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Patient Education and Awareness are Key in Preventing Flare-Ups
Chronic Obstructive Pulmonary Disease (COPD) can mean dealing with the sometimes debilitating symptoms that interrupt everyday life. A new survey by the COPD Foundation urges patients to educate themselves to help prevent exacerbations, which can become increasingly uncomfortable if not managed correctly.
The first portion of the two-part national survey found that nearly two-thirds (63%) of participants did not know much exacerbations, commonly known as flare-ups, while 16% were unaware of what an exacerbation even was. Of those that did know what a flare-up was, 60% reported that they did not have an action plan for dealing with them.
These numbers are troublesome as they reflect low patient awareness and readiness which can hinder better health and lung functionality.
The second part of the study focused on the physicians treating COPD patients. Nearly all (98%) stated that they regularly discuss exacerbations and establish action plans with their patients.
Scott Cerreta of the COPD Foundation noted that “developing an action plan with instructions to help patients – and their caregivers – identify warning signs and what steps to take if an exacerbation should occur is a critical part of managing COPD.”
These action plans must start with effective communications between physician and patient. The physician must be willing to diagnose early and provide the patient with clear and direct instructions. The patient should be willing to adhere to the appropriate strategies recommended by their physician or caregiver in order to reduce the chances of exacerbation.
The survey concluded with a just 12% of participants revealing that they felt their condition were “completely controlled.” This led researchers to assert that physicians need to “develop an individualized approach that works best for each patient” in order to increase patient awareness.
New Respiratory Disease Breakthrough
It is well known that a continuous cycle of inflammation can lead to continued decline in lung function, making it increasingly difficult for emphysema and Chronic Obstructive Pulmonary Disease (COPD) sufferers to breathe or take part in routine activities. However, a new discovery by University of Newcastle and University of Bonn respiratory researchers may change the way inflammation affects these conditions.
Published in the international journal Nature Immunology, this discovery sheds new light on an immunological factor known as the “inflammasome,” which has the ability to “inhibit inflammatory conditions at their genesis.”
Lead researcher Professor Phil Hansbro of University of Newcastle describes inflammasomes as “a recently discovered complex of proteins that form once a cell is exposed to a pathogen such as a virus or bacterial infection. They trigger the release of a load of inflammatory proteins.”
He explains that inflammasomes are “normally beneficial in response to infection but can become abnormally activated and may lead to chronic respiratory diseases” such as emphysema and COPD.
Hansboro and other researchers are finding that people may have an “overactive baseline inflammatory response” which releases inflammasomes to areas of the body that do not need them in an effort to fight off bacteria and infection. Hansboro explains that this drive a “continual cycle of inflammation…it becomes exaggerated and uncontrollable, which could underpin why we get asthma attacks or COPD exacerbations for example.”
This breakthrough finding is helping to spur the development of drugs and inhibitors that target inflammasomes and restore the perpetual inflammatory response to normal, limiting inflammatory disease development.
Click Here to Access the Full Story at The University of Newcastle
Are COPD Patients More Likely to Suffer from Depression?
A recent study by University of Amsterdam researchers sought to investigate whether depression occurs more often in patients with Chronic Obstructive Pulmonary Disease (COPD) than in those without.
The study focused on patients diagnosed with COPD who were age 40 and over and had a history of smoking. The study, which appeared in Thorax, assessed depression levels using the Centers for Epidemiologic Studies Depression (CES-D) scale. This is a screening test developed to detect levels of depressive disorder and measure the symptoms associated.
The results were conclusive in determining that patients with mild to moderate COPD did not have an increased risk of depression, while patients with severe COPD were found to have a 2.5 times greater risk of developing depression than those in the control group. It should be noted that patients at any stage of COPD who lived alone were found to have respiratory symptoms and physical impairment associated with significantly higher scores on the CES-D scale. Thus, living alone may increase the likelihood of developing depression at any stage of COPD.
Researchers note that “the results of this study underscore the importance of reducing symptoms and improving physical functioning in patients with COPD.”
The study has been the most conclusive in its results thus far in studying the occurrence of depression due to the large number of patients and control groups used. Its findings help clear the way for more selective and specified treatments and lifestyle changes for those living with COPD and bring attention to the idea that depression should be considered a disorder in COPD patients.
Limiting the Impact of COPD
Chronic Obstructive Pulmonary Disease (COPD) is described as a progressive disease, meaning it develops slowly and the symptoms gradually worsen over time. Although there is no known cure, COPD sufferers should not feel hopeless. New treatments and lifestyle changes are slowing progression of the disease while helping people feel better and remain more active. An article from the The Spectrum highlights ways COPD patients can educate themselves and limit the impact COPD has on their life.
The first major point is to know the signs of COPD. Because the disease typically progresses very slowly, many people do not recognize the symptoms until it they become debilitating.
