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FROM THE EDITOR

We have just posted the CME coverage Highlights of the European Society of Intensive Care Medicine 16th Annual Congress. Topics include the latest research on sepsis, ARDS, infectious diseases, and much more. Also, please read Conference Report - Global Vaccines -- What Are the Challenges? Highlights From the Viral Vaccine Meeting; October 25-28, 2003; Barcelona, Spain.

Regards,

Alfred J. Saint Jacques, MBA

Editor, Medscape Pulmonary Medicine

ALSO IN THIS ISSUE:NEWSMEMBER NEWSUSER SUPPORT

NEW FEATURES THIS WEEK

CONFERENCE COVERAGE

European Society of Intensive Care Medicine 16th Annual Congress

The latest critical care research on sepsis, ARDS, infectious diseases, and much more from ESICM.Medscape Critical Care

Conference Report - Global Vaccines -- What Are the Challenges?

In 2001, 1.5 million deaths occurred among children below 5 years of age that could have been prevented by vaccination. How can we immunize every child, everywhere?Medscape General Medicine 5(4) 2003

Conference Report - II. Investigating New Vaccines: SARS

Sophisticated coronavirus vectors are being refined for use as SARS vaccines.Medscape General Medicine 5(4) 2003

ASK THE EXPERTS

Ask the Experts on Cough-Variant Asthma

Please tell me the details of cough-variant asthma, its diagnosis, and how it differs from other types of asthma.Medscape Pulmonary Medicine 5(2) 2003

Ask the Experts on Albumin for Hypoalbuminemia in the Elderly

Is it justifiable to administer 100 mL of 25% human albumin over 8-10 hours to a 70-year-old patient with hypoalbuminemia?Medscape Critical Care 4(2) 2003

JOURNAL SCAN

Allergy & Clinical Immunology Journal Scan, November 2003

Review of articles on airway responsiveness in asthma, fluticasone reducing urinary LTE4 levels in nocturnal asthma, assessment of ED asthma treatment, and causative factors leading to asthma severityMedscape Allergy & Clinical Immunology 3(2) 2003

MEDLINE ABSTRACTS

MEDLINE Abstracts: Trauma Survival

What's new in the medical literature concerning trauma survival?Medscape Critical Care 4(2) 2003

INTERACTIVE CASES

Focal and Multifocal Lung Disease

These self-assessment cases are samples from the WebMD Scientific American Medicine Self-Assessment CME program, an added benefit to subscribers.WebMD Scientific American. Medicine 2003

CLINICAL REFERENCE

Disorders of the Chest Wall

Severe kyphoscoliosis management. Avoiding pulmonary complications. Muscle paralysis due to commonly used drugs. Supportive measures for kyphoscoliosis.WebMD Scientific American. Medicine 2003

JOURNAL ARTICLES

Sleep Disorders in Children

There are more than 80 ICD-9 classified sleep disorders, and scores of causes for both sleepiness and insomnia.Curr Opin Pulm Med 9(6) 2003

Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature

Sleep apnea is a common disorder that affects both children and adults.CHEST 124(4) 2003

Life-Threatening Fall

, a 3-year-old boy, came to the ED via helicopter after falling from a third story window. How would you assess and expect this patient to be managed?Pediatr Nurs 29(5) 2003

FOCUS ON HIPAA COMPLIANCE

Does your HIPAA compliance strategy need a jump start? A risk-based approach, as required by the security rule, can help restart stalled

compliance efforts. Read more in the latest Medscape HIPAA Journal Scan, NEW in the HIPAA Compliance Resource Center.

