PubMed Health⌕ Search

Biomedical subjects

A Lahdensuo

Publications and source records attributed to A Lahdensuo.

At least 19 recordsLinked to original sources
PubMed2004

Long-term follow-up study of pulmonary findings in patients with primary Sjögren's syndrome.

BACKGROUND: In a previous study pulmonary hyperinflation was observed frequently in patients with primary Sjogren's syndrome (pSS) and elevated serum beta-2 microglobulin (beta2m) concentrations were associated with hyperinflation. OBJECTIVE: To evaluate the significance of baseline serum beta2m concentration and to identify other possible risk factors for pulmonary involvement in long-term follow-up of patients with pSS. METHODS: Nineteen pSS patients whose pulmonary function tests (PFTs) had been previously studied were reexamined after a median follow-up of 10 years. Pulmonary symptoms were recorded, chest radiograph, and high-resolution computed tomography (HRCT) were evaluated and methacholine provocation and PFTs including flow-volume spirometry, body plethysmography, and diffusing capacity performed. RESULTS: Baseline serum beta2m concentrations correlated inversely with follow-up total lung capacity (TLC), vital capacity (VC), and diffusing capacity (DL), and positively with residual volume (RV), all expressed as percentage of predicted values. Diminished airways resistance (Raw) and, correspondingly, elevated specific conductance (SGaw) were frequent findings in pSS patients at follow-up, indirectly implying stiffness of the lungs and a restrictive decrease in lung volumes. Baseline serum protein concentration was higher and IgG concentration tended to be higher in pSS patients who at follow-up had elevated SGaw compared with others. Interstitial changes in HRCT were found more frequently in patients with elevated SGaw than in those without. CONCLUSION: Our results suggest that subtle restrictive changes in pulmonary function are more prone to develop in the long term in pSS patients with elevated serum beta2m concentration and other signs of immunological activity at baseline.

Follow-Up Studies↗
PubMed2000

Immunostaining for detecting lymph node metastases in non-small cell lung cancer.

OBJECTIVE: To detect lymph node metastases by immunohistochemistry, where previously undetected by routine histopathology. DESIGN: Immunostaining was carried out for high- and low molecular weight cytokeratins, and Ber-EP4 in 19 consecutive lung cancer patients who had undergone systematic mediastinal lymph node dissection. RESULTS: Eleven (58%) epidermoid carcinomas, 6 (32%) adenocarcinomas, and 2 (10%) bronchiolo-alveolar carcinomas were detected. These included 4 (21%) stage IA carcinomas, 6 (32%) stage IB, 6 (32%) stage IIB, 1 (5%) stage IIIB and 2 (10%) stage IV. Immunostaining did not reveal any undetected metastases. Two patients (squamous cell carcinoma T1N0; adenocarcinoma T1N0) had metastases (skeletal; ipsilateral lung) at time of surgery, and one patient (squamous cell carcinoma T2N0) had a regional and systemic relapse 10 months later. Serial sectioning with immunostaining of the lymph nodes from these three patients was also negative. CONCLUSION: We conclude that, even with the use of immunostaining, negative lymph nodes will not assure a good prognosis, and different determinants probably exist for lymphatic and hematogenic metastases in non-small cell lung cancer.

Aged↗
PubMed1997

Is asthma self-management cost-effective?

Many clinical studies have shown that self-management and educational programs in asthma are effective. However, these programs are costly themselves and could also lead to higher drug costs due to higher rates of compliance. On the other hand, if better usage of available treatment leads to better asthma control, the patients' utilization of other health care resources and absence from work might be reduced. An interesting question is therefore whether the self-management and educational programs in asthma have been cost-effective. This study holds a review of the evidence of cost-effectiveness of self-management and educational programs in asthma. Several methodological flaws were detected (for example, a common effectiveness, variable is lacking in the literature) and suggestions of improvements were given. The overall picture is, however, that self-management and educational programs in asthma are cost-effective interventions, both for children and for adults. As would be expected, it also seems as if programs directed at high risk groups and patients with severe asthma are even more cost-effective. Costs for absence from work were often excluded, which could lead to further societal savings. Also, some studies showed that the effect of the self-management and educational programs had effects even after the initial year. Since most studies only covered the initial year of treatment, the cost-effectiveness of self-management and educational programs in asthma is likely to be underestimated in the reported studies.

Adult↗
PubMed1997

Causes of death in patients with COPD and chronic respiratory failure.

