To contact us Click HERE
In China, chronic obstructive pulmonary disease (COPD) in people over the age of 40 is much more prevalent than previously thought, according to researchers in Guangdong.
Their findings appear in the second issue for October of the American Journal of Respiratory and Critical care Medicine, published by the American Thoracic Society. The investigators administered spirometric tests and questionnaires to a cross-sectional population in seven provinces/cities in China. Of the more than 20,000 who completed these materials, 8.2 percent of respondents over 40 met the criteria for having COPD.
Men were more than twice as likely to have COPD as women. But while smoking was, and is, a significant risk factor for COPD in China, only 24 percent of the females with COPD were smokers, as opposed to nearly 82 percent of males, suggesting that women's risk might be more strongly associated with the use of biomass fuels, especially for cooking in poorly ventilated areas.
"Although China has experienced remarkable modernization over the past two decades, in many rural areas residents continue to use wood, charcoal or coal for fuel, leading to significant biomass exposure, especially in women, who perform most of the cooking duties," wrote Don D. Sin, M.D., and Wan Tan, M.D., of the University of British Columbia in Vancouver, Canada, in an editorial in the same issue of the journal.
"To the best of our knowledge, this is the first large-scale, population-based epidemiologic study on COPD prevalence in China," wrote Nanshan Zhong, M.D., of the Guangzhou Institute of Respiratory Diseases at The First Affiliated Hospital in Guangzhou Medical College, and lead researcher.
According to an estimation by the World Health Organization, COPD ranks first among the burdens of diseases in China and accounts for one million deaths and five million disabilities each year.
The researchers selected provinces and cities from a wide range of geographic areas within China, and then selected an urban and a rural area within each province/city. They then used randomized cluster sampling from a randomly selected street or township, and attempted to recruit all individuals older than 40. About 79 percent of attempted were successfully contacted. They completed questionnaires and underwent spirometric testing for obstructive and restrictive lung disease.
While the overall rate of COPD, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) was higher than expected, there were some notable differences among the population.
"Multivariate logistic regression analyses showed that smoking, pulmonary problems in childhood, family history of respiratory diseases, male sex, low education level, aging, lower body mass index, poor ventilation in the kitchen, and exposure to biomass and occupational dust/gases/fumes are associated with COPD," wrote Dr. Zhong.
Importantly, more than a third of the subjects who had COPD were asymptomatic, and nearly two-thirds had never been diagnosed, suggesting that diagnosis of COPD on symptoms alone is not sufficient.
"Even among subjects with GOLD stages 3 and 4 of the disease, fewer than 10 percent have ever received spirometry," noted Drs. Sin and Tan. "The gross underutilization of spirometry represents a 'Great Wall,' a huge barrier to good care for patients with COPD in China."
Dr. Zhong and colleagues' findings present a dark picture of COPD in China, which is expected to grow worse before it gets better due to an aging population and rising smoking rates, especially in women.
"Our results highlight COPD as a major public health problem in China and call for more research to be directed toward preventative measures and efforts," wrote Dr. Zhong.
This news brief comes from the American Thoracic Society's peer-reviewed journal, the American Journal of Respiratory and Critical Care Medicine - ajrccm.atsjournals.
Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society has more than 18,000 members who prevent and fight respiratory disease around the globe, through research, education, patient care and advocacy.
thoracic
30 Eylül 2012 Pazar
Clinical Trial Data On The Safety And Efficacy Of Concomitant Formoterol Fumarate/ Tiotropium Treatment For COPD
To contact us Click HERE
Data presented at
CHEST 2007, the annual scientific assembly of the American College of Chest
Physicians (ACCP), demonstrate concomitant use of nebulized formoterol
fumarate and tiotropium provided improved bronchodilation over tiotropium
monotherapy and was well-tolerated in this clinical study. The only
commercially available version of nebulized formoterol fumarate is
Perforomist(TM) Inhalation Solution, which is indicated for long-term,
twice-daily maintenance treatment of bronchoconstriction for emphysema and
chronic bronchitis, also known as Chronic Obstructive Pulmonary Disease
(COPD).
Formoterol fumarate is a rapid and long-acting beta2-agonist (LABA)
that has been previously available in the U.S. in a dry powder formulation
and has twenty years of worldwide experience. Perforomist(TM) Inhalation
Solution is the first and only FDA-approved nebulized form of this
molecule. Nebulizers convert liquid medication into a mist that patients
inhale through a mouthpiece or face mask.
Results presented were from "Safety and Efficacy of Concomitant
Treatment with Nebulized Formoterol and Tiotropium in COPD," a randomized,
placebo-controlled Phase IIIb trial. The trial demonstrated that
concomitant therapy with twice-daily nebulized formoterol fumarate (FFIS)
and once-daily tiotropium provided patients with statistically significant
and clinically relevant improvements in bronchodilation over treatment with
tiotropium alone. In this six-week study, patients receiving concomitant
therapy with nebulized FFIS and tiotropium experienced fewer adverse events
or COPD exacerbations than patients receiving placebo or tiotropium
monotherapy.
According to Donald P. Tashkin, MD, FACP, FCCP, Professor of Medicine,
David Geffen School of Medicine at the University of California at Los
Angeles and the lead clinical investigator, "For the patients in this
study, adjunctive use of nebulized formoterol fumarate and tiotropium
showed statistically significant improvements in lung function by improving
bronchodilation over use of tiotropium alone. For physicians,
Perforomist(TM) Inhalation Solution and commonly prescribed long-acting
anticholinergics such as tiotropium offers a new and valuable treatment
option for COPD patients with moderate to severe manifestations of the
disease."
Christy Taylor, Chief Operating Officer at Dey, L.P., commented, "At
DEY, we specialize in developing effective new treatments for serious and
complex respiratory diseases, and it is gratifying that the newest addition
to our franchise, Perforomist(TM) Inhalation Solution, offers physicians
additional prescribing flexibility. For over a decade, Dey, L.P. has been
the U.S. leader in sales of nebulized respiratory medication. We thank Dr.
Tashkin and the other members of the research team for their assessment of
how Perforomist(TM) Inhalation Solution may be used concomitantly with
tiotropium for improved clinical effect for COPD patients."
For those attending CHEST 2007, the presentation is available as follows:
Poster viewing: Session ID 902 -- COPD Treatment II
Wednesday, October 24, 2007, 12:30 -- 2:00 PM
Convention Center, Exhibit Hall, McCormick Place, Lakeside Center, Chicago.
Poster # 251: Safety and Efficacy of Concomitant Treatment with Nebulized
Formoterol and Tiotropium in COPD
The research presented at CHEST 2007 was supported through grants
provided by Dey, L.P., which developed and markets Perforomist(TM)
Inhalation Solution. Dey, L.P. is a subsidiary of Mylan Inc. (NYSE: MYL).
About Perforomist(TM) Inhalation Solution
Indication
Perforomist(TM) Inhalation Solution is indicated for the long-term,
twice-daily (morning and evening) administration in the maintenance
treatment of bronchoconstriction in patients with chronic obstructive
pulmonary disease (COPD) including chronic bronchitis and emphysema.
Important Safety Information
Perforomist(TM) Inhalation Solution belongs to a class of medications
known as long-acting beta2-adrenergic agonists (LABAs). LABAs may increase
the risk of asthma-related death. Data from a large placebo-controlled US
study comparing the safety of another LABA (salmeterol) or placebo added to
usual asthma therapy showed an increase in asthma-related deaths in
patients receiving salmeterol. This finding with salmeterol may apply to
formoterol (a LABA), the active ingredient in Perforomist(TM) Inhalation
Solution.
Perforomist(TM) Inhalation Solution should not be used in patients with
acutely deteriorating COPD or to treat acute symptoms. Acute symptoms
should be treated with fast-acting rescue inhalers. Perforomist(TM)
Inhalation Solution should not be used with other medications containing
LABAs. Do not use more than one nebule twice daily. Perforomist(TM)
Inhalation Solution should be used with caution in patients with
cardiovascular disorders. Perforomist(TM) Inhalation Solution is not a
substitute for inhaled or oral corticosteroids. The safety and efficacy of
Perforomist(TM) Inhalation Solution in asthma has not been established.
In COPD clinical trials, the most common adverse events reported with
Perforomist(TM) Inhalation Solution were diarrhea, nausea, nasopharyngitis,
dry mouth, vomiting, dizziness, and insomnia.
About COPD
COPD refers to a number of chronic lung disorders in which the airways
to the lungs become narrowed and breathing becomes increasingly difficult.
The most common forms of COPD are chronic bronchitis and emphysema, and
many patients suffer from a combination of the two diseases.
COPD is the fourth leading cause of death in America, behind heart
disease, cancer and stroke. Twelve million Americans have been diagnosed
with COPD and at least another 12 million have symptoms but are not
diagnosed. COPD is not well understood or recognized -- most Americans have
not heard of it, not even those who may be living with the condition. The
most common cause of COPD is cigarette smoking, which is responsible for an
estimated 80 to 90 percent of COPD cases. Estimates of the total incidence
of COPD in America range from 24 to 30 million.
About Nebulization
Of the three types of devices used to deliver bronchodilators --
nebulizers, metered-dose inhalers, and dry powder inhalers -- nebulizers
require no special technique or coordination, as the medication is
converted into a fine mist that the patient inhales through a mouthpiece or
face-mask while breathing naturally. Because nebulization is an easy,
effective, and thorough method of delivering medicine directly into the
lungs, many COPD patients ask for it, particularly as their symptoms
worsen.
With Perforomist(TM) Inhalation Solution, nebulization may become a
more widely used treatment option for many COPD patients at earlier
treatment stages who could benefit from twice-daily maintenance dosing of a
nebulized LABA such as Perforomist(TM) Inhalation Solution. For example,
this new COPD treatment may be a valuable clinical option for many patients
who are not adequately controlled with short-acting bronchodilators.
About Dey, L.P.