In addition to knowing the signs and symptoms, it is helpful to understand the stages of COPD, as each level has different treatment options. The four stages of COPD are mild, moderate, severe, and very severe. These stages are based on measurements of the amount or flow of air as you inhale and exhale.
In addition to knowing the signs and symptoms, it is helpful to understand the stages of COPD, as each level has different treatment options. There four stages of COPD are mild, moderate, severe and very severe, and are based on measurements of the amount or flow of air as you inhale and exhale.
At any stage of COPD, it is imperative to avoid lung irritants such as smoking, chemical fumes, dust, or areas with dense air pollution, as these can exacerbate the symptoms. It is also important to get regular exercise to keep the lungs functioning at maximum capacity. While very severe stage COPD sufferers may be limited here, engaging in physical therapy known as pulmonary rehabilitation has been shown to improve shortness of breath and quality of life, and provide strategies for coping with COPD.
Education, awareness and knowing what to avoid can help prevent COPD from inhibiting routine activities, allowing for a better quality of life and symptom management.
One Step Closer to a Breath Test for Lung Cancer
The results of a recent University of Colorado study presented at the American Society for Clinical Oncology (ASCO) Annual Meeting 2014 show that a test of organic compounds in exhaled breath can not only distinguish patients with lung cancer from patients with chronic obstructive pulmonary disease (COPD), but can also define the stage of any cancer present. The article, published in Digital Journal, describes a device developed by researchers that resembles a Breathalyzer, with the ability to acutely detect lung cancer in four out of five cases.
With cancer as the United States’ number one killer, researchers have spent many years trying to find a more accurate screening process. They now have the technology to detect particles down to one part per trillion, greatly improving the ability to create detailed cancer scent signatures. This advancement has also accurately distinguished between early and advanced stage lung cancer 79 percent of the time.
By eliminating the large number of false positives given by CT scans, this technology could revolutionize the way patients are screened and treated for lung cancer, potentially saving billions of dollars. The breath test technology is an accurate low-cost alternative that could help to weed out those individuals who definitely do not have lung cancer.
The research team now is working on tests that can monitor tumor shrinkage to determine whether lung cancer treatments are working. While research continues, one U.S. company has already licensed the breath test technology and is working to bring it to market within the next few years.
Tiny Coils Help COPD Patients to Breathe Easier
The permanent lung damage caused by chronic obstructive pulmonary disease (COPD) may have a new foe in the form of a procedure that does not require surgery.
The new procedure, which researchers are testing in clinical trials at Cleveland Clinic and other hospitals across the U.S., helps the damaged lung tissue regain the elasticity lost to the disease. In an article posted by Health Hub at Cleveland Clinic, pulmonologist and researcher Dr. Joseph Cicenia describe the method by which they are able to treat the lung, improving quality of life for those treated.
Doctors “insert special flexible scopes through the patient’s mouth to place metal coils into the damaged tissue of the patient’s lung. The coils return elasticity to the diseased tissue, allowing the lungs to work in a more normal way,” he says.
This procedure has the potential to return COPD patients to a more normal lung function, reducing the hyperinflation that causes shortness of breath.
The procedure and coils have been in use in Europe since 2008. Patients receiving the coils in clinical studies have reported “substantial improvements in their lung function, capacity for exercise and quality of life.”
Preliminary studies show the coil procedure gives results that are comparable to the lung volume reduction surgery. However, because there are no incisions or tissue removal, the recovery process is much quicker, with patients returning home after an overnight stay in the hospital.
Dr. Cicenia says “the preliminary results are promising” and that expanded clinical trials are expected to help confirm the results seen in Europe.
Click Here to Access the Full Story on Health Hub at Cleveland Clinic
Anti-Platelet Therapy Tied to Fewer Deaths in COPD Flares
High platelet counts have been found to play a significant role in inflammation caused during chronic obstructive pulmonary disease (COPD) exacerbations. That is according to observational study published in the April 2014 online issue of Thorax, “Thrombocytosis is associated with increased short and long term mortality after exacerbation of chronic obstructive pulmonary disease: a role for antiplatelet therapy?”
The study, conducted by Michelle Harrison, MD, of the University of Dundee in Scotland, linked inflammation from high platelet counts to poor short and long-term outcomes in COPD, particularly in those patients who had suffered from acute exacerbations of COPD (AECOPD).
Acting as a secondary analysis of a previous study performed, the cohort study observed adults over the age of 40 with spirometry-confirmed COPD admitted between 2009 and 2011. The study tested two outcomes: the primary outcome was 1-year all-cause mortality and the secondary included in-hospital mortality and cardiovascular events.
While anti-platelet therapy, such as Asprin or clopidrogrel, did not significantly cut the likelihood of dying in the hospital, it was associated with a 37% reduction in the risk of 1-year mortality and may have a protective role to play in patients with AECOPD, counteracting the inflammation associated with COPD exacerbations.
