American Thoracic Society Journal news tips for June 2005 (first issue)

05/25/05

THE ASSOCIATION OF ASTHMA AND PANIC DISORDER

Based on a 21-year study of young adults from ages 19 to 40 that utilized regular follow-up interviews, researchers found a long-term (longitudinal) relationship between asthma and panic in a community sample of 591 men and women.

The researchers found that asthma was more strongly associated with panic disorder than with any panic, which included both panic disorder and panic attack. The investigators said that active asthma predicted subsequent panic disorder and panic disorder predicted subsequent asthma activity.

The 591 subjects who participated (292 men and 299 women) were selected from a larger screening sample called the Zurich Cohort Study, named for the canton where they lived in Zurich, Switzerland. In 1978, the participants were assessed using a psychological symptom questionnaire, a symptom checklist, and a questionnaire designed to yield demographic data. The present study was based on a stratified sample, a subset of the larger study, and an overrepresentation of risk cases for psychiatric disorder. The initial screening took place at age 19 for participants, with the first and second interviews in 1979 and 1981, the third and fourth interviews in 1986 and 1988, the fifth interview in 1993, and the sixth and final interview in 1999. Over the 20 years, more than 62 percent of the original group continued to participate in the research.

According to the authors, the 20-year cumulative prevalence of asthma was 7.3 percent and of panic disorder 7.8 percent. When participants were asked about any type of panic, the percentage soared almost three times higher to 20.5 percent.

The authors said that having asthma, which can be potentially a life-threatening condition, could increase the level of anxiety which might lead in some vulnerable individuals to panic. Moreover, asthma medications can have anxiety-causing properties and anxiety may further enhance the use of asthma medication.

The study appears in the first issue for June 2005 of the American Thoracic Society's peer-reviewed journal, the American Journal of Respiratory and Critical Care Medicine.

"ELECTRONIC NOSE" DETECTS LUNG CANCER

The exhaled breath from patients with lung cancer has distinct characteristics that allow those with the disease to be identified by an "electronic nose," according to a report in the first issue for June 2005 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Researchers reported the results of measuring exhaled breath of 14 individuals with bronchogenic carcinoma and 45 control subjects without cancer to develop the screening capability.

The authors said that they hypothesized that an "electronic nose" would detect lung cancer on the basis of complex "smellprints" of numerous volatile organic compounds in exhaled breath from individuals with lung cancer as compared with either other non-cancerous lung disease or healthy controls.

According to the authors, analysis of results from the "electronic nose" demonstrated its ability to discriminate between samples from lung cancer patients and those from other groups during the initial discovery and training phase of the study.

Next, the researchers tested the "electronic nose" on 14 lung cancer cases, and 62 without the disease. Of the 14 cancer patients, 10 had a positive exhaled breath test, and 4 had a negative. Of the 62 non-cancerous patients, 57 had a negative exhaled breath test and 5 had a positive.

They said that in this population with a lung cancer prevalence of 18 percent, positive and negative predictive values were slightly over 66 percent and approximately 92 percent, respectively.

The researchers noted that their results prove the feasibility of the concept of using the "electronic nose" to detect and manage lung cancer. However, further study is needed to understand the optimal strategies for using it in population-based screening.

THE EFFECT OF PRIMARY GRAFT DYSFUNCTION ON LUNG TRANSPLANT SURVIVAL

Using data collected on 5,262 patients from the United Network for Organ Sharing/International Society of Heart and Lung Transplant Registry who were operated on between 1994 and 2000, researchers found that over 43 percent of those who died within 30 days after transplantation had primary graft dysfunction.

The researchers were trying to test the association between primary graft dysfunction with individual short- and long-term mortality after lung transplantation. Outcomes studied included mortality at 30 days and 1 year after transplantation.

They said that primary graft dysfunction occurs in the first hours to days after transplantation and that the clinical course and pathophysiology of the most severe forms were similar to that of acute respiratory distress syndrome. With an incidence reported between 10 and 25 percent, primary graft dysfunction represents the leading cause of death after transplantation.

The overall incidence of primary graft dysfunction during the study period was 10.2 percent. The incidence did not vary by year over the period of the observation.

Dr. Christie said that a key finding of the study was that subjects who survive one year after primary graft dysfunction continue to have a higher risk of mortality over the next four years.

The authors pointed out that their data reinforce the importance of efforts aimed at further research into the prevention and early treatment of primary graft dysfunction.

The study appears in the first issue for June 2005 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Source: Eurekalert & others

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