American Thoracic Society news tips for the March Journal (first issue)

March 14, 2001

HORMONE REPLACEMENT THERAPY REDUCES RISK OF SLEEP APNEA

The use by postmenopausal women of hormone replacement therapy (HRT) was associated with a lower prevalence of sleep apnea in sleep laboratory tests. The risk level for these study participants was slightly less than the already low frequency seen in premenopausal women. Obstructive sleep apnea syndrome is characterized by repetitive episodes of breathing pauses (apneas) during sleep and/or hypoventilation in what is categorized as sleep-disordered breathing. The researchers examined the prevalence of apnea and sleep-disordered breathing in a sample of 1,000 women and 741 men who participated in a one-night sleep laboratory evaluation. In the study, the men had a clinically defined sleep apnea prevalence of 3.9 percent and the women 1.2 percent. Premenopausal women had a quite low rate of 0.6 percent, but postmenopausal women who used HRT registered 0.5 percent prevalence. The study appears in the first of two March issues of the American Journal of Respiratory and Critical Care Medicine.

RAPID DECLINE IN COAL MINERS LUNG FUNCTION CAN LEAD TO EARLIER DEATH

Coal miners with clinically significant losses of lung function are at greater risk for developing respiratory tract illnesses and for premature death than miners without such losses. Investigators showed that coal miners with a rapid decline in lung function over a 10-year period had twice the risk of dying from either cardiovascular or nonmalignant respiratory disease than a miner with a stable lung function. The researchers looked at symptoms, illnesses, and vital status among 121 miners who had declining lung function and 143 miners with a stable lung function. The participants filled out answers to a detailed questionnaire 19 to 28 years after they had first participated in a mine health survey. For the 92 miners who had died during the intervening years, an immediate family member answered the questions. In addition, the investigators obtained copies of the death certificates for those miners who had died. The group of miners who had shown accelerated lung function loss suffered more symptoms of cough, phlegm production, wheezing, and higher levels of breathlessness than did the miners with more stable lung function. Also, asthma, chronic bronchitis, and emphysema were reported more frequently among the miners with less stable respiratory systems at follow-up. The research appears in the first of two March issues of the American Journal of Respiratory and Critical Care Medicine.

RESEARCHERS SEE LIKELIHOOD OF HIGHER TUBERCULOSIS REINFECTION RATES

In a study on Gran Carnaria Island, Spanish investigators have concluded that reinfection of "cured" tuberculosis (TB) patients by another infected individual may be more of a significant cause of the disease in a greater number of communities than previously shown. They claim the likelihood of reinfection is high even in a community such as their own with low to moderate rates of TB and good measures to control the disease. Out of 962 TB cases confirmed on the island from 1991 to 1996, the researchers found 23 (2.4 percent) had a positive culture separated from their first one by at least 12 months. TB rates on Gran Canaria Island run between 28 to 32 cases per 100,000 inhabitants among a population of 713,768. Of the 23 positive second cases, five patients were excluded because of inadequate bacterial DNA to perform molecular "finger- printing" analysis. Consequently, 18 patients were analyzed for reinfection caused by either their original bacteria or by infection from an outside source. Eight of the 18 became reinfected by a bacteria that was different from their original one, as shown by DNA testing. The study is published in the first of two March issues of the American Journal of Respiratory and Critical Care Medicine.
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American Thoracic Society

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