Biomedical subjects

C Janson

Publications and source records attributed to C Janson.

At least 109 records · Page 6Linked to original sources

PubMed1994

Occupational exposure to water-based paints and self-reported asthma, lower airway symptoms, bronchial hyperresponsiveness, and lung function.

The associations between occupational exposure to water-based paints and the prevalence of self-reported asthma, other lower airway symptoms, bronchial hyperresponsiveness (BHR), and lung function were studied in house painters. Symptom prevalences were obtained from a self-administered questionnaire sent to 415 male painters during 1989-1992. Clinical investigations were carried out in three selected groups: 23 painters with asthmatic symptoms, nine painters with other lower airway symptoms, and 12 painters without airway symptoms. The clinical studies included lung function test, methacholine provocation test, and occurrence of atopy, confirmed by skin prick test to common allergens. In addition, a group of 18 young male painters with no occupational exposure to solvent-based paints were followed with dynamic spirometry before and after a workshift, when only water-based paints were used. The prevalence of self-reported asthma (7%) was somewhat, but not statistically, increased compared to an industrial population without exposure to water-based paints or other airway irritants. A decrease in FEV1 and FVC during the workday was observed in the young painters. In the clinical studies the painters exhibited increased BHR compared to the referents and a decreased FEV1. The number of years working as a painter was related to a decrease in FEV1, which was most pronounced in subjects with atopy who also reported lower airway symptoms in relation to the degree of work with water-based paints, but not to the degree of use of solvent-based paints. Our results indicate that house painters have an increased risk of airway problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Serum eosinophil cationic protein in relation to bronchial asthma in a young Swedish population.

How are the serum concentration of eosinophil cationic protein (S-ECP) and the blood eosinophil count (B-Eos) related to symptoms of asthma, allergy, and bronchial hyperresponsiveness (BHR)? We measured S-ECP, B-Eos, and total and specific IgE in serum in blood samples from 699 randomly selected persons 20-44 years old. They also underwent a structured interview, spirometry, a methacholine provocation test, and skin prick tests as part of the European Community Respiratory Health Survey. B-Eos and S-ECP were found to be closely related to asthma symptom score (P < 0.001), total IgE (P < 0.001), and BHR (P < 0.001). On the basis of the results, the subjects were divided into four groups: healthy controls, patients with allergic rhinitis, patients with nonallergic asthma, and patients with allergic asthma. There were significant differences in both B-Eos and S-ECP among the groups (P < 0.001), the highest values being found in the allergic asthma group. B-Eos and S-ECP each had an additive value in predicting the occurrence of asthma. Among persons with high concentrations of both variables, asthma was eight times more common than in those with low concentrations. Allergy and BHR were also found to be independently related to B-Eos and S-ECP levels. Furthermore, both B-Eos and S-ECP showed good correlation to subjective and objective measures of asthma activity. We conclude that both B-Eos and S-ECP and their interrelationship may be of value in assessing the activity of asthma. However, their role in disease management was not established in this cross-sectional study.

Adult↗

PubMed1994

Anxiety and depression in relation to respiratory symptoms and asthma.

The aim of this investigation was to study the relationship between psychologic status and respiratory health. The study comprised 715 persons aged 22 to 44 who participated in the European Commission Respiratory Health Survey. The study included a structural interview, spirometry, methacholine challenge, peak flow diary, skin prick test, and measurement of eosinophil activity in peripheral blood. The psychologic status was assessed by means of the hospital anxiety and depression (HAD) scale questionnaire. A significant correlation was found between anxiety and depression and the report of asthma-related symptoms, such as attacks of breathlessness after activity and waking with attacks of breathlessness (p < 0.01). However, there was no significant correlation between anxiety or depression and a self-reported diagnosis of asthma or objective asthma-related variables, such as peak flow variability or response to methacholine. When evaluating the combined influence of psychologic factors and objective variables, HAD score correlated independently with reported wheezing (p < 0.05), waking with attacks of breathlessness (p < 0.01), waking with chest tightness, attacks of breathlessness when at rest, and attacks of breathlessness after activity (p < 0.001). We conclude that there is an association between reported respiratory symptoms and psychologic status. However, there was no evidence that patients with diagnosed bronchial asthma had more anxiety and depression than those without asthma. This result indicates that it may be valuable to include psychologic status indicators in respiratory symptom questionnaires.

Adult↗

PubMed1994

Symptoms related to asthma and chronic bronchitis in three areas of Sweden.

