American Thoracic Society news tips for August

August 16, 2000

Survival rates rise two-fold

The first research data directed at Pneumocystis carinii pneumonia (PCP) patients who have suffered severe respiratory failure, based on figures from the most recent era of acquired immune deficiency syndrome (AIDS) treatment, shows that hospital survival rates for those requiring mechanical ventilation have risen 40 percent, representing a two-fold improvement over the years 1992 to 1995. A study of 1,660 hospital records of PCP patients in 71 public and private hospitals in seven geographical areas during the new treatment era of antiretroviral therapy, has led investigators to urge physicians caring for patients with severe HIV-related PCP to consider these improved outcomes before making recommendations to withhold or withdraw ventilatory support for respiratory failure. The study appears in the August issue of the American Journal of Respiratory and Critical Care Medicine.

New lung function data for chinese children and adolescents

New lung function data for normal Hong Kong-born Chinese children and adolescents between the ages of 7 and 19 show the lung function test called flow volume capacity (FVC) in boys was 8 to 10 percent lower than figures for white youngsters. The researchers believe that external factors contribute to differences in pulmonary function among the races. Their study results also demonstrate a significant increase in another lung function test, forced expiratory volume in 1 second, as well as improved FVC, when compared to 1985 data for Chinese youngsters. According to the head investigator, the most important characteristic predicting lung function values was height, while neither age nor weight added accuracy to the results. The research appears in the August issue of the American Journal of Respiratory and Critical Care Medicine.

Relapses part of disease process

One relapse or more which does not ultimately affect disease outcome occurs in the majority of patients with cryptogenic organizing pneumonia (COP), a rare "orphan" pulmonary illness. French researchers report that prolonged therapy to suppress relapses appear unnecessary since the initial episode of COP and return of illness is a unique and continuous phenomenon, rather than a separate event. The ailment, marked by onset of cough, fever, shortness of breath, crackling sounds in the chest, and granular tissue buds in the lung, responds "spectacularly well" to corticosteroid treatment and runs a benign course. The investigators suggest that reducing the relapse rate should not be a major therapeutic objective for physicians. Instead, clinicians should aim at obtaining a balance between using an efficient treatment protocol, and minimizing the adverse effects of corticosteroids through the use of lower doses and a shorter treatment duration. The study appears in the August issue of the American Journal of Respiratory and Critical Care Medicine.
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American Thoracic Society

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