COPD News Of The Day

 edited by Joan Costello

Volume 8, Issue 23
May 9, 2008

PENTAGON EFFORT AIMS TO REBUILD BODY PARTS
Eric Bland, Discovery. A new five-year, $250 million Defense Department
initiative aims to heal soldiers and civilians by using a patient’s own
cells to regenerate lost body parts, starting with skin and ending with
entire limbs. “Humans can regenerate ourselves, but only up to a certain
point,” said Anthony Atala, a doctor at Wake Forest University who is
involved in the new Army initiative, called the Armed Forces Institute of
Regenerative Medicine (more happily known as AFIRM).
“Army doctors already make use of existing regenerative medicine to help
heal soldiers wounded in battle. Using a human patient’s own cells,
scientists can regenerate simple tissues like skin, cartilage, bladders,
ears, noses, blood vessels and other body parts. Regenerating the heart,
lungs and entire limbs, however, becomes more complex, although promising
studies have already been done, including creating a beating rat heart in a
petri dish. The ultimate goal — a new arm or leg — is still many years
away, according to scientists, but eventually even these parts will be
regenerated. ”

Atala points out that all parts of the body have reserves of cells that can
regenerate when injury occurs. The idea is to take these cells and trigger
them to regenerate outside the body. The newly grown living cells can then
be placed over biodegradable material and shaped in the form of the missing
body part.One reason scientists are pushing so hard for regeneration
technology is that since the replacement tissue or organs are made from a
patient’s own cells, the risk of rejection is virtually nonexistent. It
takes six to eight weeks to regenerate the lost tissue, said Atala. Speeding
up that process is another goal of AFIRM. While the research is Army-funded,
civilians will also benefit from AFIRM.
http://dsc.discovery.com/news/2008/04/29/limb-regeneration.html

ALSO IN THIS ISSUE
-NO VENT, DNR, OR FULL CODE…?
-COMPUTER-CONTROLLED BREATH TRAINING MAY IMPROVE EXERCISE ABILITY
-PATIENTS WIN IN NEW AIRLINE RULING
-NEW DELPHI PORTABLE OXYGEN CONCENTRATOR
-DOCTORS HOPE STUDY WILL HELP PATIENTS WITH COPD
-RESEARCHERS CLAIM COPD MAY BE HEREDITARY
-SYNTHETIC LUNG COULD FURTHER ASTHMA RESEARCH
-MISTAKENLY SWALLOWING INHALER CAPSULES
-MISCELLANEOUS

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SOURCES: News items summarized in The COPD-NEWS are taken from secondary sources believed to be reliable. However, the COPD Family of Services does not verify their accuracy.
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NO VENT, DNR, OR FULL CODE…?
A lengthy article written by a respiratory therapist which may make you
rethink your Health Power of Attorney or Advance Directive.

The decision of whether or not you want to be placed on a ventilator, or
whether or not you want to make a decision for your loved one, is one of the
most difficult decisions one can make. In fact, this is the basis of some
very deep ethical discussions, and one of which may never be answered by
society, only by the person who has to actually make that decision. First
let us note here that a majority of patients who go on a ventilator do so
only for temporary purposes. If you have surgery, if you have severe asthma,
pneumonia, or failing heart, you may need to be placed on a ventilator short
term. If a person is involved in a trauma, or if CPR is performed, then a
person may be intubated and placed on a ventilator.

Those are easy decisions, especially when we are in emergent situations and
are trying to save a life. However, there are also times when the decision
to intubate or not to intubate can be complicated as complicated can get,
and very stressful, and often disappointing.

In some cases you can plan ahead and write in your advanced directives that
you do not want to be placed on a vent, however, sometimes I have seen this
declaration over-ruled at the point of impact when a person is in the
emergency room and they have to decide, “Do I want to risk dying now, or do
I want to let these good people here in the emergency room help me breathe
by placing a tube into my airway and assisting me with my breathing. Do I
want to do that? Do I want to allow them to place me on a ventilator?

Here I will provide some examples for you. All of these come from real life
examples as I have actually seen them in my eleven years as a registered
respiratory therapist.

