New research shows that current or former alcoholics have a high risk for developing Streptococcus pneumoniae (S pneumoniae), a bacteria known to cause pneumonia. Researchers from Spain and Germany compared the etiology, antibiotic resistance of S pneumoniae, severity, and outcome of patients with alcohol abuse with nonalcoholics hospitalized with community-acquired pneumonia (CAP). Among patients, 128 were current alcoholics, 54 former alcoholics, and 1,165 non-alcoholics. Results indicated that patients with a history of alcohol abuse had the highest incidence of S pneumoniae. Overall, 27 percent of alcoholics, 30 percent of former alcoholics, and 16 percent of nonalcoholics developed S pneumoniae. Alcoholic patients presented more severe forms of CAP, but no significant differences were found in mortality, antibiotic resistance of S pneumoniae, and other etiologies. Findings support the need to promote pneumococcal vaccination in patients with a history of alcoholism. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
BRONCHITIS MOST COMMON CAUSE OF CHRONIC COUGH IN CHILDREN
New research shows that the most common causes of chronic cough are different for children than adults, suggesting the management of chronic cough also should be different between the two groups. Previous research, utilizing an adult-based pathway for diagnosing and managing adult chronic cough, has identified asthma, upper airway cough syndrome (UACS), and gastroesophageal reflux disease (GERD) as the most common causes of chronic cough in adults. However, when Australian researchers applied the adult pathway to chronic cough in 108 children, 39.8 percent presented with bacterial bronchitis, making it the most common cause of chronic cough in children. In addition, asthma, UACS, and GERD were seen in less than 10 percent of young patients. Findings support the current evidence-based cough guidelines from the American College of Chest Physicians that recommend a distinct approach to diagnosing and managing cough in children compared with adults. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
HEAT MASK HELPS PATIENTS WITH EXERCISE-INDUCED ASTHMA
A novel mask that limits the intake of cold air has been shown to improve lung function in patients with exercise-induced asthma. Denver researchers tested a heat exchanger mask that warms and humidifies inspired air on two groups of patients with exercise-induced asthma. In the first group, 13 patients performed two randomized, single blind, treadmill tests while breathing cold air through a placebo or active heat exchanger mask. The second group of five patients each performed three treadmill exercise tests while breathing cold air: one using the heat exchanger mask, one without the mask but with albuterol pretreatment, and one with neither the mask nor albuterol treatment. In both groups, spirometry was performed before and at 5, 15, and 30 minutes after exercise. In both groups, patients demonstrated improved lung function after exercise with the active device compared with placebo. In the second group, there was no difference in the change in FEV1 between the mask and albuterol exercise, but the mask performed better than albuterol with respect to decline in FEF25-75. Overall, individuals who demonstrated a greater than 10 percent decline in FEV1 with placebo exercise had the most dramatic improvement with the active device mask. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.