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S Janson

Publications and source records attributed to S Janson.

At least 19 recordsLinked to original sources
PubMed2005

'Dampness' at home and its association with airway, nose, and skin symptoms among 10,851 preschool children in Sweden: a cross-sectional study.

UNLABELLED: There is convincing epidemiological evidence that 'dampness' in buildings is associated with respiratory effects. In order to identify health-relevant exposures in buildings with 'dampness', the study 'Dampness in Buildings and Health' (DBH) was initiated. In the first step of the study, cross-sectional data on home characteristics including 'dampness' problems, and symptoms in airway, nose, and skin among 10,851 children (1-6 years), were collected by means of a questionnaire to the parents. The prevalence of wheezing during the last 12 months was 18.9% and doctor-diagnosed asthma 5.4%. Rhinitis during the last 12 months was reported for 11.1% of the children and eczema during the last 12 months 18.7%. Gender, allergic symptoms among parents, and age of the child were associated with symptoms. Water leakage was reported in 17.8% of the buildings, condensation on windows in 14.3%, and detached flooring materials in 8.3%. Visible mould or damp spots were reported in only 1.5% of the buildings. The four 'dampness' indices were associated to higher prevalence of symptoms in both crude and adjusted analysis. Furthermore, it was found that the combination of water leakage in the home and PVC as flooring material in the child's or parent's bedroom was associated to higher prevalence of symptoms among children. However, the interpretation of this finding is unclear. The combination of water leakage and PVC may be a proxy, for example, reconstruction because of water damages. PRACTICAL IMPLICATIONS: The study have showed that moisture-related problems in buildings are a risk factor for asthma and allergic symptoms among preschool children. The recommendation to the general public is to remediate damp buildings.

Air Pollution, Indoor↗
PubMed2005

Group discussions with parents have long-term positive effects on the management of asthma with good cost-benefit.

AIM: To investigate if an intervention with extra information and support in a group setting to parents of preschool children could improve adherence and clinical outcome. METHODS: This is a controlled, prospective study where the parents of 60 newly diagnosed preschool asthmatic children aged 3 mo-6 y were randomized to either a control group or to an intervention that consisted of four group sessions in close connection with the diagnosis. The basic education on asthma and the written treatment plan were the same in both groups. The outcome measures were questionnaires to the parents and classification of the children according to symptoms and medication. The adherence rate and the burden of asthma were calculated with the help of diaries and weighing of the MDIs used between 12 and 18 mo after inclusion. RESULTS: The follow-up rate was 85% after 18 mo. The parents' presence in the sessions was around 70%, with no gender difference. The parents' view on adherence issues improved significantly in the intervention group. In the control group, 30% had poor adherence compared to 8% in the intervention group (p=0.015). Both the parents and the paediatricians underestimated the number of children with poor adherence. The children in the intervention group had significantly fewer exacerbation days during the last 6 mo-2.1 compared to 3.9 d/child-although they had lower inhaled steroid doses after 18 mo. An economic calculation showed that the intervention was profitable. CONCLUSION: This intervention resulted in an improvement in the parents' view on adherence, in the measured adherence rates and in the clinical outcome.

Adult↗
PubMed2004

Quantitation of platelet aggregation and microaggregate formation in whole blood by flow cytometry.

Platelet aggregation and microaggregate formation were measured in samples of stirred whole blood by flow cytometry. Blood samples were stirred in a multi-sample agitator with ADP, fixed and labelled with a platelet-specific CD42a-FITC fluorescent antibody. The blood was then diluted and applied directly to a flow cytometer. Platelets were identified using a gating procedure based on their expression of CD42a and then quantified. Aggregation was monitored as a fall in the number of single platelets. Both reversible and irreversible aggregation responses to ADP were determined and these were found to correlate directly with aggregation responses determined using a well-established single platelet counting technique using the Ultra-Flo 100 Whole Blood Platelet Counter. We found from flow cytometry that ADP-induced aggregation was coupled with a transient formation of platelet microaggregates over the initial 60 s following ADP addition. Assessment of single platelet loss by flow cytometry was found to be a reliable way of monitoring aggregation responses and provided new information on rapid microaggregate formation in ADP-stimulated blood.

Adenosine Diphosphate↗
PubMed2003

Pet-keeping in early childhood and airway, nose and skin symptoms later in life.

