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'Obesity paradox': Extra weight linked to better outcomes for septic shock, asthma exacerbation

2012-10-22
Although obesity is linked to a variety of health risks, new research indicates that obese patients may have an advantage over nonobese patients in certain health situations, including septic shock and acute asthma exacerbation. In two separate studies presented at CHEST 2012, the annual meeting of the American College of Chest Physicians, researchers compared outcomes in obese (BMI >30) vs nonobese patients with either septic shock or acute asthma exacerbation. Results showed that, although obese patients with asthma are more at risk for asthma exacerbations, near ...

Secondhand smoke in cars, bars impairs breathing within 20 minutes

2012-10-22
Heavy concentrations of secondhand smoke, such as those found in smoke-filled bars and cars, can lead to airway restriction for bystanders within minutes of exposure. The study, presented at CHEST 2012, the annual meeting of the American College of Chest Physicians, showed that after 20 minutes of exposure to highly concentrated secondhand smoke, participants experienced near immediate physiologic changes, including airway resistance and impedance. "Bars and cars are places where high concentrations of fine particles usually occur because of smoking. Nonsmokers are then ...

5-question survey may increase COPD diagnoses

2012-10-22
A simple, five-question patient-administered survey (COPD-PS) may lead to increased diagnoses of chronic obstructive pulmonary disease (COPD). Researchers from David Geffen School of Medicine at UCLA, Olmsted Medical Center, Boehringer-Ingelheim Pharmaceuticals Inc , and Pfizer Inc, randomized 9,704 patients with no prior COPD diagnosis from US primary care practices in seven states into three groups based on treatment: Arm 1: COPD-PS plus spirometry; Arm 2: COPD-PS alone; Arm 3: usual care. Results showed that the rate of new COPD diagnoses within 8 weeks of visit 1 was ...

College education and moderate alcohol intake linked to lower COPD risk

2012-10-22
College education and alcohol consumption may be linked to risk for chronic obstructive pulmonary disease (COPD). Researchers from Kaiser Permanente Medical Group in Oakland, California, followed 126,019 people who supplied baseline data from 1978 – 1985 through 2008 with analyses of hospitalizations attributed to COPD (emphysema, chronic bronchitis, or chronic airway obstruction). Although cigarette smoking, increasing age, and history of respiratory disease/symptoms were powerful predictors of COPD, results also showed that Asian Americans (vs whites) and college graduates ...

Critical care ultrasound training can improve physician trainee knowledge and skills

2012-10-22
A dedicated critical care ultrasound (CCUS) training program could help improve physician trainees' knowledge and skills at the bedside. Researchers from the University of North Carolina implemented a dedicated CCUS curriculum for critical care fellows consisting of didactic/bedside sessions. Participants completed surveys prior to and following the program to assess confidence in ultrasonography knowledge and skills, as well as their perception as to training effectiveness. The preintervention knowledge/bedside image acquisition scores were 71.4%and 31.5%, while ...

24-hour ICU in-house staff intensivist improves mortality and decreases length of stay

2012-10-22
The implementation of a 24-h ICU in-house staff intensivist coverage was associated with improved mortality rates and reduced length of stay, along with quicker decision-making and a positive trend in quality of end-of-life care. In two separate studies, researchers analyzed outcomes data prior to and after the implementation of the 24-h intensivist staffing model. Both studies showed significant improvements after the staffing change, including reduced mortality rates, decreased length of stay by nearly a half day, as well as improved decision-making and improved quality ...

Excessive ICU noise may harm patients

2012-10-22
New research shows that overnight noise levels in the medical ICU (MICU) often exceed recommended levels, which could potentially lead to worse outcomes. Researchers from Yale University School of Medicine reviewed 70 MICU patient charts and recorded in-room activities between midnight and 4:00 AM. Based on this chart review and via direct observation, they also identified the key elements of nocturnal patient disruption. Results showed significant in-room activity (ie, vital sign recording) and sound level maximums that exceeded 83 dB(C) every hour between midnight ...

Outpatient urological surgery costs significantly less when performed in physician offices & ACCs

2012-10-22
Philadelphia, PA, October 22, 2012 – More and more outpatient surgical procedures are being done at nonhospital-based facilities such as freestanding ambulatory surgical centers and physician offices, instead of at hospital-based outpatient departments. A new study comparing the cost to Medicare of 22 urological surgical procedures performed in each setting has found that ambulatory surgery centers and physician offices are less costly than hospitals. The results are published in the December issue of The Journal of Urology. "Our findings indicate that for comparable ...

