PubMed Health⌕ Search

Biomedical subjects

S Löth

Publications and source records attributed to S Löth.

15 recordsLinked to original sources
PubMed2001

Different methods for evaluating daytime tiredness in snoring men.

Many snorers complain of daytime tiredness and reduced mental energy. In 42 middle-aged snoring men, the results of sections relating to mental energy in 2 quality-of-life instruments, energy in the Nottingham Health Profile (NHP) and vitality in the Psychological General Well-Being (PGWB) questionnaire, were compared with those of population samples. The snorers were significantly more tired than the population samples (p < 0.001). The scores for the NHP and PGWB were then correlated with a visual analogue scale (VAS) of drowsiness. The correlation coefficient between NHP (energy) and the corresponding VAS value was r = 0.52 (p < 0.001). The correlation coefficient between PGWB (vitality) and the VAS value for drowsiness was r = -0.56 (p <0.001). When nasal breathing was improved with the use of the Nozovent nostril dilator at night for 1 month, NHP (energy) and the VAS value for drowsiness improved significantly (p < 0.001). A single VAS value for drowsiness is a good instrument for evaluating daytime tiredness and for measuring the clinical effect of treatment in snorers.

Adult↗
PubMed2000

Respiratory disturbance index: an independent predictor of mortality in coronary artery disease.

Cardiovascular mortality was prospectively investigated in consecutive coronary artery disease (CAD) patients with versus without obstructive sleep apnea (OSA) during a follow-up period of 5 yr. An overnight sleep/ventilatory study was performed in patients requiring intensive care (n = 62, mean age 67.6 +/- 10.4 yr, range 44 to 86) during a stable condition (New York Heart Association [NYHA] functional class I-II) 4 to 21 mo after discharge from the hospital. OSA, defined as a respiratory disturbance index (RDI) of 10/h or more was found in 19 patients (mean RDI 17.5 +/- 8.3). Three OSA subjects who were successfully treated with continuous positive airway pressure (CPAP) during the observation period were excluded from the final analysis. There was no statistically significant difference (Fisher two-tailed exact test) between the OSA and non-OSA patient groups in terms of number of elderly subjects (age >/= 65 yr), gender, obesity (body mass index [BMI] >/= 30 kg/m(2)), smoking history, presence of hypertension, diabetes mellitus, hypercholesterolemia, or history of myocardial infarction at the study start. During the follow-up period, cardiovascular death occurred in six of 16 OSA patients (37.5%) compared with 4 (9.3%) in the non-OSA group (p = 0.018). The univariate predictors of cardiovascular mortality were RDI (p = 0.007), OSA (p = 0.014), age at baseline (p = 0.028), hypertension at baseline (p = 0.036), history of never-smoking (p = 0.031), and digoxin treatment during the follow-up period (p = 0.013). In a Cox multiple conditional regression model, RDI remained as an independent predictor of cardiovascular mortality (exp beta = 1.13, 95% confidence interval [CI] 1.05 to 1.21, two-sided p < 0.001). We conclude that untreated OSA is associated with an increased risk of cardiovascular mortality in patients with CAD. Furthermore, it appears appropriate that RDI is taken into consideration when evaluating secondary prevention models in CAD.

Adult↗
PubMed1999

Better quality of life when nasal breathing of snoring men is improved at night.

OBJECTIVE: To evaluate whether improved nasal breathing changes the quality of life in snoring men and improves the female sleeping partners' well-being in the morning. DESIGN: During 1 month, 42 heavily snoring men slept with a nostril dilator. Before and after 1 month, the snorers rated their daytime tiredness and completed the Nottingham Health Profile questionnaire. Female sleeping partners rated the snoring, the quality of their sleep, and their sense of well-being in the morning. A population sample was used for comparison. SETTING: The Central Hospital, Skövde, Sweden. RESULTS: The snorers' quality of life before the study was significantly worse (P<.001) than that of the comparison population and improved significantly (P = .001). The men were significantly (P<.001) less tired during the day when their nasal airflow was increased. Female sleeping partners had significantly (P = .005) better sleep and an improved sense of well-being in the morning during the test period. Both were correlated with a significant reduction in the snoring (P<.001). CONCLUSIONS: When nasal breathing of snoring men was improved at night, their quality of life was significantly improved. The female sleeping partners had a reduction in sleep disturbance that correlated well with an improvement in their own sleep and feelings of well-being in the morning.

