Urban populations with a history of current or former drug use are at a greater risk of undiscovered obstructive lung diseases (OLDs), such as asthma and chronic obstructive pulmonary disease (COPD). That is according to recent research published in the International Journal of Chronic Obstructive Pulmonary Disease.
Due to race, behavioral and socioeconomic characteristics, urban drug users are at a higher risk of developing OLDs. However, OLDs are frequently unrecognized and under treated in this population. However, little data exists related to the prevalence and risk factors of OLDs in urban drug users.
Researchers out of Baltimore, Md., conducted a cross-sectional analysis of the Acquired Immunodeficiency Syndrome Linked to the Intravenous Experience (ALIVE) study, an observational study of current and former injection drug users among persons with HIV in Baltimore. Researchers then grouped ALIVE participants with spirometry-defined airflow obstruction by the presence or absence of a physician-diagnosed OLD. Further, regression models were used to identify independent risk factors of unrecognized OLDs.
While the urban population is a poorly studied group, research has found that there is an increased risk of human immunodeficiency virus (HIV) infection, which is associated with an increased prevalence of OLDs.
Of the 1,083 participants evaluated, 176 (16 percent) met the spirometric criteria for an OLD, while only 88 of those (8 percent) were diagnosed by a physician. Further, as severity of airflow obstruction increased, the prevalence of an unrecognized OLD decreased. Independent risks were identified as absence of respiratory symptoms and less severe dyspnea, while the use of antiretroviral therapy (ART) in the subset of HIV infected patients was also associated with an increased prevalence of unrecognized OLDs.
Through this analysis, researchers also looked to determine the characteristics associated with the lack of physician-diagnosed OLDs. However, it remains unclear what patient characteristics may be associated with unrecognized OLDs, especially in these high-risk populations.
Unavoidable factors in daily life, stress and anxiety can have a particularly negative effect on those suffering from chronic obstructive pulmonary disease (COPD). In particular, stress and anxiety can cause shortness of breath, cause COPD symptoms to become worse and lead to further anxiety, faster breathing and fear.
However, by developing effective ways to manage stress and learning to relax, you can help prevent shortness of breath and avoid panic. The Cleveland Clinic suggests the following techniques to effectively manage stress:
Learn to change thought patterns that produce stress. Your thoughts determine how you feel and how well you manage stress levels. By altering what you think, how you think, what you expect and what you tell yourself, stress can be properly managed.
Reduce causes of stress. By identifying major stressors in your life, such as money problems, relationship problems, grief, deadlines at work, a busy schedule or lack of support, you can avoid situations that trigger stress for you. Further, by practicing effective time-management skills, setting priorities, pacing yourself and taking time for yourself, you can resolve these issues. However, if you can’t resolve these stressors on your own, seek professional help.
Practice relaxation exercises. Simple to perform, relaxation exercises combine deep breathing, releasing of muscle tension and clearing of negative thoughts. Exercises include diaphragmatic and pursed-lip breathing, imagery, repetitive phrases and progressive muscle relaxation. If practiced regularly, these exercises can lessen the negative effects of stress. For more specific information on these exercises, commercial CDs and books are a valuable resource.
Delegating responsibility is an important stress management tool and an effective way to actively manage chronic obstructive pulmonary disease (COPD). Stress and anxiety can have a negative effect on the overall health of COPD patients, causing shortness of breath and a worsening of other symptoms, which can lead to further anxiety, faster breathing and fear.
By actively lightening the burden of responsibility, you can reduce stress levels at home and work and create more time for the activities you love. The key is to take a team approach to activities and involve all parties in sharing the load.
