Respiratory Problems
Doctors say antibiotics pointless for acute bronchitis
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Researchers say they have found no evidence in current literature that antibiotics are effective in treating the vast majority of patients with acute bronchitis and say doctors should stop routinely prescribing them.
Acute bronchitis is an inflammation of the main airways to the lungs characterised by an irritating cough, and is one of the most common conditions treated by doctors.
Combination therapy of salmeterol and fluticasone improves survival in patients with COPD
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A combination of two common medications may help patients with chronic obstructive pulmonary disease (COPD) live longer.
New research presented at CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), shows that when used in combination, inhaled salmeterol (SAL) and fluticasone propionate (FP) reduced the risk of dying by up to 17.5 percent in patients with COPD. Currently, FP, an inhaled corticosteroid, and SAL, a long-acting B2-agonist bronchodilator, are used alone and in combination to treat both asthma and COPD.
Statins show promise in slowing smoking-induced lung damage
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Statins, the widely used class of drugs for cholesterol management, are now showing promising results in slowing smoking-induced lung damage.
In a new study presented at CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), current and former smokers who used statins had lower lung function decline than those not using statins, regardless of whether patients continued or stopped smoking.
“Until now, no medication has shown to slow smoking-induced lung damage,” said Walid G. Younis, MD, University of Oklahoma Medical Center, Oklahoma City, OK. “Our study is the first to show that statins may decrease the decline in lung function in smokers and former smokers, and, therefore, prevent millions from developing debilitating diseases that could eventually lead to death.”
Apnea risk low in most infants with bronchiolitis
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In infants presenting with bronchiolitis (inflammation of the lungs), the risk of apnea (brief pauses in breathing) is less than 3 percent, study findings suggest. However, the risk is higher in very young and preterm infants.
Dr. Marvin B. Harper and colleagues at Boston’s Children’s Hospital evaluated the cases of 691 infants admitted to their institution with bronchiolitis. Nineteen of the infants (2.7 percent) developed apnea, the researchers report in the Annals of Emergency Medicine.
The team developed, a priori, a list of risk criteria for identifying infants at high risk for apnea: those born full term but less than one month of age; those born preterm (less than 37 weeks gestation) and younger than 48 weeks post-conception; or those who have had a previous witnessed episode of apnea.
Researchers step toward therapy for respiratory syncytial virus
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When a child under the age of 2 contracts a respiratory tract infection requiring hospitalization, odds are that the cause is respiratory syncytial virus (RSV).
One of the world’s most common and dangerous early-childhood infections, RSV puts more than 100,000 children a year in the hospital in the U.S. alone; the infection may also increase the chances that a child will develop asthma.
Currently, neither a safe vaccine nor an effective therapy for RSV exists. Now, however, University of Texas Medical Branch at Galveston (UTMB) researchers have taken an important step toward developing a therapy for RSV.
Computer-Driven System Reduces Patient Mechanical Ventilation Time Significantly
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For patients with acute respiratory failure, a computer-driven system can significantly reduce the duration of mechanical ventilation and length of stay in the intensive care unit (ICU), as compared with the traditional physician-controlled weaning process.
The study, which was conducted in five medical-surgical ICUs in Barcelona, Brussels, Créteil, Geneva and Paris, appears in the second issue for October 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Lung disease undiagnosed in 4 of 5 UK sufferers
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More than 80 percent of Britons with a serious long-term lung disease that is linked to smoking do not know they have the illness, health experts said on Thursday.
Chronic Obstructive Pulmonary Disease (COPD), which includes bronchitis and emphysema, is a leading cause of death worldwide but it is often undiagnosed.
“It is crucial to identify smokers with COPD and take urgent action to support them in stopping smoking because the most effective way of halting the progression of the disease is to stop smoking,” said Professor Robert West of the charity Cancer Research UK.
Lung damage from chlorine can persist in children
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Ten children who were accidentally exposed to chlorine at a swimming pool experienced substantial impairment of lung function that was still apparent to some degree several months later, according to a report from Italy.
Chlorine inhalation can cause several types of lung damage, depending on the extent of exposure, ranging from irritation of the mucous membranes to accumulation of fluid in the lungs that can cause respiratory failure. However, little information is available on the underlying process that causes these symptoms, Dr. Eugenio Baraldi, of the University of Padua, Italy, and colleagues report in the American Journal of Respiratory and Critical Care Medicine.
Although most people do recover from the chlorine exposure, the possibility of long-term damage is still a concern, they add.
Updated Sleep Apnea Screening Recommended for Commercial Drivers
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New recommendations released today by a joint task force of the American College of Chest Physicians (ACCP), American College of Occupational and Environmental Medicine (ACOEM), and the National Sleep Foundation (NSF) offer an updated and consistent approach to the screening and management of obstructive sleep apnea (OSA) among commercial motor vehicle (CMV) operators. Published as a supplement to the September issue of the Journal of Occupational and Environmental Medicine, these recommendations include a more thorough screening and evaluation process, modified criteria for returning to work after treatment, and provide follow-up and recertification recommendations.