Does the prevalence of respiratory symptoms differ between regions? As a part of the European Community Respiratory Health Survey, we present data from an international questionnaire on asthma symptoms occurring during a 12 month period, smoking and symptoms of chronic bronchitis. The questionnaire was mailed to 10,800 persons aged 20-44 yrs living in three regions of Sweden (Västerbotten, Uppsala and Göteborg) with different environmental characteristics. The total response rate was 86%. Wheezing was reported by 20.5%, and the combination of wheezing without a cold and wheezing with breathlessness by 7.4%. The use of asthma medication was reported by 5.3%. Long-term cough and/or morning cough together with problems with phlegm was reported by 12.8%; the prevalence being highest in the most polluted area (Göteborg). When using multivariate analysis, no significant difference in asthma-related symptoms was found between the centres. Women reported cough more frequently, but otherwise gender did not influence symptom prevalence. Our results indicate that bronchitis symptoms occur more frequently in Göteborg, the most polluted of the Swedish centres, but that the prevalence rates of asthma-related symptoms do not differ between these three regions.

Adult↗

PubMed1994

Excessive daytime sleepiness and fatigue in nonapnoeic snorers: improvement after UPPP.

Even in the absence of sleep apnoea, heavy snoring may be a cause of excessive daytime sleepiness (EDS) and fatigue. The aim of this investigation was to study whether uvulopalatopharyngoplasty (UPPP) is effective in relieving snoring and excessive daytime sleepiness in nonapnoeic snoring patients. UPPP was assessed in 155 nonapnoeic, snoring patients (136 men and 19 women, mean age 45 yrs). Postoperative evaluation was made after 3 months in 105 patients, and after 12 months in 50 patients. Fifty four patients were evaluated after both 3 and 12 months. In 49 patients, a further evaluation was made after 2 yrs. The results were compared with those of 76 conservatively-treated, nonapnoeic, snoring patients, who were reinvestigated 12 months after their initial examination. The proportion of patients with frequent loud snoring had decreased postoperatively from 96 to 18%. A highly significant improvement was reported in EDS and daytime fatigue. The proportion of patients who reported problems staying awake when driving had decreased from 29 to 7%, and the number who felt rested when awakening in the morning had increased from 23 to 78 after the operation. The patients in the UPPP group had somewhat more severe symptoms before treatment than those treated conservatively. One year after treatment the situation had been reversed, with significantly more snoring and excessive daytime sleepiness in the conservatively-treated group. In conclusion, these results indicate that UPPP is effective in relieving snoring and EDS in nonapnoeic snorers.

Adult↗

PubMed1993

Dyspnea in acute asthma: relationship with other clinical and physiologic variables.

This investigation comprised 58 patients (35 men, mean age 61 years) with acute asthma: mean FEV1 35% of the predicted. The dyspnea score (Borg's scale), breathing rate, pulse rate, blood pressure, FEV1, and PEF were measured on arrival and 30, 60, and 150 minutes after bronchodilator treatment. The level of clinical severity was evaluated using Hedstrand's asthma severity scale. The variables that correlated most closely with dyspnea score at arrival were asthma severity score (r = .51 P < .001) and breathing rate (r = .38, P < .01). The measurement of airflow obstruction with the closest correlation to improvement in dyspnea was FEV1 expressed as a percentage of the pretreatment value (r = -.30* after 30 min, r = -.42** after 60 and r = -.34* after 150 minutes, *P < .05, **P < .01). When examining the intraindividual correlation between the change in dyspnea score and FEV1, a correlation coefficient of more than 0.80 was found in 74% of the patients. Of 18 patients with an increase in FEV1 of less than 20% of baseline, 11 had a decrease in dyspnea score in 3 or more categories. We conclude that there is a discrepancy in the treatment of acute asthma between the effect on dyspnea and airflow obstruction, the clinical implication of which remains to be investigated.

Administration, Inhalation↗

PubMed1992

Blood eosinophil count as risk factor for relapse in acute asthma.

In this retrospective investigation comprising 54 adult patients included in two studies of the treatment of acute asthma, the risk of relapse was studied. The set of variables that best predicted the length of time before a new asthmatic attack comprised blood eosinophil count (P less than 0.001), FEV1 on arrival (P less than 0.001) and increased medication on discharge (P less than 0.01). The set of variables that best predicted the number of new attacks during a period of 1 yr consisted of eosinophil count (P less than 0.001), FEV1 (P less than 0.001), increased medication on discharge, age and breathing rate on arrival (P less than 0.05). Patients with an eosinophil count of more than 500 x 10(6) l-1 and a FEV1 of less tha 1.0 l ran a six-fold greater risk of returning with a new attack within 1 month than patients with lower eosinophil count and higher FEV1. No significant correlation was found between post-treatment PEF variation and relapse in acute asthma.

