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Articles from Other Journals

(Click on the title to go to the article summary, most recent first, date posted at end)

Long-term Use of Inhaled Corticosteroids in COPD and the Risk of Fracture. Gonzalez AV, Coulombe J, Ernst P, Suissa S. Chest. 2018;153(2):321-8. (2-15-18)

Prevention of Ventilator-Associated Pneumonia: The Multimodal Approach of the Spanish ICU “Pneumonia Zero” Program.  Álvarez-Lerma F, Palomar-Martínez M, Sánchez-García M, et al. Crit Care Med 2018;46:181-8. (2-8-18) 

Progressive Massive Fibrosis in Coal Miners From 3 Clinics in Virginia. Blackley DJ, Reynolds LE, Short C, Carson R, Storey,E, Halldin,CN, Laney AS. JAMA 2018;319(5):50-1. (2-6-18)

Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. Hackshaw A,  Morris JK, Boniface S, Tang JL, Milenković D. BMJ. 2018;360:j5855. (1-27-18)

Comparison of observed harms and expected mortality benefit for persons in the veterans health affairs lung cancer screening demonstration project. Caverly TJ, Fagerlin A, Wiener RS, Slatore CG, Tanner NT, Yun S, Hayward R. JAMA Intern Med. 2018 Jan 22. [Epub ahead of print] (1-22-18)

Risk of thromboembolism in cisplatin versus carboplatin-treated patients with lung cancer. Kim ES, Baran AM, Mondo EL, et al. PLoS One. 2017 Dec 11;12(12):e0189410. (1-8-18)

Association of cardiovascular risk with inhaled long-acting bronchodilators in patients with chronic obstructive pulmonary disease: A nested case-control study. Wang MT, Liou JT, Lin CW, Tsai CL, Wang YH, Hsu YJ, Lai JH. JAMA Intern Med. 2018 Jan 2. [Epub ahead of print] (1-5-18)

Previously selected articles that were thought important but had received little attention were summarized under our “News” section. However, the work of publication (review, DOAJ, doi, social media, etc.) has become too arduous to do justice to these publications. Therefore, we are beginning a new section titled “News from Other Journals” where selected articles are briefly summarized. Important articles that are published in journals commonly read by pulmonologists, intensivists or sleep physicians will not necessarily be reviewed but articles that are in general medicine journals or lower impact journals that might be of interest to the practicing physician are selected. As always, there will be links to the article via CrossRef and/or PubMed.

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Thursday
Feb152018

Long-term Use of Inhaled Corticosteroids in COPD and the Risk of Fracture

Gonzalez AV, Coulombe J, Ernst P, Suissa S. Chest. 2018;153(2):321-8. [CrossRef] [PubMed]

It is uncertain whether long-term use of inhaled corticosteroids (ICSs), widely used to treat COPD, increases the risk of fracture, particularly in women, in view of the postmenopausal risks. The authors assessed whether long-term ICS use in patients with COPD increased the risk of hip or upper extremity fractures, and examined sex-related differences. A nested case-control analysis was used with each case of fracture was matched with 20 control subjects. In the cohort of 240,110 subjects, 19,396 sustained a fracture during a mean 5.3 years (rate, 15.2 per 1,000 per year). Any use of ICSs was not associated with an increased rate of fracture (RR, 1.00; 95% CI, 0.97-1.03). The fracture rate was increased with > 4 years of ICS use at daily doses > 1,000 mg in fluticasone equivalents (RR, 1.10; 95% CI, 1.02-1.19). This risk increase did not differ between men and women. The authors conclude that long-term ICS use at high doses is associated with a modest increase in the risk of hip and upper extremity fractures in patients with COPD. This dose-duration risk increase does not appear to be higher for women.

