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Aukland SM, Westerhausen R, Plessen KJ, Odberg MD, Elgen IB, Peterson BS, Ersland L, Eide GE, Rosendahl K. Selectively reduced posterior corpus callosum size in a population-based sample of young adults born with low birth weight. AJNR Am J Neuroradiol 2011; 32:970-5. [PMID: 21493761 DOI: 10.3174/ajnr.a2594] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Several studies suggest that VLBW is associated with a reduced CC size later in life. We aimed to clarify this in a prospective, controlled study of 19-year-olds, hypothesizing that those with LBWs had smaller subregions of CC than the age-matched controls, even after correcting for brain volume. MATERIALS AND METHODS One hundred thirteen survivors of LBW (BW <2000 grams) without major handicaps and 100 controls underwent a 3T MR examination of the brain. The cross-sectional area of the CC (total callosal area, and the callosal subregions of the genu, truncus, and posterior third) was measured. Callosal areas were adjusted for head size. RESULTS The posterior third subregion of the CC was significantly smaller in individuals born with a LBW compared with controls, even after adjusting for size of the forebrain. Individuals who were born with a LBW had a smaller CC (mean area, 553.4 mm(2)) than the controls (mean area, 584.1 mm(2)). Differences in total area, however, did not remain statistically significant after adjusting for FBV. CONCLUSIONS The uncorrected callosal size in 19-years-olds born with LBW was smaller than that of normal controls. However, after adjusting for FBV, the group difference was restricted to the posterior third. The clinical impact of a smaller posterior part needs further investigation.
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Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning M. Traumatic spinal cord injury and concomitant brain injury: a cohort study. Acta Neurol Scand 2010:51-7. [PMID: 20586736 DOI: 10.1111/j.1600-0404.2010.01376.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the temporal trends in the incidence and demographic characteristics of traumatic spinal cord injury (TSCI) with clinical concomitant traumatic brain injury (TBI), in an unselected, geographically defined cohort, 1952-2001. MATERIAL AND METHODS The patients were identified from hospital records. TBI was classified as none, mild, moderate, and severe. RESULTS Of 336 patients, 157 (46.7%) patients had a clinical concomitant TBI. Clinical TBI was classified as mild in 30.1%, moderate in 11.0% and severe in 5.7%. The average annual incidence increased from 3.3 per million in the first decade to 10.7 per million in the last. Alcohol was the strongest risk factor of clinical TBI (OR = 3.69) followed by completeness of TSCI (OR = 2.18). CONCLUSIONS The incidence of TSCI with concomitant TBI has increased during the last 50 years. Alcohol and completeness of injury are strong risk factors. Increased awareness of dual diagnoses is necessary.
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Humerfelt S, Eide GE, Gulsvik A. Enkle spirometrimålinger i en generell mannlig befolkning. NORSK EPIDEMIOLOGI 2009. [DOI: 10.5324/nje.v7i2.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
SAMMENDRAGFormålet var å evaluere deltagelsen ved enkle spirometrimålinger utført av menn fra den generelle befolkningenog å studere mulige prediktorer for ikke å oppnå godkjent test.Alle menn i alderen 29-46 år bosatt i Hordaland fylke samt Sauda kommune (N=45 380) ble invitert til entverrsnittsundersøkelse i 1988-90. Luftveissymptomer, røykevaner og sivil status ble besvart via spørreskjemaog målinger av forsert ekspiratorisk volum ved ett sekund (FEV 1) og forsert vital kapasitet (FVC) bleutført med Vitalograph belg-spirometre.I alt deltok 29 611 menn (65%) i studien. Spirometrimålinger ble utført hos 91% av de fremmøtte og avdisse var det kun 1,6% som ikke klarte å oppnå tre godkjente registreringer med ≤300 ml mellom de tohøyeste FVC verdiene. Andelen uten tre godkjente målinger var hyppigere hos aldri-røykere, ugifte og hospersoner med luftveissymptomer enn hos hhv. røykere, gifte og asymptomatiske menn.Konklusjon Simple spirometry in a general male population.Nor J Epidemiol ENGLISH SUMMARYIn this general population study we wanted to evaluate the participation of simple spirometry and to identifypredictors of spirometric test failure.All men aged 29-46 years living in western Norway (N=45,380) were invited to a cross sectional communitysurvey. Respiratory symptoms, smoking habits and marital status were obtained from self-administeredquestionnaires and measurements of FEV 1 and FVC were performed using dry-wedge bellow spirometers.Altogether 29,611 subjects (65%) participated in this survey. Spirometric recordings were obtained in91% of the attendants (n=26,803) of whom 1.6% failed the acceptability criterion of ≤300 ml between thetwo highest of three FVC values. Spirometric failures were more prevalent in never smokers, single men andsubjects with respiratory symptoms than in ever-smokers, married and asymptomatic subjects, respectively.Conclusions : In men aged 29-46 years, spirometric test failures occurred more frequently in neversmokers than in smokers and ex smokers after adjusting for other covariables. The higher failure ratesobserved in never smokers, in single men and in subjects1997; 7 (2): 243-248.: Hos menn i alderen 29-46 år var risikoen for mislykket spirometri større hos aldri-røykere,ugifte og hos personer med luftveissymptomer enn hos hhv. røykere, gifte og asymptomatiske personer.Humerfelt S, Eide GE, Gulsvik A.