Acute Disease↗

PubMed1992

Intravenous theophylline after beta 2-agonist treatment in severe acute asthma. Effect on patients who are not pre-treated with theophylline.

The effect of i.v. theophylline after high-dose beta 2-agonist treatment in severe acute asthma was studied in 30 patients from a multicentre study who reported not having taken theophylline during the last 24 hours. One hour after the start of inhaled or i.v. salbutamol treatment, all patients received 6 mg/kg of i.v. theophylline. The plasma concentration 30 minutes after the start of the theophylline infusion was 78 +/- 13 mumol/l (mean +/- SD). The mean change (delta) in peak expiratory flow (PEF) was 8 +/- 6% of the predicted 30 minutes after the theophylline infusion and 7 +/- 5% 60 minutes after it. The increase in PEF was greater in this patient group than in a group of 101 patients from the same multicentre study who were on theophylline medication and were therefore given a reduced dose (3 mg/kg) (7 +/- 5 vs. 4 +/- 6% of the predicted value, p < 0.01). The proportion of patients with an increase in PEF of > or = 10% of the predicted at discharge was 27% (8/30) in the patient group in this investigation and 14% (14/101) in the group who was on theophylline treatment.

Administration, Inhalation↗

PubMed1992

Which patients benefit from adding theophylline to beta 2-agonist treatment in severe acute asthma?

The aim of this investigation was to study whether certain patients benefit from adding theophylline to the beta 2-agonist treatment of acute asthma. The study group comprised 101 patients who were taking oral theophylline. The patients received inhaled salbutamol (albuterol) (0.15 mg/kg x 2) (n = 53) or IV salbutamol (5 micrograms/kg) (n = 48). Aminophylline (3 mg/kg) was infused intravenously 60 minutes after the start of the salbutamol treatment. The mean increase in peak flow (PEF) after the aminophylline infusion was 22 +/- 33 L/min or 4% +/- 6% of the predicted value (mean +/- SD). A change in PEF correlated negatively to plasma theophylline before treatment (P less than .01) and positively to a change in plasma-theophylline after treatment (P less than .05). All patients with an increase in PEF of more than 10% of the predicted value (n = 14) after the theophylline infusion had plasma-theophylline levels before treatment of below 7.5 mg/L (41 mumol/L). No significant difference in the change in PEF after the theophylline infusion was found between patients who had received inhaled or intravenous salbutamol. This investigation could indicate that IV theophylline as an additive to beta 2-agonist treatment should be reserved for patients who are either not taking theophylline or who have only taken a low dose before arriving for the emergency treatment of acute asthma.

Acute Disease↗

PubMed1992

Bronchodilator intake and plasma levels on admission for severe acute asthma.

We have measured the plasma levels of salbutamol, terbutaline and theophylline in 140 patients (70 men, mean age 57 yrs) arriving for emergency treatment with severe acute asthma. The aim of the study was to investigate how the measured plasma levels correlated with the reported bronchodilator intake and whether the pretreatment beta 2-agonist levels influenced the effect of emergency salbutamol treatment. We found a highly significant correlation between the reported 24 h dose and the measured plasma concentrations for all three drugs. A plasma concentration less than 40 mumol.l-1 was found in 63 of the 107 patients who had taken theophylline, while no patient had a plasma concentration greater than 110 mumol.l-1. A plasma concentration above the suggested therapeutic range was found in 23 of the 95 patients who had taken terbutaline (greater than 30 nmol.l-1) and in 12 of the 98 patients who had taken salbutamol (greater than 60 nmol.l-1). A significant negative correlation was found between the initial plasma beta 2-agonist levels and the bronchodilation after i.v. salbutamol treatment (5 micrograms.kg-1), while there was no clear indication that high plasma beta 2-agonist levels reduced the bronchodilator effect of a high dose of inhaled salbutamol (0.15 mg.kg-1 x 2). We conclude that some patients arriving with acute asthma have high blood concentrations of beta 2-agonists, which possibly limit the response to i.v. beta 2-agonist treatment, while the effect of high-dose inhaled beta 2-agonists appears to be related to a lesser degree to the drug concentration on arrival. In this study overtreatment with theophylline appears to be uncommon.

Acute Disease↗

PubMed1991

Plasma terbutaline levels in nebulisation treatment of acute asthma.

