News Release

American Thoracic Society Journal news tips for April (first issue)

Peer-Reviewed Publication

American Thoracic Society

HOME CAT ALLERGEN CONCENTRATIONS RELATE TO ASTHMATIC DISEASE

The first prospective epidemiologic study to demonstrate a relationship between cat allergen concentrations in the home and asthmatic disease among sensitized women was carried out in 458 Boston, Massachusetts, mothers. To participate, the women had to suffer from doctor-diagnosed specific sensitization or allergic disease. They were evaluated for allergen sensitization; home exposure to dust mite, cockroach, and cat allergen; and asthma symptoms. According to the authors, there were 19 doctor-diagnosed female asthmatics who were sensitized and exposed to high levels of cat allergen in their living rooms. These individuals reported greater difficulty with asthma during the prior year, in addition to having wheezed more often without a cold. Over the four-year follow-up period, the affected persons continued to suffer from asthma, used steroid medication more often, and continued to wheeze despite having no cold. To gather data at the start of the study, the research team collected dust samples from individual homes of the mothers to assay for dust mite, cat dander, and cockroach allergens. The women were also measured for specific immunoglobulin E (IgE) antibodies to specific antigens under study. The research appears in the first issue for April of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.

DELAY IN DIAGNOSIS AND TREATMENT FOR TUBERCULOSIS IS COMMON

In a three-year study involving 17 Canadian acute-care hospitals in four cities, investigators found that initially missed diagnoses and delayed treatment for patients with active tuberculosis (TB) were not only common, but were strongly associated with late admission to the intensive care unit, as well as in-hospital death. According to the researchers, as the number of TB admissions to the hospitals decreased, the outcome for patients was worse, and delays in diagnosis and treatment more frequent, increasing the risk of exposure to TB for other hospital personnel and patients. The investigators found that, among 429 patients newly diagnosed with active pulmonary TB following hospitalization between June 1992 and June 1995, appropriate treatment was delayed one week or more in 127 cases (30 percent). Among the patients with delayed treatment, the median interval from admission until isolation of the individual was 12.5 days. Of the patients who were newly diagnosed with active pulmonary TB following hospitalization, 52 (12 percent) died. Death was associated with older age, HIV infection, and ICU admission. The research appears in the first issue for April of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.

ABNORMAL PULMONARY FUNCTION LINKED TO BACTERIAL INFECTION

In a study of 22 young children with stable cystic fibrosis, Australian researchers demonstrated that bacterial infection in the lower respiratory tract is closely linked to both inflammation and abnormal pulmonary function. The investigators showed that the presence of any level of pathogen in bronchoalveolar lavage fluid (BALF) is associated with inflammatory response in the lower airways. BALF is a procedure that doctors use to collect specimens from the smaller airways that cannot be seen through a bronchoscope. Cystic fibrosis (CF) is an inherited metabolic disease whose chief symptom is the production of sticky mucus that clogs the respiratory and gastrointestinal tracts. The aim of the study was to understand the effect of lower airway infection on clinical parameters, pulmonary function tests, and inflammation in a clinically stable group of infants and young children with CF. The age range of the 22 infants involved was from 6.7 months to 44 months, with their mean age at 23.2 months. The only complication of the test procedures, which were performed in the hospital, was high fever in three patients. The authors said that there was a close relationship between the level of pathogens found in the lower airways and the level of inflammatory cells and mediators. The study appears in the first issue for April of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.

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For the complete text of these articles, please see the American Thoracic Society Online Web Site at http://www.atsjournals.org. For contact information or to request a complimentary journalist subscription to ATS journals online, or if you would like to add your name to the Society’s twice monthly journal news mailing list (please select either postal or electronic delivery), contact Cathy Carlomagno at 212-315-6442, or by e-mail at ccarlomagno@thoracic.org


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