News briefs from the journal Chest, July 2004
PHYSICIANS FAIL TO GIVE ASTHMATICS PROPER MEDICATION
A nationwide study of treatment for asthma patients who visited the emergency department (ED) suggests that physicians are not following the recommended asthma guidelines and are underprescribing controller medications and overprescribing rescue medications, including short-acting beta-agonists (SABA). Researchers from Seattle, WA, Yardley, PA, and Research Triangle Park, NC, studied asthma medications prescribed to 12,636 patients with an asthma-related ED visit in 2001 for 12 months prior to and two months following the ED event. Even though evidence-based guidelines for asthma recommend inhaled corticosteroid (ICS) therapy for asthma control, researchers found that only a fourth of patients received ICS therapy in the year before their ED visit, while more than 80% of asthma patients received rescue medications, with a third given an oral corticosteroid (OCS) and over half given a SABA. In the two months following the ED event, 26% of the patients received ICS therapy, 38% received SABA medication, and 42% received OCS therapy. Although there was an initial modest increase in ICS and OCS use, within two months use of both dropped significantly and returned to previous levels, showing that a trip to the ED did not affect long-term asthma control. The study appears in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians and was supported by GlaxoSmithKline.
HEART ATTACK TREATMENT MORE DANGEROUS FOR WOMEN
In a recent study of heart attack patients, researchers in Taiwan found that women who receive primary percutaneous coronary intervention (PCI) are less likely to survive than men who undergo the same procedure. PCI is the method of widening a blood vessel by inserting a balloon into the clogged blood vessel following a heart attack. When researchers followed 1,032 heart attack patients (158 women and 874 men) for 30 days following the procedure, they found that women had a significantly higher mortality rate of 14.6%, compared to 7.4% in men, even though both genders had the same PCI insertion success rate. Researchers attribute the gender gap in outcome differences to female patients being older than males and that older individuals have a poorer outcome after heart attacks. As compared to men, women in the study also had more multiple health conditions, such as hypertension, diabetes, and complete atrioventricular block, and experienced more problems while hospitalized, including congestive heart failure and bleeding complications. The study appears in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
SEPTIC SHOCK: SEVERE AT FIRST MAY MEAN BETTER LATER
Researchers found that while patients in the intensive care unit (ICU) who experience early septic shock (ESS) have far more severe symptoms than patients with late septic shock (LSS), patients with ESS have a better total outcome. In a study of 65 ICU patients, Belgian researchers compared the morbidity and mortality of 41 patients who experienced ESS, classified as the onset of an episode less than 24 hours after hospital admittance, to 21 patients who experienced LSS, classified as an episode more than 24 hours after hospital admittance. The study showed that ESS patients faced significantly higher organ failure, higher blood lactate concentration, and a worse chronic health evaluation than LSS patients. Despite the increased severity of septic shock, ESS patients ultimately fared better with a shorter duration of septic shock, shorter length of stay in the ICU, and slightly lower mortality rates. The study appears in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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