Entries in Lung Disease (8)


Thalidomide May Help Patients with Deadly Lung Disease

Stockbyte/Thinkstock(NEW YORK) -- For Diane Gwartney, every waking minute was a battle against the urge to cough.

"Just try to imagine coughing all day long until it hurts your ribs," said Gwartney, a 72-year-old retired English professor. "Trying to conduct a class while you're coughing is difficult and embarrassing."

William Chambers, a 62-year-old businessman, also had a severe cough. His was so troubling, he recalled, "that I would arrange my schedule so I wouldn't have to talk so much anymore...even dinner conversation would be embarrassing."

Gwartney and Chambers both thought they had a lingering cases of bronchitis before extensive testing traced their coughs to idiopathic pulmonary fibrosis (IPF). It's a disease that kills an estimated 40,000 people every year -- about as many people as breast cancer does.

Now, a new study out of Johns Hopkins University School of Medicine suggests that the key to improving the lives of patients with IPF may be a drug with an infamous history -- thalidomide.

Marketed in the 1950s by a German-based company, Gruenenthal, for the treatment of morning sickness in pregnancy, thalidomide was linked to more than 10,000 often horrific cases of birth defects worldwide. Many children were born with improperly formed limbs, bones and internal organs.

The drug was finally withdrawn in 1961, and Gruenenthal recently issued an apology for the drug's harmful effects in late August.

But since it was withdrawn from medical practice more than half a century ago, thalidomide has been attracting attention from doctors as a possible treatment for a broad range of disorders, such as multiple myeloma, leprosy, and Crohn's disease.

The small trial from Johns Hopkins, published Monday in the Annals of Internal Medicine, hints that thalidomide may be effective in improving the lives of IPF patients as well -- a group for whom good news has been in relatively short supply.

IPF is a progressive, often fatal lung disease affecting people over the age of 40, in which normal lungs begin slowly to become stiff and scarred over time. It currently has no known cause and no cure short of a lung transplant. The average survival after diagnosis is three to five years, and up to 80 percent of patients experience a debilitating cough.

Thalidomide does not appear to treat the disease itself, but it may make it much more bearable.

Gwartney and Chambers enrolled in the Johns Hopkins study hoping for some sort of relief. They were among 20 IPF patients who were given thalidomide or a placebo for three months and asked to report their symptoms and quality of life.

All of the patients were then switched from thalidomide to placebo or vice versa for another three months, and asked to report how they did.

The researchers found that in patients taking the drug, frequency of coughing decreased by about 63 percent on average. The patients' quality of life -- in other words, their ability to do daily activities -- improved by about 20 percent.

"What is exciting about the trial for me is that, the data are so dramatic and this is the first [drug] trial in IPF to show any successful outcome," said lead study author Dr. Maureen Horton, an associate professor of medicine at Johns Hopkins University School of Medicine. "Given the [lack] of treatments we have for any aspect of this disease, it's good to have anything that can make their lives better."

Horton said the patients involved in the trial "were originally in shock" when they heard they would be taking the notorious drug. But afterward, both Gwartney and Chambers described their improvement as remarkable.

 "[Thalidomide] stopped the cough in its tracks," said Gwartney. "As far as [treating] the symptoms go, it's been a lifesaver."

Chambers echoed these sentiments; for him, the drug reduced his coughing up to 90 percent.

"I have a lot more confidence and ability to live up to my professional expertise," he said. "[Thalidomide] has been a godsend for me, and something that I have been blessed with."

However, thalidomide does not come without risks. Aside from relatively minor side effects like constipation, malaise, and dizziness, the drug is also associated with tingling in the extremities. More importantly, the drug still poses a threat for birth defects when used in women of childbearing age.

All of the patients in this trial were over the age of 50, and none were going to have children. Still, Chambers said that the drug company conducted a monthly interview with him to ensure that he did not expose any pregnant or child-bearing women to the drug.

"There's a lot of reasons for people to stay away from this drug," Chambers said.

