Publications
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Mangseth, Henrik; Sikkeland, Liv Ingunn Bjoner; Durheim, Michael Thomas; Ulvestad, Mariann; Myrdal, Ole Henrik & Kongerud, Johny Steinar
[Show all 7 contributors for this article]
(2023).
Comparison of different reference values for lung function: implications of inconsistent use among centers.
BMC Pulmonary Medicine.
23.
doi:
10.1186/s12890-023-02430-7.
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Background For interpretation of pulmonary function tests (PFTs), reference values based on sex, age, height and ethnicity are needed. In Norway, the European Coal and Steel Community (ECSC) reference values remain widely used, in spite of recommendations to implement the more recent Global Lung Function Initiative (GLI) reference values. Objective To assess the effects of changing from ECSC to GLI reference values for spirometry, DLCO and static lung volumes, using a clinical cohort of adults with a broad range in age and lung function. Methods PFTs from 577 adults (18–85 years, 45% females) included in recent clinical studies were used to compare ECSC and GLI reference values for FVC, FEV1, DLCO, TLC and RV. Percent predicted and lower limit of normal (LLN) were calculated. Bland-Altman plots were used to assess agreement between GLI and ECSC % predicted values. Results In both sexes, GLI % predicted values were lower for FVC and FEV1, and higher for DLCO and RV, compared to ECSC. The disagreement was most pronounced in females, with mean (SD) difference 15 (5) percent points (pp) for DLCO and 17 (9) pp for RV (p < 0.001). With GLI, DLCO was below LLN in 23% of the females, with ECSC in 49% of the females. Conclusions The observed differences between GLI and ECSC reference values are likely to entail significant consequences with respect to criteria for diagnostics and treatment, health care benefits and inclusion in clinical trials. To ensure equity of care, the same reference values should be consistently implemented across centers nationwide.
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Sikkeland, Liv Ingunn Bjoner; Ueland, Thor; Samersaw-Lund, May Brit; Durheim, Michael Thomas & Mollnes, Tom Eirik
(2023).
A role for the terminal C5-C9 complement pathway in idiopathic pulmonary fibrosis.
Frontiers in Medicine.
10.
doi:
10.3389/fmed.2023.1236495.
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Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial lung disease characterized by damage to the alveolar epithelium, leading to fibrosis and excessive accumulation of extracellular matrix in the interstitium of the lung. In the present study we performed high-resolution proteomic profiling of bronchoalveolar lavage (BAL) from IPF patients and controls, and found that the complement pathway was highly upregulated in IPF. The proteins C5, C6, C7, C8, and C9, all of which are part of the complement end product, TCC, were all upregulated. We also found that TCC levels were increased in plasma among IPF patients compared to controls, after adjustment for age, sex and BMI [mean (SD) 0.62 (0.24) vs. 0.33 (0.10), p = 0.031]. These findings suggest a role for the complement system in the pathogenesis of IPF.
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Smeland, Knut Bjøro; Holte, Harald; Fagerli, Unn-Merete; Bersvendsen, Hanne Skjerven; Hjermstad, Marianne Jensen & Loge, Jon Håvard
[Show all 13 contributors for this article]
(2022).
Total late effect burden in long-term lymphoma survivors after high-dose therapy with autologous stem-cell transplant and its effect on health-related quality of life.
Haematologica.
ISSN 0390-6078.
107(11),
p. 2698–2707.
doi:
10.3324/haematol.2021.280413.
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Lymphoma survivors after high-dose therapy with autologous stem-cell transplant (HDT-ASCT) are at risk of several late effects, which might impair their health-related quality of life (HRQoL). We assessed the total late effect burden in this population, and how it affects HRQoL. All lymphoma survivors treated with HDT-ASCT as adults in Norway between 1987 and 2008 were identified, and 271 (68%) attended both a comprehensive clinical assessment and completed a questionnaire. Severity of 45 conditions in 12 organ-system categories were graded as mild, moderate, severe or life-threatening, according to a modified version of CTCAEv4.03. At a median of 8 years after HDT-ASCT, 98% of survivors had at least one moderate or more severe late effect and 56% had severe or life-threatening late effects. Fourteen percent had low, 39% medium and 47% high late effect burden, defined as having moderate or more severe late effects in 0-1, 2-3 and >3 organsystems, respectively. Female sex, increasing age, B-symptoms at diagnosis and >1 treatment line prior to HDT-ASCT were independently associated with having high late effect burden. The survivors had significantly poorer physical and mental HRQoL assessed by the Short Form-36 compared to age- and sex-matched controls. The prevalence of poor physical and mental HRQoL increased with higher late effect burden (both P<0.001), and the low burden group had better physical HRQoL than controls (P<0.001). In conclusion, lymphoma survivors after HDT-ASCT have impaired HRQoL, seemingly driven by a high late effect burden. This highlights the importance of prevention, regular assessments for early detection and treatment of late effects and modifiable risk factors.
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NOMELAND, BIRGIT; Schwartz, Thomas; Barth, Zoltan; Taraldsrud, Eli; Samersaw-Lund, May Brit & Aaløkken, Trond Mogens
[Show all 9 contributors for this article]
(2022).
Associations between cardiac and pulmonary involvement in patients with juvenile dermatomyositis—a cross-sectional study.
Rheumatology International.
ISSN 0172-8172.
42,
p. 1213–1220.
doi:
10.1007/s00296-021-05071-3.
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Abstract This study aimed at exploring the association between detectable cardiac and pulmonary involvement in long-term juvenile dermatomyositis (JDM) and to assess if patients with cardiac and pulmonary involvement differ with regard to clinical characteristics. 57 JDM patients were examined mean 17.3 (10.5) years after disease onset; this included clinical examination, myositis specific/associated autoantibodies (immunoblot), echocardiography, pulmonary function tests and high-resolution computed tomography. Cardiac involvement was defined as diastolic and/or systolic left ventricular dysfunction and pulmonary involvement as low diffusing capacity for carbon monoxide, low total lung capacity and/or high-resolution computed tomography abnormalities. Patients were stratified into the following four groups: (i) no organ involvement, (ii) pulmonary only, (iii) cardiac only, and (iv) co-existing pulmonary and cardiac involvement. Mean age was 25.7 (12.4) years and 37% were males. One patient had coronary artery disease, seven had a history of pericarditis, seven had hypertension and three had known interstitial lung disease prior to follow-up. There was no association between cardiac (10/57;18%) and pulmonary (41/57;72%) involvement ( p = 0.83). After stratifying by organ involvement, 21% of patients had no organ involvement; 61% had pulmonary involvement only; 7% had cardiac involvement only and 11% had co-existing pulmonary or cardiac involvement. Patients with co-existing pulmonary or cardiac involvement had higher disease burden than the remaining patients. Patients with either cardiac or pulmonary involvement only, differed in clinical and autoantibody characteristics. We found no increased risk of developing concomitant cardiac/pulmonary involvement in JDM. Our results shed light upon possible different underlying mechanisms behind pulmonary and cardiac involvement in JDM.
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Ellingsen, Dag; Ulvestad, Bente; Samersaw-Lund, May Brit; Skaugset, Nils Petter & Sikkeland, Liv Ingunn Bjoner
(2022).
A study of pneumoproteins in crystalline silica exposed rock drillers.
Inhalation Toxicology.
ISSN 0895-8378.
34(3-4),
p. 99–105.
doi:
10.1080/08958378.2022.2048745.
