April 2, 2009, 4:54 AM CT

Supervised exercise program for COPD patients

Those suffering from chronic obstructive pulmonary disease (COPD) often complain that exercise is too exhausting and leaves them breathless. An article in the current issue of the New England Journal (NEJM) reports that supervised exercise through pulmonary rehabilitation can actually reduce their feelings of breathlessness, increase their tolerance for exercise and improve their quality of life.

The article's main author is Richard Casaburi, Ph.D., M.D., a senior investigator at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed). He directs the institute's Rehabilitation Clinical Trials Center, a facility that focuses on COPD research. Dr. Casaburi surveyed prior studies on pulmonary rehabilitation for COPD and observed that supervised exercise treatment improves aerobic function of the muscles, which helps reduce the breathlessness that is common in COPD.

"These findings are a clear indication that pulmonary rehabilitation can improve the quality of life for those living with COPD," said Dr. Casaburi. "The studies also indicate that pulmonary rehabilitation results in decreased anxiety and depression for COPD patients because they find they can exercise more, and they enjoy the feeling that they have mastered something important in their lives"......... Posted by: Scott      Read more         Source

February 20, 2009, 6:00 AM CT

Global warming and respiratory problems

High summer temperatures, pushed higher by global climate change, may bring with them a spike in hospitalizations for respiratory problems, as per an analysis of data from twelve European cities, from Dublin to Valencia. The data comes from the "Evaluation and Prevention of Acute Health Effects of Weather Conditions in Europe" (PHEWE), a multi-center, three-year collaboration between epidemiologists, meteorologists and experts in public health collaboration that investigated the short-term effects of weather in Europe.

As climate change has gone from a scientific theory to an accepted and encroaching reality, more extreme weather, including hotter summers, is anticipated around the planet. But the secondary effects of climate change are also coming into sharper focus.

The PHEWE project reviewed the effects of higher temperatures on hospitalizations for many different conditions in Europe. They observed that for every degree increase over a temperature threshold, there was a four percent average increase in respiratory-related hospitalizations, but not for cardiovascular or neurovascular- related problems.

The results were reported in the first issue for March of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine........ Posted by: Scott      Read more         Source

February 10, 2009, 6:28 AM CT

Chronic Lung Diseases In Smokers

Eventhough the immune system is designed to protect the body from harm, it may actually worsen one of the most difficult-to-treat respiratory diseases: chronic obstructive pulmonary disorder (COPD), as per new University of Cincinnati (UC) research.

In a preclinical research study, UC environmental health researchers have identified a link between cigarette smoke and activation of a specific cellular receptor (NKG2D) critical to immune system activation. They say the finding is key to understanding COPD disease progression and developing future interventional drug therapies.

"People have historically believed that if you smoke, you suppress the immune system. We've shown that you actually activate certain parts of the immune system and it could potentially work against you," explains Michael Borchers, PhD, lead investigator of the study and UC assistant professor of environmental health.

Borchers and his team report their findings in the March 2009 issue of theJournal of Clinical Investigation. The study appears online ahead of print Feb. 9, 2009. It is the first study to report data defining a link between the immune system and COPD disease progression and severity.

COPD is a progressive pulmonary disease thought to becaused by long-term cigarette smoking. Typically the irreversible and incurable condition is characterized by emphysema and severe inflammation of the lung tissue......... Posted by: Scott      Read more         Source

February 6, 2009, 5:55 AM CT

Sleep apnea may be cured if you put effort to lose weight

For sufferers of obstructive sleep apnea (OSA), a newly released study shows that losing weight is perhaps the single most effective way to reduce OSA symptoms and associated disorders, as per a newly released study in the American Journal of Respiratory and Critical Care Medicine, one of the American Thoracic Society's three peer-evaluated journals.

Weight loss may not be a new miracle pill or a fancy high-tech therapy, but it is an exciting treatment for sufferers of OSA both because of its short- and long-term effectiveness and for its relatively modest price tag. Surgery doesn't last, continuous positive airway pressure (CPAP) machines are only as effective as the patient's adherence, and most other devices have had disappointing outcomes, in addition to being expensive, unwieldy and having poor patient compliance. Furthermore, OSA is generally only treated when it has progressed to a moderate to severe state.

