October 2015 Briefing - Pulmonology

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Here are what the editors at HealthDay consider to be the most important developments in Pulmonology for October 2015. 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.

Stewardship Could Improve Appropriate Medical Imaging Use

FRIDAY, Oct. 30, 2015 (HealthDay News) -- Stewardship may be a promising approach for improving appropriate use of medical imaging technology, according to a perspective piece published in the Oct. 29 issue of the New England Journal of Medicine.

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Synchronized Prescription Renewal Process Saves Time

FRIDAY, Oct. 30, 2015 (HealthDay News) -- A synchronized prescription renewal process can save physicians time and money, which can be dedicated to patient care, according to a report from the American Medical Association (AMA).

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Increasing Numbers of Med School Applicants, Enrollees

FRIDAY, Oct. 30, 2015 (HealthDay News) -- There has been a 25 percent increase in the number of medical school enrollees since 2002, with the number reaching an all-time high of 20,630 this year, according to a report published online Oct. 22 by the Association of American Medical Colleges (AAMC).

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Income Level Doesn't Substantially Impact CPAP Use

FRIDAY, Oct. 30, 2015 (HealthDay News) -- Among patients with severe obstructive sleep apnea (OSA), patient neighborhood income level is not significantly associated with purchase of continuous positive airway pressure (CPAP) device, and the overall rate of uptake remains low, according to a study published online Oct. 16 in the Annals of the American Thoracic Society.

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Sanofi Recalls Auvi-Q Injectors Used to Treat Anaphylaxis

THURSDAY, Oct. 29, 2015 (HealthDay News) -- All packs of Auvi-Q injectors are being recalled in the United States as some may not deliver the correct dose of epinephrine, according to a news release issued by Sanofi on Wednesday.

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Early CT Scan Impacts Management of Suspected CAP

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Computed tomography (CT) findings affect the diagnosis and management of suspected community-acquired pneumonia (CAP), according to a study published in the Oct. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Nearly 15 Percent of Plans Lack In-Network Specialists

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- A considerable proportion of federal marketplace plans lack at least one in-network specialist, according to a research letter published in the Oct. 27 issue of the Journal of the American Medical Association.

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LABAs No Better Than Tiotropium in Black Adults With Asthma

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- For black patients with asthma treated with inhaled corticosteroids (ICS), outcomes are similar with addition of tiotropium and long-acting β-agonists (LABAs), according to a study published in the Oct. 27 issue of the Journal of the American Medical Association.

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Physician Emphasizes Importance of Saying Thank You

TUESDAY, Oct. 27, 2015 (HealthDay News) -- The importance of thanking patients for coming to see you, the physician, is described in an essay published online in Medical Economics.

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Mortality Rates for Major Illnesses Fall in the United States

TUESDAY, Oct. 27, 2015 (HealthDay News) -- Fewer Americans are dying from cardiovascular disease, cancer, stroke, diabetes, and injuries, a new study reveals. The report was published in the Oct. 27 issue of the Journal of the American Medical Association.

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House Dust Mite Allergen Immunotherapy Deemed Safe

TUESDAY, Oct. 27, 2015 (HealthDay News) -- For patients with mild-to-moderate asthma, house dust mite (HDM) sublingual allergen immunotherapy (AIT) appears safe, according to a study published online Oct. 14 in Allergy.

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AMA: Eight Reasons for Nonadherence to Medications

FRIDAY, Oct. 23, 2015 (HealthDay News) -- Eight reasons associated with patient's intentional nonadherence to medications have been identified in a report published by the American Medical Association (AMA).

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CRT May Be Preferred Strategy for Elderly With Lung Cancer

THURSDAY, Oct. 22, 2015 (HealthDay News) -- Chemoradiotherapy (CRT) is associated with survival benefit over chemotherapy (CT) alone for elderly patients with limited-stage small-cell lung cancer, according to a study published online Oct. 19 in the Journal of Clinical Oncology.

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Knee, Hip Arthroplasty Tied to Increased Short-Term MI Risk

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- For patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) for osteoarthritis, the risk of myocardial infarction (MI) is increased in the first postoperative month, according to a study published in the October issue of Arthritis & Rheumatology.

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Cancers Differ in Indigenous, Non-Indigenous Populations

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- In Australia, New Zealand, Canada, and the United States, indigenous populations exhibit clear differences in the scale and profile of cancer compared to non-indigenous populations, according to a study published online Oct. 14 in The Lancet Oncology.