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Objective: The objective was to assess serum concentrations of club cell protein 16 (CC-16) and the surfactant proteins A (SPs-A) and D (SP-D) in male rock drillers (N = 123) exposed to crystalline silica and in 48 occupationally non-exposed. Methods: The arithmetic mean (AM) duration of exposure was 10.7 years. The geometric mean (GM) crystalline silica exposure was 36 µg/m3 at the time of the study. The GM cumulative exposure was 239 µg/m3. Results: The concentrations of SP-D (GM 12.7 vs. 8.8 µg/L, p < 0.001) and SP-A (AM 1847 vs. 1378 ng/L, p = 0.051) were higher among rock drillers than among occupationally non-exposed. A positive significant association was observed between cumulative crystalline silica exposure and the SP-D concentrations (β = 0.07; p < 0.05). Rock drillers with small airway obstruction with maximal mid-expiratory flow % (MMEF%) <70% (N = 29) had higher SP-D concentrations than rock drillers with MMEF% ≥ 70% (N = 91) (GM 17.3 vs. 11.4 µg/L, p = 0.001). Rock drillers with MMEF% ≥70% (N = 91) had higher concentrations of SP-A (1957 vs. 1287 ng/L, p = 0.01) and SP-D (11.4 vs. 9.0 µg/L, p = 0.007) than non-exposed with MMEF% ≥70% (N = 39). Rock drillers with airway obstruction (FEV1/FVC < 0.70, N = 11) had significantly lower CC-16 concentrations than rock drillers with FEV1/FVC ≥0.70 (N = 109) after adjusting for relevant potential confounders (p = 0.02). Conclusion: The results indicate that pulmonary surfactant is a target for crystalline silica toxicity. The alterations appear to be driven by pulmonary alterations in the small airways and by exposure itself. Further studies on pneumoproteins and pulmonary function in other groups of workers exposed to crystalline silica are needed.
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Myrdal, Ole Henrik; Aaløkken, Trond Mogens; Diep, Phoi Phoi; Ruud, Ellen; Brinch, Lorentz & Fosså, Kristian
[Show all 10 contributors for this article]
(2021).
Late-Onset, Noninfectious Pulmonary Complications following Allogeneic Hematopoietic Stem Cell Transplantation: A Nationwide Cohort Study of Long-Term Survivors.
Respiration.
ISSN 0025-7931.
p. 1–9.
doi:
10.1159/000520824.
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Background: Survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at risk for pulmonary adverse events. Data on late-onset noninfectious pulmonary complications in long-term adult survivors of allo-HSCT are limited and incomplete. Objectives: This study aimed (1) to determine occurrence and degree of pulmonary sequelae in adult survivors of allo-HSCT and (2) to identify associations between pulmonary function, high-resolution CT (HRCT), and clinical characteristics. Method: In a nationwide, single-center cross-sectional study, 103 survivors (aged median [range] 35 [17–58] years, 53% females) were examined 17 (6–32) years after allo-HSCT and compared with healthy controls (n = 105). Methods included pulmonary function tests and HRCT. Results: Chronic graft-versus-host disease was diagnosed in 33% of survivors, including 12% with bronchiolitis obliterans syndrome (BOS). Mean lung volumes (TLC, FVC, and FEV1) and gas diffusing capacity were >80% of predicted for the survivors as a group, but significantly lower than in healthy controls. Pathological HRCT findings were detected in 48% of the survivors (71% airways disease, 35% interstitial lung disease, and 24% apical subpleural interstitial thickening). Air trapping (%) on HRCT correlated with % predicted FEV1, p < 0.001. In a multiple logistic regression model, both BOS and pathological findings on HRCT were associated with chemotherapy prior to allo-HSCT, p < 0.05. Conclusions: Long-term allo-HSCT survivors had significantly lower pulmonary function than age- and gender-matched healthy controls and nearly half had pathological findings on HRCT. Longitudinal data will determine if pulmonary sequelae will remain stable or progress. We recommend lifelong monitoring of pulmonary function in allo-HSCT survivors. HRCT provides additional information, but is not suited for surveillance.
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Ulvestad, Mariann; Durheim, Michael; Kongerud, Johny; Hansen, Bjørge Herman; Samersaw-Lund, May Brit & Edvardsen, Elisabeth
(2020).
Cardiorespiratory Fitness and Physical Activity following Lung Transplantation: A National Cohort Study.
Respiration.
ISSN 0025-7931.
99(4),
p. 316–324.
doi:
10.1159/000506883.
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Background: Low cardiorespiratory fitness and inactivity are common after lung transplantation (LTx). The causes of exercise intolerance are incompletely understood. Objectives: The aim of this study was to objectively assess cardiorespiratory fitness and physical activity, evaluate causes of exercise intolerance, and explore clinical factors associated with cardiorespiratory fitness after bilateral LTx (BLTx). Materials and Methods: Peak oxygen uptake (V∙O2peak) and exercise-limiting factors were evaluated by a treadmill cardiopulmonary exercise test (CPET) 6–60 months after BLTx. Physical activity was measured with accelerometers, and results were compared with Norwegian normative data and the World Health Organization’s (WHO) recommendations for physical activity. Results: In 54 included BLTx recipients (mean age 50 ± 15 years, 50% females), V∙O2peak (mL × kg–1 × min–1) was 21.8 ± 7.7 for men and 22.4 ± 6.2 for women, corresponding to 57 ± 17 and 70 ± 12% of predicted, respectively. Three patients (6%) met criteria for normal V∙O2peak. Deconditioning limited V∙O2peak in 22 patients (41%), while ventilatory limitation and abnormal gas exchange were observed in 14 (26%) and 20 (37%) patients, respectively (some had more than 1 finding). Forty-three patients (86%) did not meet the WHO physical activity recommendations. There was a moderate correlation between V∙O2peak and physical activity (r = 0.642, p < 0.01). Body mass index, physical activity, forced expiratory volume after 1 second, sex, and hemoglobin together accounted for 73% of the variability in V∙O2peak. Conclusions: Low cardiorespiratory fitness was observed in the majority of BLTx recipients. Both deconditioning and cardiopulmonary limitations were common findings. Nearly 90% were classified as being inactive according to physical activity recommendations. CPET appears to identify a deconditioned subgroup of BLTx recipients for whom exercise training may be especially beneficial.
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Søyseth, Torunn Stavnes; Dew, Mary Amanda; Samersaw-Lund, May Brit; Haugstad, Gro Killi; Søyseth, Vidar & Malt, Ulrik Fredrik
(2020).
Coping Patterns and Emotional Distress in
Patients With Chronic Obstructive Lung
Disease Who Are Undergoing Lung
Transplant Evaluation.
Progress in transplantation.
ISSN 1526-9248.
30(3),
p. 228–234.
doi:
10.1177/1526924820933817.
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Objectives: Living with severe lung disease like chronic obstructive pulmonary disease (COPD) is a very stressful situation. The way patients cope may impact their symptoms of anxiety and depression and physical function as well. We studied how ways of coping are associated with levels of emotional distress and lung function in patients with COPD being evaluated for lung transplantation. Methods: Sixty-five (mean age 57 years, 46% females) patients completed the General Health Questionnaire-30 (GHQ-30) assessing emotional distress and the Ways of Coping Questionnaire. Measurements of lung function and 6-minute walk test were included. Results: Seventeen (26%) patients had elevated emotional distress. Logistic regression of chronic GHQ score with gender, age, body mass index, lung function, and coping scales as covariates showed that escape avoidance and selfcontrolling coping and forced vital lung capacity were significantly associated with high emotional distress. Odds ratio of emotional distress increased with 5.2 per tertile (P ¼ .011) in escape avoidance coping score. Moreover, we revealed that emotionally distressed patients cope with their current situation by refusing to believe the current situation and taking their distress out on other people. Conclusion: Among patients with COPD, a high level of emotional distress was uniquely associated with escapeavoidance coping and lung function. Future work should ascertain whether coping style predicts distress or whether distress increases the use of escape-avoidance coping. Nevertheless, our findings indicate that if either element is present, health care professionals should be attentive to the need for interventions to improve patients’ well-being.
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Ulvestad, Mariann; Durheim, Michael; Kongerud, Johny; Samersaw-Lund, May Brit & Edvardsen, Elisabeth
(2020).
Effect of high-intensity training on peak oxygen uptake and muscular strength after lung transplantation: A randomized controlled trial.
The Journal of Heart and Lung Transplantation.
ISSN 1053-2498.
39(9),
p. 1–9.
doi:
10.1016/j.healun.2020.06.006.
