Walgreens Announces Sleep Apnea Program
Undiagnosed sleep apnea, which affects millions of Americans, is the target of a new program from Walgreens Health Initiatives (WHI), Deerfield, Ill. For patients who suspect they have a sleep disorder, WHI arranges for a complete sleep test.

Once a patient is diagnosed with sleep apnea and determines a treatment plan with a respiratory therapist, a member of the WHI respiratory team monitors the patient’s progress and the equipment provided. WHI reports that participants in the program have an 80% therapy compliance rate. To address the sleep laboratory shortage, WHI aims to have the capability of performing sleep testing in certain areas.

d02a.jpg (6348 bytes)AARC Releases Videoconference Schedule
The American Association for Respiratory Care (AARC), Dallas, announced its videoconference schedule for 2001. Nurses and RTs receive continuing education units for participating in the 12th annual Professor’s Rounds in Respiratory Care. The first showing of each session is a live presentation sent by satellite to participants’ facilities. Those who miss the live version can view the taped presentation and talk with the presenter in a teleconference 1 month after the initial broadcast.

This year’s topics are: Taking the Mystery Out of Weaning the Pediatric Patient from the Ventilator; Pulmonary Rehabilitation: Standard Care for Chronic Lung Disease Patients; Noninvasive Ventilation: The Latest Word; Education of the Patient with Asthma; ARDS: The Disease and Its Management; New Respiratory Drugs: What, When, and How?; Invasive Ventilation: The Latest Word; and Test Your Lungs, Know Your Numbers, Prevent Emphysema. For more information, call (972) 243-2272, or visit www.aarc.org.

d02b.gif (4332 bytes)ACCP Launches Lung Health Resources Online
To get the word out about lung disease, the American College of Chest Physicians (ACCP), Chicago, added two new tools to its Web site: the Educational Guide on Lung Health for Elementary School Children ( www.chestnet.org/children ) and the Speakers Kit on Lung Health in Minorities ( www.chestnet.org/minorities ).

“The ACCP is very committed to supporting this cause and we hope health professionals will take advantage of this valuable resource,” says Carole A. Guy, MD, FCCP, vice-chair of the ACCP NetWork on Cultural Diversity in Medicine.

Because lung disease-related minority deaths are on the rise in the United States, the Speakers Kit offers health care professionals the resources to give presentations on lung health promotion to minority audiences. The kit includes an instruction section, index, and 53 slides covering topics such as asthma, smoking cessation, immunizations, protecting the lungs from injury, controlling common pulmonary diseases, handling symptoms, and tips on talking to physicians.

The Educational Guide, designed for children in grades 3 to 6, provides educators with objectives, preparation directions, teaching points, role-playing exercises, written games, and quizzes to develop their students’ understanding of the lungs, asthma, and the effects of smoking.

Surgical Removal of Second Lung Cancer Increases Survival
Among a series of 37 patients, researchers found that aggressive surgical removal of second lung cancers resulted in 5- and 10-year survival rates of 33% and 10%, respectively. The study, by John F. Keppel, MD, FCCP, and five colleagues from the Oregon Clinic, Providence Portland Medical Center, was published in the December issue of Chest.

In a database of 800 patients, investigators identified 37 patients with second lung cancer—21 were over age 65 and 22 were female. Of these, 25 were without symptoms at the time of their second lung cancer diagnosis. Eight were continual smokers, and the balance were former smokers. About 78% of the first cancers were stage IA lesions, and 57% of the second cancers were more advanced.

The resection rate for a second lung cancer was approximately 4.5% in the 800 patients. The approximate rate for a primary second lung cancer in a patient who had a first cancer successfully removed is about 1% to 2% per patient per year. Other investigators, like Keppel’s team, have found that new pulmonary nodules found more than 2 years after the initial treatment are generally new primary cancers.

Researchers found that, although primary care providers render long-term postoperative follow-up of lung cancer resection cases, there are no set standards for the frequency of follow-up. They noted that low-dose computed tomography scans could be used effectively in follow-up of post-treatment patients since their risk for lung cancer is 10 times greater than that of smokers in general.

d02d.jpg (11143 bytes)Studies Link SDB
Researchers detected an increased risk for cardiovascular disease (CVD) in individuals with mild sleep-disordered breathing (SDB) during the Sleep Heart Health Study. The findings were published in the January issue of the American Journal of Respiratory and Critical Care Medicine.

Together with nine colleagues, Eyal Shahar, MD, of the division of epidemiology, School of Public Health, University of Minnesota, Twin Cities, examined the association between SDB and self-reported CVD in 6,424 individuals who underwent overnight, unattended polysomnographic testing at home. The participants were attached to a monitor that uses electrodes to measure sleep stages, arousals, and other physiologic variables.

With an average apnea-hypopnea index (AHI) of about 4.4 per hour of sleep, mild-to-moderate SDB was highly prevalent in this group. From interviews with participants, researchers noted that about 15% reported at least one manifestation of CVD. Of this total, 426 were women and 597 were men.

“In this study, self-reported diabetes, self-reported hypertension, other indicators of hypertension, and self-reported CVD were all positively associated with the AHI,” Shahar says. “The associations of age, race, and smoking status with AHI were only weak to moderate.”

A recent study by the Mayo Clinic, published in the November 21, 2000, issue of Circulation, found that people with obstructive sleep apnea are likely to have blood vessel impairment that may cause daytime blood pressure elevation and may lead to heart disease.

In the December/January issue, three figures were misprinted in the article titled “Capnography: The Ventilation Vital Sign” (pp 47-48). The correct figures appear here.


ALA Unveils Travel Guide
The American Lung Association of San Diego and Imperial counties offers the Better Breathers Traveler for individuals with chronic breathing problems. The $10 guide gives local and overseas travel tips for anyone with conditions such as asthma, allergies, or chronic obstructive pulmonary disease. For more information, call (619) 297-3901.