"Very low calorie diet (VLCD) combined with active lifestyle counseling resulting in marked weight reduction is a feasible and effective therapy for the majority of patients with mild OSA, and the achieved beneficial outcomes are maintained at 1-year follow-up," wrote Henri P.I. Tuomilehto, M.D., Ph.D., of the department of Otorhinolaryngology at the Kuopio University Hospital in Finland......... Posted by: JoAnn      Read more         Source

November 4, 2008, 10:56 PM CT

Lung airway cells activate vitamin D

Vitamin D is essential to good health but needs to be activated to function properly in the human body. Until recently, this activation was thought to happen primarily in the kidneys, but a new University of Iowa study finds that the activation step can also occur in lung airway cells.

The study also links the vitamin D locally produced in the lung airway cells to activation of two genes that help fight infection. The study results appear in the Nov. 15 issue of the Journal of Immunology, now online.

In addition to contributing to calcium absorption and bone health, vitamin D is increasingly recognized for its beneficial effects on the immune system. Vitamin D deficiency has been recently associated with increased risk of some infections, autoimmune diseases such as multiple sclerosis and type 1 diabetes, and some cancers.

"The more researchers have been studying vitamin D, the more we learn about new roles it plays in the human body," said the study's lead author Sif Hansdottir, M.D., fellow in internal medicine in the University of Iowa Carver College of Medicine. "The active form of vitamin D is known to affect the expression of more than 200 genes, so we were interested both in the possible lung-specific production of active vitamin D and in vitamin D-dependent production of proteins that fight infections"......... Posted by: Scott      Read more         Source

October 27, 2008, 10:39 PM CT

Statins associated with lower risk of death from pneumonia

Individuals who take cholesterol-lowering statins before being hospitalized with pneumonia appear less likely to die within 90 days afterward, as per a report in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

In the United States and Europe, pneumonia hospitalization rates have increased 20 percent to 50 percent over the past decade, as per background information in the article. About 10 percent to 15 percent of those with pneumonia die from the disease. A recent review article indicated that statins may benefit patients with sepsis (infection of the bloodstream) or bacteremia (presence of bacteria in the bloodstream), possibly due to the medications' anti-clotting, anti-inflammatory or immune-modifying properties.

Reimar W. Thomsen, M.D., Ph.D., of Aarhus University and Aalborg Hospital, Aalborg, Denmark, and his colleagues evaluated data from 29,900 adults hospitalized with pneumonia between 1997 and 2004. Of these, 1,371 (4.6 percent) were taking statins at the time.

"Mortality [death] among statin users was lower than among non-users: 10.3 percent vs. 15.7 percent after 30 days and 16.8 percent vs. 22.4 percent after 90 days," the authors write. The lowest relative death rate linked to statins was observed in patients older than 80 and in those with bacteremia. "The differences became apparent during the first few weeks of hospitalization, a period linked to a high number of pneumonia-related deaths, and they increased only minimally between 30 and 90 days after admission, which suggests that statin use is beneficial primarily in the early phase of infection"......... Posted by: Scott      Read more         Source

October 21, 2008, 9:22 PM CT

Hope to emphysema patients

Patients in the Valley with emphysema might soon be breathing a little easier thanks to a new airway bypass study called the Exhale Airways Stents for Emphysema (EASE) trial. The trial principal is Dr. Karl Van Gundy aided by researchers Drs. Michael Peterson, Jose Joseph, Timothy Evans and Kathryn Bilello all pulmonologists at UCSF Fresno Medical Education Program. The study is a multi-center, international trial that is designed to evaluate the safety and effectiveness of this new and innovative procedure. There are only two other sites administering the trial in California besides UCSF Fresno UC Davis Medical Center and Cedars-Sinai Medical Center in Los Angeles.

