the contribution of emissions from paint to indoor concentrations of formaldehyde and VOCs should be as low as possible.

Adult↗
PubMed1997

Seasonal variation in serum eosinophilic cationic protein (S-ECP) in a general population sample.

The aim of this investigation was to study the seasonal variation in the serum levels of eosinophil cationic protein (S-ECP). The study population comprised a general population sample of 379 individuals (range: 20-45 years) who were investigated with blood sample for the measurement of S-ECP, skin prick test and methacholine challenge. The examination took place between May and October 1991. Of the 379 subjects investigated, 137 (36%) were atopic. A significant seasonal variation in S-ECP was found in the group of birch-pollen-positive subjects (P < 0.05), but not in the non-atopic or birch-negative atopic group. The mean level of S-ECP in birch-positive subjects was about twice as high in June as in birch atopic subjects examined during other months. It is concluded that seasonal variation in birch-pollen-positive subjects must be taken into account when using S-ECP clinically or in epidemiological research.

Adult↗
PubMed1997

Sleep disturbances in a young adult population: can gender differences be explained by differences in psychological status?

To study the prevalence of reported sleep disturbances and the association between these complaints and psychological status, 529 randomly selected subjects aged 20-45 years were questioned about their sleep symptoms and psychological status by means of questionnaires. In this young population, feeling refreshed in the morning almost every day was reported by only 15.3%. Females reported a significantly longer mean total sleep time (TST) than males (F: 425 +/- 58 minutes, M: 403 +/- 50 minutes; p < 0.01). Despite this, the difference compared with the reported need of sleep was greater in females (56 +/- 62 minutes) than in males (40 +/- 51 minutes) (p < 0.05). Difficulties maintaining sleep (DMS, > or = 3/week) (F: 20.1%, M: 10.4%; p < 0.01), the absence of feeling refreshed in the morning (F: 36.2%, M: 26.8%; p < 0.05), and excessive daytime sleepiness (EDS) (F: 23.3%, M: 15.9%; p < 0.05) were significantly more common among females. According to the Hospital Anxiety and Depression scale, females suffered from anxiety more frequently than males (F: 32.8%, M: 18.9%; p < 0.001). An association was found between anxiety and many sleep disturbances. After making adjustments for age, smoking, snoring, gender and psychological status by means of multiple regression, the gender differences mentioned above remained significant. We conclude that despite a longer TST, females report insufficient sleep, EDS, DMS, and the absence of feeling refreshed in the morning more frequently than males. The higher prevalence of anxiety among females alone cannot explain the gender differences in sleep disturbances seen in this population.

Adult↗
PubMed1997

Physician-diagnosed asthma and drug utilization in the European Community Respiratory Health Survey.

The aim of this analysis was to estimate the geographical variation in the prevalence of physician-diagnosed asthma and treatment practice for asthma in young adults. The results are based on an ecological analysis of 34 centres in 14 countries, in which a total of 17,029 randomly selected subjects (52% females, age 20-48 yrs) underwent a structured interview and spirometry as part of the European Community Respiratory Health Survey. The sample was enriched with 2,903 symptomatic subjects when investigating treatment in subjects with physician-diagnosed asthma. The prevalence of physician-diagnosed asthma was highest in New Zealand and Australia (11-13%) and lowest in Erfurt, Germany (1.2%) and Spain (1.5-3.0%). The reported use of antiasthma medication in the last 12 months was also highest in New Zealand and Australia (12-16%) and correlated closely with the prevalence of diagnosed asthma (r=0.89, p<0.001). Herbal remedies against breathing problems had been used by 13% of subjects in Hamburg but the reported use of alternative remedies for breathing problems was low in most other centres. The use of inhaled anti-inflammatory drugs in subjects with physician-diagnosed asthma ranged from 49% in the UK to 17% in Italy and correlated with the prevalence of doctors' consultations within the last 12 months (r=0.66, p<0.05). The prevalence of anti-inflammatory treatment was positively related to the prevalence of nocturnal asthma symptoms (p<0.05). We conclude that there is a wide geographical variation in the prevalence of physician-diagnosed asthma and use of antiasthma medication. The geographical variation in the use of anti-inflammatory drugs among individuals with diagnosed asthma may be related to variations in asthma severity, as well as differences in treatment practices between countries.

Adult↗
PubMed1996

Eosinophil peroxidase: a new serum marker of atopy and bronchial hyper-responsiveness.

