#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).
#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.
#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.
#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.
#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.
#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.
#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.
#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.
#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.
#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.
#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.
#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.
#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.
#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.