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Biomedical subjects

Vibeke Backer

Publications and source records attributed to Vibeke Backer.

32 records · Page 2Linked to original sources
PubMed2005

The incidence of asthma in young adults.

STUDY OBJECTIVES: Longitudinal data on adult asthma are sparse. The objectives of this study were to determine the incidence of asthma and to establish the risk factors for the development of asthma in subjects who were 12 to 41 years old over an 8-year period. DESIGN: From birth cohorts over the period 1953 to 1982 in The Danish Twin Registry, 19,349 subjects with no history of asthma, as determined by a questionnaire-based survey in 1994, answered a follow-up questionnaire in 2002. The subjects were regarded as incident asthma cases when answering "yes" to the question "Do you have, or have you ever had asthma?" in 2002, and "no" to the same question in 1994. RESULTS: A total of 838 cases (4.3%) of new asthma were identified in 2002. The incidence rates of asthma were 4.5 and 6.4 per 1,000 person-years, respectively, among male and female subjects. For all ages, the probability of adult-onset asthma was greater for female subjects (odds ratio [OR], 1.49; p < 0.001), and for both sexes there was a slow decline in probability with increasing age. There was a positive association between increasing body mass index (BMI) and risk of adult-onset asthma applying to both sexes (OR, 1.05 per unit; p < 0.001). Furthermore, positive associations were found between incident asthma and a history of hay fever (OR: male subjects, 4.2; female subjects, 3.7; p < 0.001), eczema (OR: male subjects, 3.5; female subjects, 2.0; p < 0.001), and both (OR: male subjects, 6.9; female subjects, 8.0; p < 0.001). CONCLUSIONS: There is a continuing high incidence of asthma past childhood that is most pronounced among female subjects. Increasing levels of BMI are associated with a greater likelihood of developing asthma for both sexes. A substantial portion of cases of adult asthma is preceded by upper airway allergic symptoms and/or eczema, thus indicating a shared pathogenesis.

Adolescent↗
PubMed2004

Respiratory symptoms in greenlanders living in Greenland and Denmark: a population-based study.

BACKGROUND: Knowledge of respiratory diseases in an arctic population with increasingly westernized lifestyles provides the opportunity to obtain new information in this field. OBJECTIVE: To investigate the influence of environment and lifestyle on the presence of respiratory symptoms in a genetically homogenous population sample living under widely differing conditions. METHODS: Greenland is a part of Denmark, but its climate is mainly arctic, as opposed to the temperate climate of southern Denmark. A random sample of Inuits who had immigrated to Denmark and Inuits from 3 towns and 4 remote settlements in Greenland were studied. Of the 6,695 invited Inuits, 4,162 (62%) completed a questionnaire concerning respiratory symptoms and risk factors. RESULTS: Of the 4,162 Inuits, 847 (20%) had respiratory symptoms. Bronchitis was more frequent in the areas of Greenland than in Denmark (26% and 20% vs 13%; P < .001), whereas the pattern of asthma was contradictory (6% and 9% vs 10%; P = .057). Bronchitis was associated with living area (P = .01), tobacco consumption (P < .001), and asthma (P = .001), whereas asthma was related to living area (P = .03), hay fever (P < .001), low intake of whale (P = .04), years in Denmark (P = .09), and bronchitis (P < .001). CONCLUSIONS: Inuits' prevalence of bronchitis and asthma differed, with a higher frequency of bronchitis and a lower frequency of asthma in Inuits living in Greenland compared with Denmark. Living conditions or areas, diet, tobacco use, climate, and atopy are important for the presence of symptoms.

Adult↗
PubMed2004

Change in prevalence of asthma in Danish children and adolescents.

BACKGROUND: There is evidence suggesting that the prevalence of asthma has increased, especially in industrialized countries. OBJECTIVE: To investigate whether the prevalence of asthma in Danish children and adolescents has changed during the past 15 years. METHODS: Serial cross-sectional studies of 2 different random population samples of children aged 7 to 17 years, living in urban Copenhagen, Denmark, were performed 15 years apart. The first cohort was investigated in 1986 (n = 527) and the second in 2001 (n = 480). The same methods were applied at both occasions. Skin test reactivity was measured using standard techniques. Asthma was defined on the basis of questionnaire responses and was regarded as nonatopic (intrinsic) if no positive reactions were observed on the skin test and as atopic (extrinsic) if at least 1 positive reaction was noted. Current asthma was defined as symptoms within the preceding 12 months. RESULTS: The prevalence of current asthma increased from 5.3% in 1986 to 11.7% in 2001. This was primarily due to an increase in intrinsic asthma, which was 4.2-fold (1.5% to 6.4%), compared with extrinsic asthma, which increased only 1.4-fold (3.8% to 5.5%). The changes were more pronounced in girls. CONCLUSIONS: The prevalence of asthma has increased substantially during the past 15 years. The observed striking increase in intrinsic asthma suggests the possibility of a more heterogeneous disorder, involving more important factors than atopy. Furthermore, our findings suggest that asthma might be shifting toward female predominance in childhood.

