An international team of researchers has discovered a direct link between eating fish, fruit and dairy products with improved lung function in patients with chronic obstructive pulmonary disease (COPD). The study, which is being presented at the American Thoracic Society (ATS) 2014 International Conference, specifically examined COPD patients’ lung function within 24 hours of consuming fish, cheese, grapefruit and bananas.
“Diet is a potentially modifiable risk factor in the development and progression of many diseases, and there is evidence that diet plays a role in both the development and clinical features of COPD,” said Corinne Hanson, PhD, assistant professor of Medical Nutrition at the University of Nebraska Medical Center. “This study aimed to evaluate that association.”
The research team used data collected as part of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints study (ECLIPSE), which was designed to determine the progression of COPD and identify biomarkers associated with the disease. The team analyzed limited diet records for 2,167 ECLIPSE subjects. The participants provided dietary intake information eight times over a three-year period, reporting the amount of a specific food they had consumed during the past 24 hours.
Standard lung functionality measurements for the same group were analyzed. These assessments included the six-minute walk test (SMWT), St. George’s Respiratory Questionnaire (SGRQ) scores and inflammatory biomarkers. The team adjusted their findings for age, sex, body mass index (BMI) and smoking.
According to the results, people who reported recently consuming fish, grapefruit, bananas or cheese showed improvement in lung function, less emphysema, improved scores on the SMWT, improved scores on the SGRQ, and a decrease in certain inflammatory biomarkers associated with poor lung function including white blood cells and C-reactive protein.
“This study demonstrates the nearly immediate effects a healthy diet can have on lung function in in a large and well-characterized population of COPD patients,” Hanson said. “It also demonstrates the potential need for dietary and nutritional counseling in patients who have COPD.”
Hanson believes that the link between diet as a modifiable risk factor in COPD and the results of the new study deserves further investigation.
To properly diagnose and treat your COPD patients, implementing Spirometry into your practice...Read more..
A group of drugs commonly prescribed for insomnia, anxiety and breathing issues "significantly increase the risk" that older people with chronic obstructive pulmonary disease, or COPD, need to visit a doctor or Emergency Department for respiratory reasons, new research has found.
Benzodiazepines, such as Ativan or Xanax, may actually contribute to respiratory problems, such as depressing breathing ability and pneumonia, in these patients, said Dr. Nicholas Vozoris, a respirologist at St. Michael's Hospital.
Dr. Vozoris said the findings are significant, given that 5 to 10 per cent of the Canadian population has COPD (also known as emphysema), which is mainly caused by smoking. His previous research has shown that 30 per cent of older Canadians with COPD are prescribed benzodiazepines.
His new research was published online in the European Respiratory Journal.
Dr. Vozoris said he believes this is the first study to look at clinical outcomes of COPD patients prescribed these drugs. He used databases at the Institute for Clinical Evaluative Studies to identify older adults in Ontario who had been diagnosed with COPD, as well as prescription, health insurance and hospitalization records.
He found that COPD patients who had been newly prescribed a benzodiazepine were at 45 per cent increased risk of having an exacerbation of respiratory symptoms requiring outpatient treatment. They were at 92 per cent greater risk of needing to visit an Emergency Department for COPD or pneumonia. There was an elevated, but not statistically significant, risk of also being hospitalized for respiratory reasons.
He said the findings were consistent even after taking into account the severity of the person's illness - i.e. they were true for people with less advanced and more advanced COPD.
"Physicians, when prescribing these pills, need to be careful, use caution and monitor the patients for respiratory side effects," said Dr. Vozoris. "Patients also need to watch for respiratory-related symptoms."
This is why it is even more important that you stay connected more closely with your patients and monitor their respiratory function regularly with the use of spirometry.
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A significant knowledge gap about smoking cessation practices among perinatal substance abuse staff at a single center means pregnant women are often not being counseled about the dangers of tobacco and encouraged to quit, new research suggests.
Perinatal substance abuse counselors from the Johns Hopkins Center for Addiction and Pregnancy in Baltimore, Maryland, fared significantly worse than substance abuse staff who worked in Veteran's Administration hospital centers, other hospital-based centers, and community counseling centers throughout the United States.
"We found that they had much less knowledge about smoking cessation practices, and they also were more likely to have negative attitudes about their ability to get these women to stop smoking," senior author Margaret Chisolm, MD, from the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine, in Baltimore, told Medscape Medical News.
The findings were presented here at the American Society of Addiction Medicine (ASAM) 45th Annual Medical-Scientific Conference.
More Harmful Than Illicit Drugs
Nearly 21% of reproductive-age women in the United States smoke cigarettes, and about 13% continue to smoke during pregnancy. This percentage is as high as 90% among pregnant women with substance use disorders, Dr. Chisolm said.
"When I started working here in 2006, this issue literally hit me in the face. These pregnant women who are in our drug abuse program would smoke outside the hospital in between their group sessions, and things like that, so I wanted to know why we were not addressing this in our program, especially since smoking is the leading modifiable risk factor for pregnancy-related morbidity and mortality," she said.
"Smoking is as harmful, if not more harmful, than most of the illicit drugs that pregnant women use," Dr. Chisolm added.
In the study, Dr. Chisolm used the Smoking Knowledge, Attitudes, and Practices (S-KAP) Instrument to compare the knowledge, attitudes, and practices among the 41 perinatal substance abuse staff at her institution with the knowledge, attitudes, and practices among 335 general substance abuse treatment staff from 11 other institutions.
The S-KAP Instrument was developed by Kevin L. Delucchi, PhD, and colleagues from the University of California, San Francisco, and published in the Journal of Drug Issues.
The instrument elicits staff knowledge about the risks of smoking, attitudes toward treating...Read more..
The International Journal of COPD has published the review, “The role of microparticles in chronic obstructive pulmonary disease”.
As corresponding author Dr. Kubo says “Endothelial damage is believed to affect the pathophysiology of COPD, however, the influence of COPD exacerbation on the endothelium is not clearly understood. In this manuscript, we evaluated the influence of exacerbation on the endothelium by measuring circulating endothelial microparticles (EMPs), which are shed membrane vesicles in circulating blood that originate from activated or injured endothelium.”
Dr. Kubo continues “Several EMPs were significantly increased even at stable condition in COPD patients, but further increased during exacerbation. The increased EMPs were originated mainly from pulmonary capillary endothelial cells, suggesting pulmonary capillary is the main site suffered from exacerbation. Because circulating E-selectin EMPs increased in COPD patients who frequently underwent exacerbation, monitoring of EMP numbers is useful for evaluating endothelial damage in COPD patients and higher E-selectin EMP levels may predict the patients who are susceptible to exacerbation.”
As Dr. Richard Russell, Editor-in-Chief, explains “This is one of the first papers published on this subject. It is good science which is clear and understandable. The potential of the micro-particles both in the aetiology and treatment (even prevention) of COPD is massive.”
To help diagnose and treat COPD, Spirometry could not be an easier way to perform a test on your patients. Your patients will be correctly diagnosed and treated more accurately and conveniently in your office and Spirometry is FULLY REIMBURSABLE.
The International Journal of COPD is an international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self-management protocols. This journal is directed at specialists and healthcare...Read more..