Although the factors associated with mortality, such as forced expiratory volume in one second (FEV1), arterial oxygen tension (Pa,O2) and pulmonary arterial pressure, have been well described, there is limited information on the circumstances of death in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the causes and circumstances of death in patients with COPD and chronic respiratory failure (Pa,O2 < 8.0 kPa (60 mmHg) breathing air), treated with long-term oxygen therapy (LTOT). Ten European centres participated in the study and data were collected from patients both during a period of clinical stability and at the time of death. Of the 215 patients evaluated (161 males and 54 females; aged 66 +/- 10 yrs), the major causes of death were: acute on chronic respiratory failure (38%); heart failure (13%); pulmonary infection (11%); pulmonary embolism (10%); cardiac arrhythmia (8%); and lung cancer (7%). Seventy five percent of patients died in hospital. There was no difference in the number of patients who died in the morning, afternoon and night hours. Twenty percent of the total died during sleep and in 26% death was unexpected. A lower arterial carbon dioxide tension (Pa,CO2), less oxygen usage per 24 h, and increased incidence of arrhythmias were seen in those patients who died suddenly. Drug therapy was not related to unexpected death. The majority of patients with chronic obstructive pulmonary disease on long-term oxygen therapy died from chronic or acute on chronic respiratory failure. Prevention and treatment of respiratory failure in patients with chronic obstructive pulmonary disease is likely to have the greatest impact in reducing mortality.

Aged↗
PubMed1996

Randomised comparison of guided self management and traditional treatment of asthma over one year.

OBJECTIVE: To compare the efficacy of self management of asthma with traditional treatment. DESIGN: 12 month prospective randomised trial. SETTING: Outpatient clinics in Finland. SUBJECTS: 115 patients with mild to moderately severe asthma. INTERVENTIONS: Patient education and adjustment of anti-inflammatory therapy guided by peak flow measurements. MAIN OUTCOME MEASURES: Unscheduled admissions to hospital and outpatient visits, days off work, courses of antibiotics and prednisolone, lung function, and quality of life. RESULTS: The mean number of unscheduled visits to ambulatory care facilities (0.5 v 1.0), days off work (2.8 v 4.8), and courses of antibiotics (0.4 v 0.9) and prednisolone (0.4 v 1.0) per patient were lower and the quality of life score (16.6 v 8.4 at 12 months) higher in the self management group than in the traditionally treated group. In both groups admissions for asthma were rare. CONCLUSIONS: Self management reduces incidents caused by asthma and improves quality of life.

Adult↗
PubMed1995

Pulmonary findings in patients with primary Sjögren's syndrome.

STUDY OBJECTIVE: To evaluate pulmonary findings in patients with primary Sjögren's syndrome (SS). DESIGN: Prospective data collection. PATIENTS: Seventeen consecutive nonsmoking patients with primary SS. MEASUREMENTS AND RESULTS: Mild radiologic parenchymal changes were seen in two patients. Pulmonary hyperinflation (residual volume/total lung capacity [RV/TLC] percent ratio measured minus [-] RV/TLC percent ratio predicted > or = 8) was observed in 9 (53%) patients, whereas obstructive and restrictive changes were infrequently found in ordinary spirometry (FVC, FEV1, FEV%) (none and two cases, respectively). Patients with SS with hyperinflation had significantly lower maximal expiratory flow MEF50 (p < 0.05), MEF25 (p < 0.05), and higher total lung capacity (p < 0.05) and FRC (p < 0.05) values as compared with those patients with SS without hyperinflation. They were also more frequently dyspnoeic (six vs none, p < 0.02) and had higher mean serum beta 2-microglobulin levels (3.6 +/- 1.0 mg/L vs 2.6 +/- 0.7 mg/L, p < 0.025). The levels of serum beta 2-microglobulin correlated inversely with FVC (r = - 0.583, p < 0.01), FEV1 (r = - 0.533, p < 0.05), diffusing capacity for carbon monoxide (r = - 0.580, p < 0.01); its correlation with RV/TLC percent ratio was positive and relatively significant (r = 0.447, 0.05 < p < 0.10). CONCLUSIONS: Pulmonary hyperinflation associated with diminished peripheral spirometric flow values is frequently found in patients with primary SS. This together with the correlation of disturbed lung function parameters to elevated serum beta 2-microglobulin levels suggests that lungs and especially small airways may be an usual target organ in primary SS.

Adult↗
PubMed1993

Asbestos exposure according to different exposure indices among Finnish lung cancer patients.

