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December 2017 Briefing – Pulmonology

December 2017 Briefing – Pulmonology
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Here are what the editors at HealthDay consider to be the most important developments in Pulmonology for December 2017. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Guidelines Developed for Optimizing Treatment of HFrEF

THURSDAY, Dec. 28, 2017 (HealthDay News) — Guidelines have been developed to help optimize treatment of heart failure with reduced ejection fraction (HFrEF), according to an Expert Consensus Decision Pathway published online Dec. 22 in the Journal of the American College of Cardiology.

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Sleep May Mediate Fish-Cognition Relationship in Children

THURSDAY, Dec. 28, 2017 (HealthDay News) — Greater fish consumption is associated with fewer sleep problems and higher IQ scores in children, with sleep quality partially mediating the relationship between fish consumption and verbal IQ, according to a study published online Dec. 21 in Scientific Reports.

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Out-of-Pocket Costs Correlate With Receipt of Cancer Care

THURSDAY, Dec. 28, 2017 (HealthDay News) — Across cancers, higher out-of-pocket (OOP) costs are associated with higher rates of oral prescription abandonment and delayed initiation, according to a study published online Dec. 20 in the Journal of Clinical Oncology.

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Smoking Cessation Drug Tied to Increased Cardiovascular Risk

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — Individuals taking varenicline for smoking cessation appear to be at increased risk of cardiovascular but not neuropsychiatric events, according to a study published online Dec. 20 in the American Journal of Respiratory and Critical Care Medicine.

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Rituximab Effective for Lupus-Associated Cytopenia

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — Rituximab treatment seems effective for systemic lupus erythematosus (SLE)-associated immune cytopenias, with an overall initial response rate of 86 percent, according to a study published online Dec. 16 in the American Journal of Hematology.

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Exposure to PM2.5, Ozone at Low Levels Linked to Mortality

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — Short-term exposure to ambient fine particulate matter (PM2.5) and warm-season ozone at levels below current national air quality standards is associated with increased risk of mortality in the U.S. Medicare population, according to a study published in the Dec. 26 issue of the Journal of the American Medical Association.

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FDA Removes Boxed Warning From Certain Asthma Medications

TUESDAY, Dec. 26, 2017 (HealthDay News) — New evidence regarding safety is spurring the U.S. Food and Drug Administration to remove a Boxed Warning from certain inhaled medications used to treat asthma and chronic obstructive pulmonary disease.

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Survival Down With Ventricular Arrhythmia Early Post CF-LVAD

TUESDAY, Dec. 26, 2017 (HealthDay News) — For patients post contemporary continuous flow left ventricular assist device (CF-LVAD) implantation, early ventricular arrhythmias (VAs) are associated with significantly reduced survival, according to a study published online Dec. 20 in JACC: Clinical Electrophysiology.

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Plasma Volume Changes May Mediate Effects of Empagliflozin

TUESDAY, Dec. 26, 2017 (HealthDay News) — The reduction in risk of cardiovascular (CV) death with empagliflozin is most mediated by changes in hematocrit and hemoglobin, according to research published online Dec. 4 in Diabetes Care.

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Gender Differences Seen in Mental Stress-Induced Ischemia

THURSDAY, Dec. 21, 2017 (HealthDay News) — Men and women have different cardiovascular reactivity mechanisms for mental stress-induced myocardial ischemia (MSIMI), according to a study published online Dec. 21 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Dietary Factors May Play Role in Preserving Lung Function

THURSDAY, Dec. 21, 2017 (HealthDay News) — Intake of fruits and tomatoes may delay decline in lung function, especially in former smokers, according to a study published in the Dec. 1 issue of the European Respiratory Journal.

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Early-Stage Cancer Diagnoses Up With ACA’s Medicaid Expansions

THURSDAY, Dec. 21, 2017 (HealthDay News) — In their first year, the 2014 Medicaid expansions, facilitated by the Affordable Care Act, were associated with an increase in cancer diagnoses, particularly at the early stage, according to a study published online Dec. 21 in the American Journal of Public Health.

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Obesity Tied to Greater Asthma Impairment in Preschoolers

THURSDAY, Dec. 21, 2017 (HealthDay News) — For preschool children, overweight/obesity is associated with more asthma symptom days and exacerbations among those not treated with a daily controller, and inhaled corticosteroids (ICS) are associated with significant improvements among overweight/obese preschoolers, according to research published online Dec. 19 in the Journal of Allergy and Clinical Immunology.

