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Developing a Diagnostic Breath Test
Paramedics responding to 911 calls often find themselves in a situation where a patient is having difficulty breathing. Here they must ask themselves: is this patient suffering from acute emphysema or heart failure? While both have similar symptoms, initiating improper treatment may cause severe complications.
Researchers from Massachusetts Institute of Technology’s Research Laboratory of Electronics and Harvard Medical School recently teamed up to develop an algorithm that can be used to help determine, with high accuracy, whether a patient is suffering from emphysema or heart failure.
A capnograph, a piece of equipment used in every ambulance, uses readings that measure the concentration of carbon dioxide in a patient’s exhalations after a breathing tube is inserted. Over time, physicians observed that the capnograms of patients with congestive heart failure and emphysema were subtly but consistently different both from each other and from those of healthy subjects.
The algorithm the research team has developed uses the data the machine yields to look for correlations between the patients’ capnograms and their final diagnoses. Through the use of the algorithm, the team was able to distinguish both emphysema patients from those with congestive heart failure and healthy subjects from those with emphysema.
Currently, the team is testing the algorithm with paramedics in the field and evaluating whether capnography can measure the severity of asthma attacks and the degree of sedation in patients undergoing medical procedures.
Click here to access the full story at MIT Technology Review
Results of Costly Emphysema Operation Are Mixed, Study Finds
The widely promoted lung volume reduction surgery that promises to help ease symptoms of severe emphysema and chronic obstructive pulmonary disease (COPD) may not provide all the benefits that are expected, including prolonged life. Although the study found that participants reported improved symptoms, the research team from the National Heart, Lung and Blood Institute and the Centers for Medicare and Medicaid Service, deemed the procedure high risk, as surgical patients had a higher death rate after 90 days than those who did not have the operation.
The study’s findings are of importance because they are aiding in the United States government’s decision to have the procedure covered by Medicare for those patients age 65 and older. Currently, Medicare does not pay for the operation, which costs about $60,000, a large price tag for the risk incurred.
About a quarter of study participants saw significant symptom improvement, some even able to go for walks and exercise, but Dr. Gail Weinmann, project officer at the National Heart, Lung and Blood Institute and sponsor of the study, warns that the effects of the surgery vary widely among patients. Additionally, she noted that after 36 months the death rate was 20 percent in those who underwent the procedure.
''This is the kind of information patients should know when they are thinking about whether they should have treatment,'' said Dr. Weinmann. “It is not a procedure for everyone.”
Dr. Sean Tunis, chief medical officer of the Centers for Medicare and Medicaid services added that Medicare would probably make a coverage decision in 30 to 90 days.
Nutrition Treatment in Hospitalized COPD Patients Shows Improved Health Outcomes
The results of a recent study showed reduced hospital costs, lengths of stay and chances of returning to the hospital within 30-days for patients suffering from chronic obstructive pulmonary disease (COPD) who were receiving oral nutritional supplements.
Researchers from Harvard Medical School wanted to determine the link between poor nutrition and those most likely to have the disease, seniors. Poor nutrition constitutes the insufficient intake of adequate calories and protein for maintenance and growth. Study participants included those individuals aged 65 and older, on Medicare, who had been admitted to the hospital with a primary diagnoses of COPD.
Since Medicare will be raising its maximum penalty for hospitals that have too many patients readmitted within 30-days, the research team found it beneficial for both patients and physicians to include this in the study.
The results revealed a reduction in participant length of stay by 1.88 days (21.5 percent) and total hospital costs by $1,570 (12.5 percent) on average, compared to those who did not receive nutrition treatment. Additionally, those participants who received oral nutrition treatment had a 13.1 percent reduction in 30-day readmission.
"Our findings suggest that screening seniors in the hospital for malnutrition risk and providing cost-effective treatment for those who are malnourished or at risk, can have a positive health impact on outcomes," said Julia Thornton Snider, Ph.D., at Precision Health Economics and lead author for the study.
Research Shows Vitamin D Reduces Lung Disease Flare-ups by Over 40%
Researchers from Queen Mary University of London found that vitamin D supplements have the ability to reduce chronic obstructive pulmonary disease (COPD) flare-ups in vitamin D deficient patients.
Affecting over 65 million people worldwide, the World Health Organization estimates that nearly 5% of all deaths globally can be attributed to COPD, leading Queen Mary University researchers to create a randomized trial that investigated the affect vitamin D supplements had on individuals suffering from the disease.
Published in the journal Lancet Respiratory Medicine, researchers studied 240 COPD patients, with symptoms ranging from mild to severe. Half of participants were given a vitamin D supplement and the remaining participants received a placebo supplement.
The results of the study indicated that patients with a vitamin D deficiency benefited from taking the supplements, having dramatically fewer flare-ups with reduced severity and duration. Those without a vitamin D deficiency did not see the same results.
