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Respiratory Problems

Pricey lung disease drugs have no benefit: study

Respiratory ProblemsJul 08 10

Recommendations for expensive treatments made for a genetic disorder called alpha-1 antitrypsin deficiency should be withdrawn because the drugs have no benefit, scientists said on Wednesday.

The disorder causes chronic lung disease and researchers who reviewed data from two trials on 140 patients with it found no evidence that alpha-1 antitrypsin medicines do any good.

Based on this evidence, the researchers said the treatment, which costs up to $150,000 a year in the United States, should not be recommended by doctors and advocacy groups.

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Botox may quiet chronic cough

Drug News • • Neurology • • Respiratory ProblemsMay 28 10

Botox could help some people with nagging chronic coughs that haven’t responded to standard treatment, according to a new report on four patients.

Botox, or botulinum toxin type A, is perhaps best known as a wrinkle-filler, but it has medical uses including treating spastic muscles in patients with cerebral palsy and drying up excessive sweating.

The new findings suggest that Botox might also help quiet coughs, although it is not FDA-approved for this use. And the study’s authors caution that the toxin should not be seen as a “panacea.”

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Few Chinese lung diseased workers get redress: report

Public Health • • Respiratory ProblemsApr 27 10

Over 10,000 workers in China are diagnosed with a deadly lung disease each year from breathing in dust from cutting gemstones and drilling rocks, but only a few manage to get compensation, said a rights organisation.

The China Labour Bulletin (CLB) said some pneumoconiosis victims receive small sums that cover their medical costs for a few years, but many get nothing at all for the incurable disease.

“Pneumoconiosis is the number-one occupational disease in China, accounting for around 90 percent of all cases,” CLB said, adding that many victims cannot even manage to get an official diagnosis.

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Obesity may boost pneumonia risk in men

Obesity • • Respiratory ProblemsApr 09 10

Men who carry excess pounds may also carry an excess risk of pneumonia, a new study hints.

However, researchers note that the effect appears to be indirect. “This risk is driven by the development of chronic diseases related to obesity, rather than by obesity itself,” Dr. Jette Brommann Kornum of Aarhus University Hospital in Denmark, who led the study, told Reuters Health in an email.

Rates of hospital admission for pneumonia have been on the rise over the last decade—up 20 to 50 percent in Western countries. At the same time, more and more people worldwide are putting on unhealthy amounts of weight, which has fueled increased rates of chronic diseases such as diabetes and asthma.

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Mayo Clinic Reports its First Lung Transplantation by Donation After Cardiac Death

Heart • • Respiratory ProblemsFeb 18 10

Lung transplantation is a well-known therapy for patients with end-stage lung disease, but, as with other patients waiting for organs for transplantation, there are more recipients waiting than donors available. A potential solution for patients with end-stage lung disease is donation after cardiac death (DCD). Mayo Clinic reports its - and Minnesota’s - first lung transplantation from DCD in the February issue of Mayo Clinic Proceedings.

VIDEO ALERT: Additional audio and video resources including excerpts from an interview with Dr. Cassivi describing the research are available on the Mayo Clinic News Blog. Please see the end of the release for details.

While brain death has become the most widely used criteria for organ donation over the past few decades, the earliest organ donations were from deceased donors following cardiac death, says Stephen Cassivi, M.D., Mayo Clinic thoracic surgeon and lead study author.

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U-M researchers find those with severe H1N1 at risk for pulmonary emboli

Flu • • Respiratory ProblemsOct 14 09

University of Michigan researchers have found that patients with severe cases of the H1N1 virus are at risk for developing severe complications, including pulmonary emboli, according to a study published today in the American Journal of Roentgenology.

A pulmonary embolism occurs when one or more arteries in the lungs become blocked. The condition can be life-threatening. However, if treated aggressively, blood thinners can reduce the risk of death.
“The high incidence of pulmonary embolism is important. Radiologists have to be aware to look closely for the risks of pulmonary embolism in severely sick patients,” said Prachi P. Agarwal, M.D., assistant professor of radiology at the U-M Medical School and lead author of the study.

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New European guidelines on pulmonary hypertension provide new 6-group clinical definition

Heart • • Respiratory ProblemsAug 31 09

New 2009 Guidelines for the diagnosis and treatment of pulmonary hypertension are made public today. The Guidelines have been jointly produced by a Task Force of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS); the Task Force also included experts from the International Society of Heart and Lung Transplantation (ISHLT).

The new 2009 Guidelines provide a new clinical classification of pulmonary hypertension which identifies six different clinical groups. However, whatever the underlying causative mechanism, pulmonary hypertension is characterised by a poor prognosis. Indeed, says Professor Nazzareno Galiè, from the Institute of Cardiology at the University of Bologna, Italy, and Chairperson of the Guidelines Task Force: “It is the multidisciplinary nature of pulmonary hypertension and its severity which have made the new guidelines necessary.”

Pulmonary hypertension (the increase of blood pressure within the lung circulation) is a condition which may complicate the majority of heart and of lung diseases, or may develop without a clear initiating cause. The new 2009 Guidelines identify six different clinical groups.

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Common Cold Virus Efficiently Delivers Corrected Gene to Cystic Fibrosis Cells

Cancer • • Lung Cancer • • Genetics • • Respiratory ProblemsJul 21 09

Scientists have worked for 20 years to perfect gene therapy for the treatment of cystic fibrosis, which causes the body to produce dehydrated, thicker-than-normal mucus that clogs the lungs and leads to life threatening infections.

Now University of North Carolina at Chapel Hill School of Medicine scientists have found what may be the most efficient way to deliver a corrected gene to lung cells collected from cystic fibrosis patients. They also showed that it may take this high level of efficiency for cystic fibrosis (CF) patients to see any benefit from gene therapy.

