Newsbriefs From The Journal Chest, February 2007

Waist-to-Hip Ratio Affects Breathing in the Morbidly Obese

According to a new study, large waist-to-hip (W/H) ratios in the morbidly obese are associated with impaired pulmonary gas exchange. Canadian researchers from McGill University gathered arterial blood samples from 25 morbidly obese patients who were scheduled for bariatric surgery. Age, body mass index (BMI), body fat percentage, waist circumference, and W/H ratio were recorded. According to the study, large W/H ratios indicate substantial portions of fat mass surrounding the thorax, which could lead to ventilation abnormalities. While there was no relationship between BMI and pulmonary gas exchange, researchers found both oxygenation problems, as well as minor ventilatory constraints, in the participants. Also noted, was that all of the men had larger W/H ratios and were more likely to have a poorer gas exchange, compared with the women. Researchers concluded that a significant part of the blood-gas status in all participants was associated with their W/H ratio. This study appears in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Low-Risk Pneumonia May Be Better Treated as Outpatient

New research suggests that outpatient treatment of low-risk community-acquired pneumonia can result in a faster recovery, when compared with inpatient care. Using data from 32 emergency departments, researchers from Yale, the University of Connecticut, and the University of Pittsburgh compared 30-day mortality, time to return to work and usual activities, and patient satisfaction in 1,493 low-risk patients with pneumonia. Of the group, 944 patients were treated outpatient, and 549 were admitted to the hospital. Researchers found that overall mortality was significantly lower in those treated outpatient. Also, outpatients were shown to resume normal activity six to nine days sooner than those treated inpatient. However, patient satisfaction of treatment did not differ between the two groups. This study appears in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Heartburn Treatment May Increase Bile Reflux

A new study may explain why individuals treated for acid reflux with proton-pump inhibitors (PPI) still experience reflux symptoms. Researchers from the Lynn Health Science Institute in Oklahoma City, OK, treated 15 individuals with significant complaints of heartburn, with either a PPI or with a placebo. After one week, all participants underwent monitoring and polysomnography, both of which were done after participants were given an acid-inducing meal to raise the baseline occurrence of reflux. Researchers found that, while total reflux events and acid reflux events decreased considerably with PPI treatment, nonacidic reflux events, such as stomach bile regurgitation, were significantly greater with PPI treatment. Researchers suggest that this increase in nonacid reflux events may explain persistent symptoms in some patients, despite being treated with PPIs. This study appears in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

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Contact: Jennifer Stawarz
American College of Chest Physicians