Adolescent↗
PubMed2004

Gamma-camera 18F-FDG PET in diagnosis and staging of patients presenting with suspected lung cancer and comparison with dedicated PET.

UNLABELLED: It is not clear whether high-quality coincidence gamma-PET (gPET) cameras can provide clinical data comparable with data obtained with dedicated PET (dPET) cameras in the primary diagnostic work-up of patients with suspected lung cancer. This study focuses on 2 main issues: direct comparison between foci resolved with the 2 different PET scanners and the diagnostic accuracy compared with final diagnosis determined by the combined information from all other investigations and clinical follow-up. METHODS: Eighty-six patients were recruited to this study through a routine diagnostic program. They all had changes on their chest radiographs, suggesting malignant lung tumor. In addition to the standard diagnostic program, each patient had 2 PET scans that were performed on the same day. After administration of 419 MBq (range = 305-547 MBq) (18)F-FDG, patients were scanned in a dedicated PET scanner about 1 h after FDG administration and in a dual-head coincidence gamma-camera about 3 h after tracer injection. Images from the 2 scans were evaluated in a blinded set-up and compared with the final outcome. RESULTS: Malignant intrathoracic disease was found in 52 patients, and 47 patients had primary lung cancers. dPET detected all patients as having malignancies (sensitivity, 100%; specificity, 50%), whereas gPET missed one patient (sensitivity, 98%; specificity, 56%). For evaluating regional lymph node involvement, sensitivity and specificity rates were 78% and 84% for dPET and 61% and 90% for gPET, respectively. When comparing the 2 PET techniques with clinical tumor stage (TNM), full agreement was obtained in 64% of the patients (Cohen's kappa = 0.56). Comparing categorization of the patients into clinical relevant stages (no malignancy/malignancy suitable for treatment with curative intent/nontreatable malignancy), resulted in full agreement in 81% (Cohen's kappa = 0.71) of patients. CONCLUSION: Comparing results from a recent generation of gPET cameras obtained about 2 h later than those of dPET, there was a fairly good agreement with regard to detecting primary lung tumors but slightly reduced sensitivity in detecting smaller malignant lesions such as lymph nodes. Depending on the population to be investigated, and if dPET is not available, gPET might provide significant diagnostic information in patients in whom lung cancer is suspected.

Equipment Failure Analysis↗
PubMed2003

[Smoking cessation program for health personnel--is it worth while?].

INTRODUCTION: A smoking cessation programme was offered to the staff members at H:S Bispebjerg Hospital as part of the political process toward a smoke-free hospital. The purpose of this study was to evaluate the long-term effect of the programme on smoking cessation and to identify factors influencing the success rate. MATERIAL AND METHODS: The study was designed as a 12-month follow-up mailed questionnaire study among 345 staff-members, who participated in the smoking cessation programme between October 1998 and March 1999 (approximately 30% of the smokers employed at the hospital). The participation rate in the study was 70%. A higher participation rate was found among higher educated than lower educated staff members (p = 0.004). No differences in baseline smoking habits were found between participants and non-participants. Mean follow-up time was 389 days. RESULTS: At 12-month follow-up the success-rate was 22% among all 345 participants, and 33% among participants in the 12-month follow-up. No difference was found between men and women. We found that early debut of smoking gave a higher risk of relapse. A similar result was found for higher tobacco-consumption, lower education and earlier quit attempt, none of these findings was statistically significant, though. DISCUSSION: This smoking cessation programme had a high success rate (22%-33%) compared to clinical studies. In addition, we found that the programme could reach a large group of the smokers employed (30%). Based on the results we find it reasonable to conclude that a successful smoking cessation programme aimed at staff members can be established at hospitals as an important part moving towards a smoke-free hospital.

Adult↗
PubMed2002

Factors associated with asthma in young Danish adults.

BACKGROUND: The prevalence of asthma appears to be increasing, but our knowledge about factors associated with asthma in young adults is limited. Factors associated with asthma were studied in 624 (66% of those invited) young Danish adults (aged 19 to 29 years). OBJECTIVE: The purpose of this study was to investigate the prevalence and predictors of asthma in young Danish adults. METHODS: Case history, including respiratory symptoms, smoking habits, education, and employment, was obtained by interview, and a questionnaire and was used to evaluate the presence or absence of asthma. Pulmonary function, beta2-reversibility, airway responsiveness to histamine, and blood eosinophil count were measured using standard techniques. RESULTS: The lifetime prevalence of asthma in these young Danish adults was 17%, and the prevalence of current asthma was 9%. The proportion of current smokers was disturbingly high, 41%, and, further, the proportion of current smokers was significantly higher among those with asthma than among those without asthma (52% and 38%, respectively; P < 0.01). Asthma was significantly associated with current smoking, with lower than predicted forced expiratory volume in 1 second, with lower than predicted ratio of forced expiratory volume in 1 second/forced vital capacity, atopy, higher eosinophil count, and higher degree of airway responsiveness to histamine. The proportion of subjects with no education after junior high school was higher among those with asthma than among those without asthma (P < 0.05). Further, 16 of the 103 (16%) people with asthma had work-related worsening of their respiratory symptoms. CONCLUSIONS: The presence of current asthma was predicted by current smoking, lower level of lung function, less education, higher blood eosinophil count, and more pronounced airway responsiveness. Further, the proportion of current smokers was higher among asthmatic subjects than among nonasthmatic subjects. Greater efforts must be made to encourage young people with asthma not to smoke.

