Cover Article
Immunity is Skin-Deep—Stretching the Influenza Vaccine Supply
Vaccines introduced directly into the skin elicit a fairly strong immune response but require less than one quarter of the antigen in a traditional intramuscular vaccine. Thus, researchers are investigating whether intradermal administration of influenza vaccine is a viable way to stretch the vaccine supply and provide vaccination protection to more people.

Selected Articles

• Antibiotics Can Be OK for Patients With Chronic Rhinosinusitis
• HIV Positivity—An Independent Risk Factor for COPD?
• Predicting CPAP Adherence
• Steroid Therapy in Sepsis—What’s the Latest?
• Literature Monitor

Cover Article
Oldest and Youngest at High Risk for Flu Complications
CDC investigators analyzed estimated annual data on the number of influenza-related hospitalizations from the 1979-1980 flu season through the 2000-2001 season, noting that influenza-related hospitalization rates are high for the very young and the very old. Their findings, they say, highlight the need for improved vaccination in these two age groups.

Selected Articles

• Asthma May Be a Progressive Disease
• Eosinophils, Neutrophils, and COPD
• Tracheostomy at Your Fingertips
• Long-Term Glucose Control Strongly Influences Hyperglycemia in the Critically Ill
• Literature Monitor

Cover Article
Dietary Fiber May Reduce Cough and Phlegm
“Promoting a diet high in fiber and flavonoids, such as from fruit and soy, may be an important contribution to the prevention of chronic respiratory symptoms, both in smokers and nonsmokers,” concluded Lesley M. Butler, PhD, and colleagues after studying fiber intake and cough with phlegm incidence in nearly 50,000 Singaporean Chinese adults.

Selected Articles

• Rapid Treatment of COPD Exacerbations Aids Recovery
• Taking a Closer Look at H influenzae Colonization in COPD
• Two Suspects Involved in Airway Hyperreactivity
• Does Combination Antibiotic Therapy Improve Survival in Pneumococcal Bacteremia?
• Literature Monitor

Cover Article
The Hidden Dangers of β-Agonists
Two new meta-analyses have uncovered hidden dangers in commonly used asthma and COPD drugs: One study suggests that regular use of β-agonists causes tachyphylaxis, which may lead to an increased risk of asthma attacks. Another study indicates that β-agonists have adverse cardiovascular effects.

Selected Articles

• CDC Issues New Guidelines for Influenza Vaccination
• An Early Look at Emerging Therapies for Pulmonary Arterial Hypertension
• Changing Views of CF—Is Mucus Hypersecretion Really the Problem?
• Making the ICU a Safer Place
• Literature Monitor

Cover Article
ARDSNet Insights on Genetics, Risk Factors, and Steroid Use
At the 2004 ATS annual meeting, ARDSNet investigators reported that methylprednisolone appears to be no more effective than placebo in patients with adult respiratory distress syndrome. In fact, they said, corticosteroid use may increase the duration of intensive care in ARDS patients.

Selected Articles

• New COPD Guidelines Released
• Obese Children Especially Susceptible to Air Pollution
• Two SARS Vaccines Inhibit Viral Replication in Mouse Models
• Should Vasopressin Be Used in Septic Shock?
• Literature Monitor

Cover Article
High Marks for School-Based Asthma Programs
School-based asthma programs can be a simple, effective way to manage asthma in inner-city children. Recently, two such programs—one in Detroit and one in Rochester, New York—demonstrated significant improvement with the interventions used.

Selected Articles

• Lung Cancer Reaches Epidemic Proportions in Women
• New Insights on Why Only Some Smokers Get COPD
• Transfusion Is a VAP Risk Factor
• ACTH Test: Useful or Not in Septic Shock
• Update on Penicillin Allergies
• Literature Monitor

Cover Article
When Breathing Is a Health Risk
What is the impact of air pollution—specifically carbon dioxide—on allergies and asthma? According to a report recently released by Harvard University’s Center for Health and the Global Environment, carbon dioxide is responsible not only for poor air quality in urban areas but also for increased pollen production and allergenicity of certain plants.

