Highlights of pulmonary and critical care symposium

Jan 3 2008

New perspectives on lung cancer screening, complications of sleep apnea, cystic fibrosis, and other key topics in pulmonary and critical care medicine are presented in the special January issue of The American Journal of Medical Sciences, published by the Southern Society for Clinical Investigation and Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, provider of leading healthcare content, context and consulting.

The special issue features highlights of the 17th Annual Charleston Pulmonary and Critical Care Symposium, hosted by the Division of Pulmonary, Critical Care, Allergy and Sleep Medicine at the Medical University of South Carolina. "It was our intent to provide new, clinically useful information relating to common pulmonary disorders that can be applied to your patients," writes Dr. Steven A. Sahn, M.D., Director of the Division.

The thirteen papers in the special issue provide practical updates on conditions such as chronic obstructive pulmonary disease, a common and costly condition most often related to smoking; and sarcoidosis, an inflammatory lung disease that can range from life-threatening to asymptomatic. Several articles emphasize the need for expert evaluation for prompt diagnosis and appropriate treatment of complex conditions such as organizing pneumonia, pulmonary arterial hypertension, and "unexpandable lung."

Other topics of interest in the special Pulmonary Symposium issue include:

• Lung cancer screening. Some studies have suggested that performing chest CT scans, particularly in smokers, could help detect lung cancers earlier. So far, however, there is no evidence that CT screening improves overall survival for lung cancer patients. Future studies will determine the ultimate value of CT screening—meanwhile, programs to discourage smoking and help smokers quit are likely to have a greater impact on lung cancer deaths.
• Diagnosis and complications of cystic fibrosis (CF). With genetic screening programs, CF is being diagnosed earlier—even before birth—allowing earlier initiation of treatment. As more CF patients survive into adulthood, new patterns of pulmonary problems are starting to emerge. Monitoring, recognizing, and treating these complications is an essential part of long-term care for adults with CF.
• Metabolic complications of obstructive sleep apnea. Recent studies suggest that nightly episodes of oxygen deprivation lead to a "proinflammatory" state, which may explain some of the serious complications of this condition. There is also evidence that, without treatment, obstructive sleep apnea can interfere with appetite regulation, thus leading to increased weight gain—and worsening sleep apnea.
• Critical care for pregnant patients. There are few research data to guide care in this difficult situation. In general, unless a drug is known to be toxic to the fetus, the risks of not giving needed treatments to the mother probably outweigh the risks to the developing fetus.
• Air travel for patients with lung disease. Because of the risk of complications related to cabin pressures, a careful preflight examination is recommended for patients with serious lung diseases. Some patients may be cleared to fly if they receive supplemental oxygen. Those with certain severe or unstable pulmonary conditions should not fly.
• Pleural fluid analysis. Dr. Sahn presents two papers on pleural fluid analysis, a key test for use in diagnosing the cause of pleural effusion—an accumulation of fluid within the pleural space. As part of a comprehensive evaluation, pleural fluid analysis can diagnose the cause of the problem in up to 95 percent of patients.

Dr. Sahn serves as Director of the Charleston Symposium, a premier educational event for pulmonologists, critical care physicians, internists, and thoracic surgeons. The 18th Charleston Pulmonary and Critical Care Symposium is planned for March 14 to 16, 2008. "We encourage all interested physicians to consider joining us for this practical clinical update, emphasizing a pathophysiologic basis for a rational approach to therapy," says Dr. Sahn. For more information, visit the MUSC office of Continuing Medical Education at http://cme.musc.edu/

About The American Journal of the Medical Sciences

Founded in 1820, The American Journal of the Medical Sciences is the official journal of the Southern Society for Clinical Investigation. Regular features include the Southwestern Internal Medicine Conference, Cardiology Grand Rounds of the University of North Carolina, the Consortium for Southeastern Hypertension Control, Case Records of the VA Maryland Healthcare System/University of Maryland Medicine, and Case Report/Focused Reviews. The Journal also publishes original articles dealing with topics such as infectious disease, rheumatology/immunology, hematology/oncology, allergy, and endocrinology. Visit the journal website at http://www.amjmedsci.com/

About the Southern Society for Clinical Investigation

Founded in 1946, the Southern Society for Clinical Investigation (SSCI) is a regional academic society dedicated to the advancement of medically-related research. Its major focus is on encouraging students and postgraduate trainees (residents and fellows) to enter academic medicine and to support junior faculty success in clinical investigation. SSCI members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine. Visit the SSCI website at www.ssciweb.org.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW.com) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Wolters Kluwer Health is a division of Wolters Kluwer, a leading global information services and publishing company with annual revenues (2006) of €3.4 billion and approximately 18,450 employees worldwide.