Dexmedetomidine is a short-acting intravenous agent that provides cooperative sedation without affecting respiratory drive. This two-center prospective, randomized, double-blind, placebo-controlled study evaluated the use of dexmedetomidine for noninvasive ventilation in patients with acute respiratory failure (ARF). (Source: The Journal of Emergency Medicine)

Electronic cigarettes should be subject to the same laws that apply to tobacco products, and the federal government should ban the marketing and sale of e-cigarettes to young people, a new American Heart Association policy statement says.

The group also called for thorough and continuous research on e-cigarette use, marketing and long-term health effects.

"Over the last 50 years, 20 million Americans died because of tobacco. We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers," Nancy Brown, CEO of the American Heart Association (AHA), said in an association news release.

"Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation's youth, and could renormalize smoking in our society," Brown said. "These disturbing developments have helped convince the association that e-cigarettes need to be strongly regulated, thoroughly researched and closely monitored."

The recommendations were published Aug. 25 in the AHA journal Circulation.

• "E-cigarettes have caused a major shift in the tobacco-control landscape," statement author Aruni Bhatnagar, chair of cardiovascular medicine at the University of Louisville, said in the news release.
• "It's critical that we rigorously examine the long-term impact of this new technology on public health, cardiovascular disease and stroke, and pay careful attention to the effect of e-cigarettes on adolescents," he urged. ...

The discussion of obesity and its detrimental impact upon recent generations has sparked much interest but comparatively little success in implementing preventative strategies . The rates of child overweight and obesity continue to climb internationally in a problem that is no longer isolated to the developed world . Indeed, in a country like Australia that prides itself on its sporty outdoor lifestyles, we presently have 26% of our children as overweight or obese and 63% of our adult population similarly disposed. Moreover, the issue is of greater urgency in our indigenous population, with the proportion of overweight and obese Aboriginal children increasing more rapidly than in non-Aboriginal children in New South Wales . Whilst this is another example in developed countries of health in...

In this multicentre, double-blind, randomised control trial, a shorter 5-day course of glucocorticoids was compared with a 14-day course to assess non-inferiority. Patients received an initial dose of IV methylprednisone, then 4 days of oral prednisone, followed by further prednisone or a placebo. They all received antibiotics and inhaled corticosteroids and bronchodilators.

No differences were seen in the primary endpoint of time to next exacerbation within the follow-up period of 6 months. Similarly, there were no differences in many of the secondary endpoints, including overall mortality, requirement for mechanical ventilation and new or worsening hypertension or hyperglycaemia. Importantly, no difference was seen in incidence of side effects of steroids despite a reduced cumulative dose of over 70% in the short-term group.

The benefit gained from steroid treatment in acute exacerbations peaks within 5 days. This study confirms that further steroids seem neither to do more harm nor more good...