Pulmonology

FDA mandates smoking-cessation warnings

By Traci Dantoni July 02, 2009

The FDA is now requiring the popular smoking-cessation drugs varenicline and bupropion to carry the highest safety warning amid reports of suicide and depression.
 

Help smokers quit with a multifaceted approach

June 19, 2009

By treating smoking aggressively as a chronic, relapsing disease, clinicians can raise the odds for success, a pair of studies suggests. One gave patients a variety of cessation medications at the same time. The other investigated the effect of supplementary counseling.
 

Guidelines: How to treat resistant hypertension

By Carl Sherman May 21, 2009

In its first Scientific Statement to focus on this issue, the American Heart Association stresses the need for evaluation that spreads a broad net to identify contributing and secondary causes and treatment options that go beyond the usual antihypertensives.
 

Diet tips for heart failure, COPD updated

March 11, 2009

Registered dietitians have some new advice for your patients with heart failure or chronic obstructive pulmonary disease, now that the American Dietetic Association has published evidence-based guidelines for providing nutrition treatment to patients with these conditions.
 

FDA approves Symbicort for COPD

March 03, 2009

The FDA has approved Symbicort 160/4.5 micrograms (budesonide/formoterol fumarate dehydrate, from AstraZeneca) for the maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease.
 

Kveim test for sarcoidosis

Question by Lester N. Ploss, MD, Freeport, NY; response by Susan Kashaf, MD, MPH February 05, 2009

The status of the Kveim test for sarcoidosis: What is the status of the Kveim test in the diagnosis of sarcoidosis? Where can the antigen be obtained? What is the specificity and sensitivity of the test?
 

30

February 05, 2009

Percentage of people diagnosed with asthma who don't have the disease.
 

Feeding ventilator-dependent patients

Question by Katherine McClanahan, DO, Las Vegas; response by R. Steven Tharratt, MD, MPVM January 27, 2009

Is there a risk of aspiration with oral feeding of a patient who is ventilator-dependent and has a chronic indwelling tracheostomy tube?
 

Unconfirmed history of TB

Question asked by Sunil Modi, MD, Johnstown, Pa., and answered by Cedric W. Spak, MD, MPH January 26, 2009

A patient reports a history of TB but has no medical records and refuses purified protein derivative testing.
 

Inhaled steroids can boost pneumonia risk

January 13, 2009

Pulmonary experts at Johns Hopkins University are urging clinicians to use caution when prescribing inhaled corticosteroids (ICS). Their meta-analysis showed these drugs can increase the risk of pneumonia by a full one third.
 

Antibiotic benefits COPD patients

January 12, 2009

Macrolide therapy apparently reduced both the frequency and severity of exacerbations in patients with moderate to severe chronic pulmonary obstructive disease (COPD), according to a preliminary British study.
 

Inhaled steroids for pregnant patients

Question by Absar Quereshi, MD, Columbus; answer by R. Steven Tharratt, MD, MPVM January 07, 2009

Are the recommendations for inhaled steroids different for pregnan patients?
 

Study: Physicians overdiagnose asthma

By Myra Dembrow November 20, 2008

As many as 30% of people diagnosed with asthma don't have the disease, newly published research suggests.
 

Statins may limit blood clots

October 27, 2008

A new study suggests that the use of statins may be associated with a significant reduction in the occurrence of venous thromboembolism (VTE) in patients with solid organ tumors, including breast, lung, and colon cancers.
 

ACIP calls for smoker vaccine

October 23, 2008

The CDC's Advisory Committee on Immunization (ACIP) has recommended a vaccination specifically for smokers. The panel decided that adult smokers under 65 should get pneumococcal vaccine. The shot -- already recommended for anyone 65 or older -- protects against bacteria that cause pneumonia, meningitis and other illnesses. Studies have shown that smokers are about four times more likely than nonsmokers to suffer pneumococcal disease. From The New York Times.
 

MRSA boosts CAP numbers

October 02, 2008

A new CDC report published online in Annals of Emergency Medicine (www.annemergmed .com, accessed July 7, 2008) found an unusually high number of community-acquired pneumonia cases caused by staph infection during the 2006-2007 flu season.
 