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BACKGROUND: Peak oxygen uptake (VO2peak) remains low after lung transplantation (LTx). We evaluated the effect of high-intensity interval training (HIIT) on VO2peak, muscular strength, health-related quality of life (HRQOL), pulmonary function, and physical function after LTx. METHODS: In this randomized controlled trial, 54 participants were enrolled from 6 to 60 months after LTx. The HIIT group (n = 25) followed a supervised HIIT program, consisting of endurance and strength trainings 3 times a week for 20 weeks. The control group (n = 29) received usual care. The primary outcome was a change in VO2peak measured by cardiopulmonary exercise testing. The secondary outcomes were changes in 1-repetition maximum (1RM) for arm press and leg press, HRQOL (36-Item Short-Form Health Survey [SF-36]), pulmonary function (forced expiratory volume in 1 sec, diffusing capacity of the lungs for carbon monoxide), and physical function (1RM in handgrip, 15-sec stair run, and 30-sec chair stand). RESULTS: A total of 46 participants completed the study, including 23 of 25 in the intervention group. For the primary outcome, the intention-to-treat analysis revealed a non-significant between-group difference for change in VO2peak of 0.7 ml/(kg.min) (95% CI = ‒0.3, 1.8) (p = 0.17). The between-group differences for 1RM arm press and leg press and mental aspect of SF-36 were 4.9 kg (95% CI = ‒0.1, 9.9) (p = 0.05), 11.6 kg (95% CI = 0.1, 23.0) (p < 0.05), and 5.7 kg (95% CI = 0.9, 10.4) (p = 0.02), respectively. There were no between-group differences in pulmonary function or physical function. When excluding participants with an attendance of <70% (n = 16), the between-group difference for VO2peak was 1.2 ml/(kg.min) (95% CI = 0.1, 2.4) (p = 0.032). CONCLUSIONS: HIIT improved muscular strength and HRQOL but did not improve VO2peak more than usual care after LTx. However, with acceptable adherence, HIIT appears to have beneficial effects on VO2peak.
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Ulvestad, Bente; Ulvestad, Mariann; Skaugset, Nils Petter; Aaløkken, Trond M; Günther, Anne & Clemm, Thomas
[Show all 8 contributors for this article]
(2020).
Pulmonary function and high-resolution computed tomography in outdoor rock drillers exposed to crystalline silica.
Occupational and Environmental Medicine.
ISSN 1351-0711.
77(9),
p. 611–616.
doi:
10.1136/oemed-2019-106254.
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Objectives Chronic obstructive pulmonary disease and silicosis are associated with exposure to crystalline silica. We determined the exposure to respirable crystalline silica and estimated exposure–response relationships between cumulative exposure and pulmonary function in outdoor rock drillers.
Methods 136 rock drillers and 48 referents were recruited from three heavy construction companies. 98 air samples were collected by personal sampling for determination of respirable particulate matter and crystalline silica. Information about individual job tasks, type of drilling equipment and years of exposure in different job categories was obtained by interview. Cumulative exposure to crystalline silica was calculated for all workers. Pulmonary function was assessed by spirometry. A subgroup of 39 subjects with high cumulative exposure to crystalline silica underwent high-resolution computed tomography (HRCT).
Results Cumulative exposure (mean (min–max)) to crystalline silica was 0.69 mg٠years m–3 (0.01–5.89) in the exposed group. Mean time of exposure among rock drillers was 10.7 years (1–42). Compared with referents, the rock drillers had a lower forced expiratory volume in one second/forced vital capacity ratio (79.4 vs 81.4, p<0.05) and maximal mid-expiratory flow% (85.6 vs 93.9, p<0.05). Further, by stratifying the exposed workers into three equally large groups, a dose–response relationship was demonstrated in the highest exposed group, also in never smokers, at a mean cumulative exposure of 21.7 years at 0.08 mg٠m–3/years. Silicosis was not detected in HRCT, but other patterns of fibrosis and emphysema were seen.
Conclusions Outdoor rock drillers exposed to crystalline silica had significantly lower pulmonary function than referents, and signs of airflow obstruction. Silicosis was not detected.
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Sikkeland, Liv Ingunn Bjoner; Qiao, Shuo Wang; Ueland, Thor; Myrdal, Ole Henrik; Wyrozemski, Lukasz Adam & Aukrust, Pål
[Show all 12 contributors for this article]
(2020).
Lung CD4+ T cells in patients with lung fibrosis produce pro-fibrotic IL-13 together with IFNγ.
European Respiratory Journal.
ISSN 0903-1936.
57:2000983(3),
p. 1–4.
doi:
10.1183/13993003.00983-2020.
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Progressive fibrosing interstitial lung diseases (PF-ILD) have poor prognosis and survival, and their pathogenesis is not well understood[1]. Mechanistically, lung fibrosis is thought to result from distorted wound-healing following tissue insults and inflammation, leading to scar formation by excess deposition of extracellular matrix proteins and destruction of lung architecture[2]. The fibrotic process is complex, and CD4+ T cells are likely involved by their production of a wide range of cytokines and growth factors that promote fibroblast proliferation and differentiation, collagen production, and stimulate production of pro-fibrotic mediators by tissue macrophages[3]. However, CD4+ T cells in PF-ILD are poorly characterized. To this end, we performed a detailed analysis of phenotype, cytokine production and clonality of T cells from the lungs [bronchoalveolar lavage (BAL)] of PF-ILD patients. We found that BAL from PF-ILD lungs contained high numbers of clonally expanded CD4+ T cells that produced an unusual combination of interferon (IFN) and pro-fibrotic interleukin (IL)-13. Such cells were not found in patient blood or in control BAL samples.
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Durheim, Michael; Hoffmann-Vold, Anna-Maria; Eagan, Tomas Mikal; Hovden, Arnt-Ove; Samersaw-Lund, May Brit & Bjerke, Gisle
[Show all 10 contributors for this article]
(2020).
ILD-specific health-related quality of life in systemic sclerosis-associated ILD compared with IPF.
BMJ Open Respiratory Research.
7(1).
doi:
10.1136/bmjresp-2020-000598.
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Abstract Introduction Idiopathic pulmonary fibrosis (IPF) and systemic sclerosis-associated interstitial lung disease (SSc-ILD) are fibrotic ILDs with divergent disease populations. Little is known about health-related quality of life (HRQL) in SSc-ILD relative to IPF. Methods We used the Kings Brief Interstitial Lung Disease Questionnaire (K-BILD) to compare HRQL in a cross-sectional study of 57 patients with IPF and 29 patients with SSc-ILD. Analysis of covariance was used to adjust for age, gender and lung function. Results The unadjusted mean K-BILD score was 63.1 (95% CI 57.1 to 69.1) among patients with SSc-ILD, as compared with 54.7 (51.8–57.5) among those with IPF (p=0.005). However, this difference in HRQL was attenuated after adjustment for age, gender and lung function. In a multivariable model, only forced vital capacity was associated with K-BILD scores. K-BILD scores were correlated with both forced vital capacity and with other relevant HRQL measures, regardless of ILD diagnosis. Discussion Patients with SSc-ILD may have better ILD-specific quality of life than patients with IPF, but this difference appears to be driven primarily by better lung function. These results underscore the impact of lung function on HRQL in fibrotic ILD and the utility of K-BILD to assess HRQL in SSc-ILD.
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Hetlevik, Siri Opsahl; Flatø, Berit; Aaløkken, Trond Mogens; Samersaw-Lund, May Brit; Reiseter, Silje & Mynarek, Georg
[Show all 9 contributors for this article]
(2019).
Pulmonary manifestations and progression of lung disease in juvenile-onset mixed connective tissue disease.
Journal of Rheumatology.
ISSN 0315-162X.
46(1),
p. 93–100.
doi:
10.3899/jrheum.180019.
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Objective. To assess the occurrence and extent of interstitial lung disease (ILD) in patients with juvenile mixed connective tissue disease (JMCTD), compare pulmonary function in patients and matched controls, study associations between ILD and disease-related variables, and examine progression of pulmonary manifestations over time. Methods. A cohort of 52 patients with JMCTD were examined in a cross-sectional study after a mean 16.2 (SD 10.3) years of disease duration with high-resolution computed tomography (HRCT) and pulmonary function tests (PFT) comprising spirometry, DLCO, and total lung capacity (TLC). Matched controls were examined with PFT. Previous HRCT and PFT were available in 37 and 38 patients (mean 8.8 and 10.3 yrs before study inclusion), respectively. Results. Compared to controls, patients with JMCTD had lower forced vital capacity (FVC), DLCO, and TLC (p < 0.01). The most frequent abnormal PFT was DLCO in 67% of patients versus 17% of controls (p < 0.001). Fourteen patients (27%) had ILD on HRCT. Most had ILD in < 10% of their lungs. ILD was associated with low values for FVC and TLC, but not with DLCO. HRCT findings did not progress significantly over time, but FVC declined (p < 0.01). Conclusion. Compared to controls, patients with JMCTD had impaired pulmonary function. ILD was present in 27% of patients after a mean 16 years of disease duration, mostly as mild disease, and did not progress. ILD seems to be less common in juvenile-onset than in adult-onset MCTD, and ILD in JMCTD seems mostly mild and stable over time.
