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American College of Chest Physicians (CHEST 2006), Oct. 21-Oct. 26, 2006

CHEST 2006

The American College of Chest Physicians' annual meeting, CHEST 2006, was held Oct. 21-Oct. 26 in Salt Lake City and drew more than 4,000 attendees.

"We've had some extremely good sessions," said program chair Michael H. Baumann, M.D., professor of medicine at the University of Mississippi Medical Center in Jackson, Miss., who noted attendees were very interested in the evidence-based education workshops that used simulation. The workshops addressed areas such as bronchoscopy, sleep and critical care. For example, in one workshop, clinicians intubated mannequins with difficult airways and refreshed their critical care skills in scenarios that included the management of low blood pressure due to cardiac conditions or infection.

"Pulmonary critical care clinicians must re-certify every 10 years, and this will ensure they have basic skills on how to manage disease scenarios in patients with severe infection," Baumann said.

Other popular sessions dealt with ongoing controversies in clinical care. For example, a panel debated appropriate management of patients with bronchiectasis. "Another very hot topic was the continuing debate over pharmacologic treatment for chronic obstructive pulmonary disease," Baumann said. The management of pulmonary embolism also drew a large crowd. "This is always a big issue because the disease is frequently unrecognized until the moment of crisis and physicians always want to know the best way to diagnose and treat these patients," he added.

Keynote speakers addressed the evolving, complex area of performance measures. Panelists explored ways in which physicians can determine their performance in terms of patient mortality, hospital length of stay and patient satisfaction. Fair performance measures, Baumann said, are scientifically based, important, easily used and feasibly examined.

One retrospective study was presented that found that nicotine replacement therapy may have a negative impact on ICU patients. "Our study shows nicotine patches may increase mortality, and from this we conclude that prospective studies are needed before blindly using it in the ICU," said senior investigator, Bekele Afessa, M.D., of the Mayo Clinic in Rochester, Minn.

Of 6,000 ICU admissions, 112 patients were on nicotine replacement therapy. Eighteen of these patients died compared to only three patients who were not on nicotine replacement therapy. "Nicotine narrows coronary blood flow to heart and may cause higher heart rate; although the amount used is small, the potential exists for adverse effects," Afessa said.

CHEST: Faster Lung Function Decline in Some NYC Rescuers

WEDNESDAY, Oct. 25 (HealthDay News) -- After the Sept. 11 attacks on the World Trade Center in New York City, rescuers deficient in the alpha-1 antitrypsin (A1AT) protein had faster declines in lung function over a four-year period, but a test in development may allow earlier diagnosis of A1AT deficiency, according to two studies presented at CHEST 2006, the annual meeting of the American College of Chest Physicians in Salt Lake City.

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CHEST: Umbrella Valve Has Potential in COPD

TUESDAY, Oct. 24 (HealthDay News) -- An investigational umbrella-shaped valve showed promise as a non-invasive alternative to lung volume reduction surgery in patients with chronic obstructive pulmonary disease (COPD), according to research presented at CHEST 2006, the 72nd annual meeting of the American College of Chest Physicians in Salt Lake City.

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CHEST: Statins Cut Stroke Risk in Carotid Artery Disease

TUESDAY, Oct. 24 (HealthDay News) -- In patients with severe non-revascularized carotid artery disease, statins significantly reduce stroke, myocardial infarction and all-cause mortality, according to research presented at CHEST 2006, the annual meeting of the American College of Chest Physicians.

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CHEST: Combination Therapy Improves Survival in COPD

TUESDAY, Oct. 24 (HealthDay News) -- For patients with chronic obstructive pulmonary disease, or COPD, a combination of salmeterol plus fluticasone propionate may improve survival better than either placebo or fluticasone alone, according to a study presented Oct. 23 at CHEST 2006, the annual meeting of the American College of Chest Physicians. The combined treatment also improves lung function and symptoms of COPD.

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CHEST: Statins Can Slow Lung Function Decline in Smokers

TUESDAY, Oct. 24 (HealthDay News) -- Statins can slow the decline in lung function in current and former smokers, regardless of smoking status or level of lung impairment, according to a study presented Oct. 23 at CHEST 2006, the annual meeting of the American College of Chest Physicians.

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Physician's Briefing