One of the most frustrating examples to me is when a person has decided they
do not want to be placed on life support because “I don’t want to spend the
rest of my life on one of those,” or “because I don’t want to become a
vegetable.” In thinking this way, many people choose the following in their
advanced directives: Full Code and not Vent. I have to cringe when I see that. I cannot believe any lawyer or doctor would or advisor would recommend that option, because when a person’s heart stops, and we have to do CPR on the patient, we also have to pump in quite a bit of medicine, and 99.9% of
the time the patient does not survive a code breathing on his own: he has to
be placed on a ventilator. Thus, if we do CPR, we have to put you on a
vent — there is no other option. If you get CPR and live, you bought
yourself a vent, unless you are a DNR. However, if the people working on you
don’t know you are a DNR, you will end up on a vent regardless. However, I
do think the decision not to become a vegetable on a vent is a valid issue
for most people, one also has to consider the definition of a vegetable. Are
you a vegetable when you have no body, but your brain is fully functional as
would be the case with ALS (Lou Gehrig’s Disease) or multi system atrophy,
which is a disease my grandma suffered from at the end of her life, and is a
disease like ALS in that the person loses control of his muscles and
basically becomes a brain without a body. Some people might value life so
much that they would want to live so long as they have control of their
brain. That was my grandmas wishes, and I totally understood those wishes,
as she loved life and wanted to continue on as long as she could.

More examples at:
http://respiratorytherapycave.blogspot.com/2008/05/no-vent-dnr-or-full-code-whats-your.html

COMPUTER-CONTROLLED BREATH TRAINING MAY IMPROVE EXERCISE ABILITY
Computer-controlled breath training may improve the ability to exercise for
patients with COPD. Exercise-induced dynamic hyperinflation is a major
contributor to decreased exercise tolerance in COPD. The technique involves
learning to slow down breathing to prevent the dynamic hyperinflation of the
lungs that is a major contributor to decreased exercise tolerance. In a
randomized controlled trial, the so-called ventilation feedback combined
with exercise allowed patients to exercise for 40 minutes on average,
compared with 31.5 minutes for those who had only exercised and 16.1 minutes
for those who had only used ventilation feedback, Dr. Collins and colleagues
reported in the April 15 issue of the American Journal of Respiratory and
Critical Care Medicine…(T)he technique, once learned, continued to have an
effect on breathing patterns during exercise, the researchers said. “COPD is
a double-edged sword,” Dr. Collins said. On one hand, exercise is rendered
difficult, while on the other hand, the most effective intervention is
simply exercise, she said. Patients with the worst disease are likely to be
unable to exercise long enough for the workout to benefit them, Dr. Collins
said, mainly because dynamic hyperinflation “diminishes the patient’s
breathing efficiency.”
http://www.medpagetoday.com/Pulmonary/SmokingCOPD/tb/9125

PATIENTS WIN IN NEW AIRLINE RULING
Oxygen patients will have easier travel, thanks to a new ruling by the U.S.
Department of Transportation (DOT) that says airlines must accept certain
approved portable oxygen concentrators onboard flights.

These are the concentrators approved by the DOT that patients may carry
aboard aircraft.
AirSep FreeStyle
AirSep LifeStyle
Inogen One
Respironics EverGo
Sequal Eclipse

AARC was a major player in the effort to get a nationwide ruling that would
require air carriers to board passengers with any of the DOT-approved
concentrators. AARC joined with other groups in the Airline Oxygen Council
of America (AOCA), which spearheaded the effort to ease access to medical
oxygen for passengers. Other organizations in the AOCA include the Alpha-1
Foundation and the U.S. COPD Foundation. “For a couple of years now,
airlines could choose whether to allow DOT-approved oxygen concentrators and
many chose not to,” said Cheryl West, director of government affairs. “This
ruling makes it mandatory for all airlines to let patients aboard with their
approved devices.”