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CDC: 2015 to 2016 Saw Drop in Life Expectancy in United States

THURSDAY, Dec. 21, 2017 (HealthDay News) — From 2015 to 2016, life expectancy decreased by one-tenth of a year, and there was an increase in the rate of age-adjusted drug overdose deaths, according to two December data briefs published by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

Abstract/Full Text – Kochanek
Abstract/Full Text – Hedegaard

Varenicline Linked to Reduction in Heavy Drinking in Men

THURSDAY, Dec. 21, 2017 (HealthDay News) — Varenicline is associated with reduced heavy drinking among men and with increased smoking abstinence, according to a study published online Dec. 20 in JAMA Psychiatry.

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Cancer Probability Documentation Lacking for Some at High Risk

THURSDAY, Dec. 21, 2017 (HealthDay News) — For patients with high-risk indeterminate pulmonary nodes (IPNs), physicians rarely provide quantitative documentation of cancer probability, according to a study published online Dec. 20 in JAMA Surgery.

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Findings Support Comprehensive Approach for Seniors With Cancer

THURSDAY, Dec. 21, 2017 (HealthDay News) — Addressing persistent symptoms, managing comorbidities, promoting leisure-time physical activity, and addressing financial challenges are key in optimizing health-related quality of life (HRQOL) in older adults with cancer, according to a study published online Dec. 18 in Cancer.

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Wearing Amber Lenses Before Bed May Help With Insomnia

THURSDAY, Dec. 21, 2017 (HealthDay News) — For individuals with insomnia symptoms, wearing amber versus clear lenses for two hours before bedtime is associated with improved sleep, according to a study published in the January issue of the Journal of Psychiatric Research.

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Medicare Costs Associated With Mortality Rates in AMI Patients

WEDNESDAY, Dec. 20, 2017 (HealthDay News) — For patients hospitalized with acute myocardial infarction, Medicare expenditure growth is associated with reduced 180-day case fatality, according to a study published online Dec. 20 in JAMA Cardiology.

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Cisatracurium Ups Some ARDS Outcomes Versus Vecuronium

WEDNESDAY, Dec. 20, 2017 (HealthDay News) — Among patients with acute respiratory distress syndrome (ARDS), cisatracurium does not improve mortality versus vecuronium but is associated with improvements in other outcomes, according to a study published online in the American Journal of Respiratory and Critical Care Medicine.

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Self-Reported Symptoms in Elderly Predict Readmission

WEDNESDAY, Dec. 20, 2017 (HealthDay News) — Post-discharge symptoms self-reported by frail, elderly adults may predict 30-day hospital readmission and emergency department visits, according to a study published online Dec. 12 in the Journal of the American Geriatrics Society.

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Switching Dual Antiplatelet Therapy Beneficial After ACS

WEDNESDAY, Dec. 20, 2017 (HealthDay News) — Switching dual antiplatelet therapy (DAPT) from aspirin plus ticagrelor or prasugrel to aspirin plus clopidogrel after acute coronary syndrome (ACS) provides benefits regardless of initial platelet reactivity, according to a study published in the Dec. 26 issue of JACC: Cardiovascular Interventions.

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Narrow-Spectrum Antibiotics Best for Children With Acute RTIs

TUESDAY, Dec. 19, 2017 (HealthDay News) — For children with acute respiratory tract infections, broad-spectrum antibiotics are not associated with better clinical or patient-centered outcomes compared with narrow-spectrum antibiotics, according to a study published in the Dec. 19 issue of the Journal of the American Medical Association.

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RA Exposure In Utero Tied to Increased Disease Risk

TUESDAY, Dec. 19, 2017 (HealthDay News) — Children born to mothers with rheumatoid arthritis may have an increased risk of rheumatoid arthritis, thyroid disease, and epilepsy, according to a study published online Dec. 11 in Arthritis Care & Research.

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STEMI Patient Perceptions Impact Emergency Medical Services Use

TUESDAY, Dec. 19, 2017 (HealthDay News) — ST-elevation myocardial infarction (STEMI) patient perceptions, including those involving the speed of transport and concerns about resource misuse, are an important factor in determining emergency medical services (EMS) use, according to a study published online Dec. 13 in the Journal of Evaluation in Clinical Practice.

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Cancer Therapies May Trigger Aging Phenotypes in Survivors

TUESDAY, Dec. 19, 2017 (HealthDay News) — Cancer therapies have direct effects on telomere length, epigenetic modifications, and microRNA, which can mimic phenotypes of aging, according to a review published online Dec. 18 in ESMO Open.

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Male U.S. Doctors Receive Higher Values of Industry Payments

MONDAY, Dec. 18, 2017 (HealthDay News) — Male physicians in the United States received higher values of general payments from industry than females in 2015, according to a research letter published online Dec. 18 in JAMA Internal Medicine.

