MONDAY, OCTOBER 27
#7720PATIENTS' HOME PHOTOS HELP IDENTIFY ASTHMA TRIGGERS(Monday, October 27, 10:30 AM EST)
The use of in-home photography may be a more cost-effective alternative to in-home inspections for identifying asthma and allergy triggers. Researchers from Truman Medical Center and the University of Missouri, Kansas City, MO, selected 50 adult subjects with persistent asthma to take photos of a predetermined list of areas in their home using a disposable camera. All subjects completed a questionnaire addressing triggers prior to and after taking in-home photos. All film was reviewed with the subjects at the third visit. Subjects then received education on the identified triggers and cost-effective measures to reduce or eliminate exposure. Three of the 50 subjects were randomly selected to receive an in-home assessment by a trained environmental specialist. Triggers identified by in-home inspection by an environmental specialist were very similar to those identified by the use of a disposable camera. Results suggest in-home photography ($13 cost) may be a cost-effective alternative to professional visual home assessments ($300 to $400 cost).
#6967ASTHMA IN CHILDREN CHANGES WITH THE SEASONS(Monday, October 27, 2:30 PM EST)
Health-care utilization for children with asthma changes with the seasons, peaking in the fall. Using data from the United Healthcare database, researchers from the University of North Carolina reviewed health-care utilization patterns and asthma medication usage in children aged 2 to 5 years and 6 to 12 years from 2002 to 2004. Results showed that health-care utilization was minimal in the summer; however, September consistently served as a point of inflection for health-care utilization for both age groups. In October and November, peak emergency department visits for the two age groups were approximately 2.4 to 2.8 times higher than in July; outpatient visits were approximately 3.1 to 3.3 times higher; and hospitalizations were approximately 3.7 to 5.6 times higher. Asthma controller and reliever medications claims increased beginning in September and peaked in December. Rates for health-care use and claims for asthma medications also were elevated in February.
TUESDAY, OCTOBER 28
#7710IRREGULAR HEARTBEAT MAY DEVELOP AFTER LUNG TRANSPLANTATION(Tuesday, October 28, 10:30 AM EST)
Patients receiving donated lungs may develop arrhythmias, including atrial fibrillation. Researchers from Baylor College of Medicine in Texas reviewed the charts of all lung transplant recipients in 2006 and 2007. Of the 75 patients who underwent lung transplant, 38 percent developed arrhythmias within 30 days of transplantation. The most common arrhythmia was atrial fibrillation, followed by atrial flutter. Researchers speculate that the donor-derived tissue (atrial cuff or pulmonary vein) is a likely source of the arrhythmias passed to lung recipients.
#6783IN-HOSPITAL STATIN USE MAY IMPROVE SEVERE SEPSIS MORTALITY(Tuesday, October 28, 10:30 AM EST)
New research shows that in-hospital statin use is associated with lower mortality in patients with severe sepsis (SS). In a retrospective study, researchers from AstraZeneca Pharmaceuticals reviewed hospital patient discharges from 500 US hospitals between 2004 and 2006. The number of patients with SS ranged from 64,000 in 2004 to 89,000 in 2006. The percentage of patients with SS among all hospitalizations increased each year from 1.4 percent in 2004 to 1.7 percent in 2006, while in-hospital mortality among all patients with SS decreased each year (35 percent, 2004; 33 percent, 2005; 31 percent, 2006). In-hospital statin use increased each year (13 percent in 2004 to 18 percent in 2006). Each year, patients with SS in the statin group showed a lower mortality rate compared with those discharged from the hospital without a charge for a statin (2004, 28 percent vs. 35 percent; 2005, 26 percent vs. 35 percent; 2006, 23 percent vs. 33 percent). Although a cause and effect relationship could not be determined, researchers conclude that there is a need for further investigation in this area.
