Correlates of expected positive and negative support for smoking cessation among a sample of chronically ill veterans.

Addict Behav. 2012 Jan;37(1):135-8

Authors: Fish LJ, Gierisch JM, Stechuchak KM, Grambow SC, Rohrer LD, Bastian LA

Abstract
OBJECTIVE: To examine demographic, relationship, and smoking history factors related to expected positive and negative support for quitting smoking among chronically ill veterans.
METHODS: Data for this report comes from baseline data from a randomized controlled trial of a support-based smoking cessation intervention for veterans with chronic diseases (cancer, cardiovascular disease, hypertension, diabetes, and chronic obstructive pulmonary disease). We used separate multiple linear regression models to analyze relationships between positive and negative support and variables selected for model entry.
RESULTS: Veterans in our sample expected high positive and negative support for quitting. Veterans who were married/living as married, had some college education, were female, or named a female support person expected higher levels of positive support. Veterans who named a female or a nonsmoker as a support person expected higher levels of negative support. Males and non-Caucasians also reported higher levels of expected negative support.
CONCLUSIONS: Individual differences that influence perceptions of expected support are likely to influence intervention participation and engagement. Thus, understanding factors associated with expected positive and negative support is necessary to optimize future implementation of support-based cessation interventions through better treatment matching.

PMID: 21978930 [PubMed - indexed for MEDLINE]

Azithromycin for prevention of exacerbations of COPD.

N Engl J Med. 2011 Dec 8;365(23):2235; author reply 2236

Authors: DiNicolantonio JJ

PMID: 22150047 [PubMed - indexed for MEDLINE]

In July 2011, the Food and Drug Administration (FDA) approved Arcapta Neohaler (indacaterol maleate powder), a long-acting beta-agonist (LABA), at a dose of 75 μg once daily as a bronchodilator for patients with chronic obstructive pulmonary disease (COPD).1 Since the European Medicines Agency (EMA) had approved indacaterol at doses of 150 μg and 300 μg in 2009,2 one might question why the FDA selected a 75-μg dose.

Historically, LABAs have been developed first for patients with asthma and then the same dose has been applied to patients with COPD. Indacaterol's manufacturer, Novartis, took a different approach: it focused primarily on patients with COPD and proposed two different doses for marketing. Novartis submitted its new drug application (NDA) to the FDA in October 2009, proposing doses of 150 μg and 300 μg once daily. The NDA was not approved, because the data did not show a meaningful difference in efficacy between the proposed doses and a lower dose (75 μg), and there were safety concerns regarding the proposed doses. ...

Noninvasive Testing of Lung Function and Inflammation in Pediatric Patients with Acute Asthma Exacerbations.

J Asthma. 2011 Dec 1;

Authors: Arnold DH, Gebretsadik T, Abramo TJ, Hartert TV

Abstract
Objective. There is limited information on performance rates for tests of lung function and inflammation in pediatric patients with acute asthma exacerbations. We sought to examine how frequently pediatric patients with acute asthma exacerbations could perform noninvasive lung function and exhaled nitric oxide (FE(NO)) testing and participant characteristics associated with successful performance. Methods. We studied a prospective convenience sample aged 5-17 years with acute asthma exacerbations in a pediatric emergency department. Participants attempted spirometry for percent predicted forced expiratory volume in 1 second (%FEV(1)), airway resistance (Rint), and FE(NO) testing before treatment. We examined overall performance rates and the associations of age, gender, race, and baseline acute asthma severity score with successful test performance. Results. Among 573 participants, age was (median [interquartile range]) 8.8 [6.8, 11.5] years, 60% were male, 57% were African-American, and 58% had Medicaid insurance. Tests were performed successfully by the following [n (%)]: full American Thoracic Society-European Respiratory Society criteria spirometry, 331 (58%); Rint, 561 (98%); and FE(NO), 354 (70% of 505 attempted test). Sixty percent with mild-moderate exacerbations performed spirometry compared to 17% with severe exacerbations (p = .0001). Participants aged 8-12 years (67%) were more likely to perform spirometry than those aged 5-7 years (48%) (OR = 2.23, 95% CI: 1.45-3.11) or 13-17 years (58%) (OR = 1.61, 95% CI: 1.00-2.59). Conclusions. There is clinically important variability in performance of these tests during acute asthma exacerbations. The proportion of patients with severe exacerbations able to perform spirometry (17%) limits its utility. Almost all children with acute asthma can perform Rint testing, and further development and validation of this technology is warranted.

PMID: 22133263 [PubMed - as supplied by publisher]