The aim of this study was to assess population-based changes in incidence, treatment, and in short- and long-term survival of patients with acute respiratory distress syndrome (ARDS) over 23 years.
Analysis of all patients in Iceland who fulfilled the consensus criteria for ARDS in 1988-2010. Demographic variables, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and ventilation parameters were collected from hospital charts.
The age-standardised incidence of ARDS during the study period was 7.2 cases per 100,000 person-years and was increased by 0.2 cases per year (P?
Karolinska Institutet, Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Huddinge, and Karolinska University Hospital, SE 141 86 Huddinge and SE 171 76 Solna, Sweden. firstname.lastname@example.org
AIM: To describe age and gender differences in estimated maximum oxygen uptake (VO2max) and participation in organized physical activity in Swedish obese children and adolescents, and compare the results with an age-matched reference group representative of the general population. METHODS: Two hundred and nineteen obese children (102 boys, 117 girls, aged 8-16 years, Body Mass Index (BMI) 24.3-57.0 kg.m-2) performed a submaximal bicycle ergometry test and an interview concerning participation in organized physical activity. RESULTS: The obese children had lower relative VO2max (p
Circulating adiponectin (ADPN) levels are inversely associated with disease severity in patients with chronic obstructive pulmonary disease (COPD), while studies assessing the relationship between ADPN and lung function in subjects from the general population have shown diverging results. Accordingly, we hypothesized that ADPN would be associated with lung function in a population-based sample and tested how abdominal adiposity, metabolic syndrome, and systemic inflammation influenced this association.
We measured total ADPN in serum, forced vital capacity (FVC) and forced expiratory volume during the 1st second (FEV1) in 529 participants (median 50 years, 54.6% males) recruited from the general population. We assessed the association between ADPN and lung function by multivariate linear regression analyses and adjusted for age, gender, height, smoking habits, weight, body mass index, waist-hip ratio, metabolic syndrome, obstructive sleep apnoea (OSA) and C-reactive protein.
The median (interquartile range) level of serum ADPN was 7.6 (5.4-10.4) mg/L. ADPN levels were positively associated with FVC % of predicted (beta 3.4 per SD adiponectin, p
Chemical exposures are important determinants of respiratory health. The objective of the present study was to determine the association between the use of personal care products, which may contain respirable components, and lung function.
Using questionnaire and spirometry data collected during the Canadian Health Measures population survey, the association was tested between 1-second forced expiratory volume (FEV(l)) and forced vital capacity (FVC) expressed as a percentage of predicted, and the frequency of use of personal care products categorized as eye makeup, fragrances, hairstyle products, lipstick, and scented body products.
Five thousand sixteen of the 5604 participants in the survey reported using at least one personal care product in the past 3 months. Among men and women, an interquartile increase in hairstyle products was associated with an approximate 2% decrease in both FEV(1) and FVC (P
Lung function (FEV1 before and after bronchodilatation) was studied prospectively over five visits in 55 asthmatic children (28 boys) from childhood to adulthood (age 30). At the last follow-up recordings were made at rest, after cold air challenge (CACh), and after bronchodilatation. Results were related to clinical asthma scoring and to sensitization to furred animals, as described in a companion paper. Lung function outcome was shown to be influenced by initial FEV1 (% predicted) and gender, but not by initial asthma severity or sensitization. FEV1 (% predicted) was higher in females than in males over the first two follow-ups, but the reverse was found over the subsequent visits. It deteriorated from childhood to adulthood in the females but improved in the males. In adulthood the females (for height 170 cm) had a steeper normalized annual fall in post-bronchodilator FEV1 than the males (55 +/- 38 vs. 25 +/- 36 ml; P = 0.006). The degree of bronchial hyperresponsiveness was associated significantly with asthma severity and the extent of sensitization to furred animals, but not with gender. The results indicate a better lung function outcome for asthmatic boys than for girls, confirming trends seen in clinical asthma severity. In adulthood the extent of sensitization to relevant perennial inhaled allergens significantly influences airway responsiveness and asthma severity, but not lung function.
