A San Francisco study shows that the homeless are twice as likely to have obstructive lung disease (OLD), a condition that blocks airflow from the lungs and is a leading cause of death in the United States. Researchers at the University of California administered spirometry tests to 68 homeless adults and found that 15% had OLD, which is double the prevalence for all adults (7.2%). Other related chronic respiratory symptoms, such as chronic bronchitis, wheezing, and asthma, were also found to be common in the homeless. With smokers making up 68% of the homeless, nearly three times the percentage of smokers in the general population, researchers speculate that smoking, malnutrition, and poor access to care may be responsible for the high incidence of OLD. Researchers point out the importance of medical attention for OLD because disease must be identified early for treatment. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
IS MY LUNG FUNCTION REALLY THAT GOOD?
Researchers in Pittsburgh recently found that errors frequently occur in a common lung function test called spirometry, which can lead to significantly elevated and inaccurate test results. One common error is caused at "zeroing" when the sensor measures an air pressure gradient when there is actually no airflow. This causes falsely elevated air volumes and shifts the entire volume-time curve. Errors also can occur when the sensor is obstructed by condensation of water vapor, mucus, or a subject's fingers. These two technical problems, which can occur even when the spirometer is calibrated as recommended, are especially dangerous because the high values they produce replace accurate but lower values recorded during testing, leading technicians to believe a patient's lung function has improved or is better than what it actually is. Researchers advise that spirometry users be aware of the potential for these errors and question unusually high results, especially if the values increase in a short time period. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
DESPITE 'DRUG COCKTAIL', ICU ADMISSIONS ON THE RISE FOR PATIENTS WITH HIV
New York researchers have found that intensive care unit (ICU) admissions for patients with HIV have significantly increased in the last decade. Study researchers expected ICU rates for patients with the virus to decline due to the benefits of highly active antiretroviral therapy, the HIV "drug cocktail." In actuality, researchers found that ICU admissions for patients with HIV increased by nearly 50 percent from 1991 to 2001. Compared to the previous decade, patients with HIV admitted to ICU in 2001 were more likely to be heterosexual, African- American, injection drug users, and admitted to the ICU due to conditions unrelated to HIV. Researchers speculate that the significant increase in ICU admissions reflects the growing number of persons living with HIV and the emergence of non-HIV-associated conditions as causes of critical illness. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
AMERICAN COLLEGE OF CHEST PHYSICIANS EMBRACES PATIENT-FOCUSED CARE
In a special report issued by the American College of Chest Physicians (ACCP), the medical society announced an initiative to have its members embrace the concept of patient-focused care. The report features the inauguration speech of Richard S. Irwin, MD, FCCP, President of the ACCP, and the new ACCP Patient-Focused Care Pledge, which emphasizes the health-care provider's role as a patient advocate and underscores the provider's responsibility to provide patient-focused care whenever and wherever he or she cares for patients. Instituted in Fall 2003, the Patient-Focused Care Pledge is the foundation for a national initiative to develop interdisciplinary models of patient-focused care for use in hospitals, health-care systems, and health-care education programs around the country. The report appears in the May issue of CHEST, the peer-reviewed journal of the ACCP.