No abstract

Summary Background Severe asthma is a considerable challenge for patients, health‐care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study. Objective To describe characteristics and estimate the prevalence of severe asthma in a large adult population‐based asthma cohort followed for 10‐28 years. Methods N = 1006 subjects with asthma participated in a follow‐up during 2012‐14, when 830 (mean age 59 years, 56% women) still had current asthma. Severe asthma was defined according to three internationally well‐known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Programme (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care and were also contacted by telephone to verify treatment adherence. Results The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >90% did not have controlled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma. Conclusions and Clinical Relevance Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4%‐6%, corresponding to approximately 0.5% of the general population.

Changes in both prevalence and risk factor patterns of COPD were observed between surveys. Following a continuing decrease in smoking habits over several decades, a decrease in the prevalence of moderate to severe COPD was observed from 1994 to 2009 in northern Sweden.

Quality of life (QOL) is a concept with no generally accepted definition. Most clinical studies have had an individual approach where demographic and socio-economic population aspects have not been considered. QOL has hardly ever been used in studies of children. In this study QOL is defined as the essential resources of a child population, expressed in external, inter-personal and personal conditions. Both objective conditions and the corresponding subjective perceptions are included. A model for an empirical application is demonstrated on a random sample of 15,000 children in the five Nordic countries. The data were collected in a questionnaire mailed to the families of the children. The QOL was analysed in a normative way, where a base value was defined for each variable and the conditions of the children were compared to a Nordic standard for children's QOL. The results showed that children in the Nordic countries have a high QOL. The differences between the countries were rather small. Children in Sweden had the highest QOL, closely followed by children in Denmark and Norway, while children in Finland were in an intermediate position and the Icelandic children had the lowest QOL, mainly due to a lower level of satisfaction. This study can be considered as a base line study which later can be used in studies of time trends or in comparisons of groups of children such as children with special needs.

BackgroundChildhood obesity may soon be an equally important health threat as undernutrition and infectious diseases. Accurate information about prevalence and risk factors of obesity in children is important for the design of prevention.ObjectiveThe aim of this study was to estimate prevalence of overweight and obesity for preschool children in two Vietnamese areas, one urban and one rural, and to identify risk factors.DesignA cross-sectional study was conducted in urban Dong Da and rural Ba Vi districts, Hanoi, Vietnam. Totally, 2,677 children, 1,364 urban and 1,313 rural, were weighed and measured. Caregivers were interviewed. Background information about children and families was obtained from regular household surveys.ResultsThe prevalence of overweight and obesity combined were 21.1% (95% CI 18.9–23.3) in the urban area and 7.6% (95% CI 6.2–9.2) in the rural. Multiple logistic regression revealed that at the individual level, in both sites, the risk increased with increased child age. The identified urban risk factors were being a boy, consuming large amounts of food, eating fast, and indoor activity less than 2 hours per day. The rural risk factors were frequent consumption of fatty food. At the family level, significant association was found in rural areas with frequent watching of food advertisements on television.ConclusionsOverweight and obesity are emerging problems in Vietnam, particularly in the urban context. Prevention programs should focus on education about healthy eating habits at early preschool age and need to be tailored separately for urban and rural areas since the risk factors differ. Non-healthy food advertisement needs to be restricted.

Previous studies from this laboratory have demonstrated early and progressive alterations in the ST-T period of the fetal and neonatal electrocardiogram in relation to asphyxia. The aims of the present study were to investigate the metabolic background of these hypoxic ECG changes by means of serial myocardial biopsies in fetal lambs, relating these changes to the hypoxic depletion of glycogen, ATP and creatine phosphate stores in the heart and to the altered myocardial performance as measured by heart rate, mean arterial blood pressure, combined cardiac output and max. dP/dt. The experiments were performed on 21 fetal lambs, acutely exteriorized and subjected to graded hypoxia. During hypoxia there was a significant relationship between the degree of changes in the ST-T period according to a scoring system and the depletion of myocardial glycogen and ATP, a highly significant correlation between the rate of myocardial glycogenolysis and the rate of increase in T wave amplitude, and a parallelism between the amount of glycogen available and fetal cardiovascular function. The myocardium was capable of regenerating its glycogen stores under conditions of adequate oxygenation and in the absence of acidosis and hypoglycaemia.

The prevalence of RSP was 7-11%. The prevalence estimates differed more depending on the choice of pre- compared to post-bronchodilator values than on the choice of RSP definition. RSP was, regardless of definition, independently associated with manual work in industry and diabetes with obesity.

The study shows a strong association between COPD and cardiovascular diseases and indicates a strong association between restrictive lung function and heart diseases. Both obstructive and restrictive lung function impairments were common among subjects with heart diseases and vice versa.