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CT-Based Lung Cancer Screening in HIV

CT-Based Lung Cancer Screening in HIV

Studies have found that patients with HIV have a two- to five-fold greater risk of lung cancer when compared with patients from the general population. Other research has suggested that CT-based lung cancer screening can help decrease lung cancer mortality in heavy smokers. Pairing these findings together has led to speculation that patients with HIV, particularly those who smoke, may be a key target for CT-based lung cancer screening. However, approximately 20% of chest CT scans show abnormalities suggestive of lung cancer. This could lead to invasive tests with downstream complications. “Because patients with HIV are more likely than the general population to have a history of lung infections or other pulmonary diseases,” explains Keith Sigel, MD, MPH, “they may have more abnormalities on their CT scans. This can increase their risk of false-positive findings on CT-based lung cancer screening.” New Findings For a study published in AIDS, Dr. Sigel and colleagues analyzed data on patients with and without HIV who were at risk of lung disease. The study aimed to determine whether or not HIV had an effect on the development of lung disease by comparing the frequency of incidental findings—particularly pulmonary nodules—observed on chest CT scans. “We looked at the number of patients who had positive screens in each group and followed those patients to determine the end result of those findings on the CT scans,” says Dr. Sigel. Dr. Sigel and colleagues found that, overall, HIV-infected patients did not have significantly more positive scans (29%) than HIV-uninfected patients (24%). However, HIV-infected patients with CD4 counts lower than 200 had significantly higher odds of positive CT scans...
Transformative Leadership Begins with Self-Development

Transformative Leadership Begins with Self-Development

If healthcare leaders want to transform our healthcare system so it is truly patient-centered and cost-effective and if we are serious about creating a culture of health in which we are preventing diseases long before they result in sickness, the place to start is with ourselves. All healthcare leaders—no matter whether you practice in a small office or a large hospital—because more often than not, physicians set the tone. But what you may not realize is that your mental and emotional state has a significant effect on the people around you. In his book Primal Leadership: Unleashing the Power of Emotional Intelligence, psychologist Daniel Goleman revealed: “The actions of the leader account for up to 70 percent of employees’ perception of the climate of their organization.”[1] Leading Means Showing the Way Unhappy, dysfunctional leaders cannot create high-functioning, compassionate practice environments, and a stressed out, unhealthy organization cannot take care of the health of others. So as physicians, we need to ensure that the effect we have on others is positive and beneficial. As leaders: ♦ If, when facing a problem, we display thoughtful intelligence rather than anger or frustration, we will inspire that behavior in others and promote creative solutions. ♦ If we are trustworthy and nurture a culture of trust, our colleagues will feel safe enough to communicate honestly, therein creating an environment in which real change is possible. ♦ If our words and actions demonstrate a deep commitment to cost effective, patient care, others will follow our lead, resulting in an improved practice environment. ♦ If we hold ourselves accountable for the vision and if we foster...
CHEST 2014

CHEST 2014

New research is being presented at CHEST 2014, the annual meeting of the American College of Chest Physicians, from October 25 to 30 in Austin, TX.   Meeting Highlights Portable Ventilator Improves Health Status Trends in ARDS-Related Mortality CPAP & Sexual Quality of Life A Wrist Activity Monitor for COPD Patients Geriatric Syndromes, ADLs, & Health Status in COPD Adding ECMO to CPR Predicting Time to Wean in ARDS Transthoracic Ultrasound for CAP in the ED A Novel Approach to ED Thoracotomy Training ECMO for Refractory ARDS   News from CHEST 2014 Stopping Inhaled Steroids in COPD Feasible Mixed Results With Combo Therapy for PAH CHEST: Lower ARDS Mortality, PAH, Jerky Legs Lung Donation After Cardiac Death Shows Promise Benefits of Aclidinium Persist to 1 Year for COPD Tiotropium Showing Promise in Pediatric Asthma Implant Eliminates External Pump in Pulmonary Hypertension Common Sense Ebola Measures Save Lives in Africa, Teach US Once-Daily Combo Outperforms Twice-Daily in COPD Ebola, the Asthma Epidemic, and the Microbiome at CHEST 2014   More From CHEST 2014 Meeting Info Program Clinical Resource Center Destination and Travel Exhibitors and Support...
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