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News briefs from the August issue of Chest

American College of Chest Physicians

X-RAY MACHINES MAY SPREAD INFECTIONS IN THE ICU

Poor infection control practices when using x-ray machines may lead to nosocomial infections in the ICU. In a new study, Israeli researchers observed 173, 113, and 120 ICU chest x-rays during observation, intervention, and follow-up periods, respectively. Adequate infection control was practiced during 1 percent of observation x-rays, 42 percent of intervention x-rays, and 10 percent of follow-up x-rays. The study also showed that x-ray machine surface cultures yielded resistant gram-negative bacteria on 39 percent, 0 percent, and 50 percent of the observation, intervention, and follow-up x-rays. The authors conclude that improved infection control practices could decrease the occurrence of resistant organisms on x-ray equipment. This study is published in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.


AFRICAN-AMERICANS WITH COPD USE FEWER HEALTH SERVICES

New research shows that African-Americans (AA) with chronic obstructive pulmonary disease (COPD) use fewer health services than Caucasians with the condition. Researchers from the University of Maryland compared health services utilization and cost outcomes in 4,723 AA patients and 4,021 Caucasians with COPD, asthma, or both. After controlling for age, gender, cohort allocation, and comorbidities, results showed that AA adults with COPD, asthma, or coexisting asthma and COPD used fewer medical services and accounted for lower medical costs than Caucasians. The authors speculate that the differences in utilization and medical costs may provide an explanation for the racial disparities in outcomes of patients with COPD and asthma. The article is published in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.


NEW REVIEW DEBATES NEED FOR ADDITIONAL LABA SAFETY TRIALS

In a new commentary, Malcolm R. Sears, MD, of McMaster University in Hamilton, ON, Canada, discusses the familiar debate about the safety of using long-acting β2-agonists (LABA) in monotherapy for asthma. The commentary focuses on data provided in the metaanalysis recently undertaken by the FDA of safety outcomes of 60,954 individuals in 110 LABA trials. Results of the analysis found that LABA used with mandatory inhaled corticosteroid (ICS) was not associated with an increased risk of asthma-related mortality, intubations, or exacerbations. Dr. Sears argues that an additional analysis beyond the FDA study is not practical or needed. In addition, he suggests that the use of LABA, when indicated, in mandatory combination with appropriate doses of ICS, should remain the standard treatment for patients with moderate to severe asthma. This article is published in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

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