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  • 1
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  European Archives of Oto-Rhino-Laryngology Vol. 279, No. 5 ( 2022-05), p. 2511-2522
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC, Vol. 279, No. 5 ( 2022-05), p. 2511-2522
    Abstract: Exercise-induced laryngeal obstruction (EILO) is relatively common in young people. Treatment rests on poor evidence; however, inspiratory muscle training (IMT) has been proposed a promising strategy. We aimed to assess laryngeal outcomes shortly after IMT, and to compare self-reported symptoms with a control group 4–6 years later. Methods Two groups were retrospectively identified from the EILO-register at Haukeland University Hospital, Norway; one group had received only information and breathing advice (IBA), and another additionally IMT (IBA + IMT). At diagnosis, all participants performed continuous laryngoscopy during exercise (CLE), with findings split by glottic and supraglottic scores, and completed a questionnaire mapping exercise-related symptoms. After 2–4 weeks, the IBA + IMT-group was re-evaluated with CLE-test. After 4–6 years, both groups were re-assessed with a questionnaire. Results We identified 116 eligible patients from the EILO-register . Response rates after 4–6 years were 23/58 (40%) and 32/58 (55%) in the IBA and IBA + IMT-group, respectively. At diagnosis, both groups rated symptoms similarly, but laryngeal scores were higher in the IBA + IMT-group ( P  = 0.003). After 2–4 weeks, 23/32 in the IBA + IMT-group reported symptom improvements, associated with a decrease of mainly glottic scores (1.7–0.3; P   〈  0.001), contrasting unchanged scores in the 9/32 without symptom improvements. After 4–6 years, exercise-related symptoms and activity levels had decreased to similar levels in both groups, with no added benefit from IMT; however, full symptom resolution was reported by only 8/55 participants. Conclusion Self-reported EILO symptoms had improved after 4–6 years, irrespective of initial treatment. Full symptom resolution was rare, suggesting individual follow-up should be offered.
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1459042-6
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  • 2
    In: Advances in Atmospheric Sciences, Springer Science and Business Media LLC
    Abstract: To quantify the relative contributions of Arctic sea ice and unforced atmospheric internal variability to the “warm Arctic, cold East Asia” (WACE) teleconnection, this study analyses three sets of large-ensemble simulations carried out by the Norwegian Earth System Model with a coupled atmosphere–land surface model, forced by seasonal sea ice conditions from preindustrial, present-day, and future periods. Each ensemble member within the same set uses the same forcing but with small perturbations to the atmospheric initial state. Hence, the difference between the present-day (or future) ensemble mean and the preindustrial ensemble mean provides the ice-loss-induced response, while the difference of the individual members within the present-day (or future) set is the effect of atmospheric internal variability. Results indicate that both present-day and future sea ice loss can force a negative phase of the Arctic Oscillation with a WACE pattern in winter. The magnitude of ice-induced Arctic warming is over four (ten) times larger than the ice-induced East Asian cooling in the present-day (future) experiment; the latter having a magnitude that is about 30% of the observed cooling. Sea ice loss contributes about 60% (80%) to the Arctic winter warming in the present-day (future) experiment. Atmospheric internal variability can also induce a WACE pattern with comparable magnitudes between the Arctic and East Asia. Ice-loss-induced East Asian cooling can easily be masked by atmospheric internal variability effects because random atmospheric internal variability may induce a larger magnitude warming. The observed WACE pattern occurs as a result of both Arctic sea ice loss and atmospheric internal variability, with the former dominating Arctic warming and the latter dominating East Asian cooling.
    Type of Medium: Online Resource
    ISSN: 0256-1530 , 1861-9533
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2024
    detail.hit.zdb_id: 2228064-9
    SSG: 6,25
    SSG: 16,13
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  • 3
    In: Reviews of Geophysics, American Geophysical Union (AGU), Vol. 60, No. 1 ( 2022-03)
    Abstract: Nordic Seas heat loss dominates variability and mean Arctic Ocean heat loss Atlantic water volume and heat transport has increased over the last century consistently with increased wind forcing and heat loss Ocean heat transport anomalies affect Greenland melting, Arctic sea ice, water transformations, and Arctic CO 2 uptake
    Type of Medium: Online Resource
    ISSN: 8755-1209 , 1944-9208
    Language: English
    Publisher: American Geophysical Union (AGU)
    Publication Date: 2022
    detail.hit.zdb_id: 2035391-1
    detail.hit.zdb_id: 209852-0
    detail.hit.zdb_id: 209853-2
    SSG: 16,13
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2022
    In:  Scandinavian Journal of Medicine & Science in Sports Vol. 32, No. 6 ( 2022-06), p. 1041-1049
    In: Scandinavian Journal of Medicine & Science in Sports, Wiley, Vol. 32, No. 6 ( 2022-06), p. 1041-1049
    Abstract: Exercise‐induced bronchoconstriction (EIB) and exercise‐induced laryngeal obstruction (EILO) are the two disorders commonly considered when athletes complain of exertional dyspnea. They are highly different but often confused. We aimed to address this diagnostic challenge and its consequences in elite athletes. Methods We included all athletes competing at national or international level, referred to our institution for workup for EILO during 2013–2016. We diagnosed EILO from video‐recorded laryngoscopy performed during maximal cardiopulmonary treadmill exercise (CLE test). Symptoms and previous diagnostic evaluations were obtained from referral letters and chart reviews. Results Exercise‐induced laryngeal obstruction was diagnosed in 73/101 referred athletes, of whom 70/73 had moderate/severe supraglottic obstruction and 3/73 had primarily glottic obstruction with only minor supraglottic involvement. Of the 73 athletes with EILO, we were able to identify objective tests for asthma in 55 participants, of whom 22 had findings supporting asthma. However, 58/73 had used asthma therapy at some time previously, with current use in 28. Only three reported that asthma medication had improved their exercise‐related breathing problems, two of whom with tests confirming asthma. Treatment for EILO improved breathing problems in all but four. Conclusions Objective testing verified EILO in most of the referred athletes. EILO coexisting with asthma was common, and large proportions had used asthma medication; however, few reported effect on exercise‐related breathing problems. Unexplained persistent exertional dyspnea must not lead to indiscriminate escalation of asthma treatment, but instead incite investigation for EILO, either as a co‐morbidity or as a differential diagnosis.
    Type of Medium: Online Resource
    ISSN: 0905-7188 , 1600-0838
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2025503-2
    SSG: 31
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