Adult↗
PubMed1999

An independent association between obstructive sleep apnoea and coronary artery disease.

Previous studies of sleep and breathing suggest an independent association between coronary artery disease (CAD) and obstructive sleep apnoea (OSA) in middle-aged males and females. These studies, however, were criticized because they did not properly adjust for all important confounding factors. In order to better control for the impact of these confounders, a case-control study was performed, matching for age, sex and body mass index (BMI), and additionally adjusting for hypertension, hypercholesterolemia, diabetes mellitus and current smoking. A consecutive selection of 62 patients (44 males and 18 females, mean age 69 yrs, range 44-88 yrs) requiring intensive care for angina pectoris or myocardial infarction at the County Hospital of Skaraborg, Skövde, Sweden, as well as 62 age-, sex- and BMI- matched control subjects without history or signs of heart disease underwent an overnight sleep/ventilatory monitoring study. The time interval between discharge from the intensive care unit and the overnight study ranged between 4 and 21 months. OSA, defined as a Respiratory Disturbance Index (RDI) of > or =10 x h(-1), was present in 19 CAD patients but only in eight control subjects (p=0.017). Using a univariate logistic regression analysis, current smoking (odds ratio (OR) 8.1, 95% confidence interval (CI) 2.2-29.0), diabetes mellitus (OR 4.2, 95% CI 1.1-16.1) and OSA (OR 3.0, 95% CI 1.2-7.5), but not hypertension (OR 1.5, 95% CI 0.7-3.2) and hypercholesterolaemia (OR 1.8, 95% CI 0.7-4.1) were significantly correlated with CAD. In a multiple logistic regression model, current smoking (OR 9.8, 95% CI 2.6-36.5), diabetes mellitus (OR 4.2, 95% CI 1.1-17.1) and OSA (OR 3.1, 95% CI 1.2-8.3) all remained independently associated with CAD. In summary, these data suggest a high occurrence of obstructive sleep apnoea in middle-aged and elderly patients with coronary artery disease requiring intensive care, which should be taken into account when considering risk factors for coronary artery disease.

Adult↗
PubMed1998

Evaluation of the quality of life of male snorers using the Nottingham Health Profile.

Many snorers complain of tiredness during the day, but little is known about the impact of snoring on daily life in other respects. The objective of this study was to assess the quality of life of middle-aged men who were heavy snorers. We used the Nottingham Health Profile (NHP), which has been utilized during the last two decades as an instrument for evaluating the influence different medical conditions have on quality of life. Forty-two men (median 45 years, mean BMI 26 kg/m2 and mean Respiratory Disturbance Index 8.6) completed quality of life questionnaires. The answers were compared with those of a population sample of 786 men from the region with the same mean age. There were significant differences between the snorers and the population sample in the total score for quality of life (p=0.001) and the sections about energy (p < 0.001) and emotional reactions (p=0.02). There were highly significant differences in the frequency of health-related problems among the snoring men compared with the population sample in the ability to perform tasks around the home (p < 0.001). social life (p=0.003), family relationship (p < 0.001 ) and sexual life (p=0.001). When the snorers were compared with results reported from patients suffering from other medical conditions (hypertensives, growth hormone deficiency, myocardial infarction, chronic obstructive pulmonary disease), we found an equal level of total mean score and negative influence on their quality of life. The study illustrates that snoring men have a poor quality of life, comparable to that of patients with chronic diseases.

Adult↗
PubMed1998

Improved nasal breathing in snorers increases nocturnal growth hormone secretion and serum concentrations of insulin-like growth factor 1 subsequently.