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Huszthy PC, Immervoll H, Wang J, Goplen D, Miletic H, Eide GE, Bjerkvig R. Cellular effects of oncolytic viral therapy on the glioblastoma microenvironment. Gene Ther 2009; 17:202-16. [DOI: 10.1038/gt.2009.130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Grydeland TB, Dirksen A, Coxson HO, Pillai SG, Sharma S, Eide GE, Gulsvik A, Bakke PS. Quantitative computed tomography: emphysema and airway wall thickness by sex, age and smoking. Eur Respir J 2009; 34:858-65. [PMID: 19324952 DOI: 10.1183/09031936.00167908] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We investigated how quantitative high-resolution computed tomography (HRCT) measures of emphysema and airway wall thickness (AWT) vary with sex, age and smoking history. We included 463 chronic obstructive pulmonary disease (COPD) cases and 431 controls. All included subjects were current or ex-smokers aged > or = 40 yrs, and all underwent spirometry and HRCT examination. The HRCT images were quantitatively assessed, providing indices on lung density and airway dimensions. The median (25-75th percentile) %LAA950 (% low-attenuation area < -950 HU) was 8.9 (3-19) and 4.7 (1-16) in male and female COPD cases, respectively, and 0.71 (0.3-1.6) and 0.32 (0.1-0.8) in male and female controls, respectively. %LAA950 was higher in ex-smokers and increased with increasing age and with increasing number of pack-years. The mean+/-SD standardised AWT was 0.504+/-0.030 and 0.474+/-0.031 in male and female COPD cases, respectively, and 0.488+/-0.028 and 0.463+/-0.025 in male and female controls, respectively. AWT decreased with increasing age in cases, and increased with the degree of current smoking in all subjects. We found significant differences in quantitative HRCT measures of emphysema and AWT between varying sex, age and smoking groups of both control and COPD subjects.
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Aukland SM, Rosendahl K, Owens CM, Fosse KR, Eide GE, Halvorsen T. Neonatal bronchopulmonary dysplasia predicts abnormal pulmonary HRCT scans in long-term survivors of extreme preterm birth. Thorax 2009; 64:405-10. [PMID: 19158126 DOI: 10.1136/thx.2008.103739] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is an increasing understanding that extreme preterm birth carries a risk of long-term pulmonary sequelae. A study was undertaken to investigate if, and in what way, neonatal factors were associated with subsequent abnormalities on pulmonary high-resolution CT (HRCT) scanning and if pulmonary function was related to these abnormalities. METHODS HRCT scanning and pulmonary function tests were performed less than 2 weeks apart in 74/86 eligible subjects (86%) born at a gestational age of < or =28 weeks or with a birth weight of < or =1000 g within a defined area in Western Norway in 1982-5 (n = 42) or 1991-2 (n = 32). Mean age at examination was 18 and 10 years, respectively. HRCT scans were interpreted by a paediatric radiologist blinded to the clinical data using a structured system allowing scores from 0 to 50. RESULTS Lung parenchymal abnormalities were found in 64 subjects (86%), the median (interquartile range) score being 3.0 (1.75-5.0) points. Prolonged neonatal requirement for oxygen treatment predicted poor outcome, and an increase of 100 days increased the average HRCT score by 3.8 points (p<0.001). There was also a positive association of the severity of pulmonary function abnormalities with the extent of HRCT abnormalities, exemplified by the relation between forced expiratory volume in 1 s and total HRCT score (beta = -0.090; p<0.001). CONCLUSIONS In area-based cohorts of long-term survivors of extremely preterm birth, prolonged neonatal requirements for oxygen treatment predicted subsequent structural abnormalities on HRCT scans and in pulmonary function, and these two outcome measures were interrelated.
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Aurlien H, Gjerde IO, Eide GE, Brøgger JC, Gilhus NE. Characteristics of generalised epileptiform activity. Clin Neurophysiol 2008; 120:3-10. [PMID: 19059002 DOI: 10.1016/j.clinph.2008.10.149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 10/10/2008] [Accepted: 10/15/2008] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To study the age-related occurrence of specific features of generalised epileptiform activity (GEA), their correlation with EEG background activity (BA), and their internal correlation. METHODS 17,723 consecutive routine EEGs from 12,511 patients were annotated and categorised into a database. The first EEG containing GEA from all 325 patients with such activity were selected and categorised for GEA features. The BA was studied in multivariable fractional polynomial regression models including intervening variables. The GEA features were studied in similar models for age-dependency and internal correlation. RESULTS High GEA-amplitude and low GEA-frequency correlated with BA slowing. The occurrence of 'irregular spike/sharp slow wave' pattern increased with age (p=0.003). Hyperventilation sensitivity was not age-related. There was no correlation between hyperventilation sensitivity and photoparoxysmal response. The age-related probability for specific GEA-types was established. CONCLUSIONS High GEA-amplitude and low GEA-frequency correlate with BA slowing, indicating cerebral cortical dysfunction. Hyperventilation sensitivity and photoparoxysmal response independently increase the yield of EEG. There is no age-dependency for hyperventilation sensitivity showing that an upper age threshold for hyperventilation provocation is inappropriate. SIGNIFICANCE The results extend our understanding of GEA and help the electroencephalographer in weighing the various GEA components.
