PATIENT BELIEFS AND EXPERIENCES PREDICT ADHERENCE TO COPD MEDICATION Patients' beliefs, experiences, and behaviors regarding disease and treatment can predict their adherence to medications for chronic obstructive pulmonary disease (COPD). Researchers from Monash University and Frankston Hospital, Victoria, Australia, surveyed 276 patients (mean age 71 years), with chronic lung conditions, about their beliefs, experiences, and adherence behaviors pertaining to their disease and the recommended treatment. COPD was the underlying condition in the majority of patients. Results showed that 37 percent of patients reported perfect adherence to medications, while 59 percent reported low adherence. Main predictors of adherence included patients' acceptance of the disease process and treatment recommendation, knowledge about and faith in the treatment, effective patient-clinician interaction, and routine drug therapy. Main predictors of nonadherence included patients being confused about medication and patients varying their recommended medication based on how they are feeling. The study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

BLEACHING AGENTS PUT HAIR STYLISTS AT RISK FOR RESPIRATORY DISEASE Exposure to persulphate salts in hair bleaching agents may lead to occupational asthma and rhinitis in hair stylists, shows a new study. Italian researchers performed allergy tests, lung function tests, and specific inhalation challenge (SIC) on 47 hair stylists (mean age 25), suspected of having occupational asthma. Average overall duration of exposure to persulphate salts was seven years. Results showed that 51.1 percent of patients were diagnosed with occupational asthma, of which 87.5 percent of the cases were attributed to persulphate salts, 8.3 percent to permanent hair dyes, and 4.2 percent to latex. In addition, 54.2 percent of patients were diagnosed with occupational rhinitis, of which 84.6 percent of the cases were due to persulphate salts, and 36 percent of patients were diagnosed with occupational dermatitis. Subjects with occupational asthma attributed to persulphate salts had a long period of exposure to bleaching agents and a long latent period between the start of exposure and the onset of symptoms. The study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

PREOPERATIVE USE OF STATINS MAY PROTECT AGAINST POSTOPERATIVE ATRIAL FIBRILLATION A new study shows that statin use prior to major thoracic surgery may help to reduce the incidence of atrial fibrillation (AF), independent of c-reactive protein (CRP) levels. Elevated CRP levels, a marker of inflammation in the body, have been shown in patients with AF unrelated to surgery and statins are known to lower CRP. To determine whether elevated CRP predisposes patients to postoperative AF and whether statin use is associated with reduced AF incidence, researchers from Memorial Sloan-Kettering Cancer Center in New York, NY, studied the affects of statin use on 131 patients age 73 ± 6 years who had major lung or esophageal resection. Of the patients, 38 were treated with statins prior to surgery. AF occurred in 29 percent of patients a median of three days after surgery. Despite a significant increase in postoperative CRP levels for all patients, AF occurred in 11 percent of patients who used statins, compared to 29 percent in those who did not use statins. Researchers conclude that thoracic surgery patients with elevated CRP levels are not predisposed to AF and that statin use is associated with a significant reduction in AF. The study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

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CITATIONS

CHEST (Nov-2005)