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W Nystad

Publications and source records attributed to W Nystad.

30 records · Page 2Linked to original sources

A comparison of VO2(peak) between patients with congenital heart disease and healthy subjects, all aged 8-17 years.

The peak oxygen uptake (VO2(peak)) of 196 healthy children and adolescents aged 8-16 years, and 187 children and adolescents (in the same age range) with congenital heart disease (CHD), was measured using a graded treadmill test (Oslo-protocol). The healthy population was tested to assess the reference values that were to be used in the interpretation of the results obtained from patients with CHD. The results revealed that patients with CHD exhibited lower VO2(peak) values, with declining values for boys after the age of 12-13 years. When separated into different diagnostic groups, on average, patients with a chronic pressure overload of the left ventricle and patients with tetralogy of Fallot have lower VO2(peak) values, but make approximately the same progress with age as healthy subjects. Patients with transposition of the great arteries, however, displayed a marked decline in VO2(peak) after the age of 12-13 years. Whether exercise testing should be included in routine follow-up in patients with CHD, especially those between the ages of 10 and 16 years, when the condition of some patients deteriorates, requires special attention.

Adolescent↗

Wheezing in school children is not always asthma.

Our objective was to study whether children with reported asthma differed from children with wheeze but without asthma, and from children with neither asthma nor wheeze, regarding lung function, bronchial hyper-responsiveness (BHR) using methacholine inhalation, exercise-induced bronchoconstriction (EIB), and skin prick test (SPT) reactivity. School children (n=2188), enrolled in a survey of asthma, were classified into three mutually exclusive groups by parental report of: asthma, wheeze, and no asthma/no wheeze. A random sample of 80 children in each group was tested (n=240). Among asthmatics, 68% (95% confidence interval (CI), 57-79) had a BHR (measured as PD20 forced expiratory volume in 1 s (FEV1) < or = 8.16 micromol using methacholine) compared to 31% (CI 20-42%) and 30% (CI 19-40%) in the wheeze and no asthma/no wheeze groups. The dose-response slope (DRS) confirmed the PD20 data and distinguished equally between groups. EIB (> or =10% fall in FEV1) was more frequent (40%, CI 29-52%) among asthmatics than among children with wheeze (12%, CI 4-19%) and no asthma/no wheeze (7%, CI 1-13%). The prevalence of at least one positive SPT was twice as high in the asthma group (58%, CI 47-69%) than in the wheeze (27%, CI 16-37%) and the no asthma/no wheeze (25%, CI 15-35%) groups. These results indicate that children with asthma differ from children with wheeze and children with no asthma/no wheeze regarding lung function, BHR, EIB, and SPT reactivity. Children with wheeze are more similar to children with no asthma/no wheeze with respect to these parameters.

Adolescent↗

Day care attendance, recurrent respiratory tract infections and asthma.

OBJECTIVE: Our objective was to use a causal model for childhood asthma to determine whether the effect of day care attendance on asthma was mediated by recurrent respiratory tract infections. DESIGN: A cross-sectional survey among 1447 children aged 6-16 years in Oslo. Their parents completed written questionnaires. A recursive logit model was used to estimate direct effects in terms of adjusted odds ratios (aOR). RESULTS: Year of birth, number of siblings and length of maternal education were significantly associated with day care attendance. Attendance at day care increased the risk of early infections, aOR = 1.8 (1.3-2.5), and infections were associated with asthma, aOR = 4.9 (3.4-7.3). The crude association between day care and asthma was cOR = 1.5 (1.0-2.2), whereas the estimated direct effect was small and nonsignificant, aOR = 1.2 (0.8-1.9). The results may be influenced by overreporting of infections among parents of children with asthma. CONCLUSIONS: Our results suggest that children who attend day care have an increased risk of asthma with early infections as a mediator of risk.

Absenteeism↗

[Aerobic capacity in children and adolescents--Nordic results over the past 45 years].

The aim of this study was to reveal whether today's children and adolescents have lower aerobic capacity compared with earlier studies. Aerobic capacity may be defined as the highest amount of oxygen a subject is able to consume per unit of time. Peak oxygen uptake (VO2peak) is often used as a measure of aerobic capacity in children. VO2peak in 196 healthy children and adolescents of both sexes, aged 8-16 years, was measured on a graded treadmill test. The mean results of VO2peak (l.min-1) showed only small differences compared with previous studies in Scandinavia. There was, however, greater dispersion in the present study when the VO2peak-values were corrected for weight (ml.kg-1.min-1) than in the earlier studies. When compared to other countries in Europe, Norwegian subjects achieved higher values. The reason may be due to either genetic differences or to a higher level of physical activity among the Norwegian subjects.