In snoring men improved nasal breathing during sleep has been shown to decrease snoring and morning tiredness. The aim was to evaluate whether improved nasal breathing had any effect on growth hormone (GH) secretion, the nocturnal secretion of GH being associated with deep sleep. Forty-two snoring men, mean age 45 years and mean body mass index 26 kg.m-2, slept every night during one month with the Nozovent nostril dilator. Before and at the end of the test period, we analysed serum insulin-like growth factor 1 (IGF-1), thyrotropin (TSH), free thyroxine (free T4), free 3,5,3'-triiodothyronine (free T3), cortisol and testosterone in blood sampled at 08:00 h. Fifteen of the 37 snoring men who completed the study experienced a reduction in snoring and were less tired in the morning during the test period. In this group, the mean IGF-1 concentration was significantly increased (p < 0.05) after one month. There was no significant difference in mean IGF-1 level between the snorers and a population sample. Likewise, TSH, free T4, free T3, cortisol and testosterone concentrations were within normal limits. Snorers with reduced snoring and morning tiredness due to improved nasal breathing showed an increase in morning IGF-1 concentration which can probably be explained by higher nocturnal GH secretion induced by more deep sleep.

Adult↗
PubMed1996

Improved nasal breathing reduces snoring and morning tiredness. A 6-month follow-up study.

BACKGROUND: Dilation of the nasal valve region can increase the ability to breathe through the nose and reduce the negative intrathoracic pressure required for inspiration. Vibrations of the palate and soft tissues of the throat, which generate snoring sounds, can be prevented when patients inhale less heavily. OBJECTIVES: To evaluate the effect a nostril dilator has on patient snoring and tiredness in the morning and to determine how many patients would continue to use the device for half a year. DESIGN: For 6 months, 42 men who were heavy snorers graded their average tiredness in the morning and the patient's sleeping partner graded the average snoring using a visual analog scale from 0 to 100. SETTING: All patients were examined at the Department of Otorhinolaryngology, Central Hospital, in Skövde, Sweden. RESULTS: When the nostril dilator was used there was a significant decrease in snoring after both 1- and 6-month reports. There was a significant correlation between diminution of snoring and less tiredness in patients in the morning. The compliance was good since 60% of patients continued to use the device during the 6-month test period. CONCLUSIONS: This study illustrates the benefits that reducing nasal airway resistance during sleep has on snoring and morning tiredness in patients.

Adult↗
PubMed1994

Effect of nasal anaesthesia on lacrimal function after nasal allergen challenge.

Ocular symptoms in allergic rhinoconjunctivitis arise partly from direct contact of the allergen with the conjunctiva and presumably partly from a naso-lacrimal reflex. The aim was to study the importance of this reflex in allergic rhinitis after topical anaesthesia of the nose. Ten patients with allergic rhinoconjunctivitis to birch pollen were challenged with increasing intranasal doses of allergen until allergic symptoms occurred. The same dose of allergen was used in two other provocations, when the nasal cavity was anaesthetized with topical lidocaine in a double-blind randomized cross-over manner. The effect on the eyes was evaluated by Shirmer's test, a routine method for measuring tear production. Lidocaine per se and/or allergen challenge had no significant effect on tear production. The naso-lacrimal reflex was not involved in the eye symptoms in allergic conjunctivitis.

Adolescent↗
PubMed1991

The comparative efficacy and safety of clarithromycin and amoxycillin in the treatment of outpatients with acute maxillary sinusitis.

The efficacy and safety of clarithromycin and amoxycillin in the treatment of acute maxillary sinusitis were compared in a single-blind, multicentre outpatient study. Fifty patients were randomly assigned to receive either clarithromycin 500 mg 12-hourly or amoxycillin 500 mg 8-hourly orally. Clinical signs and symptoms, sinus culture and blood and urine laboratory profiles were assessed prior to treatment, at four to six days during treatment, and within 48 h of the end of therapy (usually 9-11 days). Patients from whom beta-lactamase producing strains were isolated were excluded from the study. Both antibiotics achieved a clinical success rate of 91% within 48 h post-treatment; radiological resolution or improvement was observed in 91% of patients treated with clarithromycin and 89% of patients who received amoxycillin. Bacteriological cure was achieved in 88% and 91% of evaluable patients for clarithromycin and amoxycillin, respectively. Adverse events were reported for 16% of patients in the clarithromycin group compared to 26% in the amoxycillin group. Gastrointestinal disturbance was the most commonly occurring adverse event in both groups. The results of this study suggest that clarithromycin is as effective and well tolerated as amoxycillin in the treatment of acute maxillary sinusitis.

