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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..

CDC Reports Annual Financial Cost of COPD to be $36 Billion in the United States

The American College of Chest Physicians (CHEST) announced the Online First publication of Total and State-Specific Medical and Absenteeism Costs of Chronic Obstructive Pulmonary Disease Among Adults Aged 18 Years in the United States for 2010 and Projections Through 2020 in the journal CHEST.

The report, presented by researchers at the Centers for Disease Control and Prevention (CDC), finds:

  • In 2010, the total national medical costs attributable to COPD were estimated at $32.1 billion dollars annually.
  • Absenteeism costs were $3.9 billion for a total burden of $36 billion in COPD-attributable costs.
  • An estimated 16.4 million days of work were lost due to COPD each year.
  • Of the medical cost, 18% was paid for by private insurance, 51% by Medicare, and 25% by Medicaid.
  • The study also projects a rise in medical costs from $32.1 billion in 2010 to $49 billion by 2020.

Chronic lower respiratory diseases, including COPD, are the third-leading cause of death in the United States. COPD claimed the lives of 134,676 people in 2010. In 2011, 12.7 million US adults were estimated to have COPD.
However, close to 24 million US adults have evidence of impaired lung function, indicating an under-diagnosis of COPD. Smoking is a primary risk factor of COPD, and approximately 80% of COPD deaths can be attributed to smoking.

"Evidence-based interventions that prevent and reduce tobacco use and reduce clinical complications of COPD may result in potential decreased COPD-attributable costs," said Earl Ford, MD, MPH, Division of Population Health, Centers for Disease Control and Prevention.

The report also offers state-by-state data. 

"For the first time, our analyses provide state-specific costs for COPD, which provide state public health practitioners with estimates of the economic burden of COPD within their borders and illustrates the potential medical and absenteeism costs savings to states through implementing state level programs that are designed to prevent the onset of COPD," says Earl Ford, MD, researcher with the Division of Population Health, CDC.

The full study can be found in the Online First section of CHEST.

80% of COPD deaths can be attributed to smoking?  It’s time to get your patients to stop smoking if they haven’t already.  As an aid to smoking cessation, a Breath CO monitor can be used as a motivational and educational tool. Self-reported smoking status has been shown to be unreliable and a CO monitor replaces...

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Yoga and COPD

In a recent publication of The Journal of Thoracic Disease, researchers performed a systematic review and meta-analysis to investigate the efficacy of yoga training in COPD patients.

Five randomized controlled trials involving 233 patients with COPD were studied.  The researchers found that yoga training lasting 3-9 months significantly improved the FEV1 and exercise capacity but had no effect on blood oxygenation or carbon dioxide levels.

Yoga originated in ancient India.  The idea is that the body’s organs and systems are cleansed through asanas (postures) and pranayama (controlling the breath).  Postures are taught to heal an illness, reduce stress or to look better.  Not only do yogic exercises have a positive effect on COPD patients but they also help those with asthma, cardiac diseases, diabetes, depressive disorders and more.

Yoga training can provide a complementary strategy for patients with COPD.  Apart from relaxing tense muscles, yoga can also alleviate mental pressure.

The conclusion of the study was that yoga seemed to improve lung function and exercise capacity and therefore might be used as part of a pulmonary rehabilitation program for COPD patients.

Help guide your patients to live a healthier lifestyle and to incorporate healing exercise like yoga into their daily lives.  This guidance will only support your treatment plan for your patients with COPD and asthma. The incorporation of spirometry into your practice continues to be the gold standard in diagnosing and properly treating your patients easily in your office.  Join us in creating a better diagnosed and treated patient today.

For more information about our Gold Standard Pulmonary Function Test—Spirometry, visit us at www.mdspiro.com.

References:
http://mdspiro.com/spirometry
http://mdspiro.com/for-your-practice
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073384/
J Thorac Dis. Jun 2014; 6(6): 795–802. doi:  10.3978/j.issn.2072-1439.2014.06.05
Manocha R, Marks GB, Kenchington P, et al. Sahaja yoga in the management of moderate to severe asthma: a randomised controlled trial. Thorax 2002;57:110-5 [PMC free article] [PubMed]
Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol 2005;94:543-8 [PubMed]
 Jayasinghe SR. Yoga in cardiac health (a review). Eur J Cardiovasc Prev Rehabil 2004;11:369-75 [PubMed]
Malhotra V, Singh S, Tandon OP, et al. The beneficial effect of yoga in...