Selected Articles

• Genetic Mutation Helps Explain Fatal Infant Surfactant Deficiency
• COPD Relapses Frequent After ED Visits
• Protein in Monkeys Blocks HIV-1 Replication
• New Device Lets Mechanically Ventilated Patients Talk
• Critical Care Medicine in Grave Condition
• Can Sepsis Be Good for Critially Ill Patients?
• Recombinant Factor VIIa Shows Early Promise in Severe Trauma
• Literature Monitor

Cover Article
Are “No Smoking” Sections Pointless?
Anyone who has sought solace from secondhand smoke in restaurants, bars, or other places has probably noticed that tobacco fumes often encroach on the nonsmoking section to such a degree that having such a section seems pointless. A recent study by Cains et al suggests that this observation may be accurate.

Selected Articles

• Avian Influenza—Not Just for Birds Anymore
• Deep Six the Extra Fluids for Respiratory Infections?
• New Procalcitonin Assay Rapidly Distinguishes Bacterial from Viral Infections
• What’s Best for Detecting Adrenal Insufficiency in the ICU?
• Medical Care Not at the Heart of Long-term Outcomes
• PaCO2 Response to Pronation Predicts Survival in ALI/ARDS
• Can Statins Prevent Sepsis?
• Literature Monitor

Cover Article
Asthma Rate in Homeless Children Disturbingly High
It is well known that asthma disproportionately affects children of color and those whose families have limited financial resources. New research suggests that an oft-ignored and understudied subgroup of the poor—homeless children—have asthma rates that are six times the national rate. Yet, many of these children have received no treatment for their asthma symptoms.

Selected Articles

• Uncovering the Source of a Superbug’s Strength
• B-Type Natriuretic Peptide Aids Evaluation of Dyspnea and Cardiovascular Risk
• Mixed Results in Large Study of Interferon Gamma-1b for IPF
• Malnutrition May Contribute to Emphysema Development
• New Guidelines for the Management of Sepsis/Septic Shock
• Albumin or Saline? Findings From the SAFE Study
• A Novel Therapy Targets Thrombolysis Directly to the Lungs
• Literature Monitor

Cover Article
Are Long-haul Flights a Health Hazard?
Air travel has been portrayed by the lay media as putting passengers at risk for venous thromboembolism (VTE). Long-haul flights, in particular, have been targeted. The true incidence and clinical relevance of VTE after long-haul flights is open to debate. However, two new studies provide much better insights into the risks associated with long-haul flights, especially among people who do not have risk factors for VTE.

Selected Articles

• Air Pollution Increases Lung Cancer Risk
• IDSA Pneumonia Guidelines Address Resistance, SARS, and Bioterror
• Ethnicity Influences Prevalence, Severity of Lung Disease
• New Test Offers Rapid Diagnosis of Pneumonia
• Using Time to Diagnose Catheter-Related Bacteremia
• Vasopressin Effective as a First-Line CPR Therapy
• In ICU, Cognitive Deficits Often Overlooked
• Literature Monitor

Cover Article
Disaster Medicine—Preparing for the Worst
The threat of another terrorist attack is never far from most Americans’ minds. But this threat is particularly pertinent for health professionals, who must grapple with a number of important questions: How can emergency health care systems better prepare for such events? What should physicians and nurses who are not part of these systems know in case they have to lend assistance during an emergency? And what can be done to increase readiness for disasters that are thought likely to occur sooner or later, such as the detonation of a “dirty bomb” or the release of chemical agents in populated areas?

Selected Articles

• Are Fish Oil Supplements Helpful for Respiratory and Allergic Disease?
• Blood Transfusions: Risks and Alternatives
• Noninvasive Ventilation for Respiratory Failure?
• Is Early Enteral Feeding a Good Idea?
• End-of-Life Care for Patients With Severe COPD
• Phase II Trial Shows Promise for Gefitinib in NSCLC
• Guaifenesin as Cough Suppressant?
• Literature Monitor

Cover Article
Polypharmacy Improves Smoking Cessation Rate
New insights into the treatment of tobacco dependence offer hope that more people will be able to quit smoking. The key is to view tobacco dependence as a chronic condition that requires both polypharmacy and long-term treatment.

Selected Articles

• Two New Anticoagulants Show Promise for VTE/PE Prophylaxis
• A New Pathway for Pulmonary Hypertension
• Diagnostic Criteria for Hypersensitivity Pneumonitis
• PA Catheters—On the Way Out?
• Is Glutamine a Lifesaving Nutrient?
• What Predicts Survival in Cardiogenic Shock?
• Literature Monitor
• CME Rounds: Today’s Approach to the Diagnosis and Management of COPD