The following reflects new findings and outcomes in medical research as presented at major medical meetings and published peer-reviewed medical journals. In this section members can view reports from important congresses as well as summaries of some recently published journal articles. Please let us know if you have a particular area of interest you would like to see covered.

PRIORITY PRESS - 5th International Primary Care Respiratory Group World Conference

COPD Inflammation as the New Target for Emerging Therapies

Toronto, Ontario / June 2-5, 2010

Toronto - It is important to diagnose chronic obstructive pulmonary disease (COPD) at a stage when early interventions can have the greatest impact, and several novel ways of detecting COPD at earlier stages were discussed by speakers here. Introduced in younger patients, long-acting anticholinergics help reduce the rate of lung function decline, underscoring the importance of early detection. Bronchodilators remain the cornerstone of treatment, with inhaled corticosteroids providing (...) Read more...

PRIORITY PRESS - 5th International Primary Care Respiratory Group World Conference

Early Intervention in Chronic Obstructive Pulmonary Disease

Toronto, Ontario / June 2-5, 2010

Toronto - Chronic obstructive pulmonary disease (COPD) is persistently under-diagnosed and therefore under-treated. By the time it is diagnosed, most patients have irreversible lung damage and interventions including smoking cessation can do little to reconstitute lung function. Physicians need to be wary of COPD in all smokers and ex-smokers 40 years of age and older and send those with suspected COPD for spirometry. Although not possible in all patients with COPD, a reduction in the rate (...) Read more...

PRIORITY PRESS - 5th International Primary Care Respiratory Group World Conference

Pediatric Asthma: Strategies for Improving Adherence to Therapy

Toronto, Ontario / June 2-5, 2010

Toronto - In young children presumed to have asthma due to persistent wheezing and breathlessness, there are two major challenges. The first is ruling out the many causes of the presenting symptoms other than asthma. If asthma is confirmed, the second is keeping patients adherent to a management plan that will control the underlying disease. For children with mild-to-moderate persistent symptoms, this treatment plan should include inhaled corticosteroids (ICS), which address the underlying (...) Read more...

PRIORITY PRESS - 30th Annual Meeting of the International Society of Heart and Lung Transplantation

Vasodilation to Reverse Complications Pre- and Post-heart Transplantation

Chicago, Illinois / April 21-24, 2010

Chicago - Phosphodiesterase type-5 (PDE-5) is abundantly expressed in the lungs. By selectively inhibiting the PDE-5 enzyme, PDE-5 inhibitors promote the accumulation of intracellular cyclic guanosine monophosphate, thereby enhancing nitric oxide-mediated effects. Because nitric oxide is a potent pulmonary vasodilator, PDE-5 inhibitors indirectly lead to relaxation of the blood vessels in the lung and decrease pulmonary pressure. Patients with advanced heart failure who are heart (...) Read more...

RESOURCE LINE

MRSA

Winter 2009

Distinct increase in MRSA over the past 20 years in eastern Ontario
Audcent et al. Clinical and subtype trends of methicillinresistant Staphylococcus aureus (MRSA) surveillance 1990 to 2009. IDSA 2009, Philadelphia, Pennsylvania.
A distinct increase in methicillin-resistant Staphylococcus aureus (MRSA) has been detected by investigators at the Children’s Hospital of Eastern Ontario (CHEO) over the last 20 years, predominantly the community-acquired (CA)-MRSA-10 (USA 300) strain.
Dr. Tobey (...) Read more...

MEDICAL FRONTIERS - 19th Annual Congress of the European Respiratory Society

Improving the Present Lives and Future Prospects of Patients with COPD

Vienna, Austria / September 12-16, 2009

Vienna - Chronic obstructive pulmonary disease is associated with a high disease burden. Therapy for this condition has two main goals: to improve symptoms (that is, act as a reliever) and to prevent long-term decline in lung function. In the case of symptom relief, evidence is emerging that these are most bothersome in the morning and can have an impact on activities performed during this time such as washing and dressing. In recognition of this, a number of new studies presented here at (...) Read more...

