Leif Johansson

Prevalence of Olfactory Dysfunction: The Skövde Population-Based Study†

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.

Prevalence of nasal polyps in adults: the Skövde population-based study.

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 ≥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.

Clinical relevance of nasal polyps in individuals recruited from a general population-based study

Objective To compare the clinical presentations of individuals with nasal polyps detected by endoscopy in a general population sample with those of patients with nasal polyp disease seeking medical attention. Material and Methods A total of 38 individuals with nasal polyps from a population-based sample were compared with 38 matched controls and a third group consisting of 44 patients who presented to an outpatient clinic with symptoms and diagnosed nasal polyps. Upper and lower airway symptoms were registered. Polyp size, peak nasal inspiratory flow (PNIF), olfactory function and health-related quality of life were measured. Results Compared with the individuals with nasal polyps in the population sample, patients actively seeking medical care for nasal polyposis experienced more symptoms of nasal blockage and an impaired sense of smell, and had more extensive polyps and reduced PNIF. There were equal frequencies of asthma symptoms in these two groups. Compared with the controls, the individuals with nasal polyps in the population sample had a greater frequency of asthma symptoms and aspirin intolerance and also experienced an impaired sense of smell. Conclusion Nasal polyps alone, as seen occasionally, are indicative of airway disease involving the upper and lower respiratory tracts.

Unemployment and Labour Market Policies in the Scandinavian Countries

Looked upon from outside, the Scandinavian welfare states exhibit important similarities with regard to labour market policy. Their governments all do a great deal m response to unemployment and they use the same type of measures for this purpose. Compared with what is regarded as normal in other modern Western nations, large amounts of money and other resources are spent on reducing unemployment or at least the burdens of unem ployment. It may thus seem that there is a Scandinavian model for labour market policy. However, when we take a closer look, we soon find that there are significant differences. The same types of programmes exist m all four countries, but they are applied in very different mixes. The main dividing line to be drawn here is between passive and active measures. We argue that active labour market policies are basically oriented towards commodification of labour power, i.e. the aim is to establish, keep or restore the saleability of labour power m the market. Passive measures, on the other hand, comprise no commodification element, although they are more or less linked to a requirement that recipients take the jobs available in the labour market. However, they generally lessen the pressure upon people to accept job offers from employers and in that sense there is no doubt a decommodifying function. From this perspective we maintain that the Swedish labour market policy contains the clearest element of commodification because it is most pronouncedly oriented towards making labour power saleable in the market. The opposite pole is represented by Denmark, where decommodifying cash benefits play the most important role. Norway and Finland are somewhere in between. For a long time Norway has had very low unemployment and accordingly less strong motives to develop its policy in the one or the other direction, while Finland, although having the reasons, has not put as much emphasis on active measures as Sweden or developed as generous passive measures as Denmark.

Do topical nasal decongestants affect polyps

Conclusions. The hypothesis that decongestants reduce the size of nasal polyps could not be verified. Decongestion is therefore recommended prior to nasal endoscopy, especially in polyp diagnosis, as it does not artificially change the size of the polyps. Objective. The role of nasal decongestants in nasal stuffiness is well established and their action is well known. Decongestants are also used prior to nasal endoscopy to achieve a better view of the nasal cavity in order to diagnose polyps. The question is whether this decongestion invalidates the estimation of polyp size in clinical and scientific practice. The aim of this study was to evaluate possible effects of topical decongestants on polyp extension in patients with nasal polyposis. Material and methods. The effect of the decongestants nafazoline and epinephrine on nasal polyp size was assessed by means of a double-blind, placebo-controlled randomized study. A sensitive endoscopic scoring system, lateral imaging, was used to assess the size and extension of the nasal polyps. Results. No significant effect of decongestion on polyp size could be found for either treatment.

