Diseases with oral manifestations among adult asthmatics in Finland : a population-based matched cohort study

Objectives Many comorbidities are associated with adult asthma and may exacerbate the asthma burden of disease. This study aims to investigate the risk for major oral diseases or oral-manifesting diseases in asthmatic compared with non-asthmatic adults. Design We conducted a population-based matched cohort study with a 13.8-year follow-up. Setting A baseline questionnaire was completed by participants in 1997 and follow-up data were extracted from the national hospital discharge registry of the National Institute for Health and Welfare in Finland from 1997 to 2014. Participants A total of 1394 adults with asthma were matched with 2398 adults without asthma based on sex, age and area of residence. Asthmatic adults were identified from the Drug Reimbursement Register of the Finnish Social Insurance Institution based on a special drug reimbursement right resulting from asthma. Participants without asthma were identified from the Population Register. Main outcomes and measures Oral health-related primary diagnoses were retrieved using codes from the International Classification of Diseases, 10th edition and divided into groups of diseases. Cox's proportional hazards models stratified by matching unit and models matched and adjusted for pack-years, education level and body mass index (when possible) were used to evaluate the matched and further adjusted HRs for diseases comparing asthmatic and non-asthmatic cohorts. Results Adult asthma was associated with a higher risk for any oral-manifesting disease (adjusted HR 1.41, 95% CI 1.11 to 1.80), herpes zoster (adjusted HR 6.18, 95% CI 1.21 to 31.6), benign tumours of the oral cavity and pharynx (matched HR 1.94, 95% CI 1.05 to 3.56) and dermatological diseases (pemphigus, pemphigoid, dermatitis herpetiformis, psoriasis and lichen planus, HR 1.67, 95% CI 1.01 to 2.78). Conclusions In this study, adult asthmatics experienced a higher risk for a major oral disease or oral-manifesting disease.Peer reviewe

Risk factors for severe adult-onset asthma : a multi-factor approach

Background The aim was to identify risk factors for severe adult-onset asthma. Methods We used data from a population-based sample (Adult Asthma in Finland) of 1350 patients with adult-onset asthma (age range 31-93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma and asthma symptoms causing much harm and regular impairment and >= 1 oral corticosteroid course/year or regular oral corticosteroids or waking up in the night due to asthma symptoms/wheezing >= a few times/month. Sixteen covariates covering several domains (personal characteristics, education, lifestyle, early-life factors, asthma characteristics and multiple morbidities) were selected based on the literature and were studied in association with severe asthma using logistic regressions. Results The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, a low education level, no professional training, ever smoking, >= 2 siblings, >= 1 chronic comorbidity and non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD) (p = 2 siblings (2.51 [1.17-5.41]). There was a dose-response effect of the total sum of these five factors on severe asthma (OR [95% CI] = 2.30 [1.81-2.93] for each one-unit increase in the score). Conclusions Male sex, smoking, NERD, comorbidities, and >= 2 siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be cumulative; each additional risk factor gradually increases the risk of severe asthma.Peer reviewe

Season of birth affects the risk of adult-onset asthma in Finland

Non peer reviewe

Higher mortality of adults with asthma : a 15-year follow-up of a population-based cohort

Astmaa sairastavilla aikuisilla havaittiin suurentunut kokonaiskuolleisuus verrattuna kaltaistettuihin verrokkihenkilöihin. Tutkimuksessa käytettiin vuonna 1997 tehtyä kyselytutkimusta, jossa kartoitettiin aikuisiän astmaan liittyviä riskitekijöitä kuten esimerkiksi ammattia, tupakointia, lapsuuden elinympäristöä ja lemmikkieläimiä. Kyselytutkimusta täydennettiin Tilastokeskuksen keräämillä kuolinsyyrekisteritiedoilla yli 15 vuoden ajalta. Tutkimukseen osallistui 1052 yli 30-vuotiasta astmaatikkoa ja 1889 sukupuolen, iän ja asuinpaikan mukaan kaltaistettua verrokkia. Kuolleisuutta ja kuolinsyytä selittävissä malleissa ryhmien välillä vakioitiin ikä, sukupuoli, tupakointi, painoindeksi ja koulutustaso. Keskimäärin 15,6 vuoden pituisena seuranta-aikana astmaa sairastavista aikuisista kuoli 221 ja verrokeista 335 henkilöä. Astmaa sairastavilla oli suurentunut kokonaiskuolleisuus (vakioitu HR 1.25; 95% CI 1.05-1.49, P=0.011). Sydän- ja verisuonisairaudet olivat yleisin kuolinsyy molemmissa ryhmissä, mutta astmaa sairastavien ja verrokkien välillä ei ollut tilastollisesti merkitsevää eroa sydänkuolleisuudessa (vakioitu HR 1.23, 0.93–1.63, P=0.145). Kuolinsyinä keuhkoahtaumatauti (vakioitu HR 12.0, 4.18–34.2, P<0.001) ja hengityselinten syövät (vakioitu HR 2.35, 1.25–4.42, P=0.008) olivat yleisempiä astmaatikoilla. Astmaa sairastavilla tupakointi ja vaikeat astmaoireet olivat yhteydessä lisääntyneeseen kuolemanriskiin ja allerginen nuha ja/tai silmätulehdus vähentyneeseen kuolemanriskiin. Verrokeilla tupakointi ja ylipaino lisäsivät yleistä kuolleisuutta, kun taas naissukupuoli vähensi kuolleisuusriskiä. Tupakoinnin lopettaminen alentaa kokonaiskuolleisuutta sekä astmaa sairastavilla että astmaa sairastamattomilla. Allerginen nuha ja/tai silmätulehdus liittyy alentuneeseen kuolleisuuteen vain astmaa sairastavilla, mikä saattaa johtua tupakoimattomuudesta tai vähemmän letaalista allergisesta astmatyypistä