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Year One Results Out for Value-Based Payment Modifier Program

MONDAY, Dec. 18, 2017 (HealthDay News) — Almost 30 percent of eligible practices failed to register and report data in the first year of the Physician Value-Based Payment Modifier program, according to a report published in the December issue of Health Affairs.

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Doctors Must Report on at Least 1 Patient, 1 Measure for MACRA

FRIDAY, Dec. 15, 2017 (HealthDay News) — In order to meet the 2017 Medicare and CHIP Reauthorization Act (MACRA) participation reporting deadline and avoid a Medicare payment penalty in 2019, physicians must report on at least one patient and one measure by Dec. 31, and submit to Medicare no later than Feb. 28, 2018, according to a report from the American Medical Association (AMA).

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Flu Vaccine Expected to Protect Against Most U.S. H3N2 Viruses

FRIDAY, Dec. 15, 2017 (HealthDay News) — A novel bioinformatics approach can predict vaccine effectiveness for the influenza season, and indicates that the current vaccines are likely to be effective against H3N2 flu viruses in the U.S. 2017/2018 flu season, according to research published online Nov. 29 in F1000 Research.

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Making Insurers Participate in Marketplace Could Cut Volatility

THURSDAY, Dec. 14, 2017 (HealthDay News) — Requiring insurers that participate in Medicare or Medicaid to also participate in Marketplaces in the same geographic area could improve access to insurance, according to a study published in the December issue of Health Affairs.

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Breathing Retraining Beneficial in Patients With Asthma

THURSDAY, Dec. 14, 2017 (HealthDay News) — A breathing retraining intervention, delivered digitally or via face-to-face sessions, can improve quality of life in patients with asthma, according to a study published online Dec. 13 in The Lancet Respiratory Medicine.

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Stereotactic Body Radiation Can Cut Ventricular Tachycardia

THURSDAY, Dec. 14, 2017 (HealthDay News) — Noninvasive mapping of cardiac arrhythmias with electrocardiographic imaging and noninvasive delivery of precise ablative radiation with stereotactic body radiation therapy (SBRT) can reduce the burden of ventricular tachycardia, according to a study published in the Dec. 14 issue of the New England Journal of Medicine.

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Day-Care Centers Have More Allergens Than Homes

THURSDAY, Dec. 14, 2017 (HealthDay News) — Mite, mouse, cat, and dog allergens are higher in day-care centers (DCCs) than in homes, according to a study published online Nov. 29 in Allergy.

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In Utero Methylphenidate Exposure Tied to Heart Defects

WEDNESDAY, Dec. 13, 2017 (HealthDay News) — Intrauterine exposure to methylphenidate is associated with a small increase in the risk of cardiac malformations, according to a study published online Dec. 13 in JAMA Psychiatry.

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Observation Care Cost Saving in Commercially-Insured Patients

WEDNESDAY, Dec. 13, 2017 (HealthDay News) — Among commercially-insured patients, the cost of observation care has increased, but it is still lower than spending for short-stay hospitalizations, according to a report published in the December issue of Health Affairs.

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FDA OKs Nucala for Eosinophilic Granulomatosis With Polyangiitis

TUESDAY, Dec. 12, 2017 (HealthDay News) — Nucala (mepolizumab) has been approved by the U.S. Food and Drug Administration as the first drug to treat adults with eosinophilic granulomatosis with polyangiitis, a rare autoimmune disease that leads to vasculitis.

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DNA Sequencing Identifies Alpha-1 Antitrypsin Deficiency

TUESDAY, Dec. 12, 2017 (HealthDay News) — SERPINA1 DNA sequencing can identify alpha-1 antitrypsin deficiency (AATD), according to research published online Nov. 28 in the Annals of the American Thoracic Society.

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CABG May Be Best Method to Revascularize in Diabetes

TUESDAY, Dec. 12, 2017 (HealthDay News) — In patients with diabetes and multivessel coronary artery disease (MV-CAD), coronary artery bypass grafting (CABG) may be the preferred method of revascularization, with lower rates of major adverse cardiac or cerebrovascular events (MACCE), according to a study published in the Dec. 19 issue of the Journal of the American College of Cardiology.

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In-Hospital Deaths in A-Fib Patients Higher in Rural Areas

MONDAY, Dec. 11, 2017 (HealthDay News) — In-hospital mortality among patients with atrial fibrillation (AF) is higher in rural hospitals than in urban hospitals, according to a study published online Dec. 11 in Heart Rhythm.

