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Biomedical subjects

O Selroos

Publications and source records attributed to O Selroos.

At least 55 records · Page 3Linked to original sources
PubMed1991

Comparison of a beta 2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma.

BACKGROUND: The presence of airway inflammation even in mild asthma points to the potential value of antiinflammatory therapy. We compared the effect of an inhaled corticosteroid, budesonide, with that of an inhaled beta 2-agonist, terbutaline, in the long-term treatment of newly detected asthma. METHODS: We studied 103 patients (29 male and 74 female patients 15 to 64 years old) in whom asthma had appeared within the previous year. The patients were randomly assigned in blinded fashion to two treatment groups: one to receive 600 micrograms of inhaled budesonide twice a day, and the other to receive 375 micrograms of inhaled terbutaline twice a day. The study period was two years. RESULTS: After six weeks of treatment, the patients treated with budesonide tolerated inhaled histamine better than the patients treated with terbutaline (a difference of one doubling dose step, P less than 0.001), and the difference was sustained. Patients' diaries kept during the first three months of the study and during the last month of the first and second years showed budesonide to be more effective than terbutaline in improving peak expiratory flow in the morning (average increase from the pretreatment value, 32.8 liters per minute for budesonide vs. 4.8 liters per minute for terbutaline; P less than 0.001) and in the evening (P less than 0.01). Budesonide was also more effective in reducing the symptoms of asthma (P less than 0.01) and the use of supplemental beta 2-agonist medication (P less than 0.01). Ten patients were withdrawn from the terbutaline group because treatment was insufficiently effective, whereas only one dropped out of the budesonide group. The adverse reactions to both treatments were few and mild. CONCLUSIONS: Antiinflammatory therapy with inhaled budesonide is an effective first-line treatment for patients with newly detected, mild asthma, and it is superior to the use of terbutaline in such patients.

Adolescent↗
PubMed1991

Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler.

BACKGROUND: High doses of inhaled corticosteroids are absorbed systemically and may cause long term side effects. As rinsing the mouth out after use and inhaling through a spacing device may reduce systemic absorption this has been further investigated. METHODS: Three crossover studies were carried out to assess the effect of budesonide given by dry powder inhaler (Turbuhaler) with and without mouth rinsing and beclomethasone dipropionate given by metered dose inhaler with or without a spacing device (Volumatic) on serum cortisol concentrations and urinary cortisol excretion in patients with asthma taking an inhaled corticosteroid. Each treatment period was two weeks with in a two week washout period. Serum cortisol concentrations at 0800 hours on day 14 and the 24 hour urinary excretion of cortisol were measured. In study 1 24 patients taking beclomethasone dipropionate 500 micrograms twice a day inhaled with (n = 10) or without (n = 14) a Volumatic spacing device were switched to a budesonide dry powder inhaler, 600 micrograms to be taken twice a day without mouth rinsing. In study 2 10 patients took budesonide 800 micrograms twice a day with and without mouth rinsing and without swallowing the rinsing water. In study 3 17 patients took budesonide 800 micrograms twice daily with mouth rinsing and beclomethasone dipropionate 500 micrograms twice daily with the spacing device and mouth rinsing. RESULTS: In study 1 no difference was seen between budesonide without mouth rinsing and beclomethasone dipropionate without a spacer: beclomethasone with spacer caused less suppression of cortisol (mean (SD) serum cortisol concentration: beclomethasone and spacer 487(148), budesonide 368(145) nmol/l). In study 2 mouth rinsing caused less suppression of morning serum cortisol concentrations (rinsing 440(63), no rinsing 375(56) nmol/1). In study 3 there was no difference in serum or urinary cortisol concentrations between twice daily beclomethasone dipropionate 500 micrograms inhaled by Volumatic spacer or budesonide by Turbuhaler 800 micrograms twice daily, both with mouth rinsing. Individual serum cortisol values were within the normal range in all patients except one in study 1. CONCLUSION: Systemic absorption of a corticosteroid inhaled from a metered dose inhaler is reduced by using a spacing device and that from a dry powder inhaler by mouth rinsing.

