Biomedical subjects

E R Omenaas

Publications and source records attributed to E R Omenaas.

3 recordsLinked to original sources

PubMed2005

Implications of reversibility testing on prevalence and risk factors for chronic obstructive pulmonary disease: a community study.

BACKGROUND: The Global Initiative for Obstructive Lung Disease (GOLD) has defined chronic obstructive pulmonary disease (COPD) as a post-bronchodilator ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) of <0.7. In the first general population based study to apply post-bronchodilator values, the prevalence and predictors of GOLD defined COPD were assessed and the implications of beta2 agonist reversibility testing examined. METHODS: Based on a random population sample, 2235 subjects (77%) aged 26-82 years performed spirometric tests before and 15 minutes after inhaling 0.3 mg salbutamol. RESULTS: The prevalence of GOLD defined COPD was 7.0% (95% confidence interval (CI) 5.9 to 8.0). This estimate was 27% lower than COPD defined without bronchodilatation. One percent of the population had severe or very severe COPD. Compared with women, men had 3.1 (95% CI 2.1 to 4.8) times higher odds for COPD. Subjects with a smoking history of more than 20 pack years had an odds ratio (OR) of 6.2 (95% CI 3.4 to 11.0) for COPD relative to never-smokers, while subjects older than 75 years had an OR of 18.0 (95% CI 9.2 to 35.0) relative to those below 45 years. Subjects with primary education only had an OR of 2.8 (95% CI 1.4 to 5.3) compared with those with university education. Subjects with body mass index (BMI) <20 kg/m2 were more likely than subjects with BMI 25-29.9 kg/m2 to have COPD (OR 2.4, 95% CI 1.1 to 5.3). The adjusted proportion of COPD attributable to smoking was 68%. CONCLUSIONS: These results indicate that community programmes on prevention of COPD should focus on anti-smoking, nutritional aspects, and socioeconomic conditions. The effect of beta2 reversibility testing on prevalence estimates of COPD was substantial.

Adult↗

PubMed2005

Maternal atopy and changes in parity.

BACKGROUND: Atopic women tend to have fewer children, although atopy may favour conception. OBJECTIVE: To assess whether atopy is associated with the number of new births and whether changes in parity are associated with a change in atopy in a cohort of young women. METHODS: Women had atopy (defined as the presence of serum-specific IgE against common aeroallergens) measured in the European Community Respiratory Health Study during the years 1991--92 (n=4580). About 9 years later, 2844 (62.1%) were recontacted and 2414 (52.7%) had atopy measured again. RESULTS: Atopic women had fewer children at baseline than non-atopic women but the association disappeared at the end of the follow-up. Atopy tended to increase parity during the follow-up, but in a non-statistically significant way (relative risk=1.08; 0.86-1.35, after adjusting for number of children at baseline, age, length of follow-up, education or social class). Prevalence of atopy during the follow-up changed by the same magnitude whatever the birth cohort and the change in the number of children (P for interaction >0.7). CONCLUSION: Atopic women did not have a significantly higher fertility rate but they may postpone having their first child compared with non-atopic women. We are unable to confirm the hypothesis that atopy in women may decrease with successive pregnancies.

Adult↗

PubMed2004

Adjustable maintenance dosing with budesonide/formoterol compared with fixed-dose salmeterol/fluticasone in moderate to severe asthma.

BACKGROUND: Current asthma guidelines recommend that patients are educated to adjust their medication according to their asthma severity using physician-guided self-management plans. However, many patients take a fixed dose of their controller medication and adjust their reliever medication according to asthma symptoms. OBJECTIVES: This study examined whether asthma control improved if patients adjusted the maintenance dose of budesonide/formoterol (Symbicort Turbuhaler* 160/4.5 microg) according to asthma severity compared with traditional fixed dosing (FD) regimens. METHODS: Symptomatic patients with asthma (n = 658, mean symptom score 1.5, mean inhaled corticosteroids 735 microg/day, mean forced expiratory volume in 1 second [FEV(1)] 84% predicted) were randomised after 2 weeks' run-in to either: budesonide/formoterol adjustable maintenance dosing (AMD), budesonide/formoterol FD or salmeterol/fluticasone (Seretide Diskus dagger 50/250 microg) FD. In a 4-week double-blind period, both budesonide/formoterol AMD and FD groups received two inhalations twice daily (bid) and salmeterol/fluticasone FD patients received one inhalation bid. In the following 6-month open extension, both FD groups continued with the same treatment. Patients in the AMD group with well-controlled asthma stepped down to one inhalation bid; others continued with two inhalations bid. All AMD patients could increase to four inhalations bid for 7-14 days if symptoms worsened. All patients used terbutaline or salbutamol for symptom relief throughout. The primary variable was the odds of achieving a well-controlled asthma week (WCAW). RESULTS: The odds ratio for achieving a WCAW did not differ between the FD regimens; however, during the open period, budesonide/formoterol AMD increased the odds of achieving a WCAW vs. budesonide/formoterol FD (odds ratio 1.335; 95% CI: 1.001, 1.783; p = 0.049) despite a 15% reduction in average study drug use. Budesonide/formoterol AMD patients had a lower exacerbation rate over the study: 40% lower vs. salmeterol/fluticasone FD (p = 0.018); 32% lower vs. budesonide/formoterol FD (NS). During the double-blind period, there were no clinically relevant differences between the budesonide/formoterol FD and salmeterol/fluticasone FD groups. Budesonide/formoterol AMD patients used less reliever medication in the open extension: 0.58 vs. 0.92 occasions/day for budesonide/formoterol FD (p = 0.001) and 0.80 occasions/day for salmeterol/fluticasone FD (p = 0.011). CONCLUSIONS: Adjustable maintenance dosing with budesonide/formoterol provides more effective asthma control by reducing exacerbations and reliever medication usage compared with fixed-dose salmeterol/fluticasone.

Adolescent↗