PRIORITY PRESS - 31st Annual Congress of the European Society of Cardiology

STRIDE-3: Selective Endothelin in Pulmonary Arterial Hypertension Management

Barcelona, Spain / August 29-September 2, 2009

Barcelona - Pulmonary arterial hypertension (PAH) is characterized by increases in pulmonary artery pressure and vascular resistance leading to right ventricular failure and death. Endothelin (ET)-1 is a potent endogenous vasoconstrictor that is overexpressed in PAH and consequently represents a rational target for its treatment. The ET-receptor antagonists have earned a place in the treatment armamentarium for PAH irrespective of its etiology, and two such agents are currently in use. (...) Read more...

PRIORITY PRESS - 86th Annual Meeting of the Canadian Paediatric Society

Monitoring for HPA Suppression in Children with Asthma: Treatment Considerations

Ottawa, Ontario / June 23-27, 2009

Ottawa - Several principles of practice can permit children with asthma who require high doses of inhaled corticosteroids (ICS) to achieve disease control with minimal risk of hypothalamic-pituitary-adrenal (HPA) suppression. This includes using the lowest effective dose of ICS, ICS preparations with a low relative risk of systemic side effects, and periodic monitoring of morning cortisol levels. ICS should never be withheld from children when this therapy is required for adequate asthma (...) Read more...

PRIORITY PRESS - American Thoracic Society International Conference

UPLIFT: New Data Reinforces a Maintenance Algorithm

San Diego, California / May 15-20, 2009

San Diego - Late last year, a large multinational study found that a maintenance pharmacologic therapy with improved outcomes in chronic obstructive pulmonary disease (COPD) over four years. It was the first study to substantiate the hypothesis that effective and sustained bronchodilation can alter the long-term disease course. Newly completed analyses of this same study further reinforce a correlation over the long term between major measures of disease control, including preservation of (...) Read more...

MEDICAL FRONTIERS - American Thoracic Society International Conference

Emerging Treatment Algorithms for Chronic Obstructive Pulmonary Disease

San Diego, California / May 15-20, 2009

San Diego - A series of large, well controlled trials have generated data appropriate for evidence-based guidelines in the treatment of chronic obstructive pulmonary disease (COPD). The most recent data confirm benefit from a combination of an inhaled corticosteroid and a long-acting beta-agonist when added to initial single-agent bronchodilator. Relative to the bronchodilator alone, the combination provided significant improvements in an array of clinically important measures, including (...) Read more...

MEDICAL FRONTIERS - American Thoracic Society International Conference

Evolving Concepts of COPD Pathogenesis: Importance of Systemic Inflammation

San Diego, California / May 15-20, 2009

San Diego - A significant evolution in the concept of the pathophysiology of chronic obstructive pulmonary disease (COPD) predicts important changes in the way this disease is treated. The evolution is based on a growing appreciation of the importance of controlling systemic inflammation. Cardiovascular disease, a frequent cause of death in COPD patients, is one example of several systemic comorbidities that appear to be exacerbated by inflammatory mediators also common to COPD. Although (...) Read more...

ABSTRACTS IN PERSPECTIVE based on presentations from the International Conference of the American Thoracic Society

An Evidence Base for Slowing COPD Progression

San Diego, California / May 15-20, 2009

EDITORIAL OVERVIEW:
Meyer Balter, MD, FRCPC, Director, Asthma and COPD Education Clinic, UHN-Mount Sinai Hospital, Professor of Medicine, Division of Respiratory Medicine, University of Toronto, Toronto, Ontario
Conducted over four years, the UPLIFT (Understanding Potential Long-term Impacts on Function with Tiotropium) Trial validated the hypothesis that treatment of chronic obstructive pulmonary disease (COPD) anchored with effective bronchodilation can modify important clinical measures (...) Read more...

PRIORITY PRESS - American Thoracic Society International Conference

Rethinking COPD

San Diego, California / May 15-20, 2009

San Diego - Historically, chronic obstructive lung disease (COPD) has always been seen as a disorder that affects the lungs and that is triggered primarily by smoking. Now, researchers are rethinking COPD as a systemic inflammatory condition that almost always co-exists with other morbidities, especially cardiovascular disease, and which may share pathogenic features with these comorbidities. What remains to be identified is an inflammatory marker that is specific to COPD; ideally, one that (...) Read more...