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Marstein, Henriette; Schwartz, Thomas; Aaløkken, Trond M; Samersaw-Lund, May Brit; Flatø, Berit & Sjaastad, Ivar
[Show all 7 contributors for this article]
(2019).
Novel associations between cytokines and pulmonary involvement in juvenile dermatomyositis - a cross-sectional study of long-term disease.
Rheumatology.
ISSN 1462-0324.
59(8),
p. 1862–1870.
doi:
10.1093/rheumatology/kez531.
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To examine associations between cytokines and pulmonary involvement in patients with medium- to long-term JDM. In a cross-sectional study, 58 patients examined median (range) 16.8 (6.6–27.0) years after symptom onset were stratified in inactive (JDM-inactive) and active (JDM-active) disease (updated PRINTO criteria); 56 age/sex matched controls were included. Twenty-nine cytokines (in serum) were analysed (Luminex technology/ELISA). Pulmonary function test included forced vital capacity, total lung capacity (TLC) and diffusing capacity for carbon monoxide reported as % of predicted and low forced vital capacity/TLC/diffusing capacity for carbon monoxide. In patients, the presence of clinical pulmonary damage was assessed and high resolution computed tomography scans were scored for interstitial lung disease, chest wall calcinosis and airways disease. Median age of patients was 21 (7–55) years, 59% were female and 36% inactive. In JDM-active and all patients, higher MCP-1, IP-10 and eotaxin correlated with high-resolution computed tomography findings (rs 0.34–0.61; P < 0.05). MCP-1 and eotaxin correlated with pulmonary damage in JDM-active and all patients (rs 0.41–0.49; P < 0.01). Higher TGF-β1 and PDGF (growth factors) were associated with lower lung volumes (forced vital capacity/TLC measures) in all patients; PDGF in JDM-active and TGF-β1 in JDM-inactive patients. IP-10 correlated with TLC% in JDM-active patients. No associations between cytokines and pulmonary function test were found in controls. In JDM, we found a novel association (not previously described in myositis) between eotaxin and pulmonary involvement; we have previously shown an association between eotaxin and cardiac dysfunction. The associations between IP-10/growth factors/MCP-1 and pulmonary involvement are novel in JDM and were mostly seen in JDM-active patients.
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Stenehjem, Jo Steinson; Smeland, Knut Bjøro; Murbræch, Klaus; Holte, Harald; Kvaløy, Stein Olav & Wethal, Torgeir
[Show all 8 contributors for this article]
(2018).
Obstructive and restrictive pulmonary dysfunction in long-term lymphoma survivors after high-dose therapy with autologous stem cell transplantation.
Acta Oncologica.
ISSN 0284-186X.
57(6),
p. 773–781.
doi:
10.1080/0284186X.2017.1406137.
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Background: Obstructive and restrictive dysfunction in long-term lymphoma survivors (LSs) after high-dose therapy with autologous stem-cell transplantation (HDT-ASCT) has not been addressed systematically previously. Material and methods: LSs treated in Norway 1987–2008 with HDT-ASCT who performed spirometry, measurement of static lung volumes and echocardiography 2012–2014 at either Oslo or St. Olavs University Hospitals was eligible. Smoking data were recorded by questionnaire. Treatment data were collected from medical records or hospital databases. Factors associated with obstructive and restrictive impairments (dichotomous outcomes) were examined by Poisson regression. Linear regression with the margins post-estimation command was used to derive adjusted mean values of forced expiratory volume in 1 s (FEV1). We used the normative reference data recommended by the European Respiratory Society for calculating percent predicted values. Results: A total of 226 LSs were studied, of whom 11.5 and 5.8% had obstructive and restrictive impairment, respectively. For women and men, mean FEV1 was 2.31 and 3.34 l corresponding to 11.4%- and 11.1%-points below that predicted from norms, respectively. In multivariable regression analyses, cumulative doxorubicin dose (400–775 mg/m2) and current smoking were associated with increased risk of obstructive impairment, and chest RT (>13–66 Gy) was associated with increased risk of restrictive impairment. Currently smoking LSs within the highest doxorubicin category (400–775 mg/m2), had the lowest adjusted mean FEV1. Conclusions: Despite intensive cancer treatment, our analysis showed modest reductions in obstructive parameters among long-term LSs after HDT-ASCT compared to normative reference data. To limit obstructive impairments in LSs after HDT-ASCT, we suggest that targeted smoking-cessation advice is directed towards patients who have received high cumulative doses of doxorubicin.
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Möller, Thomas; Lindberg, Harald L; Samersaw-Lund, May Brit; Holmstrøm, Henrik; Døhlen, Gaute & Thaulow, Erik
(2018).
Right ventricular pressure response to exercise in adults with isolated ventricular septal defect closed in early childhood.
Cardiology in the Young.
ISSN 1047-9511.
28(6),
p. 797–803.
doi:
10.1017/S1047951117002979.
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We previously demonstrated an abnormally high right ventricular systolic pressure response to exercise in 50% of adolescents operated on for isolated ventricular septal defect. The present study investigated the prevalence of abnormal right ventricular systolic pressure response in 20 adult (age 30–45 years) patients who underwent surgery for early ventricular septal defect closure and its association with impaired ventricular function, pulmonary function, or exercise capacity. The patients underwent cardiopulmonary tests, including exercise stress echocardiography. Five of 19 patients (26%) presented an abnormal right ventricular systolic pressure response to exercise ⩾ 52 mmHg. Right ventricular systolic function was mixed, with normal tricuspid annular plane systolic excursion and fractional area change, but abnormal tricuspid annular systolic motion velocity (median 6.7 cm/second) and isovolumetric acceleration (median 0.8 m/second2). Left ventricular systolic and diastolic function was normal at rest as measured by the peak systolic velocity of the lateral wall and isovolumic acceleration, early diastolic velocity, and ratio of early diastolic flow to tissue velocity, except for ejection fraction (median 53%). The myocardial performance index was abnormal for both the left and right ventricle. Peak oxygen uptake was normal (mean z score −0.4, 95% CI −2.8–0.3). There was no association between an abnormal right ventricular systolic pressure response during exercise and right or left ventricular function, pulmonary function, or exercise capacity. Abnormal right ventricular pressure response is not more frequent in adult patients compared with adolescents. This does not support the theory of progressive pulmonary vascular disease following closure of left-to-right shunts.
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Myrdal, Ole Henrik; Kanellopoulos, Adriani; Christiansen, Jon Runar; Ruud, Ellen; Edvardsen, Elisabeth & Kongerud, Johny
[Show all 8 contributors for this article]
(2018).
Risk factors for impaired pulmonary function and cardiorespiratory fitness in very long-term adult survivors of childhood acute lymphoblastic leukemia after treatment with chemotherapy only*.
Acta Oncologica.
ISSN 0284-186X.
57(5),
p. 658–664.
doi:
10.1080/0284186X.2017.1423177.
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Background: Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk of late treatment-related side-effects. Data regarding prevalence and risk factors for impairments in pulmonary function and cardiorespiratory fitness are limited, and reported findings are inconsistent and inconclusive.
Material and methods: In a cross-sectional study, 116 ALL survivors (median 5 years at diagnosis, 29 years at follow-up, 53% females) were examined, median 23 years after treatment with chemotherapy only. Individual cumulative doses of cytostatic agents were calculated. Methods included blood tests, echocardiography, pulmonary function tests and cardiorespiratory exercise test.
Results: Females had lower % predicted gas diffusing capacity (DLCO) than males (mean [SD] 84 [13] versus 97 [14], p < .001). Impairment in DLCO was found in 34% females versus 7% males, p < .001. In a multiple linear regression model, female gender, body mass index (BMI) and smoking were risk factors for reduced % predicted DLCO, with a borderline significant effect of left ventricular ejection fraction (LVEF). Impaired cardiorespiratory fitness was found in 42% of the survivors, with a borderline increased risk in females, p = .06. Smoking and BMI were risk factors for reduced % predicted VO2peak. Subjects exposed to anthracyclines had lower LVEF% and % predicted VO2peak than those not exposed, (mean [SD] 56.2 [4.3] versus 59.2 [5.2], p = .01 and 86.9 [18.4] versus 92.8 [18.4], p = .03, respectively).