Adolescent↗

Increasing risk of asthma without other atopic diseases in school children: a repeated cross-sectional study after 13 years.

Some children develop asthma and other atopic diseases, others asthma without atopic diseases. To better understand secular trends, we estimated the relative increase in asthma in children with (atopy related asthma) and without (non-atopy related asthma) other atopic diseases (eczema or hay fever) in two samples of school children born, 1965-1975 (n = 1674) and 1978-1988 (n = 2188). By analysing the samples as historical cohorts, age-specific prevalence rates were estimated and incidence rates were calculated (number of new cases by 1000 person years under risk). Cox regression was used to estimate the relative risk (RR) of asthma by year of birth. The point prevalence of asthma was 1.9% (95% CI: 1.4-2.4) in the 1965-1975 cohort and 4.6% (95% CI: 3.8-5.4) in the 1978-1988 cohort for three-year old children, and remained fairly constant throughout childhood. The age-specific prevalence of non-atopy related asthma increased relatively more from 1965-1975 to 1978-1988 compared to atopy related asthma. The age-specific incidence rates of asthma showed that the RRs comparing the two cohorts tended at all ages to be highest for non-atopy related asthma. The relative risks of non-atopy related asthma by gender and birth cohort, showed that the effect of cohort was higher for non-atopy related asthma, aRR: 4.0 (95 % CI: 2.5-6.5), than for atopy-related asthma aRR: 2.0 (95% CI: 1.3-3.2). Children without other atopic diseases have a higher relative risk of being diagnosed with asthma than children with other atopic diseases across all ages comparing two samples of school children born 1965-1975 and 1978-1988.

Adolescent↗

Recurrent respiratory tract infections during the first 3 years of life and atopy at school age.

BACKGROUND: The hypothesis that infections reduce the risk of atopy was investigated by estimating the association between recurrent respiratory tract infections during the first 3 years of life and atopy at school age. METHODS: According to surveys in three different areas of Norway, children were classified into three groups: asthma, wheeze without asthma (wheeze), and no asthma/no wheeze. The skin prick test (SPT) was conducted on a stratified random sample of children (n = 502). The outcome was at least one positive SPT. The exposure variable was retrospective parental report of respiratory tract infections during the first 3 years of life. RESULTS: Infections were negatively associated with atopy, crude odds ratio (cOR) = 0.3, 95% confidence interval (95% CI) 0.1-0.7, in the asthma group. A similar association was present in children with wheeze cOR = 0.4 (95% CI 0.1-1.2). The number of siblings was not associated with atopy in any group. Infections remained negatively associated with atopy in children with asthma, aOR = 0.3 (95% CI 0.1-0.7), in a logistic regression model adjusting for confounding factors. A similar pattern was present in the wheeze group. CONCLUSIONS: Recurrent respiratory tract infections during the first 3 years of life are negatively associated with atopy at school age in children with asthma.

Adolescent↗

Aerobic endurance testing of children and adolescents--a comparison of two treadmill-protocols.

Fifty-eight children and adolescents of both sexes, aged 8-16, were tested on a treadmill using two different protocols. The well-known Bruce-protocol has the disadvantages of steep incline and large increments at each step. A new protocol (Oslo-protocol) with less incline and smaller increments was compared to the Bruce-protocol. The results from the two protocols showed no differences with regard to peak oxygen uptake (VO2peak) or peak heart rate (HRpeak). However, the respiratory exchange ratio (R) and blood lactate concentration [La-] showed higher values when the Bruce-protocol was used. The study also indicated that the often used criteria of HRpeak, R and achievement of a plateau in VO2 to estimate VO2peak, were not reliable indicators in either protocol. When time to exhaustion was used as an estimation of aerobic endurance level, the Oslo-protocol discriminated better than the Bruce-protocol. As a conclusion, the results indicate that none of the criteria may be used as a reliable indicator of having achieved VO2peak. An experienced testleader may be essential to define when VO2peak has been reached in children. On the basis of the results from the current study, the Oslo-protocol seems suitable as a test-protocol when testing children and adolescents for VO2peak.

Adolescent↗

[Occurrence of asthma among school children in Norway during the period 1985-94].

