Study Reports Asthma Common in 1996 Olympic Athletes
At least one in six athletes representing the United States in the 1996 Olympic games in Atlanta had a history of asthma, according to the November issue of the Journal of Allergy and Clinical Immunology.

To examine the prevalence of asthma, researchers analyzed the responses from an extensive, mandatory medical history questionnaire required of all US Olympic athletes competing in the 1996 games.

John Weiler, MD, University of Iowa professor of internal medicine, and his coauthors reported that out of 699 athletes who completed the questionnaire, 117 (16.7 percent) had a history of asthma, took asthma medications, or both; 73 (10.4 percent) had active asthma, based on their need for asthma medication at the time of the questionnaire, or their need for medication on a permanent or semipermanent basis.

Among the Olympic athletes, asthma was most common in cyclists and mountain bikers and least common in athletes competing in badminton, beach volleyball, table tennis, and volleyball.

The questionnaire was designed by Dr Weiler and his colleagues and the US Olympic Committee Sports Medicine Division and included specific questions regarding allergic and respiratory disorders.

Winner of Invacare Award Announced
Gina Marshall, BS, RRT, has been awarded the Invacare Award for Excellence in home respiratory care.

Marshall, an account executive with Care IV Home Health & Infusion Services, has more than 12 years of home care experience. Thanks to her strong clinical background, Marshall’s role of a respiratory therapist has transformed into that of a case manager as a result of her work with insurance companies to cover home respiratory care when it has been denied in the past.

Marshall is a past president of the Kansas City Respiratory Care Society (KCRCS), and has participated in the society’s Asthma Camp program since its inception. She has also received numerous awards including the 1994 Home Respiratory Care Practitioner of the Year.

The Invacare Award was established in 1992 with a grant from Invacare Corp, Elyria, Ohio, and recognizes outstanding individual achievement in home respiratory care.

Study Suggests Fewer Hospital Stays, Lower Costs With University-Based Doctors
Critically ill hospitalized patients who are treated by full-time university physicians are discharged more quickly, liberated from mechanical breathing apparatus sooner, and are cared for at a lower cost compared with patients who are treated by physicians in private practice in the community, according to a study published in the November issue of the American Journal of Respiratory and Critical Care Mediciner, published by the American Lung Association.

The study also found that university-based physicians are more likely to write “do not resuscitate” orders and withdraw life-sustaining therapy. However, there were no detectable differences in survival between the two groups of patients, according to Alan R. Leff, MD, and colleagues at the University of Chicago.

A possible explanation for the differences in care is that university-based physicians rotated monthly, while the community-based group rotated weekly. In addition, the university-based group had a full-time dedicated attending physician and a fellow trainee who spent the majority of his or her day at the facility. Many of the community-based physicians care for patients in multiple facilities simultaneously.

All physicians who participated in the study were specialists in pulmonary and critical care medicine.

AARC Welcomes New President
Dianne Kimball, RRT, has been elected as the 1998-1999 president of the American Association for Respiratory Care (AARC).

Kimball will face many challenges during her tenure, but her main objective will be to influence health care payors to reimburse respiratory therapists for their services. Since Kimball took office in November, she has written letters to the Health Care Financing Administration (HCFA) and other organizations to convince decision-makers that registered nurses cannot demonstrate the same competencies as an RT.

“This is going to be one of our biggest fights. I feel that even though I have been president for only a short time, I will do everything to convince HCFA that what they have set up is wrong,” Kimball said. “We know from prior studies that nurses don’t get enough respiratory care education in school.”

Kimball points out that patients also must be more proactive in their own health care.

“Consumers need to raise their voices when we advocate for patients. Payors look at us and think ‘that’s just turf
protection,’ when in fact it isn’t,” Kimball said.

Other issues include incorporating AARC’s new bylaws that were approved at the organization’s annual international meeting in Atlanta. The bylaws will change how AARC conducts business by electing officers for external and internal affairs, as well as section chairs to seats on the board of directors; each specialty section will elect a chair to serve on the board.