During a 6-month period all lung cancer patients in a university hospital chest clinic were investigated for asbestos exposure by means of personal interview, bronchoalveolar lavage (BAL), roentgenograms, lung function testing, histology and measurement of fibre concentrations in lung tissue samples using scanning electron microscopy (SEM). About one-third of the patients (33%) were classified as having been exposed to asbestos on the basis of the interview. BAL was performed and AB counts were done in 51 patients. Fourteen (27%) BAL specimens had AB counts of 1 or more AB/ml, which is the conventional limit for non-trivial asbestos exposure. For a subgroup of 25 operated lung cancer patients fibre analysis was also available. In six cases (30%) the asbestos-containing samples had asbestos fibre concentrations equal to or more than 1 million fibres/g dry lung. In eight (32%) of the operated lung cancer patients histopathologically confirmed fibrosis was seen; five of these patients were in the two highest exposure classes. Pleural plaques on X-ray films were seen in six (24%) of the operated cases. With each indicator of exposure about 30% of lung cancer patients were found to have been exposed, confirming the "one-third rule"; however, when all the information was collated there were three cases (12%) in which exposure was most obvious according to the different parameters used in this study. In these three cases the cancer could well be attributed to asbestos. Anthophyllite was present in all asbestos-containing samples and anthophyllite was the main fibre type in 61% of these samples.

Adult↗
PubMed1993

Psychosocial changes in patients participating in a chronic obstructive pulmonary disease rehabilitation program.

Changes in physical competence, respiratory symptoms, well-being, emotional state, level of depression, every-day coping skills, and general activity and independence were studied in 40 chronic obstructive pulmonary disease patients participating in an intensive 3-week rehabilitation program. Both patient and staff ratings were used. Expectations and attitudes prior to rehabilitation were also measured. The study design included a 3-week basal period, a 3-week rehabilitation period and a 6-month follow-up. The immediate effects of rehabilitation on the variables which described subjective experiences were positive: well-being, emotional state and respiratory symptoms improved significantly (p < 0.001, p < 0.01 and p < 0.01, respectively). By the end of the follow-up period, however, all the treatment effects had dissipated. No significant effects of rehabilitation could be seen in every-day coping skills, general activity and independence or level of depression. It was not possible to predict the rehabilitation response on the basis of the patients' attitudes, expectations, level of depression or age. We conclude that pulmonary rehabilitation causes transient improvement in respiratory symptoms and some subjectively characterized psychosocial variables and that this improvement is unpredictable by attitude and expectation variables.

Adaptation, Psychological↗
PubMed1991

Relative risk of mesothelioma associated with different levels of exposure to asbestos.

The relative risk of mesothelioma associated with different levels of exposure to asbestos was evaluated. The exposure was assessed from work histories of 51 mesothelioma cases and 51 sarcoidosis referents. The lung fiber concentration of the mesothelioma patients was compared with that of two reference groups (13 random autopsy cases and 43 male lung cancer patients). When the categories definite and probable were used as an estimated probability of occupational exposure, an odds ratio of 17.7 [90% confidence interval (90% CI) 3.4-253] and 3.0 (90% CI 0.9-10.6), respectively, was obtained. A lung fiber concentration of greater than 1 million fibers/g of dry tissue as an indicator of accumulated exposure gave an odds ratio of 14.4 (90% CI 2.5-178) for the men in comparison with the autopsy cases and 3.1 (90% CI, 1.3-7.5) in comparison with the lung cancer patients. Elevated risk of mesothelioma was shown to be associated with a lung fiber concentration of greater than 1 million fibers/g of dry tissue.

Adult↗
PubMed1989

Proteinuria and haematuria are frequently present in patients with lung cancer.

The aim of the study was to ascertain whether there is an increased occurrence of proteinuria and/or haematuria among lung cancer patients. As a control group we selected patients with bronchial asthma treated at the same hospital and during the same period as the lung cancer patients. The study comprised a retrospective part, where observations were made at two hospitals on 166 and 284 lung cancer patients. Proteinuria was observed in 9% and 13% and haematuria in 5% and 9% of these patients. The prevalences were significantly greater than among the asthmatic patients. This result prompted a prospective case-control study involving 150 consecutive patients with lung cancer and asthma, respectively. Twelve patients in the cancer group and one asthmatic patient had a daily urine protein excretion exceeding 100 mg (P less than 0.004); haematuria was noted in 14 and one, respectively (P less than 0.002). We conclude that the occurrence of proteinuria and haematuria is unexpectedly increased among patients with lung cancer.

Aged↗
PubMed1989

Causes of prolonged cough in patients referred to a chest clinic.

The aim of this study was to evaluate the causes of prolonged cough in a patient population referred to a chest clinic during a single year. One hundred and ninety-eight patients (11%) of the total yearly 1745 adult admissions fulfilled our criteria of prolonged cough. Asthma, suspicion of asthma and postnasal drip were the commonest causes of prolonged cough in 147 patients with normal chest roentgenograms (26%, 9% and 16%, respectively), and in 45% the cough was of unexplained origin. Nonspecific bronchial hyperreactivity was common in this latter group of patients probably due to a previous respiratory infection. Lung cancer (37%), tuberculosis (16%), sarcoidosis (16%), and allergic alveolitis (9%) were the most important findings in patients with abnormal chest roentgenograms.

Adolescent↗