“Our findings suggest that patients with COPD should have their vitamin D status tested and should begin taking supplements if their levels are found to be low” said Professor Adrian Martineau, Lead Author, Queen Mary University of London. “Our research has shown how an inexpensive vitamin supplement can significantly reduce the risk of flare-ups for patients who are vitamin D deficient, which could have a major public health benefit.”
New Stem Cell Research Offers Insights into Novel Emphysema Therapies
A new study published in Respiratory Research, studied the impact of different mesenchymal stem cells (MSCs) in the treatment emphysema. Results indicate that lung and cardiovascular damage in research mice was reduced based on various types of MSC injections.
Researchers, who induced emphysema in mice, aimed to determine if injection of MSCs into various points of delivery, both intra-tracheal and intravenous, would reduce the lungs’ alveoli from becoming enlarged. This enlargement is often accompanied by a decrease in pulmonary regeneration, which can lead to chronic obstructive pulmonary disease (COPD).
The study found that after the mice had been injected with stem cells from bone marrow, adipose and/or lung tissue, there were “increased elastic fiber content and reduced alveolar-capillary membrane,” which allows for the regeneration of damaged lung and cardiovascular tissue.
Although the study results illustrate the benefits of stem cell use in induced emphysema, the experiment has not been conducted on humans and there currently is not have a timetable for doing so. However, researchers expect to conduct further research comparing the effects of different MSC sources and routes of administration in an effort to increase therapeutic measures.
Technology Company Gives COPD Patients a Lifeline with New Gadget
Philips, a healthcare, consumer lifestyle and lighting technology company, has released a wearable health tracker that is helping chronic obstructive pulmonary disease (COPD) patients record biometric data associated with the disease that can be accessed from the patient’s mobile device.
HealthPatchMD is attached to a disposable, adhesive bandage that is applied to the chest to monitor “physical activity and inactivity, respiratory function, heart rhythm, and heart rate variability.” Patients can then access the data collected through two cloud-based apps: Philips eCareCompanion and eCareCoordinator, “making it possible for doctors to monitor patients remotely.”
Jeroen Tas, CEO of the Philips Healthcare Informatics Solutions and Services business group, states that this new device will help patients stay ahead of the curve if their symptoms begin to worsen. "If you have a chronic condition, then leveraging mobile technology with really low cost sensors... [and link] that through real-time data analytics into a care setting, you can develop completely new propositions," says Tas.
The device is expected to be available in early 2015. Philips has indicated that it is just the beginning of what will be a trend toward innovative technology for remote monitoring for long-term, chronic illnesses like COPD.
A video is available from Philips, presenting the new system.
Protein Therapy Successful in Treating Injured Lung Cells
The most recent effort to find a treatment for those suffering from chronic obstructive pulmonary disease (COPD) and other debilitating lung conditions has shown success in repairing lung tissue in preliminary animal testing. According to an article in Medical Xpress, cardiovascular researchers at The Ohio State University Wexner Medical Center have successfully used a protein known as MG53 to treat acute and chronic lung cell injury.
The study compared control animals that lacked MG53 to those treated with the genetically human form of MG53. The former were more susceptible to lung injury while animals treated with the protein showed signs of lung cell protection.
Jianjie Ma, a professor and researcher in Ohio State's Department of Surgery and the Dorothy M. Davis Heart & Lung Research Institute, first identified MG53 in 2008. He has since focused his energy on using this cell biology to treat and repair lung injuries in a variety of forms – including COPD.
According to the American Lung Association, approximately 36 million Americans live with some form of chronic lung disease, and cite the potential benefits from a protein therapy that targets cell repair.
Ma emphasizes the importance continuing research, saying MG53, if found to work in humans, “could be used prior to surgeries to prevent damage and promote healing. It could be used in an emergency department, by paramedics or on the battlefield to treat traumatic injuries. We are hopeful as we now work to begin our clinical trials.”
Ma adds that “the implications for patient care could be quite significant; it could prevent and repair heart and lung cell damage,” a welcome possible treatment for those suffering from the lung damage associated with COPD.
COPD Treatment Shows Significant Success with Smartphone Application
Patients suffering from asthma and chronic obstructive pulmonary disease (COPD) can now get support from a new smartphone application. Offered through the Arizona Care Network, a physician-led group that has partnered with more than 10 hospitals, the app lets sufferers electronically transmit their condition data to clinicians for more effective COPD control via a connected device.
As highlighted in Health IT Outcomes,this new mobile health technology lets patients monitor their condition and interact with their physician to improve treatment for a disease that often benefits from close clinician observation.