A study was made of the effects of inhaling 5 mg of terbutaline and 0.5 mg of ipratropium bromide in 11 patients arriving at our emergency room with acute asthma (FEV1 less than or equal to 50% of the predicted). Measurable plasma levels of terbutaline before treatment were found in all patients who reported having taken oral terbutaline (mean value 30 nmol/l, range 11-89). A significant correlation was found between the reported terbutaline medication and the measured terbutaline plasma concentration (p less than 0.01). Plasma terbutaline had increased by 6-20 (mean 15) nmol/l 60 min after the start of treatment and by 6-45 (mean 14) nmol/l at 120 min, compared with the pre-treatment value. A highly significant decrease in dyspnoea and an increase in PEF and FEV1 was measured (p less than 0.01) after treatment, while no significant changes in respiratory rate, pulse rate, blood pressure or tremor were recorded. A significant positive correlation was found between delta plasma terbutaline and delta systolic blood pressure 120 min after treatment (p less than 0.05), but apart from this no statistically significant correlations were found between plasma terbutaline on arrival or delta plasma terbutaline and the other measurements of the effect of treatment. One of the advantages of adding ipratropium to nebulised beta-agonist treatment might be that it permits the use of lower doses of beta 2-agonist and thereby reduces the systemic side-effects of the treatment.

Acute Disease↗

PubMed1991

Sleep disturbances in asthma: theophylline versus enprofylline.

A double-blind cross-over study was performed on 22 asthmatic patients receiving maintenance treatment with theophylline who, in a previous study, had reported sleep problems. In one of two three-week periods the theophylline medication was replaced by an equipotent dose of slow-release enprofylline. Analysis of sleep questionnaires answered after each treatment period, and sleep diaries filled in throughout the study, showed no significant differences in the quality of sleep between the treatments. Peak expiratory flow (PEF) in the morning did not differ between the treatment periods, but mean PEF in the evening was slightly higher (20 l/min) during theophylline treatment. It was concluded that replacement of theophylline by enprofylline did not improve the quality of sleep subjectively in this group of theophylline treated asthmatics. The results suggest that adenosine receptor antagonism may not be a significant cause of sleep disturbances in asthmatic patients who are receiving theophylline as maintenance treatment.

Adult↗

PubMed1991

Plasma levels and effects of salbutamol after inhaled or i.v. administration in stable asthma.

The response and plasma levels of inhaled (0.15 mg.kg-1) and intravenous salbutamol (5 micrograms.kg-1) were studied in 12 patients who had previously been included in a study of acute severe asthma and were now in a stable phase. The maximal value for change (delta) in plasma salbutamol compared with the pretreatment value was higher after i.v. than after inhalation treatment (59 vs 30 nmol.l-1) but the areas under the curve (AUC) during 90 mins after treatment were similar for the two administration routes. The inter-individual differences in peak plasma salbutamol and AUC for delta plasma salbutamol were much greater after inhalation than after i.v. infusion. Immediately after treatment there was a greater increase in pulse rate (mean +17 vs +6 beats.min) and lower serum potassium level (mean -0.3 mmol.l-1) after i.v. than after inhalation treatment. The increase in peak expiratory flow (PEF) measured 90 min after the start of treatment (85 vs 31 l.min-1) and as AUC was significantly higher after inhalation than after i.v. treatment. Six patients had received i.v. treatment in the acute asthma study: in these patients delta PEF immediately after i.v. treatment was significantly lower in the stable situation (+49 vs +115 l.min-1). There was also a significant difference in the effect on the pulse rate immediately after i.v. treatment, with a decrease in the acute asthma and an increase in the stable asthma situation (-5 vs +16 beats.min-1).

Administration, Inhalation↗

PubMed1990

Quantitative features of chromatin structure in the prognosis of breast cancer.

In prognosis of breast cancer different parameters are in current use. Along with clinical staging the most important parameter appears to be histologic grading. Features of the grading such as nuclear pleomorphism proved to correlate closely with the proliferative activity and aggressiveness of the tumors. Because of difficulties in assessing and classifying the degree of nuclear pleomorphism by usual microscopy, the authors applied methods of digital image analysis. The study is a retrospective analysis of paraffine slides from the primary lesions of 60 breast cancers with 10 to 16 years of follow-up evaluation. Using large sets of different parameters defining nuclear morphology and chromatin structure the authors extracted criteria with prognostic importance. These included nuclear area in micron 2, eccentricity, integral optical density per micron 2, average area of a chromatin region, integral optical density of a chromatin region per micron 2, and the number of central chromatin regions per micron 2. The results demonstrate that the criteria used enable prediction of prognosis with an accuracy of 92%.

Breast Neoplasms↗

PubMed1990

Sleep disturbances in patients with asthma.