Miriam O’Day, who heads the AARC’s legislative efforts in Washington DC, was
a key player in the fight to get a mandatory ruling from the DOT. O’Day
represented the AOCA’s positions to the DOT. “This is great news for the
patients who must travel with oxygen,” she said. “Travel will be so much
more accessible and convenient for them. It’s safe, it’s secure and it opens
many possibilities for those who have been reluctant to travel in the past.”
The rule will apply to U.S. air carriers worldwide and to foreign air
carriers whose flights begin or end in the U.S. The new rule takes effect in
one year to give airlines time to implement the regulation. You can read the
final rule at www.regulations.gov, docket number DOT-OST-2004-19482.
http://www.aarc.org/headlines/08/05/airline_ruling.cfm

NEW DELPHI PORTABLE OXYGEN CONCENTRATOR
I have no interest in this company and my only purpose in giving them space
is informational.

Delphi Medical Systems, a subsidiary of Delphi Corp. is introducing its new
portable oxygen concentrator, the Central Air, which can help patients gain increased freedom and independence by providing exceptional durability in a lightweight package. Delphi also announced that it has entered an exclusive
agreement with evo Medical Solutions to distribute the device in North
America for millions of adults who require supplemental oxygen treatment
after being diagnosed with COPD. Currently, the device has 510(k) clearance
from the U.S. FDA.

Delphi’s design delivers concentrated oxygen in a compact size and
convenient format, and boasts the smallest footprint and package size in its
class. Measuring under a foot high and weighing less than 10 pounds, the
unit allows premium portability so that patients can participate in more
mobile lifestyles. The unit features a patented Delphi process that
separates oxygen from room air using a unique PSA (pressure swing
adsorption) cycle made practical for the first time with the use of Delphi’s
advanced electronics control capabilities. This design results in improved
durability. Delphi’s exclusive rotary compressor technology and design also
enables the device to operate with less vibration than conventional
compressors…the device contains several options for power so that users
can conveniently access oxygen from most locations. It can be powered by the
included conventional AC power supply or rechargeable battery, or via DC
power, such as an automotive 12-volt power receptacle. Included accessories,
such as a carrying case and pull cart, increase the device’s versatility and
allow patients to move around more readily by providing a means for safe and
easy transport. The carrying case features a shoulder strap, a fabric
enclosure and a clear protective cover that allows access to the control
panel. With the Delphi custom fold-up cart, which features large easy-roll
wheels, users can simply pull the concentrator along wherever they go. The
Central Air is available now and will be distributed in the U.S. exclusively
through evo Medical Solutions’ nationwide network. evo’s president.
http://www.marketwire.com/mw/release.do?id=852574

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COMMERCIAL FREE: We do not accept any paid advertising. Any corporations, products, medicines (prescription or non) mentioned in this newsletter are for informational purposes only and not to be construed as an endorsement or condemnation of same.
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DOCTORS HOPE STUDY WILL HELP PATIENTS WITH COPD
So far, treatments (for COPD) can control symptoms, but local researchers at the University of Pittsburgh are trying to figure out how to keeping the
disease from worsening…the condition makes it hard for people to get air
in or out of the lungs. As a result, oxygen can’t get into the blood stream,
and symptoms can worsen over time. “More short of breath, more cough, to the
point where they were near incapacitated, they were bed bound,” said Dr.
Steven Duncan, a lung specialist at UPMC. “Ideally, we’d like to get
somebody before they get to that stage.”

Doctors say the most common cause is cigarette smoking. “How much is
autoimmunity versus how much is the effect of the cigarette itself versus
how much is due to effects of infection, we don’t know,” he adds. “We think
the autoimmune response is somewhat substantial.” Because of their findings,
the doctors say they are looking for patients to take part in another study,
to see if drugs to suppress the immune system can stop the lung damage. “We
have no expectation that it will reverse disease, but again, even if we
could stop progression, that would be a wonderful thing.”