NEWS

ALLERGIC RHINITIS

New Study Refutes Link Between Rhinitis and Blood Pressure

Rhinitis does not seem to be associated with blood pressure in adults, according to a new report by German researchers.Reuters Health Information 2003

ASTHMA

Benefits of Inhaled Corticosteroids for Asthma Outweigh Risks

A consensus statement by the ACCP, AAAAI, and ACAAI evaluated the evidence of benefit and harm and concluded that ICS should remain the gold standard of asthma treatment.Medscape Medical News 2003

High BMI Associated With Wheeze and Cough in Children

The results of a study published in the December issue of Thorax suggest there is an association between a higher body mass index (BMI) and symptoms of wheeze and cough in children, an association that appears to be stronger in girls than in boys.Reuters Health Information 2003

Maternal Asthma Untreated With Steroids Linked to Reduced Female Fetal Growth

In pregnancies complicated by asthma, a fetal sex-specific effect on the maternal immune system causes adverse effects on placental function and on female, but not male, birth weight.Medscape Medical News 2003

Perception of Asthmatic Airway Narrowing Decreases During Steroid Reduction

While the daily dose of inhaled corticosteroids (ICS) in asthmatic patients is being titrated down, their perception of airway narrowing is decreased, Australian researchers report. This could complicate management of patients "at a time when they are particularly vulnerable."Reuters Health Information 2003

Eicosanoid Disturbance With Aspirin Allergy Differs by Response Type

Among patients with aspirin-induced asthma/rhinitis (AIAR), those with a bronchial/nasal response to the drug have a greater disturbance in eicosanoid metabolism than those with just a nasal response, new research shows. The results also indicate that patients with a bronchial/nasal response have more severe disease.Reuters Health Information 2003

CARDIOLOGY

Thiazolidinediones Contraindicated in Patients at Risk for Heart Failure

A joint statement from the American Heart Association and the American Diabetes Association notes reports of CHF and edema associated with these drugs.Medscape Medical News 2003

COPD

Training Intensity Higher in Nonhypoxemic COPD Patients Given Supplemental Oxygen

Supplemental oxygen benefits not only hypoxemic but also nonhypoxemic patients with chronic obstructive pulmonary disease (COPD) during high-intensity exercise training, rehab specialist report. Training intensity is higher and exercise tolerance increases.Reuters Health Information 2003

CYSTIC FIBROSIS

Children With Cystic Fibrosis May Benefit From Vitamin K Supplementation

Patients with cystic fibrosis (CF) may need vitamin K supplementation of at least 1 mg/day to prevent complications related to low bone mineral density, Dutch investigators suggest. They found that CF patients tend to have low vitamin K levels and some indication of poor bone health.Reuters Health Information 2003

DEEP VEIN THROMBOSIS

DVT Risk After Air Travel Linked to Prior Risk Factors

The risk of venous thromboembolism (VTE) is mildly elevated by air travel lasting 6 hours or more, according to three reports in the Archives of Internal Medicine for December 8/22. However, there is a multiplicative effect between air travel and established risk factors, such as thrombophilia or use of oral contraceptives.Reuters Health Information 2003

GENERAL PULMONARY MEDICINE

JCAHO Protocol to Eliminate Wrong-Site, Wrong-Procedure, Wrong-Patient Surgery: A Newsmaker Interview With Rick Croteau, MD

The Universal Protocol, to go into effect July 1, 2004, was endorsed by more than 40 leading healthcare organizations in hopes of creating zero tolerance for these preventable errors.Medscape Medical News 2003

INFLUENZA

U.S. Buys 250,000 Flu Vaccine Doses From Aventis

The U.S. government has bought 250,000 doses of influenza vaccine from maker Aventis Pasteur, Health and Human Services Secretary Tommy said on Thursday.Reuters Health Information 2003

More Flu Cases in Colorado, but May Be Peaking

The number of Colorado residents infected with this season's powerful influenza jumped by over 1000 in a week and another child has died, raising the death toll to nine youths, health officials said on Wednesday.Reuters Health Information 2003

Flu Spreading in U.S. but Not Serious Yet: CDC

The flu is spreading across the United States and the government is concerned enough to buy up 250,000 available doses of vaccine to make sure it goes to those who need it most, officials said on Thursday.Reuters Health Information 2003

Aventis Ships More Flu Vaccine in U.S.

