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Childhood Trauma Linked to COPD Development Later in Life

There is a correlation between adverse childhood experiences (ACE) and chronic obstructive pulmonary disease (COPD) development, with a more pronounced association in women, Centers for Disease Control and Prevention (CDC) researchers found.  

In study results published in International Journal of Chronic Obstructive Pulmonary Disease, researchers examined the data of 26,546 women and 19,015 men in MN, MT, VT, WA, and WI. Occurrences of childhood abuse, household dysfunction, COPD diagnoses were recorded in addition to age, gender, race, marital status, education, and smoking status.  

their analysis, the investigators noted 12.7 percent and 4.4 percent of respondents were diagnosed with asthma and COPD, respectively. Overall, 63.1 percent of participants claimed they experienced one ACE prior to age 18.  

Specifically, the writers discovered that “men were significantly (P<0.05) more likely to report childhood verbal abuse,” while “women were significantly (P<0.05) more likely to report childhood sexual abuse; living with a substance  abusing household member; living with a mentally ill  household member; and to report 5 or more ACEs compared to men.”  

Weighing the prevalence of ACEs and COPD diagnoses among their patients, the authors found women who experienced an ACE were significantly more likely (P<0.05) to have COPD than women who didn’t. While the male sample had a higher rate of COPD development (P<0.05), the link between COPD and ACEs wasn’t as strong.   

“For women who were never smokers, there was still a higher likelihood of COPD associated with physical abuse (PR=1.81, 95% CI: 1.28, 2.58), sexual abuse (PR=2.18, 95% CI: 1.46, 3.24), and living with a substance abusing household member during childhood (PR=1.70, 95% CI: 1.18, 2.43),” the investigators wrote.   

While ACEs have been tied to other chronic conditions such as depression, heart disease, cancer, diabetes, and stroke, research on their relationship to COPD is limited. From their research, the investigators claimed while they have shown an association between COPD, ACEs, and gender, the mechanism behind the trend cannot be ascertained from their study alone.  

“Programs and policies that address the underlying problems caused by experiences of childhood maltreatment and household dysfunction may prove more effective than traditional smoking prevention and cessation strategies alone,” the writers penned. “Further research examining sex...

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Kids exposed to BPA before birth at risk of wheeze and asthma

Young kids who were exposed to Bisphenol A (BPA) before birth are more likely than others to have a wheeze before age five, according to a new study that found no connection to BPA exposure after birth.

Many plastic and aluminum consumer products contain BPA, and most Americans have detectable BPA concentrations in their urine, the authors write. Some studies have suggested that exposure to the chemical may contribute to the development of asthma.

Animal studies are still going on to clarify the association between BPA and lung function, said lead author Dr. Adam J. Spanier of the pediatrics department at the University of Maryland School of Medicine in Baltimore.

In 2012, the U.S. Food and Drug Administration banned BPA from baby bottles, but said there was not enough evidence for a more widespread ban.

Researchers began by testing urine samples from nearly 400 expectant mothers in the Cincinnati, Ohio area at 16 and 26 weeks into their pregnancies.

After the children were born, the researchers asked parents every six months for the next five years if the child had wheezing in his or her chest, and at ages four and five tested how much air the children could exhale during a forced breath at age.

Researchers also collected urine samples from the children annually.

The higher the BPA concentration in the mother’s urine during pregnancy, the lower the child’s lung function tended to be at age four, the researchers found. There was no association with lung function at age five.

For wheezing, the mother’s BPA concentrations at 16 weeks’ gestation was linked to the child’s risk of persistent wheeze.

The level of BPA in the children’s urine was not related to their own wheeze or lung capacity.

The results suggest a relationship between the exposure to BPA during early pregnancy and the likelihood of developing early wheeze, said Dr. Randall M. Goldblum, director of the Child Health Research Center Lab and Children’s Asthma Program at the University of Texas Medical Branch in Galveston.

He was not involved in the new study.