But not everyone agrees that COPD is an autoimmune disease. Other
researchers say they are waiting for the results of studies in people, and
not just the proteins found in a lab to give them a clearer picture.
http://kdka.com/seenon/COPD.health.research.2.705329.html

RESEARCHERS CLAIM COPD MAY BE HEREDITARY
It follows findings that siblings of COPD patients have a much greater risk
of developing the disease than spouses. Although smoking is known to be the
most common cause of COPD, previous studies have suggested that there may be
a genetic element. Data on over 14,000 patients who had been hospitalized
for COPD in Sweden from 1986 to 2004 was analyzed for the study. In this,
604 affected siblings were identified. Standardized incidence ratios (SIRs)
of COPD among siblings, twins and spouses were also calculated. Overall, the
risk of COPD was found to be much higher in siblings (SIR of 11.87) than in
spouses (SIR of 1.6).
http://www.healthcarerepublic.com/news/GP/804060/Researchers-claim-COPD-may-hereditary/

Familial risks for COPD among siblings based on hospitalizations in Sweden,
the study at:
http://jech.bmj.com/cgi/content/abstract/62/5/398

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MEDICAL DECISIONS. Your physician should be consulted on all medical
decisions. New procedures or drugs should not be started or stopped without
such consultation. While we believe that our accumulated experience has
value, and a unique perspective, you must accept it for what it is…the work of COPD patients. We vigorously encourage individuals with COPD to take an active part in the management of their disease. They do this through education and by sharing information and thoughts with their primary physician and pulmonologist. However, medical decisions are based on complex medical principles and should be left to the medical practitioner who has been trained to diagnose and advise.
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SYNTHETIC LUNG COULD FURTHER ASTHMA RESEARCH
UK researchers have started developing a ‘lung in a test tube’, that could
aid research into respiratory diseases such as asthma and allergy and reduce
the need for animal testing. The artificial airway is made using tissue
engineering, with layers of the epithelial cells that make up the airway
tissue grown inside a microfluidic device. The device is modified to allow
lung cell growth by coating the inner surface with a membrane that will
allow access to both sides (the ‘air’ and ‘blood’ surfaces) of the cells.

“The device will allow researchers to fully understand how lung function is
affected by air particles and allergens and to test their effects without
animal testing,” said the researchers, from the University of Southampton.
In the UK, respiratory diseases account for 25 per cent of all medical
admissions to hospital, and the majority are due to bronchial asthma or
COPD…Unlike other disease areas such as cardiovascular where there have
been significant new therapeutic treatments, COPD and asthma have not
benefited from any recent major breakthroughs, according to Davies.

Last year, researchers from the University of Michigan in the US led by
Shuichi Takayama unveiled a similar research effort - dubbed the ‘lung on a
chip’ - that is designed to allow lung epithelial cells to grow in an
environment more similar to the body. Their research, published in the
Proceedings of the National Academy of Sciences, found that the chip would
allow lung cells to behave in ways not seen petri dishes, such as forming
tissue connections and adopting ‘normal’ protein secretion patterns.
http://www.labtechnologist.com/news/ng.asp?n=84971-university-of-southampton-microfluidics-asthma-copd

MISTAKENLY SWALLOWING INHALER CAPSULES
FDA has issued an advisory about the danger of mistakenly swallowing Spiriva(tiotropium bromide inhalation powder) and Foradil (formoterol fumarate
inhalation powder) inhalation capsules. These capsules are intended to be
used with inhalation devices to treat patients with asthma and COPD.

FDA and the American Association of Poison Control Centers have received
many reports of patients swallowing these capsules. This may occur because
the capsules resemble those taken by mouth. Not many patients have suffered
side effects from swallowing the capsules, but their respiratory problems
will not be treated if the drugs are taken orally rather than inhaled.

Do not swallow Spiriva or Foradil capsules. The capsules should be removed
from the blister pack and placed in the inhalation device - for Spiriva,
it’s the HandiHaler, and for Foradil, the Aerolizer. If you swallow it you
will not get the benefits of it.

Additional Information: FDA MedWatch Safety Alert. Spiriva (tiotropium
bromide inhalation powder) Capsules Foradil (formoterol fumarate inhalation
powder) Capsules.
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Spiriva

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MISCELLANEOUS
How’s your typing?
From Kim Komando’s Cool sites. http://www.komando.com/coolsites/
Studies have shown that computer games have unexpected benefits. For example, they can improve a surgeon’s coordination. Well, most of us will
never be a surgeon. But you can still refine your skills through computer
games. So, if you’re looking for a guilt-free game, try Typeracer. As you
can probably guess, it is a racing game that involves typing. It’s perfect
for hunt-and-peck! Begin by practicing your typing skills. You’ll be given a
passage to type. When you’re done, you’ll see how fast you type. When you
gain confidence, you can race others. It’s a fun way to brush up your typing
skills!
http://play.typeracer.com:80/

