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Biomedical subjects

M Bende

Publications and source records attributed to M Bende.

At least 19 recordsLinked to original sources
PubMed2005

Prevalence and risk factors for self-reported odour intolerance: the Skövde population-based study.

OBJECTIVES: The present study was performed to determine the prevalence of odour intolerance in adults with respect to both self-reported general intolerance and affective and behavioural consequences. Furthermore, we aimed to relate odour intolerance to explanatory variables and risk factors. METHOD: This is a cross-sectional, population-based epidemiological study. A random sample of 1900 inhabitants from the age of 20, stratified for age and gender, were recruited. Subjects were invited for clinical examinations that included questions about general odour intolerance, respiratory symptoms and smoking habits, as well as a smell identification test. The chemical sensitivity scale for sensory hyperreactivity (CSS-SHR) was used to quantify affective and behavioural consequences. RESULTS: In total 1387 volunteers (73% of the sample) were investigated. The overall prevalence of self-reported general odour intolerance was 33% (95% confidence interval (CI): 30-36%), with problems mainly from the upper respiratory tract. The prevalence of affective and behavioural consequences of odour intolerance (CSS-SHR score > or =43) was 19% (95% CI: 15-22%). The risk for the latter condition was increased in women compared with men (odds ratio = 2.3: 95% CI: 1.5-3.6), but no increased risk was found related to current smoking or impaired sense of smell. CONCLUSION: This study demonstrates that intolerance to odours is a widespread problem in society, and that it is about twice as common in women than in men.

Adult↗
PubMed2004

Clinical relevance of nasal polyps in individuals recruited from a general population-based study.

OBJECTIVE: To compare the clinical presentations of individuals with nasal polyps detected by endoscopy in a general population sample with those of patients with nasal polyp disease seeking medical attention. MATERIAL AND METHODS: A total of 38 individuals with nasal polyps from a population-based sample were compared with 38 matched controls and a third group consisting of 44 patients who presented to an outpatient clinic with symptoms and diagnosed nasal polyps Upper and lower airway symptoms were registered. Polyp size, peak nasal inspiratory flow (PNIF), olfactory function and health-related quality of life were measured. RESULTS: Compared with the individuals with nasal polyps in the population sample, patients actively seeking medical care for nasal polyposis experienced more symptoms of nasal blockage and an impaired sense of smell, and had more extensive polyps and reduced PNIF. There were equal frequencies of asthma symptoms in these two groups. Compared with the controls, the individuals with nasal polyps in the population sample had a greater frequency of asthma symptoms and aspirin intolerance and also experienced an impaired sense of smell. CONCLUSION: Nasal polyps alone, as seen occasionally, are indicative of airway disease involving the upper and lower respiratory tracts.

Adult↗
PubMed2004

Relationship of airway symptoms from chemicals to capsaicin cough sensitivity in atopic subjects.

BACKGROUND: It is well known that some patients with allergy complain of airway symptoms from chemicals (ASCs) and strong odours. However, the importance of such information for the treatment of allergic disease is not known. Such symptoms in non-allergic patients have previously been shown to be related to increased sensory nerve reactivity, which is expressed as increased cough sensitivity to inhaled capsaicin. OBJECTIVE: The aim of this study was to examine ASC in atopic patients and relate it to cough reaction to capsaicin inhalation. MATERIALS AND METHODS: Fifty-seven consecutively chosen, skin prick-positive patients with symptoms of the upper and/or lower airways completed a questionnaire concerning ASC. The patients were then divided into two groups, those with and those without such symptoms. Both groups were provoked with inhaled capsaicin in three increments and compared with 73 healthy control subjects. RESULTS: Out of 57 atopic patients, 34 reported ASC agents and 23 did not. The patients with ASC were older (P<0.01) and coughed significantly more on capsaicin provocation (P<0.001), but did not differ from them with respect to the allergic disease or its treatment or to smoking habits. Patients with atopy but without ASC did not differ from healthy controls with regard to sensitivity to capsaicin inhalation. The scored degree of ASC was directly related to the number of coughs during the capsaicin provocation. CONCLUSION: ASC in atopic patients are related to increased airway sensory nerve reactivity. There is still no explanation for this in certain patients with atopy, but age may be a confounding factor.

Adolescent↗
PubMed2003

A Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire: evaluation of questions about olfaction.