Chinese herbs show promise for lung cancer, flu, and idiopathic pulmonary fibrosis

2012-10-22
Chinese herbs, including JHQG, BFXL, and BFHX, may show significant benefits for patients with non-small cell lung cancer (NSCLC), idiopathic pulmonary fibrosis (IPF), and influenza. In three separate studies, researchers from China Academy of Chinese Medical Science in Beijing analyzed the health benefits of Chinese herbs on patients with NSCLC, IPF, and seasonal influenza. Researchers found that JHQG helped to prolong survival in patients with metastatic NSCLC compared with patients receiving standard care; was safe and effective in the management of IPF and could also ...

Chest band may relieve a chronic cough

2012-10-22
A soft, extendible band fitted around the chest may help to relieve cough in patients with persistent dry cough. Over the course of 1 year, Japanese researchers evaluated the antitussive effect of the chest band worn for 8 hours a day in 56 patients with chronic cough due to a variety of conditions. Results showed that 88% (n=49) of patients improved their cough scores, and 59% (n=33) were able to reduce the cough. Researchers conclude that soft chest band therapy for intractable, prolonged, and chronic cough is a safe and effective therapy. This study was presented during ...

New antidote for smoke-related cyanide toxicity shows promise

2012-10-22
Smoke inhalation is the major cause of death in fire victims due to cyanide poisoning. However, new research presented at CHEST 2012, the annual meeting of the American College of Chest Physicians, shows that a new antidote, cobinamide, may help reverse the effects of cyanide toxicity. Researchers from multiple institutions, including the University of California Irvine Medical Center, exposed six ventilator-supported New Zealand white rabbits to cold smoke breaths until toxic carbon monoxide levels were achieved, concurrent with intravenous cyanide infusion. Intravenous ...

Mold exposure at home could increase risk for sarcoidosis

2012-10-22
People who are exposed to mold in their homes could be at an increased risk for sarcoidosis, a chronic inflammatory lung disease. Researchers from Sweden and Slovenia tested 62 nonsmoking patients with sarcoidosis, 34 of whom had extrapulmonary manifestations (EPM). Patients were tested for β-glucan, an immune-modulating agent found in fungi, and accompanying inflammatory biomarkers, including interleukin (IL)-6, IL-10, and IL-12. Serum samples were also obtained from 18 control subjects with no pulmonary disease or respiratory symptoms. Results showed that levels ...

Statins may help prolong survival in NSCLC resection

2012-10-22
Patients who have undergone resection for non-small cell lung cancer (NSCLC) may improve their overall survival and reduce the risk of recurrence by taking statins. Researchers from Northwestern University Feinberg School of Medicine, Chicago, and Penn State Hershey Cancer Institute followed 803 patients who underwent resection for NSCLC, of which 315 were using statins. Results showed that statin use was associated with a significantly lower local recurrence rate and significantly higher overall survival compared with non-statin users. Researchers conclude that prospective ...

Excessive daytime sleepiness common in high school students

2012-10-22
New research shows that high school students experience excessive daytime sleepiness (EDS), with most students sleeping fewer than 7 hours per night. Researchers from West Virginia University surveyed 141 high school students, of which 28.4% were either obese or overweight. Overall, 39% of the students surveyed experienced EDS with an Epworth Sleepiness Scale (ESS) of >10, and were more likely to report perception of inadequate or nonrefreshing sleep than those with ESS < 10. However, the duration of sleep was less than 7 hours per night in both groups. There was no difference ...

More GI bleeding seen in atrial fibrillation patients on rivaroxaban than warfarin

2012-10-22
Patients with atrial fibrillation (AF) experienced more major and non-major clinically relevant GI bleeding when taking rivaroxaban than patients taking warfarin. As part of the ROCKET AF trial, researchers from multiple institutions, including Harvard Medical School; Mount Sinai Medical Center; Janssen Research & Development; and Bayer HealthCare Pharmaceuticals, randomized 14,264 patients with nonvalvular AF to receive either rivaroxaban or dose-adjusted warfarin. Post-hoc analysis was performed on all patients while receiving study medication until 2 days after the last ...

Difficulty breathing, chest pain, and cough key symptoms for embolism

2012-10-22
Difficulty breathing, chest pain, and cough may sound like symptoms of a heart attack; however, new research shows that these are the key symptoms for pulmonary embolism (PE), a potentially fatal blockage in the lung. A research team from Saint Vincent's Medical Center in Bridgeport, Connecticut, retrospectively reviewed the clinical features, risk factors, and ECG findings in 334 patients with confirmed PE. Results showed that dyspnea or difficulty breathing, chest pain, and cough were present in 72%, 38%, and 19% of the patients, respectively, and dyspnea was the only ...

Pulmonary hypertension deaths and hospitalizations on the rise

2012-10-22
New research indicates an increase in the number of US deaths and hospitalizations related to pulmonary hypertension. A research team from Howard University Hospital, Washington, DC, examined multiple cause of death mortality data from the National Vital Statistics System and hospital discharge data from the National Hospital Discharge Survey for 1999-2009. Results showed that since 1999, the number of deaths and hospitalizations, as well as death rates and hospitalization rates, have increased for pulmonary hypertension, particularly among women and older adults. During ...