Do markers of eosinophil activation differ in their ability to detect subjects with atopy or bronchial hyper-responsiveness (BHR)? Comparisons of serum levels of eosinophil peroxidase (S-EPO), of eosinophil cationic protein (S-ECP) and the blood eosinophil count (B-Eos) have been made between 154 subjects aged 20-44 years, participating in the European Community Respiratory Health Survey in Uppsala, Sweden. Subjects with atopy had significantly higher levels of S-EPO and S-ECP than those without atopy (P <0 center dot 001). Subjects with BHR had significantly higher levels of S-EPO (P <0 center dot 001) and B-Eos (P <0 center dot 01) than subjects without BHR. Persons reporting asthma-related symptoms had significantly higher levels of S-EPO and B-Eos than subjects without such symptoms (P <0 center dot 001 and P <0 center dot 01, respectively). Asthma symptom score correlated significantly to S-EPO (r = 0 center dot 26, P <0 center dot 01), S-ECP (r = 0 center dot 20, P <0 center dot 05) and B-Eos (r = 0 center dot 18, P <0 center dot 05). Finally, S-EPO was significantly more sensitive than S-ECP for detecting subjects with BHR (P <0 center dot 05) and significantly more sensitive than B-Eos for detecting both subjects with BHR and subjects with a combination of atopy and BHR (P <0 center dot 05). It is concluded that S-EPO is a promising marker with a higher sensitivity for BHR than S-ECP or B-Eos. Further studies are needed to define the value of S-EPO when following disease activity.

Adult↗
PubMed1996

Prevalence of sensitization to food allergens in adult Swedes.

BACKGROUND: The results from a population study on respiratory symptoms and bronchial hyperresponsiveness in relation to symptoms of food intolerance and sensitization to food allergens are reported. METHODS: The study included 1,812 men and women, aged 20 to 44 years and residents in three areas of Sweden who participated in the European Community Respiratory Health Survey. The prevalence of IgE sensitization to egg white, fish, wheat, peanut, soy, and milk was assayed by CAP-RAST and the prevalence of symptoms of food intolerance was determined by a standardized questionnaire. RESULTS: The study group included a random sample of 1,397 subjects from the general population at the three centers. Of these, 85 (6%) had specific IgE antibodies to one of the food allergens and 345 (25%) reported symptoms of food intolerance. After enrichment with subjects suffering from symptoms of asthma, the sample included a total of 1,812 individuals of which 144 subjects had specific IgE antibodies to one or more of the food allergens studied. Of these 144, 52% reported food intolerance but only 16% related the symptoms to any of the food allergens in the panel. Sensitization to food allergens was more common in atopic subjects, subjects reporting current asthma, and subjects with bronchial hyperresponsiveness (P < .001). These associations remained significant after adjustment for the degree of allergic sensitization, whether defined as the number of positive skin prick tests or as total serum IgE levels. CONCLUSIONS: Although sensitization to food allergens is not uncommon in adults, the correlation to specific symptoms of food intolerance is weak. Sensitization to food allergens may have special relevance to asthma and bronchial hyperresponsiveness.

Adult↗
PubMed1996

Skin prick tests and specific IgE in adults from three different areas of Sweden.

The aims of this part of the European Respiratory Health Survey were to estimate the prevalence of atopic sensitization to inhalant allergens among adults in three different areas of Sweden and to investigate the association between sensitization and certain risk factors. Randomly selected subjects aged 20-46 years from Göteborg, Uppsala, and Västerbotten were investigated with the skin prick test (SPT), analyses for specific IgE antibodies in serum (specific IgE) and total serum immunoglobulin E (total IgE), and a questionnaire. SPT was performed in 1572 subjects and analyses of specific IgE in 1470. One or more positive SPT were found in 35.6% and one or more positive specific IgE in 31.7%-approximately the same values in all three areas. Birch, grass, cat, and dog were the most frequent sensitizing agents and occurred at similar prevalences, i.e., around 15%, in all areas. The SPT to mite was positive in 14.1% in Göteborg, 7.4% in Uppsala, and 7.9% in Västerbotten. A positive SPT to pellitory of the wall (Parietaria), not described previously in Sweden, was found in 3.4% in Göteborg. Living in Göteborg was independently associated with a higher risk of a positive SPT to mite and Parietaria. Heredity, male sex, and low age were independently associated with atopy. Birth in the Scandinavian countries was independently associated with sensitization to cat, whereas birth in other countries was associated with sensitization to mite. The overall prevalence of atopy was similar in the three Swedish areas, but the sensitizing allergens varied. There is an indication that sensitization is increasing in the population, as low age was associated with sensitization. Sensitization to cat, but not to mite, appears to be particularly important in persons born in the Scandinavian countries.

Adult↗
PubMed1996

Increased prevalence of sleep disturbances and daytime sleepiness in subjects with bronchial asthma: a population study of young adults in three European countries.