“It is difficult to say if this is the cause, because the development of asthma is complex and includes genetic predisposition as well as environmental exposures like the one documented,” he told Reuters Health by email.

If children get over their early wheeze by age five there is a good chance they will not have it again later in life, he noted.

“Some of the...

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Be Proactive: Exercising for COPD Patients

Exercise may seem daunting to your patients, but has many proven benefits for people with COPD.  It will improve their ability to do more without feeling breathless and help them to rediscover activities they could no longer do.
Exercise can bring specific benefits to people with lung disease, as well as general improvements to health and well-being.

The benefits for people with lung disease are REDUCED:

  • Breathlessness for any given level of activity
  • Leg tiredness
  • Number of days in hospital
  • Stress
  • Risk of heart disease
  • Incidence of infection

INCREASED:

  • Ability to do daily activities that are important to you
  • Possibility of returning to work

IMPROVED:

  • Energy levels
  • Exercise ability
  • Mood
  • Muscle strength
  • Self-esteem
  • Bone strength
  • Immune system
  • Suppleness
  • Regulated appetite

There are different ways to incorporate exercise into your patient’s lives.  The first starts with encouragement and some moderate exercise suggestions like:

  • Getting off the bus one stop early
  • Walking to the local shops or park
  • Walking your dog
  • Doing some light gardening
  • Dancing
  • Bowling
  • Yoga, Pilates, or tai chi
  • Walking groups
  • Aqua aerobics / Swimming

Help your COPD patients to be more active, by being more PROactive in their care.  Ensure you have the Gold Standard in Spirometry for the diagnosis and management of both asthma and COPD.  For more information on our offerings, please visit: http://mdspiro.com/spirometry.

References:
http://mdspiro.com/spirometry 

 

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CVS Quits for Good

Smokers who try to quit can double or triple their chances by getting counseling, medicine, or both.  Individualized smoking cessation plans and education based on your patient’s needs and goals are key to improving the chances of your patients quitting.  Studies show that smokers assisted by a health care provider have a much greater chance.  We are here to help.

Facts about Quitting:

  • Cigarette smoking is the number one cause of preventable disease and death worldwide.
  • Smoking causes about 1 of every 5 deaths in the United States each year.
  • On average, adults who smoke cigarettes die 14 years earlier than nonsmokers.
  • After 24 hours, your risk of heart attack begins to decrease.
  • After one year, your risk of heart disease decreases to half that of a current smoker.
  • After 5 to 15 years, your risk of stroke is the same as a person who never smoked.

With CVS’s announcement that “Health is Everything” in their book, they changed their name and pulled cigarettes and tobacco products from shelves in 7,700 CVS/pharmacy locations, to help people stay on a better path to health.

"CVS Health is always looking for ways to promote health and reduce the burden of disease," said Troyen A. Brennan, M.D., M.P.H., Chief Medical Officer of CVS Health. "Putting an end to the sale of cigarettes and tobacco will make a significant difference in reducing the chronic illnesses associated with tobacco use."

BOLD decision?  Yes.

Throughout the rest of 2014, the CVS/pharma stores will be unveiling new signage behind the checkout and will introduce a smoking cessation program, while enhancing their nicotine replacement products in select stores.

Why don’t you join CVS Health and pull cigarettes and tobacco use from your patient’s lives?  Join MDSpiro’s family and bring health and wellness into your practice with Smoking Cessation programs and products.

Let’s be BOLD together.  

References:
Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Available at http://www.cdc.gov/nchs/data/series/sr_10/sr10_249.pdf 

Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses–United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a3.htm  accessed Mar. 11, 2011.

Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years...

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Pet Allergies by Asthma and Allergy Foundation of America

Who Gets Pet Allergies?

Six out of 10 people in the United States come in contact with cats or dogs. The total pet population is more than 100 million, or about four pets for every 10 people.

Allergies to pets with fur or feathers are common, especially among people who have other allergies or asthma. From 15 percent to 30 percent of people with allergies have allergic reactions to cats and dogs.

