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July 2008 Briefing - Pulmonology

Here are what the editors at HealthDay consider to be the most important developments in Pulmonology for July 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Joint Replacement Linked to Cardiac Complications

THURSDAY, July 31 (HealthDay News) -- Among total joint replacement surgery patients, two new risk factors -- revision surgery and bilateral joint replacement -- as well as traditional risk factors increase odds of cardiac complications, according to an article published in the July issue of Arthritis & Rheumatism.

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Childhood Cancer Survivors Less Likely to Smoke

WEDNESDAY, July 30 (HealthDay News) -- English childhood cancer survivors are significantly less likely to smoke than the general British population, according to an article published online July 29 in the Journal of the National Cancer Institute.

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Sleep Apnea Cardiovascular Link Needs More Research

MONDAY, July 28 (HealthDay News) -- Despite the link between sleep-disordered breathing and cardiovascular disease, more research is needed to explain how these two conditions interact so that sleep medicine specialists and cardiologists can develop a consensus concerning best practice, according to an American Heart Association/American College of Cardiology Foundation scientific statement published online July 28 in Circulation.

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Medical Errors Have Impact After Hospital Discharge

MONDAY, July 28 (HealthDay News) -- Medical errors affect patients in the months after hospital discharge as well as during their hospital stays, leading to excess costs, deaths and hospital readmissions, according to a study published online July 25 in Health Services Research.

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Tuberculosis Screenings Urged for Psoriasis Patients

THURSDAY, July 24 (HealthDay News) -- Before psoriasis patients are treated with systemic and biologic agents, they should be screened and treated for latent tuberculosis infections, according to a National Psoriasis Foundation consensus statement published in the August issue of the Journal of the American Academy of Dermatology.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Shifts in Focus Could Reduce Tuberculosis

TUESDAY, July 22 (HealthDay News) -- Focusing on some foreign-born individuals with latent tuberculosis infection may represent one of the more effective options for improving TB control in this group in the United States, and a framework of strategic activities in HIV care programs could address pressing global concerns related to TB, according to two studies in the July 23/30 issue of the Journal of the American Medical Association.

Abstract - Cain
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Abstract - Havlir
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Gene Expression May Help Predict Lung Cancer Outcomes

TUESDAY, July 22 (HealthDay News) -- A combination of tumor gene expression and clinical covariates may help predict survival in patients with lung adenocarcinoma, according to an article published online July 20 in Nature Medicine.

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Prevention Programs Could Save $16 Billion Annually

THURSDAY, July 17 (HealthDay News) -- Community-based disease prevention programs to increase physical activity, improve nutrition and prevent tobacco use could save the United States $16 billion a year in medical costs within five years, mostly from Medicare and private payers, according to a new report by Trust for America's Health.

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Bacterial Infection Linked to Reduced Childhood Asthma

THURSDAY, July 17 (HealthDay News) -- Childhood infection with Helicobacter pylori reduces the likelihood of developing asthma and related illnesses, according to an article published online July 3 in the Journal of Infectious Diseases. A related review in the May issue of Gut discusses the current evidence and possible mechanisms linking H. pylori infection, asthma and allergy.

Abstract - Journal of Infectious Diseases
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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

Abstract - Dienstag
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No Asthma Control Benefit from Low-Sodium Diet

THURSDAY, July 17 (HealthDay News) -- In contrast to the results of small clinical trials, asthma patients who follow a low-sodium diet as an adjunct to normal treatment do not have any related improvement in their symptoms, according to a new report published in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Warfarin Appears Safe After Cardioembolic Stroke

THURSDAY, July 17 (HealthDay News) -- The initiation of warfarin for anticoagulation appears to be safe soon after cardioembolic stroke, according to research published online July 14 in the Archives of Neurology.

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Therapy-Suspected Link Reported in Lung Cancer Patient

WEDNESDAY, July 16 (HealthDay News) -- A case of lung cancer in an individual using anti-tumor necrosis factor (TNF) therapies -- which regressed upon withdrawal of the drugs -- raises concerns about the use of anti-TNF therapy in older patients with a history of smoking, according to correspondence in the July 17 issue of the New England Journal of Medicine.

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Costs, Medical Services Use High for Pulmonary Patients

WEDNESDAY, July 16 (HealthDay News) -- Patients with chronic obstructive pulmonary disease (COPD) alone or with asthma use more medical services and incur higher costs than patients with asthma alone, according to the results of a study in the July issue of Chest. A related study in the same issue found that the use of spirometry to diagnose COPD varies greatly among regions in the United States.

Abstract - Shaya
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Abstract - Joo
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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Ventilation Does Not Improve Mortality Rate in Lung Edema

WEDNESDAY, July 9 (HealthDay News) -- Non-invasive ventilation improves symptoms of respiratory distress but not short-term mortality in patients with acute cardiogenic pulmonary edema, researchers report in the July 10 issue of the New England Journal of Medicine.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

Abstract - Cookson
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Abstract - Popay
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Test Provides Good Specificity for Latent Tuberculosis

MONDAY, July 7 (HealthDay News) -- Interferon-γ-release assays (IGRAs) and tuberculin skin tests both offer high specificity for tuberculosis in populations unvaccinated with bacille Calmette-Guerin, but the IGRAs also offer high specificity in those who are vaccinated, according to research published in the Aug. 5 issue of the Annals of Internal Medicine.

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Conventional Secondhand Smoke Assessment Faulted

FRIDAY, July 4 (HealthDay News) -- In the assessment of patients exposed to secondhand smoke, measurements of biological markers may be better indicators of exposure and lung cancer risk than conventional assessment methods, researchers report in the July issue of The Lancet Oncology.

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Smokeless Tobacco May Be Safer Than Cigarettes

THURSDAY, July 3 (HealthDay News) -- Smokeless tobacco users probably have a lower risk of several common cancers than smokers, but a higher risk than people who use no tobacco products, according to the results of a study published in the July issue of The Lancet Oncology.

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Molecular Analysis Monitors Changes in Lung Cancer

WEDNESDAY, July 2 (HealthDay News) -- In patients with non-small-cell lung cancer, molecular analysis of circulating tumor cells isolated from blood may be a non-invasive procedure that helps physicians monitor changes in epithelial tumor genotypes during treatment, according to the results of a study published online July 2 in the New England Journal of Medicine.

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Smoke-Free Policies Linked to Many Health Benefits

WEDNESDAY, July 2 (HealthDay News) -- Smoke-free policies -- such as legislation to protect individuals from secondhand smoke -- can lead to health improvements including reduction of respiratory symptoms, and may help reduce adult and youth tobacco use, according to a report published in the July issue of The Lancet Oncology.

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Tuberculosis Outbreaks Predicted from First Cases

TUESDAY, July 1 (HealthDay News) -- Large tuberculosis outbreaks occurring within two years of the initial case can be predicted based on the characteristics of the first two cases, researchers report in the July 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Editorial

New Recommendations for Quality Performance Measures

TUESDAY, July 1 (HealthDay News) -- Health care quality performance measures should be developed with the participation of end users and should take a cautious and flexible approach, according to an article published in the July 1 issue of the Annals of Internal Medicine.

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Physician's Briefing