A form of chronic obstructive pulmonary disease (COPD), emphysema is a progressive lung disease that keeps air trapped inside the lungs (not allowing it to escape) resulting in shortness of breath. Since the disease develops gradually over a number of years, symptoms of emphysema might not occur until irreversible damage has already happened.

"COPD is the fourth leading cause of death in the United States and a significant cause of disability in the world," said Dr. Peterson, who also is chief of medicine at UCSF Fresno Medical Education Program. "Very few new therapys have become available for this disease." ......... Posted by: Scott      Read more         Source

July 31, 2008, 11:29 PM CT

Sleep apnea linked to increased risk of death

Sleep-disordered breathing (also known as sleep apnea) is linked to an increased risk of death, as per new results from the Wisconsin Sleep Cohort, an 18-year observational study supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Scientists observed that adults (ages 30 to 60) with sleep-disordered breathing at the start of the study were two to three times more likely to die from any cause in comparison to those who did not have sleep-disordered breathing. The risk of death was associated with the severity of sleep-disordered breathing and was not attributable to age, gender, body mass index (an indicator of overweight or obesity), or cardiovascular health status.

"Sleep-Disordered Breathing and Mortality: Eighteen-Year Follow-Up of the Wisconsin Sleep Cohort," is published August 1 in the journal Sleep.

Scientists followed 1522 generally healthy men and women for an average of 13.8 years after testing them for sleep-disordered breathing using a standard overnight sleep test. Participants with severe sleep-disordered breathing were three times more likely to die during the study than those without breathing problems that may occur during sleep. Those who were not treated were at even greater risk. Participants with untreated severe sleep-disordered breathing were four times more likely to die from any cause and five times more likely to die from cardiovascular conditions......... Posted by: Scott      Read more         Source

May 18, 2008, 9:09 PM CT

Men at increased risk of death from pneumonia

Men who come to the hospital with pneumonia generally are sicker than women and have a higher risk of dying over the next year, despite aggressive medical care, as per a research studybeing presented Tuesday, May 20, at the 104th International Conference of the American Thoracic Society. Scientific sessions are scheduled May 16 to 21 in Toronto.

It is well known that women live longer than men. We have always assumed that these differences occur because men engage in riskier behaviors and have a greater burden of chronic diseases, said Sachin Yende, M.D., co-author of study and assistant professor in the Department of Critical Care Medicine, University of Pittsburgh School of Medicine. Our study showed that men were more likely to die up to a year after pneumonia, despite adjusting for health behaviors and chronic conditions. Further, our findings indicate this may be associated with differences in immune response.

The University of Pittsburgh scientists reviewed data from 1,136 men and 1,047 women with symptoms of pneumonia who were treated at 28 hospital emergency departments in the United States.

On average, men arrived at the emergency departments with poorer vital signs, were more likely to be smokers and had a greater variety of complicating health conditions. After hospitalization, men received timely antibiotic therapys more often than women and were twice as likely to be admitted immediately to intensive-care units......... Posted by: Scott      Read more         Source

May 18, 2008, 9:03 PM CT

Personalized therapy for asthma and COPD

Scientists at Washington University School of Medicine in St. Louis have defined a new type of immune response that is activated in patients with severe asthma and COPD (chronic obstructive pulmonary disease). Their discovery could dramatically improve diagnosis and therapy of patients with chronic inflammatory lung disease.

"We've cracked the first part of the molecular code that links a viral infection to the later development of chronic inflammatory diseases like asthma and COPD," says senior author Michael Holtzman, M.D., the Selma and Herman Seldin Professor of Medicine, director of the Division of Pulmonary and Critical Care Medicine and a pulmonary specialist at Barnes-Jewish Hospital. "With this information, we can more precisely diagnose and monitor these types of diseases and then better target our therapy to specific abnormalities. That's a big step forward from simply monitoring breathing status".

