New research from the Centers for Disease Control and Prevention (CDC) underscores the widespread disparities associated with chronic obstructive pulmonary disease (COPD) mortality by state, poverty level, and urban vs rural location. The study, presented at CHEST 2012, the annual meeting of the American College of Chest Physicians (ACCP), found that COPD mortality is highest in rural and poor areas. "Many factors contribute to the differences in COPD mortality, including smoking prevalence, air quality, and access to health care," said study co-author James B. Holt, ...

New research suggests that antibiotics are not effective in treating cough due to the common cold in children. The study, presented at CHEST 2012, the annual meeting of the American College of Chest Physicians, found that when children with acute cough were treated with either antitussive medication or antibiotics, antibiotics alone showed a lower percentage of cough resolution. "In our experience, antibiotics are often prescribed by the general practitioner to treat cough in children, many times to pacify parents," said lead study author Francesco de Blasio, MD, FCCP, ...

Fainting after recent air travel could be a sign of pulmonary embolism (PE), a potentially fatal blockage in the lungs. Syncope or fainting is an uncommon symptom of pulmonary embolism; however, new research presented at CHEST 2012, the annual meeting of the American College of Chest Physicians (ACCP), found that fainting associated with recent air travel may be a key indicator for PE diagnosis. Fainting as a precursor to PE diagnosis was also associated with a saddle embolism, a larger and more life-threatening form of PE, as well as more abnormal ECG readings. "Fainting ...

High blood pressure, blood sugar, blood lipids, and body mass index—characteristics that are often lumped together as the metabolic syndrome—are jointly linked with an increased risk of dying from prostate cancer. That is the conclusion of a new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society. The study's results suggest that public health recommendations regarding diet and lifestyle to prevent heart disease and diabetes may also decrease a man's likelihood of dying from prostate cancer. Researchers have little knowledge ...

National efforts are underway to reduce 30-day readmission for chronic obstructive pulmonary disease (COPD); however, new research suggests that COPD readmissions may be related to risk factors that cannot be modified, including advanced disease and psychosocial factors. Researchers from the University of Texas Medical Branch in Galveston performed a retrospective chart review of all patients with primary discharge diagnosis of COPD. Of the 160 patients admitted for a total of 193 hospitalizations, 30 patients were readmitted within 30 days. Patients who were readmitted ...

Roflumilast was associated with significant improvements in lung function in patients with moderate and severe chronic obstructive pulmonary disease (COPD) after 6 months of treatment compared with placebo. Roflumilast is approved to reduce the risk of exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. To examine the drug's impact on lung function, researchers from multiple institutions, including Baylor College of Medicine; Takeda Pharmaceuticals International GmbH; and Forest Research Institute, randomized 4,746 ...

Children with asthma who have their tonsils and adenoids (T&A) removed may experience fewer asthma symptoms. Researchers from Children's Hospital and Research Center in Oakland, California, followed 105 children with asthma (7-21 years) referred for sleep study for suspected sleep apnea. Twenty-four patients with sleep apnea required T&A, of which 11 patients followed through with surgery. Results indicated that asthma scores trended toward improvement with T&A. However, there was no significant increase in the lung function following T&A. This study was presented ...

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 ...

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 ...

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 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 ...

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 ...

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 ...

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 ...

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, 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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 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 ...

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 ...

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, ...