Conclusions: Impairments in pulmonary function and cardiorespiratory fitness are common in very long-term survivors of childhood ALL. Risk factors are female gender, BMI and smoking. In order to preserve pulmonary function and cardiorespiratory fitness, we suggest increased attention and targeted advice on modifiable lifestyle factors such as smoking, inactivity and overweight.
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Reiseter, Silje; Gunnarsson, Ragnar; Corander, Jukka; Haydon, Joanna; Samersaw-Lund, May Brit & Aaløkken, Trond Mogens
[Show all 9 contributors for this article]
(2017).
Disease evolution in mixed connective tissue disease: Results from a long-term nationwide prospective cohort study.
Arthritis Research & Therapy.
ISSN 1478-6354.
19(1).
doi:
10.1186/s13075-017-1494-7.
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Background The phenotypic stability of mixed connective tissue disease (MCTD) is not clear, and knowledge about disease activity and remission is scarce. We aimed to establish the occurrence of evolution from MCTD to another defined rheumatic condition, and the prevalence and durability of remission after long-term observation. Methods In this large population-based prospective observational MCTD cohort study (N = 118), disease conversion was defined by the development of new auto-antibodies and clinical features compliant with another well-defined rheumatic condition. Remission was defined by a combination of systemic lupus erythematosus disease activity index 2000 (SLEDAI-2 K) of 0 and European League Against Rheumatism scleroderma trials and research (EUSTAR) activity index <2.5. Predictors of phenotypic stability and disease remission were assessed by logistic regression. Results Among 118 patients, 14 (12%) developed another well-defined rheumatic condition other than MCTD after mean disease duration of 17 (SD 9) years. Puffy hands predicted a stable MCTD phenotype in univariable regression analysis (OR 7, CI 2–27, P = .010). Disease activity defined by SLEDAI-2 K, decreased gradually across the observation period and > 90% of patients had EUSTAR activity index <2.5. There were 13% patients in remission throughout the whole mean observation period of 7 (SD 2) years. The strongest predictor of remission was percentage of predicted higher forced vital capacity. Conclusions Our results strengthen the view of MCTD as a relatively stable disease entity. Long-term remission in MCTD is not frequent; however, the low SLEDAI-2 K and EUSTAR scores during the observation period suggests that the disease runs a milder course than systemic lupus erythematosus and systemic sclerosis.
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Kirkhus, Niels Einar; Skare, Øivind; Ulvestad, Bente; Aaløkken, Trond Mogens; Günther, Anne & Olsen, Raymond
[Show all 9 contributors for this article]
(2017).
Pulmonary function and high-resolution computed tomography
examinations among offshore drill floor workers.
International Archives of Occupational and Environmental Health.
ISSN 0340-0131.
91(3),
p. 317–326.
doi:
10.1007/s00420-017-1281-4.
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Purpose:
The aim of this study was to assess short-term changes in pulmonary function in drill floor workers currently exposed to airborne contaminants generated as a result of drilling offshore. We also aimed to study the prevalence of pulmonary fibrosis using high-resolution computed tomography (HRCT) scans of another group of previously exposed drill floor workers.
Methods:
Pulmonary function was measured before and after a 14-day work period in a follow-up study of 65 drill floor workers and 65 referents. Additionally, 57 other drill floor workers exposed to drilling fluids during the 1980s were examined with HRCT of the lungs in a cross-sectional study.
Results:
The drill floor workers had a statistically significant decline in forced expiratory volume in 1 s (FEV1) across the 14-day work period after adjustment for diurnal variations in pulmonary function (mean 90 mL, range 30–140 mL), while the small decline among the referents (mean 20 mL, range − 30 to 70 mL) was not of statistical significance. Larger declines in FEV1 among drill workers were associated with the fewer number of days of active drilling. There were no signs of pulmonary fibrosis related to oil mist exposure among the other previously exposed drill floor workers.
Conclusion:
After 14 days offshore, a statistically significant decline in FEV1 was observed in the drill floor workers, which may not be related to oil mist exposure. No pulmonary fibrosis related to oil mist exposure was observed.
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Gabrielsen, Anne Marie; Omland, Torbjørn; Brokner, Mette; Fredheim, Jan Magnus; Jordan, Jens & Lehmann, Sverre
[Show all 9 contributors for this article]
(2016).
The effect of surgical and non-surgical weight loss on N-terminal pro-B-type natriuretic peptide and its relation to obstructive sleep apnea and pulmonary function.
BMC Research Notes.
9(440).
doi:
10.1186/s13104-016-2241-x.
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Background Obesity is a major risk factor for obstructive sleep apnea, impaired pulmonary function and heart failure, but obesity is also associated with paradoxically low levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). In subjects with severe obesity undergoing weight loss treatment, we assessed the associations between changes in severity of obstructive sleep apnea, pulmonary function and serum NT-proBNP levels. Methods One-year non-randomized controlled clinical trial. Participants, 69.6 % women, mean (SD) age 44.6 (10.8) years and body mass index (BMI) 45.1 (5.6) kg/m2, underwent gastric bypass surgery (n = 76) or intensive lifestyle intervention (n = 63), resulting in 30 (8) % and 8 (9) % weight loss, respectively. The reference group included 30 normal weight, healthy, gender and age matched controls. Sleep recordings, arterial blood gases, pulmonary function and blood tests were assessed before and 1 year after the interventions. Results NT-proBNP concentrations increased significantly more after surgery than after lifestyle intervention. The post intervention values in both groups were significantly higher than in a normal weight healthy reference group. In the whole study population changes (∆) in NT-proBNP correlated significantly with changes in both BMI (r = −0.213) and apnea hypopnea index (AHI, r = −0.354). ∆NT-proBNP was, independent of age, gender and ∆BMI, associated with ∆AHI (beta −0.216, p = 0.021). ∆AHI was, independent of ∆BMI, significantly associated with changes in pO2 (beta −0.204), pCO2 (beta 0.199), forced vital capacity (beta −0.168) and forced expiratory volume first second (beta −0.160). Conclusions Gastric bypass surgery was associated with a greater increase in NT-proBNP concentrations than non-surgical weight loss treatment. Reduced AHI was, independent of weight loss, associated with increased NT-proBNP levels and improved dynamic lung volumes and daytime blood gases. Clinical Trial Registration ClinicalTrials.gov NCT00273104, retrospectively registered Jan 5, 2006 (study start Dec 2005)
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Reiseter, Silje; Molberg, Øyvind; Gunnarsson, Ragnar; Lund, May Brit; Aaløkken, Trond Mogens & Aukrust, Pål
[Show all 12 contributors for this article]
(2015).
Associations between circulating endostatin levels and vascular organ damage in systemic sclerosis and mixed connective tissue disease: an observational study.
Arthritis Research & Therapy.
ISSN 1478-6354.
17:231.
doi:
10.1186/s13075-015-0756-5.
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Introduction: Systemic sclerosis (SSc) and mixed connective tissue disease (MCTD) are chronic immune-mediated disorders complicated by vascular organ damage. The aim of this study was to examine the serum levels of the markers of neoangiogenesis: endostatin and vascular endothelial growth factor (VEGF), in our unselected cohorts of SSc and MCTD. Methods: Sera of SSc patients (N = 298) and MCTD patients (N = 162) from two longitudinal Norwegian cohorts were included. Blood donors were included as controls (N = 100). Circulating VEGF and endostatin were analyzed by enzyme immunoassay. Results: Mean endostatin levels were increased in SSc patients 93.7 (37) ng/ml (P < .001) and MCTD patients 83.2 (25) ng/ml (P < .001) compared to controls 65.1 (12) ng/ml. Median VEGF levels were elevated in SSc patients 209.0 (202) pg/ml compared to MCTD patients 181.3 (175) pg/ml (P = .017) and controls 150.0 (145) pg/ml (P < .001). Multivariable analysis of SSc subsets showed that pulmonary arterial hypertension (coefficient 15.7, 95 % CI: 2.2–29.2, P = .023) and scleroderma renal crisis (coefficient 77.6, 95 % CI: 59.3–100.0, P < .001) were associated with elevated endostatin levels. Multivariable analyses of MCTD subsets showed that digital ulcers were associated with elevated endostatin levels (coefficient 10.5, 95 % CI: 3.2–17.8, P = .005). The risk of death increased by 1.6 per SD endostatin increase (95 % CI: 1.2–2.1, P = .001) in the SSc cohort and by 1.6 per SD endostatin increase (95 % CI: 1.0–2.4, P = .041) in the MCTD cohort after adjustments to known risk factors. Conclusions: Endostatin levels were elevated in patients with SSc and MCTD, particularly SSc patients with pulmonary arterial hypertension and scleroderma renal crisis, and MCTD patients with digital ulcers. Elevated endostatin levels were also associated with increased all-cause mortality during follow-up in both groups of patients. We propose that endostatin might indicate the degree of vascular injury in SSc and MCTD patients.