Dr. Micah Bhatti, a fellow in infectious disease at the University of Chicago Medical Center, said he thought patients "would be open to the use of thalidomide if they've exhausted other treatment options and there is a frank and open discussion about the known side effects."

All of the patients in the study -- Gwartney and Chambers included -- requested to stay on the drug after the trial was over, despite its potential risks. They have both been taking it now for nearly two years.

Gwartney said that she feels that new treatments designed actually to treat her disease will probably come too late to help her. The disease, she said, continues to progress.

"But that's not the fault of the thalidomide," she said. "That, at least, makes each day livable."

Copyright 2012 ABC News Radio


UN Leaders Strategize Prevention of ‘Non-Communicable Diseases’

Comstock/Thinkstock)(ATLANTA) -- Experts and leaders from 193 nations across the globe will meet next week at the United Nations conference in New York City to discuss strategies to lower the death toll from “non-communicable diseases” like cancer, lung disease and diabetes.

HealthDay reports that these diseases are the leading cause of death worldwide, killing as many as 36 million people a year, according to a new report issued this week by the World Health Organization (WHO).

Cardiac illnesses are accountable for 48 percent of non-communicable disease fatalities, according to WHO.

"This will be the first time that the U.N. has actually focused on the major killer of most people," said chief medical officer for the American Cancer Society, Dr. Otis Brawley, and a professor of oncology and epidemiology at Emory University in Atlanta.

"We need this," he added. "We need a chronic disease movement. We need to drive attention toward overall health. Because cancer, for example, kills more people in the world than HIV/AIDS, malaria and tuberculosis combined."

Additional findings in the WHO report suggest that 87 percent of all deaths in the U.S. are caused by non-communicable diseases.

Copyright 2011 ABC News Radio


Lifetime Risk for COPD Higher than Heart Failure, Common Cancers

Stockbyte/Thinkstock(TORONTO) -- COPD: chronic obstructive pulmonary disease. It's a disease that affects your air passages, causing difficulty breathing, and now a new study suggests COPD is a greater threat than heart disease or cancer.
COPD covers a range of diseases that restrict the function of your lungs, such as chronic bronchitis and emphysema.
Symptoms include difficulty breathing, wheezing, shortness of breath and chronic coughing that produces mucus. It is sometimes mistakenly thought to be a "smoker's cough."
A new study in the medical journal Lancet shows that one in every four people 35 and older are likely to develop COPD in their lifetime, comparable to diabetes and asthma.
Researchers at the Institute for Clinical Evaluative Sciences in Toronto followed 13 million Canadians for up to 14 years.
They found the risk of getting COPD was double that of congestive heart failure, three to four times greater than breast cancer in women and prostate cancer in men and more than seven times the risk of other cancers.  
By 2030, COPD is projected to be the third-most common cause of death worldwide.

Copyright 2011 ABC News Radio


Toxic Air Causes Long-Term Damage for Deployed Troops

U.S. Marine Corps/Lance Cpl. Dexter S. Saulisbury/Released(NASHVILLE, Tenn.) -- A growing number of soldiers who have served early on in the wars in Iraq and Afghanistan are now being diagnosed with deployment-related lung disease from inhaling toxic waste from sources like dust storms, combat smoke, and burn pits used to incinerate material, human waste, debris, and chemicals.

While the U.S. Department of Defense reports that it has shut down all burn pits in Iraq -- replacing some with closed incinerators -- and plans to do the same in Afghanistan by the end of the year, new evidence suggests the health effects may be irreparable for soldiers who were already exposed.

A new report by researchers at Vanderbilt University found that nearly half of 80 soldiers in Fort Campbell, Kentucky, who could not pass a standard 2-mile run because of breathing problems, were diagnosed with constrictive bronchiolitis.  More than 80 percent of those with constrictive bronchiolitis were exposed to dust storms and more than 60 percent were exposed to burn pits, according to the report, which was published Wednesday in the New England Journal of Medicine.

"I don't' think that we can say that our data says these exposures are the cause, at least not of yet," said Dr. Robert Miller of Vanderbilt University Medical Center. "But I think it is very concerning."

