American Thoracic Society, May 13-18

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The American Thoracic Society's 2016 International Conference

The annual meeting of the American Thoracic Society was held from May 13 to 18 in San Francisco 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, and provided insight into critical care medicine and sleep disorders.

In one study, R.K. Putman, M.D., of the Beth Israel Deaconess Medical Center in Boston, and colleagues found that interstitial lung abnormalities were associated with an increased risk of death, and this increased risk could not be explained by measures of chronic obstructive pulmonary disease or cardiovascular disease severity or reports of malignancy.

"Interstitial lung abnormalities, a specific set of densities seen on chest computed tomography, have been associated with physiologic and genetic abnormalities, which suggest that they may represent an early or mild form of pulmonary fibrosis. In research participants in four different cohorts, interstitial lung abnormalities were present in approximately one out of 11 to one out of 14 participants. These changes were more common in older participants and in those who had increased tobacco exposure," Putnam said. "Moving forward, now that antifibrotic therapies that slow the progression of fibrosis are available for the treatment of idiopathic pulmonary fibrosis, we believe it will be important to include patients with earlier stage disease in trials of these medications, in an attempt to slow disease progression."

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In another study, Lillian Benck, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues found that being fit and staying fit were associated with less decline in pulmonary function over time among a large, long-term longitudinal cohort study of healthy young adults.

"Our key conclusions include that better baseline fitness, maintenance of higher levels of fitness, and improving fitness from young adulthood to middle age is associated with less loss of lung function. This is important because, as a modifiable risk factor, fitness presents us with a unique opportunity to potentially improve lung health," Benck said. "In addition, future study of this population as it ages may yield data on whether or not cardiorespiratory fitness is associated with a decrease in the development of incident lung disease. Finally, randomized trials aimed at improving fitness with an outcome measure of decline in pulmonary function are needed to explore this subject further."

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Jennifer Stevens, M.D., of the Beth Israel Deaconess Medical Center in Boston, and colleagues found that opioid-overdose-related admissions to the intensive care unit (ICU) in the last six years have increased and become more severe.

The investigators found that 27,325 patients with opioid overdoses were admitted to the ICU during the time period evaluated among the hospitals included in the study. In addition, ICU admissions for opioid overdoses increased from 45 patients per 10,000 ICU admissions to 65 patients per 10,000 ICU admissions over these six years, an increase of 46 percent. The investigators also found a total increase of 87 percent in ICU deaths from overdoses between 2009 and 2015, and mortality among patients admitted to the ICU with opioid overdoses increased 0.5 percent per month.

"People have described the opioid epidemic in communities and in emergency rooms. What is new about our study is that it shows that this epidemic is impacting even the most intensive and technologically advanced parts of health care," Stevens said. "This study tells us that the opioid epidemic has made people sicker and killed more people in spite of all the things we can do in the ICU to save them, including life support, dialysis, and round-the-clock care."

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ATS: Monthly Resident Hand-Off Tied to Higher Mortality Risk

THURSDAY, May 19, 2016 (HealthDay News) -- Hospital patients may face an increased risk of death when medical residents leave their monthly rotations, according to findings presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Feeding Infants Certain Foods Early May Cut Allergy Risk

THURSDAY, May 19, 2016 (HealthDay News) -- Earlier introduction to potentially allergenic foods may decrease the risk of sensitization, according to findings presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Hydroxyurea Can Up Lung Function in Sickle Cell Disease

WEDNESDAY, May 18, 2016 (HealthDay News) -- Hydroxyurea may help preserve lung function in children with sickle cell disease, according to findings presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Reintubation More Likely for Nighttime Extubations

WEDNESDAY, May 18, 2016 (HealthDay News) -- Patients extubated at nighttime are more likely to be reintubated and have higher mortality than those extubated during the day, according to a study presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Aggressive Melanoma Linked to Severe, Untreated Sleep Apnea

TUESDAY, May 17, 2016 (HealthDay News) -- Severe, untreated cases of obstructive sleep apnea (OSA) are associated with more aggressive melanomas, according to findings presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Untreated OSA Affects Outcomes After Revascularization

TUESDAY, May 17, 2016 (HealthDay News) -- Patients with obstructive sleep apnea (OSA) undergoing angioplasty may be at increased risk of a major adverse cardiac and cerebrovascular event (MACCE) after their procedure, according to findings presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Nurse Work Environment Predicts VAP Risk

TUESDAY, May 17, 2016 (HealthDay News) -- Nurse work environment is a significant predictor of ventilator-associated pneumonia (VAP) when controlling for intensive care unit (ICU) physician staffing, with the effect of the nurse work environment varying according to physician staffing. These findings were presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Home-Based Pulmonary Rehab Good for Stable COPD

MONDAY, May 16, 2016 (HealthDay News) -- For patients with stable chronic obstructive pulmonary disease (COPD), home-based pulmonary rehabilitation (PR) is associated with short-term clinical outcomes that are at least equivalent to those of hospital PR programs, according to a study presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: No Benefit for Early Renal-Replacement Therapy

MONDAY, May 16, 2016 (HealthDay News) -- For patients with severe acute kidney injury, mortality does not differ with either an early or delayed strategy for renal-replacement therapy initiation, according to a study published online May 15 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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ATS: Indacaterol-Glycopyrronium Cuts COPD Exacerbations

MONDAY, May 16, 2016 (HealthDay News) -- For patients with a history of chronic obstructive pulmonary disease (COPD) exacerbations, indacaterol-glycopyrronium is more effective for prevention of exacerbations than salmeterol-fluticasone, according to a study published online May 15 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

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