January 2018 Briefing - Pulmonology

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Here are what the editors at HealthDay consider to be the most important developments in Pulmonology for January 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Mortality Impacted by Treatment Modality, Age in Early Lung CA

WEDNESDAY, Jan. 31, 2018 (HealthDay News) -- For patients with early non-small-cell lung cancer, mortality rates are higher after surgery versus stereotactic body radiotherapy (SBRT), and the difference increases as a function of age, according to a study published online Jan. 18 in the Journal of Clinical Oncology.

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Non-Sleep Specialists May Offer Similar Quality Sleep Apnea Care

WEDNESDAY, Jan. 31, 2018 (HealthDay News) -- Non-sleep specialists (NSSs) and sleep specialist physicians (SSPs) provide similar quality care with similar patient outcomes for adults with known or suspected obstructed sleep apnea (OSA), according to a review published online Jan. 30 in the Annals of Internal Medicine.

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Survival Trends for Cancer Generally Increasing Worldwide

WEDNESDAY, Jan. 31, 2018 (HealthDay News) -- Worldwide, survival trends for cancer are generally increasing, although there is considerable global variation in survival rates, according to a study published online Jan. 30 in The Lancet.

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Early Alzheimer's Tied to Rest-Activity Rhythm Fragmentation

TUESDAY, Jan. 30, 2018 (HealthDay News) -- Preclinical Alzheimer's disease (AD) and aging are independently associated with rest-activity rhythm fragmentation among cognitively normal adults, according to a study published online Jan. 29 in JAMA Neurology.

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E-Cigarette Smoke Carcinogenic to Murine Lung, Bladder

MONDAY, Jan. 29, 2018 (HealthDay News) -- Electronic cigarette (e-cigarette) smoke causes damage to DNA and reduces repair activity in a mouse model and in human cells, according to a study published online Jan. 29 in the Proceedings of the National Academy of Sciences.

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Prevalence of PE Low for Patients Presenting to ER With Syncope

MONDAY, Jan. 29, 2018 (HealthDay News) -- For patients presenting to the emergency department with syncope, the prevalence of pulmonary embolism (PE) is low, according to a study published online Jan. 29 in JAMA Internal Medicine.

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Regulators Trying to Reduce Physician Burden Linked to EHR

MONDAY, Jan. 29, 2018 (HealthDay News) -- The Office of the National Coordinator for Health Information Technology (ONC) is trying to address some of the issues relating to physician electronic health record (EHR) burden, partly with the appointment of Don Rucker, M.D., who is skilled in informatics and board-certified in emergency and internal medicine, according to an article published in Medical Economics.

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Pre-Op Physical Therapy May Cut Pulmonary Complications

MONDAY, Jan. 29, 2018 (HealthDay News) -- A 30-minute preoperative physical therapy session focused on breathing exercises is associated with a reduced incidence of postoperative pulmonary complications (PPCs) among patients undergoing upper abdominal surgery, according to a study published online Jan. 24 in The BMJ.

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Health Care Spending Up, Mainly Due to Rising Prices

MONDAY, Jan. 29, 2018 (HealthDay News) -- Americans under age 65 years who were insured through their employer spent more than ever before on health care in 2016, with faster spending growth in 2016 than in recent years, according to the Health Care Cost Institute (HCCI)'s annual Health Care Cost and Utilization Report.

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Most ICU Patient Alarms Not Clinically Accurate or Relevant

MONDAY, Jan. 29, 2018 (HealthDay News) -- Most intensive care unit (ICU) patient monitoring alarms are not clinically accurate or relevant, according to a review published in the January issue of the American Journal of Critical Care.

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Smokers Have Distorted View of Onset of Adverse Consequences

FRIDAY, Jan. 26, 2018 (HealthDay News) -- Compared with nonsmokers, smokers believe the mild and severe adverse consequences of smoking will take a longer time to develop, according to a study published recently in the Journal of Cognitive Psychology.

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Heart Disease, Stroke Risk Up Even Smoking 1 Cigarette/Day

THURSDAY, Jan. 25, 2018 (HealthDay News) -- Smoking one cigarette per day is still associated with a significant increased risk of coronary heart disease and stroke, according to research published online Jan. 24 in The BMJ.

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Lung Cancer Screening More Efficient for Those at Higher Risk

THURSDAY, Jan. 25, 2018 (HealthDay News) -- Lung cancer screening (LCS) is more effective and efficient for high-risk individuals, according to a research letter published online Jan. 22 in JAMA Internal Medicine.

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Influenza, Some Viral URIs Increase Risk of Acute MI

WEDNESDAY, Jan. 24, 2018 (HealthDay News) -- Certain respiratory infections, especially influenza, are associated with an increased risk of acute myocardial infarction during the first seven days after respiratory specimen collection, according to a study published in the Jan. 25 issue of the New England Journal of Medicine.