Administration, Inhalation↗
PubMed1990

Concentration of tumor-associated trypsin inhibitor (TATI) in pleural effusions.

We measured the concentration of tumor-associated trypsin inhibitor (TATI) in plasma and pleural fluid of 84 patients with pleural effusions of various causes. We observed elevated (greater than 30 micrograms/L) TATI levels in pleural fluid in 45 percent of patients with pleural effusion associated with malignant disease and in 15 percent of patients with benign disease. Similar results were obtained for TATI in plasma. The concentration of TATI in pleural fluid closely parallelled that in plasma. In patients with renal insufficiency and in patients with biliary obstruction, the TATI levels were elevated both in plasma and pleural fluid. A positive correlation was seen between the concentration of TATI and the activity of alkaline phosphatase in plasma. The results show that simultaneous determination of TATI in plasma and pleural fluid improves the diagnosis of cancer only marginally. Our results also support the hypothesis that elevated TATI levels may reflect an acute phase reaction caused by inflammatory disease or tissue destruction associated with cancer not only in inflammatory conditions, but also in malignant disease where the tumor itself is not producing TATI.

Biomarkers, Tumor↗
PubMed1990

Pulmonary sarcoidosis in the Nordic countries 1950-1982. II. Course and prognosis.

The review is based on studies of pulmonary sarcoidosis from Denmark, Finland and Sweden during 1950-1982, focusing on the course and prognosis of the disease. Cases with acute onset with chest X-ray stage I, fever, arthritis and erythema nodosum had a 85-90% remission rate during the first two years. The overall 5 year remission rate for stage I was 82%, stage II 66% and stage III 30%. Among cases with stage I, 2-5%, and among cases with stage II and III, 6-10% developed chronic pulmonary disease. Patients with stage I had a normal mortality rate, whereas those with stage II, III and IV had a rate threefold higher than expected due to sarcoidosis-related cardiopulmonary complications.

Denmark↗
PubMed1990

Pulmonary sarcoidosis in the Nordic countries 1950-1982. Epidemiology and clinical picture.

The review is based on studies from Denmark, Finland, Norway and Sweden during 1950-1982. In general sarcoidosis was slightly more frequent in females than in males, especially after 40 years of age. The majority of cases were diagnosed before 35 years; 59% had symptoms, 41% were found by chance. Radiological stage I was present in 50%, stage II in 35%, and stage III-IV in 14%. The prevalence was age dependent with maximum between 18-35 years, varying from 8-102/10(5) examined persons in Finland to 27 in Norway and 64 in Sweden. The incidence was likewise age related, being highest in 18- to 20-years-old males (57/10(5) examined persons/year); overall incidence varied from 14-15/10(5) examined persons/year in Denmark, Finland and Norway to 24 in Sweden. No definite change in incidence figures has occurred. The accumulated lifetime risk of acquiring sarcoidosis was identical in the two sexes up to 45 years of age, and then increased in females; at 65 years the risk was 1.6% in females and 1.2% in males based on the population examined.

Adolescent↗
PubMed1988

Inhaled budesonide influences cellular and biochemical abnormalities in pulmonary sarcoidosis.

In a randomized, double-blind study 19 patients with newly-detected pulmonary sarcoidosis were treated with either inhaled budesonide, 800 micrograms twice daily (n = 9), or placebo (n = 10) for 8-10 weeks. Before and after treatment, chest roentgenograms, lung function tests, bronchoalveolar lavage (BAL) and biochemical tests were performed. Angiotensin converting enzyme (ACE) activity and beta2-microglobulin (beta 2M) concentrations were measured in serum. The same tests, as well as albumin and hyaluronan were measured in the BAL-fluid. The total cell number in BAL-fluid, differential counts and lymphocyte subpopulations were determined (total T- and B-lymphocytes, T-helper/inducer (OKT-4) and T-suppressor/cytotoxic (OKT-8) lymphocytes). No significant changes in chest roentgenograms or lung function tests were observed during the short study time. However, a decrease in serum ACE (p less than 0.1) and beta 2 M (p less than 0.05) as well as in BAL-hyaluronan (p less than 0.01) was found in the budesonide-treated patients as well as a decrease in the percentage of BAL T-lymphocytes (p less than 0.05) and the T4/T8 ratio (p less than 0.1). No significant changes were seen in the placebo group. The findings suggest that treatment with inhaled budesonide influences biochemical and cellular findings in patients with early sarcoidosis in the same way as treatment with systemic corticosteroids. The results may also explain clinical effects seen in sarcoidosis patients treated with inhaled corticosteroids. However, further studies are required to determine the long-term clinical benefits of inhaled steroids in pulmonary sarcoidosis.

