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Biomedical subjects

T Ringbaek

Publications and source records attributed to T Ringbaek.

8 recordsLinked to original sources
PubMed2005

Standardised mortality rates in females and males with COPD and asthma.

Mortality studies of males and females with chronic obstructive pulmonary disease (COPD) and asthma have suggested that females have a poorer prognosis than males, but the results are either not unanimous or based on poorly characterised patients. The current study analysed the mortality of 279 asthma patients and 869 COPD patients, who were seeking pension due to disability, and compared mortality rates with expected rates derived from the general population. The mean follow-up period was 13.3 yrs (range 2.5-22.4 yrs) during which time 96 (34.4%) and 671 (77.2%) deaths were identified among asthma and COPD patients, respectively. The average age at study entry was 46.8 and 56.6 yrs, and the average forced expiratory volume in one second (FEV1) was 68.8 and 44.1 % predicted in the two diagnostic groups. After adjustment for predictors of survival (age, FEV1 % predicted, chronic bronchitis, body mass index, smoking status, oral prednisolone, ischaemic heart disease, and cor pulmonale), the relative risk of death was 1.21 (95% confidence interval: 0.77-1.89) and 0.98 (0.83-1.16) in females compared with males, in asthma and COPD patients, respectively. The standardised mortality rate (SMR) for males was 1.54 (1.10-2.09) and 2.7 (2.5-3.0), and for females 1.91 (1.44-2.49) and 4.8 (4.2-5.4), in asthma and COPD patients, respectively. Direct comparison of the SMR of males and females showed that females had higher mortality than males, with a rate ratio of 1.24 (0.82-1.84) and 1.8 (1.5-2.0), in asthma and COPD patients, respectively. Poisson regression analysis with control for the confounders did not change this result. Females and males with the same level of obstructive lung disease appear to have the same level of mortality. However, using standardised mortality rates, females have a higher mortality than males, suggesting that the protective effect of being female is lost in chronic obstructive pulmonary disease patients.

Asthma↗
PubMed2003

Is there any association between inhaled ipratropium and mortality in patients with COPD and asthma?

BACKGROUND: To determine whether ipratropium was associated with premature death in patients with asthma and chronic obstructive pulmonary disease (COPD). METHODS: A longitudinal cohort of 827 patients with COPD and 273 with asthma who were evaluated for compensation by two specialists in pulmonary medicine. RESULTS: By June 1999, 538 of the patients with COPD and 77 of those with asthma had died. Atthe consultation, 77% ofthe COPD patients and 8.1% of the asthmatic patients were treated with inhaled ipratropium. Ipratropium was associated with mortality risk ratio (RR) of 2.0 (95% confidence interval: 1.5-2.6) for COPD and 3.6 (1.8-7.1) for asthma patients. After adjustment for confounding factors [forced expiratory volume 1 s (FEV1), smoking habits, asthma medication, and presence of cor pulmonale] the RR for COPD was 1.6 (1.2-2.1) and for asthma 24 (1.2-5.0). CONCLUSIONS: The increased risk of premature death associated with ipratropium is of concern and necessitates further evaluation, e.g., in a randomised study.

Administration, Inhalation↗
PubMed2001

Has the perception of disability among COPD patients applying for pension changed during the last 20 years?

The aim is to examine the change in lung function, treatment and pulmonary symptoms in patients with chronic obstructive pulmonary disease (COPD) or chronic bronchitis (CB) applying for a pension during the period 1977-1996. In addition, we compared the perception of disability in males and females. From 1977 to 1996, 947 patients with COPD or CB were evaluated for obtaining economic support due to disability. In order to test the trend, the patients were divided into three periods: (1) 1977-1983, (2) 1984-1989 and (3) 1990-1996. Compared to females, males had substantial more pack-years of smoking (36 vs. 28, P<0.001), but their FEV1 was only slightly decreased (46.9% versus 49.6% predicted, P=0.047). Females reported significantly more often attacks of dyspnoea [OR: 1.5(1.00-2.2)] and any kind of dyspnoea during daytime [OR: 4.0(1.2-13.3)]. From period 1 to period 3, FEV1 increased significantly (45-53% predicted, P<0.001). Despite the increased FEV1, the use of inhaled corticosteroid had increased markedly (9-32% of the patients, P<0.001). The results did not change when patients with asthma were included. Our data suggest that both sexes, especially females, have become more aware of pulmonary symptoms and tend to react to them more actively by demanding evaluation and treatment.

Asthma↗
PubMed1999

Compliance with LTOT and consumption of mobile oxygen.

The aim of the study was to investigate compliance with long-term oxygen therapy (LTOT), the consumption of mobile oxygen and factors that might influence on these measures. The study included 182 patients with LTOT and 125 patients answered a questionnaire on daily activities. Information on arterial gas tension, lung function, and diagnosis was obtained from the medical file. Data on oxygen systems and the actual usage of oxygen were obtained from the oxygen suppliers. Seventy-six per cent of the patients had a concentrator and 35% had both stationary and mobile oxygen. Good compliance (use of oxygen > 15 h day-1) was seen in 65%. Of the tested factors, only mobile oxygen had an influence on the effective usage. Outdoor activity was reported in 65% of the patients. Only 48% of these patients had mobile units, while 21% of the home-bound patients had mobile units. Of the patients with mobile oxygen, only 39% used their mobile unit > 2 h week-1. Poorer usage of stationary oxygen was observed in patients with outdoor activity (2.4 hours day-1 less). Although only 16 (13%) patients reported a usage less than 15 h day-1, the actual consumption was less than 15 h day-1 in 29%. In conclusion, patients on LTOT tended to overestimate their oxygen usage. Acceptable compliance was observed in 65% of the patients. Only mobile oxygen had a significant impact on the overall compliance. As more patients had outdoor activities than expected, and as these activities had a negative impact on the usage of stationary oxygen, more attention must be paid on detecting outdoor activities. However, as fewer than half of the patients with outdoor activity and mobile oxygen used their mobile systems, there is a need for measures to improve compliance with mobile oxygen. Using lists referring to the actual usage and discussing the usage with the patients may improve the compliance and cost-benefit.

Adolescent↗
PubMed1999

Diagnostic and therapeutic process and prognosis in suspected lung cancer.

Survival rates of patients with lung cancer are poor in Denmark and worse than in the other Nordic countries. The study focuses on the diagnostic process, the selection for operation, prognostic factors and outcome in lung cancer. The study comprised 467 consecutive patients with cancer-suspect lesions. In 40% of cases the diagnostic delay exceeded 30 days. Fibreoptic bronchoscopy and fine-needle biopsy (FNB) were the most important diagnostic tests, with approximately 90% accuracy in central and peripheral lesions. FNB of peripheral lesions diagnosed benign histology or small cell lung cancer (SCLC) in 16 patients, and due to that procedure a thoracotomy was prevented. Surgery was performed on 83 (33%) of 252 patients with non-small cell lung cancer. Three-year survival was 37% in all surgically treated patients and 64% after radical operation; 59% of the patients with stage I tumours were alive after three years, but none with stage IV at diagnosis. Among patients operated on, preoperated forced expiratory volume (FEV1) was related to survival rate. Survival rates were higher in women than in men with or without surgery. Of 43 patients with SCLC, 32 received chemotherapy, and half of these were alive after one year. Conclusions from the study were that diagnosis should be speeded up and that diagnostic FNB of peripheral lesions is of value for preventing unnecessary operations. Standard registration of tumour, node, metastasis (TNM) classification, resection, FEV1 (% of predicted) and gender could increase the validity of international comparisons.

Aged↗