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November Is COPD Awareness Month: The Third Leading Cause of Death in the U.S.

Try to imagine what it might feel like to take every breath through a straw. For many people with lung diseases like chronic obstructive pulmonary disease or COPD, they don't have to imagine because that's what breathing can feel like on many days, especially days when air pollution levels are high. With COPD it often becomes more and more difficult for people to breathe over time because the air sacs that carry air from the nose and mouth to the lungs become less elastic.

November is COPD Awareness Month and Wednesday, Nov. 19, was World COPD Day. If there's one thing that the American Lung Association of the Northeast wants the public to know as we shine the spotlight on this disease this month is that COPD can be treated.

When diagnosed early and properly managed, both COPD's progression and its severity can be minimized. That's why it is so important to be aware of the signs and symptoms of this disease so that if you notice symptoms in yourself or a loved one, you know to make an appointment to see your doctor right away.


Are your lungs trying to tell you something?

The most common symptoms of COPD include constant coughing, shortness of breath while performing everyday activities, excess sputum production, feeling unable to breathe or take a deep breath, and wheezing. COPD most often occurs in people age 40 and over who have a history of smoking, have had long-term exposure to lung irritants or have a rare genetic condition called alpha-1 antitrypsin (AAT) deficiency.

COPD is the third leading cause of death in the United States, claiming more than 120,000 American lives each year. More than 12 million people have been diagnosed, but another 12 million people are likely to have COPD and don't know it.

Particularly alarming is the rise of COPD in Women. Last year, the American Lung Association reissued its report Taking Her Breath Away, which found that the number of deaths among women from COPD has increased four-fold over the past three decades. Since 2000, more women than men in this country have died of this disease.

As we observe COPD Awareness Month, please spread the word to your loved ones that if they have trouble breathing they should see their doctor. Never assume that trouble breathing is a normal part of aging; it is not. Get yourself checked out. COPD is diagnosed using a simple test called spirometry. Spirometry is a noninvasive test that checks the amount of air you can blow out of your lungs and how fast you...

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Smoking Causes 14 Million Medical Conditions in U.S. Yearly, Study Finds

Smoking is to blame for about 14 million major medical conditions among American adults yearly, a new study shows.

That number is higher than the U.S. Centers for Disease Control and Prevention's (CDC) last estimate, in the year 2000, which found that American adults suffered from 12.7 million smoking-attributable conditions.

Chronic obstructive pulmonary disease (COPD) — which includes conditions like chronic bronchitis and emphysema — accounts for more than half of the medical cases attributable to smoking, the researchers found.

"The disease burden of cigarette smoking in the United States remains immense, and updated estimates indicate that COPD may be substantially underreported in health survey data," wrote the researchers, who published their findings on October 13, 2014 in the journal JAMA Internal Medicine.

Data from the CDC's National Health Interview Survey initially suggested that 6.9 million adults in the United States suffered from a combined 10.9 million smoking-attributable medical conditions, including COPD, cancers, heart attacks and diabetes. But the actual number of conditions is likely higher because this survey relies on people’s self-reports, and COPD is underreported, the researchers said.

To account for this gap, the researchers — led by Brian Rostron, of the U.S. Food and Drug Administration's Center for Tobacco Products — also looked at data from another CDC survey, the National Health and Nutrition Examination Survey. In this survey program, participants are not only interviewed, but they also undergo physical exams, including a lung function test called spirometry that is used to diagnose COPD.

Based on that data, Rostron and colleagues estimated that cases of COPD were 70 percent higher than the number of cases based on self-reported data. The researchers estimated that 14 million American adults had a smoking-related condition in 2009.

The lack of COPD diagnoses might be the result of current clinical guidelines, the researchers said. Physicians are advised to use spirometry to test patients who report symptoms such as wheezing and chronic cough. But doctors are advised not to screen patients who don't report these symptoms because of the economic and health care costs.

"Individuals with slowly declining respiratory function or individuals who have become accustomed to some degree of chronic airway obstruction may not report these conditions to physicians and consequently would not be...

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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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