#6363TADALAFIL PROVES EFFECTIVE THERAPY FOR PULMONARY HYPERTENSION(Tuesday, October 28, 10:30 AM EST)
New research shows that the erectile dysfunction drug, tadalafil, may be an effective adjunct therapy for patients with pulmonary arterial hypertension (PAH). Italian researchers randomized 405 patients with PAH, of whom 53 percent were taking concomitant bosentan, to two study arms. The groups received either tadalafil or placebo orally once daily as monotherapy or as add-on therapy to bosentan. Compared with placebo, tadalafil, 40 mg, increased 6-minute walk distance, delayed the time to clinical worsening, and improved six of the eight short form (SF)-36 domains. In addition, tadalafil, 40 mg, increased cardiac output and reduced pulmonary artery pressures and pulmonary vascular resistance compared with baseline. Discontinuation due to adverse events was low (11 percent for tadalafil vs. 16 percent for placebo). Researchers conclude that tadalafil may provide an effective oral, once-daily therapy that can be combined with bosentan therapy for patients with PAH.
#7310OMEGA-3 FATTY ACID LEVELS MAY AFFECT SLEEP APNEA SEVERITY(Tuesday, October 28, 1:00 PM EST)
The level of omega-3 fatty acids found in a patient's blood may determine the severity of his or her sleep apnea. Researchers from the University of Missouri, Kansas City, MO, tested fatty acid levels in 350 subjects with apnea-hypopnea index scores of 0 to 104. Results showed that lower levels of docosahexaenoic acid (DHA), a type of omega-3 fatty acid, was associated with increased apnea severity, even after controlling for age, sex, race, smoking, BMI, fish intake, omega-3 supplementation, flaxseed oil supplementation, and other fatty acids normally present in cellular membranes. Researchers are unclear whether the increased severe apnea induces systemic changes, which lower DHA levels, or whether lower DHA levels might lead to worsening apnea.
#6618STATIN THERAPY MAY BENEFIT ICU PATIENTS(Tuesday, October 28, 1:00 PM EST)
Statins may provide a protective effect for patients admitted to the ICU. In a retrospective study, researchers from Saudi Arabia compared 194 ICU patients who received consistent statin therapy for 1 year prior to ICU admission with a control group of 1,188 patients who did not receive statin therapy. The ICU mortality rate for the statin group was 10 percent compared with 12 percent for the control group. The apparent mortality benefit persisted after controlling for differences in age and gender. Researchers speculate that their study demonstrates a potential survival benefit for ICU patients receiving statin therapy.
#7047ANKLE EXERCISES INCREASE BLOOD FLOW DURING AIR TRAVEL(Tuesday, October 28, 1:00 PM EST)
Simple ankle exercises, done while sitting or at rest, may help increase blood flow through the legs. In a study conducted at St. Joseph Mercy Oakland in Michigan, 18 healthy volunteers, aged 20 to 40 years, underwent Doppler measurements of right and left femoral vein blood velocity while supine, at rest. They also underwent Doppler measurements of right femoral blood velocity while sitting and during ankle exercise. Volunteers flexed their ankles 80 times per minute and rested for at least 3 minutes before each measurement. At rest, while supine, average blood velocity was the same in the right and left femoral vein (17 cm/s). During exercise, while supine, average blood velocity increased to 30 cm/s. When sitting at rest, femoral blood velocity decreased from 17 cm/s to 9 cm/s but increased to 18 cm/s with exercise. Researchers suggest that ankle exercise may reduce stasis in bedridden patients, and it also may reduce stasis while sitting, especially during prolonged air travel.
#6480INSOMNIA DOES NOT PREDICT HIGH BLOOD PRESSURE(Tuesday, October 28, 1:00 PM EST)
Difficulty falling asleep may be associated with a lower risk of hypertension than researchers once believed. Researchers from the University of Kentucky proposed the hypothesis that insomnia would predict hypertension, particularly among African-Americans. Data were analyzed from 1,419 older individuals with a mean age of 73.4 years who were not hypertensive at baseline. Researchers found that difficulty falling asleep, alone or in combination with other sleep complaints, predicted a significantly reduced risk of incident hypertension for men who were not African-American over a 6-year period of follow up. Furthermore, insomnia complaints did not predict hypertension in women or in African-Americans, although there may not have been enough power to show a significant association for African-Americans.