DIVERGENT BPs AT HOME AND THE OFFICE

Question raised by Bhavana Japi, MD, New Hyde Park, N.Y. and answered by Samuel J. Mann, MD July 01, 2008

If you record a high BP in the office, but the patient says it is normal at home, should the dosage of his antihypertensive medication be adjusted? Is 24-hour monitoring of BP useful?
 

Miliary TB

Question raised by Win N. Yo, MD, New York City, NY and answered by Cedric W. Spak, MD, MPH July 01, 2008

An Asian immigrant with miliary pulmonary TB diagnosed by lung biopsy tests negative on a purified protein derivative test and sputum culture. While awaiting culture reports of the lung biopsy, she has been receiving four anti-TB medications. How long must she be on respiratory isolation?
 

Clearing for duty after PPD conversion

Question by Duc Nguyen, MD, Gainesville, Fla., and answered by Cedric W. Spak, MD, MPH May 01, 2008

Should asymptomatic employees with a positive PPD test be allowed to return to work while x-ray results are pending?
 

A complex case of shortness of breath

Question by J. Delyaei, MD, Santa Clara, Calif., and answered by R.S. Tharratt, MD, MPVM March 24, 2008

A 90-year-old man with a five-year history of chronic obstructive pulmonary disease complains of worsening shortness of breath for the past several months. When he lies down, he feels fine, but when he stands up, he feels unwell. He denies chest pain. His medical history includes...
 

Is it really asthma?

By Alan Kaplan, MD January 22, 2008

Many upper- and lower-airway problems cause wheeze and cough, and some conditions coexist with asthma. Here's how to pin down a diagnosis.
 

Spirometry: A role in primary care?

By Thomas L. Petty, MD November 20, 2007

Recent studies show that many patients are being treated for COPD without confirmatory spirometry. In-office testing is easy and available.
 

Bypassing nasotracheal intubation

Question raised by Mapara Qureshi, MD, Frederick, Md. and answered by Christopher Ruser, MD October 17, 2007

Is it possible to give food or oral medications to nasotracheally intubated patients?
 

Bronchiectasis: A serious uncommon lung disorder

By Mark L. Metersky, MD, and Aydin Uzunpinar, MD October 17, 2007

Most often secondary to childhood infection, bronchiectasis is irreversible. But there are steps you can take to improve your patients' quality of life.
 

Confirm all positive PPD tests?

Question raised by Julie Lavinder, MD, Alliance, Ohio, and answered by Cedric W. Spak, MD, MPH September 17, 2007

When a purified protein derivative (PPD) test read as positive at 13-mm induration was repeated,the area became red but not indurated. Since then, yearly PPD tests have been nonreactive. Should we confirm every "positive" reaction with a subsequent PPD test?
 

Using steroids for COPD

January 22, 2007

How should steroids be used in patients with exacerbation of chronic obstructive pulmonary disorder (COPD)? What is the dosage in this case?
 

Antibiotics: When less is more

September 14, 2006

In medicine, as in life, more isn't always better. Short-course antibiotic therapy, currently emerging as an important dosing strategy for treatment of a number of bacterial infections, is a prime example. Although short-course therapy is gaining traction for many reasons, the main one can be summed up in just two words: antimicrobial resistance.
 

Chronic bronchitis: Help patients breathe easy

By Kimberly A. Hardin, MD June 06, 2006

A change in the usual cough, sputum, or dyspnea can signal an acute exacerbation of chronic bronchitis. Now the BODE index can help quantify that change and guide you in keeping the disease under control.
 

Deep venous thrombosis: Keeping clots in check

By Suresh Vedantham, MD April 15, 2006

The dangers of DVT lie primarily in its complications, which may be preventable. Here's what primary-care physicians need to know about managing and preventing life-threatening clots.
 

Not your typical cause of hip pain

Case and analysis by U. Sharma, MD, M. Kulshreshtha, MD, C. Epstein, MD, and V. Lazo De La Vega, MD March 15, 2006

While waiting for space in a shelter, the homeless patient was hospitalized — a fortuitous event.
 

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