Dey, L.P., a subsidiary of Mylan Inc. (NYSE: MYL), is a specialty
pharmaceutical company focused on the development, manufacturing and
marketing of prescription drug products for the treatment of respiratory
diseases, respiratory-related allergies, and emergency care medicine. As
the U.S. leader in sales of nebulized respiratory medication, Dey, L.P.
puts patients first through its development of innovative and affordable
therapies. The Web sites for Dey, L.P. include dey,
accuneb, curosurfusa, cyanokit, duoneb, epipen and perforomist.
Perforomist is a trademark of Dey, L.P.
About Mylan
Mylan Inc. is one of the world's leading quality generic and specialty
pharmaceutical companies. The Company offers one of the industry's broadest
and highest quality product portfolios, a robust product pipeline and a
global commercial footprint through operations in more than 90 countries.
Through its controlling interest in Matrix Laboratories Limited, Mylan has
direct access to one of the largest active pharmaceutical ingredient (API)
manufacturers in the world. Dey L.P., Mylan's fully integrated specialty
business, provides the Company with innovative and diversified
opportunities in the respiratory and allergy therapeutic areas.
For more information about Mylan, please visit mylan
This press release includes statements that constitute "forward-looking
statements," including with regard to the concomitant use of nebulized
formoterol fumarate and tiotropium and its effects. These statements are
made pursuant to the safe harbor provisions of the Private Securities
Litigation Reform Act of 1995. Because such statements inherently involve
risks and uncertainties, actual future results may differ materially from
those expressed or implied by such forward-looking statements. Factors that
could cause or contribute to such differences include, but are not limited
to: the risk that the adjunctive use may not ultimately prove to be as
successful as anticipated; the impact of the competitive COPD environment;
and the other risks detailed in the Company's Form 10-Q for the quarter
ended June 30, 2007 and its other periodic filings with the Securities and
Exchange Commission. The Company undertakes no obligation to update these
statements for revisions or changes after the date of this release.
Dey, L.P.
dey
CHEST 2007, the annual scientific assembly of the American College of Chest
Physicians (ACCP), demonstrate concomitant use of nebulized formoterol
fumarate and tiotropium provided improved bronchodilation over tiotropium
monotherapy and was well-tolerated in this clinical study. The only
commercially available version of nebulized formoterol fumarate is
Perforomist(TM) Inhalation Solution, which is indicated for long-term,
twice-daily maintenance treatment of bronchoconstriction for emphysema and
chronic bronchitis, also known as Chronic Obstructive Pulmonary Disease
(COPD).
Formoterol fumarate is a rapid and long-acting beta2-agonist (LABA)
that has been previously available in the U.S. in a dry powder formulation
and has twenty years of worldwide experience. Perforomist(TM) Inhalation
Solution is the first and only FDA-approved nebulized form of this
molecule. Nebulizers convert liquid medication into a mist that patients
inhale through a mouthpiece or face mask.
Results presented were from "Safety and Efficacy of Concomitant
Treatment with Nebulized Formoterol and Tiotropium in COPD," a randomized,
placebo-controlled Phase IIIb trial. The trial demonstrated that
concomitant therapy with twice-daily nebulized formoterol fumarate (FFIS)
and once-daily tiotropium provided patients with statistically significant
and clinically relevant improvements in bronchodilation over treatment with
tiotropium alone. In this six-week study, patients receiving concomitant
therapy with nebulized FFIS and tiotropium experienced fewer adverse events
or COPD exacerbations than patients receiving placebo or tiotropium
monotherapy.
According to Donald P. Tashkin, MD, FACP, FCCP, Professor of Medicine,
David Geffen School of Medicine at the University of California at Los
Angeles and the lead clinical investigator, "For the patients in this
study, adjunctive use of nebulized formoterol fumarate and tiotropium
showed statistically significant improvements in lung function by improving
bronchodilation over use of tiotropium alone. For physicians,
Perforomist(TM) Inhalation Solution and commonly prescribed long-acting
anticholinergics such as tiotropium offers a new and valuable treatment
option for COPD patients with moderate to severe manifestations of the
disease."
Christy Taylor, Chief Operating Officer at Dey, L.P., commented, "At
DEY, we specialize in developing effective new treatments for serious and
complex respiratory diseases, and it is gratifying that the newest addition
to our franchise, Perforomist(TM) Inhalation Solution, offers physicians
additional prescribing flexibility. For over a decade, Dey, L.P. has been
the U.S. leader in sales of nebulized respiratory medication. We thank Dr.
Tashkin and the other members of the research team for their assessment of
how Perforomist(TM) Inhalation Solution may be used concomitantly with
tiotropium for improved clinical effect for COPD patients."
For those attending CHEST 2007, the presentation is available as follows:
Poster viewing: Session ID 902 -- COPD Treatment II
Wednesday, October 24, 2007, 12:30 -- 2:00 PM
Convention Center, Exhibit Hall, McCormick Place, Lakeside Center, Chicago.
Poster # 251: Safety and Efficacy of Concomitant Treatment with Nebulized
Formoterol and Tiotropium in COPD
The research presented at CHEST 2007 was supported through grants
provided by Dey, L.P., which developed and markets Perforomist(TM)
Inhalation Solution. Dey, L.P. is a subsidiary of Mylan Inc. (NYSE: MYL).
About Perforomist(TM) Inhalation Solution
Indication
Perforomist(TM) Inhalation Solution is indicated for the long-term,
twice-daily (morning and evening) administration in the maintenance
treatment of bronchoconstriction in patients with chronic obstructive
pulmonary disease (COPD) including chronic bronchitis and emphysema.
Important Safety Information
Perforomist(TM) Inhalation Solution belongs to a class of medications
known as long-acting beta2-adrenergic agonists (LABAs). LABAs may increase
the risk of asthma-related death. Data from a large placebo-controlled US
study comparing the safety of another LABA (salmeterol) or placebo added to
usual asthma therapy showed an increase in asthma-related deaths in
patients receiving salmeterol. This finding with salmeterol may apply to
formoterol (a LABA), the active ingredient in Perforomist(TM) Inhalation
Solution.
Perforomist(TM) Inhalation Solution should not be used in patients with
acutely deteriorating COPD or to treat acute symptoms. Acute symptoms
should be treated with fast-acting rescue inhalers. Perforomist(TM)
Inhalation Solution should not be used with other medications containing
LABAs. Do not use more than one nebule twice daily. Perforomist(TM)
Inhalation Solution should be used with caution in patients with
cardiovascular disorders. Perforomist(TM) Inhalation Solution is not a
substitute for inhaled or oral corticosteroids. The safety and efficacy of
Perforomist(TM) Inhalation Solution in asthma has not been established.
In COPD clinical trials, the most common adverse events reported with
Perforomist(TM) Inhalation Solution were diarrhea, nausea, nasopharyngitis,
dry mouth, vomiting, dizziness, and insomnia.
About COPD
COPD refers to a number of chronic lung disorders in which the airways
to the lungs become narrowed and breathing becomes increasingly difficult.
The most common forms of COPD are chronic bronchitis and emphysema, and
many patients suffer from a combination of the two diseases.
COPD is the fourth leading cause of death in America, behind heart
disease, cancer and stroke. Twelve million Americans have been diagnosed
with COPD and at least another 12 million have symptoms but are not
diagnosed. COPD is not well understood or recognized -- most Americans have
not heard of it, not even those who may be living with the condition. The
most common cause of COPD is cigarette smoking, which is responsible for an
estimated 80 to 90 percent of COPD cases. Estimates of the total incidence
of COPD in America range from 24 to 30 million.
About Nebulization
Of the three types of devices used to deliver bronchodilators --
nebulizers, metered-dose inhalers, and dry powder inhalers -- nebulizers
require no special technique or coordination, as the medication is
converted into a fine mist that the patient inhales through a mouthpiece or
face-mask while breathing naturally. Because nebulization is an easy,
effective, and thorough method of delivering medicine directly into the
lungs, many COPD patients ask for it, particularly as their symptoms
worsen.
With Perforomist(TM) Inhalation Solution, nebulization may become a
more widely used treatment option for many COPD patients at earlier
treatment stages who could benefit from twice-daily maintenance dosing of a
nebulized LABA such as Perforomist(TM) Inhalation Solution. For example,
this new COPD treatment may be a valuable clinical option for many patients
who are not adequately controlled with short-acting bronchodilators.
About Dey, L.P.
Dey, L.P., a subsidiary of Mylan Inc. (NYSE: MYL), is a specialty
pharmaceutical company focused on the development, manufacturing and
marketing of prescription drug products for the treatment of respiratory
diseases, respiratory-related allergies, and emergency care medicine. As
the U.S. leader in sales of nebulized respiratory medication, Dey, L.P.
puts patients first through its development of innovative and affordable
therapies. The Web sites for Dey, L.P. include dey,
accuneb, curosurfusa, cyanokit, duoneb, epipen and perforomist.
Perforomist is a trademark of Dey, L.P.
About Mylan
Mylan Inc. is one of the world's leading quality generic and specialty
pharmaceutical companies. The Company offers one of the industry's broadest
and highest quality product portfolios, a robust product pipeline and a
global commercial footprint through operations in more than 90 countries.
Through its controlling interest in Matrix Laboratories Limited, Mylan has
direct access to one of the largest active pharmaceutical ingredient (API)
manufacturers in the world. Dey L.P., Mylan's fully integrated specialty
business, provides the Company with innovative and diversified
opportunities in the respiratory and allergy therapeutic areas.