48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy/Infectious Diseases Society of America 46th Annual Meeting

Combatting the Increasing Prevalence of Hospital-acquired and Community-acquired Pneumonias

Washington, DC / October 25-28, 2008

Washington, DC - Widespread use of antibiotics—often for inappropriate applications—has put selection pressures on common pathogens, causing the emergence of strains resistant to many once-potent front-line antimicrobial agents. One Gram-positive species in particular, Staphylococcus aureus, has evolved into new and potentially devastating methicillin-resistant strains. There is now evidence of the growing prevalence of these organisms as the cause of skin and skin-structure infections and as (...) Read more...

ABSTRACTS in PERSPECTIVE based on presentations from the 18th Annual Congress of the European Society of Respiratory

Addressing Future Risk and Exacerbations in Asthma Management Today

Berlin, Germany / October 4-8, 2008

EDITORIAL OVERVIEW:
J. Mark FitzGerald, MB, MD, FRCPC, FRCPI, FACCP
Professor of Medicine, Head, UBC Respiratory Medicine Program, Vancouver, British Columbia
A couple of decades ago, asthma management was mainly focused on the episodic nature of asthma exacerbations. Associated with this strategy were an over-reliance on symptom relief therapy with short-acting bronchodilators and intermittent use of inhaled corticosteroids (ICS) or systemic corticosteroids. This approach was associated (...) Read more...

18th Annual Congress of the European Respiratory Society

Changing Practices in Asthma Management

Berlin, Germany / October 4-8, 2008

Berlin - The way in which asthma is managed has come a long way over the last two to three decades. Treatment used to be described as “palliative,” an implicit admission that not much could be done to alter the course of the disease. The focus was very much on the treatment of exacerbations with high-dose, often systemic steroids, with the associated long-term safety issues. Now, the disease is very much considered a chronic disease that demands treatment, not just when exacerbations occur. A (...) Read more...

18th Annual Congress of the European Respiratory Society

Improvements in Patients with Early-stage Pulmonary Arterial Hypertension

Berlin, Germany / October 4-8, 2008

Berlin - Until recently, treatments for pulmonary arterial hypertension (PAH) were studied mainly in patients with advanced disease, i.e. World Health Organisation functional class (WHO FC) III and IV. The results of the first clinical trial performed entirely in a population of patients with WHO FC II PAH showed that compared with placebo, treatment with bosentan was associated with a significant improvement in pulmonary hemodynamics (reduction in pulmonary vascular resistance) and an (...) Read more...

18th Annual Congress of the European Respiratory Society

Approaches to Management of Severe Chronic Obstructive Pulmonary Disease

Berlin, Germany / October 4-8, 2008

Berlin - Chronic obstructive pulmonary disease (COPD) represents an increasing burden on society in general and health care services in particular. Indeed, by 2020, it is expected to be the third leading cause of death worldwide. While new treatments are unlikely to become available in the near future, we are fortunately learning about how to use existing treatments more effectively, and so manage the disease better. In patients with severe COPD, a number of aspects of management are worthy (...) Read more...

18th Annual Congress of the European Respiratory Society

COPD Landmark Trial UPLIFT: Meeting Important End Points

Berlin, Germany / October 4-8, 2008

Berlin - UPLIFT was one of the largest trials ever carried out in COPD, involving almost 6000 patients from 37 countries. This trial was notable for including a large proportion of patients (46%) with early-stage disease in whom treatment benefits were even more marked. The results of UPLIFT showed that an once-daily, inhaled long-acting anticholinergic agent administered in patients with chronic obstructive pulmonary disease (COPD) produced sustained improvements in pulmonary function for (...) Read more...

10th Annual Society for Research on Nicotine and Tobacco (SRNT) Europe Conference

Update on Safety Profiles in Smoking Cessation Strategies

Rome, Italy / September 23-26, 2008

Rome - Medication-assisted smoking cessation programs have, at times, been linked with psychiatric adverse effects, including symptoms of depression. However, smoking cessation without medication use has also been linked to these symptoms, leading researchers to hypothesize that any increased risk of depressed mood may be due to nicotine withdrawal rather than a medication. To better evaluate the safety of smoking cessation medications, all psychiatric adverse events reported by more than (...) Read more...