Pulmonary hypertension combination therapy may lead to greater disease burden

2012-10-22
Patients with pulmonary arterial hypertension (PAH) receiving combination therapy with intravenous (IV) PGI2 may suffer from greater disease burden compared with those receiving monotherapy or combination therapy, excluding IV PGI2. Researchers from Massachusetts General Hospital and Novartis Pharma AG in Switzerland performed statistical tests on 446 patients with PAH, of which (a) 337 were receiving monotherapy; (b) 88 were receiving non-IV PGI2 combination therapy; and (c) 21 were receiving IV PGI2 combination therapy. Results showed that pulmonary vascular resistance, ...

Guideline implementation may impact VTE quality of care

2012-10-22
The quality of care of patients hospitalized with venous thromboembolism (VTE) significantly improved between 2005 and 2009, and researchers suggest these improvements may be due to the implementation of VTE treatment guidelines. Using data from the Nationwide Inpatient Sample, researchers from Inova Fairfax Hospital and Betty and Guy Beatty Center for Integrated Research, Falls Church, Virginia, reviewed quality care measures in 800,000 VTE discharges that took place from 2005 to 2009. Results showed that in-hospital mortality and length of stay decreased during this time, ...

Trainee presence during endobronchial ultrasound increases complications

2012-10-22
The presence of a trainee during endobronchial ultrasound (EBUS) may have negative implications, including increased procedure time and complications. Researchers from the University of Calgary retrospectively reviewed 607 EBUS procedures, of which a trainee was present for 512. Significant differences were seen when a trainee was present vs when no trainee was present for procedure length (58.32 vs 37.69 min) and for the dose of propofol used (178.28 vs 137.11 mg). In addition, more complications were seen in the trainee group (24 vs 1). This study was presented during ...

10-minute 'tension tamer' can help reduce stress and improve sleep

2012-10-22
A simple, 10-minute stress reduction technique could help to relieve stress, improve sleep quality, and decrease fatigue. Researchers from Walter Reed National Military Medical Center, Bethesda, Maryland, attempted to determine the effect of a brief, stress reduction technique, the 10-minute Tension Tamer, on improvement of stress levels and sleep parameters in 334 patients in a heart health program. After a 30-minute introductory workshop, subjects were given instruction and guided opportunities to practice 10-minute Tension Tamers over the course of four 30-minute visits ...

'Elbow test' may predict sleep apnea

2012-10-22
Have you ever been "elbowed" by your bed partner because you were snoring? If yes, new research says you could have obstructive sleep apnea (OSA). Prior to polysomnography testing, researchers from the University of Saskatchewan asked 124 patients two questions: (1) Does your bed-partner ever poke or elbow you because you are snoring; and (2) Does your bed-partner ever poke or elbow you because you have stopped breathing? Answering 'yes' to being awakened for snoring or apneic spells increased the likelihood of an apnea-hypopnea index (AHI) >5/h (indicating at least mild ...

2.5 hours of patient/therapist contact time increases CPAP use

2012-10-22
Although continuous positive airway pressure (CPAP) is often used as therapy for obstructive sleep apnea (OSA), patient compliance with CPAP remains an issue. However, new research presented at CHEST 2012, the annual meeting of the American College of Chest Physicians, shows that patients who meet with a respiratory therapist for a total of 2.5 hours within 30 days of initiating CPAP had significant compliance after 1 month of therapy. Researchers from Kaiser Permanente retrospectively reviewed the charts of 39 patients with OSA who were treated with CPAP and on a portable ...

Study demonstrates how fear can skew spatial perception

2012-10-22
That snake heading towards you may be further away than it appears. Fear can skew our perception of approaching objects, causing us to underestimate the distance of a threatening one, finds a study published in Current Biology. "Our results show that emotion and perception are not fully dissociable in the mind," says Emory University psychologist Stella Lourenco, co-author of the study. "Fear can alter even basic aspects of how we perceive the world around us. This has clear implications for understanding clinical phobias." Lourenco conducted the research with Matthew ...

Artspace Warehouse Stages Art Show at Warner Bros.

2012-10-22
Warner Bros. Studios in Burbank, an iconic film and television production company, partnered with Los Angeles gallery Artspace Warehouse exhibiting an installation of contemporary artworks from emerging Los Angeles and Swiss artists. Warner Bros. employees got a unique chance to revel in the works of these artists exhibited at Central Perk, the cafe featured in the Warner Bros. hit show Friends which was filmed on the lot. Hot emerging artists in this show included Courtney Raney, Hilary Bond, Mark Acetelli, Paul Kirley and Colleen Sandland among others. The artworks ...
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