New Research Suggests COPD Treatment Should Include Surgery for Some
The treatment of chronic obstructive pulmonary disease (COPD), which is a major cause of disability and premature death for millions affected, now has renewed hope as a result of clinical trials performed by researchers at Imperial College London. The study, “Surgical approaches for lung volume reduction in emphysema” which was published in the April issue of Clinical Medicine, suggests that lung volume reduction surgery (LVRS) could reduce breathlessness and improve exercise capacity and survival for patients who have severe emphysema restricted to one part of the lung.
During LVRS, surgeons remove the most damaged area of the lung enabling the remaining parts of the lung to work more effectively.
The study, which reviewed patient outcomes from 2000 to 2012, showed that in a series of 81 patients who had undergone the procedure there were no deaths and only six percent were still in the hospital one month after the operation. Despite the benefits, historical concerns about the risks associated with LVRS have limited the number of procedures.
Lead author of the study, Dr. Nicholas Hopkinson from Imperial's National Heart and Lung Institute, supports this evidence stating that “these results suggest that concerns about the risks of surgery have been exaggerated and doctors looking after patients with COPD should be encouraged to identify people eligible for this procedure.”
Dr. Hopkinson also insists that based on evidence found “there are thousands more people with lung disease in the UK who could profit from this approach.”
Other treatments that have been found to aid in the treatment of COPD include stopping smoking, exercise programs and inhaled medications. However, many people with the condition remain extremely breathless.
Improved Kitchen Ventilation Shown to Improve Lung Function, Reduce Risk of COPD
Improving kitchen ventilation and switching cooking fuels may reduce the risk of chronic obstructive pulmonary disease (COPD) and improve lung function, according to a recent study published in the March online issue of PLOS Medicine, “Lung Function and Incidence of Chronic Obstructive Pulmonary Disease after Improved Cooking Fuels and Kitchen Ventilation: A 9-Year Prospective Cohort Study.”
The study examined nearly 1,000 eligible participants across 12 villages in southern China over a nine-year period, paying close attention to their choice of fuel and ventilation and the subsequent effects on their health. In addition, researchers provided participants with safer and healthier options for combustion fuels (biogas) used for cooking and improved kitchen ventilation in their homes. Questionnaire interviews and spirometry tests were performed in three-year intervals, while improved air quality was confirmed via measurements of indoor air pollutants in a randomly selected subset of the participants’ homes.
To determine the effect of the improved ventilation and cooking fuel, researchers compared annual declines in lung function and incidence of COPD between those participants who implemented one, both, or neither of the interventions. They found that the use of clean fuels and improved ventilation was associated with a reduced decline in lung function compared to those who took up neither intervention.
“These findings suggest that, among people living in rural southern China, the combined interventions of use of biogas instead of biomass and improved kitchen ventilation were associated with a reduced decline in lung function over time and with a reduced risk of COPD,” said the study authors.
However, due to the absence of a control or intervention group, a direct link between kitchen ventilation, cooking fuel and COPD could not be developed. Regardless, these findings suggest that “the use of biogas as a substitute for biomass for cooking and heating and improvements in kitchen ventilation might lead to a reduction in the global burden of COPD associated with biomass smoke.”
COPD May Increase Risk of Mild Cognitive Impairment
Chronic obstructive pulmonary disease (COPD) may increase of the risk of contracting Mild Cognitive Impairment (MCI), an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. That is according to a recent study published in the March issue of JAMA Neurology, “A Prospective Study of Chronic Obstructive Pulmonary Disease and the Risk for Mild Cognitive Impairment.”
The study, which followed 1,425 cognitively normal individuals aged 70 to 89, used interviews and neurologic exams to identify the incidence of two types of MCI: amnestic MCI (A-MCI) and non-amnestic MCI (NA-MCI). A baseline was established at the beginning of the study, with interviews and exams occurring every 15 months thereafter.
Researchers found that nearly 25% of the study group developed some incidence of MCI. However, a COPD diagnosis significantly increased the risk for NA-MCI by 83%. In addition, researchers discovered that those individuals with a long-term COPD diagnosis were at the greatest risk of developing MCI, with patients who have a diagnosis of five years or longer being at the greatest risk of developing either form.
While little research has been done around the effect of COPD on cognitive impairment, researchers now believe that the blockage of airflow in COPD patients can lead to MCI. A progressive and treatable disease characterized by chronic limitation of the air ducts, COPD eventually leads to the development of hypoxemia and hypercapnia, as well as serious complications for patients.
Researchers note that these findings “highlight the importance of COPD as a risk factor for MCI and may provide a substrate for early intervention to prevent or delay the onset and progression of MCI, particularly NA-MCI.”