Thursday
Feb082018

Prevention of Ventilator-Associated Pneumonia: The Multimodal Approach of the Spanish ICU “Pneumonia Zero” Program

Álvarez-Lerma F, Palomar-Martínez M, Sánchez-García M, et al. Crit Care Med 2018;46:181-8. [CrossRef] [PubMed]

The Spanish “Pneumonia Zero” project is a prospective, interventional, multimodal intervention to prevent ventilator-associated pneumonia (VAP). Ten VAP prevention measures were implemented in 181 ICUs throughout Spain. In a total of 171,237 ICU admissions a total of 3,474 VAP episodes were diagnosed in 3,186 patients. The adjusted VAP incidence density rate decreased from 9.83 (95% CI, 8.42–11.48) per 1,000 ventilator days in the baseline period to 4.34 (95% CI, 3.22–5.84) after 19–21 months of participation. Outcomes data (contained in the on-line supplement to table 3) reported that mortality did not change (38.5% baseline vs. 40.9% intervention, p=0.0320). The ICU length of stay increased with the intervention (27.9 + 20.7 vs. 32.5 + 24.5 days, p<0.001). The reduction in VAP was sustained 21 months after implementation. 

Thursday
Feb082018

Prevention of Ventilator-Associated Pneumonia: The Multimodal Approach of the Spanish ICU “Pneumonia Zero” Program

Álvarez-Lerma F, Palomar-Martínez M, Sánchez-García M, et al. Crit Care Med 2018;46:181-8. [CrossRef] [PubMed]

The Spanish “Pneumonia Zero” project is a prospective, interventional, multimodal intervention to prevent ventilator-associated pneumonia (VAP). Ten VAP prevention measures were implemented in 181 ICUs throughout Spain. In a total of 171,237 ICU admissions a total of 3,474 VAP episodes were diagnosed in 3,186 patients. The adjusted VAP incidence density rate decreased from 9.83 (95% CI, 8.42–11.48) per 1,000 ventilator days in the baseline period to 4.34 (95% CI, 3.22–5.84) after 19–21 months of participation. Outcomes data (contained in the on-line supplement http://links.lww.com/CCM/C886ICU) reported that mortality did not change (38.5% baseline vs. 40.9% intervention, p=0.0320). The ICU length of stay increased after the intervention (27.9 + 20.7 vs. 32.5 + 24.5 days, p<0.001). The reduction in VAP was sustained 21 months after implementation. 

Tuesday
Feb062018

Progressive Massive Fibrosis in Coal Miners From 3 Clinics in Virginia

Blackley DJ, Reynolds LE, Short C, Carson R, Storey,E, Halldin,CN, Laney AS. JAMA 2018;319(5):50-1. doi and PubMed citations unavailable at the time of this writing.

The authors are reporting a clustering of 416 cases of progressive massive fibrosis (PMF) among 11,200 observed coal miners in Appalachia. PMF was rarely observed in the 1990’s but a 2014 report documented an apparent increase in PMF. A high proportion of these cases had r-type opacities, category B and C large opacities, and coal mining tenure of less than 20 years, which are indications of exceptionally severe and rapidly progressive disease. PMF has no treatment other than supportive care and lung transplantation. Smoking seems to hasten the disease. The reason for the sudden increase in reported cases is not clear but may be partly explained by workers seeking compensation after economic hardship brought on by a decline in the coal industry. A 2014 federal rule improved protection for miners, including decreased allowable dust concentrations, changes in dust monitoring, and expansion of the health surveillance. Whether these added protections will decrease the apparent increase in PMF requires continued observation.

Saturday
Jan272018

Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports.

Hackshaw A,  Morris JK, Boniface S, Tang JL, Milenković D. BMJ. 2018;360:j5855. [CrossRef] [PubMed]

It is well known that the more cigarettes smoked per day, the greater the health risk. Based on this principle, many have assumed that smoking one or two cigarettes a day carried little risk, i.e., only about 5-10% of the risk of smoking 20 cigarettes (1 pack) per day. However, investigators from the UK challenged that assumption. The authors performed a meta-analysis and found that among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day. For stroke, the pooled relative risks were 1.25 and 1.64 for smoking one or 20 cigarettes for men per and 1.31 and 2.16 for women. The study is strongly suggestive that the only way to eliminate the risk from smoking is to quit.