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Article ; Online: Chronic rhinosinusitis is associated with non-cystic fibrosis bronchiectasis: A new clinical implication?

Mäntylä, Jarkko / Kauppi, Paula / Toppila-Salmi, Sanna

The Journal of allergy and clinical immunology

2022 Volume 150, Issue 3, Page(s) 592–593

MeSH term(s)	Bronchiectasis ; Chronic Disease ; Fibrosis ; Humans ; Sinusitis/complications
Language	English
Publishing date	2022-07-14
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	121011-7
ISSN	1097-6825 ; 1085-8725 ; 0091-6749
ISSN (online)	1097-6825 ; 1085-8725
ISSN	0091-6749
DOI	10.1016/j.jaci.2022.07.002
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Article: In bronchiectasis, poor physical capacity correlates with poor quality of life.

Mäntylä, Jarkko / Mazur, Witold / Törölä, Tanja / Bergman, Paula / Kauppi, Paula

European clinical respiratory journal

2022 Volume 9, Issue 1, Page(s) 2095104

Abstract: Purpose: Patients with bronchiectasis (BE) who suffer frequent exacerbations are likely to experience negative effects on quality of life (QoL) and require more healthcare utilization. We aimed to discover, in a cohort of Finnish BE patients, those risk ...

Abstract	Purpose: Patients with bronchiectasis (BE) who suffer frequent exacerbations are likely to experience negative effects on quality of life (QoL) and require more healthcare utilization. We aimed to discover, in a cohort of Finnish BE patients, those risk factors that influence QoL. Methods: Non-cystic fibrosis BE patients of a Helsinki University Hospital cohort were examined with high-resolution computed tomography (HRCT) of the chest. They completed a disease-specific quality of life-bronchiectasis (QoL-B) questionnaire in Finnish translation. We considered scores in the lowest quarter (25%) of that QoL-B scale to indicate poor QoL. The bronchiectasis severity index (BSI), FACED score, and modified Medical Research Council (mMRC) dyspnoea scale were used. Results: Overall, of 95 adult BE patients, mean age was 69 (SD ± 13) and 79% were women. From the cohort, 82% presented with chronic sputum production and exacerbations, at a median rate of 1.7 (SD ± 1.6). The number of exacerbations (OR 1.7), frequent exacerbations (≥3 per year) (OR 4.9), high BSI score (OR 1.3), and extensive disease (≥3 lobes) (OR 3.7) were all predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in 1 s (FEV1), and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, with 11.6% classified as severe according to their FACED score. The mMRC dyspnoea score ( Conclusion: The strongest determinants of poor QoL in the cohort of Finnish BE patients were frequent exacerbations, radiological disease severity, and high BSI score. Neither comorbidities nor BE aetiology appeared to affect QoL. Reduced physical capacity correlated with dyspnoea and severe disease. Study registration: University of Helsinki, Faculty of Medicine, 148/16.08.2017.
Language	English
Publishing date	2022-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.1080/20018525.2022.2095104
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Article ; Online: Impact of a digital web-based asthma platform, a real-life study.

Genberg, Emma M / Viitanen, Hilkka T / Mäkelä, Mika J / Kautiainen, Hannu J / Kauppi, Paula M

BMC pulmonary medicine

2023 Volume 23, Issue 1, Page(s) 165

Abstract: Background: Digital health technology (DHT) is a growing area in the treatment of chronic diseases. Study results on DHT's effect on asthma control have been mixed, but benefits have been seen for adherence, self-management, symptoms, and quality of ... ...