To evaluate health-related quality-of-life (HR-QoL) and the asthma control test (ACT) in children with problematic severe asthma and those with controlled asthma and to identify whether clinical characteristics show correlations with these measurements.
This multicentre cross-sectional study included 93 children in total, 54 with problematic severe asthma and 39 age-matched with controlled asthma. Subjects completed the Paediatric Asthma Quality-of-Life Questionnaire as well as a standardized health questionnaire and the ACT. Objective measurements of exhaled nitric oxide, specific sensitization, pulmonary function and bronchial hyper-responsiveness to methacholine were also taken.
HR-QoL was reduced in children with problematic severe asthma (5.4 vs. 6.7, p
The paper analyzes the data available in the literature on the prevalence of smoking and its impact on different systems of the human body. Basic documents of the World Health Organization on smoking control policy are presented.
Interstitial lung diseases (ILDs) form a heterogeneous group of rare diseases characterised by varying degrees of pulmonary inflammation and fibrosis. We hypothesised that IPF and unclassifiable ILD were common in a Danish ILD cohort and that prognostic factors based on disease characteristics and comorbidities could be identified The aims of the PhD study were to describe the demographics of ILD in Central Denmark, to characterise the distribution of ILD diagnoses, and to assess prognostic factors in IPF and unclassifiable ILD. The study is based on a cohort of 431 ILD patients referred to our department during a 6-year period. All ILD diagnoses were re-evaluated according to current diagnostic criteria. Patients were followed from the time of first visit on suspicion of an ILD to the last visit to the centre, death, transplantation, or discharge from follow-up. The incidence of ILD was 4.1 per 100,000 inhabitants, and the incidence of IPF was 1.3 per 100,000 inhabitants in Central Den-mark. The most frequently occurring ILDs were IPF (28%), unclassifiable ILDs (extensive fibrotic disease and other unclassifiable ILDs) (24%), connective tissue disease-related ILD (14%), hyper-sensitivity pneumonitis (7%) and NSIP (7%). Cardiovascular dis-ease was present in 21% of the patients. The presence of cardio-vascular disease at the time of IPF diagnosis did not lead to increased mortality, whereas cardiovascular disease diagnosed during the course of IPF was a statistically significant predictor of mortality. Our study also showed that diabetes and concomitant anticoagulant therapy were associated with worse outcome in IPF, and that a simple HRCT scoring system could be used in the prediction of outcome in fibrotic ILDs. The study of unclassifiable ILD revealed two disease categories: one group characterised by extensive fibrotic disease and one characterised by more inflammatory features. The latter group was characterised by younger age and significantly better prognosis. We evaluated the pragmatic disease classification based on the clinical disease pattern included in the 2013 revision of the guidelines of diagnosis and treatment of interstitial lung diseases. We found that it was able to separate patients with unclassifiable ILD into categories with highly significant differences in survival. We also evaluated the ILD-GAP model, which is based on gender, age and pulmonary function (physiology), and found that it was a valuable predictor of survival in unclassifiable ILD. In a multivariate model, the two prediction scores showed significant individual contribution to the prognostic assessment. The present study has provided the first estimate of ILD and IPF incidence in the Danish population and has shown that demographics and survival of IPF in this cohort were comparable to what has been reported in other studies. Comorbidities were common among patients with IPF, and the results of the study have led us to believe that careful diagnosis and treatment of comorbidities are important in order to optimise outcome in patients with IPF, although our findings need to be confirmed in larger studies. Unclassifiable ILD is frequent in daily clinical practice but has not been characterised in detail. Our study showed that it was possible to identify predictors of outcome and to validate the ILD-GAP model in this cohort. The study also showed that the Disease Behaviour Classification can be used in the management of patients with unclassifiable ILD.