Respiratory Problems
Respiratory training can help lung patients
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For people with chronic obstructive pulmonary disease (COPD) such as emphysema, a simple home-based training routine aimed at the muscles used for breathing, led to a significant improvement in exercise endurance and other benefits, Dutch researchers.
Dr. Ralph J. H. Koppers of Medical Center Leeuwarden and colleagues note that impaired exercise capacity is often a problem for COPD patients. Respiratory muscle endurance training based on increasing the level of carbon dioxide breathed can be helpful but requires complicated and expensive equipment.
The researchers developed a simplified approach in which a tube connected to a mouthpiece increases dead space and prompts rebreathing of exhaled carbon dioxide, according to their report in the medical journal Chest
Corticosteroids do not improve survival in patients with late-stage ARDS
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Corticosteroids do not improve survival in patients with late-stage acute respiratory distress syndrome (ARDS), according to new results from the ARDS Clinical Research Network of the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
The study is the first multi-center randomized clinical trial to evaluate the effects of moderate doses of steroids in ARDS patients when treatment is started 7 days or more after the onset of the condition.
ARDS is a sudden, life-threatening lung condition that affects about 150,000 people in the United States each year. ARDS develops in patients who are critically ill with other diseases such as pneumonia or sepsis (severe and widespread bacterial infection), or who have sustained major injuries that result in severe fluid building up in both lungs, leading to breathing failure. An estimated 30 percent to 50 percent of ARDS patients die. Results of the Late Steroid Rescue Study appear in the April 20, 2006, issue of the New England Journal of Medicine.
Physical activity low among emphysema patients
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People with chronic obstructive lung disease, commonly emphysema, have low levels of physical activity during and after being hospitalized for an acute flare-up of their condition, researchers report. This in turn can lead to further worsening of their condition.
“Acute exacerbations have a negative impact on various aspects of the progression of COPD,” write Dr. Rik Gosselink, of University Hospitals, Leuven, Belgium and colleagues in the medical journal Chest, “but objective and detailed data on the impact of hospitalizations for an acute exacerbation on physical activity are not available.”
To investigate, the researchers used an activity monitor to assess physical activity in 17 COPD patients while they were in the hospital for an acute exacerbation and after they were discharged.
C-reactive protein helps identify progressive precancerous lesions in the lung
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C-reactive protein (CRP), a biomarker for inflammation in the blood, can help to identify individuals whose abnormal precancerous lesions will advance closer to invasive lung cancer.
The results appear in the first issue for March 2005 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Stephen Lam, M.D., F.R.C.P.C., of the Lung Tumour Group, British Columbia Cancer Agency at the University of British Columbia in Vancouver, Canada, and three associates measured CRP, lung function and other inflammatory markers in 65 individuals. All participants had at least one abnormal cell site in their lungs (bronchial dysplasia) greater than 1.2 millimeters in size, which was biopsied at the start of the study and re-examined 6 months later.
Chronic Obstructive Pulmonary Disease (COPD)
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Chronic Obstructive Pulmonary Disease is a common and important health problem among seniors in Canada. The number of individuals with COPD will likely increase in the future because of the aging population. While cigarette smoking is the principal cause of COPD, workplace exposures and outdoor air pollution contribute to the development or the exacerbation of COPD. Exposure of the fetus and young child to environmental tobacco smoke and repeated respiratory infections contributes to a decrease in lung function that can contribute to COPD in later life.
As their disease progresses, individuals with COPD experience a reduced quality of life due to limited activity levels caused by an increase in shortness of breath. Their families face not only the challenge of providing an increasing level of care, but also the difficulty of watching the relentless progression of the disease in their loved one. The costs associated with COPD affect the family, the health care system, and the community as a whole with loss in productivity and the need for additional services.
Continuous positive airways pressure for obstructive sleep apnoea in adults
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A machine that delivers air through a nasal mask worn during sleep can reduce daytime sleepiness and other symptoms associated with sleep apnea, but apnea patients are not always happy with the treatment, according to two new reviews of recent studies.
In apnea patients, the airway in the nose and throat periodically narrows or closes off during sleep, stopping breathing for seconds at a time. People with apnea usually snore and feel sleepy and less alert in the daytime. Some studies suggest apnea can contribute to high blood pressure, heart disease and stroke and may be a factor in traffic accidents.