For more information about Mylan, please visit mylan
This press release includes statements that constitute "forward-looking
statements," including with regard to the concomitant use of nebulized
formoterol fumarate and tiotropium and its effects. These statements are
made pursuant to the safe harbor provisions of the Private Securities
Litigation Reform Act of 1995. Because such statements inherently involve
risks and uncertainties, actual future results may differ materially from
those expressed or implied by such forward-looking statements. Factors that
could cause or contribute to such differences include, but are not limited
to: the risk that the adjunctive use may not ultimately prove to be as
successful as anticipated; the impact of the competitive COPD environment;
and the other risks detailed in the Company's Form 10-Q for the quarter
ended June 30, 2007 and its other periodic filings with the Securities and
Exchange Commission. The Company undertakes no obligation to update these
statements for revisions or changes after the date of this release.
Dey, L.P.
dey
Budesonide Added To Formoterol And/or Short Acting Beta 2 Agonist Lowers Mortality Risk For Severe COPD Patients
To contact us Click HERE
Important new data from the analysis of combined data from the two pivotal Symbicort(R) studies, announced today at the 5th International Multidisciplinary Conference on Chronic Obstructive Pulmonary Disease (COPD5), reveals that budesonide added to formoterol (Symbicort (R)) and/or terbutaline significantly reduces mortality in severe COPD over one year, compared to the bronchodilators formoterol and/or terbutaline alone.
Today's results show fewer deaths in the Symbicort / budesonide group compared with the bronchodilator group (p=0.036), with an associated hazard ratio of 0.564 (p=0.039). This represents a 44% reduction in all-cause mortality over one year for patients treated with Symbicort / budesonide1 .
"Previous findings have shown the beneficial effects of combination budesonide and formoterol, i.e. Symbicort, therapy in significantly reducing COPD exacerbations", explained Professor Peter Calverley, Aintree Chest Centre, University of Liverpool. "Today's presentation further demonstrates the link between COPD exacerbations and an increased risk of mortality, reinforcing the importance of reducing these events, as indicated by COPD guidelines".
The re-analysis comprised data from 1834 patients with severe COPD evenly distributed between the two treatment groups, i.e. budesonide added to bronchodilators compared to bronchodilators alone.
The survival benefits in this analysis also appear to corroborate the findings in the three year prospective TORCH (TOwards a Revolution in COPD health) study2, presented at the American Thoracic Society Congress in 2006, which has reported a 17% reduction in mortality for fluticasone/salmeterol compared with placebo.
The retrospective pooled analysis also showed that health-related quality of life (HRQL) - as measured by the St. Georges Respiratory Questionnaire (SGRQ), an independently validated tool for measuring quality of life in COPD - was the strongest predictor of mortality in COPD, over and above any other reported predictor (e.g. lung function, breathlessness, Body Mass Index and age), equating to better quality of life leading to lower risk of premature death3. Using the SGRQ, a change of four points is defined as clinically meaningful, equating to a patient being able to walk up a flight of stairs without stopping or to being able to sleep without disruption from coughing. The data presented today suggests that SGRQ scores may have a role in identifying patients at increased risk of mortality over 1 year.
"Previous studies have demonstrated that budesonide/ formoterol is a very effective treatment in preventing COPD exacerbations, leading to clinically important improvements in health-related quality of life", explained Professor Paul Jones, St George's Hospital Medical School, London "Today's data are important, suggesting as it does that a combination of budesonide and formoterol may provide a tangible survival benefit as well as improving the patients quality of life".
The pooled-analysis, presented today at COPD5, is based upon the data from two 1-year prospective Symbicort studies in COPD (Calverley et al. 4 and Szafranski et al5), both published in the European Respiratory Journal in 2003.
"Randomised, controlled trials are the best way of determining whether therapy is effective in COPD. However, re-analysis of pooled data from comparable clinical trials, as we did in this case, can provide new and potentially important clinical insights", Professor Calverley concluded.
References:
1 Peter Calverley, Paul Jones, Thomas Larsson, Stefan Peterson. Preventing mortality in COPD: The value of inhaled budesonide added to bronchodilators. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
2 TORCH Study Group. The TORCH (TOwards a Revolution in COPD health) survival study protocol Eur Respir J 2004;24:206-210
3 Paul Jones, Peter Calverley, Thomas Larsson, Stefan Peterson. SGRQ scores may help identify COPD patients at increased risk of death in 1 year. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
4 Calverley PM, Boonsawat Z, Zhong N, Peterson S and Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Resp J 2003; 22; 912-919.
5 Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, Peterson S, Olsson H. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Resp J 2003; 21: 74-81.
astrazeneca
Today's results show fewer deaths in the Symbicort / budesonide group compared with the bronchodilator group (p=0.036), with an associated hazard ratio of 0.564 (p=0.039). This represents a 44% reduction in all-cause mortality over one year for patients treated with Symbicort / budesonide1 .
"Previous findings have shown the beneficial effects of combination budesonide and formoterol, i.e. Symbicort, therapy in significantly reducing COPD exacerbations", explained Professor Peter Calverley, Aintree Chest Centre, University of Liverpool. "Today's presentation further demonstrates the link between COPD exacerbations and an increased risk of mortality, reinforcing the importance of reducing these events, as indicated by COPD guidelines".
The re-analysis comprised data from 1834 patients with severe COPD evenly distributed between the two treatment groups, i.e. budesonide added to bronchodilators compared to bronchodilators alone.
The survival benefits in this analysis also appear to corroborate the findings in the three year prospective TORCH (TOwards a Revolution in COPD health) study2, presented at the American Thoracic Society Congress in 2006, which has reported a 17% reduction in mortality for fluticasone/salmeterol compared with placebo.
The retrospective pooled analysis also showed that health-related quality of life (HRQL) - as measured by the St. Georges Respiratory Questionnaire (SGRQ), an independently validated tool for measuring quality of life in COPD - was the strongest predictor of mortality in COPD, over and above any other reported predictor (e.g. lung function, breathlessness, Body Mass Index and age), equating to better quality of life leading to lower risk of premature death3. Using the SGRQ, a change of four points is defined as clinically meaningful, equating to a patient being able to walk up a flight of stairs without stopping or to being able to sleep without disruption from coughing. The data presented today suggests that SGRQ scores may have a role in identifying patients at increased risk of mortality over 1 year.
"Previous studies have demonstrated that budesonide/ formoterol is a very effective treatment in preventing COPD exacerbations, leading to clinically important improvements in health-related quality of life", explained Professor Paul Jones, St George's Hospital Medical School, London "Today's data are important, suggesting as it does that a combination of budesonide and formoterol may provide a tangible survival benefit as well as improving the patients quality of life".
The pooled-analysis, presented today at COPD5, is based upon the data from two 1-year prospective Symbicort studies in COPD (Calverley et al. 4 and Szafranski et al5), both published in the European Respiratory Journal in 2003.
"Randomised, controlled trials are the best way of determining whether therapy is effective in COPD. However, re-analysis of pooled data from comparable clinical trials, as we did in this case, can provide new and potentially important clinical insights", Professor Calverley concluded.
References:
1 Peter Calverley, Paul Jones, Thomas Larsson, Stefan Peterson. Preventing mortality in COPD: The value of inhaled budesonide added to bronchodilators. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
2 TORCH Study Group. The TORCH (TOwards a Revolution in COPD health) survival study protocol Eur Respir J 2004;24:206-210
3 Paul Jones, Peter Calverley, Thomas Larsson, Stefan Peterson. SGRQ scores may help identify COPD patients at increased risk of death in 1 year. Abstract scheduled for presentation at COPD5, Birmingham, UK, 28 June 2006
4 Calverley PM, Boonsawat Z, Zhong N, Peterson S and Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Resp J 2003; 22; 912-919.
5 Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, Peterson S, Olsson H. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Resp J 2003; 21: 74-81.
astrazeneca
Kamada Completes Enrollment In Its Phase II Bronchiectasis Trial With Inhaled AAT
To contact us Click HERE
Kamada (TASE:KMDA), a biopharmaceutical company engaged in the development, production and marketing of specialty life-saving biotherapeutics, announced recently that it has completed patient enrollment in its Phase II clinical trial evaluating treatment of bronchiectasis patients with inhaled Alpha-1 Antitrypsin (AAT) delivered by the investigational eFlow® nebulizer system (PARI Pharma GmbH).
Chief Executive Officer of Kamada, David Tsur, said, "We are very pleased with the progress of this study and look forward to its upcoming completion. We believe that Kamada's AAT delivered by PARI's eFlow® has the potential to become a novel treatment for bronchiectasis. Kamada is committed to the development of inhaled AAT to treat bronchiectasis and to proceed with its ongoing clinical efforts in Alpha 1 Antitrypsin Deficiency and Cystic Fibrosis."
About the study
A total of 21 patients with brochiectasis were enrolled and randomized into this , double-blind, placebo controlled Phase II study. The purpose of the trial is to investigate safety and efficacy of inhaled AAT in this patient population.
About Kamada's Inhaled AAT
Kamada's AAT product has the advantages of a high purity preparation combined with a liquid, ready to use, presentation that does not include stabilizers or preservatives. Efficacy trends towards reduction in lung inflammation were also shown recently by inhaled AAT in a phase II cystic fibrosis study sided to a high safety profile for the given study period.
Kamada's inhaled AAT, which is delivered via an optimized Investigational eFlow Nebulizer System (PARI Pharma GmbH), has received Orphan Drug Designation from the US FDA for the bronchiectasis indication.
About Bronchiectasis
Bronchiectasis is an abnormal stretching and enlarging of the airways. Bronchiectasis patients usually suffer from recurrent, severe episodes of bronchitis, chronic cough and sputum production. According to the US COPD foundation approximately 600,000 individuals suffer from bronchiectasis worldwide, with an estimated 100,000 people in the US alone (excluding cystic fibrosis patients).