#7123BRONCHOSCOPY SAFE FOR RETRIEVING ASPIRATED PINS FROM MUSLIM SCARVES(Tuesday, October 28, 1:00 PM EST)
Flexible bronchoscopy may be a safe method of retrieving aspirated metallic pins that are used to fix Muslim women's scarves, now a common problem in Islamic countries. Researchers in Egypt reviewed the charts of 115 patients who underwent fiberoptic bronchoscopy in order to remove a metallic pin from the trachea or left or right bronchial trees. Overall, 120 metallic pins were successfully retrieved with no major complications. Researchers conclude that flexible bronchoscopy is a safe way to retrieve aspirated metallic pins and avoid rigid bronchoscopy and general anesthesia.
#7151OUTCOME POOR FOR REPEATED CPR IN HOSPITALIZED PATIENTS(Tuesday, October 28, 1:00 PM EST)
Hospitalized patients who undergo repeated in-hospital CPR have a high mortality rate. Researchers from Western Pennsylvania Hospital in Pittsburgh reviewed the charts of 151 patients, aged 25 to 99 years, who underwent CPR as a consequence of cardiopulmonary arrest. Out of these patients, only 16 (eight men and eight women) required repeated CPR after the first successful attempt. None of these patients survived to the time of hospital discharge. Researchers suggest that patients who are seriously ill, as well as their families, should be well informed regarding the expected outcome of multiple in-hospital resuscitation events.
#6574SWIMMING EFFECTIVE THERAPY FOR ASTHMA(Tuesday, October 28, 1:00 PM EST)
Swimming may be an effective intervention for children with asthma. Taiwanese researchers followed 30 children with asthma to investigate the effects of a 6-week swimming intervention on pulmonary function testing (PFT), peak expiratory flow monitoring (PEFM), and the severity of asthma (SOA). Twenty boys and 10 girls were randomly assigned to receive regular asthma treatment combined with a 6-week swimming training (experimental group) or regular asthma treatment alone (control group). Compared with the control group, the experimental group showed significant improvements in PEFM and SOA. These results suggest that swimming may be an effective nonpharmacologic intervention for children with asthma.
#6834SHINGLES COMMON AFTER LUNG TRANSPLANTATION(Tuesday, October 28, 1:00 PM EST)
Herpes zoster, or shingles, is a common complication after lung transplantation. Israeli researchers reviewed 198 lung transplants performed at their institution over a 7-year period and continued to follow up with patients for a median time of 34 months. Twenty-three episodes of shingles occurred in 23 patients (11 percent); however, antiviral prophylaxis was protective against shingles. Furthermore, treatment with the antibody RATG also increased the incidence of shingles.
#7725YOUNGER PATIENTS WITH LUNG CANCER HAVE BETTER SURVIVAL(Tuesday, October 28, 1:00 PM EST)
Lung cancer in younger patients may exhibit distinct clinical features than lung cancer in older patients, including better survival rates at each disease stage. Researchers from Stanford Cancer Center in California compared disease characteristics and survival of lung cancer patients aged 15 to 39 years at diagnosis with patients aged ≥40 years at diagnosis. The age-adjusted incidence rate of lung cancer in patients aged 15 to 39 years was 1.2 per 100,000, whereas the rate in patients aged ≥40 years was 141 per 100,000. A higher proportion of younger patients (57 percent) had distant disease at diagnosis compared with older patients (51 percent). Mean 5-year cause-specific survival was 34 percent in the group of patients aged 15 to 39 years and 16 percent in the group aged ≥40 years. In addition, at each disease stage, mean 1- and 5-year cause-specific survival rates were better in the younger group.
