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American Thoracic Society Journal news tips for October (second issue)

American Thoracic Society

BIG SAMPLE OF U.S. ASTHMA PATIENTS SUFFER FROM MODERATE TO SEVERE DISEASE

In a cross-sectional, random-dial telephone survey of over 42,000 households in the U.S., researchers found that the majority of the population with asthma experienced moderate to severe persistent disease rather than mild illness, and that the resulting impact on patient activity was "substantial." The investigators analyzed data from 3,273 households that met the criteria for current asthma. Limiting their data request to respondents who were over 16 years of age, they captured answers from a 1,778-person national sample of older adolescents and adults with asthma. Of this group, 77.3 percent had moderate to severe persistent disease and 10.7 percent had mild intermittent illness. In addition, the impact of asthma on the respondent's daily activities was "considerable," according to the researchers. Two thirds of the individuals reported their asthma had "some" or "a lot" of impact on their physical activities. Consequently, the investigators believe that the goals of the National Asthma Education and Prevention Program "to maintain normal activity levels (including exercise and other physical activity)" are not being met. The research appears in the second issue for October 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

ANTIBIOTICS REDUCE INFECTIONS FOR SEVERELY ILL IN CRITICAL CARE

Intensive care unit (ICU) investigators have revealed that the prophylactic administration of a short course of intravenous antibiotics, in combination with topical non-absorbable antibiotics, has significantly reduced the incidence of infections and prevented progression to severe organ failure in critically ill surgical and trauma patients. (Despite the high level of care, ICU patients are at increased risk for the development of severe and even fatal infections.) German researchers analyzed data from 527 patients in the largest prospective clinical trial conducted to date designed to investigate antibiotic prophylaxis in critically ill patients. As contrasted to placebo, the total number of infections among the 256 treated patients was much lower (141 infections versus 274). The authors discovered that the treated patients had fewer: cases of pneumonia (6 versus 29); other lower respiratory tract disorders (39 versus 70); bloodstream infections (14 versus 36); and urinary tract infections (36 versus 70). Also, a significantly smaller number of treated patients suffered from severe organ dysfunction (63 patients versus 96). The study appears in the second issue for October 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

SECONDARY HEATING SOURCES CAUSE WHEEZE AND COUGH

Use of secondary heating sources during the winter, including wood stoves, gas space heaters, and kerosene heaters, is associated with wheeze and cough in infants during the first year of life. Biomedical scientists studied 890 infants born in 12 hospitals in Connecticut and Virginia. From their study, they found that use of gas space heaters was related to both new episodes of wheeze and total wheeze days in infants. Wood stove use was related to days of cough, and kerosene heater use was associated with episodes of cough. However, fireplace use was not related to cough or wheeze, which the researchers attribute to a limited duration of exposure for the infants. The study authors point out that heating sources such as gas, kerosene, or wood are important producers of particulate matter in the home. Unvented or poorly vented gas heaters produce high levels of nitric dioxide, which is released directly into the home. Wood stoves and fireplaces, even when vented to the outside, may emit a high concentration of pollutants into the indoor air, including inhalable particles, carbon monoxide, and nitric dioxide. The research appears in the second issue for October 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

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For the complete text of these articles, please see the American Thoracic Society Online Web Site at http://www.atsjournals.org. For contact information or to request a complimentary journalist subscription to ATS journals online, or if you would like to add your name to the Society's twice monthly journal news mailing list (please select either postal or electronic delivery), contact Cathy Carlomagno at (212) 315-6442, or by e-mail at ccarlomagno@thoracic.org.

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