About PARI Pharma and the Investigational eFlow® Nebulizer System
Kamada's Inhaled AAT is delivered by the Investigational eFlow Nebulizer System (PARI Pharma GmbH). The Investigational eFlow Nebulizer System uses eFlow Technology to enable extremely efficient aerosolization of liquid medications via a vibrating, perforated membrane that includes thousands of small holes that produce the aerosol mist. Compared to other nebulization technologies, eFlow Technology produces aerosols with a very high density of active drug, a precisely defined droplet size, and a high proportion of respirable droplets delivered in the shortest possible period of time. Combined with its silent mode of operation, small size (it fits in the palm of your hand), light weight, and battery use, eFlow Technology reduces the burden of taking daily, inhaled treatments. The Investigational eFlow Nebulizer System and eFlow Technology are proprietary to PARI Pharma and can be optimized to specific drug formulations.
PARI Pharma focuses on the development of aerosol delivery devices and therapies. Based on PARI's 100-year history working with aerosols, PARI Pharma develops treatments for pulmonary and nasal administration optimized with advanced delivery technologies, such as eFlow technology. Online at PariPharma.
About Kamada
Kamada is a public biopharmaceutical company (kamada) developing, producing and marketing a line of specialty life-saving biopharmaceuticals using its proprietary chromatographic purification technologies. Several of these specialty therapeutics are currently undergoing advanced clinical trials.
Chief Executive Officer of Kamada, David Tsur, said, "We are very pleased with the progress of this study and look forward to its upcoming completion. We believe that Kamada's AAT delivered by PARI's eFlow® has the potential to become a novel treatment for bronchiectasis. Kamada is committed to the development of inhaled AAT to treat bronchiectasis and to proceed with its ongoing clinical efforts in Alpha 1 Antitrypsin Deficiency and Cystic Fibrosis."
About the study
A total of 21 patients with brochiectasis were enrolled and randomized into this , double-blind, placebo controlled Phase II study. The purpose of the trial is to investigate safety and efficacy of inhaled AAT in this patient population.
About Kamada's Inhaled AAT
Kamada's AAT product has the advantages of a high purity preparation combined with a liquid, ready to use, presentation that does not include stabilizers or preservatives. Efficacy trends towards reduction in lung inflammation were also shown recently by inhaled AAT in a phase II cystic fibrosis study sided to a high safety profile for the given study period.
Kamada's inhaled AAT, which is delivered via an optimized Investigational eFlow Nebulizer System (PARI Pharma GmbH), has received Orphan Drug Designation from the US FDA for the bronchiectasis indication.
About Bronchiectasis
Bronchiectasis is an abnormal stretching and enlarging of the airways. Bronchiectasis patients usually suffer from recurrent, severe episodes of bronchitis, chronic cough and sputum production. According to the US COPD foundation approximately 600,000 individuals suffer from bronchiectasis worldwide, with an estimated 100,000 people in the US alone (excluding cystic fibrosis patients).
About PARI Pharma and the Investigational eFlow® Nebulizer System
Kamada's Inhaled AAT is delivered by the Investigational eFlow Nebulizer System (PARI Pharma GmbH). The Investigational eFlow Nebulizer System uses eFlow Technology to enable extremely efficient aerosolization of liquid medications via a vibrating, perforated membrane that includes thousands of small holes that produce the aerosol mist. Compared to other nebulization technologies, eFlow Technology produces aerosols with a very high density of active drug, a precisely defined droplet size, and a high proportion of respirable droplets delivered in the shortest possible period of time. Combined with its silent mode of operation, small size (it fits in the palm of your hand), light weight, and battery use, eFlow Technology reduces the burden of taking daily, inhaled treatments. The Investigational eFlow Nebulizer System and eFlow Technology are proprietary to PARI Pharma and can be optimized to specific drug formulations.
PARI Pharma focuses on the development of aerosol delivery devices and therapies. Based on PARI's 100-year history working with aerosols, PARI Pharma develops treatments for pulmonary and nasal administration optimized with advanced delivery technologies, such as eFlow technology. Online at PariPharma.
About Kamada
Kamada is a public biopharmaceutical company (kamada) developing, producing and marketing a line of specialty life-saving biopharmaceuticals using its proprietary chromatographic purification technologies. Several of these specialty therapeutics are currently undergoing advanced clinical trials.
29 Eylül 2012 Cumartesi
Closed Circuit Breathing Device Could Transform The Lives Of Patients With Chronic Obstructive Pulmonary Disease
To contact us Click HERE
A UNIQUE partnership between Smiths Medical, part of the FTSE 100
technology business Smiths Group, and University College London (UCL)
has resulted in the development of a breakthrough clinical device that
could transform the lives of patients with COPD across the world. COPD
will be the third leading cause of death worldwide by 2030, according to
the World Health Organisation (WHO).
The new technology is based on a closed circuit oxygen device invented
over 50 years ago by the British rocket scientist Tom Bourdillon, who
hoped that it would help take him to the top of the world.
Three days before Edmund Hillary and Tenzing Norgay made the first
ascent of Mount Everest in 1953, Bourdillon nearly got there first with
the help of his ground-breaking invention. When he and his climbing
partner Charles Evans, a British brain surgeon, set out on the first
ever summit attempt they were breathing pure oxygen from the device. It
helped them climb higher than any man had ever been before and at speeds
that have rarely been matched since.
The two men were just 90 metres from the summit when Evans' device
malfunctioned dashing their hopes of becoming the most celebrated
mountaineers in the world. Three days later Hillary and Norgay claimed
that honour using open circuit oxygen devices.
Bourdillon believed that closed circuit oxygen was more efficient and
effective than open circuit because a closed circuit efficiently
recycles exhaled oxygen, which would be lost to the atmosphere in an
open circuit.
His research was forgotten for 50 years but now Smiths Medical and UCL
have developed Bourdillon's idea into a breakthrough medical device that
could help patients with COPD, which is a disease of the lungs in which
the airways become narrowed leading to a limitation of the flow of air
to and from the lungs, causing shortness of breath.
"We are hoping that this new technology will transform the lives of
people living with COPD by allowing them to breathe more easily,
exercise and ultimately reduce their dependence on oxygen. It is
incredible to think that this breakthrough device is based on a British
invention designed to help the first mountaineers reach the top of the
world," said Dr Jeremy Russell, head of research and development at
Smiths Medical International.
Bourdillon's research was rediscovered by Jeremy Windsor and Roger
McMorrow, mountaineering scientists at the UCL Centre for Altitude,
Space and Extreme Environment Medicine (CASE), who had the idea to
redevelop it into a modern breathing circuit for climbers.
"Bourdillon recognized that the problem on Everest was low levels of
oxygen and if you solved the problem of delivering oxygen you would
effectively reduce the height of the mountain to sea level," said Dr
McMorrow. "No-one knows exactly why his device failed but when I tested
my prototype on Cho Oyu in the Himalayas 2005 it also failed. In my case
the soda lime CO2 absorber malfunctioned and it is possible Bourdillon
had the same problem although another theory is that it was a frozen
valve. A recently invented CO2 absorber called ExtendAir solved the
problem on my circuit."
Dr McMorrow, when a Smiths Medical Research Fellow at UCL, showed his
mountaineering prototype to Dr Russell at Smiths Medical, which has a
long-standing partnership with UCL that includes collaboration on
research in the field of respiratory medicine. The two scientists
quickly realized that the prototype for mountaineers had the potential
to evolve into a ground-breaking device for COPD patients as well as for
other patients weaning from oxygen in hospital and those on home oxygen.
Last year the device was successfully tested on Mount Everest at the
Smiths Medical High Altitude Laboratory at Namche Bazaar, Nepal at
3,400m, (11,154 ft) as part of the Caudwell Xtreme Everest Study (CXE),
a medical research project conducted by CASE. Smiths Medical is now
optimizing and miniaturizing the prototype for patients.
Exercise is important for COPD patients but existing oxygen systems mean
it is often not possible. The size of current open circuit systems mean
that patients are often confined to their hospital beds or treated at
home with large cylinders that severely restrict their mobility.
Portable open circuit systems are not able to deliver high enough
volumes of oxygen for long enough to permit exercise. In an open circuit
system the faster a person breathes the more they dilute the oxygen with
ordinary air. This means that if a patient dependent on oxygen starts to
exercise their oxygen levels actually drop as their breathing grows
faster.
Dr Russell added: "The new system is portable and should deliver a very
high concentration of oxygen for a sustained period of time. It should
help keep oxygen levels constant no matter how fast or slow a patient is
breathing."
Previously, portable closed circuits have been used by Special Forces
frogmen (because there are no bubbles), mine rescue workers,
firefighters and in bioterrorism suits.
George Band, who was the youngest member of the 1953 Everest expedition,
said: "I remember how passionate Tom was about his closed circuit device
and how disappointed he and Charles were not to make it to the summit.
I'm sure Tom would have been really thrilled that his research on the
closed-circuit oxygen equipment did not go to waste and could help
people suffering from respiratory problems today."
Professor Monty Mythen, Smiths Medical Professor of Anaesthesia at UCL
and Director of Research and Development at UCL Hospitals said: "This
project is a fantastic example of the success that comes from scientists
in industry working closely with clinicians and university academics for
patient benefit. Smiths Medical in collaboration with UCL and NHS
Partners makes a formidable team and I am delighted that the Caudwell
Xtreme Everest expedition is beginning to reap rewards for patients."
COPD
COPD stands for chronic obstructive pulmonary disease. This is a term
used for a number of conditions including chronic bronchitis and
emphysema. COPD leads to damaged airways in the lungs, causing them to
become narrower and making it harder for air to get in and out of the
lungs. The word 'chronic' means that the problem is long-term. The WHO
predicts it will be the third leading cause of death worldwide by 2030.