BACKGROUND: It is discussed whether exposure to pets during childhood is a risk or a protective factor for sensitization and allergic symptoms. The aim of this study was to investigate the association between pet-keeping at time of birth and allergic symptoms in airways, nose and skin among young children in Sweden. METHOD: A questionnaire was sent to the parents of 14 077 children (1-6 years), the focus being on allergic symptoms, home environment and other background factors including pet-keeping and avoidance behaviour. The response rate was 79%. RESULTS: Almost one-tenth of the population had got rid of pets because of allergy in the family, and 27.3% reported "avoidance" behaviour towards pets. In a cross-sectional analysis current pet-keeping was "protective", but this may be due to the fact that people avoid exposing their child to something that they believe is a risk factor for allergies. Pet-keeping at the time of birth was associated with "wheezing", "asthma" and "rhinitis on pet-exposure" later in life for children from families with an "avoidance" behaviour, and was not "protective" for other children. There was also an indication of a dose-response relationship between the number of types of furred pets at time of birth and later symptoms in analyses adjusted for avoidance behaviour or current pet-keeping. CONCLUSION: The distribution of pet-keeping in the population is largely explained by avoidance behaviour, meaning that those who have pets mainly are those who can stand them, indicating a "healthy pet-keeping effect".

Animals↗
PubMed2002

The burden of asthma as reflected by the prevalence defined by doctor's diagnosis and the use of healthcare services by preschool children in a Swedish region.

AIM: Epidemiological data and reports on the prevalence and burden of preschool asthma are mainly based on questionnaires and generally give a prevalence of above 6% in Sweden. In this study we used other ways of studying the prevalence, risk factors and the use of healthcare services in a defined region. METHODS: The catchment area included 9410 children aged 0-6 y. All outpatient clinics had computerized records of patients and visits to the outpatient clinic could be studied as well as admissions to hospital for asthma between 1988 and 1998. RESULTS: According to patients' record data, the prevalence of doctor-diagnosed asthma was 4.5% in 1998. Seventy-nine percent of recorded patients are seen outside the hospital, thus the burden of asthma for the health system is mainly on the outpatient clinics. Admissions and especially readmissions to the hospital have decreased during the past decade. One-third of the children with newly diagnosed asthma had recurring exacerbations and risk for persistent asthma. CONCLUSIONS: The prevalence of doctor-diagnosed asthma as measured by total mapping in a region is lower than that reported from questionnaire-based studies. Hospital admissions for preschool asthma have decreased possibly as a result of improved medical care in the paediatric outpatient clinics where asthma is a dominating diagnose. In one-third of identified new asthmatics, there is a high risk of developing persistent asthma.

Asthma↗
PubMed2001

Advancing the science of symptom management.

UNLABELLED: Since the publication of the original Symptom Management Model (Larson et al. 1994), faculty and students at the University of California, San Francisco (UCSF) School of Nursing Centre for System Management have tested this model in research studies and expanded the model through collegial discussions and seminars. AIM: In this paper, we describe the evidence-based revised conceptual model, the three dimensions of the model, and the areas where further research is needed. BACKGROUND/RATIONALE: The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home-care settings because few models of symptom management have been tested empirically. To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly-based symptom management model allows the integration of science from other fields.

Holistic Nursing↗
PubMed2001

Relationship between airway inflammation, hyperresponsiveness, and obstruction in asthma.

BACKGROUND: Although the role of eosinophils in airway inflammation in chronic asthma has been extensively studied, a role for neutrophils has not been well characterized. Furthermore, prior studies have not systematically sought or controlled for factors that might confound the relationship between cellular markers of inflammation and physiologic measures of airway function. OBJECTIVE: The purpose of this study was to determine whether eosinophilic and neutrophilic inflammation independently contribute to abnormalities of airway function in asthma. METHODS: Multivariate analysis of data collected during screening and enrollment of 205 asthmatic adults for clinical trials was conducted to examine the relationships between cellular inflammation in induced sputum and FEV(1) and methacholine responsiveness (PC(20)) while confounding factors were controlled for. RESULTS: We found that age, sex, ethnicity, and use of inhaled corticosteroids were important confounding factors of the relationship between cellular inflammation and airway function. When these factors were controlled for, multivariate analysis showed that eosinophil percentage in induced sputum is independently associated with lower FEV(1) and lower PC(20) (P = .005 and P = .005, respectively). In the same models, increased sputum neutrophil percentage is independently associated with lower FEV(1) (P = .038) but not with PC(20) (P = .49). CONCLUSIONS: These results suggest that both eosinophilic inflammation and neutrophilic inflammation independently contribute to abnormalities of FEV(1) in asthma. Therapies directed specifically at control of neutrophilic inflammation might be useful in improving airway caliber in patients with chronic asthma.

