PubMed Health⌕ Search

Biomedical subjects

S Kristjánsson

Publications and source records attributed to S Kristjánsson.

14 recordsLinked to original sources
PubMed2003

'You and your skin': a short-duration presentation of skin cancer prevention for teenagers.

The effectiveness of a short-duration presentation of the educational material 'You and Your Skin' was tested on 184 adolescents (age 13-15) at the Year 7 and 8 levels. A non-equivalent control group design was used with pre-testing and post-testing 3 months after the intervention. The intervention increased the students' knowledge of known risks factors for skin cancers. However, the students' attitudes to abstaining from sunbathing and tanning was not significantly affected. The effect of the intervention on the stage of change was primarily a progression from the precontemplation stage to the contemplation stage regarding avoiding the mid-day sun. We conclude that a brief presentation of the educational kit 'You and Your Skin' can be used to increase knowledge, but there is a need for a more extensive intervention effort to affect students' readiness to change their behavior and attitude towards sunbathing and tanning. Therefore, it is important to emphasize the necessity of using the educational kit as a multi-lesson programme with its several group exercises.

Adolescent↗
PubMed2003

Transtheoretical model: investigation of adolescents' sunbathing behaviour.

The incidence of malignant melanoma and non-melanoma skin cancers has increased rapidly in Sweden as well as in other western countries during the last 20 years. Adolescents are an important group in skin cancer prevention. Interventions targeting this group have been reported to affect knowledge and attitudes, but the effect on sun protection behaviour has been slight. The aim of this study was to investigate the applicability of the Transtheoretical Model (TTM) for skin cancer prevention for adolescents. A random sample of 1200 18-year-olds living in Stockholm County was selected from the national census registry. A questionnaire that included three of the major constructs of the TTM (i.e. stages of change, processes of change and decisional balance) was sent by mail. The majority of the teenagers were in the precontemplation stage for giving up intentional tanning. The relations between the stages of change and two other major constructs of the TTM, processes of change and decisional balance, were consistent with data on other health behaviours. The results may aid in developing successful skin cancer prevention programmes. The results give support for the stages of change measurement used in this study and that utilizing the TTM in skin cancer prevention may be appropriate.

Adolescent↗
PubMed2001

Readiness to change sun-protective behaviour.

The incidence of malignant melanoma and non-melanoma skin cancers has increased rapidly in Sweden during the last 20 years. The best-known way to revert this trend is primary prevention. Matching health messages to readiness to change in the population may enhance the effect of community-based prevention. The aims of this study were to investigate readiness to change sun-protective behaviour in two groups (visitors to mobile screening units and beach-goers) and to test a single-item algorithm in assessing the stage of change in sun-protective behaviour. Seven hundred and forty-two visitors to the mobile screening units and 202 individuals on nearby beaches answered a short questionnaire. The assessment of readiness to change was based on stages of change in sun-protective behaviour modified from the Transtheoretical Model of Behaviour Change. As expected, the visitors to the screening units were more often in action/maintenance stages than the beach group for most sun-protective behaviours. In conclusion, the single-item algorithm method appears to be sensitive to assess readiness to change sun-protective behaviour, based on the Transtheoretical Model of Behaviour Change. This method can be incorporated into population surveys and may aid in developing successful skin cancer prevention programmes.

Adult↗
PubMed2001

Relationship between respiratory syncytial virus bronchiolitis and future obstructive airway diseases.

Evidence from a large number of prospective case-control studies shows that respiratory syncytial virus (RSV) bronchiolitis in infancy is often associated with recurrent wheezing and asthma during subsequent years. However, wheezing tends to diminish and most studies show no significant increase in wheezing compared to controls by school age or adolescence. An unresolved question is whether severe RSV infection during infancy causes the respiratory sequelae or inherent abnormalities predispose an infant to develop severe respiratory infection and sequelae, i.e. RSV is associated with the development of pulmonary sequelae. Studies on long-term outcome of RSV bronchiolitis are reviewed from an evidence-based perspective. The majority of prospective placebo-controlled studies do not show any long-term beneficial effects of corticosteroid treatment, i.e. the risk of subsequent wheezing is not diminished by the treatment. The evidence for an increased risk of allergic sensitization after RSV bronchiolitis is not nearly as strong as the evidence for an increased risk of subsequent wheezing. In fact, most studies do not show any significant increase in atopy after RSV bronchiolitis. This suggests that the increased risk of wheezing after RSV is not linked to an increased risk of atopy. There are some indications that infants who develop severe RSV and subsequent wheezing may have aberrations that predate the RSV infection. To decide whether respiratory syncytial virus bronchiolitis causes, or is associated with the respiratory sequelae (or with subsequent allergy), it will be necessary to conduct prospective, randomized studies, where the cytokine profile prior to bronchiolitis onset is known. Such studies should preferably include some form of intervention against respiratory syncytial virus. A more complete understanding of the risk factors for severe respiratory syncytial virus infection and the role of respiratory syncytial virus infection in the initiation of asthma is needed as a basis for large-scale and cost-effective programmes to prevent respiratory syncytial virus-related morbidity.

