Objectives/Hypothesis Patients with olfactory dysfunction appear repeatedly in ear, nose, and throat practices, but the prevalence of such problems in the general adult population is not known. Therefore, the objectives were to investigate the prevalence of olfactory dysfunction in an adult Swedish population and to relate dysfunction to age, gender, diabetes mellitus, nasal polyps, and smoking habits. Study Design Cross‐sectional, population‐based epidemiological study. Methods A random sample of 1900 adult inhabitants, who were stratified for age and gender, was drawn from the municipal population register of Skövde, Sweden. Subjects were called to clinical visits that included questions about olfaction, diabetes, and smoking habits. Examination was performed with a smell identification test and nasal endoscopy. Results In all, 1387 volunteers (73% of the sample) were investigated. The overall prevalence of olfactory dysfunction was 19.1%, composed of 13.3% with hyposmia and 5.8% with anosmia. A logistic regression analysis showed a significant relationship between impaired olfaction and aging, male gender, and nasal polyps, but not diabetes or smoking. In an analysis of a group composed entirely of individuals with anosmia, diabetes mellitus and nasal polyps were found to be risk factors, and gender and smoking were not. Conclusion The sample size of the population‐based study was adequate, with a good fit to the entire population, which suggests that it was representative for the Swedish population. Prevalence data for various types of olfactory dysfunction could be given with reasonable precision, and suggested risk factors analyzed. The lack of a statistically significant relationship between olfactory dysfunction and smoking may be controversial.
The present data provide normative values for the "Taste Strips" based on over 500 subjects tested.
Previous studies of sleep and breathing suggest an independent association between coronary artery disease (CAD) and obstructive sleep apnoea (OSA) in middle-aged males and females. These studies, however, were criticized because they did not properly adjust for all important confounding factors. In order to better control for the impact of these confounders, a case-control study was performed, matching for age, sex and body mass index (BMI), and additionally adjusting for hypertension, hypercholesterolemia, diabetes mellitus and current smoking.A consecutive selection of 62 patients (44 males and 18 females, mean age 69 yrs, range 44±88 yrs) requiring intensive care for angina pectoris or myocardial infarction at the County Hospital of Skaraborg, Sko Èvde, Sweden, as well as 62 age-, sex-and BMI-matched control subjects without history or signs of heart disease underwent an overnight sleep/ventilatory monitoring study. The time interval between discharge from the intensive care unit and the overnight study ranged between 4 and 21 months.OSA, defined as a Respiratory Disturbance Index (RDI) of $10 . h -1 , was present in 19 CAD patients but only in eight control subjects (p=0.017). Using a univariate logistic regression analysis, current smoking (odds ratio (OR) 8.1, 95% confidence interval (CI) 2.2±29.0), diabetes mellitus (OR 4.2, 95% CI 1.1±16.1) and OSA (OR 3.0, 95% CI 1.2±7.5), but not hypertension (OR 1.5, 95% CI 0.7±3.2) and hypercholesterolaemia (OR 1.8, 95% CI 0.7±4.1) were significantly correlated with CAD. In a multiple logistic regression model, current smoking (OR 9.8, 95% CI 2.6±36.5), diabetes mellitus (OR 4.2, 95% CI 1.1±17.1) and OSA (OR 3.1, 95% CI 1.2±8.3) all remained independently associated with CAD.In summary, these data suggest a high occurrence of obstructive sleep apnoea in middle-aged and elderly patients with coronary artery disease requiring intensive care, which should be taken into account when considering risk factors for coronary artery disease. Eur Respir J 1999; 14: 179±184. Coronary artery disease (CAD) is associated with a high mortality. Male sex, obesity, smoking, diabetes mellitus, hypertension and hypercholesterolemia are all traditionally considered as risk factors for CAD. Obstructive sleep apnoea (OSA) is common in the adult population [1]. A substantial proportion of patients with OSA are overweight [2] and suffer from systemic hypertension [3]. Retrospective studies suggest that untreated OSA is associated with increased mortality [4], which may be due to coexisting cardiovascular morbidity [5]. Previous studies of sleep and breathing in CAD patients suggest an independent association between CAD and OSA in middle-aged males [6,7] and females [8]. These studies [6,7], however, were criticized because they did not properly adjust for all of the important confounding factors [9]. Moreover, it is unclear whether the association between OSA and CAD remains independent when including elderly subjects in the analysis.In order to better control for the impact of t...
Patients with nasal polyps present repeatedly in otorhinolaryngology practices, but the prevalence of nasal polyps in the general population is not known. Our objective was to investigate the prevalence of nasal polyps in an adult Swedish population in relation to age, gender, asthma, and aspirin intolerance. A random sample of 1,900 inhabitants over the age of 20 years, stratified for age and gender, was drawn from the municipal population register in Skövde, Sweden, in December 2000. The subjects were called to clinical visits that included questions about rhinitis, asthma, and aspirin intolerance and examination by nasal endoscopy. In total, 1,387 volunteers (73% of the sample) were investigated. The sample size was adequate, with a good fit to the whole population. The prevalence of nasal polyps was 2.7% (95% confidence interval, 1.9-3.5), and polyps were more frequent in men (2.2 to 1), the elderly (5% at > or = 60 years of age), and asthmatics. Subjective symptoms of aspirin intolerance were not found to correlate with polyps. Nasal polyps were more common in adults than was stated by the a priori estimate. The Skövde population-based study is considered representative for the Swedish population.
The capsaicin provocation test may be a valuable method for showing not only a greater cough sensitivity, but also asthma-like symptoms. The pathophysiology underlying the symptoms may be related to increased sensitivity of free, overactive nerve endings in the respiratory mucosa. Therefore, we suggest that this overreaction in the lower airways be called "sensory hyperreactivity".
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