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Waje-Andreassen U, Naess H, Thomassen L, Eide GE, Meijer R, Vedeler CA. Ultrasound, atherosclerosis and stroke at a young age: a cross-sectional long-term follow-up in western Norway. Eur J Neurol 2008; 15:512-9. [PMID: 18355304 DOI: 10.1111/j.1468-1331.2008.02118.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies have shown significantly higher mortality and vascular morbidity amongst patients with ischaemic stroke onset at a young age compared with controls after a mean observation time of more than 11 years. METHODS In the present cross-sectional study, we measured the carotid intima-media thickness (IMT) in 140 (75%) of 187 survivors of ischaemic stroke after a mean observation time of 11.9 years. Their mean age when included was 41.1 years. IMT was measured by B-mode ultrasonography. RESULTS Total maximum IMT <1.0 mm was found in 34 (24%) patients, [1.0-1.2 mm) in 29 (21%) patients, [1.2-1.5 mm) in 29 (21%) patients and >or=1.5 mm in 48 (34%) patients. Increasing total maximum IMT was related to increasing age, male gender, recurrent ischaemic stroke, coronary atherosclerosis, peripheral atherosclerosis, smoking, hypertension and diabetes mellitus. DISCUSSION IMT changes confirm increased vascular morbidity in patients who suffered ischaemic stroke at a young age.
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Lehmann S, Bakke PS, Eide GE, Gulsvik A. Clinical data discriminating between adults with positive and negative results on bronchodilator testing. Int J Tuberc Lung Dis 2008; 12:205-213. [PMID: 18230255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE To evaluate how spirometry, symptoms and smoking discriminate between subjects who are responsive to bronchodilator testing and those who are non-responsive, and to examine how cut-off points of positive tests are related to symptoms of chronic obstructive pulmonary disease (COPD) and asthma. METHODS Subjects aged 47-48 and 71-73 years living in Bergen, Norway, were recruited. The 3506 participants (69%) filled in questionnaires and performed a bronchodilator test using salbutamol. RESULTS Tests were positive (forced expiratory volume in 1 s [Delta FEV1] >or=200 ml and >or=12%) in 107 subjects (3%). In logistic regression, spirometry (FEV1 < 80%, OR 6.0, 95%CI 3.6-10.2, and FEV1/FVC < 0.70, OR 3.1, 95%CI 1.9-5.2) and pack-years >or= 20 (OR 0.3, 95%CI 0.2-0.7), but not symptoms, predicted the test outcome. FEV1% and FEV1/forced volume capacity (FVC) discriminated equally well between positive and negative tests (area under the receiver operating characteristic [ROC] curve 0.81, 95%CI 0.77-0.85 vs. 0.77, 95%CI 0.72-0.82). The largest likelihood ratio for positive tests was 5.4 (95%CI 3.8-7.8) using FEV1 < 80% and FEV1/FVC < 0.70. CONCLUSIONS Spirometry and to a lesser extent smoking, but not symptoms, are useful in discriminating between middle-aged and elderly patients with positive and negative bronchodilator tests. Acute responses to salbutamol, expressed by commonly used Delta FEV1 cut-off points, are poorly related to COPD- and asthma-like symptoms.