Smiths Medical
Smiths Medical is a leading supplier of high-quality medical devices and
products for global markets. It designs and manufactures specialist
medical devices in three key areas: Safety Devices, Vital Care and
Medication Delivery. Smiths Medical's customers include hospitals,
alternate care such as home care, and other healthcare providers
worldwide. Smiths Medical is part of the global technology business
Smiths Group, a world leader in the practical application of advanced
technologies. Smiths is a global technology company listed on the London
Stock Exchange. For further information, visit smiths-medical
Smiths Group
Smiths is a global technology company listed on the London Stock
Exchange. A world leader in the practical application of advanced
technologies, Smiths Group delivers products and services for the threat
& contraband detection, medical devices, energy and communications
markets worldwide. Our products and services make the world safer,
healthier and more productive. Smiths Group employs more than 20,000
people in over 50 countries. For more information visit smiths
Caudwell Xtreme Everest (CXE)
Caudwell Xtreme Everest is a research project coordinated by the UCL
Centre for Altitude, Space and Extreme (CASE) environment medicine -
doctors and scientists studying human systems stretched to breaking
point in extreme environments to increase our understanding of
critically ill patients. The goal is to place a research team on the
summit of Mount Everest in 2007 and make the first ever measurement of
the level of oxygen in human blood at this altitude. This is the
centrepiece of an extensive programme of research into hypoxia (low
oxygen levels) and human performance at extreme altitude aimed at
improving the care of the critically ill and other patients where
hypoxia is a fundamental problem. The Caudwell Xtreme Everest
expedition is being sponsored by John Caudwell, a businessman and
founder of The Caudwell Charity. Scientific studies in the run-up to
the expedition have been supported by a research grant from medical
gases specialist BOC Medical.
Caudwell Xtreme Everest
technology business Smiths Group, and University College London (UCL)
has resulted in the development of a breakthrough clinical device that
could transform the lives of patients with COPD across the world. COPD
will be the third leading cause of death worldwide by 2030, according to
the World Health Organisation (WHO).
The new technology is based on a closed circuit oxygen device invented
over 50 years ago by the British rocket scientist Tom Bourdillon, who
hoped that it would help take him to the top of the world.
Three days before Edmund Hillary and Tenzing Norgay made the first
ascent of Mount Everest in 1953, Bourdillon nearly got there first with
the help of his ground-breaking invention. When he and his climbing
partner Charles Evans, a British brain surgeon, set out on the first
ever summit attempt they were breathing pure oxygen from the device. It
helped them climb higher than any man had ever been before and at speeds
that have rarely been matched since.
The two men were just 90 metres from the summit when Evans' device
malfunctioned dashing their hopes of becoming the most celebrated
mountaineers in the world. Three days later Hillary and Norgay claimed
that honour using open circuit oxygen devices.
Bourdillon believed that closed circuit oxygen was more efficient and
effective than open circuit because a closed circuit efficiently
recycles exhaled oxygen, which would be lost to the atmosphere in an
open circuit.
His research was forgotten for 50 years but now Smiths Medical and UCL
have developed Bourdillon's idea into a breakthrough medical device that
could help patients with COPD, which is a disease of the lungs in which
the airways become narrowed leading to a limitation of the flow of air
to and from the lungs, causing shortness of breath.
"We are hoping that this new technology will transform the lives of
people living with COPD by allowing them to breathe more easily,
exercise and ultimately reduce their dependence on oxygen. It is
incredible to think that this breakthrough device is based on a British
invention designed to help the first mountaineers reach the top of the
world," said Dr Jeremy Russell, head of research and development at
Smiths Medical International.
Bourdillon's research was rediscovered by Jeremy Windsor and Roger
McMorrow, mountaineering scientists at the UCL Centre for Altitude,
Space and Extreme Environment Medicine (CASE), who had the idea to
redevelop it into a modern breathing circuit for climbers.
"Bourdillon recognized that the problem on Everest was low levels of
oxygen and if you solved the problem of delivering oxygen you would
effectively reduce the height of the mountain to sea level," said Dr
McMorrow. "No-one knows exactly why his device failed but when I tested
my prototype on Cho Oyu in the Himalayas 2005 it also failed. In my case
the soda lime CO2 absorber malfunctioned and it is possible Bourdillon
had the same problem although another theory is that it was a frozen
valve. A recently invented CO2 absorber called ExtendAir solved the
problem on my circuit."
Dr McMorrow, when a Smiths Medical Research Fellow at UCL, showed his
mountaineering prototype to Dr Russell at Smiths Medical, which has a
long-standing partnership with UCL that includes collaboration on
research in the field of respiratory medicine. The two scientists
quickly realized that the prototype for mountaineers had the potential
to evolve into a ground-breaking device for COPD patients as well as for
other patients weaning from oxygen in hospital and those on home oxygen.
Last year the device was successfully tested on Mount Everest at the
Smiths Medical High Altitude Laboratory at Namche Bazaar, Nepal at
3,400m, (11,154 ft) as part of the Caudwell Xtreme Everest Study (CXE),
a medical research project conducted by CASE. Smiths Medical is now
optimizing and miniaturizing the prototype for patients.
Exercise is important for COPD patients but existing oxygen systems mean
it is often not possible. The size of current open circuit systems mean
that patients are often confined to their hospital beds or treated at
home with large cylinders that severely restrict their mobility.
Portable open circuit systems are not able to deliver high enough
volumes of oxygen for long enough to permit exercise. In an open circuit
system the faster a person breathes the more they dilute the oxygen with
ordinary air. This means that if a patient dependent on oxygen starts to
exercise their oxygen levels actually drop as their breathing grows
faster.
Dr Russell added: "The new system is portable and should deliver a very
high concentration of oxygen for a sustained period of time. It should
help keep oxygen levels constant no matter how fast or slow a patient is
breathing."
Previously, portable closed circuits have been used by Special Forces
frogmen (because there are no bubbles), mine rescue workers,
firefighters and in bioterrorism suits.
George Band, who was the youngest member of the 1953 Everest expedition,
said: "I remember how passionate Tom was about his closed circuit device
and how disappointed he and Charles were not to make it to the summit.
I'm sure Tom would have been really thrilled that his research on the
closed-circuit oxygen equipment did not go to waste and could help
people suffering from respiratory problems today."
Professor Monty Mythen, Smiths Medical Professor of Anaesthesia at UCL
and Director of Research and Development at UCL Hospitals said: "This
project is a fantastic example of the success that comes from scientists
in industry working closely with clinicians and university academics for
patient benefit. Smiths Medical in collaboration with UCL and NHS
Partners makes a formidable team and I am delighted that the Caudwell
Xtreme Everest expedition is beginning to reap rewards for patients."
COPD
COPD stands for chronic obstructive pulmonary disease. This is a term
used for a number of conditions including chronic bronchitis and
emphysema. COPD leads to damaged airways in the lungs, causing them to
become narrower and making it harder for air to get in and out of the
lungs. The word 'chronic' means that the problem is long-term. The WHO
predicts it will be the third leading cause of death worldwide by 2030.
Smiths Medical
Smiths Medical is a leading supplier of high-quality medical devices and
products for global markets. It designs and manufactures specialist
medical devices in three key areas: Safety Devices, Vital Care and
Medication Delivery. Smiths Medical's customers include hospitals,
alternate care such as home care, and other healthcare providers
worldwide. Smiths Medical is part of the global technology business
Smiths Group, a world leader in the practical application of advanced
technologies. Smiths is a global technology company listed on the London
Stock Exchange. For further information, visit smiths-medical
Smiths Group
Smiths is a global technology company listed on the London Stock
Exchange. A world leader in the practical application of advanced
technologies, Smiths Group delivers products and services for the threat
& contraband detection, medical devices, energy and communications
markets worldwide. Our products and services make the world safer,
healthier and more productive. Smiths Group employs more than 20,000
people in over 50 countries. For more information visit smiths
Caudwell Xtreme Everest (CXE)
Caudwell Xtreme Everest is a research project coordinated by the UCL
Centre for Altitude, Space and Extreme (CASE) environment medicine -
doctors and scientists studying human systems stretched to breaking
point in extreme environments to increase our understanding of
critically ill patients. The goal is to place a research team on the
summit of Mount Everest in 2007 and make the first ever measurement of
the level of oxygen in human blood at this altitude. This is the
centrepiece of an extensive programme of research into hypoxia (low
oxygen levels) and human performance at extreme altitude aimed at
improving the care of the critically ill and other patients where
hypoxia is a fundamental problem. The Caudwell Xtreme Everest
expedition is being sponsored by John Caudwell, a businessman and
founder of The Caudwell Charity. Scientific studies in the run-up to
the expedition have been supported by a research grant from medical
gases specialist BOC Medical.
Caudwell Xtreme Everest
Children With Severe Asthma At Increased Risk Of Developing COPD
To contact us Click HERE
Children with severe asthma have more than 30 times the risk of developing adult chronic obstructive lung disease (COPD) as adults compared to children without asthma, according to a prospective longitudinal cohort study from the Royal Children's Hospital in Melbourne.
The results will be presented at the ATS 2010 International Conference in New Orleans.
"There is important epidemiological evidence to suggest that events in childhood that influence lung growth constitute a significant risk for COPD," explained lead author, Andrew Tai, MBBS, FRACP. "The aim of this study was to describe the association between the pattern of childhood asthma and the risk of developing adult COPD in a longitudinal cohort."
Subjects of the Melbourne Asthma Study were recruited at the age of seven, from a 1957 birth cohort and were assessed regularly until the age of 50. At recruitment, subjects were classified as having no history of wheeze, intermittent asthma (such as viral-induced wheezing), persistent asthma (in the absence of illness), or severe asthma. Of the surviving members of the original group, 197 answered a detailed questionnaire and underwent lung function testing for the current study.
Subjects who were classified as having severe asthma in childhood had an adjusted risk of COPD of 31.9 times that of children without asthma. Interestingly, children with mild asthma were not at increased risk of developing adult obstructive lung disease.
"At this stage, children with mild asthma are those who have symptoms of wheeze which are triggered primarily by respiratory infections. A majority [of children with mild asthma] remit by adolescence or adulthood," explained Dr. Tai. "However, children with more severe asthma features tend to have predisposing risk factors (like atopy) and continue to have symptoms of wheeze well into adult life."
