MINIATURE CHEST RADIOGRAPHY IS TOP METHOD OF DETECTING TUBERCULOSIS IN HIGH-RISK JAILS
Miniature chest radiography is the most cost-effective, efficient, and successful method of identifying active tuberculosis (TB) in jails. Each year, over 10 million persons pass through U.S. correctional facilities, and, on any given day, 5 of every 1,000 Americans are behind bars. According to the authors of this study, the TB rate in the general U.S. population in 1998 was 6.8 cases per 100,000 persons, yet in jails there were 200 cases per 100,000 inmates or higher. Most jails try to detect active TB with tuberculin skin testing as prisoners are admitted. The investigators believe the skin testing method is neither sensitive nor specific enough to detect active disease. By contrast, a high-quality miniature chest radiograph can be performed in under 60 seconds at approximately one-tenth the radiation dose of a conventional radiograph. The process is also more sensitive to and specific for active TB than other screening methods, is less dependent on patient cooperation than symptom-based screening, provides objective data for decision-making, and allows completion of screening within hours instead of days. One study mentioned by the authors showed that 65 percent of persons with radiographs highly suggestive of active TB would have been missed by the tuberculin skin testing program. They urge serious consideration be given to miniature chest radiography as an important tool in the fight to eliminate TB from the high-risk population in jails. The study appears in the first of 2 July issues of the American Journal of Respiratory and Critical Care Medicine.
UPPER RESPIRATORY DISEASE COMMON IN HEARTBURN/ACID REFLUX PATIENTS
Upper respiratory symptoms are much more common in persons with chronic heartburn who have acid reflux disease, according to a study. Investigators discovered for the first time the prevalence of upper respiratory symptoms in 74 patients with heartburn who were monitored for acidity associated with gastroesophageal reflux disease (GERD). Acid reflux, or GERD, is a backflow of stomach contents into the esophagus, where it can cause pain, inflammation, and potential cell damage. From their study of 74 subjects with suspected GERD through 24-hour monitoring for acid and reflux episodes, the researchers found that 44 out of 52 with proven acid reflux had at least 1 upper respiratory symptom present more than 4 days per month. Thirty-five of the subjects with GERD had 2 or more upper respiratory symptoms for more than 4 days per month. The research appears in the 1st of two July issues of the American Journal of Respiratory and Critical Care Medicine.
COMPOUND IN APPLES REDUCES SEVERE EMPHYSEMA SYMPTOMS
A sub-class of a dietary compound called flavonoids, found in apples, has been associated with better lung function test results, less chronic cough, and diminished breathlessness. These symptoms, at least one of which was reported by 16 percent of 13,651 adults in three Dutch cities, are associated with chronic obstructive pulmonary disease (COPD). The sub-class of flavonoids called catechins include pigments that constitute most of the yellow, red, or blue colors found in many fruits and vegetables. A growing worldwide problem, COPD results from the effects of chronic bronchitis or severe emphysema, caused mostly by smoking. Lungs damaged by changes from emphysema gradually lose their elasticity, making it difficult to move air in and out of the damaged lungs. According to the authors, catechin intake showed a strong beneficial association with better lung function test results and an mprovement in COPDsymptoms. They believe the benefits were associated with consumption of a solid fruit such as apples. The research appears in the 1st of two July issues of the American Journal of Respiratory and Critical Care Medicine.
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