People with dog allergies may be allergic to all dogs or to only some breeds. Cat allergies are about twice as common as dog allergies.

What Causes a Pet Allergy?

The job of immune system cells is to find foreign substances such as viruses and bacteria and get rid of them. Normally, this response protects us from dangerous diseases. People with pet allergies have supersensitive immune systems that react to harmless proteins in the pet's dander (dead skin that is shed), saliva or urine. These proteins are called allergens.

Dogs and cats secrete fluids and shed dander that contain the allergens. They collect on fur and other surfaces. The allergens will not lose their strength for a long time, sometimes for several months. They appear to be sticky and adhere to walls, clothing and other surfaces.

Pet hair is not an allergen. It can collect dander, though. It also harbors other allergens like dust and pollen.  Cat and dog allergens are everywhere. Pet dander is even in homes never occupied by these animals because it is carried on people's clothing. The allergens get in the air with petting, grooming or stirring the air where the allergens have settled. Once airborne, the particles can stay suspended in the air for long periods of time.

What Are the Symptoms? 
Reactions to cat and dog allergens that land on the membranes that line eyes and nose include swelling and itching of the membranes, stuffy nose and inflamed eyes. A pet scratch or lick can cause the skin area to become red.
If allergen levels are low or sensitivity is minor, symptoms may not appear until after several days of contact with the pet.

Many airborne particles are small enough to get into the lungs. When inhaled, the allergens combine with antibodies. This can cause severe breathing problems-coughing, wheezing and shortness of breath-in highly sensitive people within 15 to 30 minutes. Sometimes highly sensitive people also get an intense rash on the face, neck and upper chest.

For about 20 percent to 30 percent of people with asthma, cat contact can trigger a...

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COPD Overlooked in Cardiovascular Patients

More than a quarter of patients with cardiovascular disease (CVD) and a history of smoking also have air flow limitation compatible with chronic obstructive pulmonary disease (COPD), Japanese study data show.
Strikingly, the vast majority (87.7%) of patients found to have such airflow limitation had not previously been diagnosed with COPD, report Katsuya Onishi (Onishi Heart Clinic, Mie) and colleagues.

“This suggests that it is important to look routinely for COPD in CVD patients >40 years old with a history of smoking, as the combination of COPD with CVD is known to be associated with poorer prognosis”, they remark.
The researchers prospectively measured forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6) by handheld spirometry in 995 consecutive outpatients (mean age 66.6 years, 95.5% men) with a smoking history who routinely visited one of 17 CVD clinics in Japan. The 269 patients with a FEV1/ FEV6 ratio less than 0.73 were classed as having airflow limitation compatible with COPD.

These patients were, on average, significantly older than patients without airflow limitation (71 vs 65 years), had a significantly lower mean body mass index (23.3 vs 25.1 kg/m2), and were more likely to have chronic bronchitis symptoms (25.3 vs 18.6%) and a higher COPD assessment test score (8.3 vs 6.4).

Although the prevalence of COPD increased with age (up to 39% in those aged 70 years and older) and was more likely to have previously been diagnosed in older patients (13.8% of those aged 70 years and older), cases still occurred in younger patients, with a rate of 5.1% observed in those aged 40 to 49 years, none of whom had been previously diagnosed.

As expected, the percentage of patients with a prior diagnosis of COPD increased with increasing spirometry use, but still only reached 14.0% in centres classed as using spirometry “often” (≥10 times/month), compared with 11.1% in those that seldom used it (<2 times/month).

The researchers also point out that around 20% of the patients they studied had lung function less than 50% of the Global initiative for chronic Obstructive Lung Disease FEV1 predicted values. This shows that even patients with severe to very severe airflow limitation had not previously been diagnosed with COPD, they say.

The study findings are published in the International Journal of Chronic Obstructive Pulmonary Disease.

For more information on MD Spiro and how we can help support your practice to...

