Biomedical subjects

J Vestbo

Publications and source records attributed to J Vestbo.

126 records · Page 7Linked to original sources

PubMed1991

Exposure to cement dust at a Portland cement factory and the risk of cancer.

The relation between exposure to cement dust and cancer was examined in a population of 546 cement workers and a reference population of 858 randomly sampled men of similar age and area of residence. In 1974 all men gave lifelong occupational and smoking histories; information on incidence of cancer in the period 1974-85 was obtained from the Danish Cancer Registry. No increased risk of overall cancer was found among cement workers. Among men with more than 20 years exposure to cement dust, 14 cases of respiratory cancer were observed (observed/expected (O/E) 1.52, 95% confidence interval (95% CI) 0.90-2.57) when compared with all Danish men. Men with 1-20 years exposure had O/E 1.14 (95% CI 0.59-2.19) based on nine cases of cancer. After excluding all men with documented exposure to asbestos during employment in an asbestos cement factory no increased risk of overall cancer or respiratory cancer was found among cement workers compared with white collar workers from the local reference population, using a Cox regression model controlling for age and smoking habits. Relative risks were 0.5 (95% CI 0.1-1.5) and 1.0 (95% CI 0.4-2.6) for men with 1-20 and more than 20 years of exposure to cement dust respectively compared with white collar workers.

Aged↗

PubMed1991

Bronchodilator and corticosteroid reversibility in ambulatory patients with airways obstruction.

With the aim of characterising subgroups, we analysed reversibility tests from 1,048 patients with airways obstruction (baseline FEV1 less than 60% of predicted normal (%pred), and FEV1 to FVC ratio less than 0.6). Spirometry before and after inhalation of salbutamol 0.3 mg and ipratropium bromide 0.06 mg was performed before and after one week of treatment with prednisone 30 mg daily. The changes in FEV1 after bronchodilators showed unimodal distribution (mean = 7.0 %pred, st.dev. = 6.6 %pred). The responses to corticosteroid were more spread out (mean = 6.3 %pred, st.dev. = 13.8 %pred). The correlation between bronchodilator responses before and after corticosteroid treatment was poor (r = 0.30), although highly significant (p less than 0.000,001). The responses to bronchodilators were virtually independent of the steroid reversibility. The corticosteroid response was inversely related to age (r = -0.20, p less than 0.000,001) and smoking habits (r = -0.17, p less than 0.000,001), and moderately associated with blood eosinophilia (r = 0.34, p less than 0.000,001). The frequency distribution of the bronchodilator responses and the steroid response and combinations of the responses were all unimodal, making any distinction between nosologic subgroups arbitrary. It is clear from the study that criteria other than just response to therapy must be employed for distinction of subgroups among patients with airways obstruction.

Adolescent↗

PubMed1990

[Observer variations in computerized 201 thallium myocardial scintigraphy].

The observer variation (reproducibility) in computerized 201Tl scintigraphy was determined by describing the results of 20 investigations as being normal, suggestive of ischaemia or representing scar tissue. At an interval of two months, two physicians evaluated the results independently. As to normality, the interobserver variation was small, the level of agreement corrected for chance agreement, the kappa coefficient, being from 69-100%. For the diagnosis of ischaemia, kappa was also high, 58-100%. The intraobserver variations were of the same magnitude. In scar tissue, the kappa coefficients were somewhat lower. The present method has an acceptable observer variation in distinguishing between a diseased and a normal myocardium. The lower kappa coefficients for scar tissue and recent findings showing that persistent defects on the delayed images are viable tissue in 30% of the cases, makes it difficult to diagnose scar tissue.

Adult↗

PubMed1990

Small-airways dysfunction in never smoking asbestos exposed Danish plumbers.

Among 701 Copenhagen plumbers we examined the lung function of 23 never smokers, who had removed asbestos insulation and intermittently been exposed to high levels of asbestos for about 25 years without being exposed to welding fume. The plumbers had significantly lower TLC, MEF25, MEF50, closing volume and closing capacity in comparison to 23 never smoking electricians without asbestos exposure. There was no reduction in TLCO. Pulmonary clearance of aerosolized 99mTc-DTPA was normal indicating that the asbestos had not induced increases in pulmonary epithelial permeability. However, in 11 of the 23 plumbers the 99mTc-DTPA ventilation scintigrams had a slightly irregular and spotty appearance, which together with the results of the lung function tests are suggestive of small airways' dysfunction. None of the subjects had symptoms or clinical signs of lung disease.

Adult↗

PubMed1990

Long-term exposure to cement dust and later hospitalization due to respiratory disease.