Standard tests that are used to detect respiratory diseases, such as a pulmonary function test or CT scan, could not pick up the soldiers' condition.  Only a lung biopsy could detect constrictive bronchiolitis in the soldiers, he said.

"A large number of soldiers who have these respiratory disorders are being missed," said Miller, who suggested that more soldiers may have a form of respiratory condition and not know it.

And Miller said many doctors won't test further if standard tests fail to find anything.

"It's unusual for someone to take people normal on the tests and still give them a biopsy, but it's the only way these guys would've gotten the compensation that they needed," he said.

Miller said serious respiratory cases might be easier to detect if soldiers had a record of their breathing capacity before deploying.

"Everybody that is deployed should get a pulmonary function test before deploying," he said.  "If we have baseline breathing test on everybody we were seeing, then that would limit the amount of biopsies."

Copyright 2011 ABC News Radio


Heat Wave Especially Horrible for People with Certain Illnesses

Creatas/Thinkstock(NEW YORK) -- With about half the country baking in a heat wave, hospitals in some of the worst-hit areas are reporting cases of people coming into emergency rooms with heat-related illnesses. Many expect more as the heat wave continues. And they don't necessarily involve heat stroke or heat exhaustion.

"We do not see a lot of hot people but rather people with diseases, alcohol, drugs, old age and disability whose conditions are worsened by the heat," said Dr. James Adams, professor and chair of the Department of Emergency Medicine at Northwestern Memorial Hospital.

Very high heat and humidity can affect everyone, but experts say in addition to children and the elderly, people with the medical conditions that follow are especially susceptible to heat-related illness:

Allergies, Asthma and Other Breathing Problems

Allergy and asthma specialists say they are seeing more patients whose illnesses have been triggered by the heat and humidity as well as by increased levels of pollutants in the air.

"[We] have seen many new patients for the first time with a diagnosis of asthma made worse by heavy pollens and extreme temperature and humidity levels," said Dr. Clifford Bassett, medical director of Asthma & Allergy Care of New York.

Bassett also said that in addition to pollen, mold levels increase when it's very humid.

The heat wave is also causing more serious breathing problems, including very severe asthma attacks and a worsening of chronic obstructive pulmonary disease (COPD). At Temple University Hospital in Philadelphia, several patients needed emergency treatment for both these conditions. One of them even needed a breathing tube.

During a heat wave, experts say room air conditioners may not make the environment cool enough.

Bassett advises anyone with allergies or asthma to stay where it's air conditioned, and to change and clean the filters frequently. If you need to go outside, check the pollen counts and pay special attention to ozone alerts.

Heart Disease

"During times of extreme heat, people are prone to dehydration," said Dr. Phil Ragno, director of cardiovascular health and wellness at Winthrop University Hospital in Mineola, N.Y. "The more activities we perform, we're losing fluid through perspiration, and that decreases the volume of blood in our system. Blood vessels also dilate when it's hot, and as a result, the heart has to pump harder to circulate a smaller amount of blood."

Ragno also says people with heart conditions should drink a lot of fluids before they leave the house when it's hot and should keep hydrated throughout the day.

"People with heart conditions should weigh themselves each morning. If their weight is down a bit, it might not be body weight, but body fluid they're losing, which is a sign of impending troubles," Ragno said.

Pregnant Women

"Pregnant women are already undergoing a lot of physiological changes," said Dr. Eric Coris, associate professor of family medicine at the University of South Florida College of Medicine in Tampa. "Blood volume expands and sometimes blood return is not as good, so they may get swelling in certain parts of the body."

Increased blood flow and hormone changes that occur during pregnancy can make women feel hotter, and the swelling can have that same effect. As a result, women need to drink plenty of water.

Pregnant women with borderline high blood pressure also need to carefully monitor salt intake.

Other Tips for Beating Heat-Related Illness

Besides staying indoors where it's cool, experts have advice for others who need or want to venture outside.

"People who are bedridden and don't have access to water and are not in an air-conditioned area are at highest risk of developing heat stroke," said Slovis.