To modify stress levels and responsibility, The Cleveland Clinic health information website suggests applying the following guidelines to situations at home or modifying them to fit situations at work:
- Make a list of tasks involved in each job you are responsible for
- Take the time to train someone to handle specific jobs or tasks
- Assign responsibility to a specific person
- Give clear, specific instructions and deadlines
- Rotate unpleasant duties
- Be appreciative and let people know that you are pleased with a job well done
- Allow others to execute a task in their own way
- Give up being a perfectionist
Following these guidelines will allow you to actively manage stress levels and take control of your COPD and overall health. Remember, your family and friends are there to support you. By allowing them to help you with everyday activities, you will not only feel better but also have more time to spend with them doing the things you enjoy.
Emphysema and chronic obstructive pulmonary disease (COPD) patients may be at a higher-than-average risk for developing shingles, according to a recent study published in the Canadian Medical Association Journal.
A painful rash caused by the same virus that causes chicken pox, shingles (herpes zoster) is caused by a recurrence of the chickenpox virus, which hides in the body’s nerve tissue where it can become active again later in life. It is most common in people 50 years of age and older, as well as in those whose bodies cannot fight off illness as well as others. However, if people have not had chickenpox in their life, they are not at risk for shingles.
In the study, researchers examined nearly 8,500 COPD patients age 50 and older. They found on average that every year for 10 years, 16 of every 1,000 patients developed shingles. They compared this group to a group of nearly 34,000 COPD-free adults of the same age; in the COPD-free group, only nine out of every 1,000 adults developed shingles each year. When outside factors were considered, such as overall health and income, COPD was linked to a twofold increase in the risk of shingles.
Researchers believe this increased vulnerability is a result of the widespread inflammation in the body and the disruption of some parts of the immune system caused by COPD. These findings are concurrent with past studies that have linked other inflammatory conditions, like rheumatoid arthritis and inflammatory bowel disease, to a higher-than-average risk of shingles.
Like chickenpox, there is no cure for shingles. However, antiviral drugs can lessen symptoms and speed recovery, especially if they are taken soon after the rash appears. A one-time vaccine, called Zostavax, is also available and reduces the risk of developing the condition in the first place.
“Because shingles is frequently complicated with chronic pain, leading to reduced quality of life, we suggest COPD patients discuss with their doctor if they are appropriate for shingles vaccination,” said Dr. Ya-Wen Yang of Tapei Medical University, the lead researcher on the study, in a press release.
The U.S. Centers for Disease Control and Prevention estimates that one-quarter to one-third of adults will develop shingles at some point in their life. Of those, one-third of which will develop complications, most commonly long-lasting nerve pain that can go on for months or even years after the rash has healed.
According to a recent health interview survey conducted by the Centers for Disease Control and Prevention (CDC), deaths in U.S. related to chronic obstructive pulmonary disease (COPD) have increased much faster among women than men over the last 20 years, while women were also more likely to receive hospitalization or emergency room care due to COPD.
While experts question if this increase in COPD-related care may be due to the fact that women are more likely to report symptoms and seek professional help when health issues arise, a growing body of research suggests that women may be biologically more susceptible to developing lung-related illness.
According to a 2007 study published in the American Journal of Respiratory and Critical Care Medicine, women who smoke may be at a higher risk of developing COPD.
“Smoking-related lung diseases such as [COPD] and lung cancer are growing epidemics in women in the United States and elsewhere,” wrote study authors. “Although some of this disturbing trend in women can be attributed to changing smoking habits, there is emerging evidence that women may be biologically more susceptible to the harmful effects of cigarette smoke than are men.”
Researchers note that “estrogen and related compounds may up-regulate the expression of cytochrome P450 (CYP) enzymes in lungs and liver, which are involved in the metabolism of various constituents of cigarette smoke.” This metabolic process can transform harmless substances, such as the polycyclic aromatic hydrocarbon found in cigarette smoke, into toxic chemicals through metabolic bioactivation.
In another study, researchers from Harvard University and the University of Bergen in Norway found that women with COPD were younger when they were diagnosed and had smoked less than men with the chronic lung condition.
To decrease their risk of developing COPD, women should take the following steps:
- Quit smoking. According to the U.S. Department of Health and Human Services, women who smoke are 13 times more likely to die from COPD than women who do not.