Abstract	Background: Digital health technology (DHT) is a growing area in the treatment of chronic diseases. Study results on DHT's effect on asthma control have been mixed, but benefits have been seen for adherence, self-management, symptoms, and quality of life. The aim was to evaluate the impact of an interactive web-based asthma treatment platform on asthma exacerbations and health care visits. Methods: In this real-life study, we retrospectively collected data on adult patients registered on a web-based interactive asthma treatment platform between December 2018 and May 2021. Patients who activated their accounts were active users, and patients who did not were inactive users and considered as controls. We compared the number of exacerbations, total number of exacerbation events defined as the sum of oral corticosteroid (OCS) and antimicrobial courses, emergency room visits, hospitalizations, and asthma-related health care visits before and one year after the registration on the platform. Statistical tests used included the t-test, Pearson's chi-square test and Poisson regression models. Results: Of 147 patients registered on the platform, 106 activated their accounts and 41 did not. The active users had significantly fewer total number of exacerbation events (2.56 per person years, relative decline 0.78, 95% CI 0.6 to 1.0) and asthma-related health care visits (2.38 per person years, relative decline 0.84, 95% CI 0.74 to 0.96) than before registration to the platform, whereas the reductions in health care visits and the total number of exacerbation events were not significant in the inactive users. Conclusions: An interactive web-based asthma platform can reduce asthma-related health care visits and exacerbations when used actively.
MeSH term(s)	Adult ; Humans ; Quality of Life ; Retrospective Studies ; Asthma/drug therapy ; Adrenal Cortex Hormones/therapeutic use ; Internet ; Anti-Asthmatic Agents/therapeutic use
Chemical Substances	Adrenal Cortex Hormones ; Anti-Asthmatic Agents
Language	English
Publishing date	2023-05-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2059871-3
ISSN	1471-2466 ; 1471-2466
ISSN (online)	1471-2466
ISSN	1471-2466
DOI	10.1186/s12890-023-02467-8
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Article ; Online: Are there differences in the patient-reported medication-related problems among asthma and allergy patients? A community pharmacy survey in Finland.

Heikkilä, Juha Markus / Bergman, Paula / Jantunen, Juha / Salimäki, Johanna / Pohjanoksa-Mäntylä, Marika / Kauppi, Paula

BMC public health

2023 Volume 23, Issue 1, Page(s) 1570

Abstract: Background: A medication-related problem is an event involving medication that interferes with desired health outcomes. Those are largely studied among asthma patients, but little is known about medication-related problems among allergy patients. The ... ...

Abstract	Background: A medication-related problem is an event involving medication that interferes with desired health outcomes. Those are largely studied among asthma patients, but little is known about medication-related problems among allergy patients. The objective of this study was to determine the most common patient-reported medication-related problems among asthma patients compared to allergy patients during the self-management of diseases. The other objective was to identify how demographic variables and the received treatment information influence reported problems. Methods: A nationwide survey was conducted in Finnish community pharmacies (n = 785) in September 2016. The survey targeted patients buying prescription medicines for asthma or allergy. Results: Responses were received from 46% of targeted pharmacies from 956 respondents. At least one medication problem was reported by 24% of asthma patients and 12% of allergy patients. The most common problems among asthma patients were having problems taking medicines on time (16%), problems in the administration technique (7%) and in the use of the inhaler (4%). Among allergy patients, 10% reported problems remembering to take medicines on time. Severe asthma and allergy increased the risk for medication-related problems (OR 1.20, 95% CI 1.04-1.40 and OR 1.17, 95% CI 1.0-1.37). A higher age and less education were associated with fewer reported medication-related problems among both patient groups. Conclusions: Asthma patients reported more medication-related problems than allergy patients. Among both investigated patient groups, remembering to take medicines on time was the most common. Health care professionals should educate younger patients but also older and less educated asthma and allergy patients to recognize and, to solve medication-related problems. In addition, severe asthma patients still need medication counseling.
MeSH term(s)	Humans ; Pharmacies ; Finland/epidemiology ; Hypersensitivity ; Asthma/drug therapy ; Asthma/epidemiology ; Surveys and Questionnaires ; Patient Reported Outcome Measures
Language	English
Publishing date	2023-08-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-16423-y
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Article ; Online: Occupational health check-ups and health-promoting programs and asthma.

Hakola, Riina / Leino, Timo / Luukkonen, Ritva / Kauppi, Paula

BMC public health

2020 Volume 20, Issue 1, Page(s) 1313

Abstract: Background: The focus in occupational health check-ups is in work and health, but they offer also a possibility to assess health behavior and give guidance e.g. on weight control. We wanted to study whether having occupational health checks-up, ... ...