Several comparable surveys of childhood as have been performed in Norway. This article describes the prevalence among children, 6-13 years old, during the period 1985-94, and how this prevalence is influenced by the operational definition of asthma. Questionnaires were administered in eight areas; Troms/Finnmark (1985), Nordland (1985), Ardal/Laerdal (1989/92), Sør-Varanger (1992), Oslo (1994), Hallingdal (1994) and Odda (1994). The response rates varied from 85 to 96%. The parent-reported lifetime prevalences were lowest in the areas where the studies took place in 1985, the earliest year of study; Nordland 7.2% (95% CI 6.5-7.9), Troms/Finnmark 8.1% (7.4-8.8). The prevalence increased up to 1994, with the highest prevalence in Oslo 13.7% (12.0-15.4). The prevalence of current asthma was about half the lifetime prevalence; Oslo 5.7% (4.6-6.8) compared with 10.1% (8.5-11.6). When respiratory symptoms the estimates were doubled in some areas and regional differences were reduced. The prevalence increased during the study period and seemed to be highest in northern Norway. Regions classified as polluted did not have a higher prevalence.

Adolescent↗

The prevalence of respiratory symptoms and asthma among school children in three different areas of Norway.

The role of exposure to ambient air pollution has been a topic of interest as a potential risk factor for respiratory symptoms and asthma. We expected that the prevalence rates would vary in Norway between the capital, Oslo, the mountainous area Hallingdal and the industrial area Odda. Surveys were conducted in school children, aged 6-16 years, in; Oslo (n = 2577), Hallingdal (n = 1177) and Odda (n = 831). The parent-reported prevalence of wheeze in past year was almost similar in Oslo (13.1 (95% CI 11.7-14.5)) and Upper Hallingdal (14.2 (13.1-15.3)), but lower in Odda (9.0 (7.0-11.0)). The findings for severe respiratory symptoms were almost equal. The age patterns within each area differed. The risk of wheeze ever (p < 0.001) and wheeze in past year (p = 0.04) decreased with increasing age in Odda, while there was an increase in the risk of exercise induced wheeze in Oslo (p = 0.02) and Hallingdal (p < 0.001). The lifetime prevalence of asthma was lowest in Odda (5.4 (3.8-7.0)) compared to Oslo (9.4 (8.2-10.6)) and Hallingdal (8.5 (6.8-10.2)). There was a positive association between physical activity and wheeze in past year. The results do not support the hypothesis that respiratory morbidity is more common in urban than rural areas, age and physical activity can influence the prevalence rates of respiratory symptoms in school children.

Adolescent↗

The physical activity level in children with asthma based on a survey among 7-16 year old school children.

The objective was to compare the physical activity level of children with asthma with that of non-asthmatic children. A standardized written questionnaire was administered in a survey of school children in three different areas of Norway: Oslo (n = 2577), Hallingdal (n = 831) and Odda (n = 1177). Response rates were > 85% in all areas, and approximately 50% of the respondents were female. No significant differences were found between the distributions in exercise frequency either for children reported ever to have had asthma (P = 0.8) or for those with current asthma (P = 0.3) compared to non-asthmatics. Similar results were found for exercise hours a week. More than 50% of all children took part in organized sport. The data suggest that asthmatic children are as physically active as their peers.

Adolescent↗

Changing prevalence of asthma in school children: evidence for diagnostic changes in asthma in two surveys 13 yrs apart.

It is still unclear whether the reported increase in the prevalence of asthma is real or due to changes in diagnostic criteria. The objectives of this study were to compare the prevalence of diagnosed asthma with the prevalence of respiratory symptoms, and to compare the association between asthma and other atopic diseases in 1981 and 1994. The study populations comprised randomly selected school classes in Oslo in 1981 (n=1,772) and 1994 (n=2,577). The main outcomes in these comparable cross-sectional studies of children, 6-16 yrs of age, were parent-reported prevalence of diagnosed asthma, respiratory symptoms, eczema and hay fever. The questionnaire was identical in 1981 and 1994. The response rates were 94% (1,674 out of 1,772) in 1981 and 85% (2,188 out of 2,577) in 1994. The lifetime prevalence of asthma increased from 3.4% in 1981 to 9.3% in 1994; odds ratio (OR) 2.9 (95% confidence interval (95% CI) 2.1-4.0) comparing 1994 to 1981. The prevalence of occasional wheezing increased from 9.0 to 10.8%; OR 1.2 (95% CI 1.0-1.5), and attacks of wheezing from 3.7 to 6.8%; OR 1.8 (95% CI 1.3-2.5). Survival analyses for 3 year birth cohorts showed that asthma was more readily diagnosed in the latest birth cohort (1985-1988). The association between asthma and other atopic diseases decreased during the period under study. The increase in diagnosed asthma and respiratory symptoms supports a true increase in asthma. However, the larger increase in diagnosed asthma than wheezing and a reduced association between asthma and other atopic diseases suggest that the increase in asthma may be explained, in part, by changes in diagnostic criteria.

Adolescent↗