Labor Market Regimes and Patterns of Flexibility: A Sweden-Canada Comparison

tax expenditures, case by case, rather than merely adding them up at full value. I also wished Howard would have pushed further down the path of comparison to ascertain the degree to which America’s tax expenditures constitute a functional equivalent to European spending programs. Finally, tax expenditures differ from social expenditures in mores ways than their ambiguity. Social spending programs are mainly redistributive—not the case for many tax expenditures with social welfare purposes. All the same, Howard’s accomplishment is great. He has written what will surely become the official sourcebook to America’s hidden welfare state. It is difficult to imagine a better guide through the mysteries of the tax code. Howard cuts through the tangle of jargon and official documents with keen reasoning and lucid style. His employment of theories of and analogies to social policy is always resourceful. The Hidden Welfare State shows that scholars concerned with states’ efforts toward economic redistribution evade taxation only at their analytical peril.

Heredity of nasal polyps.

BACKGROUND Nasal polyps is a common disease but little is known about its` pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps. METHODOLOGY Patients with nasal polyps who attended the clinic were recruited to the study and were asked whether they had any close adult relatives (siblings, parents or children). We intended to recruit two relatives per patient, one of each gender, for nasal endoscopy. The prevalence of nasal polyps in these relatives was compared with the prevalence of nasal polyps in a general population. RESULTS During a 4-year period, 368 patients and 410 relatives were recruited to the study. Although we were unable to recruit two close relatives for every patient, we were able to calculate nasal polyp prevalence within families as being 19.2%. Compared with the prevalence of nasal polyps among individuals in a general Swedish population from the same geographical area, the relative risk for polyps among relatives was almost five times higher. CONCLUSION This study strongly indicates that heredity is a factor of importance for development of nasal polyps.

Relative frequencies of symptoms and risk factors among patients with chronic rhinosinusitis with nasal polyps using a case-control study

Abstract Objectives: The aim of this study was to investigate the relative frequency of important symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP), the link between CRSwNP and the lower airways and the importance of smoking in CRSwNP. Method: Three hundred and sixty-eight patients with CRSwNP and 1349 controls were recruited to the study and underwent a structured interview about symptoms from the upper and lower airways, and about smoking habits. Furthermore, all participants were clinically examined using nasal endoscopy. Results: Due to interactions between the outcome variables, a multiple logistic regression model was fitted to the data. Nasal secretions, nasal blockage and impaired sense of smell were symptoms associated with CRSwNP. Furthermore, male gender, increasing age and asthma were also associated with the disease. Current smoking was less frequent among patients with CRSwNP. Conclusion: By comparing symptoms and risk factors of patients with CRSwNP with those of a large population-based control group and testing them in a multiple logistic regression model, we have been able to generate data that address key research interests in CRSwNP.

What Happens With Untreated Nasal Polyps Over Time? A 13-Year Prospective Study

Objectives: Nasal polyps are often seen in ENT practice, but little is known about the pathogenesis and the natural development. Our objective was to follow individuals with untreated nasal polyps prospectively, in terms of polyp size, symptoms, and respiratory function. Methods: Thirty-three individuals, aged 27 to 87 years, with untreated nasal polyps were identified in a population-based study. Peak nasal inspiratory flow, olfactory function, and size of the nasal polyps were examined. Respiratory symptoms were also registered. Follow-up examinations were performed after 6 and 13 years, with change between visits analyzed. Results: Over time, polyp size as well as occurrence of unilateral or bilateral polyps varied without an obvious pattern, with no consistent trends in respiratory function or symptoms. Twenty-one individuals (64%) were still untreated at the 6-year follow-up, and 12 (36%) remained untreated during the whole 13-year follow-up. Dropouts were due mainly to death. Seven individuals (21%) started treatment during the follow-up and had larger polyps and more subjective respiratory symptoms at baseline compared to the untreated group. Conclusion: Nasal polyps found occasionally are often part of a chronic entity but do not necessarily evolve into a more serious condition over time. Treatment should therefore be based on the patients’ subjective problems.