Aventis SA, the largest influenza vaccine supplier in the United States, said on Thursday it had started shipping an extra 250,000 doses held in reserve to help tackle tight supply in parts of the country.Reuters Health Information 2003

Chiron in Talks to Increase Flu Vaccine Supply Levels

Chiron Corp. said on Tuesday it is working with the U.S. government to help boost flu vaccine supplies for this year after raising production of its own vaccine by about 50% versus last season.Reuters Health Information 2003

U.S. Government Goes on Hunt for Flu Vaccine

U.S. government officials said on Tuesday they are searching for alternative supplies of influenza vaccine and monitoring whether shortages are putting patients in danger.Reuters Health Information 2003

Flu Season Hits Western United States Hard

The flu season is hitting the Western United States hard. Colorado is seeing the worst outbreak in the country, with authorities on Monday confirming that eight children have now died in the state since the season began last month.Reuters Health Information 2003

Flu Season Expected to Be Bad but Not a Pandemic

The current U.S. influenza outbreak may be unusually early and somewhat more severe than usual, but health experts said on Monday it is not the killer pandemic they have been warning will eventually come.Reuters Health Information 2003

Influenza-Related Hospitalizations of HIV-Infected Patients Fall With HAART

Cardiopulmonary hospitalizations of HIV-infected patients during influenza seasons have fallen since the introduction of highly active antiretroviral therapy (HAART), according to a report in the November 1st Journal of Acquired Immune Deficiency Syndromes.Reuters Health Information 2003

LUNG CANCER

Passive Smoke Exposure Can Increase Lung Cancer Risk by Nearly One Third

People exposed to secondhand smoke are 13% to 32% more likely to develop lung cancer than unexposed individuals, according to a report published in the December 10th online issue of the International Journal of Cancer.Reuters Health Information 2003

LUNG TRANSPLANTATION

Lung Transplant Boosts Gastric Reflux

Although lung transplantation appears to increase gastroesophageal reflux disease (GERD), the mechanisms involved are still unclear, Canadian and US researchers report in the November issue of Chest.Reuters Health Information 2003

PERTUSSIS

Pertussis Rates Have Increased Among Infants in US

Reported cases of pertussis among infants in the US rose nearly 50% in the 1990s compared with the 1980s, according to a report published in the December 10th issue of the Journal of the American Medical Association.Reuters Health Information 2003

Value of ECMO Questioned for Pertussis-Related Respiratory Failure

The use of extracorporeal membrane oxygenation (ECMO) for infants hospitalized with pertussis seems to be increasing, but new research indicates that mortality remains high even when this modality is employed.Reuters Health Information 2003

SARS

Adenoviral-Based SARS Vaccine Shows Promise in Macaques

U.S. researchers have created a vaccine based on surface antigens of the SARS coronavirus and delivered by a modified adenovirus that can induce a strong, specific immune response in rhesus macaques. Human clinical trials are being planned in the "near future."Reuters Health Information 2003

SLEEP DISORDERS

Sleep Apnea May Persist in Heart Failure Patients After Cardiac Transplantation

Even if heart transplantation restores normal cardiac function and sympathetic nervous system activity, central sleep apnea may persist in heart failure patients with the breathing disorder, new research indicates. The results suggest that other factors underlie sleep apnea in such patients.Reuters Health Information 2003

Melatonin Improves Sleep Architecture in Blind Individuals

The single administration of a pharmacologic dose appears to synchronize the inhibition of pituitary-adrenal activity with central nervous system sleep processes.Medscape Medical News 2003

SMOKING

Lancet Editorial Calls for Tobacco Ban in Britain

The British government should ban tobacco, a leading medical journal said Friday. "If tobacco were an illegal substance, possession of cigarettes would become a crime, and the number of smokers would drastically fall," The Lancet said in an editorial. "We call on Tony Blair's government to ban tobacco."Reuters Health Information 2003

TUBERCULOSIS

Investigation Continues Into TB Outbreak Among King County Homeless

Local, state, and federal health officials are continuing to investigate an ongoing outbreak of tuberculosis (TB) among homeless persons in King County, Washington.Reuters Health Information 2003

MEMBER NEWS

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