Latest Conference Articles

During a panel discussion, Darren Taichman, MD, PhD, executive deputy editor of the Annals of Internal Medicine and adjunct associate professor of medicine, Perelman School of Medicine, University of Pennsylvania, presented updates to pulmonary hypertension treatment guidelines, and Daniel Oulette, MD, FCCP, leader of the American College of Chest Physicians guideline oversight committee, discussed the move toward evidence-based guidelines that allow for continuous updates.

The molecular heterogeneity of idiopathic pulmonary fibrosis (IPF) may be important when selecting treatment strategies, including 2 new medications for delaying the progression of IPF-pirfenidone and nintedanib. In a featured lecture, Steven K. Huang, MD, an expert in IPF and an assistant professor of internal medicine at the University of Michigan, discussed characterization of the disease from the perspective of genetics.

The big news at the 2014 CHEST meeting in Austin, TX, was that 2 new drugs - pirfenidone and nintedanib - were approved to treat idiopathic pulmonary fibrosis, according to Steven Nathan, MD, medical director of the Lung Transplant Program at Inova Fairfax Hospital in Falls Church, VA.

Guidelines for the treatment of healthcare-associated pneumonia recommend the use of broad-spectrum therapy. But based on current evidence, use of broad-spectrum therapy may not be warranted, according to Marcos I. Restrepo, MD, MSc, of the University of Texas Health Science Center at San Antonio.

In this session, Gerard A. Silvestri MD, MS, a professor at the Medical University of South Carolina, discussed the evolution of therapy for non-small cell lung cancer (NSCLC). The use of targeted therapies has led to a dramatic improvement in survival for a certain subset of patients with NSCLC whose cancers have specific driver mutations.

Lung cancer is a good candidate for broad, population-based screening because it is a common disease with a high mortality rate that is often more successfully treated when a diagnosis is established early in the disease process. In an educational session, Gerard A. Silvestri, MD, MS, a professor at the Medical University of South Carolina, discussed the state of the art in lung cancer screening.

Treating bipolar depression with standard antidepressants has long been controversial, because some patients do not respond and it is believed that the drugs trigger manic episodes. Two physicians outline data on an antipsychotic initially approved for schizophrenia that received an additional indication for bipolar depression.

Treating psychiatric disorders in children and teenagers offers benefits that far outweigh risks, according to Craig Donnelly, MD, of Geisel School of Medicine at Dartmouth. If mental health problems go untreated, the teenager runs the risk of developing a more serious disorder as an adult.

Patients with serious mental illness die 15 to 20 years earlier than those with similar cardiovascular conditions. According to Joseph P. McEvoy, MD, of the Medical College of Georgia, "There's no mystery here." Cognitive deficits, issues, and lack of access can make it hard for these patients to get primary care, and to stick with the instructions they do receive. To help this group, Dr McEvoy believes psychiatrists can gain competency to treat hypertension, diabetes, obesity and to help these patients quit smoking.

Steven D. Hickman, PsyD, associate clinical professor at the University of California, San Diego, invited a roomful of conference attendees to put down the notes, close their eyes, set an intention, and breathe, gaining an "awareness of the breath." His session, "Mindfulness-Based Stress Reduction for Patients with Chronic or Life-Threatening Illness," highlighted techniques based on 2000-year-old Eastern philosophy that can help patients learn to respond to pain, not react to it.

Evidence of who gets post-traumatic stress disorder, how genetics plays a role, and how to treat it is growing, but much work remains to help the estimated 3.5% of the population who suffer its effects in any given year, according to Murray B. Stein, MD, MPH, professor of Psychiatry and Family and Preventive Medicine, and vice chair for Clinical Research in Psychiatry at the University of California, San Diego.

For more than 70 years, standard care for those addicted to alcohol or drugs has called for the afflicted person to abstain from the substance completely, and to become immersed in a community of fellow sufferers for support. This is particularly true in the early months, when the "phenomenon of craving" remains acute.

Building trust, or a "therapeutic alliance," between the therapist and patient with personality disorder is needed to help the patient work through core beliefs of worthlessness and unlovability that affect behavior, according to Judith S. Beck, PhD, who was the featured speaker Saturday at the US Psychiatric and Mental Health Congress, being held in Orlando, Florida.

If psychiatrists and other mental health professionals don't actively measure their effectiveness, they typically don't know things have gone awry until it's too late, said Mark Zimmerman, MD, director of Outpatient Psychiatry and the Partial Hospital Program at Rhode Island Hospital.

The National Bone Health Alliance working group expanded criteria for the clinical diagnosis of osteoporosis to include T-score < 2.5 at the spine or hip; low-trauma hip fracture; low-trauma vertebral, proximal humerus, pelvis or some distal forearm fractures in the setting of osteopenia; or FRAX score in a patient with osteopenia meeting or exceeding the National Osteoporosis Foundation Guidelines.

Osteogenesis imperfecta, a skeletal disorder caused by mutations in type I collagen, exhibits structural and functional differences on a genotypic level that contribute to diverse phenotypes.

Fracture Liaison Services (FLS) attempt to ensure that patients with potentially osteoporosis-associated fractures are followed appropriately with screening and intervention. In the United States, industry, non-profits, and governmental steering committees support FLS.

Autophagy functions in numerous critical ways, including in quality control, cell remodeling, and energy production. Understanding the molecular pathways of autophagy can result in understanding and treating neurodegenerative disorders, metabolic disorders, and physiologic changes associated with aging.

Cilia appear in a wide variety of cell types, including osteoclasts and osteoblasts, where they function as physiologic and biochemical sensors.

By studying dense connective tissue, scientists are discovering ways that the cell nucleus adapts and changes in response to the administration of force, time, and differentiation.

Paul Wicks, PhD, vice president of innovation at PatientsLikeMe, discussed the benefits of using technology in multiple sclerosis research by patients, providers, researchers, and other decision-makers.

Despite the benefit of having more choices than ever before to treat patients with multiple sclerosis, the abundance of options has led to more complexity, according to speakers at the 2014 ACTRIMS-ECTRIMS Joint Meeting in Boston, Massachusetts.

Current novel therapeutics for the prevention and treatment of bone loss in patients with inflammatory joint disease target cytokines and other inflammatory mediators. Mesenchymal stem cell therapy is a compelling new treatment currently being studied in clinical trials.

Bone erosion, a common side-effect of rheumatoid arthritis, can be prevented by using a combination of close patient monitoring and individualized therapeutic regimens that include agents to block cytokines, block osteoclasts, or target abnormal cellular reactions.

As a medium, the Internet neither helps nor harms in multiple sclerosis care - what matters is how clinicians and patients engage in that medium, according to Paul Wicks, PhD, vice president of innovation at PatientsLikeMe.

Inflammatory bone loss is caused by a complex pathway that begins with inflammatory cell production of cytokines, progresses to abnormal bone absorption, and culminates in the destruction of joints, bone fractures, and patient debility.

At this year's ECTRIMS conference in Boston, Alasdair Coles, MD, University of Cambridge, discussed alemtuzumab and its effectiveness in treating multiple sclerosis.

The second year of the extension study of Lemtrada (alemtuzumab) for multiple sclerosis reported positive interim results with 70% of patients not requiring a third course of treatment.