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Nocturnal Hypoxemia Severity Linked to Renal RAS Activity

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- In obstructive sleep apnea (OSA), the severity of nocturnal hypoxemia is associated with the extent to which renal renin-angiotensin system (RAS) activity is increased, according to a study published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Outpatient Spending Higher With Physician-Hospital Integration

TUESDAY, Oct. 20, 2015 (HealthDay News) -- Markets with greater increases in physician-hospital integration show greater increases in spending for outpatient care, but not inpatient care, for a large commercially insured population, according to a study published online Oct. 19 in JAMA Internal Medicine.

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Value of Bedside Exam for ICU Patients Discussed

TUESDAY, Oct. 20, 2015 (HealthDay News) -- A checklist-based bedside physical examination in the intensive care unit (ICU) is suggested as clinically useful in spite of a lack of evidence demonstrating this, according to a commentary published in the October issue of the Annals of the American Thoracic Society.

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Report Details Benefits, Risks of Nivolumab for Squamous NSCLC

TUESDAY, Oct. 20, 2015 (HealthDay News) -- For patients with metastatic squamous non-small-cell lung cancer (SQ NSCLC), nivolumab has been granted U.S. Food and Drug Administration approval. The benefit-risk summary was reviewed in a report published online Oct. 15 in JAMA Oncology.

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Gene Expression Ratio May Aid Rapid Pneumonia Diagnosis

MONDAY, Oct. 15, 2015 (HealthDay News) -- A ratio evaluating the expression of two molecular markers may assist in the rapid diagnosis of community-acquired pneumonia (CAP) on ICU admission, according to a study published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Time-Limited Strategies Feasible for ICU Critical Cancer Care

FRIDAY, Oct. 16, 2015 (HealthDay News) -- For patients with poor-prognosis cancer, trials of intensive care unit (ICU) care of short duration may be sufficient, according to a study published online Oct. 15 in JAMA Oncology.

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Budesonide May Be Beneficial in Extremely Preterm Infants

THURSDAY, Oct. 15, 2015 (HealthDay News) -- For extremely premature infants, early inhaled budesonide is associated with reduced incidence of bronchopulmonary dysplasia but may be linked to increased mortality, according to a study published online Oct. 14 in the New England Journal of Medicine.

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Myopathy in Patient With Rx-Related Respiratory Symptoms

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Administration of nivolumab can cause adverse effects, including respiratory symptoms, according to a case study published in the October issue of The Journal of Dermatology.

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Coadministering Tdap, Flu Vaccines Safe in Pregnancy

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Coadministering tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccines appears safe in pregnancy, according to a study published online Oct. 5 in Obstetrics & Gynecology.

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Similar CV Care Quality Seen for NPs, PAs, Physicians

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Advanced practice providers (APPs), including nurse practitioners and physician assistants, deliver a quality of outpatient cardiovascular care that is similar to that provided by physicians, according to a study published online Oct. 12 in the Journal of the American College of Cardiology.

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Enterovirus D68 Doesn't Raise Mortality Risk in Children

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Enterovirus D68 (EV-D68) seems to be a more virulent pulmonary pathogen in children than rhinovirus or non-EV-D68 enterovirus, but it does not increase the risk of death, according to a study published Oct. 13 in CMAJ, the journal of the Canadian Medical Association.

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COPD Tied to Increased Risk of Ischemic, Hemorrhagic Stroke

MONDAY, Oct. 12, 2015 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) is associated with increased risk of all stroke, ischemic stroke, and hemorrhagic stroke, although the risks are attenuated after adjustment for smoking, according to a study published online Sept. 28 in the American Journal of Respiratory and Critical Care Medicine.

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Six-Minute Walk Distance Predicts Lung Transplant Survival

MONDAY, Oct. 12, 2015 (HealthDay News) -- Preoperative six-minute walk distance (6MWD) is significantly associated with post-lung transplant survival, according to a study published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Americans Spend More on Health Care, but Fare Worse

MONDAY, Oct. 12, 2015 (HealthDay News) -- When compared to 12 other industrialized nations, Americans spend more on health care services, but they fare worst in terms of life expectancy, according to recent findings from The Commonwealth Fund.

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Hospital Factors Can Overcome 'Weekend Effect'

MONDAY, Oct. 12, 2015 (HealthDay News) -- More nurses and electronic medical records can help hospitals overcome the "weekend effect" (WE) associated with urgent general surgery procedures performed on weekends, according to a study published in the October issue of the Annals of Surgery.

