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John M Travaline

Publications and source records attributed to John M Travaline.

6 recordsLinked to original sources
PubMed2005

Patient-physician communication: why and how.

Patient-physician communication is an integral part of clinical practice. When done well, such communication produces a therapeutic effect for the patient, as has been validated in controlled studies. Formal training programs have been created to enhance and measure specific communication skills. Many of these efforts, however, focus on medical schools and early postgraduate years and, therefore, remain isolated in academic settings. Thus, the communication skills of the busy physician often remain poorly developed, and the need for established physicians to become better communicators continues. In this article, the authors briefly review the why and how of effective patient-physician communication. They begin by reviewing current data on the benefits of effective communication in the clinical context of physicians caring for patients. The authors then offer specific guidance on how to achieve effective communication in the patient-physician relationship.

Communication↗
PubMed2005

Effect of bilateral lung volume reduction surgery on FEV1 decline in severe emphysema.

STUDY OBJECTIVE: To examine whether lung volume reduction surgery (LVRS) alters the anticipated natural rates of decline in FEV1. DESIGN: Retrospective analysis of spirometry results (188 studies) in patients before and after bilateral LVRS. Setting. Large, urban, academic medical center. PATIENTS: 25 patients with severe emphysema (mean (SD) age 60+/-8 yrs; FEV1 0.74+/-0.29 L, 29% predicted). INTERVENTIONS: Bilateral LVRS performed via median sternotomy, with areas targeted for resection based on preoperative evaluation using high-resolution computed tomography, quantitative perfusion scans, and intraoperative inspection of the lungs. Linear regression analysis was performed on each patient using all serial postbronchodilator FEV1 values from before and after LVRS. RESULTS: Lung function data were available between 2-1001 days prior to LVRS and 71-1169 days after LVRS. Comparison of single pre- and post-LVRS FEV1 results confirmed a significant post-operative (3 month) improvement in lung function. The calculated rate of decline in FEV1 prior to LVRS was 202+/-205 mL/yr. Following LVRS, the rate of decline in FEV1 was unchanged at 178+/-150 mL/yr (p = 0.64). CONCLUSIONS: In patients with severe emphysema, bilateral LVRS does not appear to significantly alter the rate of FEV1 decline.

Aged↗
PubMed2003

Lung cancer risk in white and black Americans.

PURPOSE: To test whether differences in smoking-related lung cancer risks in blacks and whites can explain why lung cancer incidence is greater in black males than in white males but about equal in black and white females, given that a greater proportion of blacks are smokers, but smoke far fewer cigarettes per day than do whites. METHODS: A hospital-based case-control study was conducted between 1984 and 1998 that included interviews with 1,710 white male and 1,321 white female cases of histologically confirmed lung cancer, 254 black male and 163 black female cases, and 8,151 controls. Relative risks were estimated via odds ratios using logistic regression, adjusted for age, education, and body mass index. RESULTS: We confirmed prior reports that smoking prevalence is higher but overall dosage is lower among blacks. Overall ORs were similar for blacks and whites, except among the heaviest smoking males (21+ cigarettes per day or 37.5 pack-years), in whom ORs for blacks were considerably greater than for whites. Long-term benefits of cessation were similar for white and black ex-smokers. Smokers of menthol flavored cigarettes were at no greater risk for lung cancer than were smokers of unflavored brands. CONCLUSIONS: Lung cancer risks were similar for whites and blacks with similar smoking habits, except possibly for blacks who were very heavy smokers; this sub-group is unusual in the general population of African American smokers. Explanations of racial disparities in lung cancer risk may need to account for modifying factors including type of cigarette (yield, mentholation), diet, occupation, and host factors such as ability to metabolize mainstream smoke carcinogens.

Black or African American↗