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Lutale JJK, Thordarson H, Holm PI, Eide GE, Vetvik K. Islet cell autoantibodies in African patients with Type 1 and Type 2 diabetes in Dar es Salaam Tanzania: a cross sectional study. JOURNAL OF AUTOIMMUNE DISEASES 2007; 4:4. [PMID: 17963519 PMCID: PMC2147002 DOI: 10.1186/1740-2557-4-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Accepted: 10/27/2007] [Indexed: 11/10/2022]
Abstract
Background The aim of the present study was to assess the occurrence of glutamic acid decarboxylase autoantibodies (GADA) and insulinoma antigen 2 autoantibodies (IA2A) among patients of African origin in Dar es Salaam, Tanzania and to compare the occurrence of autoimmune mediated Type 1 diabetes with findings previously reported from the same place and from other African diabetic populations. Methods Two hundred and forty five patients from the diabetic clinic at Muhimbili Hospital were recruited for a cross sectional study. Patients were clinically classified into groups with Type 1 (T1D) and Type 2 diabetes (T2D); there were 94 patients with T1D and 151 with T2D. Autoantibodies for GAD and IA2 were measured with an assay based on radioligand binding. Fasting and random blood glucose, HbA1c, and C-peptide levels were also determined. Results Of the patients with T1D, 28 (29.8%) were GADA positive and 20 (21.3%) were IA2A positive. The overall occurrence of any autoantibody was 42.6%. The GAD and IA2 autoantibodies were detected more frequently among patients with T1D than among patients with T2D (P < 0.001). A higher autoantibody prevalence was observed with combined GADA and IA2A measurements compared to individual autoantibody measurements; 40 (42.6%) patients with T1D versus 11 (7.3%) with T2D had at least one positive autoantibody titer. There was no correlation between duration of disease and detection of autoantibodies in patients with T1D. There was a strong association with family history of diabetes among the autoantibody positive versus autoantibody negative patients with T1D (p < 0.01). Conclusion The prevalence of GAD and IA2 autoantibodies among African patients with T1D in Dar es Salaam was the same as that reported previously for South Africa and Ethiopia. It was much higher than the prevalence of islet cell autoantibodies (ICA) reported from the same clinic about 15 years ago. For unknown reasons the prevalence of pancreatic related autoantibodies in this African population is lower than the prevalence found among Caucasian populations.
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Júlíusson PB, Roelants M, Eide GE, Hauspie R, Waaler PE, Bjerknes R. Overweight and obesity in Norwegian children: secular trends in weight-for-height and skinfolds. Acta Paediatr 2007; 96:1333-7. [PMID: 17718787 DOI: 10.1111/j.1651-2227.2007.00421.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The prevalence of overweight and obesity in paediatric populations has been rapidly increasing in many countries over the past decades. The aims of the present study were to provide new data on weight-for-height and skinfolds, and to compare these to growth references for children between 3 and 17 years, collected in the same city between 1971 and 1974. MATERIAL The present study is based on cross-sectional data of 4115 children (2086 boys and 2029 girls) aged 4-15 years measured in 2003-6. RESULTS Overall, 18.0% of the boys and 20.1% of the girls were above the 90th weight-for-height percentile of the 1971-1974 references, 8.0% and 7.2% were above the 97.5th percentile, indicating an upward shift in weight-for-height. An even more prominent increase was observed for skinfold thicknesses; for triceps skinfolds about 30% of the boys and 28% of the girls were above the 90th percentile of the 1971-1974 references, and corresponding values for subscapular skinfolds were 26.5% and 25.9%. Using international cut-off values for body mass index, the overall prevalence of overweight and obesity was 12.5% and 2.1% in boys, and 14.8% and 2.9% in girls. CONCLUSIONS Our study has demonstrated a significant increase in weight-for-height in Norwegian children over the last 30 years, and that these changes are caused by an increase in fat tissue, as shown by skinfold measurements. The current prevalence of overweight and obesity is comparable to recent estimates from most Western and Northern European countries.
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Waje-Andreassen U, Naess H, Thomassen L, Eide GE, Vedeler CA. Long-term mortality among young ischemic stroke patients in western Norway. Acta Neurol Scand 2007; 116:150-6. [PMID: 17714327 DOI: 10.1111/j.1600-0404.2007.00822.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To obtain data on long-term mortality among young ischemic stroke patients compared with controls in this population-based study. MATERIAL AND METHODS We used Kaplan-Meier survival analysis to compare 232 patients aged 15-49 years with first-ever cerebral infarction in 1988-1997 and 453 controls followed from inclusion to death or 1 August 2005 for 2515 and 5558 person-years respectively. In a subanalysis of 192 patients, we compared risk factor variables using the Kaplan-Meier method and log-rank testing. We applied a Cox proportional hazards model to adjust for multiple risk factors. RESULTS Forty-five patients and nine controls died during follow-up (P < 0.0005). Independent risk factors for mortality were active tumor disease (P < 0.0005), high consumption of alcohol (P < 0.0005), coronary atherosclerosis (P < 0.001), living alone (P < 0.02), seizures (P < 0.04) and smoking (P = 0.08). CONCLUSIONS Long-term mortality was significantly increased among young stroke patients, mainly due to such lifestyle factors as high consumption of alcohol and tobacco.