Abstract	Background: The focus in occupational health check-ups is in work and health, but they offer also a possibility to assess health behavior and give guidance e.g. on weight control. We wanted to study whether having occupational health checks-up, receiving physicians' advice to change health behavior or participation in health promotion programs had an effect on obesity in a five-year follow-up from 1998 to 2003 in asthmatic and non-asthmatic workers. Methods: Altogether 23,220 individuals aged 20-54 years were picked up from a randomized Finnish population sample. Univariate and multivariate logistic regression analysis was used to calculate the risk for obesity in 2003. The variables used in the modelling were gender, age, smoking, asthma, depression, and physical workload. Results: Both asthmatic and non-asthmatic workers gained weight during the follow-up. Of the asthmatics 48 and 47% of the non-asthmatics had occupational health-check-up in the last 5 years. Of the asthmatics 18 and 14% of the non-asthmatics had received physician's advice to change their health behavior (p < 0.001). Associated factors for obesity (BMI > 30) in 2003 were gender (men OR 1.19), older age (OR 1.25), smoking (OR 1.07) or depression (OR 1.44). Conclusions: Results show that having occupational health checks-up or receiving physicians' advice to change health behavior or participation in health promotion programs did not stop gain of weight during a five-year follow-up. Asthmatic workers did not differ from non-asthmatics. Male gender, older age, smoking, and depression were associated with obesity but not the physical workload.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asthma/epidemiology ; Asthma/prevention & control ; Depressive Disorder/epidemiology ; Depressive Disorder/prevention & control ; Female ; Finland/epidemiology ; Health Behavior ; Health Promotion/methods ; Humans ; Male ; Middle Aged ; Obesity/epidemiology ; Obesity/prevention & control ; Occupational Health ; Prevalence ; Regression Analysis ; Risk Assessment/statistics & numerical data ; Sex Factors ; Smoking Prevention/methods ; Workload/psychology ; Young Adult
Language	English
Publishing date	2020-08-31
Publishing country	England
Document type	Comparative Study ; Journal Article
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/s12889-020-09403-z
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Article ; Online: Effectiveness of inhalation technique assessment service for patients with Respimat® inhaler.

Rossi, Vilma / Salimäki, Johanna / Sandler, Charlotta / Airaksinen, Marja / Kauppi, Paula

Pulmonary pharmacology & therapeutics

2021 Volume 71, Page(s) 102077

Abstract: Objectives: The objective of this study was to examine how Inhalation Technique Assessment Service (ITAS) by community pharmacies affect patients' inhalation techniques when using the Respimat® soft mist inhaler. The inhaler was simultaneously updated ... ...

Abstract	Objectives: The objective of this study was to examine how Inhalation Technique Assessment Service (ITAS) by community pharmacies affect patients' inhalation techniques when using the Respimat® soft mist inhaler. The inhaler was simultaneously updated into a reusable inhaler. The study focused on the Respimat® inhaler because its use is known to be challenging for patients. Methods: The study was performed as a pre-post design in 33 community pharmacies (CPs) in Finland. Patients' inhalation technique was assessed before ITAS (baseline) and immediately after ITAS (follow-up 1). Follow-up 2 was performed when the patient came to the pharmacy for a refill (1-3 months after the baseline and the follow-up 1). A Respimat specific twenty item checklist was used to assess inhalation technique. The checklist included 1) preparation steps before the first use of the Respimat® inhaler (8 items) and 2) daily use steps of the Respimat® inhaler (12 items). After ITAS, the patients received a brief questionnaire to assess their asthma/COPD history. Results: A total of 228 patients were enrolled at the first visit (mean age 67.8 years, 61.0% female, 85.5% had previous Respimat® use experience) and 42 of them attended the follow-up 2, 1-3 months later (mean age 70.1 years, 69.0% female, 92.9% had previous Respimat® use experience. The median number of the steps performed correctly increased from 17/20 at the baseline to all the 20 steps at the follow-up 1 (p < 0.001). At the baseline, 27.6% of the patients (n = 228) performed all preparation steps correctly, while 87.3% at the follow-up 1 and 71.4% at the follow-up 2. The percentage of the patients with acceptable inhalation technique (all critical daily use steps correct) increased from 69.7% at the baseline to 93.0% at the follow-up 1 (p < 0.001). The corresponding figure at the follow-up 2 was 69.0%. At the baseline, 30.3% of patients had optimal inhalation technique (all daily use steps correct). At the follow-up 1 corresponding figure was 85.1%, and 54.8% at the follow-up 2. Conclusions: A pharmacist-led intervention significantly improved asthma and COPD patients' inhalation technique with the Respimat® inhaler. Significant improvements were found in the daily use steps and the preparation steps before the first use.
MeSH term(s)	Administration, Inhalation ; Aged ; Asthma/drug therapy ; Bronchodilator Agents/therapeutic use ; Female ; Humans ; Male ; Nebulizers and Vaporizers ; Pulmonary Disease, Chronic Obstructive/drug therapy
Chemical Substances	Bronchodilator Agents
Language	English
Publishing date	2021-09-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1399707-5
ISSN	1522-9629 ; 1094-5539
ISSN (online)	1522-9629
ISSN	1094-5539
DOI	10.1016/j.pupt.2021.102077
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Article ; Online: The continuous laryngoscopy exercise test in severe or in difficult-to-treat asthma in adults: a systematic review.

