By Debbie Bunch
February 7, 2025
Genetic Test for COPD in the Works
COPD is an underdiagnosed condition but finding people among the general public who have the disease so that early treatment can begin has been a challenge.
U.S. researchers who published their findings in JAMA believe a simple and low-cost genetic test could improve that.
The genetic sample needed for the test can be gathered from a cheek swab or blood test, which results in a polygenic risk score for COPD based on genome-wide association studies of lung function identified in multiple cohorts.
The investigators added the risk score to the Lung Function Questionnaire, which asks questions about demographics, smoking history, and other relevant topics, and then tested the combined method in 3,385 people taking part in the Framingham Heart Study (FHS) who reported no history of COPD, and 4,095 people participating in the COPDgene study, which involved people who previously smoked or were current smokers.
Results showed combining results from the score and the questionnaire significantly improved discrimination performance in the FHS and among non-Hispanic African Americans and non-Hispanic whites in the COPDGene study.
At a risk threshold for spirometry referral of 10%, the addition of the genetic test to the questionnaire score correctly reclassified 13.8% of COPD cases in the FHS.
“A COPD polygenic risk score may provide additional clinical utility in identifying undiagnosed COPD cases beyond conventional case-finding approaches, particularly in the general population,” wrote the authors. Read Article Read Abstract
Pulmonary Rehabilitation for Mechanically Ventilated Patients Pays Off
According to the authors of a meta-analysis published in BMC Pulmonary Medicine, pulmonary rehabilitation (PR) featuring procedures such as inspiratory muscle training (IMT) and neuromuscular electrical stimulation (NMES) can significantly improve outcomes for patients on mechanical ventilation.
The Chinese investigators decided to conduct the analysis because while there are numerous studies on PR in the ICU, inconsistency in interventions, lack of multidisciplinary cooperation, and variable indicators have led to uncertainty about the optimal PR protocol. “This systematic review and meta-analysis aimed to explore the effects of different PR on respiratory function in mechanically ventilated patients and to determine the optimal rehabilitation type,” they wrote.
The researchers found 12 papers to include in their systematic review and ten made it into the meta-analysis. Four of the studies evaluated IMT alone while two studies looked at NMES. Another two studies focused on extremity muscle training. One study evaluated chest physiotherapy. Several studies looked at multiple interventions.
All the study patients were 18 years old or older and had been on mechanical ventilation in the ICU for at least 24 hours.
The overall results showed maximum inspiratory pressure, maximum expiratory pressure, and tidal volume improved following the pulmonary rehabilitation interventions. The rapid shallow breathing index did not significantly improve.
The best therapeutic effects were seen for IMT and NMES, and patients who had been mechanically ventilated for more than 48 hours saw the greatest benefit. The authors suggest training could be applied twice a day for seven days using an inspiratory threshold device. Read Article Read Full Paper
Law Banning Sales of Tobacco Products to Those Under 21 Falls Short
Federal law prohibits the sale of tobacco products to people under the age of 21. Still, researchers from Wake Forest University School of Medicine and Rutgers University say the law is not keeping kids and young adults from purchasing these products in New Jersey.
“We randomly sampled tobacco retailers in both high- and low-population density municipalities within a 25-mile radius of New Brunswick,” said study author Amanda Kong, PhD, assistant professor of social sciences and health policy at Wake Forest. “We found that businesses sold to underage purchasers 49.5% of the time.”
Overall, 2,663 attempts to purchase tobacco products at 70 retailers were made by people between the ages of 18 and 20. Cigarettes, cigars, and/or cigarillos accounted for about 32% of attempted sales each, with electronic cigarettes making up 24.5% and nicotine pouches 10.5%.
An ID check took place in only 60% of these purchase attempts, and even after finding an underage buyer, about 15% of the sales were completed anyway. However, when electronic ID scanning was used to check buyer age, far fewer underage buyers were able to purchase the products. About 22% of the purchase attempts involved electronic scanning, and only 3.2% resulted in underage sales.
The authors plan to conduct further studies aimed at uncovering factors that contribute to underage sales of tobacco products. “We hope to be able to identify modifiable factors that can help inform regulatory efforts, retailer education programs, and overall compliance and enforcement to reduce and prevent tobacco use consistently among youth and young adults,” said Dr. Kong.
The study was supported by the National Cancer Institute and published by JAMA Network Open. Read Press Release Read Full Paper
