February 2013

Join. Renew. Win.

The AARC has launched a new membership drive for 2013, so CLICK OVER NOW to see what it’s all about and then share the link with your colleagues who are not yet members of the Association. They’ll be eligible for some great prizes if they join–and you will be too when you renew your membership in your professional organization. There’s a little friendly competition going on between the states to see who can grow by the most members and largest percentage of members from now through Oct. 31 too.

PFT Changes May Predict Radiological Response to Chemotherapy in MPM Patients

Measuring changes in pulmonary function might be a good way to evaluate response to chemotherapy in patients with malignant pleural mesothelioma (MPM), report Italian researchers publishing ahead of print in the European Journal of Cardio-Thoracic Surgery on Jan. 23. They arrived at that conclusion after studying 62 consecutive patients who underwent pulmonary function tests before and after three cycles of platinum-based chemotherapy. Radiological evaluation of response to chemotherapy was assessed using modified RECIST criteria. A radiological stable disease was seen in 30 patients, 23 had a partial response to chemotherapy, and nine were determined to have progressive disease. A significant correlation was observed between change in FEV1% predicted and FVC% predicted from baseline to post-chemotherapy, and the percent change in linear tumor measurement. “Dynamic lung volumes and radiological changes after chemotherapy seem directly related,” write the authors. “Lung function changes could be an additional tool to better evaluate the response to chemotherapy in MPM.” READ ABSTRACT

BHR: An Indirect Predictor of All-Cause Mortality?

FEV1 has been shown to predict all-cause mortality, and studies have also linked asthma to a higher risk of death from all causes. But what about one of the key symptoms of asthma, bronchial hyperresponsiveness (BHR)? German researchers decided to find out if BHR was also linked to all-cause mortality in a study involving 1162 adults age 20-65 who participated in a cross-sectional survey. All of the participants underwent standard lung function tests and BHR testing by methacholine inhalation. During a mean follow up of 17.4 years, 85 people died. FEV1 predicted mortality, and BHR increased the mortality risk in men after adjustment for age and body mass index; additional adjustment for asthma did not change the risk. However, the increased risk was no longer statistically significant after adjustment for pack years of cigarette smoking or airway obstruction, leading the researchers to conclude that, at best, BHR “might be an indirect predictor for all-cause mortality.” The study was published ahead of print in the Journal of Asthma on Jan. 23. READ ABSTRACT

No Link Seen Between PFTs and Bone Mineral Density

British researchers who studied 985 men and women age 60-72 who underwent bone mineral density (BMD) and pulmonary function testing found no link between BMD and PFTs, even in patients diagnosed with COPD. The participants were also tested for bone mineral content and body area, and an initial association between those measures and PFTs was removed after the results were adjusted to take body size and lifestyle choices into account. The authors conclude, “There was no association between lung function and bone mass in this community dwelling cohort after adjustment for body size and other confounders.” The study was published ahead of print by the Archives of Osteoporosis on Jan. 15. READ ABSTRACT

Blood Counts Can’t Replace Invasive Testing in Kids with Severe Asthma

Peripheral blood counts have been shown to reveal inflammatory phenotypes of severe asthma in adults. If the same were true for children, kids could be spared invasive testing, but unfortunately that wasn’t the case in a study published ahead of print in Allergy on Jan. 25. The British investigators looked at 88 children who underwent blood tests, exhaled nitric oxide (FeNO) testing, sputum induction, bronchoalveolar lavage (BAL), and endobronchial biopsy (EB). Results showed:

• Sixty-three of the patients (71.6%) had a normal blood profile and only 1/88 had a combined blood eosinophilia and neutrophilia.
• 76/88 (86%) had normal blood eosinophils, but of these, 84% had airway eosinophilia in either BAL or EB.
• In children with severe therapy-resistant asthma, blood eosinophilia was associated with airway eosinophilia. However, normal blood eosinophil levels did not exclude airway eosinophilic inflammation.

The researchers conclude, “Peripheral blood counts are not reliable in characterizing airway inflammation in severe asthmatic children exposed to high dose steroid therapy, therefore bronchoscopy with BAL should be considered.” READ ABSTRACT