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Periodontitis in Older Adults Tied to Higher Total Cancer Risk

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Individuals with periodontitis have an increased total cancer risk, according to a study published online Jan. 12 in the Journal of the National Cancer Institute.

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Diabetes Tied to Higher Rates of Serious Infection

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Patients with diabetes, particularly type 1 diabetes mellitus (T1DM), are at increased risk of serious infection, according to a study published online Jan. 12 in Diabetes Care.

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Prevalence of Cigarette Smoking 15.5 Percent in 2016

TUESDAY, Jan. 23, 2018 (HealthDay News) -- The prevalence of cigarette smoking was 15.5 percent in 2016, which was not significantly different from the 15.1 percent prevalence in 2015, according to research published in the Jan. 19 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Out-of-Pocket Expenditures Down With ACA Implementation

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Implementation of the Affordable Care Act (ACA) was associated with reduced out-of-pocket spending, although increases were noted in mean premium spending, according to a study published online Jan. 22 in JAMA Internal Medicine.

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Older Adults Less Likely to Have Provider-Ordered Flu Testing

MONDAY, Jan. 22, 2018 (HealthDay News) -- Older adults are less likely than younger adults to have provider-ordered influenza testing, according to a study published online Jan. 17 in the Journal of the American Geriatrics Society.

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Anticoagulation Guidance Issued for Cardiopulmonary Bypass

MONDAY, Jan. 22, 2018 (HealthDay News) -- Clinical practice guidelines for anticoagulation therapy for cardiopulmonary bypass (CPB) have been developed and were published in the February issue of the Annals of Thoracic Surgery.

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Blood Test Found to Detect Eight Common Cancer Types

FRIDAY, Jan. 19, 2018 (HealthDay News) -- A multi-analyte blood test, CancerSEEK, can detect eight common cancer types, with high sensitivity and specificity, according to a study published online Jan. 18 in Science.

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Professionals Disagree About Asking Patients About Sexuality

THURSDAY, Jan. 18, 2018 (HealthDay News) -- National Health Service (NHS) England recently recommended that professionals ask all patients their sexual orientation at every opportunity, although opinions are divided on whether this is appropriate, according to an article published online Jan. 17 in The BMJ.

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Nearly 30 Percent of Veterans Report Current Tobacco Use

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- Overall, 29.2 percent of veterans report current use of one of five tobacco products, according to research published in the Jan. 12 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Human Rhinovirus Commonly Detected in Febrile Infants

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- For febrile infants, human rhinovirus (HRV) is common, and detection does not alter risk of concomitant urinary tract infection or invasive bacterial infection, according to a study published online Jan. 17 in Pediatrics.

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Rising BMI Has Slowed Improvement in U.S. Mortality

TUESDAY, Jan. 16, 2018 (HealthDay News) -- The rate of improvement in mortality in the United States has been slowed by rising body mass index (BMI), according to a study published online Jan. 15 in the Proceedings of the National Academy of Sciences.

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USPSTF: Evidence Lacking for Nontraditional CVD Risk Factors

TUESDAY, Jan. 16, 2018 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has concluded that current evidence is insufficient to assess the use of nontraditional risk factors for cardiovascular disease (CVD) risk assessment. They also conclude that evidence is lacking for the use of the ankle-brachial index (ABI) to screen for peripheral arterial disease (PAD) in asymptomatic individuals. These findings form the basis of two draft recommendation statements published online Jan. 16 by the USPSTF.

Evidence Review - CVD
Draft Recommendation Statement - CVD
Comment on Recommendation Statement - CVD
Evidence Review - PAD
Draft Recommendation Statement - PAD
Comment on Recommendation Statement - PAD

Spontaneous Pharynx Perforation After Forceful or Stifled Sneeze

TUESDAY, Jan. 16, 2018 (HealthDay News) -- Spontaneous pharyngeal perforation can occur after a forceful sneeze, according to a case report published online Jan. 15 in BMJ Case Reports.

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Increased Risk of Thrombosis in Myeloproliferative Neoplasms

TUESDAY, Jan. 16, 2018 (HealthDay News) -- Patients with myeloproliferative neoplasms (MPNs) have increased risk of arterial thrombosis and venous thrombosis across all age groups and MPN subtypes, according to a study published online Jan. 16 in the Annals of Internal Medicine.

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Non-Ventilator Hospital-Acquired Pneumonia Risk Affects All Ages

FRIDAY, Jan. 12, 2018 (HealthDay News) -- Non-ventilator hospital-acquired pneumonia (NV-HAP) is a significant burden in U.S. acute care hospitals and poses a risk to nonelderly, non-intensive unit (ICU) patients, according to research published in the January issue of the American Journal of Infection Control.