#6786TOBACCO ABUSE BY US TROOPS IN IRAQ TWICE NATIONAL AVERAGE(Tuesday, October 28, 2:30 PM EST)
The prevalence of tobacco use by US military deployed to Iraq is more than twice the national average. Researcher Michael A. Wilson of the United States Navy surveyed 408 Marines and sailors deployed in Iraq to assess the prevalence of tobacco abuse and usage patterns related to service. Overall, 260 (64 percent) of the Marines and sailors surveyed used some form of tobacco. Of those, 213 (52 percent) smoked cigarettes, 145 (36 percent) used smokeless tobacco (dip, chew), and 98 (24 percent) used both. For all tobacco abusers, 74 percent expressed a desire to quit using tobacco. Researchers conclude that the prevalence of tobacco abuse during deployment to Iraq is significantly higher than the national average of 29.6 percent reported in a 2006 national survey. The rate of usage also was higher than the 38.9 percent reported for troops returning from Iraq, based on a 2004 survey.
#6973NEW YORK SMOKERS FEEL IMPACT OF STATE TOBACCO CONTROL PROGRAM(Tuesday, October 28, 2:30 PM EST)
New York residents who smoke are feeling the effects of the tobacco reduction strategies imposed by the New York Department of Health Tobacco Control Program (DOH-TCP). In a recent survey, researchers from North Shore-LIJ Center for Tobacco Control asked 277 New York residents attending a smoking cessation program why they intended to quit smoking. Of the participants, 33 percent of women and 8 percent of men cited greater social pressure to quit smoking, while 42 percent of women and 26 percent of men wanted to quit due to odor from tobacco use. Thirty percent of men and 17 percent of women reported wanting to quit because of pressure from their doctor, while 29 percent of men and 34 percent of women are quitting due to high cigarette prices. Furthermore, 16 percent of men and 11 percent of women cited quitting because there are fewer places where smoking is still permitted. Researchers conclude that the strategies imposed by the DOH-TCP, including increasing cigarette taxes, banning smoking at work, and educating health-care providers and the public about tobacco dependence, are having an impact on smokers in New York.
WEDNESDAY, OCTOBER 29
#6987REMOTE PHYSICIAN CARE SAVES LIVES(Wednesday, October 29, 10:30 AM EST)
Whether located in a neighboring hospital or in a clinic three states away, teleintensivists, physicians who remotely monitor and care for critically ill patients, are saving lives. Researchers from the University of Kansas, Kansas City, MO, compared 700 critically ill patients 1 year prior to remote telemonitoring implementation with 4,592 critically ill patients 2 years after telemonitoring implementation. They evaluated the severity-adjusted ICU and hospital length of stay (LOS) and ICU and hospital mortality. Results showed that remote teleintensivist care correlated with an improvement of severity-adjusted ICU and hospital LOS. Results showed a further trend toward improved mortality.
#6960THAI CHI HELPS PATIENTS CONTROL ASTHMA(Wednesday, October 29, 10:30 AM EST)
Thai chi training may help patients with asthma improve their exercise performance and asthma control. Researchers in Thailand enrolled 17 patients with persistent asthma in a 6-week Thai Chi Qigong training program. After Tai Chi Qigong training, patients showed significant improvements in peak flow variability, asthma control test score, negative inspiratory pressure, 6-minute walk distance, and quality of life. Patients also increased their maximum work rate, maximum oxygen consumption, and exercise endurance time. Researchers conclude that Tai Chi Qigong training could be an effective, nonpharmacologic, adjunctive therapy for patients with persistent asthma to help them achieve better asthma control and quality of life.
