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."
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...Read more..
Kids who have exercise-induced asthma (EIA) develop asthma symptoms after vigorous activity, such as running, swimming, or biking. Some develop symptoms only after physical exertion, while others have additional asthma triggers. With the proper medications, most kids with EIA can play sports like any other child. In fact, asthma affects more than 20% of elite athletes, and one in every six Olympic athletes, according to the American Academy of Allergy, Asthma, and Immunology.
As a doctor you can properly and accurately diagnose EIA after performing an exercise challenge with a pulmonary function test in your practice. You might want to target a child's tolerance for a particular exercise, as not every type or intensity of exercise affects kids with EIA the same way.
If exercise is the only asthma trigger, you may prescribe a medication for the child to take before exercising to prevent airways from tightening up. Of course, even after taking a preventive medication, asthma flare-ups can still occur and it is extremely important to monitor the child on an ongoing basis through spirometry tests and the utilization of peak flow meters during the course of treatment.
Parents or older kids should carry the proper rescue medication to all games and activities. Rescue medications work immediately to relieve asthma symptoms when they occur. The school nurse, coaches, club leaders (Boy Scouts, Girl Scouts, etc.), and teachers must be informed of a child's asthma plan of care so that kids take their medication as needed when away from home.
Additionally, asthma can be triggered by allergies. An estimated 75% to 85% of people with asthma have some type of allergy. Even if the primary triggers are colds or exercise, allergies can sometimes play a role in aggravating the condition.
Work with your patient’s parents to create an asthma action plan today. Take that next step in further caring for your patients and bring spirometry into your practice. Your patients will be correctly diagnosed so you can treat them more accurately and conveniently. Help children with asthma breathe easier and play a part in keeping them active and healthy.
The Centers for Disease Control and Prevention state that COPD is the THIRD leading cause of death in America. The third. With heart disease and cancer taking the lead. Approximately 15 million U.S. adults are estimated to have COPD. When combining COPD with other health issues, this can be a serious problem in the lives of your patients and loved ones.
COPD is diagnosed in four stages, each of which are characterized by a measure of lung function and measured by the breathing test spirometry. This important test shows how much air your patients’ lungs can hold and how fast they can release the air from the lungs.
Stage one is mild COPD. A spirometry test will show some restriction. A mild cough may be in play.
Stage two is moderate COPD. Air flow begins to worsen at this stage. Your patient may begin to notice a shortness of breath in activities like climbing stairs. A cough may begin increasing and mucus production begins. They often will have prolonged symptoms of the flu or cough. Typically this is the stage patients start to seek treatment.
Stage three is severe COPD. Your patient will become short of breath after very little activity and will quickly become fatigued. Their cough will become more frequent and airflow is severely limited, with times requiring hospitalization.
Stage four is very severe COPD. At this point, quality of life for your patient is greatly impaired and symptoms have become life-threatening. Lung function can be dropped to 30% or less and your patient usually requires oxygen therapy on a daily basis. Complications can arise such as weight loss, fluid build-up in the legs and feet, chronic respiratory failure and heart disease (the number ONE killer of Americans).
Catching COPD early can make all of the difference in your patients’ lives so they can live a longer, happier, and healthy life.
Take the step in caring for your patients and bring spirometry into your practice today. Your patients will be correctly diagnosed so you can treat them more accurately and conveniently in your practice.Read more..
First responders to a fire are trained to understand the dangers of carbon monoxide (CO) poisoning and are also trained to recognize potential signs and symptoms. CO poisoning can go unrecognized and untreated, which can lead to long-term health problems.
Know the Facts about CO poisoning:
• CO poisoning can be difficult to detect.
• CO poisoning puts firefighters at significant risk at the scene of a fire.
• CO poisoning significantly increases long-term health risks.
Do you have firefighters in your life and in your practice? If so, it is critical to test your patients for CO poisoning. It’s a matter of life and death. They risk their lives to save ours. We should be properly diagnosing and treating them for CO poisoning and save their lives right back.
Implementing CO poisoning detection into your practice can help to quickly and inexpensively diagnose CO poisoning enabling you to properly provide triage and rehabilitation to firefighters and other emergency providers.
For more information about our Breath CO Monitors, visit us at www.mdspiro.com.
Hampson NB et al. American Journal of Emergency Medicine. 2008; 26:665-669.
Jakubowski G. FireRescue Magazine. 2004; 22(11):52-55.
Bledsoe BE. FireRescue Magazine. 2005.
NFPA 1584: Standards on the Rehabilitation Process for Members During Emergency Operations and Training Exercises. Annex A section A.188.8.131.52(1).
Hampson NB et al. Crit Care Med. 2009; 37(6): 1941-47.
Every year in the U.S. over 392,000 people die from tobacco-caused disease, making it the leading cause of preventable death. Another 50,000 people die from exposure to secondhand smoke. Tragically, each day thousands of kids still pick up a cigarette for the first time. The cycle of addiction, illness and death continues. What can be done to stop smoking?
It starts with you. Bringing Smoking Cessation into your practice as a key element to the treatment of your patients that smoke will help to drop these numbers of people that suffer and die from tobacco. Our Breath CO monitor is a simple test that can help to diagnose just how high their CO is elevated and how the disease is progressing. This is an aid to smoking cessation that can be used as a motivational and educational tool. “Self-reported” smoking status amongst patients has been shown to be quite unreliable. That’s where our monitor steps into play.
Not only do tobacco products kill us, but tobacco products negatively impact and damage our environment. Cigarette butts are not just a nuisance, they are toxic waste. They contain chemicals that contaminate our waterways and ground soil and harm our wildlife. Discarded lit cigarettes can cause fires, which can damage homes and land. It is also very costly to clean up cigarette waste - a problem that continues to grow every year.
To properly treat your patients, it’s time to implement a solid Smoking Cessation program in your practice. It is a key component to caring for your patients. Encouraging them to stop smoking and to take better care of themselves along with their treatment plan will help their lung function and overall well-being.
Novotny, Lum, Smith, Wang, & Barnes, "Cigarettes Butts and the Case for an Environmental Policy on Hazardous Cigarette Waste." International Journal of Environmental Research and Public Health. 2009 May; 6(5): 1691-1705.
Register, Kathleen. "Cigarette Butts as Litter - Toxic as Well as Ugly." Underwater Naturalist Bulletin of the American Littoral Society. 25(20), August 2000.
American for Nonsmokers' Rights, "Tobacco Environmental Toll." ANR Update,...
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..