Respiratory News

Nurses at the Salem, Virginia Veterans Affairs (VA) Medical Center began ensuring their patients brushed their teeth twice a day. This simple act dramatically reduced the number of cases of hospital-acquired pneumonia by 90 percent (people were not on a ventilator). Calling the program Project HAPPEN (Hospital-Acquired Pneumonia Prevention by Engaging Nurses), they have expanded the effort to eight VA hospitals so far and have to date prevented 117 cases of pneumonia – saving an estimated 21 lives and reducing costs by $4.69 million.

New research now published in the jour- nal mSphere examines the effects of poor dental hygiene on the respiratory health of elderly Japanese people. They found not only do the bacteria on our tongues, reach our guts, but seniors are also particularly likely to inhale some of these microorgan- isms. Problems such as difficulty swallowing and cough reflux may cause the elderly to accidentally inhale bacteria that could lead to pulmonary infections, such as pneumonia.

The CDC released its report, Mortality in the United States, moving COPD from the third to the fourth leading cause of death based on early findings of death data for 2016. This report showed that preventable and accidental deaths are now the third lead- ing cause of death, having risen 10 percent in 2016. The increase in accidental deaths is due to a dramatic spike in motor vehicle accidents and drug overdoses. COPD death rates have not improved.

Researchers from the University of Texas Medical Branch at Galveston found testos- terone replacement therapy can help slow the progression of COPD in men. Long-term steroid-based medications help treat pulmo- nary symptoms but they are also associated with testosterone dysfunction. Previous stud- ies have shown that men with COPD have low testosterone levels, which could lead to a worsening of the condition.

An article in the European Respiratory Journal discusses the use of inhaled corti- costeroids (ICS) to treat COPD by reducing inflammation in your airways. Examples include Pulmicort and Flovent; and com- bined with a long-acting bronchodilator in Symbicort and Advair. After reviewing the evidence, researchers found ICS should not be used as a single, stand-alone therapy in COPD. The people most likely to benefit from the addition of ICS to long-acting bronchodilators include those with history of multiple or severe exacerbations despite appropriate maintenance bronchodilator use. The risk of pneumonia may also be greater with ICS use in those who are older with lower body mass index.

A new product is expected to be approved as a treatment for severe asthma. Dupixent® (dupilumab), already approved for atopic dermatitis, has an FDA action date of Octo- ber 20 for its asthma indication. The Phase 3 Liberty Asthma QUEST study of 1,902 subjects showed that Dupixent® reduces acute exacerbations by almost 50 percent compared with a placebo.