#7008SPECIALISTS DISAGREE WITH BLACK BOX WARNING ON LABAs(Wednesday, October 29, 10:30 AM EST)
New research shows that more pulmonologists and allergists (specialists) disagree with the black box warning (BBW) given to long-acting β-agonists (LABAs) compared with internists and family physicians (primary care physicians). Researchers from North Shore University Hospital in New York surveyed 429 pulmonologists, 395 allergists, 141 internists, and 132 family physicians regarding their awareness of and attitude toward BBWs. Twice as many primary care physicians (45.6 percent) agreed with the BBW compared with specialists (24.2 percent). Primary care physicians also were more likely to alter their prescribing habits compared with specialists (40 percent vs. 34 percent) however, specialists were more likely to discuss the BBW with their patients than were primary care physicians (87 percent vs. 64 percent).
#7511SEDATIVE-HYPNOTIC MEDICATION MAY IMPROVE CPAP COMPLIANCE(Wednesday, October 29, 10:30 AM EST)
The use of sedatives-hypnotic medication could improve patient compliance with continuous positive airway pressure (CPAP). Researchers from Walter Reed Army Medical Center in Washington, DC, retrospectively reviewed 400 patients who underwent CPAP therapy. Of the variables measured, only age and the use of sedative-hypnotics during CPAP titration polysomnography were associated with better patient compliance. In addition, those who received sedative-hypnotics for polysomnography experienced longer sleep times, greater sleep efficiencies, and improved CPAP titrations. Researchers speculate that improved short-term CPAP compliance may improve long-term compliance.
#7359INCREASED BMI MAY BLUNT ASTHMA MEDICATIONS(Wednesday, October 29, 10:30 AM EST)
People who are overweight or obese may not experience the intended effects of asthma medications. In a retrospective analysis, researchers from GlaxoSmithKline analyzed the effect of increasing body mass index (BMI) on achieving asthma control with fluticasone propionate/salmeterol via Diskus compared with montelukast. Overall, a BMI >25 appeared to blunt a person's response to asthma therapy in general; however the superiority of FSC compared to MON persisted over the entire range of BMIs.
#6700CHEST COMPRESSIONS DIFFICULT FOR MEN AND WOMEN TO PERFORM(Wednesday, October 29, 10:30 AM EST)
Female hospital staff members have more difficulty performing adequate chest compressions (CC) than male hospital staff. Researchers from Albert Einstein College of Medicine in New York compared the CC technique of 28 male and 30 female medical housestaff using a patient simulator, before and after CC training. Subjects also went through a posttraining endurance test where they attempted to perform adequate CC for 120 seconds or until fatigue prevented further effort. Prior to training, 50 percent of the male group performed adequate CC, while none of the female group performed adequate CC. Post-training, 89 percent of the male group performed adequate CC and 37 percent of the female group performed adequate CC. There was no correlation between body mass index and adequate CC in either group, however taller females performed better CC than shorter females. Regardless of gender, only 14 percent of subjects were able to maintain adequate CC for 120 seconds, the recommended guideline for one cycle of compressions.
#7010NEW ANTIDOTE FOR CYANIDE POISONING(Wednesday, October 29, 1:00 PM EST)
The novel agent cobinamide could be an ideal antidote for cyanide poisoning, particularly during fire rescues or mass casualty situations where prolonged fire smoke inhalation may occur. Researchers from the University of California - Irvine infused a New Zealand white rabbit with a sodium cyanide solution followed by cyanide treatment with either high-dose or low-dose cobinamide. Diffuse optical spectroscopy (DOS) measurements and concurrent physiologic measurements, including arterial and venous blood gases, carbon monoxide, and oxygen saturation, were obtained throughout the experiment. Results showed that cobinamide caused rapid and complete reversal of cyanide toxicity effects when administered intravenously or by transpulmonary routes, as demonstrated noninvasively by DOS and confirmed by blood sampling. Researchers suggest that the high potency and solubility of cobinamide make it potentially an ideal agent for treatment of mass casualty cyanide exposures.