Airway Obstruction↗
PubMed1996

Urinary eosinophil protein X in children with atopic asthma: a useful marker of antiinflammatory treatment.

BACKGROUND: Bronchial asthma is associated with elevated serum levels of eosinophil products, such as eosinophil protein X (EPX), but the occurrence in urine of this substance in patients with asthma has not previously been studied. OBJECTIVE: This study was performed to clarify whether increased amounts of eosinophil granulocyte proteins in urine and serum reflect ongoing asthmatic inflammation and whether decreasing values reflect successful treatment. METHODS: Twelve children with a median age of 12.5 years who had mild or moderate atopic asthma were studied for 3 months. At the time of inclusion in the study, treatment with inhaled budesonide was initiated. Nine children of the same age without atopic disease served as control subjects. Levels of EPX, eosinophil cationic protein (ECP), and myeloperoxidase in serum and in urine (urinary EPX) were determined at inclusion and then after 3 months of treatment. Spirometry was performed on the same occasions. RESULTS: At the time of inclusion, urinary EPX and serum ECP were significantly higher in children with atopic asthma than in the control subjects (mean, 116.4 vs 43.0 micrograms/mmol creatinine [p = 0.004] and 37.0 vs 14.8 micrograms/L [p = 0.004]). In the asthma group urinary EPX, as well as serum ECP, decreased significantly after 3 months of treatment with budesonide (116.4 to 68.4 micrograms/mmol creatinine [p = 0.005] and 37.0 to 24.0 micrograms/L [p = 0.04]). At the same time, peak expiratory flow values increased significantly in the children with asthma (76.0% to 87.8% of predicted value [p = 0.005]) but not in the control subjects (87.0% to 90.1%). In the asthma group the levels of myeloperoxidase were similar to those in the control group, both at inclusion and after 3 months. CONCLUSION: Increased urinary EPX and serum ECP levels seem to reflect active atopic asthma, whereas decreased levels after antiinflammatory treatment probably reflect normalization of airway inflammation, and indirectly, improved lung function.

Adolescent↗
PubMed1996

Decrease in hospitalization for treatment of childhood asthma with increased use of antiinflammatory treatment, despite an increase in prevalence of asthma.

BACKGROUND: During the past 15 years, the prevalence of asthma in children in Sweden has doubled. However, since 1985, antiinflammatory treatment with inhaled steroids has increased continuously. OBJECTIVE: The aim of this study was to analyze the net effect of these changes in terms of hospitalization of children for treatment of asthma. METHODS: The numbers of hospital days, admissions, and individual patients admitted to the Children's Hospital in Göteborg because of acute asthma were recorded from 1985 through 1993. all the in-patient treatment of children is centralized at this hospital (i.e., the study was population-based). Göteborg has half a million inhabitants. Hospitalization policies were not altered during the study period. RESULTS: In children aged 2 to 18 years, the number of hospital days per year gradually decreased to less than a third (r = 0.9; p less than 0.001), and admissions decreased by 45% (r = 0.7; p less than 0.05). The decrease in hospitalization was most marked in the group older than the age of 5 years in which hospital days were reduced to one fifth (r = 0.9; p less than 0.0001) and admissions were halved (r = 0.8; p less than 0.05). A decreasing trend in number of hospital days was also seen in the 2- to 5-year-old group. The number of individual patients admitted did not show a statistically significant decreasing trend. In children under the age of 2 years, the number of hospital days fluctuated, and there was no clear-cut change with time. CONCLUSION: Although increased concentration on the education of parents and patients may have been a contributing factor, the major reason for the decrease in hospitalization in the group of children aged 2 to 18 years is most probably antiinflammatory treatment with inhaled steroids. The results suggest that this is a very cost-effective therapeutic approach.

