Newsbriefs from the journal Chest, August 2006

PATIENTS SHOW POOR KNOWLEDGE AND LACK OF INTEREST IN CPR

A new study shows that patients facing end-of-life (EOL) care do not have adequate knowledge about cardiopulmonary resuscitation (CPR) and that a large population show little interest in discussing EOL preferences. Canadian researchers administered face-to-face questionnaires to 440 hospitalized patients with end-stage cancer or advanced medical diseases. One hundred and sixty family members also participated in the questionnaire, which focused on two aspects: issues related to quality of EOL care and aspects of CPR, EOL communication, and decision-making issues. Researchers found that less than three percent of all patients had accurate knowledge of CPR outcomes and more than one-third declined EOL discussions with their doctor. The study also showed that more than half of patients surveyed had no EOL order (no intubation, "do not resuscitate," etc) in their chart.

This study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

OCCUPATIONAL ASTHMA UNDERDIAGNOSED BY CLINICIANS

Clinicians may fail to recognize and effectively manage occupational asthma (OA) in newly diagnosed patients, according to a new study. Researchers from Duke and Stanford Universities analyzed the electronic medical records, pulmonary function test results, and questionnaire responses of 197 adults with newly diagnosed asthma at a California VA hospital. The questionnaire was administered while patients waited to perform the pulmonary function test and included questions about past and current pulmonary history, respiratory symptoms, smoking history, and occupational exposures. Researchers found that while over half of patients reported occupational exposure to respirable agents, cough, and dyspnea, only two percent received a diagnosis of OA. The study showed that none of the patients were diagnosed with work-related asthma and that only one patient had action taken by a health-care provider. Twenty-five percent of patient records showed no mention of job title or employment status.

The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians

"FUNNEL CHEST" SURGERY NOT ONLY FOR COSMETIC PURPOSES

New research suggests that surgery on patients with pectus excavatum significantly improves cardiovascular function, contradicting arguments that the procedure offers only cosmetic benefits. Researchers from Nebraska and California conducted a metaanalysis that included 169 patients with the chest wall deformity, also known as "funnel chest." Patient data were pulled from eight original investigations from 1960 to 2005, which met five inclusion criteria, including duration between pre- and postoperative assessments and quantitative measures of cardiovascular function. Researchers concluded that the average cardiovascular lung function increased by greater than one-half standard deviation following surgery.

The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

HOSPITALIZATION VARIES AMONG YOUNG MINORITIES WITH ASTHMA

A new, cross-sectional study reveals that health-care utilization of Puerto Rican and African-American children, residing in the same community, are disproportionate. Researchers from New England screened 6,554 children for asthma using a parental survey. Medicaid and Supplementary Children's Health Insurance Plan provided health-care utilization data that were collected for each child for the 12 preceding months. Of the children initially screened, 2,304 were diagnosed with asthma-77 percent of which were of Puerto Rican or African-American decent. Researchers found that 21 percent of Puerto Rican children had moderate or severe persistent asthma, compared with 14 percent of African-American children. While Puerto Rican children also had an increased number of emergency department and outpatient hospital visits, research showed that African-American children spent three times as many days in the hospital.

The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

AIRWAY INFLAMMATION CAUSED BY TRAUMA OF CHRONIC COUGH

New findings suggest that airway trauma, caused by the act of coughing, may cause inflammation associated with chronic cough. Researchers from the University of Massachusetts Medical School conducted a cross-sectional, controlled study of 24 respiratory patients with chronic cough. The patients were split into four groups: intrapulmonary diseases, extrapulmonary diseases, unexplained cough, and four additional volunteers provided the nonsmoking, asymptomatic controls. All patients underwent flexible bronchoscopy, and a comparative analysis was performed. Results suggest that the airway inflammation associated with chronic cough, based on morphologic appearance and inflammatory cell counting, may be due to the trauma of cough itself and not to an underlying cause of cough. Researchers conclude that, because airway inflammation caused by chronic cough may be similar to that seen in other respiratory conditions, clinicians must be cautious when attributing importance to inflammatory changes in patients with chronic cough.

This study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

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