"It is important to emphasize that the lung function decline in this group is not increased compared to those with mild or no asthma, as has been raised in some other studies," Dr. Tai continued. "However, lung function in children with severe asthma are reduced in childhood years and decline in adult life to levels consistent with adult obstructive lung disease. Fundamentally, we believe that this severe asthma group start with a lesser baseline lung function and gradually deteriorate to the levels consistent with a diagnosis of COPD. At this stage, there is no data on when airway remodeling occurs in children and hence, its impact on lung function, but there is an emerging relationship between childhood severe asthma and adult obstructive lung disease."
Importantly, this study was performed on a group of children recruited in the 1960s when anti-inflammatory treatment was not available. Studies to date suggest that anti-inflammatory medications do not alter the natural progression of mild childhood asthma, but there are no studies performed in those children with severe asthma.
"There should be greater emphasis on the surveillance and treatment of children with asthma, therefore potentially preventing the development of adult obstructive lung disease," said Dr. Tai.
Researchers still do not fully understand the mechanisms that link severe childhood asthma with adult COPD, but these findings suggest that appropriate treatment strategies (and surveillance) should be instigated early in life to potentially minimize future risk.
"Early treatment to prevent airway remodeling in childhood may reduce the incidence of this long-term complication of childhood asthma," concluded Dr. Tai.
"Currently, there are more than 30 birth cohort studies of varying duration being conducted around the world. In particular, the long-term follow-up of the Tucson birth cohort into young adulthood has shown trends similar to our findings of airway obstruction originating from early life. Clearly, more research to understand the mechanisms and timing of changes within the airway wall, inflammation and function needs to be conducted, applying preferably non-invasive methods in determining potential contributing factors."
"Pediatric Origins of Adult Chronic Obstructive Pulmonary Disease (COPD): Childhood Asthma" (Session A95, Sunday, May 16, 1:30-4:00 p.m., CC-Room 295-296 (Second Level), Morial Convention Center; Abstract 2206)
Source
American Thoracic Society (ATS)
The results will be presented at the ATS 2010 International Conference in New Orleans.
"There is important epidemiological evidence to suggest that events in childhood that influence lung growth constitute a significant risk for COPD," explained lead author, Andrew Tai, MBBS, FRACP. "The aim of this study was to describe the association between the pattern of childhood asthma and the risk of developing adult COPD in a longitudinal cohort."
Subjects of the Melbourne Asthma Study were recruited at the age of seven, from a 1957 birth cohort and were assessed regularly until the age of 50. At recruitment, subjects were classified as having no history of wheeze, intermittent asthma (such as viral-induced wheezing), persistent asthma (in the absence of illness), or severe asthma. Of the surviving members of the original group, 197 answered a detailed questionnaire and underwent lung function testing for the current study.
Subjects who were classified as having severe asthma in childhood had an adjusted risk of COPD of 31.9 times that of children without asthma. Interestingly, children with mild asthma were not at increased risk of developing adult obstructive lung disease.
"At this stage, children with mild asthma are those who have symptoms of wheeze which are triggered primarily by respiratory infections. A majority [of children with mild asthma] remit by adolescence or adulthood," explained Dr. Tai. "However, children with more severe asthma features tend to have predisposing risk factors (like atopy) and continue to have symptoms of wheeze well into adult life."
"It is important to emphasize that the lung function decline in this group is not increased compared to those with mild or no asthma, as has been raised in some other studies," Dr. Tai continued. "However, lung function in children with severe asthma are reduced in childhood years and decline in adult life to levels consistent with adult obstructive lung disease. Fundamentally, we believe that this severe asthma group start with a lesser baseline lung function and gradually deteriorate to the levels consistent with a diagnosis of COPD. At this stage, there is no data on when airway remodeling occurs in children and hence, its impact on lung function, but there is an emerging relationship between childhood severe asthma and adult obstructive lung disease."
Importantly, this study was performed on a group of children recruited in the 1960s when anti-inflammatory treatment was not available. Studies to date suggest that anti-inflammatory medications do not alter the natural progression of mild childhood asthma, but there are no studies performed in those children with severe asthma.
"There should be greater emphasis on the surveillance and treatment of children with asthma, therefore potentially preventing the development of adult obstructive lung disease," said Dr. Tai.
Researchers still do not fully understand the mechanisms that link severe childhood asthma with adult COPD, but these findings suggest that appropriate treatment strategies (and surveillance) should be instigated early in life to potentially minimize future risk.
"Early treatment to prevent airway remodeling in childhood may reduce the incidence of this long-term complication of childhood asthma," concluded Dr. Tai.
"Currently, there are more than 30 birth cohort studies of varying duration being conducted around the world. In particular, the long-term follow-up of the Tucson birth cohort into young adulthood has shown trends similar to our findings of airway obstruction originating from early life. Clearly, more research to understand the mechanisms and timing of changes within the airway wall, inflammation and function needs to be conducted, applying preferably non-invasive methods in determining potential contributing factors."
"Pediatric Origins of Adult Chronic Obstructive Pulmonary Disease (COPD): Childhood Asthma" (Session A95, Sunday, May 16, 1:30-4:00 p.m., CC-Room 295-296 (Second Level), Morial Convention Center; Abstract 2206)
Source
American Thoracic Society (ATS)
Patients dislike hospital admission more than worsening symptoms in exacerbations of COPD
To contact us Click HERE
Exacerbations of COPD - an acute worsening of symptoms, often triggered by a respiratory infection, requiring medical intervention and often hospitalisation - are extremely distressing for patients with this condition and their families.
But what features of exacerbations do patients with COPD consider most important and most distressing?
In this study, undertaken by John Haughney (University of Aberdeen, UK) and his European colleagues, 125 patients from five countries with recurring exacerbations of COPD were interviewed face-to-face. This study was the first of its kind to use discrete-choice modelling in COPD.
Discrete-choice modelling is a powerful tool, which, through forcing choice, allows measurement of the relative importance of different features of a scenario, in this case exacerbations of COPD. It has been used widely in commercial situations and a number of studies have now been reported in the medical literature.
Contrary to a popularly held belief that symptom control is the main aim of treatment, the authors report that the feature that most patients with COPD desire at the time of an exacerbation is not to be housebound, and, in particular, not to be admitted to hospital.
These features ranked as more important than relief of breathlessness, cough and speed of recovery.
The authors conclude that clinicians should focus their efforts on minimising the frequency and severity of exacerbations; the relief of symptoms, such as breathlessness and cough, is not enough.
The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 7,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).
European Respiratory Journal
But what features of exacerbations do patients with COPD consider most important and most distressing?
In this study, undertaken by John Haughney (University of Aberdeen, UK) and his European colleagues, 125 patients from five countries with recurring exacerbations of COPD were interviewed face-to-face. This study was the first of its kind to use discrete-choice modelling in COPD.
Discrete-choice modelling is a powerful tool, which, through forcing choice, allows measurement of the relative importance of different features of a scenario, in this case exacerbations of COPD. It has been used widely in commercial situations and a number of studies have now been reported in the medical literature.
Contrary to a popularly held belief that symptom control is the main aim of treatment, the authors report that the feature that most patients with COPD desire at the time of an exacerbation is not to be housebound, and, in particular, not to be admitted to hospital.
These features ranked as more important than relief of breathlessness, cough and speed of recovery.
The authors conclude that clinicians should focus their efforts on minimising the frequency and severity of exacerbations; the relief of symptoms, such as breathlessness and cough, is not enough.
The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 7,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).
European Respiratory Journal
Bladder Prolapse Repair
To contact us Click HERE
What is bladder prolapse repair?
The bladder prolapse repair is one of the major organs. This is a cave like organ that stores urine until the release of the organism's body urethra. Bladder prolapse, also known as fallen bladder or cystocele common in women as it involves the bladder and vagina.
What causes bladder prolapse repair?
There are many causes of bladder prolapse repair but women who suffer from this condition have to recognize the symptoms to seek treatment immediately. It is important to consult with your doctor regularly for symptoms for mild cases are at times hidden.
What are the symptoms of bladder prolapse repair?
The initial early warning symptoms of bladder prolapse repair is a feeling of fullness or pressure in the vagina. This is the first step bladder prolapse. These networks can be prominent in the vagina and may bleed. Discomfort and pain around the hip and difficulty in urination may be a symptom of bladder prolapse. In later stages of this condition, bladder infections can be a lot that can affect other.
How is bladder prolapse repair diagnosed?
Bladder prolapse repair requiring treatment in the mild stages of the base. This can be a self-care options for action that is used methodically. Seeing as this condition involves the bladder plus the vagina, there is a need to strengthen the pelvic floor muscles through exercise and proper diet. Lower back pain can also be experienced and the patient may suffer from stress incontinence, a condition where you lose control of urine when coughing and sneezing. On a more serious stage, urination can no longer be controlled.
How is bladder prolapse repair treated?
An action is called pessary can be integrated in the treatment where the rubber ring is inserted into the vagina to cradle the bladder. Doctors also recommend taking estrogen to strengthen the pelvic floor muscles. Estrogen can be taken by mouth or by using a vaginal cream for women in menopause.
Additional Info
American College of Obstetricians and Gynecologists
P.O. Box 96920
Washington, DC 20090-6920
Phone: 202-638-5577
www.acog.org
 |
Bladder Prolapse Repair |
The bladder prolapse repair is one of the major organs. This is a cave like organ that stores urine until the release of the organism's body urethra. Bladder prolapse, also known as fallen bladder or cystocele common in women as it involves the bladder and vagina.
What causes bladder prolapse repair?
There are many causes of bladder prolapse repair but women who suffer from this condition have to recognize the symptoms to seek treatment immediately. It is important to consult with your doctor regularly for symptoms for mild cases are at times hidden.
What are the symptoms of bladder prolapse repair?
The initial early warning symptoms of bladder prolapse repair is a feeling of fullness or pressure in the vagina. This is the first step bladder prolapse. These networks can be prominent in the vagina and may bleed. Discomfort and pain around the hip and difficulty in urination may be a symptom of bladder prolapse. In later stages of this condition, bladder infections can be a lot that can affect other.
