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Smoking Ban Reduces pre-term births, childhood asthma
On Friday, March 28, 2014, researchers stated that bans on smoking in public and the workplace led to a 10 percent drop in premature births and in emergency asthma treatment for children.
 
The evidence, based on the records of more than two million children, comes from 11 published investigations into the impact of local or national smoking bans in the United States, Canada, and four European countries.
 
Researchers found, within a year of a ban being imposed, rates of pre-term births and hospital treatment for childhood asthma each fell by more than a tenth.
 
Premature births are associated with a low birth weight and health problems for the child later in life.
 
Previous research into the benefits of smoking bans have focused mainly on adults, but children are disproportionately affected by passive smoking because their developing lungs and immune systems are more easily irritated.
 
A previous study in 2011, of 192 countries, found that children account for more than a quarter of the annual toll of 600,000 deaths attributed to second-hand smoking.
 
The new investigation, published in The Lancet, covered more than 2.5 million births and 250,000 hospital admissions of children who suffered an asthma attack. The data was for the period 2008-2013.
 
"Our research shows that smoking bans are an effective way to protect the health of our children," said Jasper Been of the University of Edinburgh's Centre for Population Health Sciences in Scotland.
 
"These findings should help to accelerate the introduction of anti-smoking legislation in areas not currently protected."
In a comment, smoking experts Sara Kalkhoran and Stanton Glantz at the University of California in San Francisco said the figures showed, among other things, that smoking bans pay for themselves.
 
"Medical expenses for asthma exceeded $50 billion (36.5 billion euros) in the USA in 2007 and $20 billion in Europe in 2006," they said.
 
"If asthma emergency department visits and admissions to hospitals decreased by even 10 percent, the savings in the USA and Europe together would be $7 billion annually."
 
A 2012 analysis found a 15 percent reduction in heart attacks and strokes and a 24 percent drop in hospital admissions for respiratory disease after anti-tobacco laws were passed.
 
For more information on Smoking Cessation products for your practice, visit MD Spiro, your breathing...
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Removing mold may reduce adult asthma risk
Reuters Health reports that mold exposure in the home raises the risk of asthma symptoms, researchers found.  Men were especially vulnerable after recent exposure to visible mold.
 
"The mold exposure that we were talking about is the typical mold that we all see in our homes from time to time, that is, mold that you see in the wet areas of the house, e.g., bathroom, kitchen and laundry," John Burgess told Reuters Health in an email.
 
Burgess, a researcher with the Melbourne School of Population and Global Health at the University of Melbourne, co-led the study with colleague Desiree Meszaros.
 
"We were not talking about 'whole-house' mold infestation that might occur under special circumstances such as following the house being flooded," Burgess said.
 
While a number of previous studies have examined indoor air pollutants and asthma, the majority focused on children and adolescents, Burgess said, but little research has looked at the relationship between these exposures and asthma in middle-aged adults.
 
About 25 million Americans have asthma, according to the National Heart, Lung and Blood Institute, and 7 million of them are children. Asthma typically begins in childhood, and often occurs in kids with allergies.
 
Burgess and his colleagues were interested in the effect of indoor air pollutants on adults' asthma symptoms and also in any differences between responses by those with allergic asthma and those with non-allergic asthma.
 
The research team used data from an ongoing study that began in 1968 when the participants were seven years old. In 2004, a total of 5,729 participants filled questionnaires about a variety of health topics, including respiratory symptoms and their home environment.
 
Participants were asked about asthma, asthma symptoms, amount of visible mold in the home, the number of smokers and types of heating and cooking appliances they had.
 
About 11.6 percent of the participants had asthma at the time of the 2004 questionnaire. About 17 percent had chest tightness at night and 23 percent reporting wheezing during the previous year. About 30 percent of the participants were smokers and about 15 percent of households included at least one regular smoker other than the study participant.
Almost half reported ever having had mold on any home surface, and about a third said they'd seen mold at home within the last 12 months, according to the results...
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Doctors are Missing Chances to Diagnose COPD Earlier
A retrospective study of almost 39,000 patients shows that opportunities to diagnose chronic obstructive pulmonary disease (COPD) at an earlier stage are frequently being missed in both primary and secondary care in the UK. The findings, published in The Lancet Respiratory Medicine, reveal missed opportunities to diagnose COPD occurred in up to 85 percent of people. 
 