#6719COCONUT OIL: A NEW THERAPY FOR PEDIATRIC PNEUMONIA?(Wednesday, October 29, 1:00 PM EST)
New research shows that virgin coconut oil (VCO) may be an effective adjunct therapy for treating pediatric community-acquired pneumonia (CAP). Researchers from the Philippines divided 40 children with CAP into two treatment groups. Group A (VCO group) received IV ampicillin plus 2 mL/kg/day of VCO orally, taken for a maximum period of 3 days, and group B (control group) received IV ampicillin alone. The respiratory rate of the VCO group normalized significantly earlier than the control group. In addition, after 72 hours, more patients in the control group were still noted to have crackles compared with the VCO group. VCO supplementation also resulted in a quicker time to normalize temperature and oxygen saturation, and a shorter time of hospitalization, than in the group receiving IV ampicillin alone.
#6725ICU NURSING TASKS INTERRUPTED BY ALARMS, OTHER NURSES(Wednesday, October 29, 1:00 PM EST)
In the ICU, nursing task interruptions are most often caused by device alarms or other nurses and can lead to nurses switching their focus or multitasking. Researchers from the University of Utah analyzed nursing task interruptions, other error producing conditions, and actual or potential medical device related harm, as documented in 59 observation sessions totaling more than 140 hours. Direct care, indirect care, and medical device use constituted 15.3 percent, 70.3 percent, and 14.4 percent of the nurses' task hours, respectively. Overall, 7,382 nursing tasks were observed, of which 886 (12 percent) were interrupted. The two most frequent causes of interruption were device alarms (35 percent) and other nurses (17 percent); physicians caused 10 percent of interruptions. When interrupted, the nurses switched focus to the interrupting task (30 percent) or multitasked (31 percent), most commonly in response to a device alarm. They did not immediately attend to a majority of device alarms.
#6844PHYSICIANS USE MP3 PLAYERS TO RECOGNIZE HEART MURMURS(Wednesday, October 29, 1:00 PM EST)
The use of MP3 players may be an effective way for physicians to improve their recognition of the different types of heart murmurs. In a new study by researchers at Temple University School of Medicine, 255 general internists took a pretest consisting of five heart murmurs played in random order. They then listened to audio files of five basic murmurs on an MP3 player, while viewing posters with phonocardiograms of each sound. The audio files consisted of 200 repetitions of each of the five murmurs played during a single 30-minute session. All participants took a posttest consisting of the same murmurs played in a random order. The murmurs used in the training session were simulated heart sounds, while the murmurs used for both the pretest and posttest were human heart sounds. Participants' correct answers improved from 53.2 on the pretest to 78.9 on the posttest.
#6890SLOW-WAVE SLEEP YIELDS FEWER APNEA EVENTS(Wednesday, October 29, 1:00 PM EST)
Slow-wave sleep (SWS) may have a protective effect for events related to sleep apnea. Researchers from Walter Reed Army Medical Center in Washington, DC, analyzed the polysomnography results of 20 male and 10 female patients who were previously diagnosed with obstructive sleep apnea (OSA). The analysis showed a significant decrease in incidence of apnea events in stages 3 and 4 of SWS when compared with stages 1 and 2 (t(28)=4.36, p<0.01). Researchers speculate that pharmacologically prolonging SWS may help alleviate some of the symptoms of OSA.
#7006RELIGION AND ETHNICITY HELP PATIENTS COPE WITH ILLNESS(Wednesday, October 29, 1:00 PM EST)
Religious faith and ethnicity seem to have a positive effect on the perceptions of critically ill patients. Researchers from the Medical University of South Carolina surveyed 100 sequential medical ICU patients and/or their surrogate using five perception domains: timeline, consequences, control, illness coherence, and emotional representation. Demographics, illness severity, and survival status were obtained from the medical record and/or respondent self-report. Results showed that African-Americans tended to perceive the critical illness as less chronic and less serious, they felt more personal control and more confidence in treatments, and they felt less emotional impact from the illness compared with Caucasian respondents. African-Americans, however, tended to report lower illness comprehension compared with Caucasians. In addition, "being active in faith/church" was associated with a perception of less serious consequences, more confidence in treatments, and less emotional impact of critical illness.