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Back to School: Allergy and Asthma Preparation

Sending children back to school comes with a long checklist of items to remember. For example, you need to know what school supplies to buy. You will want to visit the school to find the classroom and meet the teacher. You will also plan after-school activities full of fun enrichment opportunities. If you have a child with asthma or allergies going back to school this fall, you need another item on that list. Specifically, your checklist should also include connecting with the teachers, school nurse and other school staff about your child’s symptoms, treatment and prevention strategies.

Here is a checklist for mothers, fathers and doctors to ensure your child is in good hands and prepared for the new school year.

Ensure your patients (and/or children) have an asthma check-up prior to school starting.  Even if the child is well controlled, meeting with the doctor is an opportunity to evaluate medications and physical activity restrictions.

Confirm medications are up-to-date, filled and not expired.  Double check that their current inhaler isn’t about to lose its’ juice on first day of school with no back-up.

Get an asthma or anaphylaxis action plan put together.  This should include informing staff at school, nurse, teachers, and your child!

Discuss medical emergency policies and procedures.  Ensure that your child’s school has procedures in place for identifying symptoms and for treatment of emergencies.  Be sure to check your state laws as they will govern what the school can and cannot do.  You can check out the 2014 State Honor Roll to see where your state stands regarding policies for children with asthma and allergies in school settings.

Talk to the school and teachers about triggers.  Insect stings.  Chalk dust.  Playground games.  Show and tell where animals are involved.  Food allergies.

There are so many things to think about during these back to school times!  But your patient’s health is KEY to a successful start to their school year.  Make sure you have scheduled appointments with your asthmatic “little ones” as they head on into their next year of school—healthy and prepared.

To help treat and diagnose them before the school year begins, be sure to implement Spirometry into your practice.  It is quick and easy to implement and train your staff on—even before school starts.

References:
http://mdspiro.com/for-your-practice 
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They Can’t Quit.  But What’s the Point?

We have been talking a lot about smoking over the past few weeks and its effect on COPD, asthma, and general health long-term.  And today, we have more.  Nearly 10 percent of cancer patients still smoke.  Nearly nine years after diagnosis, bad habits die hard and some are saying “What’s the point?”

Nine years after being diagnosed with cancer, nearly 10 percent of survivors still smoke cigarettes – and more than 80 percent of them light-up every day.  That’s according to a new study from American Cancer Society researchers who say the findings underscore the tenacity of tobacco cravings and the need for better long-term help.

Quitting smoking is really difficult,” said Dr. Lee Westmaas, Director of Tobacco Research at the American Cancer Society. “I think we tend to underestimate the power of addiction.”

Better screening of smoking habits and referral to smoking cessation programs are needed, not just right after a cancer diagnosis, but years later, the study published Wednesday in the journal Cancer Epidemiology, Biomarkers & Prevention, found.

Westmaas and his team analyzed data from patients in 11 state cancer registries, targeting those with the 10 most common kinds of cancer. They analyzed results from 2,938 survivors who answered a survey between January 2010 and December 2011, about nine years after they were diagnosed.

Overall, some 9.3 percent of cancer patients still smoked, the study found. But the rates jumped higher for different kinds of cancer: more than 17 percent for survivors of bladder cancer, nearly 15 percent for lung cancer, and more than 11 percent for ovarian cancer.

Other cancers included in the study were breast, prostate, uterine, skin melanoma, colorectal, kidney, and non-Hodgkin lymphoma.

Survivors were more likely to smoke if they were younger, had less education and income, and drank more alcohol, the study found.

15 Daily Cigarettes
Most of the current smokers – some 83 percent – lit up every day and smoked an average of nearly 15 cigarettes a day. Forty percent of the daily smokers puffed more than 15 cigarettes each day, the study found.

“That’s not surprising,” said Dr. Jonathan Bricker, a clinical psychologist and expert in smoking cessation with the Fred Hutchinson Cancer Research Center’s Public Health Sciences Division.

“You’d think it’s logical that a cancer diagnosis would be a wake-up call to people,” Bricker said. “But it’s not true.” Read more..