Assemble a skeleton
http://www.bbc.co.uk/science/humanbody/body/factfiles/skeleton_anatomy.shtml

Eagle Eyes
Do you have eagle eyes? Small changes in photographs can be difficult to
see. Unless you really study a photograph, you may miss them. Of course,
spotting differences in pictures is a popular child’s game. And it is a good
way to teach children to be attentive to life’s details. With that in mind,
check out Eagle Eyes. It’s a game developed by Audubon and the Cornell Lab
of Ornithology. You’re presented with five groups of two photographs. You
have to spot five differences in between the photos in each group. It’s
easier than it sounds. As you may have guessed, the photos are mostly of
birds. The photos themselves are impressive.
You can choose from several timed versions of the game. Or, you can play
without time restrictions. Good luck, eagle eyes! You will be scored! 20
seconds is not enough. Allow yourself as much time as you can.
http://audubon.org/gbbc/game/index.php

Not Quite A Shot In The Dark
This is a shooter game. However, you’re not aiming at people. Rather, you’re
aiming at enemy outposts. The non-line-of-sight cannon used in the game
simulates military technology. It is the future of U.S. field artillery.
http://dsc.discovery.com:tv/future-weapons/games/cannon/cannon.html

Printable Paper…Need a special type?
http://www.printablepaper.net/

Until next Friday,

Joan Costello, Editor
Jadece@rcn.com

Web version of the News: http://copd-support1.com/news.html
Archives at: http://home.ease.lsoft.com/archives/copd-news.html

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How should you eat as you get older? Which foods are likely to keep you most healthy and which ones should you limit? Is it possible to eat well and stay within a healthy weight? These and other questions are addressed in “Eating Well as You Get Older,” the latest topic to be added to NIHSeniorHealth, the health and wellness Web site developed by the National Institute on Aging (NIA) and the National Library of Medicine (NLM), both part of the National Institutes of Health.

“Eating well is vital at any age, but as you get older, your daily food choices can make an important difference in your health. Good nutrition is one component of an overall strategy to stay healthy,” says Richard J. Hodes, M.D., director of the NIA, which developed the content for the topic on NIHSeniorHealth. Eating a well-planned, balanced mix of healthy foods every day may help prevent heart disease, type 2 diabetes, bone loss, some kinds of cancer, and anemia.

However, eating healthy may not always be easy for older adults. Changing appetites, slower metabolism, eating alone, buying ready-to-eat meals, and living on a fixed income can affect the quality of one’s food choices. Yet our need for healthy foods does not diminish with age. As we age, our bodies still require essential nutrients to help us maintain function, and most of those nutrients are found in foods.

“It is important for older adults to select foods that provide them with the nutrients and energy they need for healthy, active living,” says Dr. Hodes. “NIHSeniorHealth is a valuable source of information on this important issue.” In addition to learning how to make wise food choices, older adults who visit http://nihseniorhealth.gov/eatingwellasyougetolder/toc.html will find information about food labels, food safety, meal planning, food shopping, and ways to enhance the enjoyment of eating.

One of the fastest growing age groups using the Internet, older Americans increasingly turn to the Internet for health information. In fact, 68 percent of online seniors surf for health and medical information when they go on the Web. NIHSeniorHealth, which is based on the latest research on cognition and aging, features short, easy-to-read segments of information that can be accessed in a variety of formats, including large-print type sizes, open-captioned videos and even an audio version. Additional topics coming soon to the site include Parkinson’s disease, complementary and alternative medicine, and leukemia.

The NIA leads the federal effort supporting and conducting research on aging and the health and well being of older people.

The NLM, the world’s largest library of the health sciences, creates and sponsors Web-based health information resources for the public and professionals.

The National Institutes of Health - The Nation’s Medical Research Agency - is comprised of 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov

 Here’s some great information if you’re considering a trip ( I’d like to go to Disney World. And Arizona…)

Test Predicts COPD Patients’ Response to Travel

Results on the hypoxia inhalation test (also known as the hypoxia altitude simulation test) predict how patients with chronic obstructive pulmonary disease (COPD) will respond during air travel, researchers from New Zealand report in the April issue of Chest.