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Duelien T, Eagan TML, Eide GE, Gulsvik A, Bakke PS. The adult incidence of asthma and respiratory symptoms by passive smoking in utero or in childhood. Eur Respir Rev 2006. [DOI: 10.1183/09059180.00010115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Geisler J, Lønning PE, Krag LE, Løkkevik E, Risberg T, Hagen AI, Schlichting E, Lien EA, Ofjord ES, Eide GE, Polli A, di Salle E, Paolini J. Changes in bone and lipid metabolism in postmenopausal women with early breast cancer after terminating 2-year treatment with exemestane: a randomised, placebo-controlled study. Eur J Cancer 2006; 42:2968-75. [PMID: 16963261 DOI: 10.1016/j.ejca.2006.07.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 06/28/2006] [Accepted: 07/11/2006] [Indexed: 11/21/2022]
Abstract
Aromatase inhibitors improve relapse-free survival in early breast cancer, but there is concern about possible detrimental effects on bone mineral density (BMD) and plasma lipids. This paper presents the results of a 2-year study evaluating the effects of exemestane versus placebo on BMD, bone markers, plasma lipids and coagulation factors, including a 1-year follow-up after termination of treatment in 147 patients. During treatment, the mean annual rate of loss of BMD in the lumbar spine was 2.17% in the exemestane group versus 1.84% in the placebo group (n.s.) and 2.72% versus 1.48%, respectively, in the femoral neck (P=0.024). A loss of BMD above that expected in both arms of this study could be due to low vitamin D status (88% of all patients had vitamin D levels <30 ng/ml). The changes observed with exemestane were partially reversed during a 1-year follow-up, with no significant difference between the two arms. Similarly, the moderate decrease in high-density lipoprotein (HDL)-cholesterol was reversed. The bone marker values decreased, although a difference at 6 months of follow-up was still recorded, in particular for the markers of bone synthesis.
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Lonning P, Geisler J, Krag LE, Løkkevik E, Risberg T, Hagen AI, Schlichting E, Eide GE, Di Salle E. Vitamin D deficiency: A threat to bone health in breast cancer patients during adjuvant treatment with aromatase inhibitors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
554 Background: To evaluate potential detrimental effects of the aromatase inactivator exemestane on bone, 147 postmenopausal women with early breast cancer were randomised to receive either exemestane for 2 years or placebo (J. Clin. Oncol. 23 [22], 5126–5137, 2005). Exemestane increased the annual bone loss from the femoral neck (2.72%) compared to placebo (1.48%; P = 0.024) with a non-significant increase in the lumbar spine (exemestane 2.17% versus placebo 1.84%). The annual bone loss was higher than expected in the placebo arm. Methods: Various biomarkers involved in bone metabolism (25-hydroxyvitamin D, parathormone, calcium, estrogens, androgens) were analysed to elucidate their influence on bone status at baseline and BMD loss during treatment with exemestane compared to placebo. Results: Using a cut-off value of 30 ng/ml for 25-hydroxyvitamin D (J. Clin. Endocrinol. Metab. 90 [6], 3800–3801, 2005), the majority of study participants suffered from vitamin D deficiency (56 of 62 patients in the placebo group and 52 of 59 in the exemestane group). The mean levels (95% confidence interval) of vitamin D were 22.6 ng/ml (21.2 - 24.1) in the placebo group and 21.6 ng/ml (20.0 - 23.3) in the treatment group, revealing no differences between these groups. Low serum calcium levels at baseline were found to be significantly correlated to low BMD in the femoral neck in the exemestane group. However, individual levels of vitamin D, parathormone and estradiol at baseline were not correlated significantly to BMD. Conclusions: Considering an annual bone loss of 0.5% to be representative for postmenopausal women (Osteoporos. Int. 15, 881–886, 2004), our data indicate that vitamin D deficiency could be the most important factor elevating bone loss among patients treated with exemestane as well as in the placebo group. These findings, together with the observation of a moderate additional effect of exemestane on bone loss, underlines the need for proper vitamin D substitution of postmenopausal women in general and in breast cancer patients during treatment with aromatase inhibitors in particular. [Table: see text]
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Skorge TD, Eagan TML, Eide GE, Gulsvik A, Bakke PS. Indoor exposures and respiratory symptoms in a Norwegian community sample. Thorax 2005; 60:937-42. [PMID: 16055627 PMCID: PMC1747222 DOI: 10.1136/thx.2004.025973] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Limited data are available on the effect of a poor indoor climate on the respiratory health of adults. No data are available regarding the contribution of indoor exposures to the burden of respiratory symptoms in the population. METHODS In 1996-7 a community sample of 3181 adults aged 26-82 years was invited to participate in a survey on indoor climate and respiratory health in Hordaland County, Norway. 2401 subjects agreed to take part. Logistic regression was used to examine the relationship between eight markers of indoor exposure and physician diagnosed asthma and five respiratory symptoms, after adjustment for sex, age, smoking, educational level, smoking habits, pack years, and occupational airborne exposure. RESULTS Mould exposure was associated with all the respiratory symptoms; the adjusted odds ratios (OR) varied from 1.6 (95% confidence interval (CI) 1.0 to 2.4) for cough with phlegm to 2.3 (95% CI 1.4 to 3.9) for grade 2 dyspnoea. Keeping a cat or dog in childhood was associated with grade 2 dyspnoea and attacks of dyspnoea, with adjusted ORs of 1.3 (95% CI 1.0 to 1.7) and 1.4 (95% CI 1.1 to 1.8), respectively. Having a fitted carpet in the bedroom was negatively associated with three of the five respiratory symptoms. 3-5% of the frequency of the respiratory symptoms in the study population could be attributed to exposure to visible moulds. CONCLUSION Mould exposure is an independent risk factor for several respiratory symptoms in a general population covering a wide age span, but it makes only a small contribution to the respiratory symptom burden in the population at large.