Kimball has also implemented a new program that no other president has done in the past. Members can contact her directly by emailing questions, ideas, or suggestions regarding the organization.

“This was something that I wanted to do to let the members know that I am a therapist just like everybody else and I am happy to help anybody get the information that they need,” Kimball said.

In addition to holding the office of president, Kimball is public health educator at the Butte-Silverbow Health Department in Butte, Mont.

A Mission Of Discovery For Sleep And Aging Studies
John Glenn has returned to space once again–not to orbit earth this time–but to participate in a series of first-time experiments on sleep disruption and aging during space flight.

The experiment, known as Sleep-2, was conducted on board the space shuttle Discovery and may provide clues as to why astronauts suffer from sleep disruption during space flight. The data may also provide insight for many people on earth who suffer from sleep disorders as they age. In addition, since space flight and aging share similar physiologic responses, the experiments may help scientists better understand the aging process.

The Sleep-2 experiment evaluated the normal sleep levels of the crew members before, during, and after space flight to identify factors that may contribute to sleep disturbances. A preliminary evaluation was performed on the use of melatonin and its effectiveness in improving quality of sleep for astronauts. The crewmembers also wore a wrist actigraph to assess their sleep-wake cycles.

In addition, the astronaut’s sleep was characterized more completely via recordings that assessed several sleep parameters. During each of the four monitoring sessions, the crew members wore an electrode net on their heads that connected to a digital sleep recorder that monitored brain waves, eye movements, muscle tension, body movements, and respiration. Other factors, such as mental performance and environmental parameters, were assessed to complement the data collected with the sleep recorder.

Another issue that investigators tackled was space flight and its effect on aging. The physiologic effects in younger astronauts during space flight often mimic the aging process. Astronauts suffer from loss of bone density and muscle mass, loss of sleep, and balance disturbance, just as older people experience on earth.

“A lot of things that happen in space are similar to things that happen to people as they age. It’s kind of like getting old rapidly, but temporarily,”said G. Kim Prisk, PhD, associate professor of medicine at the University of California, San Diego, and a coinvestigator of Sleep-2. “If we can see something that happens in young people versus older people in space flight, that will give us a clue how to think about things differently.”

According to Prisk, data from the mission may take up to a year to conclude.

Steroids To Bear New Warning Label
Inhaled steroids, specifically corticosteroids in the pill form, that are used to treat asthma and allergies must now bear new warnings that the drugs may slow growth in some children, according to the FDA.

The FDA ordered that steroids, inhaled or sprayed up children’s noses, be relabeled to inform parents and physicians that the drugs may temporarily slow children’s growth. Long-term height effects are not known and pediatricians should chart patients’ growth carefully and prescribe the lowest possible dose.

Studies have found that the drugs can slow children’s growth an average of one-third of an inch per year, possibly more, depending on the dosage and the length of time the drug was taken. Drug manufacturers argue that children’s growth could catch up or the difference proves too small to notice. Additional research is necessary to provide further data.

However, the FDA has cautioned that children should not stop taking these drugs unless otherwise advised by a pediatrician.

Smoking Taking Toll in China
According to the world’s largest analytical study of smoking patterns, China is reported to consume nearly one-third of the world’s cigarettes, according to a study published in the November 21, 1998 issue of the British Medical Journal.

If present patterns continue, smoking will kill nearly 100 million of the 0.3 billion males now aged 0 to 29 years old resulting in about 3 million male deaths per year from tobacco when these young adults reach old age, according to the study. Of the Chinese deaths now being caused by tobacco, 45 percent are from chronic lung disease, 15 percent from lung cancer, and 5-8 percent each from esophageal cancer, stomach cancer, liver cancer, stroke, ischemic heart disease, and tuberculosis. However, women, particularly those living in cities, have become less likely to start smoking, and scientists are not sure why.

Letter to the Editor
RT is an excellent magazine that rivals anything being published in its layout, graphics, and professionalism. Sometimes I can’t believe it’s free!

Dennis Holland, RRT
The RT Corner