#7085RELATIVES OF ICU PATIENTS HANDLE STRESS BASED ON CULTURE(Wednesday, October 29, 1:00 PM EST)
Families of Indian origin experience a high prevalence of anxiety and depression related to loved ones being in the ICU. Researchers from Ben Taub General Hospital in Houston compared the prevalence of anxiety, depression, and posttraumatic stress disorder in relatives of critically ill patients in the ICUs of a public hospital in India (n=47 relatives) and the United States (n=43 relatives). Anxiety and/or depression were more prevalent in relatives of Indian ICU patients (87.23 percent) than in a similar cohort in the US (18.6 percent). Researchers suggest that further studies correlating these responses to cultural, as well as patient-related, family-related, and ICU environment-related factors, can help ICU staff better understand these differences and provide improved targeted support and coping strategies to affected families.
#7087BMI MAY PREDICT SLEEP APNEA DIAGNOSIS IN CHILDREN(Wednesday, October 29, 1:00 PM EST)
Physicians may be reluctant to order overnight polysomnography studies in children because of the high cost of the examination or the anxiety that is induced by separating the child from his or her family. New research shows that body mass index (BMI) in children may predict whether they have obstructive sleep apnea (OSA), which would then warrant overnight polysomnography. Researchers from East Tennessee State University performed a retrospective review of 158 pediatric patients who were tested for OSA in a pediatric sleep lab. Of the patients, 129 had a positive test result for OSA. Of the 129 patients who were positive for OSA, 117 fell in the <5th percentile for BMI or >95th percentile for BMI. Researchers speculate that for children in these two percentile groupings, overnight polysomnography may be warranted to diagnose OSA.
#7183SMOKING LINKED TO PULMONARY FIBROSIS IN MEN(Wednesday, October 29, 1:00 PM EST)
Swedish researchers have identified a strong association between smoking and the development of idiopathic pulmonary fibrosis (IPF) in men. The research team investigated a national sample of 172 patients with severe pulmonary fibrosis, of which 133 were judged as having IPF, as well as 745 randomly sampled control subjects from the general population. All participants answered a postal questionnaire about their smoking habits. Results showed that men who smoked were 3.5 times more likely to develop severe pulmonary fibrosis compared with control subjects.
#7447PULMONARY HYPERTENSION DEMOGRAPHICS CHANGE(Wednesday, October 29, 1:00 PM EST)
Despite increased awareness of pulmonary arterial hypertension (PAH), the disease is being diagnosed later and in women who are reaching middle age, according to research from Baylor College of Medicine in Texas. The researchers looked at data from the current REVEAL registry compared with the original National Institutes of Health registry, the French Registry, and a large, single-center US registry. The REVEAL registry confirms that in the 21st century, the US population of patients with PAH is older (mean age of 48), with a higher female preponderance of PAH (4:1) than reported previously. In addition, despite increased awareness of PAH, the time from symptoms to diagnosis has increased by 10 months.
#7577SMALL ARTERIES MAY EXPLAIN HEART DISEASE IN ASIAN-INDIANS(Wednesday, October 29, 1:00 PM EST)
Published reports have shown that Asian-Indians have a higher rate of coronary heart disease than other ethnic groups, and their small arteries may be to blame. Researchers from Jamaica Hospital Medical Center in New York explored the differences in the sizes of coronary arteries between Asian-Indians, Caucasians, and African-Americans (n=273). Results showed that ethnic group significantly predicted the diameter of all arteries. Even after controlling for other risk factors, the left anterior descending and left circumflex arteries were significantly smaller in Asian-Indians than other ethnic groups.