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Eagan TML, Brøgger JC, Eide GE, Bakke PS. The incidence of adult asthma: a review. Int J Tuberc Lung Dis 2005; 9:603-12. [PMID: 15971386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
In recent years, several new studies have estimated the incidence of adult asthma. These studies vary in design and quality. The current paper summarises the findings of major population studies in the adult incidence of asthma. The pooled estimate of the adult incidence of asthma was 4.6 per 1000 person-years in women and 3.6 per 1000 person-years in men. The estimate among only general population cohort studies was higher, respectively 5.9 and 4.4 per 1000 person-years in women and men. The adult incidence of asthma was slightly higher in women than men. In the few studies that allowed the incidence of asthma to be estimated among those aged >50 years, there was a trend towards a higher incidence with age. It is thought likely that this is at least partly explained by misclassification with COPD. However, the current findings from these studies may imply that the incidence of asthma in the elderly has previously been under-estimated. Finally, the review shows that estimates of adult asthma incidence have tended to be higher in later studies, implying a rise in asthma incidence in adults within the timeframe of observation.
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Brøgger J, Bakke P, Eide GE, Johansen B, Andersen AR, Gulsvik A. Trends in symptoms of obstructive lung disease in Norway. Int J Tuberc Lung Dis 2004; 8:1416-22. [PMID: 15636486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
SETTING Evidence is accumulating that there has been an increase in the adult population burden of obstructive lung disease. Has this increased the burden of symptoms? It is possible that diagnostic efficiency has improved, so that milder asthma cases are being diagnosed. OBJECTIVE To investigate changes in symptom burden by asthma diagnosis, age and sex. DESIGN We performed two postal cross-sectional studies among adults aged 15-70 years in Oslo, Norway, in 1972 and again in 1998/1999 (total = 39998). Changes in 11 self-reported respiratory symptoms were investigated. RESULTS The prevalence of having at least one symptom increased from 50% to 60% (P < 0.001), and the distribution of symptoms showed an overall increase. Nine symptoms increased in prevalence. The increase was largest among the young and females, and was present in both those with and those without asthma. For any given number of reported symptoms, asthma prevalence was higher in 1998 than in 1972, suggesting increased case finding. CONCLUSION There has been an increase in the population burden of respiratory symptoms matching the observed increase in young adult asthma, together with a probable increase in the clinical willingness to give an asthma diagnosis.
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Laxdal E, Eide GE, Wirsching J, Jenssen GL, Jonung T, Pedersen G, Amundsen SR, Dregelid E, Aune S. Homocysteine Levels, Haemostatic Risk Factors and Patency Rates after Endovascular Treatment of the Above-Knee Femoro-Popliteal Artery. Eur J Vasc Endovasc Surg 2004; 28:410-7. [PMID: 15350565 DOI: 10.1016/j.ejvs.2004.06.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2004] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the relationship between plasma homocysteine and other haemostatic variables and restenoses or reocclusions after endovascular treatment of symptomatic atherosclerosis of the above-knee femoro-popliteal artery. DESIGN Prospective observational study. SETTING University hospital. PATIENTS AND METHODS The study included 103 patients (116 limbs), treated with subintimal angioplasty in 58 cases (50%) and with intraluminal PTA in 58 (50%): 39 (34%) patients were treated for critical limb ischaemia. Blood samples for analyses of fasting plasma values of homocysteine, fibrinogen, D-dimer, activated protein C resistance were drawn upon admission. Median follow-up for all procedures was 11 months (range 0-42 months). Outcome events (arterial patency) were defined as > or =50% restenosis or reocclusion in the treated arterial segment. Patency rates were estimated with the product limit method and Kaplan-Meier curves. Variables found to be related significantly to patency were included in multivariate analysis performed with the Cox proportional hazard model. RESULTS The 1-year cumulative primary patency rate for all procedures was 48%. One-year limb salvage rate in cases of critical ischaemia was 74%. Multivariate analysis demonstrated significant independent associations between patency rates and plasma D-dimer, diabetes mellitus, the nature of the lesion treated (stenosis vs. occlusion) and antithrombotic therapy with aspirin after the procedure. Plasma levels of homocysteine, fibrinogen or activated protein C resistance were not associated with patency rates. Homocysteine levels were higher in patients with critical limb ischaemia than those with intermittent claudication. CONCLUSIONS Early restenosis or reocclusion after endovascular intervention of lesions in the above-knee femoro-popliteal artery was more frequent following treatment of occlusion (versus stenosis), for patients with diabetes, patients with elevated D-dimer and those without antithrombotic therapy after the procedure. Plasma homocysteine did not appear to influence the outcome of endovascular intervention.
