CHEST 2009
CHEST 2009 -- the annual meeting of the American College of Chest Physicians -- took place Oct. 31 to Nov. 5 in San Diego, attracted about 5,000 attendees from around the world, and featured 500 presentations by expert speakers.
"Highlights included literature reviews in multiple clinical areas limited to the last year of publication," said Scientific Program chair, Lisa K. Moores, of the Uniformed Services University of the Health Sciences in Bethesda, Md. "Our presenters honed in on practice-changing papers in sleep medicine, chest infections, pulmonary vascular disease, obstructive lung disease, clinical care, and mechanical ventilation so that primary intensivists, pulmonologists, and sleep docs could pick and choose which ones were most useful to them."
"One of the meeting's major themes was telemedicine and tele-health, both from an electronic intensive care unit (eICU) and specialty-care perspective, and how we take care of chronic obstructive pulmonary disease (COPD) and asthma patients in rural areas," Moores said.
In one study, researchers from the Overton Brooks VA Medical Center in Shreveport, La., studied the pre- and post-effects on 100 COPD patients of a new telemedicine program that included use of an in-home electronic device that requests information on participants' health and transmits responses to a registered nurse. They found that the telemedicine program was associated with fewer significant COPD exacerbations and that unscheduled hospital visits for COPD decreased from 3.59 to 1.95 per year, a 46 percent relative reduction.
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In a second related study, researchers from the Kansas-based Via Christi Health System in Wichita studied the effects of a tele-ICU program in rural facilities and how it reduces carbon footprints and saves money. In 203 patients who were able to stay in their hometown hospital because of the program, the researchers estimated savings in gasoline, lodging, and meals of more than $133,000.
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During the meeting, Gerard A. Silvestri, M.D., of the Medical University of South Carolina in Charleston, presented a review of three papers addressing the new staging system in lung cancer. "The new system classifies patients differently based on the size of their primary tumor or on their nodal status," Moores said. "It has down-staged some patients who may need more aggressive therapy. It also dictates the way we approach therapy, either with adjuvant chemotherapy and surgery, and how to avoid surgical approaches in patients who won't benefit."
In one study of 29 patients with suspected lung cancer who underwent endobronchial ultrasound, Silvestri and colleagues found that malignancy was associated with nodes larger than 40 mm compared to those smaller than 20 mm (odds ratio, 3.84) and that round-shaped nodes were more likely than triangular-shaped nodes to be malignant (odds ratio, 9.09).
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Other significant studies showed that extended therapy may be useful in preventing venous thromboembolism in patients who undergo total joint replacement, and that high blood sugar is associated with poorer outcomes in patients who present with pulmonary embolism.
In a study of 135 pulmonary embolism patients, researchers from the Coimbra University Hospital in Portugal, found that those with blood-sugar levels above 250 mg/dL were significantly more likely than those with lower levels to experience the primary end-point: a composite of in-hospital mortality and the need for catecholamine infusion, mechanical ventilation, or cardiopulmonary resuscitation (25 versus 8.9 percent).
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In another study of 20,843 World Trade Center responders, researchers from the Mount Sinai School of Medicine in New York City found that less than 1 percent had self-reported asthma episodes or attacks before the 9/11 attacks, which increased to 8 percent between 2005 and 2007.
"Asthma and other chronic lung conditions remain a significant burden for rescue and recovery workers responding to the attacks on the World Trade Center," Kalpalatha Guntupalli, M.D., of the Baylor College of Medicine in Houston, and president of the American College of Chest Physicians, said in a statement. "The significant chronic health problems associated with the World Trade Center attacks only reinforces the need for stronger disaster preparedness plans, as well as long-term medical follow-up for 9/11 responders and individuals who respond to disaster-related events."
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On a lighter note, researchers from the Morristown Memorial Hospital in Madison, N.J., studied 12 male golfers who received nasal positive airway pressure treatment for obstructive sleep apnea. They found that treatment was associated with improved daytime sleepiness scores and a lowered golf handicap of up to three strokes.
"Providers typically attempt to maximize compliance with nasal positive airway pressure by promoting its medical benefits or warning patients of the risks involved in not being treated, but this approach does not always work," lead author, Marc Benton, M.D., said in a statement. "In the case of this study, the possibility of improving one's ability to play golf appears to have been a significant motivation to improve treatment compliance."
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CHEST: Nutrition, Fitness Can Affect Lung Function
THURSDAY, Nov. 5 (HealthDay News) -- Vitamin B12 supplementation may benefit some patients with chronic cough, and increased physical fitness may help preserve lung function in elderly adults, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
Abstract - Bucca
Abstract - Kwon
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CHEST: Abnormal Sleep Can Affect Intensive Care Nurses
THURSDAY, Nov. 5 (HealthDay News) -- Intensive care unit (ICU) nurses are more likely than floor nurses to show evidence of abnormal sleep, which may be associated with an increased number of errors during their shifts. In addition, a high-intensity staffing model may decrease pneumonia rates in the ICU, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
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CHEST: Clinician Smoking-Cessation Awareness May Be Low
THURSDAY, Nov. 5 (HealthDay News) -- Hospital workers are unlikely to have formal training in smoking-cessation methods. In addition, patients may be more likely to quit if they participate in pulmonary rehabilitation programs or know their true lung age, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
Abstract - Chen
Abstract - Chan-Thim
Abstract - UCLA
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CHEST: More ICU Patients Discharged Directly to Home
WEDNESDAY, Nov. 4 (HealthDay News) -- An increasing number of intensive care unit patients are being discharged directly to home. In addition, mortality is higher among patients with acute respiratory failure who are admitted to teaching hospitals, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
Abstract - Rashid
Abstract - Kuo
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CHEST: Lower Doses Benefit Pediatric Asthma Patients
WEDNESDAY, Nov. 4 (HealthDay News) -- In children who are hospitalized with asthma, a reduced-dose steroid regimen has no effect on hospital stays, and low-dose albuterol treatment is associated with a lower risk of metabolic acidosis than high-dose treatment, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
Abstract - Edwards
Abstract - Rishi
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CHEST: Statins May Be Beneficial in Select Patients
WEDNESDAY, Nov. 4 (HealthDay News) -- In patients with heart failure, statin use can be helpful or harmful; however, in patients hospitalized with heart attack or stroke, statin use may significantly reduce the risk of venous thromboembolism, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
Abstract - Cahalin
Press Release
Abstract - Khemasuwan
Press Release
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CHEST: Disparities Seen in Restless Legs Syndrome
TUESDAY, Nov. 3 (HealthDay News) -- Caucasian women are disproportionately affected by restless legs syndrome, according to research presented this week at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
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CHEST: Bruxism Can Affect One-Quarter of OSA Patients
TUESDAY, Nov. 3 (HealthDay News) -- In patients with obstructive sleep apnea (OSA), bruxism is highly prevalent, especially among men and Caucasians, according to research presented this week at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.
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