January 2008

Section Bulletin Online Now
The Winter edition of the Bulletin is on the SECTION WEB SITE and ready for viewing. Check it out for great articles on:

  • Section activities
  • 2007 Specialty Practitioner of the Year
  • NHANES III reference equations for spirometry

 

Section Bulletin Needs Your Input
The section is currently seeking topics and articles for the 2008 Section Bulletins, and we would like to invite all our members to weigh in by filling out our ONLINE FORM. So start thinking about what you’d like to see in your Bulletins this year, and then suggest those topics via the form. If you’d like to write an article for the Bulletin, you can note that in your comments as well, and our Bulletin editor will contact you for more information.

Spirometry in the Primary Care Practice
Belgian researchers take a good look at primary care spirometry in the January issue of the European Respiratory Journal, noting that while spirometry can be a valuable tool in this setting, low acceptability of spirometric maneuvers has been reported and could impact clinical decision making. They also address the potential for softening the stringent ATS/ERS criteria, noting that it could enhance the acceptability rates, but that the clinical implications of such simplifications have yet to be thoroughly investigated. While handheld spirometers developed in recent years are user friendly and acceptable for the primary care setting, the precision of the FVC measurements is lacking in some models. Training and refresher courses for primary care practices could enhance the use of spirometry in this setting. READ ABSTRACT

IOS May Be Suitable for Children, Others
Impulse oscillometry (IOS) may be an adequate substitute for spirometry and peak expiratory flow rate (PEFR) in young children or others who are unable to perform the traditional procedures. That’s the key finding from Korean researchers who evaluated the correlation of IOS parameters with spirometry values and PEFR measurements in 48 children with asthma and 66 controls. Total serum IgE levels, total eosinophil counts, and specific IgE levels were measured as well, and the children also underwent methacholine challenge. Results showed:

  • FEV1 and PEFR showed a significant correlation with impedance and resistance (R) at 5, 10, 20, and 35 Hz, both in atopic asthmatic and atopic control children.
  • FVC showed a correlation with impedance and R at 10, 20, and 35 Hz, both in atopic asthmatic and atopic control children.
  • FEF(25-75%) did not show a correlation with resistances.

 

The study appeared in the Dec. 10 Epub edition of Acta Paediatrica. READ ABSTRACT

Bilateral BAL More Accurate for Diagnosing VAP
Bilateral bronchoalveolar lavage (BAL) is superior to unilateral BAL in diagnosing ventilator-associated pneumonia (VAP), report University of Cincinnati researchers in the Dec. 19 Epub edition of the American Journal of Surgery. In a study involving 73 patients with suspected VAP who underwent bilateral BAL, they found 60% were VAP positive. Among the positive patients, 64% had concordant samples. Fifteen false-negative samples were noted. The authors conclude, “Sole use of the unilateral samples to guide treatment would have inappropriately directed antibiotic avoidance and/or discontinuation in 25% of VAP patients . . . Unilateral BAL may be insensitive in patients with clinically significant contralateral infection.” READ ABSTRACT

Airway Cytokine Profile Differs in Severe Asthma
A new study out of Canada finds differences in the expression of key inflammatory markers between people with severe asthma and people with moderate asthma. The investigators compared test results for 24 severe asthma patients with those obtained from 26 patients with moderate asthma. Both neutrophils and eosinophils were increased in patients with severe asthma. Differences were also noted in the airway cytokine/chemokine expression. “Excess neutrophilia may be explained by increased expression of IL-8 but differences in eosinophilia do not appear to be associated with IL-5 and eotaxin expression,” write the authors. The report appeared in the Dec. 10 Epub edition of CHEST. READ ABSTRACT

 


 

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