American Thoraic Society Journal news tips for May 2003 (first issue)

MENOPAUSAL WOMEN WITH DAYTIME SLEEPINESS SHOULD BE EVALUATED

Evaluation for sleep-disordered breathing should be a priority for menopausal women with complaints of snoring, daytime sleepiness, or unsatisfactory sleep. Researchers studied a population-based sample of 589 women enrolled in the Wisconsin Sleep Cohort Study. They tested the hypothesis that menopause is an independent risk factor for sleep-disordered breathing (SDB) using in-laboratory sleep testing (polysomnography). (SDB is a condition characterized by repeated breathing pauses during sleep.) In addition to sleep testing, the investigators elicited information on stage of menopause, duration of menopause, use of hormone replacement therapy, history of hysterectomy and oophorectomy (surgical removal of the ovaries), vasomotor symptoms, plus other physical details. According to the authors, postmenopausal women were 2.6 times more likely to have SDB defined by an apnea/hypopnea index of 5 events (pauses) per hour and 3.5 times more likely to have the condition when SDB is defined by an index of 15. The study is published in the first issue for May 2003 of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.

STATIN USE VERY BENEFICIAL TO LUNG TRANPLANT PATIENTS

Statins, designed to lower blood cholesterol levels, if given to lung transplant patients, were shown to significantly reduce mild-to-severe tissue rejection, lower the potential for lung cirrhosis, improve pulmonary function, and offer greater longevity to patients. These investigators examined the outcomes of 39 lung transplant patients who were prescribed statins for elevated lipids in their blood. The results were compared with 161 control recipients who did not receive these drugs. (Statins have been reported to also exert a large number of highly varied anti-inflammatory effects.) The six-year survival rate for lung transplant recipients who took statins at any point after their operation was 91 percent, which was much higher than that of control subjects (54 percent). The researchers said that their data indicate that statin use could have substantial clinical benefits following pulmonary transplantation. But they believe that their results need to be further corroborated by a prospective randomized clinical trial before physicians begin prescribing widespread use of statins for lung transplant recipients. The research is published in the first issue for May 2003 of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.

DAY CARE ATTENDANCE AND RECURRENT WHEEZING

Among children who were born to mothers with a history of asthma, day care attendance in the first year of life was associated with an increased risk of wheezing in the first six years of life. Investigators studied 453 children to age 6 who had a parent with a history of hay fever, asthma, or allergies. They were examining the relationship between day care attendance in the first year of life and asthma, recurrent wheezing, and eczema by age 6. The researchers pointed out that the relationship between day care attendance in the first year of life and wheezing during the first six years of life was significantly influenced by the mother’s history of asthma. The investigators pointed out that their findings suggest that maternal history influences the relationship between day care-related exposure and childhood asthma through as yet-unidentified genetic factors and/or early life environmental exposures shared by mother and child. In children whose mothers had no history of asthma, day care attendance in early life was associated with a decreased risk of asthma and recurrent wheezing at the age of 6. The study appears in the first issue for May 2003 of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.