Adult↗
PubMed2001

Estimated prevalences of respiratory symptoms, asthma and chronic obstructive pulmonary disease related to detection rate in primary health care.

OBJECTIVE: To assess the prevalence of respiratory symptoms, asthma and chronic obstructive pulmonary disease (COPD), and to relate it to an estimated detection rate in primary health care. DESIGN: A two-staged study with a cross-sectional survey and a clinical validation. SETTING: The adult population of Värmland, a county in Sweden. SUBJECTS: 4814 persons completed the survey and 206 the confirmative validation study. MAIN OUTCOME MEASURES: Prevalence of respiratory symptoms, of asthma and COPD. RESULTS: More than 40% reported respiratory symptoms. Wheeze was reported by 8.0%, shortness of breath by 11.4% and sputum production by 14.1%. Smoking was more common among women than among men. The prevalence of asthma was 8.2% and COPD 2.1%. Of persons with asthma, 33% were estimated to be undiagnosed, 67% used medication and nearly 60% attended primary health care services. CONCLUSION: Respiratory symptoms as well as asthma were common in this study and equivalent to earlier findings. The difference between the epidemiologically estimated prevalence of asthma and the lower detection rate in primary health care can be explained by at least three factors: persons who did not seek any care, were underdiagnosed or attended other health care providers.

Adolescent↗
PubMed2001

Alcohol, head injury, and pulmonary complications.

The purpose of this study was to determine the difference in rates of pulmonary complications (e.g., aspiration, pneumonia) in head-injured patients with and without concomitant alcohol intoxication. The records of 98 consecutive patients admitted over a 1-year period to a Level I Trauma Center were reviewed. The patients were grouped into three subsets: acutely intoxicated (n = 26), acutely intoxicated with a diagnosis of chronic alcoholism (n = 14), and non-intoxicated (n = 58). Alcohol intoxication was defined as a blood alcohol level (BAL) > or = 0.08 mg/dl. Admission BALs and Glasgow Coma Scale (GCS) scores were tabulated at admission. Frequency of arterial blood gas (ABG) measurements, need for an artificial airway/mechanical ventilation, and length of stay (LOS) were analyzed by using one-way analysis of variance. Intergroup differences in breath sounds were compared by using the nonparametric Kruskall-Wallis technique. We found no statistical difference between groups in terms of pulmonary sequelae despite the remarkably high BALs observed in the study groups. Similarly, there was no statistically greater LOS in the groups with alcohol intoxication than in alcohol-free cohorts. Despite a great deal of BAL science research to support our hypothesis, we failed to demonstrate a significantly higher rate of pulmonary problems in inebriated individuals with head injuries. We found that our strict exclusion criteria (no concomitant chest, abdominal, or pelvic trauma) limited the sample to only those patients without significant intracranial bleeding, whereas most complications in blood alcohol neuroscience research have been associated with much larger mass lesions (e.g., epidural or subdural hematomas). In addition, we found the characterizations of patients as chronically alcoholic were cumbersome and inaccurate in many cases. Future research should allow for a greater range of concomitant injuries that might suggest a positive or negative relationship to acute intoxication.

Acute Disease↗
PubMed2000

Evidence for multiple species within the endoparasitic dinoflagellate Amoebophrya ceratii as based on 18S rRNA gene-sequence analysis.

Parasitism within the group of dinoflagellates is a widespread phenomenon. Whether the parasitic dinoflagellates exhibit specificity in their infection is not well known, but this possibility has become an important issue in the development of biological control of harmful algal blooms. The 18S rDNA sequences from the parasite Amoebophrya sp. and its dinoflagellate host Dinophysis norvegica were determined and compared with the published sequence of Amoebophrya sp. infecting Gymnodinium sanguineum and other dinoflagellates. The results showed that the sequence from the parasite within D. norvegica was clustered with that of the one from G. sanguineum with 100% bootstrap support in a maximum-likelihood analysis. The observed identity between these two sequences was 93%, which indicates that they are not identical species. The two sequences from Amoebophrya sp. were deeply branched within the group of dinoflagellate sequences and represent the earliest diverging dinoflagellates. The sequence from the parasite Parvilucifera infectans, also infecting D. norvegica, was not closely related to the Amoebophrya sp. sequences. The sequence from D. norvegica appeared as a sister group to a cluster containing Prorocentrum lima and Alexandrium spp. without significant bootstrap support. The data presented herein support the hypothesis that A. ceratii comprises more than one species, and this opens the possibility that infections of harmful algal species might involve more than one Amoebophrya species.

Animals↗