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Bugge, Anders Standal; Naalsund, Anne; Johnsrud, Kjersti; Berstad, Audun Elnæs; Samersaw-Lund, May Brit & Kongerud, Johny
(2014).
PET-CT i utredningen av lungekreft ved Rikshospitalet 2007 - 11.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
134(9),
p. 938–944.
doi:
10.4045/tidsskr.12.1512.
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BAKGRUNN PET-CT er et hjelpemiddel ved utredning av lungekreft for å finne operable pasienter. Undersøkelsen anbefales hos de fleste pasienter med ikke-småcellet lungekreft som etter primærutredning antas å ha kurativ sykdom. Vi ønsket å beregne nytteverdien av PET-CT hos antatt operable pasienter som har fått utført undersøkelsen ved Rikshospitalet.
MATERIALE OG METODE Pasienter innlagt til lungekreftutredning registreres fortløpende i avdelingens kvalitetsdatabase. Vi har analysert data for perioden 2007 – 11 for pasienter som etter primærutredning hadde en antatt operabel tumor. Av kapasitetshensyn ble noen operert uten forutgående PET-CT.
RESULTATER Av 651 antatt operable pasienter ble PET-CT utført hos 533, hvorav 403 (76 %)ble operert. Vi beregnet at undersøkelsen hadde sensitivitet 78 % (95 % KI 70 – 86) og spesifisitet 88 % (95 % KI 85 – 91), positiv prediktiv verdi 64 % (95 % KI 55 – 72) og negativ prediktiv verdi 94 % (95 % KI 91 – 96) for spredning til mediastinale lymfeknuter. Diagnostisk nøyaktighet var 86 % (95 % KI 83 – 89) med kappaoverensstemmelse 0,61 (95 % KI 0,53 – 0,69) mellom
PET-CT og faktiske funn av maligne eller benigne mediastinale lymfeknuter.
FORTOLKNING PET-CT var et nyttig verktøy for utvelgelse av potensielt operable lungekreftpasienter ved Rikshospitalet 2007 – 11. Forutsatt at populasjonen vi undersøker med PET-CT ikke endrer seg, kan pasienter med negativ PET-CT med få unntak henvises direkte til operasjon uten ytterligere invasiv utredning.
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Sikkeland, Liv Ingunn Bjoner; Samersaw-Lund, May Brit & Kongerud, Johny
(2014).
Immunological Analysis of Induced Sputum in Work Exposures.
Journal of Environmental Immunology and Toxicology.
1(4),
p. 183–189.
doi:
10.7178/jeit.10.
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Gabrielsen, Anne Marie; Lund, May Brit; Kongerud, Johny; Viken, Karl Erik; Røislien, Jo & Hjelmesæth, Jøran
(2011).
The Relationship Between Anthropometric Measures, Blood Gases, and Lung Function in Morbidly Obese White Subjects.
Obesity Surgery.
ISSN 0960-8923.
21(4),
p. 485–491.
doi:
10.1007/s11695-010-0306-9.
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Naalsund, Anne; Rostad, Hans; Strøm, Erik Heyerdahl; Lund, May Brit & Strand, Trond-Eirik
(2011).
Carcinoid lung tumors - incidence, treatment and outcomes: a population-based study.
European Journal of Cardio-Thoracic Surgery.
ISSN 1010-7940.
39(4),
p. 565–569.
doi:
10.1016/j.ejcts.2010.08.036.
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Lund, May Brit; Sikkeland, Liv Ingunn Bjoner & Kongerud, Johny
(2009).
Utredning av yrkesastma på ulike nivåer i helsevesenet.
Fagbladet Allergi i praksis.
ISSN 0806-5462.
1,
p. 16–23.
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Lund, May Brit
(2009).
Nitrogenoksid i utåndingsluft: en biomarkør for astma.
Fagbladet Allergi i praksis.
ISSN 0806-5462.
4,
p. 8–12.
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Lund, May Brit; Kongerud, Johny; Nystad, Wenche; Boe, Jacob & Harris, Jennifer
(2007).
Genetic and environmental effects on exhaled nitric oxide and airway responsiveness in a population-based sample of twins.
European Respiratory Journal.
ISSN 0903-1936.
29(2),
p. 292–298.
doi:
10.1183/09031936.00044805.
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Lund, May Brit; Brinch, Lorentz; Kongerud, Johny & Boe, Jacob
(2004).
Lung function 5 yrs after allogeneic bone marrow transplantation conditioned with busulphan and cyclophosphamide.
European Respiratory Journal.
ISSN 0903-1936.
23,
p. 901–905.
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Ulvestad, B. & Lund, May Brit
(2003).
Tunnelarbeid gir økt risiko for kronisk obstruktiv lungesykdom.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
123,
p. 2292–2295.
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Vi ønsket å undersøke forekomst av luftveissymptomer og redusert lungefunksjon hos arbeidstakere eksponert for partikler fra boring, sprengning og dieseleksos.
Materiale og metode. 212 tunnelarbeidere og en referansegruppe på 205 anleggsarbeidere som jobbet utendørs, ble inkludert i en tverrsnittsstudie. Luftveissymptomer og lungefunksjon ble studert i relasjon til antall år utsatt for eksponering, kontrollert for røyking. En subgruppe på 29 ikke-røykende betongarbeidere som hadde arbeidet i et tunnelanlegg i ett år, ble undersøkt med akustisk rhinometri, utåndet NO, spirometri og spørreskjema. Kohorten fra tverrsnittsstudien ble inkludert i en prospektiv studie og undersøkt på nytt etter åtte år.
Resultater. Blant tunnelarbeiderne var prevalensen av kronisk obstruktiv lungesykdom 14 % versus 8 % i referansegruppen. Tunnelarbeiderne hadde et signifikant økt fall i forsert ekspiratorisk volum i ett sekund (FEV1), relatert til antall år utsatt for eksponering. Betongarbeiderne, som kun hadde jobbet ett år ved et tunnelprosjekt, viste økt nivå av utåndet NO og økt grad av nesetetthet målt ved rhinometri sammenliknet med en gruppe som hadde utført samme arbeidsoppgaver utendørs. I den prospektive kohortstudien fant vi et økt fall i FEV1 blant tunnelarbeidere som var assosiert med kumulativ eksponering for respirabelt støv og kvarts.
Fortolkning. Inhalasjon av produksjonsgenerert støv og gass fører til økt risiko for utvikling av kronisk obstruktiv lungesykdom. Sykdommen bør godkjennes som yrkessykdom hos tunnelarbeidere, uavhengig av røykevaner.
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Horni, Guro; Meirik, Kathinka & Lund, May Brit
(2003).
Malignt nevroleptikasyndrom hos pasient behandlet med olanzapin.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
123,
p. 2867–2869.
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Malignt nevroleptikasyndrom er en sjelden, men alvorlig bivirkning ved bruk av antipsykotika. Kliniske kjennetegn er hypertermi, rigiditet, autonom instabilitet og tegn til skjelettmuskelskade. Syndromet var opprinnelig knyttet til bruk av klassiske nevroleptika, men kan også oppstå ved bruk av de nyere antipsykotiske midlene.
Materiale og metode. Vi presenterer en 52 år gammel mann som utviklet malignt nevroleptikasyndrom etter 2 1/2 års behandling med annengenerasjonspreparatet olanzapin.
