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American Thoracic Society, May 17-22, 2013

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The American Thoracic Society's 2013 International Conference

The annual meeting of the American Thoracic Society was held from May 17 to 22 in Philadelphia and attracted more than 14,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in pulmonary disease. The conference highlighted recent advances in the prevention, detection, and treatment of pulmonary conditions as well as provided insight into critical care medicine and sleep disorders.

In one study, Daphne Koinis Mitchell, Ph.D., of Brown University's Alpert Medical School in Providence, R.I., and colleagues found that poorly-controlled asthma not only has detrimental effects on urban children's asthma morbidity (restriction of activities), but it can also impact children's school functioning. The investigators used objective methods (versus self-report instruments) to assess both lung function and sleep quality over time and in real time in urban and ethnic minority children with persistent asthma.

"The implications of poorly-controlled asthma are widespread and include poor quality sleep (as this study showed), which can negatively influence how children function in school on a daily basis," said Koinis Mitchell. "Poorly-controlled asthma, which can initiate nocturnal asthma, can affect sleep quality in children. For urban children who are already at risk for high morbidity rates and are exposed to urban poverty, this combination of risks has detrimental effects on their school functioning."

Koinis Mitchell recommends intervening to control nighttime asthma and sleep in order to enhance school functioning in this group in meaningful way.

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In another study, Janneane Gent, Ph.D., of the Yale School of Public Health in New Haven, Conn., and colleagues found that community-level concentrations of traffic-related pollutants were associated with increased asthma morbidity in pregnant woman.

The investigators evaluated 637 pregnant women (<24 weeks' gestation) diagnosed with active asthma. During each 28-day gestational month, the investigators evaluated asthma severity levels, measured by days of wheeze, medication use, and a five-level asthma severity score.

"Air pollution is a known trigger for asthma symptoms," Gent said in a statement. "In our study, exposures were assessed using a sophisticated air pollution modeling system (Community Multiscale Air Quality) that permits community-level estimates (i.e., close to where the subject resides) instead of assigning regional measurements made at Environmental Protection Agency (EPA) central site monitors to all subjects. Using community-level estimates, we found that exposure to nitrogen dioxide at levels much lower than the current EPA standard was associated with increased risk of asthma morbidity."

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Elizabeth Townsend, Ph.D., of Columbia University in New York City, and colleagues found that purified components of ginger were effective in improving symptoms associated with asthma.

The investigators evaluated three components of ginger, including 6-gingerol, 8-gingerol, or 6-shogaol. The investigators exposed airway smooth muscle (ASM) tissue samples to these three components as well as unadulterated isoproterenol (bronchodilating medication or β-agonist).

"Taken together, these data show that ginger constituents 6-gingerol, 8-gingerol and 6-shogaol act synergistically with the β-agonist in relaxing ASM, indicating that these compounds may provide additional relief of asthma symptoms when used in combination with β-agonists," Townsend said in a statement. "By understanding the mechanisms by which these ginger compounds affect the airway, we can explore the use of these therapeutics in alleviating asthma symptoms."

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ATS: Azithromycin Delays Next Hospitalization in COPD

WEDNESDAY, May 22 (HealthDay News) -- For patients with chronic obstructive pulmonary disease (COPD) hospitalized for a respiratory-related event, administration of azithromycin is associated with a prolonged time to next respiratory hospitalization, according to a study presented at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Lung Cancer Diagnosis 7 Percent With Low-Dose CT

WEDNESDAY, May 22 (HealthDay News) -- The preliminary rate of lung cancer diagnosis using low-dose computed tomography (CT) screening is 7 percent at a Veterans Affairs Medical Center, according to a study presented at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: High Prevalence of COPD Misdiagnosis Among Uninsured

WEDNESDAY, May 22 (HealthDay News) -- The prevalence of chronic obstructive pulmonary disease (COPD) misdiagnosis seems to be high among uninsured populations, with more than 40 percent showing no signs of obstruction on spirometry, according to a study presented at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Genetic Variant Tied to Interstitial Lung Disease

WEDNESDAY, May 22 (HealthDay News) -- Copy number variants of the common promoter polymorphism (rs35705950) in the MUC5B gene are associated with increased odds of interstitial lung abnormalities, particularly in older people, according to a study published online May 21 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Adenotonsillectomy Offers Relief to Kids With Sleep Apnea

TUESDAY, May 21 (HealthDay News) -- Compared to watchful waiting, early adenotonsillectomy improves some symptoms, but not attention or executive function, in school-age children with obstructive sleep apnea syndrome, according to a study published online May 21 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: BAL Findings Tied to Early Bronchiectasis in Kids With CF

TUESDAY, May 21 (HealthDay News) -- There is a higher chance of early bronchiectasis in children with cystic fibrosis among those patients with neutrophil elastase activity in bronchoalveolar lavage (BAL) fluid early in life, according to a study published online May 21 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Short Steroid Course Non-Inferior for COPD Exacerbations

TUESDAY, May 21 (HealthDay News) -- For patients presenting to the emergency department with acute chronic obstructive pulmonary disease (COPD) exacerbations, five days of treatment with glucocorticoids is non-inferior to conventional 14-day therapy for reexacerbation within six months, according to a study published online May 21 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Dupilumab Safe, Effective for Moderate, Severe Asthma

TUESDAY, May 21 (HealthDay News) -- Dupilumab, a fully human monoclonal antibody, appears safe and effective for the treatment of patients with persistent, moderate-to-severe asthma and elevated eosinophils, according to a study published online May 21 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Injured Women Receive Less Trauma Care Than Men

TUESDAY, May 21 (HealthDay News) -- A significant gender gap exists in trauma care, with injured women significantly less likely to receive care in a trauma center than men, according to a study presented at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Early Parenteral Nutrition Doesn't Reduce Day-60 Death

TUESDAY, May 21 (HealthDay News) -- For critically ill patients with relative contraindications to early enteral nutrition (EN), the provision of early parenteral nutrition (PN) is not associated with reductions in day-60 mortality, according to a study published online May 20 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Air, Noise Pollution May Raise Cardiovascular Risk

TUESDAY, May 21 (HealthDay News) -- Long-term exposure to air pollution and high levels of nighttime noise caused by proximity to road traffic are independently linked with calcification of the thoracic aorta, a measure of subclinical atherosclerosis, according to research presented at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Nighttime Intensivist Staffing Doesn't Cut ICU Stay

MONDAY, May 20 (HealthDay News) -- Nighttime intensivist staffing in the intensive care unit (ICU) on the day of admission is not associated with reduced length of stay in the ICU and does not improve other patient outcomes, according to a study published online May 20 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Patient-Directed Music Cuts Anxiety, Sedation in ICU

MONDAY, May 20 (HealthDay News) -- For patients in the intensive care unit (ICU) receiving acute ventilatory support for respiratory failure, self-initiated patient-directed music (PDM) can reduce anxiety and sedation frequency and intensity more effectively than usual care, according to a study published online May 20 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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ATS: Early Prone Positioning Reduces Mortality in ARDS

MONDAY, May 20 (HealthDay News) -- For patients with acute respiratory distress syndrome (ARDS), prolonged prone positioning during mechanical ventilation is associated with significantly reduced mortality at 28 and 90 days, according to a study published online May 20 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.

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