Rhonchi

The ‘Jaws’ of Pulmonary Fibrosis

The recent loss of Jaws author Peter Benchley adds another name to the long list of prominent people affected by pulmonary fibrosis; Academy Award-winning actor Marlon Brando, acclaimed screenwriter Peter Stone, and music producer Sam Phillips. In the United States, over 200,000 individuals are living with the disease. As a consequence of misdiagnosis, the numbers may be significantly higher. Of these, more than 40,000 are lost each year. There is no cure for pulmonary fibrosis and the origin and development of the disease are not completely understood. Some causes include inhaled environmental and occupational pollutants, diseases such as scleroderma, rheumatoid arthritis, lupus and sarcoidosis, certain medications or drugs, and therapeutic radiation. In cases when the cause cannot be identified, the disease is termed “idiopathic.”

more at pulmonaryfibrosis.org

Lincare execs reap millions via stock plans – Tampa Bay – MSNBC.com
The 2003 Medicare reform law hurt Lincare in two areas beginning in 2005, said the president of The Weeks Group, a Melbourne-based management consulting firm for the home care industry. The law reduced reimbursement for durable medical equipment, including the oxygen equipment that Wallace Weeks called Lincare’s bread and butter, as well as fees Lincare collects for respiratory drugs mailed to patients nationally.

While some companies are getting out of the respiratory medicine business, others are finding ways to take cost out of their systems through different delivery methods or changing their payor mix, Weeks said. He expects Lincare, which is not a client of Weeks’, to follow suit.

Lincare has gone back to its suppliers to get better pricing, Lehman analyst Fischbeck wrote in a Feb. 14 report. Cutting the cost of goods and services has kept cash flow strong, allowing Lincare to buy back stock as well as expand through acquisitions, he said.

That positions the company to take advantage of disruption at competitors and be a consolidator in the market, wrote Fischbeck, who has a $47 a share price target for Lincare stock. Balaji Gandhi, an analyst at Oppenheimer, has set an even higher price target, $51 a share, citing expected acceleration in merger and acquisition activity among other factors.

Role model beats odds every year: South Florida Sun-Sentinel
Linda Bowman recently celebrated her 45th birthday. Five-year-old Kristy Lamb hopes to eventually celebrate hers, too.

They are both fighting cystic fibrosis, a genetic disease that causes their bodies to produce thick mucus that clogs their lungs. Half of people with the disease live until age 32; the rest die before that age.

But Bowman, of Boca Raton, beats statistics. That’s why she’s a role model for Kristy, of Coral Springs, and other young cystic fibrosis patients hoping to see their futures.

More at http://www.cff.org/home/ 

Man Coughs Up Nail 35 Years After Accident
His family rushing him to the hospital with a 105-degree temperature. There, doctors found the culprit, a small nail that had dropped down inside Hart’s body cavity and nestled inside his ribcage.

Doses of penicillin helped Hart heal, but since removing the metal would require major surgery and doctors suspected the nail would seal itself off in Hart’s body, the foreign object was forgotten for years.

“If it ain’t broke, don’t fix it,” Hart said.

Years later, the nail turned up again on a doctor’s x-ray, but again, the unobtrusive item was left alone.

Then, three weeks ago, an internal camera captured an image of the nail during a routine doctor’s office visit. But it wasn’t in Hart’s ribcage area as he’d always thought — the object was actually in Hart’s lung. As Hart and his doctors made plans to remove the nail once and for all, natural physiology took over.

Apparently the mucociliary blanket is much tougher than I was led to believe.

Hospital in Northern California needs weekend coverage for possible strike!!

• The facility needs coverage for one weekend only!!  February 23rd and 24th
• We will pay for flight and hotel
• You will do orientation on Friday evening the 22nd.
• You will be working 2 twelve hour shifts
• You will be compensated $1000 for working the 24 hours on the weekend.
• If you work the graveyard shift you will be compsated an additional $150
• You MUST have a current California license.
• If you would like to know more, please contact me at (866) 953-0011 or email me at ksmith [at] platinumselect.org

Centre Daily Times | 02/13/2006 | Pulmonary rehab brings hope to sufferers of lung disease
Ever increasing de-conditioning results in more shortness of breath, and so the vicious cycle continues. A comprehensive pulmonary rehabilitation program provides an educational forum about COPD, as well as supervised exercise under the watchful eye of a respiratory therapist and psychosocial support. This intervention has been shown to reduce the sense of breathlessness described by COPD patients, thus allowing them to increase their activity level.

Pulmonary rehabilitation has been shown to reduce the number of hospitalizations associated with exacerbation. It probably does not prolong the lives of patients with COPD, but it certainly improves their quality of life.

Kind of a scary article:

Misdiagnosis of Pulmonary Embolism Found Frequent and Harmful – CME Teaching Brief – MedPage Today

Despite evidence-based guidelines, diagnostic mismanagement of a suspected pulmonary embolism is common and harmful, according to French researchers.
Two large studies reported in the Feb. 7 issue of the Annals of Internal Medicine alerted physicians to a serious diagnostic problem involving a suspected pulmonary embolism and suggested a method of providing less subjective diagnoses for these patients.

An ad on the Super Bowl for asthmacontrol.com : watch it here:Jerome Bettis: Asthma Control Test – Google Video
Informaton about this ads: Produced by Advair for GlaxoSmithKline.

Asthma doesn’t stop The Bus, and it doesn’t have to stop you. Take the Asthma Control Test (TM) and share your results with your doctor. Take the Asthma Control Test and know your asthma score. The American Lung Association supports the Asthma Control Test and wants everyone 12 years of age and older with asthma to take it, no matter how well controlled you think your asthma is. This commercial aired during the 2006 Super Bowl.

What happens if you have mass casualties who all need mechanical ventilation? Sounds like a mess to me, but folks are thinking hard about the allocation of ventilation technologies in such an event. Let’s hope we don’t need to implement it.
Concept of Operations for Triage of Mechanical Ventilation in an Epidemic — Hick and O’Laughlin, 10.1197/j.aem.2005.07.037 — Academic Emergency Medicine

The recent outbreak of severe acute respiratory syndrome and the growing potential of an influenza pandemic force us to consider the fact that despite great advances in critical care medicine, we lack the capacity to provide intensive care to the large number of patients that may be generated in an epidemic or multisite bioterrorism event. Because many epidemic and bioterrorist agent illnesses involve respiratory failure, mechanical ventilation is a frequently required intervention but one that is in limited supply. In advance of such an event, we must develop triage criteria that depend on clinical indicators of survivability and resource utilization to allocate scarce health care resources to those who are most likely to benefit. These criteria must be tiered, flexible, and implemented regionally, rather than institutionally, with the backing of public health agencies and relief of liability. This report provides a sample concept of operations for triage of mechanical ventilation in epidemic situations and discusses some of the ethical principles and pitfalls of such systems.

Read the whole thing.

Most WTC Health Registry Enrollees Reported New or Worsened Respiratory Symptoms After 9/11/01

Most enrollees in the World Trade Center Health Registry reported having one or more respiratory problems that either began or got worse in the weeks and months after the September 11, 2001 terrorist attacks in New York City, according to the latest quarterly report issued today by the New York City Department of Health and Mental Hygiene (DOHMH).