- Avoid secondhand smoke. Secondhand smoke can be just as dangerous as smoking itself and should be avoided at all costs.
- Avoid lung irritants. These includedust, air pollution, paint sprays, chemical fumes and other airborne irritants, which can bother your lungs.
Women who are at risk of developing COPD, including those who currently smoke or have smoked in the past, should also ensure that regular lung screenings are a part of their healthcare plan. While there is no cure for COPD, early detection is key to managing the disease.
A recent survey on the impact of chronic obstructive pulmonary disease (COPD) has revealed substantive insight into the economic, social and personal impact of COPD for working-aged patients around the world. The survey, which was published in the peer-reviewed BMC Public Health Journal, reveals the true extent to which people with COPD experience a decrease in their overall level of savings and face a future of financial uncertainty.
The cross-sectional survey examined the lives of 2,426 participants, ages 45-67, from six countries (Brazil, China, Germany, Turkey, USA and UK). Participants were all diagnosed with COPD, had a smoking history of more than 10 years and were using COPD medications three months prior to completing the questionnaire.
The survey, COPD Uncovered: An Intentional survey on the impact of chronic obstructive pulmonary disease (COPD), reveals that:
- On average, COPD patients lose around $1,800 of their income each year as a direct result of their condition. This equates to a lifetime loss of nearly $20,000.
- Nearly 1 in 5 of 45-67 year olds with COPD are forced to retire prematurely due to their condition, thereby incurring increased healthcare utilization costs, reducing personal tax and pension contributions and increasing government disability costs.
- The impact of COPD on people’s earning power and overall income makes them concerned about its impact on their lives, and those of their families, and therefore their ability to maintain the same lifestyle as they had before.
While previous studies have attempted to highlight the financial burden of COPD, the authors note that direct costs only account for a portion of overall cost and past studies have not captured the full extent of the personal economic burden or the burden on society as a whole. The authors believe that publication of COPD Uncovered will help healthcare professionals and policy makers understand the true impact of the disease and raise awareness.
Hundreds of people suffering from chronic obstructive pulmonary disease (COPD) may have yet to be diagnosed with a genetic condition that causes severe hereditary emphysema, according to a recent study published in Respiratory Research.
The study, which was conducted by the Royal College of Surgeons in Ireland (RCSI), Beaumont Hospital and Trinity College Dublin, found that Ireland has one of the highest incidences in the world of this inherited condition known as alpha-1 antitrypsin deficiency (alpha-1).
The root of the most severe form of hereditary emphysema, alpha-1 is caused by a deficiency in alpha-1 antitrypsin, which protects the lungs from the harmful effects of cigarette smoke and bacterial infection. Patients diagnosed with alpha-1 typically develop COPD in their 40s and 50s and are prone to liver disease.
Thought to be a rare disease, alpha-1 is much more common than expected in Ireland, with one in 25 individuals found to be carriers, according to the study. These findings make alpha-1 the most common fatal inherited lung condition in Ireland after cystic fibrosis.
In its most severe form, alpha-1 is estimated to affect more than 2,000 people nationally, while 10,000 individuals are at increased risk for a less severe form of the condition and 170,000 individuals are carriers and may be at risk of developing lung disease, particularly if they smoke.
“Our study shows the prevalence of alpha-1 in Ireland is among the highest in the world and although a simple blood test is all that is required to diagnose this condition, over 90 percent of alpha-1 individuals remain undiagnosed,” said Gerry McElvaney, Professor of Medicine at the RCSI and senior author on the research in a recent article from the Irish Medical Times. “The importance of an early diagnosis of alpha-1 cannot be overstated, as the proper medical follow-up and lifestyle changes can help prevent or at least delay the development of lung and liver disease associated with this condition and greatly increase life expectancy.”
McElvaney and colleagues hope that the findings of this study will lead to increased awareness of the disease and earlier diagnosis.