OBJECTIVE: A Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire (MCSTQ-Sc) was evaluated with respect to comprehension and test-retest reliability for responses to questions about olfactory dysfunction (abnormal sensitivity, parosmia and phantosmia) and related questions about medical history and consequences of olfactory dysfunction. MATERIAL AND METHODS: Comprehension was evaluated in a first study in 20 patients with chief complaints of olfactory dysfunction by comparing questionnaire- and interview-based responses. Test-retest reliability was evaluated in a second study in 30 other patients with olfactory complaints. RESULTS: Data from the two studies suggest that the vast majority of the questions evaluated from the MCSTQ-Sc are comprehensible and generate responses with very good reliability. Distinct exceptions were poor agreement between the questionnaire- and interview-based responses for questions about the number of cigarettes smoked and the pleasantness and typical episode length of phantosmia; the test-retest reliability regarding the nostril side of phantosmia also showed poor agreement. The results suggest the importance of probing these areas further in the clinical interview. CONCLUSION: The findings imply that, with a few caveats, the MCSTQ-Sc is a useful tool for the clinical assessment of olfactory dysfunction and its consequences.

Female↗
PubMed2002

Capsaicin inhalation test for identification of sensory hyperreactivity.

BACKGROUND: Patients with upper and lower airway symptoms and with pronounced sensitivity to chemical odours, such as perfumes, flower scents and tobacco smoke, have been suggested to have sensory hyperreactivity (SHR). The symptoms have been difficult to identify with physiological measurements and the effects of various medications are doubtful. However, these patients have been found to be more sensitive to inhalation of capsaicin than healthy people. The aim of this study was to establish limit values with the capsaicin inhalation test in patients with SHR. METHODS: Ninety-five consecutive patients with upper and lower airway problems, who were admitted for allergy testing, underwent a capsaicin inhalation test with three different concentrations. The number of coughs was registered during each challenge. Score systems were used for symptoms and influence on social life of sensitivity to odours. In relation to scored symptoms, the patients were grouped as SHR or not, and compared with 73 healthy controls. RESULTS: All patients and controls coughed on capsaicin in a dose-dependent manner. Symptom score of odour sensitivity in patients was positively correlated to the response of the test. Out of 95 patients, 15 (16%) were scored to SHR. Patients with SHR reacted more to the capsaicin inhalation test than the other patients and the healthy controls. The limit values for a positive capsaicin inhalation test for the SHR were determined to be 10, 35 and 55 coughs at 0.4, 2.0 and 10 microM capsaicin, respectively. CONCLUSION: The capsaicin inhalation test well reflects the degree of airway sensitivity to chemicals and to what extent the social life is influenced. The cut-off values of the test can distinguish patients with pronounced sensitivity to odours.

Administration, Inhalation↗
PubMed2002

Sensitivity of a new grading system for studying nasal polyps with the potential to detect early changes in polyp size after treatment with a topical corticosteroid (budesonide).

We have previously compared different scoring systems for endoscopic staging of nasal polyps. Of the five methods evaluated, we found that two were better than the others with regard to reproducibility and agreement between physicians. One method was lateral imaging, developed by the authors, and the other was a scoring system developed by Lildholdt et al. The main objective of the present study was to compare the sensitivity of these two methods. Another aim was to study the effect on nasal polyposis of topical nasal corticosteroids over a 2-week period. Patients with bilateral nasal polyposis (n = 100) were randomized to a 2-week treatment with a topical corticosteroid (budesonide aqueous nasal spray: 128 microg b.i.d.) or placebo in a double-blind manner. Nasal symptoms were scored before treatment and after 3, 7 and 14 days of treatment, and the patients underwent nasal endoscopy at clinical visits. Patients treated with active substance had an improvement in their symptoms, an effect already detectable after 3 days of treatment, compared with those who received placebo. In addition, a statistically significant decrease in polyp size could be registered after 14 days using lateral imaging but not with the other scoring system. In conclusion, lateral imaging was more sensitive and could detect effects earlier than the other scoring system and can be recommended for the endoscopic staging of nasal polyps in clinical studies.

Administration, Topical↗
PubMed2001

Capsaicin cough sensitivity is decreased in smokers.

Although capsaicin provocation has been used to evaluate treatment against cough, which is one of the most common respiratory symptoms, there are still methodological considerations that are not fully known. Capsaicin stimulates the unmyelinated slow C-fibres of the sensory nervous system, which leads to coughing. Smoking often leads to respiratory symptoms with cough and phlegm. The aim of this study was to examine the effect of smoking on capsaicin provocation. Subjectively healthy smokers and non-smokers were challenged with capsaicin in increasing doses. The coughs were counted and irritation of the lower airways was graded on a symptom score. Smokers reacted to provocation with significantly fewer coughs, but there was no difference regarding other symptoms. These results are in agreement with the hypothesis that nicotine inhibits or blocks C-fibres of the sensory nervous system of the lower respiratory tract. Clinically, this may serve to explain increasing airway symptoms that are often seen after cessation of smoking.

