News briefs from the journal Chest, October 2004



Children with siblings may be less likely to develop asthma than those without siblings, yet genetic and prenatal and postnatal factors may increase a child's risk for asthma. Canadian researchers followed 170,960 newborns to identify factors that may increase physician-diagnosed asthma in children from birth to age six. Of the newborns, 14.1 percent were seen for asthma, with the highest incidence of asthma in the first two years of life. Children of multiple births or those who had siblings had a lower asthma risk than children without siblings. Children born during winter months of January through March also had a lower asthma risk than those born from July through December. Conversely, the likelihood of early childhood asthma increased if newborns were male, were treated by a pediatrician as a primary care provider, lived in an urban area, were born premature, or had low birth weight. Other factors that increased asthma incidence included a maternal or sibling history of asthma, infant exposure to upper or lower respiratory tract infections, and the presence of congenital conditions, including cystic fibrosis and respiratory distress syndrome. The study appears in the October issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.


Children with asthma and their parents may be inaccurately assessing medication levels in asthma inhalers, causing misuse of the medication. North Carolina researchers questioned 50 patients or their parents on their understanding of inhaler use and what methods they use to determine the fullness level of their pressurized metered-dose inhaler. Results showed that 78 percent of subjects knew they were supposed to shake the canister before use, yet, only half shook the canister when asked to demonstrate inhaler use. In addition, 72 percent of the subjects determined the canister was empty when they could no longer hear the canister make a sound when it was activated. Four subjects had been told to float the canisters in water to determine medication level. When researchers tested the assessment methods for accuracy, they found that auditory assessment of medicine level was inaccurate because the number of audible "puffs" in each canister was significantly higher than the number listed by the manufacturer, causing patients to continue using the inhaler even after the medication was depleted. Researchers also found the flotation method of assessment to be inaccurate and dangerous due to water collection at the top of the valve system. Although researchers conclude that counting the number of "puffs" is currently the most accurate method of determining if a canister is empty, they feel patients are rarely instructed on this method. The study appears in the October issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.


Despite the availability of medications for treatment of tuberculosis (TB) in the United States, patients admitted to the hospital for TB have a high in-hospital mortality rate and incur over $385 million a year in hospital charges. In the largest US study to provide estimates for TB outcomes of hospitalized patients, researchers from Baltimore, MD, used data from the 2000 Nationwide Inpatient Sample, which represents 20% of the country's hospitalizations, and examined the characteristics and outcomes of 2,279 people admitted to the hospital with a primary diagnosis of the disease. Researchers found that of those hospitalized with TB, 64% were men, 72% were minorities, 50% lived in areas of median incomes less than $35,000, and 66% had publicly funded health insurance or no health insurance. The study also showed that the in-hospital morality rate for TB patients was 4.9%, which is double the 2.4% in-hospital mortality rate of all other hospital admissions. Having comorbid illnesses, being older, and being admitted to the hospital through the emergency room were each a significant predictor of morbidity. The study's authors suggest that because $385 million is spent on in-hospital TB care every year, expanding public health programs that educate about the prevention and early identification of TB would reduce the significant burden on the US health system. The study appears in the October issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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