"The substantial numbers of patients misdiagnosed and under diagnosed in this study is a cause for concern. It is important that COPD is diagnosed as early as possible so effective treatment can be used to try to reduce lung damage, improve quality of life, and even life expectancy", explains author Dr Rupert Jones from Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK.
 
"The first signs of lung disease should prompt appropriate investigations such as pulmonary function tests (spirometry). However, both general practitioners (GPs) and patients are failing to recognize the significance of symptoms."
 
The UK Department of Health estimates that around 2.2 million people in the UK are undiagnosed and state that earlier diagnosis and treatment could save the National Health Service more than £1 billion over 10 years.
 
Using data from the General Practice and Optimum Patient Care Research databases, the researchers assessed whether a COPD diagnosis might have been made in an earlier primary or secondary care visit. They identified 38 859 patients aged 40 years or older who had received a COPD diagnosis between 1990and 2009 and for whom data was available for at least two years before and one year after diagnosis.
 
Results showed that in the 5 years before diagnosis, 85% of patients had visited their GP or a secondary care clinic at least once with lower respiratory symptoms. These consultations represent missed opportunities to further investigate patients for a possible diagnosis of COPD. Opportunities for diagnosis were missed in 58% of patients in the 6–10 years before diagnosis and 42% in the 11–15 years before diagnosis.
 
Over the 20 year study, a significant increase in the number of chest x-rays in the 2 years before diagnosis was noted, but only a third of these patients were also given spirometry testing.
 
They researchers say, "Although we have seen small improvements in earlier diagnosis over the past 20 years, many patients are still being diagnosed with severe or very severe airway...
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Secondhand Smoke Could Cancel out Asthma Treatment
It isn’t rocket science that parents should not be smoking at home with children that suffer from asthma.  A new study finds, that secondhand smoke may be counteracting the effects of the child’s asthma treatment.
 
The study, published in the journal Chest, finds that the oxidants in cigarette smoke were shown to be capable of destroying key anti-inflammatory enzymes in asthma medicine.  Great.
 
“Passive smoking in the home and in cars is damaging to the lungs,” lead researcher Professor Peter Barnes told Medical Daily. “What our study shows is that it can stop a key asthma treatment — inhaled steroids — from working properly, so it means that asthma is not as well-controlled.”
 
Because asthma is characterized by chronic inflammation in a person’s airways that makes breathing difficult, asthmatics rely on inhalers to deliver corticosteroid, which helps to stop the abnormal inflammation signal.  Children that live in homes where smoking transpires, Barnes explains, were shown to have the same resistance to these steroids as adults who actively smoke.
 
For more information on Smoking Cessation and integrating it into your practice, to help save the children in smoking homes, visit MD Spiro’s Breath CO section today.
 
References:
 
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Carbon monoxide (CO) is a deadly, colorless, odorless, poisonous gas.  It is produced by the incomplete burning of various fuels, such as coal, wood, oil, propane, and natural gas.  Other sources of CO are products and equipment such as cars, lawn mowers, portable generators and power washers.  In addition, Smokers and Firefighters have extreme exposure rates.
 
Symptoms:
 
Because CO is colorless and odorless, some people may not know they are being exposed to the deadly gas.  
Symptoms of poisoning are similar to the flu:
  • Fatigue
  • Shortness of breath
  • Nausea
  • Headache
  • Dizziness
High levels of poisoning result in more severe symptoms:
  • Mental confusion
  • Loss of muscular coordination
  • Loss of consciousness
  • Vomiting
  • Death
The duration and level of exposure is directly related to the symptoms of someone exposed to CO.  
 
Testing and Measuring for CO:
 
Breath carbon monoxide is the level of CO in a person’s exhalation.  It can be measured by testing using a Breath CO monitor.  The test is design to be a clinical aid in assessing CO poisoning.  CO breath monitors are used by emergency services to help identify patients who are suspected of having CO poisoning.  Because of its make-up, odorless, colorless, and tasteless, it is very difficult to detect.
 
There is an outstanding product on the market that can monitor CO:
 
The MicroCO Breath CO Monitor is designed to be an essential tool for CO monitoring, smoking cessation, and firefighter rehab.  Some of the features are fast response time, 1ppm resolution, immediate display of CO levels in ppm and %COHb, breath-hold countdown timer and color light indicators.
 
