March 2011

Nominate a Fellow Section Member for Our Specialty Practitioner of the Year Award
Every year we honor one of our own with a Specialty Practitioner of the Year award at the AARC International Respiratory Congress. Since this year’s Congress will take place a month earlier than usual (it’s Nov. 5–8, in Tampa, FL), we need to begin gathering nominations for our 2011 award now. Take a few moments to brainstorm deserving candidates, then visit the section website to fill out our ONLINE NOMINATION FORM.

Posttussive Emesis Plus Cough Could Mean Asthma
Asthma should be considered in the differential diagnosis of children who present with cough and a history of posttussive emesis, report researchers publishing in the February issue of the Annals of Allergy, Asthma & Immunology. They arrived at that conclusion after analyzing results from a questionnaire distributed to parents of children ages 2-17 being treated in pediatric and allergy-immunology clinics. The overall prevalence of posttussive emesis was 33% among the 500 children in the study, but children with physician-diagnosed asthma and those with surrogate markers suggestive of asthma had significantly higher rates, 56% and 71%, respectively, than children with no evidence of asthma, who had a posttussive emesis prevalence of 16%. Taking pertussis and gastroesophageal reflux into account did not change the findings. READ ABSTRACT

V/P SPECT May be Useful in Tracking COPD
Noting that FEV1 alone does not explain the underlying pathophysiology of airflow limitation in COPD patients, Swedish researchers studied the relationship between ventilation/perfusion single photon emission tomography (V/P SPECT), spirometry, high-resolution computed tomography (HRCT), and symptoms in 30 patients with stable COPD. V/P SPECT, which visualizes regional ventilation and perfusion, was used to assess total lung function and degree of obstructive disease. HRCT was used to assess the extent of emphysema. Results showed a significant correlation between V/P SPECT, extent of emphysema, and spirometric lung function. The authors believe V/P SPECT is not only sensitive to early changes in COPD but may also help identify comorbid disease. The study was published ahead of print by the European Journal of Nuclear Medicine on Mar. 2. READ ABSTRACT

sRaw and FEV1 are Not Interchangeable
A new study out of France finds specific airway resistance (sRaw) cannot be used interchangeably with FEV1 as a marker of bronchodilator response in children. The research was conducted among 481 children ranging in age from 6 to 17 with actual or suspected asthma. FEV1 reversibility was best predicted by an sRaw cutoff value denoting a 42% decrease from baseline. The value was independent of height and age. FEV1 changes were significantly but independently related to ΔsRaw and ΔFVC (index of air trapping) The authors conclude that while a 42% decrease in sRaw predicted FEV1 reversibility reasonably well, a smaller decrease in sRaw failed to detect approximately one out of two positive responses detected by FEV1, with no influence of height or age. The study was published ahead of print by Respirology on Mar. 1. READ ABSTRACT

Specific Genotype May Lead to More Severe CF
Genotype influences pulmonary phenotype in cystic fibrosis patients, conclude researchers from Sweden who published their findings ahead of print in the Journal of Cystic Fibrosis on Feb. 25. The investigators compared lung function tests in 170 CF patients with two class II mutations, 18 with two class I mutations, and 78 with a combination of class I and II mutations. Lower lung function, as measured by FEV1 and FVC, was seen in the group with two class I mutations when compared to those with either a combination of class I and II mutations or two class II mutations. The authors conclude, “CF patients carrying two class I mutations risk developing more severe lung disease compared to patients with at least one class II mutation.” READ ABSTRACT