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Deceleration in Health Care Spending Growth in 2016

MONDAY, Dec. 11, 2017 (HealthDay News) — Health care spending growth slowed in 2016 following faster growth in 2014 and 2015, according to research published online Dec. 6 in Health Affairs.

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Prenatal Sugar Intake May Increase Asthma Risk in Offspring

FRIDAY, Dec. 8, 2017 (HealthDay News) — Increased maternal prenatal and early childhood intake of sugar-sweetened beverages and fructose is associated with increased odds of developing childhood asthma, according to a study published online Dec. 8 in the Annals of the American Thoracic Society.

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Novel Subcutaneous Furosemide May Be Option in Heart Failure

FRIDAY, Dec. 8, 2017 (HealthDay News) — A novel, pH-neutral furosemide formulation administered subcutaneously (SC) in outpatients with worsening heart failure appears to be safe and effective, according to a study published online Dec. 6 in JACC: Heart Failure.

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ORBIT Bleeding Risk Score Performs Best in A-Fib

FRIDAY, Dec. 8, 2017 (HealthDay News) — Four contemporary clinical bleeding risk scores are able to identify atrial fibrillation (AF) patients at risk for major bleeding and life-threatening bleeding, according to a study published online Nov. 7 in the Journal of Internal Medicine.

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Influenza Picking Up in U.S., Predominantly A(H3N2)

FRIDAY, Dec. 8, 2017 (HealthDay News) — Influenza activity was low during October 2017 but started increasing in November, with influenza A, predominantly A(H3N2), most commonly identified, according to research published in the Dec. 8 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

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MedDiet Adherence Doesn’t Affect Acute Heart Failure Mortality

THURSDAY, Dec. 7, 2017 (HealthDay News) — For patients with acute heart failure, adherence to the Mediterranean diet (MedDiet) does not influence long-term mortality, according to a study published online Dec. 6 in JACC: Heart Failure.

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Pharmacomechanical Thrombolysis No Benefit in DVT

THURSDAY, Dec. 7, 2017 (HealthDay News) — The addition of pharmacomechanical thrombolysis does not reduce the risk of post-thrombotic syndrome among patients with acute proximal deep vein thrombosis, according to a study published in the Dec. 7 issue of the New England Journal of Medicine.

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Traffic Pollution Prevents Cardiac Benefits of Walking

WEDNESDAY, Dec. 6, 2017 (HealthDay News) — The beneficial cardiopulmonary effects of walking are attenuated when walking in a traffic polluted area, according to a study published online Dec. 5 in The Lancet.

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State Newborn Screening Policies Cut Infant Cardiac Deaths

TUESDAY, Dec. 5, 2017 (HealthDay News) — Implementation of state newborn screening policies for critical congenital heart disease is associated with a decrease in infant cardiac deaths, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

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CVS-Aetna Merger Has Implications for Doctors’ Offices

TUESDAY, Dec. 5, 2017 (HealthDay News) — CVS Health’s planned purchase of insurance giant Aetna, a $69 billion deal, was announced Sunday.

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Specialty Care Tied to Reduced Mortality in New-Onset A-Fib

MONDAY, Dec. 4, 2017 (HealthDay News) — Cardiologist care is associated with a lower rate of death in patients with new-onset atrial fibrillation (AF), according to a study published in the December issue of the Canadian Journal of Cardiology.

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Editorial

ACC Guides Treatment of Bleeding With Oral Anticoagulation

FRIDAY, Dec. 1, 2017 (HealthDay News) — A decision pathway has been developed to guide management of acute bleeding in patients treated with oral anticoagulants (OACs); the decision pathway was published online Dec. 1 in the Journal of the American College of Cardiology.

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Lobectomy Beats SBRT Survival in Early-Stage NSCLC

FRIDAY, Dec. 1, 2017 (HealthDay News) — For stage I non-small-cell lung cancer, survival is better with lobectomy than stereotactic body radiation therapy (SBRT), although there is no difference for sublobar resection and SBRT, according to a study published online Nov. 29 in the Annals of Thoracic Surgery.

Abstract
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Differences in Cancer Survival by Type of Insurance

FRIDAY, Dec. 1, 2017 (HealthDay News) — From 1997 to 2014, improvements in cancer survival were mainly limited to patients with private or Medicare insurance, according to a study published online Nov. 30 in JAMA Oncology.

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>40% of Cancers, Cancer Deaths Due to Modifiable Risk Factors

FRIDAY, Dec. 1, 2017 (HealthDay News) — An estimated 42.0 percent of all incident cancers and 45.1 percent of cancer deaths in the United States are attributed to potentially modifiable risk factors, according to a study published online Nov. 21 in CA: A Cancer Journal for Clinicians.

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