Thomander, Tuuli / Malmberg, L Pekka / Toppila-Salmi, Sanna / Aaltonen, Leena-Maija / Kauppi, Paula

The Journal of asthma : official journal of the Association for the Care of Asthma

2022 Volume 60, Issue 1, Page(s) 1–10

Abstract: Objective: A systematic review was performed to determine if the continuous laryngoscopy exercise test (CLE) has been used in the diagnostics of exercise dyspnea in adults with asthma, and whether inducible laryngeal obstruction (ILO) is found in those ... ...

Abstract	Objective: A systematic review was performed to determine if the continuous laryngoscopy exercise test (CLE) has been used in the diagnostics of exercise dyspnea in adults with asthma, and whether inducible laryngeal obstruction (ILO) is found in those with asthma or with severe or difficult-to-treat asthma. Data sources: We used Scopus and PubMed databases. The articles published up to 13 August 2019 were considered. Study selections: We excluded manuscripts that did not contain information about adult patients with asthma. We included six studies from 59 search results in Scopus and none from the 17 search results in PubMed. Results: The articles included 455 study individuals. Of these, 229 (50.3%) had diagnosed asthma or were treated with asthma medication. Altogether 31/229 (13.5%) subjects with diagnosis of asthma or previous asthma treatment had exercise-induced laryngeal obstruction (EILO) as comorbidity. The CLE test was performed on 229 patients with asthma. The method was used only for differential diagnosis of exercise-induced dyspnea to confirm EILO. At least 10/455 (2.2%) out of the 455 subjects experienced adverse events. Conclusions: This systematic review revealed that only a small proportion of patients with asthma had undergone the CLE test to assess exercise-induced dyspnea. None of the selected manuscripts reported severity of asthma. Whether CLE provides a valuable diagnostic tool for patients with severe or difficult-to-treat asthma cannot be determined according to this review.
MeSH term(s)	Humans ; Adult ; Asthma/diagnosis ; Laryngoscopy/methods ; Exercise Test ; Airway Obstruction/diagnosis ; Laryngeal Diseases/diagnosis ; Dyspnea/diagnosis ; Asthma, Exercise-Induced/diagnosis
Language	English
Publishing date	2022-02-06
Publishing country	England
Document type	Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.1080/02770903.2022.2029481
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Article ; Online: Mortality of asthma, COPD, and asthma-COPD overlap during an 18-year follow up.

Mattila, Tiina / Vasankari, Tuula / Kauppi, Paula / Mazur, Witold / Härkänen, Tommi / Heliövaara, Markku

Respiratory medicine

2022 Volume 207, Page(s) 107112

Abstract: Background: We studied asthma, COPD, and asthma-COPD overlap (ACO) to predict mortality in a cohort of Finnish adults with an 18-year follow up.: Methods: A national health examination survey representing Finnish adults aged ≥30 years was performed ... ...