Resultater. De første 2 - 3 døgn var tilstanden alvorlig og ustabil, og nødvendiggjorde behandling i overvåkingsavsnitt. Ved utskrivning etter 12 døgn var han ikke fullt restituert, men pleiebehovene kunne ivaretas av hjemmebaserte tjenester.
Fortolkning. Malignt nevroleptikasyndrom må mistenkes hos pasienter som behandles med enhver type antipsykotika og som utvikler uforklarlig feber. Tilstanden kan være livstruende og pasienten bør behandles i overvåkingsavsnitt. Antipsykotika skal seponeres. Behandling er primært symptomatisk og inkluderer avkjøling, væsketilførsel, korreksjon av elektrolyttforstyrrelser, arytmiovervåking og hyppig kontroll av nyrefunksjon og kreatinkinasenivå. Medikamentell behandling med dantrolen bør overveies. Mistenkte tilfeller av malignt nevroleptikasyndrom skal meldes som bivirkning. For medikamenter under særlig overvåking, slik som olanzapin, er bivirkningsrapportering spesielt viktig.
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Ulvestad, Bente; Bakke, Berit; Eduard, Wijnand; Kongerud, Johny & Lund, May Brit
(2001).
Cumulative exposure to dust causes accelerated decline in lung function in tunnel workers.
Occupational and Environmental Medicine.
ISSN 1351-0711.
58(10),
p. 663–669.
doi:
10.1136/oem.58.10.663.
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OBJECTIVES To examine whether underground construction workers exposed to tunnelling pollutants over a follow up period of 8 years have an increased risk of decline in lung function and respiratory symptoms compared with reference subjects working outside the tunnel atmosphere, and relate the findings to job groups and cumulative exposure to dust and gases.
METHODS 96 Tunnel workers and a reference group of 249 other heavy construction workers were examined in 1991 and re-examined in 1999. Exposure measurements were carried out to estimate personal cumulative exposure to total dust, respirable dust, α-quartz, oil mist, and nitrogen dioxide. The subjects answered a questionnaire on respiratory symptoms and smoking habits, performed spirometry, and had chest radiographs taken. Radiological signs of silicosis were evaluated (International Labour Organisation (ILO) classification). Atopy was determined by a multiple radioallergosorbent test (RAST).
RESULTS The mean exposure to respirable dust and α-quartz in tunnel workers varied from 1.2–3.6 mg/m3 (respirable dust) and 0.019–0.044 mg/m3 (α-quartz) depending on job task performed. Decrease in forced expiratory volume in 1 second (FEV1) was associated with cumulative exposure to respirable dust (p<0.001) and α-quartz (p=0.02). The multiple regression model predicted that in a worker 40 years of age, the annual decrease in FEV1 would be 25 ml in a non-exposed non-smoker, 35 ml in a non-exposed smoker, and 50–63 ml in a non-smoking tunnel worker (depending on job). Compared with the reference group the odds ratio for the occurrence of new respiratory symptoms during the follow up period was increased in the tunnel workers and associated with cumulative exposure to respirable dust.
CONCLUSIONS Cumulative exposures to respirable dust and α-quartz are the most important risk factors for airflow limitation in underground heavy construction workers, and cumulative exposure to respirable dust is the most important risk factor for respiratory symptoms. The finding of accelerated decline in lung function in tunnel workers suggests that better control of exposures is needed.
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Ulvestad, Bente; Lund, May Brit; Bakke, Berit; Djupesland, PG; Kongerud, Johny & Boe, J
(2001).
Gas and dust exposure in underground construction is associated with signs of airway inflammation.
European Respiratory Journal.
ISSN 0903-1936.
17(3),
p. 416–421.
doi:
10.1183/09031936.01.17304160.
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Exposure to gases and dust may induce airway inflammation. It was hypothesized that heavy construction workers who had been exposed to dust and gases in underground construction work for 1 yr, would have early signs of upper and lower airway inflammation, as compared to outdoor workers. A study group comprising 29 nonsmoking underground concrete workers (mean +/- SD age 44+/-12 yrs), and a reference group of 26 outdoor concrete workers (39+/-12 yrs) were examined by acoustic rhinometry, nasal and exhaled nitric oxide spirometry and a questionnaire on respiratory symptoms. Exposure measurements were carried out. The underground workers had higher exposure to total and respirable dust, alpha-quartz and nitrogen dioxide than the references (p<0.001). The occurrence of respiratory symptoms was higher in the underground workers than in the references (p<0.05). Exhaled nitric oxide (NO) (geometric mean+/-SEM) was higher in the underground workers than in the references (8.4+/-1.09 versus 5.6+/-1.07 parts per billion (ppb), p = 0.001), whereas spirometric values were comparable. The underground workers had smaller nasal cross-sectional area and volume than the references, and more pronounced increases after decongestion (p<0.001). To conclude the exposure in underground construction may cause nasal mucosal swelling and increased levels of exhaled nitric oxide, indicating signs of upper and lower airway inflammation.
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Bakke, Berit; Ulvestad, Bente; Stewart, Patricia; Lund, May Brit & Eduard, Wijnand
(2001).
Effects of blasting fumes on exposure and short-term lung function changes in tunnel construction workers.
Scandinavian Journal of Work, Environment and Health.
ISSN 0355-3140.
27(4),
p. 250–257.
doi:
10.5271/sjweh.612.
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Objectives: This study attempts to determine the effects of exposure to blasting fumes and its influence on the lung function of tunnel workers.
Methods: Two groups of tunnel workers, one using ammonium nitrate fuel oil (ANFO) as the explosive and the other using size-sensitized emulsion (SSE), with 24 workers per group, were compared with a reference group (N=34) with low exposure. Spirometry was used to determine lung function. Personal exposure to total and respirable dust, alpha-quartz, volatile organic compounds, oil mist and vapors, formaldehyde, nitrogen dioxide, and carbon monoxide was measured.
Results: The ANFO workers were more exposed to all the agents than the reference group and more exposed than the SSE workers to all the agents except total dust and carbon monoxide. The SSE workers were significantly more exposed to total dust and alpha-quartz than the reference group. High peak exposures to nitrogen dioxide (up to 20 ppm) occurred for the ANFO workers in contrast to the SSE workers, whose exposure did not exceed 2 ppm. The lung function of the ANFO workers significantly decreased by 3% for forced vital capacity, 7% for forced expiratory volume in 1 second, and 8% for forced expiratory flow rate from 25% to 75% of the forced vital capacity over the 11-day period. The changes were reversible. There were no significant changes among the SSE workers and the outdoor workers. The ANFO workers had a significant decrease in FEV1.0 when compared with both the SSE and outdoor workers.
Conclusions: Tunnel workers using ANFO explosive show a temporary reduction in lung function, whereas those using SSE do not. The most likely explanation for the observed changes is peak exposures to nitrogen dioxide.
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Knobel, Heidi; Loge, Jon Håvard; Lund, May Brit; Forfang, Kolbjørn; Nome, Ole & Kaasa, Stein
(2001).
Late medical complications and fatigue in Hodgkin's disease survivors.
Journal of Clinical Oncology.
ISSN 0732-183X.
19,
p. 3226–3233.
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Ulvestad, B.; Lund, May Brit; Bakke, B.; Djupesland, Per Gisle; Kongerud, Johny & Boe, Jacob
(2001).
Exposure to gases and dust in underground construction work is associated with signs of airway inflammation.
European Respiratory Journal.
ISSN 0903-1936.
17,
p. 416–421.
Full text in Research Archive
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Bakke, B.; Ulvestad, B.; Stewart, P.; Lund, May Brit & Eduard, Wijnand
(2001).
Effects of blasting fumes on exposure and short-term lung function changes in tunnel construction workers.
Scandinavian Journal of Work, Environment and Health.
ISSN 0355-3140.
27,
p. 250–257.
Full text in Research Archive
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Ulvestad, B.; Bakke, B.; Kongerud, Johny & Lund, M. B.
(2001).
Cumulative exposure to dust causes accelerated lung function decline in tunnel workers.
Occupational and Environmental Medicine.
ISSN 1351-0711.
163,
p. 670–677.
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Ulvestad, Bente; Bakke, Berit; Melbostad, Erik; Fuglerud, Per; Kongerud, Johny & Lund, May Brit
(2000).
Increased risk of obstructive pulmonary disease in tunnel workers.