Administration, Inhalation↗
PubMed1996

Inflammatory markers in childhood asthma.

The importance of airway inflammation in the pathogenesis of asthma is clearly established. Studies in adults as well as in children have led to the concept that asthma is a chronic inflammatory disease. Airway inflammation is found even in mild asthma. Bronchoconstriction and hyper-reactivity appear to be secondary to the release of inflammatory mediators. The changed view of the pathogenesis of asthma and current emphasis on anti-inflammatory treatment have raised a need for markers that reflect the inflammatory status in the airways. This is of special importance in paediatric practice because lung function tests are less easily performed in young children, and it is preferable to keep steroid doses as low as possible. The eosinophil granulocyte has a multitude of proinflammatory functions and plays a key role in the asthmatic inflammation. It secretes toxic proteins and produces cytokines, which have important roles in airway inflammation. Use of eosinophil granula proteins to monitor inflammation is now finding its place. Measurement of eosinophil cationic protein (ECP) seems to be a valuable complement to the recording of lung function. For paediatric use, measurement of urinary eosinophil protein X (EPX) is promising because it does not require blood sampling.

Asthma↗
PubMed1995

Leukotriene B4 and C4 generation by human leukocytes after ex vivo stimulation with Ca-ionophore and opsonized zymosan in children with atopic asthma.

The ex vivo release of leukotriene B4 (LTB4) and leukotriene C4 (LTC4) from leukocytes was evaluated after stimulation with both Ca-ionophore (Ca-I) and opsonized zymosan (OZ) in children with atopic asthma. Twenty-seven patients with asthma of varying severity were evaluated and divided into three groups: 1) moderate to severe asthma using inhaled steroids and symptom-free for the last 3 weeks (n = 8), 2) mild asthma with sporadic symptoms, only using inhaled beta 2-agonists < 3 times/week (n = 8), and 3) acute asthmatic attacks admitted to hospital (n = 11). A group of children without atopic disease or any other known disease served as controls (n = 15). Total serum IgE levels were significantly increased in the children with asthma compared with the control group. LTC4 production was only significantly increased in the group of children with moderate to severe asthma after stimulation with Ca-I, when compared with controls. In the same group, a trend towards increased LTC4 production after stimulation with OZ was found. LTB4 was not significantly increased in any patient group compared with the control group. A significant correlation between LTC4 production after stimulation with Ca-I, but not OZ, and the relative blood eosinophil count was found in all subjects. LTC4 generation per eosinophilic cell after stimulation with Ca-I or OZ was not statistically different in any patient group compared with the controls. We conclude that the increased leukotriene (LT) levels found after the stimulation of peripheral white blood cells sampled from atopic children with asthma are mainly the result of increased numbers of LT-producing cells, rather than due to increased releasability from these cells.

Adolescent↗
PubMed1994

Inhibitory effects of theophylline, terbutaline, and hydrocortisone on leukotriene B4 and C4 generation by human leukocytes in vitro.

Leukotriene B4 (LTB4) and leukotriene C4 (LTC4) are considered to be important mediators in the pathophysiology of asthma. Theophylline, terbutaline, and hydrocortisone are drugs commonly used in the treatment of asthma. In the present study we have investigated the in vitro inhibitory effects of theophylline, terbutaline, and hydrocortisone on LTB4 and LTC4 generation from human leukocytes. After preincubation in the presence of these drugs, the cells were stimulated with the calcium ionophore A 23187 and the supernatants were analyzed for their LTB4 and LTC4 content using reverse-phase high-performance liquid chromatography (HPLC). Total leukotriene (LT) production (the combined amounts of LTB4 and LTC4) was dose-dependently inhibited by pretreatment with theophylline, terbutaline or hydrocortisone. Therapeutic levels of hydrocortisone (5 x 10(-6) M) plus theophylline (5 x 10(-5) M) inhibited LTB4 and LTC4 production in an additive way, as did the combination of hydrocortisone plus terbutaline (5 x 10(-8) M). A statistically significant effect of diminished LTB4 generation was obtained after preincubation with therapeutic levels of theophylline plus terbutaline, but no such effect was seen for LTC4 levels. The in vitro inhibitory effects on LTB4 and LTC4 generation from human leukocytes by theophylline, terbutaline, and hydrocortisone, as well as the additive effect of hydrocortisone plus theophylline or terbutaline, add to our understanding of the therapeutic effects of these drugs in the treatment of bronchopulmonary obstruction.