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Considerable Economic Burden for Asthma in United States

FRIDAY, Jan. 12, 2018 (HealthDay News) -- Asthma places a considerable economic burden on the United States, with a total cost of $81.9 billion in 2013, according to a study published online Jan. 12 in the Annals of the American Thoracic Society.

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Serial Intralesional Steroids May Improve Tracheal Stenosis Sx

FRIDAY, Jan. 12, 2018 (HealthDay News) -- For adults with subglottic and proximal tracheal stenosis (SGS/PTS), serial in-office intralesional steroid injection (ISI) after endoscopic dilation is associated with a prolonged surgery-free interval (SFI), according to a study published online Jan. 11 in JAMA Otolaryngology-Head & Neck Surgery.

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AMA Online Tools Address Systems-Level Physician Burnout

THURSDAY, Jan. 11, 2018 (HealthDay News) -- Tools and resources have been developed to help address physician burnout at the systems level, which may affect more than half of doctors, according to a report published by the American Medical Association (AMA).

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Prenatal PPI, H2 Blocker Use Linked to Asthma Risk in Child

THURSDAY, Jan. 11, 2018 (HealthDay News) -- Prenatal, maternal, acid-suppressive drug use is associated with an increased risk of childhood asthma, according to a review published online Jan. 11 in Pediatrics.

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Race, Education Level Predict CRT in Very Elderly With NSCLC

THURSDAY, Jan. 11, 2018 (HealthDay News) -- In patients aged 80 and older with advanced non-small-cell lung cancer (NSCLC), overall survival is improved with concurrent chemoradiation therapy (CRT), but black race and lower-educated census tract are associated with not receiving care, according to a study published online Jan. 8 in Cancer.

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Closure of Patent Foramen Ovale Cuts Recurrent Stroke/TIA Risk

THURSDAY, Jan. 11, 2018 (HealthDay News) -- Percutaneous and transcatheter patent foramen ovale (PFO) closure prevent recurrent stroke in adults with PFO and cryptogenic stroke, according to two reviews published online Jan. 9 in the Annals of Internal Medicine.

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Neurodevelopment Not Impacted by Glucocorticoids in Preemies

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Use of inhaled glucocorticoids in extremely preterm infants for the prevention of bronchopulmonary dysplasia does not lead to a higher rate of neurodevelopmental disability at 2 years, according to a study published in the Jan. 11 issue of the New England Journal of Medicine.

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Economic Impact of Physicians Quantified for 2015

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Physicians have a large economic impact across the nation, creating an aggregate of $2.3 trillion of economic activity and supporting employment of nearly 12.6 million Americans, according to a report published by the American Medical Association.

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School-Based Telemedicine Asthma Management Is Effective

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- A School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program can improve symptoms for children with persistent asthma, according to a study published online Jan. 8 in JAMA Pediatrics.

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Barriers to Initial Chemo, Radiation for Small-Cell Lung CA

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- A considerable proportion of patients with small-cell lung cancer (SCLC) do not receive chemotherapy or radiation therapy, according to a study published online Jan. 4 in JAMA Oncology.

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Mental Disorders Common in Kids With Chronic Physical Conditions

TUESDAY, Jan. 9, 2018 (HealthDay News) -- Children with a physical condition frequently have a mental disorder, which impacts quality of life, according to a study published in the January issue of BMJ Open.

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Kidney Injury Common After Non-Kidney Transplants in Children

MONDAY, Jan. 8, 2018 (HealthDay News) -- In children who receive a non-kidney solid organ transplant, acute kidney injury (AKI) is common in the first year after surgery and is associated with an increased risk of chronic kidney disease (CKD), according to a study published online Dec. 29 in the American Journal of Transplantation.

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CV Exercise Betters Cardiac Aging in Sedentary Middle-Aged Adults

MONDAY, Jan. 8, 2018 (HealthDay News) -- Two years of high-intensity exercise training (ExT) is associated with improved maximal oxygen uptake and reduced cardiac stiffness in previously sedentary healthy middle-aged adults, according to a study published online Jan. 8 in Circulation.

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Repeated Flu Vaccinations Help Prevent Severe Infection

MONDAY, Jan. 8, 2018 (HealthDay News) -- Vaccination for influenza for multiple seasons is twice as effective in preventing severe influenza -- compared with non-severe influenza -- in older patients admitted to hospital, according to a study published in the Jan. 8 issue of CMAJ, the journal of the Canadian Medical Association.

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Physicians Frequently Continue to Work While Ill

FRIDAY, Jan. 5, 2018 (HealthDay News) -- Many physicians continue working and caring for patients while they are sick, according to an article published in Medical Economics.