Adolescent↗
PubMedDate not supplied

In vitro diagnostic evaluation of patients with inhalant allergies: summary of probability outcomes comparing results of CLA- and CAP-specific immunoglobulin E test systems.

For the diagnosis of allergy, presence of allergen-specific immunoglobulin E (IgE) usually is established either by allergen skin tests or by in vitro allergen-specific IgE measurements. However, in vitro assays of specific IgE often are modified as manufacturers improve allergens or change reagents to optimize test performance, affecting the diagnostic performance of in vitro allergen-specific IgE assays. This investigation compares the diagnostic outcomes of the Hitachi Chemical Diagnostics chemiluminescent assay (CLA) and Pharmacia, capsulated hydrophilic carrier polymer (CAP) in vitro allergen-specific IgE test methods in patients with inhalant allergy to a panel of selected allergens. Sera were obtained from 60 consecutive patients who had a clinical history suggesting inhalant allergy and were evaluated by allergen skin-prick test (SPT). Only patients with clinical findings of allergic asthma or rhinoconjunctivitis were included. Sera from patients with at least one positive SPT, which clinically correlated with the case history, were used for specific IgE measurements. Sensitivity and specificity were defined as conditional probabilities describing performances of the CAP system and the CLA system in reference to a standard composed of a combination of allergen-specific symptoms and a positive SPT. A test concordance of 79% was found between the CLA and CAP test results with a correlation coefficient of 0.8. Allergen-specific IgE assay sensitivity of the CLA and CAP systems was similar and allergen dependent, ranging from 67 to 100%. Assay specificity ranged from 39 to 86% for the CLA system and from 36 to 81% for the CAP system. When comparing the specific IgE results with allergen SPTs, 75% (+/- 3%) of CLApositive patients had a positive SPT, and 92% (+/- 4%) of CAPpositive patients had a positive SPT. Eighty-four percent (+/- 4%) of CLAnegative patients had a negative SPT, whereas 69% (+/- 5%) of CAPnegative patients had a negative SPT. The overall concordance between skin tests and in vitro tests was 76% for CLA and 67% for CAP. CLA and CAP score values showed good correlation and both tests may be useful when skin tests cannot be performed to identify subjects with IgE-mediated allergy. The CLA and CAP assays for allergen-specific IgE may be useful as part of an initial allergy evaluation because of the high negative predictive value of negative test results. For the majority of allergens the sensitivity was high. However, the specificity of both in vitro tests was low, indicating that positive in vitro test results should be evaluated carefully in conjunction with clinical symptoms and allergen-specific skin tests to determine the clinical relevance of the allergen sensitization.

Adult↗
PubMedDate not supplied

Early life exposures and risk of atopy among Danish children.

A large proportion of atopy develops in childhood and early life exposures are suspected to play a considerable role in the inception. The aim of this study was to examine the association between early life exposures and development of atopic disease in children. We performed a case-cohort study of a random population-based sample of children (n = 480) 7-17 years of age, living in urban Copenhagen, Denmark. Information on breast-feeding, supplementation, wheezy bronchitis, use of antibiotics, and parental smoking during pregnancy and in early life was obtained retrospectively by questionnaire. Skin test reactivity to 10 common aeroallergens was measured using standard techniques. Atopic disease was defined as a history of hayfever and/or asthma concomitantly with a positive skin-prick test. Logistic regression showed that parental atopy (odds ratio [OR] = 1.98; 95% confidence interval [CI], 1.12, 3.49; p = 0.019) and wheezy bronchitis before the age of 2 years (OR = 3.13; 95% CI, 1.63, 6.01; p < 0.001) were predictors of atopic disease, the latter especially when predisposition to atopy was present (OR = 8.63; 95% CI, 3.64, 20.44; p < 0.001). Duration of breast-feeding was longer in subjects with atopic heredity (p = 0.017), whereas smoking exposure during pregnancy (p = 0.019) and in the 1st year of life (p = 0.018) was less prevalent. Wheezy bronchitis was equally frequent among subjects with and without atopic predisposition (p = 0.893). Wheezy bronchitis before the age of 2 years seems to be independent of familial predisposition to atopic disease and significantly increases the likelihood for development of atopy in genetically susceptible individuals. Parental knowledge of atopic heredity significantly influences smoking and breast-feeding habits.

Adolescent↗