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FDA Approves Expanded Use of Opdivo in Advanced Lung Cancer

FRIDAY, Oct. 9, 2015 (HealthDay News) -- The U.S. Food and Drug Administration has approved Opdivo (nivolumab) to treat patients with advanced non-small-cell lung cancer (NSCLC) whose disease progressed despite platinum-based chemotherapy.

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Two Decision Instruments ID Major Injuries in Blunt Trauma

FRIDAY, Oct. 9, 2015 (HealthDay News) -- Two decision instruments (DIs) have high sensitivity for identifying blunt trauma patients with clinically significant thoracic injuries, according to a study published online Oct. 6 in PLOS Medicine.

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Most Cancer Patients Believe Surgery Will Be Curative

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Most patients undergoing surgery for lung or colorectal cancer believe that the surgery is likely to be curative, according to a study published in the Oct. 15 issue of Cancer.

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Being Overweight Helps Women With Heart Failure, but Not Men

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Overweight and mildly obese women with heart failure may live significantly longer than similarly heavy men with the progressive disease, according to a study published Oct. 7 in JACC: Heart Failure.

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'GOLD' Criteria May Misdiagnosis Normal Phenotypes

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- The Global Lung Initiative (GLI)-defined normal spirometry includes adjusted mean values in the normal range for multiple phenotypes, even when classified as respiratory impairment by Global Initiative for Chronic Obstructive Lung Disease (GOLD), according to a study published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Guidelines Developed for Managing Conflicts of Interest

TUESDAY, Oct. 6, 2015 (HealthDay News) -- The Guidelines International Network has developed principles for disclosure and management of conflicts of interest (COIs) during the clinical practice guideline development process, according to a report published in the Oct. 6 issue of the Annals of Internal Medicine.

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Nitrites Aid Heart Failure With Preserved Ejection Fraction

TUESDAY, Oct. 6, 2015 (HealthDay News) -- In patients with heart failure with preserved ejection fraction (HFpEF), sodium nitrite infusion favorably reduces exercise-linked hemodynamic derangements of cardiac failure, according to a study published in the Oct. 13 issue of the Journal of the American College of Cardiology.

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Flu Vaccine Benefits Extend to Fewer Pneumonia Admissions

MONDAY, Oct. 5, 2015 (HealthDay News) -- Influenza vaccination can substantially reduce the risk of hospitalizations for influenza pneumonia, according to research published online Oct. 5 in the Journal of the American Medical Association.

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Modified SOAP Ups Student Awareness of Health Care Costs

MONDAY, Oct. 5, 2015 (HealthDay News) -- Modification of the traditional Subjective-Objective-Assessment-Plan (SOAP) presentation to consider value (SOAP-V) can help medical students learn to practice high-value, cost-conscious care, according to a study published online Sept. 28 in the Journal of Hospital Medicine.

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Providers Must Understand Legal Limits of Telemedicine

FRIDAY, Oct. 2, 2015 (HealthDay News) -- In order to minimize risk when practicing telemedicine, providers should ensure they hold the proper medical licenses, have medical liability insurance coverage, and communicate with patients regarding the potential risks of telemedicine, according to a report published in Medical Economics.

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Palliative Radiotherapy Often Overused in Stage IV NSCLC

FRIDAY, Oct. 2, 2015 (HealthDay News) -- Stage IV nonsmall-cell lung cancer (NSCLC) patients in the United States often receive more radiation therapy than recommended, according to a study published online Sept. 30 in the Journal of the National Cancer Institute.

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CPAP Eases Symptoms of Depression in OSA Patients

FRIDAY, Oct. 2, 2015 (HealthDay News) -- Patients with obstructive sleep apnea (OSA) are at increased risk for depression, but continuous positive airway pressure (CPAP) therapy may ease their depression symptoms, a new study suggests. The findings appear in the September issue of the Journal of Clinical Sleep Medicine.

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CT Scans for Lung Cancer Result in Few False-Positives

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Surgical intervention for a non-lung cancer diagnosis is rare following low-dose computed tomography (CT) screening for lung cancer, according to a study published in the October issue of the Annals of Thoracic Surgery.

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Strategies Provided for Improving EHR Efficiency

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Several strategies can be implemented in order to better use electronic health records (EHRs) for patient care and efficiency, according to an article published in Medical Economics.

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Dysbiosis in Infancy Tied to Asthma Risk in Children

THURSDAY, Oct. 1, 2015 (HealthDay News) -- The presence of four types of gut bacteria in infancy may reduce a child's risk for asthma, Canadian researchers report. The new report was published online Sept. 30 in Science Translational Medicine.

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