#7701HERBAL REMEDIES MAY HELP PATIENTS WITH ADVANCED LUNG CANCER(Wednesday, October 29, 1:00 PM EST)
The use of herbal remedies may be an effective supportive therapy to control symptoms and improve quality of life in patients with advanced stage lung cancer. Researchers from Jafary Medical Clinics in West Virginia followed 15 patients with end-stage primary lung cancer who failed to improve with a conventional treatment of chemotherapy and radiation therapy. Patients were treated with American ginseng for fatigue, morphine sulfate for control of severe dyspnea and pain, licorice root powder for control of severe coughing spells, and bilevel pressure ventilation for respiratory depression related to IV morphine. Two patients also were taking oldenlandia, a Chinese herb for lung cancer. Results showed that licorice and ginseng were effective therapies for the majority of patients, and morphine, used as nebulizer in two patients, was effective in the control of marked dyspnea and pain. One patient lived 4 months using the supportive therapy, while the remaining patients lived 6 to 12 weeks.
#7748NIGHT NURSES MORE ALERT AT END OF SHIFT(Wednesday, October 29, 1:00 PM EST)
Nurses who work the night shift have better reaction times toward the end of their shifts than the beginning of their shifts. Researchers at Texas A&M University compared reaction times between day-shift and night-shift nurses by having them complete two sets of reaction time measurements, at the beginning of their shift, and at the end of the same 12-hour shift. Among day-shift nurses, the reaction times were unchanged across the shift; however, night-shift nurses performed better on reaction tests towards the end of the shift. Researchers speculate that circadian influences may play a role in nurse reaction time.
#7214ESSENTIAL AMINO ACIDS MAY IMPROVE STRENGTH IN COPD PATIENTS(Wednesday, October 29, 1:00 PM EST)
Patients with chronic obstructive pulmonary disease (COPD) may improve muscle strength and exercise endurance by taking essential amino acid supplements. For 3 months, researchers from Italy treated 20 patients with stage 3 and 4 COPD with 8 g of essential amino acids plus usual pharmacologic treatment. Compared with 20 patients in the matched control group, after 3 months, patients in the study group showed a statistically significant increase of muscle strength and covered distance during a 6-minute walk test, and a decrease of breathless degree. Researchers conclude that essential amino acids supplementation may be a valid adjunct therapy for patients with advanced COPD, especially for those presenting with loss of muscle mass or respiratory muscle weakness.
#6601NASAL SPRAY IMPROVES RHINITIS-RELATED CHRONIC COUGH(Wednesday, October 29, 1:00 PM EST)
Patients with rhinitis-related chronic cough may be able to control their cough using nasal sprays. Researchers at Cough Center, Inc, in California treated 266 patients (ages 7 to 85 years) with seasonal allergic (3 percent), nonallergic (65 percent), or mixed rhinitis (32 percent) with open-label combinations of azelastine nasal spray, steroid nasal sprays, ipratropium nasal spray, or cromolyn nasal spray. The median duration of cough was 7 years and the percentage of smokers was less than 1 percent. Of the patients, 72 percent with rhinitis-associated chronic cough experienced improvement with intranasal therapy. The most effective combination therapies were azelastine nasal spray with ipratropium and cromolyn sprays (73 percent) and azelastine nasal spray and intranasal steroid sprays (76 percent). Researches conclude that chronic cough, due to both allergic and nonallergic causes of postnasal drip, can be adequately controlled with the use of nasal rinses and sprays.
#6936MOUTH INJECTION PROCEDURE DECREASES SIMPLE SNORING(Wednesday, October 29, 1:00 PM EST)
Snoreplasty, a nonsurgical procedure involving the injection of a hardening agent into the upper palate, may help to reduce simple snoring. Researchers from Egypt enrolled 34 patients with simple snoring in their study. The patients received an average of 1.8 injections of a sclerosing agent in their upper palates. Of the patients, 32 reported a significant decrease in snoring. In addition, no significant postinjection pain or complications were reported. Researchers conclude that injection snoreplasty is a simple, safe, low cost, and effective office treatment for simple snoring.