Abstract	Background: We studied asthma, COPD, and asthma-COPD overlap (ACO) to predict mortality in a cohort of Finnish adults with an 18-year follow up. Methods: A national health examination survey representing Finnish adults aged ≥30 years was performed in 2000-2001. The study cohort included 5922 participants (73.8% of the sample) with all relevant data, including a comprehensive clinical examination and spirometry. These participants were followed continuously from baseline until end of 2018 for total, cardiovascular, cancer, and respiratory mortality through a record linkage. Asthma, COPD, and ACO were defined based on the survey data, including spirometry and register data. There were three separate groups of obstructive subjects (one definition excluding the others). Results: Asthma and COPD were significantly associated with higher total mortality in Cox's model adjusted for sex, age, smoking, education level, BMI, leisure time physical activity, cardiovascular disease, diabetes, and hypertension. Hazard ratios (HR) (95% confidence interval [CI]) for asthma, COPD, and ACO were 1.29 (1.05-1.58), 1.50 (1.20-1.88), and 1.26 (0.97-1.65), respectively. Additionally, asthma (HR 1.47, 95% CI 1.09-1.97) and COPD (HR 1.53, 95% CI 1.08-2.16) were associated with cardiovascular mortality. Although ACO did not predict mortality in the whole cohort, there was a significant association with mortality risk among those with hs-CRP 1-2.99 mg/l. Conclusions: Asthma or COPD predicts higher total mortality and premature death from cardiovascular diseases.
MeSH term(s)	Adult ; Humans ; Asthma ; Cardiovascular Diseases ; Diabetes Mellitus ; Follow-Up Studies ; Lung ; Pulmonary Disease, Chronic Obstructive ; Finland
Language	English
Publishing date	2022-12-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2022.107112
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Article ; Online: Occupational exposure to vapors, gasses, dusts, and fumes in relation to causes of death during 24 years in Helsinki, Finland.

Jalasto, Juuso / Luukkonen, Ritva / Lindqvist, Ari / Langhammer, Arnulf / Kankaanranta, Hannu / Backman, Helena / Rönmark, Eva / Sovijärvi, Anssi / Piirilä, Päivi / Kauppi, Paula

International archives of occupational and environmental health

2023 Volume 97, Issue 2, Page(s) 145–154

Abstract: Purpose: Environmental particulate matter (PM) exposure has been shown to cause excess all-cause and disease-specific mortality. Our aim was to compare disease-specific mortality by estimated occupational exposure to vapors, gasses, dusts, and fumes ( ... ...

Abstract	Purpose: Environmental particulate matter (PM) exposure has been shown to cause excess all-cause and disease-specific mortality. Our aim was to compare disease-specific mortality by estimated occupational exposure to vapors, gasses, dusts, and fumes (VGDF). Methods: The data source is the Helsinki part of the population-based FinEsS study on chronic obstructive pulmonary diseases including information on age, education level, main occupation, sex, and tobacco smoking combined with death registry information. We compared estimated VGDF exposure to mortality using adjusted competing-risks regression for disease-specific survival analysis for a 24-year follow-up. Results: Compared to the no-exposure group, the high occupational VGDF exposure group had sub-hazard ratios (sHR) of 1.7 (95% CI 1.3-2.2) for all cardiovascular-related and sHR 2.1 (1.5-3.9) for just coronary artery-related mortality. It also had sHR 1.7 (1.0-2.8) for Alzheimer's or vascular dementia-related mortality and sHR 1.7(1.2-2.4) for all respiratory disease-related mortality. Conclusion: Long-term occupational exposure to VGDF increased the hazard of mortality- to cardiovascular-, respiratory-, and dementia-related causes. This emphasizes the need for minimizing occupational long-term respiratory exposure to dust, gasses, and fumes.
MeSH term(s)	Humans ; Dust/analysis ; Cause of Death ; Finland/epidemiology ; Occupational Diseases/etiology ; Occupational Exposure/adverse effects ; Occupational Exposure/analysis ; Pulmonary Disease, Chronic Obstructive/etiology ; Gases/analysis ; Risk Factors
Chemical Substances	Dust ; Gases
Language	English
Publishing date	2023-12-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	129038-1
ISSN	1432-1246 ; 0340-0131 ; 0367-9977
ISSN (online)	1432-1246
ISSN	0340-0131 ; 0367-9977
DOI	10.1007/s00420-023-02031-1
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Article ; Online: Long-term clinical outcome of oral immunotherapy in adults with milk, peanut, and egg allergy: A pilot study.

Thomander, Tuuli / Toppila-Salmi, Sanna / Palosuo, Kati / Voutilainen, Helena / Kukkonen, Kaarina / Pallasaho, Paula / Kauppi, Paula

The journal of allergy and clinical immunology. In practice

2023 Volume 12, Issue 3, Page(s) 776–778.e2

MeSH term(s)	Adult ; Humans ; Animals ; Egg Hypersensitivity/therapy ; Milk ; Arachis ; Pilot Projects ; Allergens/therapeutic use ; Immunotherapy ; Peanut Hypersensitivity/drug therapy ; Administration, Oral ; Desensitization, Immunologic
Chemical Substances	Allergens
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2023.10.047
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