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Home Physical Activity Coaching May Up Physical Activity in COPD

FRIDAY, Jan. 5, 2018 (HealthDay News) -- A home-based health coaching intervention can increase physical activity levels among patients with chronic obstructive pulmonary disease (COPD), according to a study published online Dec. 28 in the Annals of the American Thoracic Society.

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Cancer Death Rate Continuing to Decline in United States

FRIDAY, Jan. 5, 2018 (HealthDay News) -- In both men and women in the United States, the cancer death rate declined by about 1.5 percent annually from 2006 to 2015, according to a study published online Jan. 4 in CA: A Cancer Journal for Clinicians.

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For Hospitals, No Benefit for Early Adoption of Financial Incentives

FRIDAY, Jan. 5, 2018 (HealthDay News) -- Hospitals that volunteered to be under financial incentives for more than a decade as part of the Premier Hospital Quality Incentive Demonstration (early adopters) do not have better process scores or lower mortality than hospitals where these incentives were implemented later under the Hospital Value-Based Purchasing program (late adopters), according to a study published online Jan. 4 in The BMJ.

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Impaired Survival With LVEF <60 Percent in Aortic Stenosis

THURSDAY, Jan. 4, 2018 (HealthDay News) -- For patients with severe aortic stenosis (AS), left ventricular ejection fraction (LVEF) below 60 percent is associated with impaired survival, according to a study published online Dec. 27 in JACC: Cardiovascular Interventions.

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Certain Stresses, Burnout Causing Some Women to Leave Medicine

THURSDAY, Jan. 4, 2018 (HealthDay News) -- Though equal numbers of men and women are now entering medical schools, the majority of physicians are still male, and female physicians face several unique stressors, according to a report published online in Medical Economics.

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Immune-Related Adverse Events Up With Checkpoint Inhibitors

THURSDAY, Jan. 4, 2018 (HealthDay News) -- Although patients with pre-existing autoimmune disease who receive checkpoint inhibitors (CPIs) are at risk for exacerbation of their disease, immune-related adverse events (irAEs), or both, events can often be managed without discontinuing CPIs, according to a review published online Jan. 2 in the Annals of Internal Medicine.

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CVD Risk Up With β2-Agonist, Antimuscarinic Antagonist Start

THURSDAY, Jan. 4, 2018 (HealthDay News) -- For patients with chronic obstructive pulmonary disease (COPD), new initiation of inhaled long-acting β2-agonists (LABAs) and long-acting antimuscarinic antagonists (LAMAs) is associated with increased risk of cardiovascular disease (CVD), according to a study published online Jan. 2 in JAMA Internal Medicine.

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Missed Opportunities to Screen for Lung CA With USPSTF Criteria

WEDNESDAY, Jan. 3, 2018 (HealthDay News) -- Lung cancer screening based on U.S. Preventive Services Task Force (USPSTF) criteria decreased from 2010 to 2015, and risk-targeted screening is associated with modest gains in terms of early lung cancer mortality per person screened, according to two studies published online Jan. 2 in the Annals of Internal Medicine.

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Silent Myocardial Infarction Linked to Heart Failure Risk

WEDNESDAY, Jan. 3, 2018 (HealthDay News) -- Silent myocardial infarction (SMI) is associated with an increased long-term risk of heart failure, according to a study published in the Jan. 2 issue of the Journal of the American College of Cardiology.

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Higher Risk of Musculoskeletal Disorders in Some Physicians

WEDNESDAY, Jan. 3, 2018 (HealthDay News) -- The prevalence of work-related musculoskeletal disorders (MSDs) appears to be high for at-risk physicians, according to a review published online Dec. 27 in JAMA Surgery.

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Pharmaceutical Aids Not Found to Be Helpful for Smoking Cessation

TUESDAY, Jan. 2, 2018 (HealthDay News) -- Pharmaceutical aids are not effective for increasing long-term smoking cessation, according to a study published online Dec. 21 in the Journal of the National Cancer Institute.

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Fractional Exhaled NO Moderately Accurate to Diagnose Asthma

TUESDAY, Jan. 2, 2018 (HealthDay News) -- Fractional exhaled nitric oxide (FeNO) measurement can diagnose asthma in individuals aged 5 years and older with moderate accuracy, according to a review published online Dec. 20 in Mayo Clinic Proceedings.

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Pre-Op Accelerometry Can Assess Cardiopulmonary Fitness

TUESDAY, Jan. 2, 2018 (HealthDay News) -- For patients scheduled for major surgery, preoperative accelerometry can assess cardiopulmonary fitness and act as a supplement to formal cardiopulmonary exercise tests, according to a study published online Dec. 12 in Anaesthesia.

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