The findings, published online May 18, 2008, in Nature Medicine, promise a way to determine whether a patient's asthma or COPD is the result of a chronic immune response that can be turned on by a respiratory viral infection. Guided by these new findings, this type of immune response could be detected by monitoring specific types of inflammatory cells or molecules in the lung or potentially in the bloodstream, giving physicians a more precise approach to diagnosis and therapy of lung disease......... Posted by: JoAnn      Read more         Source

April 7, 2008, 10:45 PM CT

Asthma and Smoker's Lung

Dry airways may not only play a central role in the development of the in-herited lung disease cystic fibrosis, but also in much more common ac-quired chronic lung diseases such as asthma and smoker's lung, the ciga-rette smoke-induced chronic obstructive pulmonary disease (COPD). This is the conclusion reached by researchers at Heidelberg University Hospital under the direction of Assistant Professor Dr. Marcus Mall from the Department of Pediatrics at Heidelberg University Hospital and Professor Dr. Richard Boucher of the University of North Carolina at Chapel Hill. In ani-mal studies, they observed that insufficient hydration of the airway surfaces leads to pathologies typical of chronic obstructive lung diseases in humans.

Thus, these findings point to a new approach for the therapy of these diseases, which are listed by the World Health Organization WHO as the fourth leading cause of death worldwide. There are currently no causal therapies available for treating these diseases; only the symptoms such as shortness of breath and oxygen deficiency can be treated. The results of the study have now been reported in the "American Journal of Respira-tory and Critical Care Medicine".

Cystic fibrosis gene causes airways to dry out and thickens mucus.

In the hereditary disease cystic fibrosis, which affects about 8,000 people in Gera number of (about 80,000 people in the Western world), a defective gene causes a change in the transport of salt and water across the mucosal sur-faces in the lungs, the intestine and other organs, and thus produce a change in the composition of the secretions......... Posted by: JoAnn      Read more         Source

April 1, 2008, 8:31 PM CT

Smokers With Lung Disease Need More

OHSU Smoking Cessation Center scientists outline key steps for developing and implementing clinic-based systems to provide smoking cessation therapy tailored to smokers with respiratory disorders.

Smokers with lung disease require more than brief smoking cessation interventions to successfully quit, scientists in the Oregon Health & Science University Smoking Cessation Center report.

Their recommendations will be published Tuesday, April 1, in the online edition of Pulmonary and Critical Care Update, a publication of the American College of Physicians.

Eventhough effective therapys for smoking cessation exist, and research has shown that patients who receive smoking cessation therapy are twice as likely to quit -- limited insurance coverage, poor adherence to practice guidelines, lack of physician training in smoking cessation, time constraints and inadequate clinic systems to easily identify and treat smokers have limited the availability and quality of smoking cessation therapy.

"Most clinicians who treat their patients for smoking cessation provide only brief interventions, often just three short steps: asking about tobacco at every visit, advising all smokers to quit and referring them to other resources, such as quit lines for assistance and follow-up," said David Gonzales, Ph.D., lead author and co-director of the OHSU Smoking Cessation Center in the OHSU School of Medicine. "When we evaluated the data, we observed that brief intervention is often insufficient for the more dependent, high-risk patients with pulmonary disease"......... Posted by: Scott      Read more         Source

March 13, 2008, 9:16 PM CT

Artificial butter chemical harmful to lungs

A new study shows that exposure to a chemical called diacetyl, a component of artificial butter flavoring, can be harmful to the nose and airways of mice. Researchers at the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, conducted the study because diacetyl has been implicated in causing obliterative bronchiolitis (OB) in humans. OB is a debilitating but rare lung disease, which has been detected recently in workers who inhale significant concentrations of the flavoring in microwave popcorn packaging plants.

When laboratory mice inhaled diacetyl vapors for three months, they developed lymphocytic bronchiolitis - a potential precursor of OB. None of the mice, however, were diagnosed with OB.

This is one of the first studies to evaluate the respiratory toxicity of diacetyl at levels relevant to human health. Mice were exposed to diacetyl at concentrations and durations comparable to what may be inhaled at some microwave popcorn packaging plants, said Daniel L. Morgan, Ph.D., head of the Respiratory Toxicology Group at the NIEHS and co-author on the paper that appears online in the journal, Toxicological Sciences. The study was done in collaboration with Duke University researchers.