Effective, Cheap Treatment for Cystic Fibrosis Lung Disease
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Working half a world away from each other, two teams of medical scientists have identified what they believe is a simple, effective and inexpensive treatment to reduce lung problems associated with cystic fibrosis, the leading fatal genetic illness among whites.
The new therapy, identified through studies supported chiefly by the Cystic Fibrosis Foundation and the National Heart, Lung and Blood Institute, also appears to be safe and easy to take.
Screening advised for families with lung diseases
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New research suggests that genetics may make people susceptible to lung cancer, chronic obstructive pulmonary disease (COPD) and reduced lung function. If so, then a family history of these disorders should place individuals in the high-risk category.
If they also have a history of smoking, then they should be screened with a CT scan, investigators suggest in the American Journal of Respiratory and Critical Care Medicine.
Lung disease patients breathe easier with rehab
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Pulmonary rehabilitation produces significant benefits for patients with advanced emphysema and plays an important role in the selection of patients for lung surgery, according to results of the National Emphysema Treatment Trial, or NETT.
“The NETT highlights the important benefits of pulmonary rehabilitation—as practiced in a large number of centers across the country—as a standard of care for patients with advanced chronic lung disease and an important adjunct to lung volume reduction surgery programs,” said Dr. Andrew L. Ries, from the University of California, San Diego.
Fish oil curbs heart trouble linked to pollution
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Daily supplementation with omega-3 fatty acid (fish oil) prevents a potentially-deadly decline in heart rate variability (HRV) associated with exposure to indoor air pollution, researchers from the US and Canada report.
HRV measures the variability in the intervals between heartbeats, with lower variability being associated with higher risks of heart disease and death.
Genes influence risk from second-hand smoke
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Children harboring a particular variant in the TNF gene who are exposed to second-hand smoke are at increased risk of frequent respiratory-related absences from school, researchers at the University of Southern California, Los Angeles, report.
In a study of more than 1,300 fourth graders, Dr. Frank D. Gilliland and colleagues found the effect of passive smoke exposure on illness differed according to TNF genotype.
UVa Health System Opens Clinical Trial of Emphysema Treatment
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Doctors at the University of Virginia Health System have opened a new clinical trial to try and help people with emphysema breathe better. The study will test the safety and effectiveness of a bronchoscopic valve, an experimental device designed to channel air to healthier portions of the lung. The idea is to improve a patient’s physical functioning, tolerance for exercise and general quality of life.
The study device works by limiting airflow to a selected portion of the lung in patients with emphysema. The bronchoscopic valve is implanted without an incision, hopefully providing an alternative to lung volume reduction surgery. The device is a small valve shaped like an umbrella. It’s placed in the bronchial tree to prevent air from entering targeted sections of the lung. Doctors successfully implanted the device in UVa’s first patient Dec. 2, the first time the device has been used in a clinical trial in the Southeast.
Sleep Apnea, Blood Pressure Linked
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Full-night sleep studies and echocardiography may need to be incorporated into routine assessments of patients with difficult-to-treat high blood pressure, suggests UAB researcher Monique Pratt-Ubunama, M.D. “And those who are resistant to treatment and are found to have sleep apnea may benefit from mineralocorticoid receptor antagonists, since levels of aldosterone were high in study patients; and continuous positive airway pressure (CPAP) should be encouraged,” she said.
Ubunama’s suggestions are based on results of a study funded by the National Heart, Lung and Blood Institute and presented last month at the American Heart Association annual meeting. “We found a direct relationship between the severity of sleep apnea and cardiovascular changes associated with high blood pressure.”
Sleep apnea tied to higher risk of stroke
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People with sleep apnea are at a higher risk of having a stroke than those without the condition, Canadian and US researchers report.
Senior investigator Dr. T. Douglas Bradley of Toronto General Hospital, said that “evidence going back to the early 1970s suggests that sleep apnea, strokes and heart attacks often happen together, but that doesn’t mean that there is a cause/effect relationship.”
Viagra may be useful for serious lung disease
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Treatment with Viagra (sildenafil) can improve exercise capacity and functional ability in patients with pulmonary arterial hypertension, a serious disease involving high pressure in the blood vessels that enter the lungs, new research suggests.
The findings, which appear in The New England Journal of Medicine, are based on a study of 278 patients who were randomly selected to receive Viagra, at one of three doses, or inactive “placebo” three times daily for 12 weeks.
