News briefs from the May issue of Chest

“WEIGHT LOSS GENE” MAY KEEP SMOKERS THIN

Research has shown that smokers weigh less and have less body fat than nonsmokers, and now scientists may know the reason why. A research team from Weill Medical College of Cornell University New York used several different assays to evaluate the levels of alpha2-zinc-glycoprotein1 (AZGP1), a gene linked to weight loss, in 37 healthy nonsmokers and 55 healthy smokers. All test results showed that AZGP1 levels were higher in smokers than nonsmokers. Although researchers could not directly prove that smoking-induced increases in AZGP1 are sufficient to mediate weight loss, they speculate that the increased AZGP1 levels in smokers could be one mechanism contributing to the weight difference between smokers and nonsmokers. This study is published in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

CPAP MAY IMPROVE OUTCOMES AFTER CARDIAC SURGERY

New research suggests that patients undergoing cardiac surgery may benefit from the postoperative use of continuous positive airway pressure (CPAP). Researchers in Germany compared outcomes in 232 cardiac surgery patients who received standard postoperative treatment, including 10 minutes of CPAP every 4 hours, and 236 cardiac surgery patients who received prophylactic CPAP for at least 6 hours after surgery. Results showed that prophylactic CPAP significantly improved arterial oxygenation without altering heart rate or mean arterial blood pressure. Patients who received prophylactic CPAP also experienced reduced pulmonary complications, including hypoxemia, pneumonia, and reintubation rates, as well as significantly reduced ICU readmission rates. Researchers conclude that CPAP may be a useful tool to prevent postoperative pulmonary complications in patients recovering from cardiac surgery. The study is published in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

END-OF-LIFE REPORT OUTLINES CARE NEEDS FOR DYING PATIENTS

Critically ill patients within the ICU receive prompt and aggressive life-sustaining interventions. However, for patients in the ICU who are dying, the focus often turns to palliative or comfort care, where pain management is a principal component. A new report developed by the American College of Chest Physicians, American Association of Critical-Care Nurses, and the American Society of Health-System Pharmacists discusses the complex nature of the critically ill patient and the specific care needs of patients dying in the ICU. This report emphasizes a need for a focused approach to pain management in the ICU, effective communication and cultural sensitivity with the patient-family unit, and a coordinated health-care team approach to delivering palliative care. The report is published in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

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