Using parainfluenza virus, one of the viruses that causes common colds, the UNC scientists found that delivery of a corrected version of the CFTR gene to 25 percent of cells grown in a tissue culture model that resembles the lining of the human airways was sufficient to restore normal function back to the tissue.

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Severe COPD may lead to cognitive impairment

Respiratory ProblemsJul 07 09

Severe chronic obstructive pulmonary disease (COPD) is associated with lower cognitive function in older adults, according to research from Mount Sinai School of Medicine. Researchers compared cognitive performance in over 4,150 adults with and without COPD and found that individuals with severe COPD had significantly lower cognitive function than those without, even after controlling for confounding factors such as comorbidities.

The results were published in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine.

“Our findings should raise awareness that adults with severe COPD are at greater risk for developing cognitive impairment, which may make managing their COPD more challenging, and will likely further worsen their general health and quality of life,” wrote lead author of the study, William W. Hung, M.D., M.P.H., assistant professor at Mount Sinai School of Medicine.

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Early pacifier use linked to shorter breastfeeding

Children's Health • • Respiratory ProblemsMar 16 09

Mothers who want to breastfeed their baby successfully may want to hold off on giving their infant a pacifier, new research from Denmark shows.

Drs. Hanne Kronborg and Michael Vaeth of the University of Aarhus found that women who gave their infant a pacifier in the first weeks of life were less likely to continue breastfeeding their babies.

In Denmark, registered nurses visit newborns and their families soon after the baby is discharged from the hospital. To investigate whether early breastfeeding technique and pacifier use might affect breastfeeding success, the researchers had health visitors specially trained in breastfeeding counseling visit 570 mother-baby pairs.

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Scientists Find Gene That Modifies Severity of Cystic Fibrosis Lung Disease

Genetics • • Respiratory ProblemsMar 04 09

Researchers at Wake Forest University Baptist Medical Center, and colleagues, have identified a gene that modifies the severity of lung disease in people with cystic fibrosis, a lethal genetic condition. The findings open the door to possible new targets for treatment, researchers say.

The study appeared online last week in advance of print publication in Nature. It is the first published study to search the entire genome looking for genes that modify the severity of cystic fibrosis lung disease.

“This is a good example of researchers with different expertise coming together and using the knowledge gained from mapping the human genome to make discoveries that improve our understanding of cystic fibrosis,” said Carl Langefeld, Ph.D., a study co-author and Wake Forest University School of Medicine researcher. “It may also help in the identification of targets for drug development and the development of tools for the earlier diagnosis of individuals with cystic fibrosis who are susceptible to severe lung disease.”

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Respiratory virus common in US children: study

Children's Health • • Respiratory ProblemsFeb 05 09

A highly contagious respiratory virus is far more widespread among children than once thought and puts more of them in the hospital than influenza (flu), U.S. researchers reported on Wednesday.

They projected that the respiratory syncytial virus, known as RSV, affects 2.1 million children under the age of 5 each year.

Over four years, from November through April, the virus was responsible for 20 percent of hospitalizations, 18 percent of visits to emergency rooms and 15 percent of office visits for respiratory infections in children younger than age 5 in three U.S. counties, Dr. Caroline Breese Hall of the University of Rochester Medical Center in New York and colleagues found.

“This causes hospitalization in children three times as often as influenza,” Hall said in a telephone interview.

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Daytime impairments in older men with obstructive sleep apnea are related to total sleep time

Respiratory Problems • • Sleep AidFeb 02 09

A study in the Feb. 1 issue of the journal SLEEP shows that daytime functional impairments in older men with obstructive sleep apnea (OSA) are largely explained by total sleep time rather than OSA severity.

A modest link between OSA severity and daytime sleepiness, measured by the Epworth Sleepiness Scale, was no longer statistically significant after controlling for total sleep time. Neither sleep disturbances, measured by the Pittsburgh Sleep Quality Index, nor sleep-related quality of life, measure by the Functional Outcome of Sleep Questionnaire, were associated with OSA severity; all three measures were modestly associated with total sleep time.

According to lead author Dr. Eric J. Kezirian, director of the division of sleep surgery in the department of otolaryngology at the University of California in San Francisco, the study shows that the functional consequences of OSA in older men may differ from those in younger populations and may need to be measured with instruments designed specifically for the demographic.

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Sleep disordered breathing and obesity: Independent effects, causes

Obesity • • Respiratory Problems • • Sleep AidJan 23 09

In a study that addressed the issue of insulin sensitivity with respect to sleep disordered breathing (SDB), Naresh Punjabi, M.D., Ph.D. sought to examine the relationship between SDB and insulin resistance using the best tools at his disposal to do so.

The results definitively link SDB to pre-diabetic changes in insulin production and glucose metabolism. It was published in the first issue for February of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

“In the past researchers have used body mass index, or BMI, as a proxy measure for body fat, but we know this to be a variable and crude tool to assess the true percentage of body fat,” said Dr. Punjabi. “In addition, previous studies have used surrogate measurements to assess the body’s response to insulin without investigating the interaction that occurs between reduced insulin sensitivity and increased insulin production in the body.”

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ARDS mortality is unchanged since 1994

Respiratory Problems • • StressJan 23 09

Mortality in patients with acute respiratory distress syndrome (ARDS) has not fallen since 1994, according to a comprehensive review of major studies that assessed ARDS deaths. This disappointing finding contradicts the common wisdom that ARDS mortality has been in steady decline.

The study was published in the first issue for February of the American Journal of Respiratory and Critical Care Medicine.

The authors reviewed all prospective observational and randomized controlled trials between 1984 and 2006 that included more than 50 ARDS/ALI patients and reported mortality.

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