The relationship between exposure to cement dust in a Portland cement factory and later hospitalization due to respiratory disease and in particular chronic obstructive lung disease (COLD) was examined in a cohort initially examined in 1974. A total of 546 men with different lengths of employment in the cement factory were compared with 857 randomly sampled men of the same age from the same geographical area. Information on hospitalization was obtained from a nationwide register administered by the Danish National Board of Health. During a 9-year, 8-month period, 7.8% of the total population studied had been admitted to hospital at least once because of respiratory disease and 4.3% had been admitted because of COLD. Cement workers had no increased rates of hospitalization when compared with other blue collar workers from the random sample or the whole random sample. A vague tendency towards increasing rates of hospitalization due to COLD with increasing duration of exposure to cement dust up to 30 years was found. Given at least one hospitalization, exposure to cement dust was not related to the accumulated number of days in hospital in the observation period. We conclude that long-term exposure to cement dust does not lead to higher morbidity of severe respiratory disease than other types of blue collar work.

Aged↗

PubMed1990

Predictive value of the single-breath nitrogen test for hospitalization due to respiratory disease.

The relationship between indices of the single-breath nitrogen test (SBNT) measured in 1974 and hospitalization in the 9 year period 1977-1986 was examined in a random population sample of 876 men aged 46-69 years. Men who could not perform acceptable SBNT tracings had an increased risk of hospitalization due to respiratory disease in general. When age and smoking habits were controlled for, slope of phase III was significantly related to hospitalization due to respiratory disease in general and chronic obstructive pulmonary disease (COPD), whereas closing volume and closing capacity were marginally related to hospitalization due to respiratory disease in general but not to hospitalization due to COPD. The relationship between slope of phase III and hospitalization due to COPD remained significant after the forced expiratory volume in 1 sec (FEV1) was controlled for: odds ratio 1.4 per % N2/L (95% confidence interval 1.1-1.7). The effect of the slope of phase III was considered to be clinically insignificant, and we conclude that in a random population sample indices from only 1 SBNT do not provide prognostic information concerning hospitalization in addition to that provided by FEV1.

Aged↗

PubMed1990

The single-breath nitrogen test, mortality, and cancer.

The relationship between indices of the single-breath nitrogen test and mortality, overall cancer incidence, and respiratory cancer incidence was examined in a cohort of 876 men, 46 to 69 yr of age, examined in 1974 and followed until June 1985. Closing volume, closing capacity, and slope of phase III were not related to mortality or cancer. In contrast, FEV1 was related to mortality, with an estimated relative mortality risk of 1.37 (95% confidence interval, 1.11 to 1.70) per liter under the expected FEV1, given height, age, and smoking, but FEV1 was not related to cancer. Inability to perform acceptable single-breath nitrogen test tracings was related to mortality with a relative mortality risk of 2.03 (1.45 to 2.85), but not to cancer. We conclude that indices of the single-breath nitrogen test have no predictive value concerning overall mortality and cancer incidence.

Aged↗

PubMed1990

The effect of smoking and occupation on changes in respiratory symptoms in middle-aged Danish men.

A group of 1404 middle-aged men from Aalborg who were examined in 1974 with interview and lung function tests were re-examined in 1985 using a postal questionnaire. Of the 1404 men, 1045 could be classified into well-defined occupational categories using information up to 1974. Of these men, 791 were alive at the time of the questionnaire survey. Questions on lung symptoms, occupation and smoking habits since the 1974 study were included in the follow-up survey; the response rate was 88%. Age and main occupation until 1974 were significantly related to the development of severe breathlessness from 1974 to 1985. After controlling for age, both cement workers and blue collar workers were considerably more likely to develop severe breathlessness than white collar workers: odds ratios (ORs) 2.51 (95% confidence interval 1.04-6.7) and 2.35 (1.02-5.42), respectively. Although weakened, these relationships remained after further controlling for forced expiratory volume in one second (FEV1) in 1974. Present smoking habit was an important determinant for the presence of cough, both in men with and without cough in 1974, yielding ORs of approximately 3 when comparing with lifetime nonsmokers. Cement workers tended to have cough in 1985 more frequently than white collar workers, OR = 2.09 (0.89-4.89) for men without cough in 1974 and OR = 2.60 (1.04-6.51) for men with cough in 1974.

Air Pollutants, Occupational↗

PubMed1989

Scintigraphic demonstration of the thoracic duct following oral ingestion of 123I-heptadecanoic acid.

A new noninvasive method for scintigraphic demonstration of the anatomic localization and function of the thoracic duct is described. Seven volunteers ingested 123I-heptadecanoic acid; approximately one hour later the entire thoracic duct was demonstrated and correspondingly a sharp rise in the plasma appearance rate of radioactivity was recorded. The method is simple and without side effects. The usefulness of this examination in clinical practice remains to be elucidated.

Administration, Oral↗

PubMed1989

The value of mucus hypersecretion as a predictor of mortality and hospitalization. An 11-year register based follow-up study of a random population sample of 876 men.