The prevalence of sleep complaints and sleep disturbances was studied prospectively in 98 consecutive adult asthmatic patients (mean age 45 years, 46% men) attending an out-patient clinic by means of questionnaires and sleep diaries. The results were compared with those from an age- and sex-matched group of 226 healthy individuals. The most common sleep disturbances among the asthmatic patients were early morning awakening (51%), difficulty in maintaining sleep (DMS; 44%) and daytime sleepiness (44%). With decreasing asthma control (i.e. increased number of acute asthmatic attacks) there was an increase of DMS, nocturnal wakefulness, nocturnal breathing problems and bronchodilator inhalations at night. A decrease in estimated sleep time (P less than 0.05) and increase in nocturnal wakefulness (P less than 0.05) was seen with decreasing daytime FEV1--measured as percentage of the predicted value (%FEV1). There was also significant correlation between increasing age and decreasing %FEV1 (P less than 0.01). Among the 26 patients who were only taking one oral bronchodilator, no definite difference regarding sleep quality was found between those treated with theophylline and those taking an oral beta 2-agonist. The prevalence rates of DIS, DMS and daytime sleepiness were about twice as high among the asthmatic patients than in the healthy population. It is concluded that impaired quality of sleep, with disturbed sleep during the night, early morning awakenings and daytime sleepiness, is common among patients with bronchial asthma.

Acute Disease↗

PubMed1989

Quantitative nuclear morphology in the diagnosis of ovarian tumors of low malignant potential (borderline).

Ovarian tumors of low malignant potential or of borderline malignancy are characterized histologically by the association of malignant type of epithelial proliferation with a noninvasive pattern of growth. Because epithelial proliferation relates to features of nuclear morphology and chromatin structure and because of the difficulties to distinguish nuclear atypism seen in borderline malignancy from that in frankly invasive tumors by usual microscopic study, the authors concentrated their studies exclusively on computerized analysis of cell nuclei images. Using specially developed methods of analysis the authors described geometrical, optical, and structural differences among the epithelial and stromal cell nuclei of benign, borderline, and malignant ovarian tumors. The structural differences concern the pattern of chromatin condensation and suggest that the cytokinetic properties of the borderline tumors are intermediate to those of benign and malignant. The results demonstrate that the quantitative evaluations provide objective and reproducible data useful in the differential diagnostic of the borderline malignancy.

Adenoma↗

PubMed1989

Theophylline disturbs sleep mainly in caffeine-sensitive persons.

In order to study effects of theophylline on sleep, a randomised double-blind cross-over study with slow release theophylline vs. placebo was performed on 13 healthy male volunteers (mean age 24 years), eight of whom were considered caffeine-sensitive and five caffeine-insensitive. A sleep diary was filled in during the entire period. At the end of each 2 week study period a sleep questionnaire was filled in and a sleep recording was conducted. Seven of the eight caffeine-sensitive persons reported that their sleep was disturbed during the theophylline period, while none of the five caffeine-insensitive experienced any difference between the periods. Analysis of the sleep diaries (mean +/- SD) revealed a significant increase in sleep latency (16 +/- 11 vs 4 +/- 7 min) and decrease in sleep efficiency (95 +/- 3 vs 98 +/- 3%) among the caffeine-sensitive persons during the theophylline period compared with the placebo period, while no such difference was found among the caffeine-insensitive. We conclude that theophylline seems to disturb sleep mainly in caffeine-sensitive persons.

Caffeine↗

PubMed1989

Quantitative aspects in defining prognostic factors of breast cancer.

Although many attempts have been made to define prognostic criteria, the long-term prediction of breast cancer prognosis remains a difficult task. In search of morphologic criteria with prognostic significance, we investigated 101 ductal invasive breast carcinomas by means of computerized image analysis. Our purpose was to define prognostic measures of the basic characteristics of breast cancers, growth rate and metastatic potential. Consequently, three principal types of analysis were performed: on Feulgen stained nuclei, on histological structures by using differential stainings and on desmosome-complexes revealed by immunofluorescence microscopy. The data obtained from analysis of the cell nuclei morphology and the chromatin structure served to establish objective nuclear grading. In comparison to the visual grading made during routine histology, the objective grading correlates better with the existence of lymph node metastases and with receptor status. The description of desmosome-complexes by using quantitative immunofluorescence microscopy indicates that in order to obtain relevant results, the histological pattern of the tumors has to be considered. In order to characterize these structures we introduced special methods of cluster analysis. The studies are an example of complex quantitative analysis of tumor morphology performed with different combined methods of microscopy and image processing.

Breast Neoplasms↗