Acute Disease↗
PubMed1989

The clinical efficacy of budesonide in hay fever treatment is dependent on topical nasal application.

During the last decade topical glucocorticoids have been established as the first hand choice for the treatment of allergic rhinitis. Although they are clinically effective, their precise mode of action has not been sufficiently clarified. In order to evaluate whether the clinical effect is dependent on the topical administration a randomized, double-blind, double-dummy study was performed. Ninety-eight patients with allergic rhinitis due to birch pollen were recruited at two centres in southern Sweden. The patients received one of the following three treatment alternatives: 200 micrograms of nasally applied budesonide twice daily, 250 micrograms of budesonide given orally twice daily or a placebo. The selection of the doses was based on previous pharmacokinetic studies giving almost equal plasma levels of the nasally and orally administered budesonide. To evaluate the possible clinical efficacy of the treatment, the patients kept a diary in order to register symptoms according to a 0-4 scale. After a run-in week with no treatment the patients entered the treatment period which lasted for 3 weeks. A total of 96 patients completed the study. The symptom data showed that topically applied budesonide was clinically effective with a pronounced reduction in all the nasal symptoms registered and compared with placebo treatment there was a statistically significant difference in favour of the budesonide treatment (P less than 0.001). The nasal symptoms of the patients receiving oral budesonide did not differ from those receiving placebo. Intranasally administered budesonide proved to be significantly more effective than orally applied budesonide (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗
PubMed1988

Nasal mucosal blood flow in patients with diabetes mellitus.

Fifty patients with diabetes mellitus of varying duration were divided into two groups according to whether they were on treatment with insulin or not. Nasal mucosal blood flow was investigated and the results were compared with a reference material from healthy subjects, and were also related to the degree of retinopathy. Patients with diabetes mellitus had normal mucosal blood flow. There was no correlation between the duration of diabetes and nasal blood flow, nor was there any correlation between the degree of retinopathy and nasal blood flow. Diabetes mellitus does not seem to be accompanied by changes in blood flow in the nasal mucosa.

Adult↗
PubMed1986

Vascular effects of topical oxymetazoline on human nasal mucosa.

Oxymetazoline, a derivative of imidazoline, is a widely used nasal decongestant. In contrast to other topical decongestants related to phenylephrine, sympathomimetic amines, it also induces a reduced nasal mucosal blood flow. The purpose of the present investigation was to evaluate the duration of effect of oxymetazoline on nasal airway resistance and mucosal blood flow. During the eight hours of study, the blood flow was reduced by 30-40 per cent in six hours. A similar decongestant effect of about 30 per cent was found during the same interval. The pharmacological profile of oxymetazoline seems questionable, since a reduced nasal mucosal blood flow might not be of value in the treatment of upper airways infections.

Administration, Topical↗
PubMed1985

The effect of topical phenylpropanolamine on nasal secretion and nasal airway resistance after histamine challenge in man.

The effect of topically administered phenylpropanolamine (PPA) on nasal secretion and nasal airway resistance (NAR) was evaluated in a placebo controlled double blind cross-over study in 10 healthy subjects. The nasal secretion was collected in hankerchiefs and weighed. NAR was measured by anterior rhinomanometry and the degree of nasal blockage, secretion and the number of sneezes were registered in a score. PPA (25 mg/ml) significantly reduced nasal secretion, NAR and the degree of blockage and so PPA may be useful as a topical nasal decongestant.

Administration, Intranasal↗
PubMedDate not supplied

Effects of glypressin on human nasal mucosa.

The effect of intravenous and topical glypressin, a triglycyl hormonogen of vasopressin, on the nasal mucosa was evaluated in healthy subjects. A dose-dependent reduction of nasal blood flow resulted from both intravenous and topical glypressin. The effect of the latter in gel form lasted 2 hours. Glypressin was also found to decongest the nasal mucosa. Topical application of glypressin gel might be an alternative to conventional treatment with intranasal packing in nose-bleed.

Administration, Intranasal↗