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ACT NOW! DON’T LET THIS BE YOUR LAST ISSUE. To make sure you keep receiving this magazine, you need to renew your FREE subscription. HERE’S HOW: Just call 800-355-1088, (M-F, 8am-6pm ET) OR, RENEW ONLINE AT www.advanceweb.com/respiratory Your FREE subscription, online and in print, gains you access to many advantages of ADVANCE: Articles on timely clinical topics The latest professional news Job opportunities Useful career advice New product information and helpful resource directory Exclusive online content, digital edition archives, specialty spotlights, blogs & more ADVANCE Healthcare Shop product catalogs ADVANCE for Healthcare Careers 19
n CHRONIC OBSTRUCTIVE PULMONARY DISEASE CALLING ALL STUDENTS! IT’S A CONTEST JUST FOR YOU. ADVANCE is proud to announce the Faces of the Future: National Student Writing Contest, which will highlight the field’s new class of thought leaders. WIN $250! Gain recognition in the field and plump up your resume. One first place article will win a $250 cash prize and be published online in August. might be different between the races.” Does the evidence hold up Gerard J. Criner, MD, serves as Philadelphia clinical center director for the National Institute of Health’s massive COPDGene study. The underlying purpose of the study, Dr. Criner said, is to discover if there are independent genetic factors that can explain racial and gender differences in susceptibility to smoking and COPD. “We’re identifying different patterns found on X-ray — more airway disease, more emphysema, more airways obstruction — things that no one could articulate before, without study information,” Dr. Criner said. “We may discover separate clinical phenotypes found in COPD patients that have some relationship to race.” While variables of susceptibility may exist, Dr. Criner emphasized that in more than 10,000 COPD patients involved in the study there is a substantial amount of genetic mixture that has occurred over the generations. “So, there may be more variability than can be explained by gender or race,” he said. “But we won't know for sure until data has been analyzed. We need to use caution. It still remains to be seen.” But Dr. Dransfield drew a line in the genetic susceptibility debate, noting there are most certainly differences between the races. “It’s a touchy subject, but there clearly are,” he said. “It’s not all about access of care and quality of care, as some might suggest. That’s another issue that is valid. But there is still more. Just as there are differences between men and women that have to do with hormones, so are there differences between the races in a variety of gene frequencies. There could be lots of differences, including nicotine metabolism, how well the body deals with oxygen stress, or how aggressively the neutrophils in the body respond to the stimulus from cigarette smoke. We are not all exactly the same.” And both men agreed that genetic factors, working in concert with environmental factors — such as an urban or rural atmosphere, or exposure to certain pollutants or chemical substances — could point toward heightened COPD susceptibility. Why does it matter “Biological Environmental Physiological I don’t know. It could be all of them, none of them, or a combination,” said a reflective Dr. Criner, who is also a professor, chief of pulmonary and critical care medicine, and director of the intensive care unit and ventilator rehabilitation unit at Temple University Hospital, Philadelphia. But he stated with certainty that when it comes to patient care, defining the susceptibility variables will have landmark effects. Once it is established that there are distinct presentations of this disease predicted by certain characteristics of gender or race, patients will be followed earlier, more carefully, and their outcomes may be different. “If we can identify certain proteins or genes or combinations that could indicate a different prognosis or even identify potential targets for treatment, that will have significant impact on improved practice,” Dr. Criner said. “And it will certainly give more credence to the notion of personalized health care. We can’t treat everybody the same.” n Contact Valerie Neff Newitt at vnewitt @advanceweb.com ENTER ONLINE Visit www.advanceweb.com/respiratory and click on “Faces of the Future” icon to submit your 1,400 word article. ENTRY DEADLINE: JUNE 20, 2011 QUESTIONS Contact Kristen Ziegler at 800-355-5627, ext. 1803, or kziegler@advanceweb.com Ask the Expert Q: I am considering using one-way valves to prevent cross contaminations in my spirometry testing. Is this the best method A: One-way valves can be a potential cost-saving consumable that prevent inhalation through a reusable sensor for hygiene purposes. However, in terms of diagnostic spirometry, the inspiration following the forced expiration is key information to assess patient compliance. Compared to a one-way valve, a disposable turbine that is singularly packed and factorycalibrated guarantees hygiene and cost-effectiveness, along with the advantage of adding full-featured diagnostic capabilities of a complete flow/volume loop as recommended by the American Thoracic Society. —Donald Melnikoff, president, MIR Medical International Research USA 20 ADVANCE for Healthcare Careers
Page 1 and 2: Our digital editions give you two u
Page 3 and 4: Introducing Easy® ApneaTrak for ho
Page 5 and 6: Cover Story 14 Dialing In to Better
Page 7 and 8: ■ Advertiser Index ENTRY DEADLINE
Page 9 and 10: ■ Allergy and asthma By Valerie N
Page 11 and 12: ■ Ventilation Today By Kristen Zi
Page 13 and 14: ■ Sleep Tracks By Valerie Neff Ne
Page 15 and 16: n Xxxx cover story Respiratory ther
Page 17 and 18: n cover story relay your message cl
Page 19: n CHRONIC OBSTRUCTIVE PULMONARY DIS
Page 23 and 24: EDUCATION OPPORTUNITIES First 2 Wee
Page 25 and 26: WEST NORTH CENTRAL Director of Clin
Page 27 and 28: ■ Barely BreathinG By Brent Swage
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