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6 Surprising Asthma Triggers

Chances are, you know someone with asthma -- after all, about one in 12 people in the U.S. has the condition. Having asthma means to have airways that are inflamed, which makes them particularly sensitive to substances ranging from pollution to dust. Exposure to an asthma trigger can cause the narrowing and swelling of the airways, as well as increased production of mucus, making it very difficult to breathe. When these asthma symptoms are particularly intense, that’s called an asthma attack — and knowing what exactly triggers these attacks is vital for people with the respiratory condition.

Some asthma triggers are more commonly known than others. Secondhand smoke is an obvious one, as is mold. 

Mice
While it is common knowledge in the asthma world that pets can trigger an asthma attack, other animals can be culprits, too -- such as mice. It is a rather common allergen, especially in the cities.

Stinkbugs
It's hard to say many people find stinkbugs to be generally appealing to begin with. They really penetrate homes when the weather cools down.  Stinkbugs can be found in most states, including New York, Pennsylvania, New Jersey, the Carolinas, Virginia, West Virginia and Ohio. Plus, dead stinkbugs in the home could even attract mice, a distressing double-whammy for people with asthma.

Ladybugs
Ladybugs are certainly cuter than stinkbugs, but they can be just as harmful to people with asthma. Asian lady beetles in particular, penetrate homes in the fall and their body parts decompose. That allergen, the dust from their body parts, is pretty strong. 

The Highway
Sure, cars and highways are pretty hard to avoid in this day and age. But unfortunately for people with asthma, close proximity to a highway can spell trouble. The emissions of cars can not only increase the risk of asthma, but also increase the severity of asthma. Running along a highway is a bad idea too.  It is probably not a good idea for anybody, but that’s especially true for people with asthma.

Rhinovirus
Getting a cold is an annoyance for anyone, but for people with asthma, it can be life-threatening. That's because rhinoviruses -- the main cause of the common cold -- can also induce asthma attacks.  Allergens can trigger asthma attacks, but usually it is not as severe as that associated with the rhinovirus.

The flu can also pose a danger to people with asthma, which is why people with asthma should make sure they get their flu vaccine because the flu can...

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Obesity Increases the Risk of COPD Even for Non-Smokers

Obesity increases the risk and progression of chronic obstructive pulmonary disease (COPD), even for people who’ve never smoked before. A team of American and German researchers measured the waists, hips, body mass index (BMI), and physical activity of newly diagnosed COPD cases in the U.S., and published the clear link they found in the Canadian Medical Association Journal.

"We observed a stronger positive relation with abdominal body fat than with total body fat and COPD," Dr. Gundula Behrens, of the Department of Epidemiology and Preventive Medicine at the University of Regensburg in Germany, wrote. "In particular, overweight as measured by BMI emerged as a significant predictor of increased risk of COPD only among those with a large waist circumference."

Study:

The 113,279 men and women they looked at, all of whom were between the ages of 50 and 70, did not have COPD, heart disease, or cancer at the beginning of the study. The 10-year follow-up revealed that COPD had developed in 3,648 people. Women who had a waist circumference of 110 centimeters (43.3 inches) and men with a circumference of 118 centimeters (46.4 inches) had a 72 percent increased risk of COPD.

COPD is a lung disease caused by either chronic bronchitis or emphysema, making it very difficult for people to breathe over time. It is the third leading cause of death in America, according to the American Lung Association. There are 6.8 million women diagnosed with chronic bronchitis, which makes them twice as likely to be diagnosed as men, who make up 3.3 million of the affected population.

"Increased local, abdominal, and overall fat depots increase local and systemic inflammation, thus potentially stimulating COPD-related processes in the lung," the authors wrote, according to a press release earlier this month.

Obesity is a common and serious condition that's present in more than one-third of U.S. citizens — their BMIs are 30 or higher, according to the Centers for Disease Control and Prevention as they define obesity. BMI is not a direct measure of body fat, and knowing this, the researchers also looked at other factors including their amount of physical activity. In addition to waist circumference, other causes of COPD are pollution, smoking, and toxic particles or dust in the work place, which trigger chronic inflammation and difficult-to-heal injury in the lungs.

Those with large hip circumferences, who were also physically active at least five times a...

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