“Sleepiness and inattention contribute to a significant number of CMV crashes each year and OSA has been shown to significantly increase a driver’s risk of driving drowsy. Yet, current CMV screening and treatment procedures for OSA are ambiguous and not reflective of the latest advancements in the diagnosis and management of OSA,” said Nancy Collop, MD, FCCP, Sleep Institute, American College of Chest Physicians. “Conflicting approaches to screening and management of OSA have left drivers undiagnosed, which puts the driver and general public at risk. We hope our joint recommendations will assist the Federal Motor Carrier Safety Administration and states to update screening and treatment guidelines for sleep apnea which, in turn, may help identify and treat more CMV drivers who suffer from this serious condition.”
COPD patients benefit from physical activity
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COPD patients who engage in regular physical activity, even a relatively small amount, may lower their risk not only of being hospitalized but also of dying, a new study shows.
COPD—short for chronic obstructive pulmonary disease—is a progressive lung illness caused by smoking that includes emphysema and chronic bronchitis. It is characterized by airflow limitation that is not completely reversible.
At present, only oxygen therapy, the use of certain drugs like bronchodilators, and flu shots are thought to be effective in altering the course of COPD.
Car seats may make it hard for baby to breathe
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Infant car seats are important safety devices but a new study suggests that these devices may make it hard for baby to breath. The study, published in the journal Pediatrics, found that healthy term infants placed in car seats or car beds can develop low oxygen levels.
“Car seats may need to be remodeled,” Dr. T. Bernard Kinane, of Mass General Hospital for Children, Boston said. “We need to find out why babies have problems in both devices,” he stressed. “It may be related to the tightness of the harness.”
Kinane and colleagues compared oxygen levels in 67 healthy term infants placed in either a car safety seat or a car bed within the first week of life. “Most infants are transported in car seats,” Kinane explained. “If babies have problems with breathing, we place them in car beds.”
Nasal rinsing technique eases sinusitis
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Nasal irrigation, a traditional therapy that has been shown to help people with chronic sinus problems, can be easily learned with a 30-minute group training session, a new study shows.
Patients in the study also reported a sense of “empowerment” because they could use and adjust the technique effectively on their own rather than requiring multiple doctor visits and prescriptions, Dr. David Rabago of the University of Wisconsin at Madison and colleagues report.
Used for thousands of years in the Ayurvedic and Yogic traditions, nasal irrigation involves rinsing the nasal cavity with a saline solution to get rid of mucus that may contain allergens or infectious agents.
Respiratory virus cases on rise in western US
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Between January and March of this year, health departments from Arizona, New Mexico, North Dakota, Texas, and Washington State reported an increased incidence of a respiratory viral infection, called human hantavirus pulmonary syndrome (HPS).
Human hantavirus infection follows exposure to the virus in rodent saliva or feces.
Previous experience with early increases in hantavirus infection suggests that the total number of cases will be high throughout 2006, according to a report in the Morbidity and Mortality Weekly Report, published by the Centers for Disease Control and Prevention.
Muscle training may lessen COPD symptoms
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For people with chronic obstructive pulmonary disease (COPD) such as emphysema, high intensity training of the muscles used for breathing can improve muscle function and reduce dyspnea (difficulty breathing) and fatigue, according to a study.
Still, used alone, such training is unlikely to yield clinically relevant improvements in exercise capacity, which is often a problem for COPD patients, researchers say.
So-called inspiratory muscle training (IMT) “may be of particular benefit to COPD patients who report dyspnea during activities of daily living and/or fatigue, but are unable to effectively participate in whole-body exercise training because of comorbid conditions, such as musculoskeletal impairments,” note Dr. P. R. Eastwood, from the Sir Charles Gairnder Hospital in Nedlands, Western Australia, and colleagues.
Women with COPD Fare Worse than Men with Same Level of Disease
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Women with chronic obstructive pulmonary disease (COPD) fare worse than men both in terms of the severity of their disease and their quality of life, according to a study to be presented at the American Thoracic Society International Conference on May 22nd.
These differences may play a role in the increased death rate seen among female patients with COPD, said researcher Claudia Cote, M.D., Assistant Professor of Medicine at the University of South Florida in Tampa.
The researchers studied 85 women, and compared them with 95 men who had the same levels of COPD severity according to guidelines of the Global Initiative for Chronic Lung Disease (GOLD). They found that female patients were significantly younger than male patients with the same severity of disease. The women had lower lung function, more trouble breathing, and reported a worse quality of life. The women also received a worse score on the BODE index, which looks at lung function, nutritional status, symptoms and exercise capacity in order to measure a COPD patient’s disease severity and predicted survival.