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Halvorsen T, Skadberg BT, Eide GE, Røksund OD, Carlsen KH, Bakke P. Pulmonary outcome in adolescents of extreme preterm birth: a regional cohort study. Acta Paediatr 2004; 93:1294-300. [PMID: 15499947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
AIMS The pulmonary outcome of extreme prematurity remains to be established in adults. We determined respiratory health and lung function status in a population-based, complete cohort of young preterms approaching adulthood. METHODS Forty-six preterms with gestational age < or = 28 wk or birthweight < or = 1000 g, born between 1982 and 1985, were compared to the temporally nearest term-born subject of equal gender. Spirometry, plethysmography, reversibility test to salbutamol and methacholine bronchial provocation test were performed. Neonatal data were obtained from hospital records and current symptoms from validated questionnaires. RESULTS When entering the study at a mean age of 17.7 (SD: 1.2) y, a doctor's diagnosis of asthma and use of asthma inhalers were significantly more prevalent among preterms than controls (one asthmatic control compared to nine preterms, all but one using asthma inhalers). Peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) were decreased and the discrepancies relative to controls increased parallel to increased severity of neonatal lung disease. Parameters of increased neonatal oxygen exposure significantly predicted FEV1. Adjusted for height, gender and age, FEV1 was reduced by a mean of 580 ml/s in subjects with a history of bronchopulmonary dysplasia. Fifty-six percent of preterms had a positive methacholine provocation test compared to 26% of controls. CONCLUSION A substantially decreased FEV1, increased bronchial hyperresponsiveness and a number of established risk factors for steeper age-related decline in lung function were observed in preterms. A potential for early onset chronic obstructive pulmonary disease is present in subsets of this group.
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Laxdal E, Eide GE, Amundsen SR, Dregelid EB, Pedersen G, Jonung T, Aune S. Homocysteine Levels, Haemostatic Risk Factors and Restenosis after Carotid Thrombendarterectomy. Eur J Vasc Endovasc Surg 2004; 28:323-8. [PMID: 15288638 DOI: 10.1016/j.ejvs.2004.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To investigate the effect of elevated serum homocysteine and haemostatic as well as clinical risk factors on the tendency to restenosis after carotid artery thrombendarterectomy. DESIGN A prospective, observational study. PATIENTS AND METHODS In the period from October 1999 to October 2002, 86 patients were subjected to 96 carotid endarterectomies because of internal carotid artery stenoses. The carotid stenoses were symptomatic in 86 cases (90%). Fasting plasma homocysteine, fibrinogen, D-dimer and activated protein C resistance were measured the day before surgery. Follow-up was done 1, 3, 6, 12 and 18 months postoperatively and yearly thereafter with clinical assessment and triplex ultrasonography. The median follow-up time was 17 months (range 9-42 months). Freedom from restenosis was estimated with Kaplan-Meier curves, using log-rank test for comparison between groups. Variables found to be significantly related to restenosis rates were included in a multivariate analysis performed with the Cox proportional hazards model. Comparison of means of continuous data between two groups was done with Student's t-test and more than two groups with one-way analysis of variance. RESULTS Restenoses within 12 months of the operation occurred in 11 cases (11%). Univariate analysis revealed that plasma homocysteine values < or =10 micromol/l and freedom from ischaemic heart disease were both significantly associated with an increased risk of restenosis (p=0.0076 and 0.0059). However, multivariate analysis showed that only plasma homocysteine values <10 micromol/l were independently and significantly associated with an increased risk of restenosis (p=0.046). There were no associations between the degree of atherosclerotic affection of the precerebral circulation or symptoms on one hand and the levels of homocysteine, fibrinogen, D-dimer and activated protein C resistance on the other. CONCLUSION There seems to be an independent, significant association between homocysteine values within the lower two thirds of the normal range and restenosis after carotid endarterectomy. Studies on the biological properties of human endothelial cells from different types of vasculature and different locations, specifically with respect to homocysteine metabolism and its effect, are warranted.
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Brogger J, Eagan T, Eide GE, Bakke P, Gulsvik A. Bias in retrospective studies of trends in asthma incidence. Eur Respir J 2004; 23:281-6. [PMID: 14979504 DOI: 10.1183/09031936.03.00041103] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is evidence for an increase in adult asthma prevalence. Several retrospective studies have shown an increase in asthma incidence by year of birth, consistent with an increasing trend in asthma incidence. The validity of this retrospective approach is unknown. Retrospective and prospective asthma incidence by year of birth were compared in the same community, during the same time period, from two independent studies; a cohort study and a cross-sectional study in Western Norway. In the prospective study, subjects without asthma were followed from 1985-1996/1997. In the retrospective study in 1998, subjects reported the age at which the disease started. Analyses of incident asthma in the period 1985-1996 were compared between the studies. The retrospective analysis showed a large increase in asthma incidence by year of birth, with an odds ratio (OR) of 2.9 comparing those born in 1969 with those born in 1927. The prospective study showed the opposite, with an OR of 0.2 comparing those born in 1969 with those born in 1927. There was only a 20% difference in the cumulative incidence of asthma. To conclude, retrospective estimates of trends in asthma incidence are likely to be severely biased by differential recall.