Administration, Inhalation↗
PubMed1988

Inhaled corticosteroids and pulmonary sarcoidosis.

Corticosteroids are the drugs of choice for treatment of sarcoidosis. Frequently the pulmonary parenchymal lesions with impaired lung function represent the indication for starting treatment. Oral glucocorticosteroids may cause systemic side-effects and therefore treatment is often started too late in the hope of a spontaneous recovery. With the introduction of the locally potent glucocorticosteroid budesonide (Pulmicort) the active alveolitis as well as the pulmonary parenchymal lesions can be treated with only inhaled steroids and without causing systemic effects. If wanted, treatment of pulmonary sarcoidosis can therefore be started early without waiting for a possible spontaneous improvement. Systemic sarcoidosis outside the lungs cannot, however, be treated with locally administered drugs. The most rapid improvement of the pulmonary manifestations is achieved if an initial combination of oral and inhaled steroids is used for 2-3 months. Thereafter the long-term maintenance treatment can be given with only inhaled budesonide.

Administration, Inhalation↗
PubMed1987

Relation between clinical stage of sarcoidosis and serum values of angiotensin converting enzyme and beta2-microglobulin.

We measured angiotensin converting enzyme (ACE) and beta2-microglobulin (beta 2M) in the serum of 107 patients with sarcoidosis in different clinical stages and in healthy subjects. In patients with acute sarcoidosis and erythema nodosum (EN) we found increased beta 2M values but low ACE activity. Patients with newly-detected sarcoidosis but without EN had increased ACE activity; however, their beta 2M-levels were normal or only slightly elevated. Patients with chronic active sarcoidosis had high ACE activity; however, their beta 2M-levels were normal in a stable phase, but significantly increased during clinical relapses. Patients with resolved sarcoidosis had normal ACE and beta 2M values. The results indicate that serum beta 2M concentrations are increased in connection with new granuloma formation-i.e. lymphocytic activation-whereas the serum ACE activity increases later on when active granulomas have been formed. In sarcoidosis, simultaneous determinations of serum ACE and beta 2M may be useful for describing the stage of the disease. The correlation between ACE and beta 2M will also be different, depending on the composition of the clinical series of sarcoidosis patients.

Erythema Nodosum↗
PubMed1983

Usefulness of fine-needle aspiration biopsy of spleen in diagnosis of sarcoidosis.

Fine-needle aspiration biopsy of the spleen was carried out in 557 patients. In 381 cases, the aspiration was performed because of suspected sarcoidosis. The sensitivity of the technique was 59 percent and the specificity 97 percent. The cytologic picture of the spleen was abnormal in 184 patients with sarcoidosis and in seven patients with extrinsic allergic alveolitis. No major complications occurred. The method provides a simple, safe, quick, and reliable way of producing evidence of a granulomatous process in patients with suspected sarcoidosis. The biopsy method can be used with advantage before application of more invasive techniques.

Biopsy, Needle↗
PubMed1982

The Finnish leukaemia group: levamisole in maintenance therapy of acute myeloid leukemia in adults.

The Finnish Leukaemia Group has carried out a randomized, multicenter trial to study the effect of levamisole on the remission maintained with 6-mercaptopurine and methotrexate in acute myeloid leukaemia in adults. Levamisole was given on 3 consecutive days every 2 weeks. Twenty-five patients received only chemotherapy, while 26 patients received levamisole as well. The patients receiving levamisole showed significantly better remission duration than those given only chemotherapy (P = 0.033, Mantel's summary chi 2-text). There are four long term survivors in the levamisole group versus none in the chemotherapy group. The remissions have lasted 48-75 months.

Adult↗