Adolescent↗
PubMed2000

Quality of life and capsaicin sensitivity in patients with sensory airway hyperreactivity.

BACKGROUND: A group of patients with asthma-like symptoms and sensitivity to chemical irritants has shown an increased cough sensitivity to inhaled capsaicin compared to patients with asthma and to healthy controls. The condition is called sensory hyperreactivity (SHR), and the patients often feel that they are socially handicapped because of the risk of exposure to chemical irritants in daily life. METHODS: Twenty-six patients with asthma-like symptoms after exposure to nonspecific irritating stimuli, but without IgE-mediated allergy or demonstrable bronchial obstruction, were selected for a study of the response to a capsaicin test and measurement of quality of life by a general health profile (the Nottingham Health Profile [NHP]). We also investigated whether there was a correlation between quality of life and sensitivity to capsaicin. RESULTS: The patients demonstrated a dose-dependent response to the capsaicin provocation, with coughing and respiratory and other symptoms, that significantly differed from 12 healthy controls. The health profile showed that patients with SHR had a significantly reduced quality of life compared to reference values, and there was a significant correlation between the health profile and sensitivity to capsaicin. CONCLUSIONS: Patients with asthma-like symptoms verified by the capsaicin inhalation test for sensory hyperreactivity have a poor quality of life. The correlation between quality of life and sensitivity to capsaicin objectively demonstrates the validity of this general health profile study.

Administration, Inhalation↗
PubMed2000

Effect of nasal air temperature on FEV1 and specific airways conductance.

We investigated whether changes in nasal air temperature affect specific airway conductance (SGaw) and one second forced expiratory volume (FEV1) in 10 asthmatic patients with a history of cold-sensitive asthma and eight healthy subjects. An air-stream (0.6 l s-1) of -15 degrees C, +22 degrees C or +37 degrees C was blown into both nostrils during a Valsalva manoeuvre. Each provocation consisted of 10 puffs of air, each of 15 s duration, at 1 min intervals. Before and at regular intervals after the provocations, SGaw and FEV1 were determined. In asthmatics, after cold air provocation, SGaw fell 23% (P<0.01) and FEV1 8% (P<0.01). After the warm air provocations, SGaw rose 15% (P<0.01) and FEV1 6% (P<0.01). After the ambient air provocations, no significant changes occurred in SGaw or FEV1. In the healthy subjects, the nasal provocations caused no significant changes in lung function. The present study shows that cold air in the nose causes a slight obstruction and warm air possibly a slight dilatation of the lower airways in patients with a history of cold-sensitive asthma but not in healthy subjects.

Adult↗
PubMed2000

Nasobronchial relationship after cold air provocation.

Provocation with cold air in the nose causes broncho-obstruction while warm air causes bronchodilation in patients with asthma, but not in healthy subjects. These findings have suggested the existence of a nasobronchial reflex. The present study aimed to block this effect and evaluate the mechanisms underlying the effect on lung function after cold stimulation of the nose. Lung function, as measured with specific conductance and forced expiratory flow, was reduced after cold stimulation of the nose, but this effect could not be blocked by anesthetizing the nose or by inhaling an anti-cholinergic drug before the provocation. These results confirm the presence of a nasobronchial relationship, but not of a nasobronchial reflex.

Adult↗
PubMed2000

Evaluation of methods for endoscopic staging of nasal polyposis.

Endoscopy is needed for reliable evaluation of the treatment of nasal polyposis. In this study, we compared the reproducibility of various score systems for staging nasal polyposis and the inter-individual variations between investigators. The mass of the polyps was assessed by five methods, three new techniques (numbers 1, 2 and 3) and two established ones (numbers 4 and 5). These were: 1, lateral imaging projecting the extension of the polyps by drawing on a schematic picture of the lateral wall of each nasal cavity; 2, assessment of polyp obstruction estimating the proportion of the total nasal cavity volume occupied by polyps; 3, nasal airway patency--determining the relationship between the patient's patent airway lumen and an imaginary maximal nasal airway lumen; 4, a score system with four steps ad modum Lildholdt et al.--determining their relationship to fixed anatomical landmarks; and 5, a score system with three steps ad modum Lund and Mackay--determining their relationship to the middle meatus. High correlations were found between the first and the second assessments by a given investigator with all five methods used to score nasal polyposis. High correlations were also shown between the various methods. When three investigators examined a given patient, there were no significant differences between the investigators using score systems 1, 3 and 4. However, with score systems 2 and 5, there was insufficient agreement between the investigators. The patient's symptom of nasal blockage was not a good indicator of the size of the polyps, especially as regards small polyps. Two of the best methods tested (1 and 4) were selected for further clinical studies regarding evaluation of the sensitivity of score systems to detect changes in polyp size during treatment.