Thorax.
ISSN 0040-6376.
55(4),
p. 277–282.
doi:
10.1136/thorax.55.4.277.
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BACKGROUND Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure.
METHODS Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy.
RESULTS Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV1) % predicted when related to years of exposure. Adjusted FEV1 decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects.
CONCLUSION Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV1, respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.
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Lund, M. B.; Oksne, P.I.; Hamre, Rakel & Kongerud, Johny
(2000).
Increased nitric oxide in exhaled air: an early marker of asthma in non-smokin aluminium potroom workers?
Occupational and Environmental Medicine.
ISSN 1351-0711.
57(4),
p. 274–278.
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Stavem, Knut; Bjørtuft, Øystein; Lund, M. B.; Kongshaug, K.; Geiran, Odd & Boe, Jacob
(2000).
Health-related quality fo life in lung transplant candidates and recipients.
Respiration.
ISSN 0025-7931.
67,
p. 159–165.
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Lund, M. B.; Kongrud, J.; Boe, Jacob; Ihlen, Halfdan; Forfang, Kolbjørn & Abrahamsen, Arne Foss
(1999).
Senkomplikasjoner etter behandling for Hodgkins sykdom.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
119,
p. 933–937.
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Lund, May Brit
(1998).
Måling av nitrogenoksid (NO) i utåndingsluft: en ny lungefunksjonstest ?
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
118,
p. 2021–2024.
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Stenehjem, Jo Steinson; Smeland, Knut Bjøro; Murbræch, Klaus; Holte, Harald; Kvaløy, Stein Olav & Thorsen, Lene
[Show all 9 contributors for this article]
(2015).
Exercise capacity in lymphoma survivors after high-dose chemotherapy with autologous stem cell transplantation: a national cross-sectional study.
Norsk Epidemiologi, Supplement.
ISSN 0803-4206.
25,
p. 28–28.
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Søyseth, Torunn Stavnes; Heldal, Aasta; Haugstad, Gro Killi; Søyseth, Vidar; Bjørtuft, Øystein & Lund, May Brit
(2011).
Anxiety, depression and coping in patients awaiting lung transplantation.
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Gabrielsen, Anne-Marie; Hjelmesæth, K; Viken, KE; Kongerud, Johny & Lund, May Brit
(2008).
The relationship between measures of obesity and arterial blood gases.
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Sikkeland, Liv Ingunn Bjoner; Eduard, W; Stangeland, AM; Skogstad, Anders; Lund, May Brit & Kongerud, Johny
(2008).
Airway Inflammation in Bacterial Protein Production Workers Was Partly Reversed One Year after Cessation of Exposure.
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Tangen, Morten; Lund, May Brit; Bjørge, Trond & Naalsund, Anne
(2007).
Detection of operable lung cancer - a question of sheer luck?
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Brun, Henrik; Holmstrøm, Henrik Alf B; Fredriksen, Per Morten; Matthews, Iren; Lund, May Brit & Thaulow, Erik
(2005).
Behandlingsprogram ved Eisenmenger-syndrom- hvordan måle effekt?
Paidos: Tidsskrift for Norsk barnelegeforening.
ISSN 1503-5360.
p. 10–10.
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Abstrakt fra Norsk Barnelegeforenings høstmøte 2004
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Nystad, Wenche; Lund, M. B.; Kongerud, Johny; Boe, Jacob; Magnus, Per & Harris, Jennifer R.
(2002).
Genetic and environment influences on different atsthma phenotypes.
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Lund, May Brit; Hamre, A.; Bjermer, L & Kongerud, Johny
(2001).
Sputum neutrophilia is correlated with levels of exhaled nitric oxide in patients with chronic, stable sarcoidosis.
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Ulvestad, B.; Bakke, B. & Lund, May Brit
(2001).
Exposure and short-term lung function changes in tunnel construction workers: effects of blastin fumes.
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Ulvestad, B.; Bakke, B.; Eduard, Wijnand; Kongerud, Johny & Lund, May Brit
(2001).
Cumulative exposure to dust causes accelerated lung function decline in tunnel workers.
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Lund, M. B.; Brinch, Lorentz; Evensen, Stein A. & Boe, Jacob
(2000).
Lung function is reduced one year after allogeneic bone marrow transplantation with busulphan and cyclophosphamide, but restored after five years.
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Lund, M. B.; Ulvestad, B.; Fuglerud, P.; Bakke, B. & Boe, Jacob
(2000).
A longitudinal study of lung function in tunnel workers.
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Lund, M. B.; Brinch, Lorentz; Evensen, Stein A.; Kongerud, Johny & Boe, Jacob
(2000).
Lungefunksjonen er redusert det første året etter benmargstransplantasjon, men normalisert etter fem år.
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Ulvestad, B.; Bakke, B.; Eduard, Wijnand; Kongerud, Johny & Lund, M. B.
(2000).
Kumulativ eksponering og fall i lungefunksjon hos anleggsarbeidere, en 8-års oppfølgingsstudie.
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Lund, M. B.; Brinch, Lorentz; Evensen, Stein A.; Kongerud, Johny & Boe, Jacob
(2000).
Lungefunksjonen er redusert det første året etter benmargstransplantasjon, men normalisert etter fem år.
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Lund, May Brit; Smith, Hans-Jørgen; Geiran, Odd; Kongerud, Johny & Boe, Jacob
(1999).
Effect of lung volume reduction surgery on lung areas assessed by dynamic MR imaging.
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Ulvestad, B.; Bakke, B.; Djupesland, Per Gisle; Kongerud, Johny; Boe, Jacob & Lund, M. B.
(1999).
Eksponering for støv og dieseleksos ved tunnelarbeid fører til nesetetthet og økning av nitrogenoxid i ekspirasjonsluft.
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Ulvestad, B.; Lund, May Brit; Djupesland, Per Gisle; Kongerud, Johny & Boe, Jacob
(1999).
Eksponering for støv og NO2 ved tunnelarbeid fører til nesetetthet og økt nitrogenoksid (NO) i utåndingsluft.
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Lund, May Brit; Ulvestad, Bente; Bakke, Berit; Boe, Jacob & Kongerud, Johny
(1999).
Tunnel workers have higher levels of exhaled nitric oxide than outdoor construction workers.
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Lund, May Brit; Hamre, Rakel; Jonsson, A. & Kongerud, Johny
(1999).
Exhaled nitric oxide is not increased in patients with chronic sarcoidosis.
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Stavem, Knut; Bjørtuft, Øystein; Lund, May Brit; Kongshaug, Kirsten; Geiran, Odd & Boe, Jacob
(1999).
Health-related quality of life assessed by two lung-specific questionnaires in lung transplant candidates and recipients.
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Stavem, Knut; Bjørtuft, Øystein; Lund, May Brit; Kongshaug, Kirsten; Geiran, Odd & Boe, Jacob
(1998).
Health-related quality of life in lung-transplant candidates and recipients.
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Lund, May Brit; Øksne, P.I.; Mork, Rakel & Kongerud, Johny
(1998).
Increased nitric oxide (NO) in exhaled air of non-smoking aluminium potroom workers.
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Lund, May Brit; Øksne, P.I.; Mork, Rakel & Kongerud, Johny
(1998).
Nitrogenoksid (NO) i utåndingsluft: en tidlig markør for luftveisinflammasjon hos ikke-røykende elektrolysehallarbeidere?
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Lund, May Brit; Bjørtuft, Øystein; Kongerud, Johny & Geiran, Odd
(1998).
Volumreduserende kirurgi for emfysem ved Rikshospitalet.
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Lund, May Brit; Bjørtuft, Øystein; Kongerud, Johny & Geiran, Odd
(1997).
Lungevolumreduserende kirurgi ved Rikshospitalet: Søknadsbehandling og pasientseleksjon.
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Lund, May Brit; Bjørtuft, Øystein & Kongerud, Johny
(1997).
Lungevolumreduserende kirurgi ved Rikshospitalet: Preliminære resultater.
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Lund, May Brit
(1997).
Pulmonary and cardiac complications after high-dose radiation and/or chemotherapy: A study of patients curatively treated for breast cancer, leukemias and Hodgkin's lymphoma.
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Published
May 25, 2016 10:34 AM
- Last modified
May 25, 2016 10:34 AM