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Welle I, Eide GE, Gulsvik A, Bakke PS. Pulmonary gas exchange and educational level: a community study. Eur Respir J 2004; 23:583-8. [PMID: 15083758 DOI: 10.1183/09031936.04.00106704] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Socio-economic status (SES) is related to increased risk of airway disease in terms of forced expiratory volume in one second (FEV1) and forced vital capacity. No data are available as to what extent SES predicts alveolar function in a general population. In this cross-sectional study, 1,275 subjects aged 18-73 yrs underwent pulmonary testing, including the single-breath carbon monoxide transfer capacity of the lungs (TL,CO). Educational level was used as an index for SES. Mean +/- SD TL,CO % predicted was 97% among those with primary school education, 99% among those with secondary school education and 104% among those with a university degree. In a multiple linear regression analysis, adjusting for age, height, haemoglobin, carboxyhaemoglobin, smoking habits, occupational exposure, FEV1 and body mass index, TL,CO was significantly related to educational level in males but not in females. Occupational exposure was not significant. In this study, socio-economic status was found to be an independent determinant of TL,CO. Even in an affluent country such as Norway, socio-environmental risk factors may differ based on individuals' SES. Such risk factors may, for instance, be higher exposure to airborne pollutants, poorer housing conditions, or lower consumption of fruit and vegetables. Further exploration is called for.
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Eagan TML, Gulsvik A, Eide GE, Bakke PS. Remission of respiratory symptoms by smoking and occupational exposure in a cohort study. Eur Respir J 2004; 23:589-94. [PMID: 15083759 DOI: 10.1183/09031936.04.00041204] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Few studies have estimated the remission rates of respiratory symptoms in general populations. No community cohort studies have examined the impact of smoking cessation and previous dust or fumes exposure on the remission of respiratory symptoms. In the Hordaland County Study, an 11-yr community cohort (1985-1996/1997) from Western Norway, data from 2,819 subjects were used to examine the remission of six respiratory symptoms. The measured cumulative remission varied from 42.3% for morning cough to 58.4% for chronic cough. Smoking cessation was a significant predictor of remission of the cough symptoms and wheezing, with odds ratios (OR) (95% confidence intervals (CI)) varying from 2.2 (1.3-3.7) for wheezing to 6.2 (3.5-11.2) for morning cough, after adjustment for sex, age, pack-years smoked, previous dust or fumes exposure, and educational level. In those not previously exposed to dust or fumes, the adjusted OR (95% CI) for the remission of morning cough, phlegm cough, dyspnoea grade 2, attacks of dyspnoea and wheezing varied from 1.5 (0.9-2.5) for attacks of dyspnoea to 2.1 (1.1-3.9) for dyspnoea grade 2, as compared to those previously exposed to dust or fumes. This study suggests a beneficial effect of smoking cessation and an adverse effect of occupational exposure on the remission of respiratory symptoms.
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Vetrhus M, Søreide O, Eide GE, Solhaug JH, Nesvik I, Søndenaa K. Pain and quality of life in patients with symptomatic, non-complicated gallbladder stones: results of a randomized controlled trial. Scand J Gastroenterol 2004; 39:270-6. [PMID: 15074398 DOI: 10.1080/00365520310008502] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cholecystectomy is intended to relieve symptoms of gallstones, but unfortunately some patients will experience postcholecystectomy symptoms, including pain. There is limited information in the literature on gallstone-related pain and its influence on quality of life. The aim of this study was to examine how pain and quality of life in patients with symptomatic, uncomplicated gallbladder stones were affected by observation of their condition compared with removal of the gallbladder. METHODS One-hundred and thirty-seven patients were randomized to observation (watchful waiting; n = 69) or cholecystectomy (n = 68) and answered questionnaires on pain, quality of life (PGWB index and NHP Part II) at randomization and fixed intervals (6, 12 and 60 months). All gallstone-related events (hospital admission for pain, complications of gallstone disease and cholecystectomy) and crossover between treatment groups were recorded. RESULTS Of patients randomized to observation, 35 of 69 patients (51%) eventually underwent a cholecystectomy. Significant improvements in quality of life and pain scores were detected regardless of surgical treatment. Patients that subsequently experienced gallstone-related events had significantly higher pain scores at randomization than patients that did not experience any subsequent events, and this difference was maintained throughout follow-up. CONCLUSIONS Unexpectedly, in the majority of patients symptoms did abate without any significant differences between groups in pain and quality of life. Patients that had high intensity and frequency of pain at randomization had a higher risk of experiencing subsequent events.
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