Lead investigator Paul T. Kelly of Christchurch Hospital told Reuters Health, “Air travel will cause significant desaturation in passengers with COPD, which will be worsened by in-flight activity such as visiting the lavatory.”

Kelly and his colleagues performed preflight respiratory function tests on 13 volunteers with COPD who were planning to take commercial flights for their own purposes. Physiologic parameters were measured while subjects were airborne, and the hypoxia inhalation tests were done after the flights.

Mean altitude during the flights was 2165 m. Participants did not use oxygen, and no adverse events were recorded. However, oxygen saturation fell from 95% before the flight, to 86% during the flight, and to as low as 78% during onboard activity.

Hypoxia inhalation tests conducted an average of 2 weeks after the flight had similar results, with a mean oxygen saturation value of 84%. Subjects’ mean partial pressure of inspired oxygen was significantly higher during the flights than on the hypoxia inhalation tests (113 versus 107 mm Hg), suggesting that oxygen saturation values on the test have the closest correlation with the in-flight values.

“We found that simulating the aircraft environment in the laboratory using a low inspired oxygen gas mix was the best test to predict in-flight response in this group of passengers,” Kelly said.

read the complete article by following this link - and however you decide to get there, Bon Voyage!

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The need for meaningful health care reform remains one of the hottest topics in the public as we approach our national election. An important new study, in the prestigious Annals of Internal Medicine, reveals a growing consensus among practicing physicians that our broken health care system would be best fixed by legislation establishing national health insurance (NHI).

Researchers at Indiana University, in a study of randomly chosen physicians representing the total population of U.S. physicians across all specialties, found a shift in the thinking over the past five years. Now a solid majority of doctors, almost 60 percent, support government legislation to establish NHI — a 10 percent increase in support since 2002.

In another indication that doctors’ attitudes are changing, in December 2007 the nation’s largest medical specialty group, the 124,000-member American College of Physicians, endorsed a single-payer NHI program for the first time.

NHI plans typically involve a single-payer federally administered social insurance fund that guarantees health care coverage for everyone, much like Medicare provides for seniors. Such plans allow patients to go to the doctors and hospitals of their choice, but eliminate or substantially reduce the role of private insurance companies in the health care financing system.

This growing consensus is one more indication that physicians are increasingly rejecting the “marketplace medicine” that has eroded the American value of caring for and supporting one another and that has frustrated our traditional professional ethics. It is in no doubt connected to the daily witnessing of the suffering caused by inequities in health care delivery as well as the waste and inefficiency associated with a private insurance industry that consumes 31 percent of every U.S. health care dollar on bureaucratic paperwork and overhead.

As doctors, we see more and more of our patients experiencing a deterioration in the quality of their employer-based coverage, or losing such coverage altogether, often leading to their financial ruin. Families USA now estimates that one working-age Washingtonian dies each day because of lack of health insurance. In Washington we waste $5.2 billion on excess administrative expenses, more than enough to cover our 746,000 uninsured. Surely we can and must do better.

Click Here to read this article in its entirety

Please visit my website COPD and So Much More

Visit the COPD and So Much More bookstore

OCEAN VIEW, Hawaii (AP) — For eight years, Tony and Sam Bayaoa have grown thousands of bright red, yellow and pink protea flowers on their farm. Then in March, Kilauea volcano opened a new vent and began spewing double the usual amount of toxic gas.

Now about 70 percent of their crop is dried, brown and brittle.

“The first reaction was — did someone poison the plants?” said Tony Bayaoa, whose two-acre farm is 35 miles from the volcano. “I’ve lost my livelihood.”

Big Island crops are shriveling as sulfur dioxide from Kilauea wafts over them and envelops them in “vog,” or volcanic smog. People are wheezing, and schoolchildren are being kept indoors during recess. High gas levels led Hawaii Volcanoes National Park to close several days last month, forcing the evacuation of thousands of visitors.

Residents of this volcanic island are used to toxic gas. But this haze is so bad that farmers are thinking about growing different crops, and many people are worrying about their health.

to read the remainder of this article follow this link