Photoinduced energy and charge transfer in layered porphyrin-gold nanoparticle thin films

In thin films of porphyrin (H2P) and gold nanoparticles (AuNPs), photoexcitation of porphyrins leads to energy and charge transfer to the gold nanoparticles. Alternating layers of porphyrins and octanethiol protected gold nanoparticles (dcore ∼3 nm) were deposited on solid substrates via the Langmuir-Schäfer method, forming bilayer films denoted as H 2P/AuNP. Photoinduced electron transfer from the gold nanoparticle layer to the porphyrin layer was observed as a distinct photovoltage response of the H2P/AuNP film when studied via the time-resolved Maxwell displacement charge (TRMDC) method. Time-resolved fluorescence and absorption measurements of the H2P/AuNP film demonstrated a significant reduction of the lifetime of the excited singlet state of porphyrin caused by the gold nanoparticles. Transients of the charge transfer reaction were not observed in the time-resolved absorption measurements, which indicates that the quantum yield of the charge transfer is low in the H2P/AuNP film. Energy transfer from the excited singlet state of porphyrin to the gold nanoparticles is the main deactivation path of excited porphyrins in the H 2P/AuNP film. The critical distance of the energy transfer was estimated to be 6.4 nm, based on the dependence of fluorescence quenching on the distance between the porphyrin and gold nanoparticle layers

Photoinduced energy and charge transfer in layered porphyrin-gold nanoparticle thin films

In thin films of porphyrin (H2P) and gold nanoparticles (AuNPs), photoexcitation of porphyrins leads to energy and charge transfer to the gold nanoparticles. Alternating layers of porphyrins and octanethiol protected gold nanoparticles (dcore ∼3 nm) were deposited on solid substrates via the Langmuir-Schäfer method, forming bilayer films denoted as H 2P/AuNP. Photoinduced electron transfer from the gold nanoparticle layer to the porphyrin layer was observed as a distinct photovoltage response of the H2P/AuNP film when studied via the time-resolved Maxwell displacement charge (TRMDC) method. Time-resolved fluorescence and absorption measurements of the H2P/AuNP film demonstrated a significant reduction of the lifetime of the excited singlet state of porphyrin caused by the gold nanoparticles. Transients of the charge transfer reaction were not observed in the time-resolved absorption measurements, which indicates that the quantum yield of the charge transfer is low in the H2P/AuNP film. Energy transfer from the excited singlet state of porphyrin to the gold nanoparticles is the main deactivation path of excited porphyrins in the H 2P/AuNP film. The critical distance of the energy transfer was estimated to be 6.4 nm, based on the dependence of fluorescence quenching on the distance between the porphyrin and gold nanoparticle layers

Synthesis and time-resolved fluorescence study of porphyrin-functionalized gold nanoparticles

Free-base porphyrins with two thioacetate terminated linkers in different positions on the porphyrin molecule were synthesized and attached to tetraoctylammonium bromide (TOABr) stabilized gold nanoparticles with a core diameter of 5 nm. The different positions of the linkers affect the stability of the functionalized gold nanoparticles and have an effect on the packing density of the molecules on the nanoparticle surface. However, the intended control of the orientation of the porphyrin molecules relative to the gold nanoparticle surface is not well achieved with the chosen linkers. Fluorescence of the porphyrins is observed to be strongly quenched after the attachment to the nanoparticles. Fluorescence lifetimes of the porphyrin-functionalized gold nanoparticles were determined with the up-conversion method to be very short, 3-5 ps. The short fluorescence lifetimes indicate efficient energy transfer to the gold cores