Athletes who are exercising for a long period of time should drink at least 8 to 10 ounces of water every 15 minutes. If they are exercising for 30 to 60 minutes or longer, Coris says they should drink sports drinks to help replenish the salt lost through sweating.

"Salt helps the body hold on to fluid and as your sweat rate goes up, you're losing salt as well," Coris said.

But doctors also say people who are diabetic or hypertensive should be careful with sports drinks since they may contain sugar and salt.

It's also important to be aware of the signs of heat stroke, including a shallow pulse, dizziness or fainting, fever with a severe headache, loss of consciousness or signs of confusion.

Copyright 2011 ABC News Radio


Transplant-Rejection Drug Is First Treatment for Rare Lung Disease

Hemera Technologies/Thinkstock(CINCINNATI) -- The drug sirolimus (Rapamycin) is the first to produce any benefit for women who suffer from a rare lung disease called lyphangioleiomyomatosis, or LAM.  The disease has had no cure, and until now, no suitable treatments.

While sirolimus has already been approved as a transplant-rejection drug, a study released Wednesday in the New England Journal of Medicine reports that when given to LAM patients, lung function and quality of life is improved.

LAM is the loss of lung function due to the abnormal growth of muscle tissue causing airway obstruction.  Internationally, an estimated 250,000 women are undiagnosed or misdiagnosed, according to the LAM Foundation.

The study's lead author, Dr. Francis X. McCormack of the University of Cincinnati and scientific director of the LAM Foundation, noted the "rare and special" nature of the treatment's discovery, but said that stabilized lung function only occurred "for as long as patients took the drug."  If a patient stopped taking the drug, a decline in lung function would resume, McCormack said.

McCormack added that sirolimus costs around $8 a tablet, and that the recommended dosage is two tablets a day.

Jill Raleigh, executive director of the LAM Foundation, indicated the treatment isn't likely to be a cure-all for everyone.

"It's not a cure," she said. "But it's hope."

Copyright 2011 ABC News Radio 


Could Blood Test to Detect Early Lung Disease Help Smokers Quit?

Brand X Pictures/Thinkstock(NEW YORK) -- Despite evidence that smoking damages the lungs, people continue to smoke. But a new blood test may be more definitive proof that it's time to quit, say researchers.

Lung disease covers a range of disorders from asthma and influenza to COPD, TB, and cancer. Some of the warning signs include chronic coughing, shortness of breath, wheezing, coughing up blood or chest pains.

But this blood test may detect the early onset of the lung disease emphysema.

According to a report in the American Journal of Respiratory and Critical Care Medicine, researchers identified a specific physical trait in the blood of smokers with early lung disease.

That same biomarker was present in the blood of smokers who were not sick, but it was not found in the blood of non-smokers.

The authors concluded that the presence of this biomarker could be an early indication of emphysema.

They suggest that a blood test showing smokers are developing lung disease may be a stronger incentive to kick the habit than the threat of being at risk of getting the disease.

Copyright 2011 ABC News Radio 


Nelson Mandela Hospitalized, Reports of Collapsed Lung

Photo Courtesy - Getty Images(JOHANNESBURG) – As Nelson Mandela undergoes tests during his second straight day at a hospital in Johannesburg, South Africa, reports surfaced Thursday that the 92-year-old former South African president and anti-apartheid hero may have suffered a collapsed lung.
A collapsed lung is the collection of air in the space around the lungs, also known as pneumothorax, and can occur as a “primary spontaneous pneumothorax”, or PSP.  In those cases, it occurs without a precipitating event in a person without known lung disease. 

About 7.4 out of 100,000 people suffer a collapsed lung each year in the United States with men more likely to suffer it than women.

Although Mandela is known to undergo routine health examinations, the most recent visit has garnered attention due to its unusual length. Although it is not yet known why Mandela was hospitalized, reports have circulated both that Mandela entered the hospital for routine testing as well as rumors that he was suffering chest pains and had trouble breathing prior to being admitted.

Copyright 2011 ABC News Radio

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