Adult↗
PubMed1999

An independent association between obstructive sleep apnoea and coronary artery disease.

Previous studies of sleep and breathing suggest an independent association between coronary artery disease (CAD) and obstructive sleep apnoea (OSA) in middle-aged males and females. These studies, however, were criticized because they did not properly adjust for all important confounding factors. In order to better control for the impact of these confounders, a case-control study was performed, matching for age, sex and body mass index (BMI), and additionally adjusting for hypertension, hypercholesterolemia, diabetes mellitus and current smoking. A consecutive selection of 62 patients (44 males and 18 females, mean age 69 yrs, range 44-88 yrs) requiring intensive care for angina pectoris or myocardial infarction at the County Hospital of Skaraborg, Skövde, Sweden, as well as 62 age-, sex- and BMI- matched control subjects without history or signs of heart disease underwent an overnight sleep/ventilatory monitoring study. The time interval between discharge from the intensive care unit and the overnight study ranged between 4 and 21 months. OSA, defined as a Respiratory Disturbance Index (RDI) of > or =10 x h(-1), was present in 19 CAD patients but only in eight control subjects (p=0.017). Using a univariate logistic regression analysis, current smoking (odds ratio (OR) 8.1, 95% confidence interval (CI) 2.2-29.0), diabetes mellitus (OR 4.2, 95% CI 1.1-16.1) and OSA (OR 3.0, 95% CI 1.2-7.5), but not hypertension (OR 1.5, 95% CI 0.7-3.2) and hypercholesterolaemia (OR 1.8, 95% CI 0.7-4.1) were significantly correlated with CAD. In a multiple logistic regression model, current smoking (OR 9.8, 95% CI 2.6-36.5), diabetes mellitus (OR 4.2, 95% CI 1.1-17.1) and OSA (OR 3.1, 95% CI 1.2-8.3) all remained independently associated with CAD. In summary, these data suggest a high occurrence of obstructive sleep apnoea in middle-aged and elderly patients with coronary artery disease requiring intensive care, which should be taken into account when considering risk factors for coronary artery disease.

Adult↗
PubMed1999

Nasal stuffiness during pregnancy.

OBJECTIVE: To investigate the occurrence of nasal stuffiness during pregnancy. STUDY DESIGN: Prospective longitudinal study, with collection of data during 1 year in a cohort of 2,264 pregnant women. METHODS: Self-reported nasal stuffiness in gestational weeks 12, 20, 30, and 36 was correlated to age, parity, body mass index, and smoking habits. RESULTS: The prevalence of nasal stuffiness increased during pregnancy and occurred in 27% of the women at 12 weeks of gestation, in 37% at 20 weeks, in 40% at 30 weeks and in 42% at 36 weeks. Sixty-five percent of the women reported stuffiness at some time when asked. It was commoner in multiparous than in nulliparous women. Age, body mass index, and smoking habits were not associated with nasal stuffiness. CONCLUSION: Self-reported nasal stuffiness for 3 or more weeks was common during pregnancy and could occur at any time in two thirds of the women. Treatment regimens to alleviate this symptom should be developed.

Adult↗
PubMed1998

The Scandinavian Odor-Identification Test: development, reliability, validity and normative data.

The Scandinavian Odor-Identification Test (SOIT) was developed to address the need for a culturally valid odor-identification test for clinical use on the Scandinavian population that (i) has good ability to generalize performance to olfactory status, (ii) assesses olfactory and trigeminal function separately, (iii) requires only limited cognitive demands, (iv) has normative data and good sensitivity and specificity, and (v) is fast, easy to administer and inexpensive. Sixteen odorous test stimuli were selected that were relatively identifiable, familiar, strong in intensity and pleasant according to healthy participants. Four response alternatives were then selected for each test stimulus based on a confusion matrix of identification rates obtained from healthy participants, in a manner that controlled for task difficulty. Results on the SOIT from healthy persons and hyposmic patients showed satisfactory test-retest reliability, split-half reliability and validity. Cut-off scores for olfactory diagnosis (normosmia, hyposmia, anosmia) based on normative data obtained from 171 healthy persons showed a satisfactory sensitivity and specificity of the SOIT. Assessment of 22 anosmic patients with the SOIT revealed that three of the test stimuli were significant trigeminal stimulants.