How is bladder prolapse repair diagnosed?
Bladder prolapse repair requiring treatment in the mild stages of the base. This can be a self-care options for action that is used methodically. Seeing as this condition involves the bladder plus the vagina, there is a need to strengthen the pelvic floor muscles through exercise and proper diet. Lower back pain can also be experienced and the patient may suffer from stress incontinence, a condition where you lose control of urine when coughing and sneezing. On a more serious stage, urination can no longer be controlled.
How is bladder prolapse repair treated?
An action is called pessary can be integrated in the treatment where the rubber ring is inserted into the vagina to cradle the bladder. Doctors also recommend taking estrogen to strengthen the pelvic floor muscles. Estrogen can be taken by mouth or by using a vaginal cream for women in menopause.
Additional Info
American College of Obstetricians and Gynecologists
P.O. Box 96920
Washington, DC 20090-6920
Phone: 202-638-5577
www.acog.org
Rectocele
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What is rectocele?
This can be caused by vaginal childbirth. Difficulties passing stool may result. Some women find it helps to place one or more fingers inside the vagina to help support the bulging tissues and facilitate a bowel movement. In women, the vagina is separated from the rectum by a firm wall of tough, fibrous tissue called fascia. Sometimes, an area of this wall gets weak, and part of the rectum bulges into the vagina. This bulge is called a rectocele. In women, the rectum may bulge into the vagina Because of weakening of the vaginal wall and other supportive tissue causing a rectocele.
What causes rectocele?
In some cases, the patient must use a technique called manual evacuation of digitization to help empty the rectum. In this technique, the patient pressed the rectocele with her fingers to help the bowel to pass stools. The most common cause for a rectocele is obstetric trauma. During a vaginal delivery, the connective tissue, the rectum and vagina Between can be torn, and then years after the vaginal delivery this weakness in connective tissue can form a hernia in the which the rectum bulges into the vagina.
What are the symptoms of rectocele?
Some women have to put their fingers in the vagina to relieve pressure as well as some women have to push on their perineum or move in a certain position to help fill their empty stomachs. A small rectocele may not cause any symptoms, especially if the bulge is less than 2 cm (less than 1 inch) into the vagina. However, larger rectoceles can trigger a variety of complaints rectum and vagina. The most common symptoms of a rectocele is pelvic pressure, pelvic pain, and something that stands out or protrude into the vagina. Some women have difficulty emptying their bowels due to the fact that when they strain to defecate, the feces will not get out through the anus, feces in the bag this bulge into the vagina rectocele.
How is rectocele diagnosed?
You will be asked to tighten your pelvic muscles as if you are trying to stop urinating, to see how strong your pelvic muscles. After reviewing the rectal and vaginal symptoms, your doctor may also ask about urinary problems that suggest that you might have cystocele and rectocele. You will be asked to strain or pressure. This can cause the rectocele to bulge, so its size and location can be checked.
How is rectocele treated?
Treatment is not required for prolapse which causes little or no symptoms. If the prolapse is disturbing, some of the treatments available, milder forms of prolapse can fix it by practicing Kegel exercises., A support brace (called a pessary) can be worn inside the vagina to support the bulging walls, the walls are damaged can be repaired through surgery.
For more informationAmerican Urogynecology Society (AUGS)2025 M Street NWSuite 800Washington, DC 20036Phone: 202-367-1167Fax: 202-367-2167Email: info@augs.orgwww.augs.org
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Rectocele |
This can be caused by vaginal childbirth. Difficulties passing stool may result. Some women find it helps to place one or more fingers inside the vagina to help support the bulging tissues and facilitate a bowel movement. In women, the vagina is separated from the rectum by a firm wall of tough, fibrous tissue called fascia. Sometimes, an area of this wall gets weak, and part of the rectum bulges into the vagina. This bulge is called a rectocele. In women, the rectum may bulge into the vagina Because of weakening of the vaginal wall and other supportive tissue causing a rectocele.
What causes rectocele?
In some cases, the patient must use a technique called manual evacuation of digitization to help empty the rectum. In this technique, the patient pressed the rectocele with her fingers to help the bowel to pass stools. The most common cause for a rectocele is obstetric trauma. During a vaginal delivery, the connective tissue, the rectum and vagina Between can be torn, and then years after the vaginal delivery this weakness in connective tissue can form a hernia in the which the rectum bulges into the vagina.
What are the symptoms of rectocele?
Some women have to put their fingers in the vagina to relieve pressure as well as some women have to push on their perineum or move in a certain position to help fill their empty stomachs. A small rectocele may not cause any symptoms, especially if the bulge is less than 2 cm (less than 1 inch) into the vagina. However, larger rectoceles can trigger a variety of complaints rectum and vagina. The most common symptoms of a rectocele is pelvic pressure, pelvic pain, and something that stands out or protrude into the vagina. Some women have difficulty emptying their bowels due to the fact that when they strain to defecate, the feces will not get out through the anus, feces in the bag this bulge into the vagina rectocele.
How is rectocele diagnosed?
You will be asked to tighten your pelvic muscles as if you are trying to stop urinating, to see how strong your pelvic muscles. After reviewing the rectal and vaginal symptoms, your doctor may also ask about urinary problems that suggest that you might have cystocele and rectocele. You will be asked to strain or pressure. This can cause the rectocele to bulge, so its size and location can be checked.
How is rectocele treated?
Treatment is not required for prolapse which causes little or no symptoms. If the prolapse is disturbing, some of the treatments available, milder forms of prolapse can fix it by practicing Kegel exercises., A support brace (called a pessary) can be worn inside the vagina to support the bulging walls, the walls are damaged can be repaired through surgery.
For more informationAmerican Urogynecology Society (AUGS)2025 M Street NWSuite 800Washington, DC 20036Phone: 202-367-1167Fax: 202-367-2167Email: info@augs.orgwww.augs.org
28 Eylül 2012 Cuma
Rectal Prolapse
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What is rectal prolapse?
Rectum may be displaced from its normal position and visible protruding from the anus. Rectal prolapse is the extension of the tissue of the rectal wall through the anal canal wall. In more serious cases, the circular ring of the rectal wall sticks out through the anus and outside the body. This condition causes a bulge rectum called rectal prolapse. Rectal prolapse is a condition in which the tissue loose near the end of the bowel slides down. The network may be partially or completely stay out of the anus.
What causes rectal prolapse?
Constipation, which is nothing but the formation of hard stools is the main culprit behind the rectum refugees. Pushing hardened stool through the colon, placing an undue burden on the rectum. This excessive force during the evacuation of the colon to the rectum to release the portion of the rectum of the pelvis. This in turn causes rectal prolapse, which can be a cause of great discomfort. Undue pressure on the rectum at the time of delivery can also cause rectal prolapse in women.
What are the symptoms of rectal prolapse?
Abnormal position of the rectum can cause painful bowel movements. In other words, bowel evacuation becomes a difficult task. Because the rectum is no longer in a position to withstand dirt, it causes the urge to defecate. As the condition worsens, it can interfere with day-to-day activities and cause pain when walking or sitting.
How is rectal prolapse treated?
For partial rectal prolapse, the use of natural stool softener is a good choice. Stool softeners can reduce constipation and promote bowel movements. A bench softened not put pressure on the rectum during bowel movements, so it is not possible to exacerbate the problem. To get rid of constipation is very important to eliminate rectal prolapse. Form of treatment is successful, only if the condition is detected in the early stages of development.
For more informationNational Institutes of Health (NIH)9000 Rockville PikeBethesda, MD 20892Phone: 301-496-4000www.nih.gov
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Rectal Prolapse |
Rectum may be displaced from its normal position and visible protruding from the anus. Rectal prolapse is the extension of the tissue of the rectal wall through the anal canal wall. In more serious cases, the circular ring of the rectal wall sticks out through the anus and outside the body. This condition causes a bulge rectum called rectal prolapse. Rectal prolapse is a condition in which the tissue loose near the end of the bowel slides down. The network may be partially or completely stay out of the anus.
What causes rectal prolapse?
Constipation, which is nothing but the formation of hard stools is the main culprit behind the rectum refugees. Pushing hardened stool through the colon, placing an undue burden on the rectum. This excessive force during the evacuation of the colon to the rectum to release the portion of the rectum of the pelvis. This in turn causes rectal prolapse, which can be a cause of great discomfort. Undue pressure on the rectum at the time of delivery can also cause rectal prolapse in women.
What are the symptoms of rectal prolapse?
Abnormal position of the rectum can cause painful bowel movements. In other words, bowel evacuation becomes a difficult task. Because the rectum is no longer in a position to withstand dirt, it causes the urge to defecate. As the condition worsens, it can interfere with day-to-day activities and cause pain when walking or sitting.
How is rectal prolapse treated?
For partial rectal prolapse, the use of natural stool softener is a good choice. Stool softeners can reduce constipation and promote bowel movements. A bench softened not put pressure on the rectum during bowel movements, so it is not possible to exacerbate the problem. To get rid of constipation is very important to eliminate rectal prolapse. Form of treatment is successful, only if the condition is detected in the early stages of development.
For more informationNational Institutes of Health (NIH)9000 Rockville PikeBethesda, MD 20892Phone: 301-496-4000www.nih.gov
Vaginal Mesh
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What is vaginal mesh?
Vaginal mesh has been widely used in the operation, especially in hernia repair. Mesh is a synthetic material and is permanent. Mesh has many holes in it to allow the body's own tissue to grow into the mesh. Mesh then provide a framework support.Vaginal mesh, or transvaginal mesh, intended to correct pelvic organ prolapse and stress urinary incontinence. Because these devices were first introduced, vaginal mesh gained great popularity among women seeking innovative solutions to their delicate condition. Despite the early success stories among the masses, the report soon appear very different.