The authors conclude that these findings suggest that workplace exposure to diacetyl contributes to the development of OB in humans, but more studies are needed......... Posted by: Scott      Read more         Source

July 30, 2007, 9:57 PM CT

One cannabis joint equal to up to 5 cigarettes

A single cannabis joint has the same effect on the lungs as smoking up to five cigarettes in one go, indicates research published ahead of print in the journal Thorax.

The scientists base their findings on 339 adults up to the age of 70, selected from a research study that's ongoing of respiratory health, and categorised into four different groups.

These comprised those who smoked only cannabis, equivalent to at least one joint a day for five years; those who smoked tobacco only, equivalent to a pack of cigarettes a day for at least a year; those who smoked both; and those who did not smoke either cannabis or tobacco.

All the participants had high definition x-ray scans (computed tomography) taken of their lungs and they took special breathing tests designed to assess how well their lungs worked.

They were also questioned about their smoking habits.

Seventy five people smoked only cannabis, and 91 smoked both. Eighty one people did not smoke either, and 92 smoked only tobacco.

Combined smokers tended to use less tobacco, the findings showed.

Cannabis smokers complained of wheeze, cough, chest tightness and phlegm. But emphysema, the progressive and crippling lung disease, was only seen in those who smoked tobacco, either alone or in combination......... Posted by: Janet      Read more         Source

May 21, 2007, 12:14 AM CT

'Healthy' children with smoking parents aren't really so healthy

Children of smokers who dont show any signs of respiratory problems may still be experiencing damaging changes in their airways that could lead to lung disease during the later part of life, as per a new study presented at the American Thoracic Society 2007 International Conference, on Sunday, May 20.

"Everyone knows that children of smokers have more respiratory problemsmore puffing, wheezing, cases of pneumoniabut until now we havent known if lung function is impaired in children of smokers who dont have any respiratory complaints or diagnosed lung problems," says researcher Bert Arets, M.D., Ph.D., of University Medical Center Utrecht in the Netherlands.

The study included 244 children ages 4 to 12 without any history of lung or airway disease. They were divided into four groups as per the smoking pattern of their parents: never smokers, smoking after birth but not during pregnancy, during pregnancy but not after birth, and both before and after birth.

The scientists observed that children of smoking parents had significantly reduced lung function similar to that seen in smokers. Smoking after birth appeared to be more harmful than smoking during pregnancy alone. The scientists have now expanded their study to include 2,000 healthy children of smokers......... Posted by: Janet      Read more         Source

May 21, 2007, 11:41 AM CT

Sleep Apnea Patients And Risk Of Car Crashes

People with obstructive sleep apnea have a markedly increased risk of severe motor vehicle crashes involving personal injury, as per a research studypresented at the American Thoracic Society 2007 International Conference, on Sunday, May 20.

The study of 800 people with sleep apnea and 800 without the nighttime breathing disorder observed that patients with sleep apnea were twice as likely as people without sleep apnea to have a car crash, and three to five times as likely to have a serious crash involving personal injury. Overall, the sleep apnea group had a total of 250 crashes over three years, compared with 123 crashes in the group without sleep apnea.

While a number of prior studies have shown that sleep apnea patients are at increased risk of car crashes, this study is the first to look at the severity of those crashes. We were surprised not only about how a number of of the sleep apnea patients crashes involved personal injury, but that some patients had fairly mild sleep apnea and were still having serious crashes, says Alan Mulgrew, M.D., of the UBC Sleep Disorders Program in Vancouver, British Columbia.

Patients self-reported feeling of sleepiness was not found to be linked with an increased risk of car crashes, suggesting that patients are unaware of their driving hazard, Dr. Mulgrew says. Even patients with fairly mild sleep apnea were at increased risk of car crashes. Based on these findings, I now consider driving risk when deciding on therapy for patients with mild sleep apnea, he says......... Posted by: Scott      Read more         Source