The aim of this study was to investigate whether asthma is associated with decreased quality of sleep and increased daytime sleepiness. The study involved a random population of 2,202 subjects supplemented by 459 subjects with suspected asthma, aged 20-45 yrs. The subjects were from Reykjavik (Iceland), Uppsala and Göteborg (Sweden) and Antwerp (Belgium), and participated in the European Community Respiratory Health Survey. The investigation included a structured interview, methacholine challenge, skinprick tests and a questionnaire on sleep disturbances. Participants in Iceland and Sweden also estimated their sleep times and made peak expiratory flow (PEF) recordings during a period of 1 week. Asthma was defined as self-reported physician-diagnosed asthma with current asthma-related symptoms (n = 267). Difficulties inducing sleep (DIS) and early morning awakenings (EMA) were about twice as common, and daytime sleepiness 50% more common, in asthmatics compared with subjects without asthma. After adjusting for possible confounders, a positive association was found between asthma and: DIS (odds ratio (OR) = 1.8); EMA (OR = 2.0); daytime sleepiness (OR = 1.6); snoring (OR = 1.7); and self reported apnoeas (OR = 3.7). Allergic rhinitis, which was reported by 71% of subjects with asthma, was independently related to DIS (OR = 2.0) and daytime sleepiness (OR = 1.3). A significant correlation was found between the number of asthma-related symptoms and sleep disturbances (p < 0.001). Asthma is associated with decreased subjective quality of sleep and increased daytime sleepiness. Concurrent allergic rhinitis may be an important underlying cause of sleep impairment in asthmatic patients.

Adult↗
PubMed1996

Habitual coughing and its associations with asthma, anxiety, and gastroesophageal reflux.

STUDY OBJECTIVE: Coughing was studied in relation to different disorders and objective variables indicative of airway inflammation. SETTING: A random sample of 800 persons, aged 20 to 44 years, was chosen from a larger cohort of participants in the European Community Respiratory Health Survey in Uppsala Sweden; of these, 623 participated. This sample was enriched with 201 individuals who reported asthma-related symptoms or the use of asthma medication. METHODS: The study comprised a structured interview, including questions about habitual (productive and nonproductive) and nocturnal coughing and spirometry, methacholine challenge, peak flow diary, skin prick tests, and measurements of blood eosinophil count and serum eosinophil cationic protein (S-ECP). RESULTS: A significant positive correlation was found between productive coughing and asthma (adjusted odds ratios [OR] = 2.0), allergic rhinitis (OR = 1.9), gastroesophageal reflux (OR = 4.4), smoking (OR = 1.9), and anxiety (OR = 1.8), while nonproductive coughing was related to female gender (OR = 1.8) and anxiety (OR = 1.7). Nocturnal coughing was positively correlated to female gender (OR = 1.8), smoking (OR = 1.9), and asthma (OR = 2.2). Bronchial hyperresponsiveness was positively related to productive coughing (p < 0.001), nonproductive coughing, and nocturnal coughing (p < 0.05). S-ECP was significantly higher in individuals with nonproductive coughing compared with subjects without habitual coughing (p < 0.01). CONCLUSIONS: We conclude that habitual coughing has a significant association with different disease categories.

Adult↗
PubMed1996

Serology of chlamydia in relation to asthma and bronchial hyperresponsiveness.

Antibodies to the 3 strains of chlamydia were measured in the sera of 197 subjects; 122 with asthma-related symptoms and 75 from the general population. The subjects underwent a structured interview, spirometry, a methacholine provocation test and skin-prick tests. For chlamydia antibodies, IgG titer values of > or = 1:512 and/or IgM > or = 1:16 were regarded as evidence of a current or recent infection while IgG levels < 1:512 and > 1:32 were regarded as indicative of a previous infection. For Chlamydia pneumoniae, a relationship was found between current or recent infection and wheezing (odds ratio (OR) 6.0, confidence intervals (CI) 1.3-28) and also between IgA antibodies and bronchial hyperresponsiveness (BHR) (OR 3.3, CI 1.3-8.3). For Chlamydia trachomatis, serological signs of a previous infection were found significantly more often in subjects who reported having had asthma at some time: (OR 3.2, CI 1.4-7.1), asthma during the last year (OR 3.2, CI 1.4-7.1), wheezing during the last year (OR 4.2, CI 1.6-6.6) and in those who had BHR (OR 2.7, CI 1.2-6.1). We conclude that a relationship may exist between Chlamydia pneumoniae and Chlamydia trachomatis infections and asthma-related symptoms and BHR.

Adult↗