If you or a loved one feel you have symptoms that are associated with CO poisoning, seek out a practitioner that carries these products.  To learn more, visit www.mdspiro.com.
 
References:
 
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According to a September, 2012 report by the American Lung Association (ALA), 7.1 million children had asthma in 2011, with the prevalence being between the ages of 5-11.  The report additionally showed that boys were 16% more likely to develop asthma than girls.  Why is that and what does it mean for parents and practitioners, alike?
 
Why asthma is harder on boys than girls remains a bit of a mystery, although one theory suggests that boys’ lungs are less fully developed and their air passages are smaller than that of a girl.  Another theory is that boys tend to be more into sports, or more likely to play in areas that are dirtier which in turn increases their exposure to mold, dust, and other asthma triggers.
 
Parents need to create living environments that are conducive to helping support the respiratory health of their child, boy or girl.   Keeping track of daily symptoms of the child’s asthma, peak flow values, and medicine intake are key components to respiratory health.
 
Keeping track of this information will help you and your pediatrician to better monitor the asthmatic child.  Having asthma under control is no easy feat.  But it will be easier if as a parent you are engaged with the day-to-day activities, symptoms, and triggers and be in good communication with the doctor caring for the child.
 
At the heart of respiratory health is good communication, spirometry testing, and eliminating as many triggers to the child as possible.  Talk to your patients and your doctor about next steps in asthma care and have spirometry become an integral part of the care.
 
References
 
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Early Intervention Lowers Asthma in Pregnant Women
In an original study at Monash University, Australia, for Multidisciplinary Approach to Management of Maternal Asthma (MAMMA), it was found that early intervention to better manage the asthmatic condition in a pregnant women can statistically and clinically control their asthma.
 
Intervening through monthly asthma education, monitoring, feedback, and follow-up helped yield better asthma control results after 6-months of care.  
 
“With one in eight pregnant women suffering from asthma, this research is telling us we need to improve management during pregnancy by finding new strategies to improve education and awareness,” says lead investigator Angelina Lim of the Centre for Medicine Use and Safety at Monash University. ”Poorly controlled asthma during pregnancy is hazardous for the health of the mother and the baby and has been associated with an increased risk of preterm birth, low birth weight, and pre-eclampsia.
 
“Proper asthma management among pregnant women should be regarded as a leading priority in antenatal care. This is a simple intervention that could be easily implemented in antenatal settings with minimal additional resources.”
 
In the intervention group, no asthma-related oral steroid use, hospital admissions, emergency visits, or days off work were reported during the trial.  The findings of this study are detailed and published in the journal Chest.
 
References
 
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Spirometry is Good Business
Spirometry is the gold standard for the diagnosis and management of both Asthma and Chronic Obstructive Pulmonary Disorder (COPD).  The earlier you detect the disease and its state; the easier and faster you can treat your patients.
 
Spirometry is good medicine.  The patients you see every day in your office can be correctly diagnosed and treated more accurately and effectively in the convenience of your office.
 
Spirometry is easy.  Unless the equipment is easy-to-use, it will not be fully embraced and utilized by your staff.  All MD Spiro spirometers are menu-driven via a large, graphic display and testing takes less than five minutes to perform.  The easy-to-read reports, quality checks, and built-in interpretation assist you for an accurate diagnosis.
 
Spirometry is good business. Office spirometry is third-party reimbursable with an average reimbursement of $33.00 for a simple five-minute non-invasive test.  The average primary care physician tests ten patients per week and pays for their equipment in three months or less then generates over $20,000 per year in additional revenue.
 
Facts about Asthma:
  • Asthma accounts for one-quarter of all emergency room visits in the US each year
  • With 2 million emergency room visits, asthma is the number one cause of school absenteeism among children accounting for more than 14M total missed school days.
  • An estimated 26 million Americans suffer from asthma, which equates to 1 in 15 Americans according to the American College of Allergy, Asthma, and Immunology
 
Facts about COPD:
  • COPD is the third leading cause of death in the US
  • An individual dies of COPD every 4 minutes in the US
  • The single, best test for detecting early COPD is spirometry
  • Treatment for COPD is more effective if given before symptoms occur
For more information about how MD Spiro can help add spirometry into your practice, visit: www.mdspiro.com. 
 
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