Calcimycin↗
PubMed1994

Eosinophil cationic protein, myeloperoxidase and tryptase in children with asthma and atopic dermatitis.

Serum levels of eosinophil cationic protein (ECP), myeloperoxidase (MPO), tryptase, total IgE and differential blood cell counts were studied in atopic children with: 1) moderate to severe asthma using inhaled steroids and symptom-free for the last 3 weeks (n = 13), 2) mild asthma with sporadic symptoms, using only inhaled beta 2-agonists < 3 times/week (n = 15), 3) acute asthmatic attacks admitted to hospital (n = 12), 4) mild to moderate atopic dermatitis (n = 14). Fifteen children without any history of atopy served as controls. ECP, MPO, tryptase and IgE were measured in serum by radioimmunoassays (RIA). The symptom-free children with inhaled steroids had similar median ECP and MPO values as the controls, 8.0 and 360 micrograms/l, vs. 9.0 and 310 micrograms/l, while both ECP and MPO were significantly (p < 0.001) increased in the symptom-free children without anti-inflammatory treatment, 32 and 887 micrograms/l and in those with acute asthma, 28 and 860 micrograms/l. The children with atopic dermatitis had increased ECP but normal MPO levels, 16.0 and 455 micrograms/l. Tryptase in serum was not measurable in any patient. All groups except the control group had significantly elevated total IgE levels. The results indicate that in atopic children serum ECP is a good marker of ongoing asthma or atopic dermatitis. The normal levels of ECP and MPO in the children with asthma using inhaled steroids seem to reflect successful anti-inflammatory treatment. The increased levels of ECP and MPO in the children with mild asthma and no anti-inflammatory treatment may indirectly reflect airway inflammation.

Adolescent↗
PubMed1994

Inhalation of racemic adrenaline in the treatment of mild and moderately severe croup. Clinical symptom score and oxygen saturation measurements for evaluation of treatment effects.

The aim of this study was to evaluate the immediate effect of inhaling racemic adrenaline to treat croup and to evaluate a scoring system. Two groups were investigated. One group inhaled a racemic adrenaline solution and the other group received the same solution with no racemic adrenaline. The study was double-blinded and placebo-controlled. Fifty-four children (0.4-10.8 years) with mild to moderately severe croup were included in the study after clinical evaluation. The clinical score was useful when evaluating the treatment effects in mild to moderately severe croup and may be used as a quality assurance tool when treatment protocols are re-evaluated. Oxygen saturation before and after treatment did not change significantly in either group and therefore its measurement did not provide additional information on the effect of treatment. In both groups, a significant improvement in total mean clinical scores was seen 30 min after inhalation, compared with before inhalation (p < 0.001). However, racemic adrenaline was significantly better than placebo in terms of improvement in total clinical score, inspiratory stridor, retractions and air entry, and should therefore be used as first-line treatment.

Administration, Inhalation↗
PubMed1993

Nebulised racemic adrenaline in the treatment of acute bronchiolitis in infants and toddlers.

The effect of inhaled nebulised racemic adrenaline upon symptoms of acute bronchiolitis was investigated in 29 infants and toddlers aged 2-17.5 months by transcutaneous oxygen tension (TcPO2), oxygen saturation, transcutaneous carbon dioxide tension (TcPCO2), and clinical evaluation in a double blind placebo controlled study. Clinical score and TcPO2 improved significantly at 30, 45, and 60 minutes after inhalation of racemic adrenaline, with an increase in TcPO2 > or = 0.5 kPa in 72% of the children < 1 year of age. No significant improvement was observed after inhalation of placebo. No significant changes in heart rate or TcPCO2 were observed from before to after inhalation, but a small increase in mean systolic blood pressure was observed immediately and 45 minutes after racemic adrenaline inhalation. This study demonstrates that treatment with nebulised racemic adrenaline improved oxygenation and clinical signs in hospitalised children aged less than 18 months with bronchiolitis.

Acute Disease↗