by TimH | Apr 1, 2015 | Articles, Lung Cancer, Oncology, Primary Care, Pulmonology/Critical Care, Recent Features, Slider
Studies have suggested a relationship between previous respiratory diseases and a lung cancer diagnosis. Most of this research has been conducted in Asian populations and does not account for the high level of co-occurrence that has been observed among different respiratory diseases. To better understand the relationship between multiple previous respiratory diseases and lung cancer risk, Paolo Boffetta, MD, MPH, and colleagues pooled data from a consortium of seven case-control studies as part of the SYNERGY project, which provided detailed information on smoking habits in European and North American populations. New Findings Data on five previous respiratory diseases—chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma—were collected by self-report for the study, which was published in the American Journal of Respiratory and Critical Care Medicine. Analyses were stratified by gender and adjusted for study center, age, employment in an occupation with an excess risk of lung cancer, level of education, smoking status, cigarette pack-years, and time since quitting smoking. According to the results, patients with chronic bronchitis, emphysema, and pneumonia were at higher risk of lung cancer when compared with those who had no previous respiratory disease diagnoses. In men, chronic bronchitis and emphysema were associated with odds ratios (ORs) of 1.33 and 1.50, respectively, for lung cancer. Men who were diagnosed with pneumonia 2 or fewer years prior to lung cancer were also at greater risk of lung cancer (OR, 3.31), but this correlation leveled off when a pneumonia diagnosis was made after the 2-year threshold. Patients with co-occurring chronic bronchitis, emphysema, and pneumonia had a higher risk of lung cancer than those who had any of these conditions alone....
by TimH | Feb 11, 2013 | Articles, Guidelines, Opinion Article, Pain, Primary Care, Recent Features, Rheumatology, Slider
In 2008, the American College of Rheumatology (ACR) issued guidelines for the use of non-biologic and biologic treatments in rheumatoid arthritis (RA). Much has changed in the years since the last recommendations, with the availability of new drugs and increased experience with the older agents. The ACR guideline update, which was published in the May 2012 issue of Arthritis Care & Research, focuses on early treatment, special considerations for high-risk patients, and screening for tuberculosis. “The 2012 update re-emphasizes the importance of more aggressive treatment in early RA.” The ACR update re-emphasizes the importance of aggressive treatment in early RA. In addition to better outcomes, early intensive treatment can help patients maintain physical function and quality of life. Prevention is critical because joint damage resulting from RA is permanent once it occurs. It should be noted that the updated recommendations focus on common clinical scenarios. They should be used as a guide for clinicians with the clear understanding that the best treatment decisions can only be made by having collaborative dialogue with patients. For each patient, physicians must consider: The risks and benefits of treatment. Comorbidities and concomitant medications. Patient preferences. Practical economic considerations. Rheumatoid Arthritis Treatment Recommendations The goal of early RA treatment is for remission or at least low disease activity. For patients who have been symptomatic for 6 months or less, the usual approach should be disease-modifying antirheumatic drug (DMARD) monotherapy. If disease activity is moderate or high and patients have poor prognosis, combination DMARD therapy can be tried. If disease activity is high in early RA and the prognosis is poor, an anti-tumor necrosis factor...
by SkepticalScalpel | Dec 31, 2012 | Articles, Infectious Disease, Pharmaceuticals, Pulmonology/Critical Care
First drug to treat multi-drug resistant tuberculosis On Dec. 28, the U.S. Food and Drug Administration approved Sirturo (bedaquiline) as part of combination therapy to treat adults with multi-drug resistant pulmonary tuberculosis (TB) when other alternatives are not available. TB is an infection caused by Mycobacterium tuberculosis and is one of the world’s deadliest diseases. It is spread from person to person through the air and usually affects the lungs, but it can also affect other parts of the body such as the brain and kidneys. According to the Centers for Disease Control and Prevention, nearly 9 million people around the world and 10,528 people in the United States became sick with TB in 2011. Multi-drug resistant TB occurs when M. tuberculosis becomes resistant to isonazid and rifampin, two powerful drugs most commonly used to treat TB. Sirturo is the first drug approved to treat multi-drug resistant TB and should be used in combination with other drugs used to treat TB. Sirturo works by inhibiting an enzyme needed by M. tuberculosis to replicate and spread throughout the body. “Multi-drug resistant tuberculosis poses a serious health threat throughout the world, and Sirturo provides much-needed treatment for patients who have don’t have other therapeutic options available,” said Edward Cox, M.D., M.P.H, director of the Office of Antimicrobial Products in the FDA’s Center for Drug Evaluation and Research. “However, because the drug also carries some significant risks, doctors should make sure they use it appropriately and only in patients who don’t have other treatment options.” Sirturo is being approved under the FDA’s accelerated approval program, which allows the agency to approve a...
by admin | Apr 5, 2011 | Articles, Conference Coverage, HIV/AIDS, Infectious Disease, Recent Features
This feature highlights some of the studies that emerged from the 2011 CROI annual conference, including the protective effects of circumcision against HIV, treatment of HIV-tuberculosis coinfection, and research on HIV-resistant T cells. » Circumcision Provides Protection Against HIV » Prompt Treatment Needed for HIV-TB Coinfection » Nurse Care Effective in HIV Management » Optimism on HIV-Resistant T Cells Circumcision Provides Protection Against HIV The Particulars: Previous research has suggested that circumcising men may help protect them in the future from contracting the HIV virus. Findings from recent original randomized trials have suggested that circumcision reduces the risk of catching HIV by about 50%. Clinicians have expressed some concern about the effect of male circumcision on changing sexual behaviors and the adoption of more risk practices. A study was conducted to see how circumcision affects both the risk of HIV and human behavior. Data Breakdown:Researchers found that HIV incidence was 73% lower among trial participants who were circumcised and those who got circumcised later when compared with those in a control arm who did not accept circumcision. Researchers offered men in the control arm the chance to be circumcised, and 80.4% accepted. Among control participants who were circumcised, the risk of HIV was reduced 67%, compared with the men who declined the procedure. In post-trial surveillance, the study group observed no change in the number of non-marital sex partners between intervention and control patients. There was also no significant difference in condom use between the 1,321 men who got circumcised and the 372 who did not. Take Home Pearls: The benefit of male circumcision for HIV prevention appears to persist, even...