The solution, called Propeller, is a small device that attaches to the top of the patient’s existing inhaler and tracks their medication use by recording the time and place it was used. The data collected, along with immediate and customized feedback, can help patients better understand and manage their asthma or COPD.
Many experts recommend that COPD patients keep track of their symptoms, triggers, and medications. However, many COPD patients have trouble remembering to update a diary so it can become an inaccurate and incomplete record of respiratory health over time. Because Propeller’s data can be easily shared with physicians, patients have the ability to review the data with their clinicians during office visits and physicians can use the information to remotely monitor symptoms and determine when a change in therapy may be needed.
The application offers several treatment options ranging from daily therapy to early intervention in an effort to prevent emergencies. Treatments can also be customized to each patient’s needs based on the data collected.
Helping COPD and asthma sufferers better manage and control their condition can lead to reduced healthcare costs, the prevention of unnecessary hospital visits and allow sufferers to control their condition while maintaining a higher quality of life.
Managing COPD in the Summer
With summer upon us, it is imperative that individuals suffering from emphysema andchronic obstructive pulmonary disease (COPD) know how to manage their symptoms in hot and humid weather. An article from the Lung Institute provides helpful tips on dealing with potential hazards associated with the heat of the summer that can make normally enjoyable outdoor activities intolerable for those with COPD.
Higher temperatures require your body to go into overdrive to maintain a regular temperature. That is true for even the healthiest individuals. The harder your body works, the more oxygen it needs, which in turn makes breathing more difficult. The following recommendations can help COPD sufferers better tolerate summer’s heat and humidity:
Stay Indoors: By limiting time outdoors, the body is able to more easily maintain a temperature of 98.6, which helps regulate breathing and limits the potential to become short of breath. The Lung Institute also suggests that if you do not already own a portable air conditioning or air filtration system it may be beneficial to invest in one.
Stay Hydrated: Proper hydration is essential for regulating body temperature. It is suggested that you drink eight full glasses of water each day on average. It is also be a good idea to carry a thermos or water bottle to ensure that you stay hydrated throughout the day.
Allergy Awareness: During summer, many plants and allergens exacerbate COPD, especially asthma. Be aware of which affect you and talk to your doctor about selecting allergy medications or inhalers that will best support your breathing in the summer heat.
Combat Humidity: Be aware of your location. Many areas are prone to excessive heat and humidity, making it even harder to breathe. Purchasing a small humidifier for your home and bedroom can drastically improve the ability to breathe.
Finally, remaining active is crucial to maintaining a healthy, positive lifestyle and may reduce shortness of breath. So if the summer months require you to stay indoors on days that are too hot or humid, find alternative ways to stay active.
Pulmonary Rehabilitation Life-Changing for Many COPD Sufferers
Many chronic obstructive pulmonary disease (COPD) patients could see a return to normalcy through pulmonary rehabilitation, according to article in Medical Xpress “COPD patient returns to active lifestyle thanks to pulmonary rehabilitation.”
The article, which explores the success of the UK Healthcare’s Pulmonary Rehabilitation Clinic in reducing breathlessness for patients, takes a look how this program positively affected life-long scuba diver and recently diagnosed COPD patient, Mike Graham.
After only nine weeks in the program, Graham shares that his progress has allowed him to return to many of his beloved activities, including walking out to his pasture, an activity which was previously “out of the question.”
Affecting over 24 million Americans, COPD is the number 5 killer in the United States. Pulmonary Rehabilitation Program director Dr. John McCormick describes COPD patients in their program as already having “seriously compromised lung function” with many individuals “reliant on supplemental oxygen.” However, Dr. McCormick claims that “pulmonary rehab can be the lifeline that returns sufferers to a fuller life.”
The magic of the program relies on the interdisciplinary team of pulmonologists, nurses, exercise physiologists, dietitians and lifestyle therapists, who together “help patients restore strength and endurance, reduce disease symptoms, and self-manage common complications.” These life-saving measures also decrease symptoms of depression and anxiety for those patients who have already completed the program.
Aside from the physical benefits of the program, there are also financial benefits. Due to the decrease in post-rehab COPD symptoms, program participants require less care in the future and most pulmonary rehabilitation programs are covered by insurance.
Like Dr. McCormick, Graham insists the success of the program relies on the staff that has educated him on his condition, motivated him to quit smoking, and constantly encouraged him during his training. Dr. McCormick also attributes program success to the patient care that goes beyond the walls of the facility, taking the patients on field trips. Graham reflects on one trip in particular to a local grocery store for a hands-on tutorial on reading nutrition labels and making healthy food choices.
Graham, who has now returned to scuba-diving, credits the program and its positive impact for changing his life. He now volunteers with the National COPD Foundation for a program that pairs newly-diagnosed sufferers with mentors like himself who are able to offer advice and encouragement.