Adolescent↗
PubMed1998

Sensory hyperreactivity--a possible mechanism underlying cough and asthma-like symptoms.

BACKGROUND: Investigations of patients referred for suspected asthma have revealed a little-known group with symptoms suggesting hyperreactive airways in whom provocation with methacholine does not lead to bronchial obstruction. The underlying mechanisms are not known, and no objective diagnostic method has been available. METHODS: Provocations by inhalation of capsaicin solutions in stepwise increasing concentrations were used. Ten patients with asthma-like symptoms after exposure to nonspecific irritating stimuli, but without IgE-mediated allergy or demonstrable bronchial obstruction, were compared to 10 patients with verified bronchial asthma and 28 healthy controls. RESULTS: The patients with asthma-like symptoms reacted with cough in a dose-dependent way. The number of coughs was significantly greater than in asthmatic patients and healthy controls. The latter two groups did not differ significantly. CONCLUSIONS: The capsaicin provocation test may be a valuable method for showing not only a greater cough sensitivity, but also asthma-like symptoms. The pathophysiology underlying the symptoms may be related to increased sensitivity of free, overactive nerve endings in the respiratory mucosa. Therefore, we suggest that this overreaction in the lower airways be called "sensory hyperreactivity".

Adult↗
PubMed1998

Evaluation of side effects after nicotine nasal spray in patients with chronic rhinitis.

Thirty-three subjects with chronic rhinitis used nicotine nasal spray in an open study as an aid in smoking cessation. Thirty-eight percent of them were completely abstinent at 12 weeks, whereas 35% were completely abstinent at 20 weeks. The nasal spray was associated with irritant nasal side effects, which occurred most often in the early stages of treatment. Clinical nasal examinations could not observe any significant impairment in nasal conditions following spray use. In conclusion, this study confirms the short-term safety of the nicotine nasal spray as an aid in smoking cessation.

Administration, Intranasal↗
PubMed1997

Glucocorticoid treatment for nasal polyps. The use of topical budesonide powder, intramuscular betamethasone, and surgical treatment.

BACKGROUND: The treatment of nasal polyps is controversial, and medical treatment alone has been little investigated to our knowledge. OBJECTIVE: To examine the efficacy of therapy using only topical budesonide powder and topical budesonide powder supplemented with surgical removal or intramuscular betamethasone. DESIGN: Randomized, double-blind comparison of 2 dosages and additional treatment, if therapy failed. After 1 year, treatment with medication was stopped, and the demand for renewed treatment was monitored for another year. PATIENTS: Patients with bilateral nasal polyps who demanded treatment were consecutively enrolled in a hospital outpatient clinic or specialty private practice. During a 15-month period from 1990 to 1992, a total of 126 patients entered the 2-year study. INTERVENTIONS: In phase 1, randomized and double-blind treatment with a topical medication, budesonide powder, 800 micrograms or 400 micrograms daily, or a placebo was given for 1 month. In phase 2, randomized and double-blind treatment with budesonide powder, 800 micrograms or 400 micrograms daily, was given. At the end of phase 1, failed therapy was supplemented by randomly assigned treatment of either surgical removal or a single injection of sustained released betamethasone. In phase 3, treatment with the medication was discontinued, and patients were monitored for another year. The time when treatment was required again was noted. The present article deals with phases 2 and 3. MAIN OUTCOME MEASURES: Patients' scores of treatment efficacy as well as symptoms and signs. Semiquantitative measurement of sense of smell and calculation of peak expiratory flow rate index based on nasal and oral peak expiratory flow. RESULTS: In all outcome measures, a comparison of the data before treatment with the corresponding figures during phase 2 showed statistically significant efficacy. The clinical course was described at the end of phase 2. About 85% of the patients, including those who received additional therapy because the initial therapy failed, rated total or substantial control over the symptoms. The 2 dosages investigated showed equal results. These findings were consistent with the signs recorded and the peak expiratory flow rate index. The results of phase 3 showed that 50% of patients had demanded treatment after 4 months, while 34% managed without medication after 1 year. CONCLUSIONS: The clinical course in this study showed that most patients with nasal polyps do well with medical treatment. Therefore, surgery was required in few patients. However, the potential of medical treatment should be further explored in future studies.

Administration, Inhalation↗