Ad-lib albuterol effective for severe asthma cases
The efficacy of inhaled, short-acting [beta]-agonists for outpatients with asthma symptoms is well documented, but only a small amount of data exists to support using these treatments for hospitalized patients with more severe asthma symptoms. Consequently, researchers designed a double-blind, placebo-controlled study that included 62 hospitalized acute asthma patients. Participants received nebulizations of either albuterol or saline solution every 4 hours.
There weren't many differences between the two groups' lengths of stay, rate of improvement in peak flow, or symptoms. Results indicate that ad-lib albuterol administration is as effective as scheduled administration. Ad-lib albuterol administration also reduces the total number of treatments during hospitalization.
Source: Chandra A, et al. Regular vs ad-lib albuterol for patients hospitalized with acute asthma. Chest. 2005;128:1115-1120. Available at: http://www.chestjournal.org/cgi/content/abstract/128/3/1115. Accessed December 19, 2005.
Heart failure undiagnosed in older COPD patients
A recent study in the European Heart Journal found that in one of five older patients with stable chronic obstructive pulmonary disease (COPD), heart failure goes unrecognized by healthcare providers. Researchers say this percentage can decrease with better teamwork and cooperation between cardiologists, pulmonologists, and general practitioners. The elderly patient sample was categorized as at least 65 years of age with COPD, but without a known history of heart failure. Of these 405 patients who received an in-depth diagnostic workup, researchers found that 20% had previously unrecognized heart failure, and almost 12% had possible heart failure. Of those found to have had heart failure, almost 51% had systolic heart failure and approximately 49% had isolated diastolic heart failure. Right-sided heart failure wasn't experienced by any of the patients.
Researchers championed proper treatment of heart failure in its early stages to decrease symptoms and slow the disease's progression.
Source: Reuters Health. Unrecognized heart failure common in elderly COPD patients. Available at: http://www.reutershealth.com/archive/2005/ 10/21/professional/links/20051021clin009.html. Accessed December 19, 2005.
Relationship between BMI and lung cancer?
Researchers conducted a case-control study to investigate the relationship between body mass index (BMI) and the risk of lung cancer. Previous studies have reported an inverse relationship between the two, indicating leanness as a risk factor for lung cancer. The study, conducted over a 10-year period, evaluated 363 lung cancer cases and 1,089 control subjects. Researchers found no such association for the women in the group, and an inverse association between BMI and lung cancer in men. Consequently, it's possible that the previous finding of leanness and lung cancer association in women was incorrect, and in fact could possibly be related to smoking or smoking-related respiratory disease. Experts believe that a larger-scale study will confirm this study's results.
Source: Kanashiki, M, et al. Body mass index and lung cancer. Chest. 2005;128:1490-1496. Available at: http://www.chestjournal.org/cgi/content/abstract/128/3/1490. Accessed on December 19, 2005.
CDC intervenes to prevent central line BSIs
The Centers for Disease Control and Prevention partnered with the Pittsburgh Regional Healthcare Initiative to participate in a 4-year intervention program to develop and implement strategies to decrease the incidence of central line-associated bloodstream infections (BSIs). Approximately 250,000 cases of central line-associated BSIs occur in hospitals each year. The multifaceted intervention promoted education about central line-associated BSIs and prevention strategies, evidence-based catheter insertion practices, standardized lists of contents for catheter insertion kits, methods for recording adherence to recommended practices, and distribution of central line-associated BSI rate data. Among the 32 participating hospitals, 66 intensive care units (ICUs) were included in the analysis, providing data for a median of 15 quarters between April 2001 and March 2005. The rate of BSIs per 1,000 central line days decreased by 67% among medical/surgical ICUs and 69% among other ICU types. Experts believe additional study will be needed to determine whether these methods will achieve similar success with the prevention and reduction of other health care-associated infections.
Source: Muto C, et al. Reduction in central line-associated bloodstream infections among patients in intensive care units-Pennsylvania, April 2001-March 2005. MMWR Weekly. 2005;55(40);1013-1016. Available at: http://www.cdc.gov/preview/mmwrhtml/mm5540a2.htm. Accessed December 19, 2005.
Insulin aspart approved for use in children, adolescents
Insulin aspart [rDNA origin] injection received approval for an expanded indication that allows its use in the treatment of type 1 or type 2 diabetes in children and adolescents. Previously, this product was approved for use only in adults.
The approval was based on the results of a clinical study of 283 children and adolescents (ages 6 to18) with type 1 diabetes. Insulin aspart achieved a level of gylcemic control comparable to that of the company's regular human insulin, according to hemoglobin A1C results. A second study of insulin aspart in young children with type 1 diabetes (ages 2 to 6) also showed that insulin aspart and regular human insulin yielded similar levels of hemoglobin A1C control.
In both studies, the children using the insulin aspart had similar rates of hypoglycemia.
Coffee intake and childhood growth show no connection
Many parents still believe coffee intake at an early age can stunt their child's growth, despite years of scientific research that the common belief is incorrect. No evidence has been found that coffee consumption has any effect on height. A 6-year study tracking 81 adolescents found no difference in bone gain or density between those with the highest daily caffeine intake and those with the lowest. Scientists believe that the association between coffee and height stems from early studies linking high intake of caffeine with reduced bone mass. Recent studies suggest that any effect of caffeine upon height is small and may be easily offset with an adequate intake of calcium.
Source: O'Connor A. The claim: drinking coffee can stunt a child's growth. The New York Times. October 18, 2005. Available at: http://www.nytimes.com/2005/10/18/health/18real.html. Accessed December 19, 2005.
Treatment time affects hypertension patients' blood pressure pattern
Experts studied the impact of treatment time on the blood pressure pattern of patients with resistant hypertension. Of the trial's 700 patients, 299 were given all medication on awakening, and 401 received an antihypertensive drug at bedtime. Of the 578 patients with resistant hypertension, patients taking one drug at bedtime showed a significant reduction in systolic and diastolic blood pressure. In comparison to the all-drug group, the one-drug-at-bedtime group also displayed a large reduction in average levels of glucose, cholesterol, fibrinogen, and urinary albumin excretion. Results indicate that pharmacological therapy would do well to take into account the rest-activity cycle of each patient with respect to treatment time.
Source: Hermida R, et al. Effects of time of day of treatment on ambulatory blood pressure pattern of patients with resistant hypertension. Hypertension. 2005;46:1053. Available at: http://hyper.ahajournals.org/cgi/content/abstract/46/4/1053. Accessed December 19, 2005.