The value of mucus hypersecretion as a predictor of mortality and hospitalization was studied in a random population sample of 876 men, aged 46-69 years. The cohort was examined in 1974 with the British Medical Research Council questionnaire and lung function tests. A total of 219 men had died between 1974 and 1985. Twenty-seven men died from lung cancer and 14 died from other respiratory diseases. Mucus hypersection was not found to be significantly related to overall mortality after controlling for age, smoking and FEV1. Similarly, mucus hypersection was not a predictor of lung cancer mortality after controlling for age and smoking habits. The predictive value concerning death due to respiratory disease could not be examined because of the limited number of deaths in the cohort from these diseases. Mucus hypersecretion was not significantly related to hospitalization in general. Mucus hypersecretion had a significant predictive value concerning hospitalization due to respiratory disease in general, but the value was insignificant after controlling for FEV1. In contrast to this, mucus hypersecretion was a significant predictor of hospitalization due to COPD, even after controlling for FEV1. We conclude that the predictive value of mucus hypersecretion concerning mortality is of no value. Concerning morbidity, our results show that, although secondary to airflow obstruction, mucus hypersecretion must be viewed as an indicator of severity of COPD.

Aged↗

PubMed1989

Respiratory symptoms and FEV1 as predictors of hospitalization and medication in the following 12 years due to respiratory disease.

The predictive value of cough, mucus hypersecretion, breathlessness, chronic bronchitis and forced expiratory volume in one second (FEV1) for hospitalization and medication were examined in a random population sample of 876 men, 46-69 yrs of age. All of the men were examined in 1974 with interview and lung function tests. Information on hospitalization in the period 1977-1986 was obtained from the Danish National Patient Register, and information on drug usage was obtained from 567 men in a questionnaire survey ultimo 1985. FEV1 was a strong predictor of both hospitalization and medication. Respiratory symptoms were good predictors of hospitalization due to either respiratory disease in general (odds ratios 2.56-3.29), or chronic obstructive pulmonary disease (COPD), (odds ratios 4.16-5.75). They contained predictive values in addition to that provided by FEV1. Respiratory symptoms were good predictors of medication for airway obstruction, relative risks 3.56-4.70, and/or airway disease in general, relative risks 2.67-4.69. After controlling for FEV1, cough was still significantly associated with treatment for airway disease in general and both cough, mucus hypersecretion and chronic bronchitis were significantly associated with treatment for airway obstruction. We conclude that apart from FEV1, respiratory symptoms are independent predictors of hospitalization and medication due to respiratory disease.

Aged↗

PubMed1988

Value of Tru-cut lung biopsy in focal and diffuse lung disease.

The results of 382 consecutive Tru-cut lung biopsies were reviewed to evaluate this investigation. The age of the patients ranged from 16 to 84 years (median 63 years); 284 patients suffered from focal and 98 from diffuse lung disease. Of the 206 patients with focal disease in whom the final diagnosis was a malignancy, 161 (78%) had a correct biopsy diagnosis. Of the 78 patients in whom the final diagnosis was non-malignant disease, 60 (77%) had a correct biopsy diagnosis. In diffuse pulmonary disease the histological diagnosis was correct in 75 of 98 patients (77%). In focal benign disease and in diffuse disease the reliability of the diagnosis increased with the specificity of the diagnosis. Where the biopsy diagnosis was not in accordance with the final diagnosis, histological examination usually showed normal lung tissue (with or without non-specific inflammation), necrotic tissue, or no tissue at all. Two patients died from the procedure. Minor complications occurred in 18%. It is concluded that the usefulness of Tru-cut biopsy is not confined to malignant focal disease; it is also reliable in benign focal disease and diffuse pulmonary disease when a specific diagnosis is obtained.

Adolescent↗

PubMed1988

Should we continue using questionnaires on breathlessness in epidemiologic surveys?

The construct validity and ability to predict mortality on the basis of 4 British Medical Research Council (BMRC) questions on breathlessness were examined and compared to that of spirometric measurements, in particular FEV1, in a cohort of 1,045 men. Of these, 1,030 answered questions on breathlessness and 994 performed acceptable spirometry. Using 2 levels of dyspnea, white collar workers had significantly fewer symptoms of breathlessness than both cement workers and other blue collar workers, and this effect was present even after controlling for FEV1 as well as other spirometric measurements. We found an effect of age on dyspnea but not of smoking category. Furthermore, questions on breathlessness showed a dependence on extreme overweight. In a 10-yr follow-up, 219 men had died. Dyspnea Grade 3 or worse according to Fletcher's breathlessness score was a good predictor of overall mortality, yielding a mortality ratio of 1.57 for given occupation, smoking category, years with central heating, and overweight status, after controlling for FEV1. We conclude that in a standardized setting, questions on breathlessness provide a sensitive and objective tool. They contain information additional to that provided by FEV1 and other spirometric measurements.

Aged↗

PubMed1986