What causes vaginal mesh?
There are a lot of mesh implants with different names. They all mesh or bladder sling devices we look for vaginal mesh lawsuits. Food & Drug Administration (FDA) issued a public health notification urged for physicians and patients about the serious complications associated with transvaginal placement of surgical mesh in the repair of Pelvic Organ Prolapse and Stress Urinary Incontinence.
How is vaginal mesh diagnosed?
Different models vaginal mesh made of different materials. These materials fall into four categories: synthetic mesh to absorb; non-absorbable polypropylene mesh, organic or biological. Many women who experience stress incontinence or pelvic organ prolapse treated with transvaginal mesh implantation. Unfortunately, although these products are supposed to help keep everything in place and help them feel better, in many cases, it begins to cause serious and significant medical problems that sometimes far worse than what it is intended to treat mesh.
What are the symptoms of vaginal mesh?
If you have not been to the doctor and had symptoms of severe pain, pain during intercourse, increased disability incontinence, urinary or difficulty in urination, infection, bleeding, and other symptoms that are presented in the 'National Women's Health Information Center'.If you have had surgery to repair pelvic organ prolapse or stress urinary incontinence, your surgeon may have used vaginal mesh. Defects vaginal mesh can cause serious injuries and life-threatening infections. if you have been to the doctor and have been told you need surgery revision or removal of mesh or have undergone revision surgery or mesh removed.
How is vaginal mesh treated?
Some women would be suitable to try vaginal pessary instead of surgery. Vaginal pessaries are devices that support the vagina, which need to be replaced every 2 to 5 months. Vaginal pessaries has proven successful as surgery in relieving the symptoms of prolapse in women. Because vaginal mesh implants have been associated with severe complications and even death so many women suffer from stress urinary incontinence and pelvic organ prolapse are attempting to remove the device and search for other ways to treat their pelvic conditions.
For more information
National Women's Health Information Center (NWHIC)
8550 Arlington Blvd.
Suite 300
Fairfax, VA 22031
Toll-Free: 1-800-994-9662
TTY: 1-888-220-5446
www.4woman.org
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Vaginal Mesh |
Vaginal mesh has been widely used in the operation, especially in hernia repair. Mesh is a synthetic material and is permanent. Mesh has many holes in it to allow the body's own tissue to grow into the mesh. Mesh then provide a framework support.Vaginal mesh, or transvaginal mesh, intended to correct pelvic organ prolapse and stress urinary incontinence. Because these devices were first introduced, vaginal mesh gained great popularity among women seeking innovative solutions to their delicate condition. Despite the early success stories among the masses, the report soon appear very different.
What causes vaginal mesh?
There are a lot of mesh implants with different names. They all mesh or bladder sling devices we look for vaginal mesh lawsuits. Food & Drug Administration (FDA) issued a public health notification urged for physicians and patients about the serious complications associated with transvaginal placement of surgical mesh in the repair of Pelvic Organ Prolapse and Stress Urinary Incontinence.
How is vaginal mesh diagnosed?
Different models vaginal mesh made of different materials. These materials fall into four categories: synthetic mesh to absorb; non-absorbable polypropylene mesh, organic or biological. Many women who experience stress incontinence or pelvic organ prolapse treated with transvaginal mesh implantation. Unfortunately, although these products are supposed to help keep everything in place and help them feel better, in many cases, it begins to cause serious and significant medical problems that sometimes far worse than what it is intended to treat mesh.
What are the symptoms of vaginal mesh?
If you have not been to the doctor and had symptoms of severe pain, pain during intercourse, increased disability incontinence, urinary or difficulty in urination, infection, bleeding, and other symptoms that are presented in the 'National Women's Health Information Center'.If you have had surgery to repair pelvic organ prolapse or stress urinary incontinence, your surgeon may have used vaginal mesh. Defects vaginal mesh can cause serious injuries and life-threatening infections. if you have been to the doctor and have been told you need surgery revision or removal of mesh or have undergone revision surgery or mesh removed.
How is vaginal mesh treated?
Some women would be suitable to try vaginal pessary instead of surgery. Vaginal pessaries are devices that support the vagina, which need to be replaced every 2 to 5 months. Vaginal pessaries has proven successful as surgery in relieving the symptoms of prolapse in women. Because vaginal mesh implants have been associated with severe complications and even death so many women suffer from stress urinary incontinence and pelvic organ prolapse are attempting to remove the device and search for other ways to treat their pelvic conditions.
For more information
National Women's Health Information Center (NWHIC)
8550 Arlington Blvd.
Suite 300
Fairfax, VA 22031
Toll-Free: 1-800-994-9662
TTY: 1-888-220-5446
www.4woman.org
Uterine Procidentia
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What is uterine procidentia?
Uterine procidentia is a common term used to describe a condition in which the pelvic organs or tissue down into the vaginal canal. Uterine procidentia is a decline in the womb (uterus) into the vaginal canal. The group is also known as pelvic floor disorders or pelvic support disorders.
What causes uterine procidentia?
Uterine procidentia include uterine prolapse, and prolapse of the vagina (prolapsed vagina), bladder (cystocele), rectum (rectocele) and small intestine (enterocele). Disorders of uterine procidentia may occur alone or in combination with one another.
How is uterine procidentia diagnosed?
In order to properly diagnose the cause and extent of your incontinence, specialists will have to examine the abdomen, pelvis, rectum, and your nervous system Uterine procidentia include uterine prolapse, and prolapse of the vagina (vaginal prolapse), bladder (cystocele), rectum (rectocele) and small bowel (enterocele). Procidentia uterine disorders may occur alone or in combination with one another.
What are the symptoms of uterine procidentia?
For women dealing with mild symptoms, a simple change may be an effective treatment of uterine procidentia Symptoms can be aggravated by prolonged standing or walking. This is due to additional pressure placed on the pelvic muscles by gravity. Women who have just started experiencing symptoms of uterine procidentia may opt for non-surgical methods as a first step.
How is uterine procidentia treated?
Many doctors or physical therapists recommend routine pelvic muscle exercises, known as Kegel exercises many women. It can help strengthen the pelvic floor muscles and can relieve some of the symptoms of mild prolapse. There is a choice of surgical and non-surgical treatment for uterine procidentia. The treatment chosen will depend on the severity of the condition, as well as general women's health, age and the desire to have children. Treatment is generally effective for most women.
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Uterine Procidentia |
Uterine procidentia is a common term used to describe a condition in which the pelvic organs or tissue down into the vaginal canal. Uterine procidentia is a decline in the womb (uterus) into the vaginal canal. The group is also known as pelvic floor disorders or pelvic support disorders.
What causes uterine procidentia?
Uterine procidentia include uterine prolapse, and prolapse of the vagina (prolapsed vagina), bladder (cystocele), rectum (rectocele) and small intestine (enterocele). Disorders of uterine procidentia may occur alone or in combination with one another.
How is uterine procidentia diagnosed?
In order to properly diagnose the cause and extent of your incontinence, specialists will have to examine the abdomen, pelvis, rectum, and your nervous system Uterine procidentia include uterine prolapse, and prolapse of the vagina (vaginal prolapse), bladder (cystocele), rectum (rectocele) and small bowel (enterocele). Procidentia uterine disorders may occur alone or in combination with one another.
What are the symptoms of uterine procidentia?
For women dealing with mild symptoms, a simple change may be an effective treatment of uterine procidentia Symptoms can be aggravated by prolonged standing or walking. This is due to additional pressure placed on the pelvic muscles by gravity. Women who have just started experiencing symptoms of uterine procidentia may opt for non-surgical methods as a first step.
How is uterine procidentia treated?
Many doctors or physical therapists recommend routine pelvic muscle exercises, known as Kegel exercises many women. It can help strengthen the pelvic floor muscles and can relieve some of the symptoms of mild prolapse. There is a choice of surgical and non-surgical treatment for uterine procidentia. The treatment chosen will depend on the severity of the condition, as well as general women's health, age and the desire to have children. Treatment is generally effective for most women.
Fallopian Tube Blockage
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What is a fallopian tube blockage procedure?
The fallopian tube blockage play an important role in the process of ovulation and conception She had to track her cycle ovulation predictor kit carefully with fallopian tube blockage can prevent the egg and sperm from meeting, thus interfere with conception, or to prevent the fertilized egg into the uterus. The eggs can not be fertilized and the embryos can not reach the uterus for implantation without fallopian tubes. Using fluoroscopy or hysteroscopy to guide the instruments, a doctor inserts a catheter or cannula, through the cervix and uterus and into the fallopian tubes.
How effective is a fallopian tube blockage procedure?
This in turn causes rectal prolapse, which can be a cause of great discomfort. Excessive pressure in the rectum at the time of delivery can also cause rectal prolapse in women. The problem is when a woman has scar tissue that builds up in her fallopian tubes. As the scar tissue build up blocked fallopian tubes. This is also the reason that many women will get pregnant but the fertilized egg will implant into the fallopian tubes and lead to ectopic pregnancies. Constipation, which is nothing but the formation of hard stools is the main culprit behind the refugees rectum. Pushing hardened stool through the colon, placing an undue burden on the rectum. This excessive force during the evacuation of the colon to the rectum to release the pelvic portion of the rectum.
What are the risks of a fallopian tube blockage procedure?
The risk of fallopian tube surgery include: pelvic infection. Scar tissue (adhesions) form in the reproductive organs, causing them to bind to the abdominal wall or to other organs. Increased risk of tubal (ectopic) pregnancy after surgery. Blocked fallopian tubes can occur for several reasons. The most common reason is an infection that you may not even know you had. Pelvic inflammatory disease is one of the main reasons. When a woman has a pelvic infection he may not even be aware of it. Cases of pelvic inflammation can be so mild that a woman can go without the signs and then clean up
How can I get pregnant if I have fallopian tube blockage problems?
A laparoscopy can repair damaged fallopian tubes and increase fertility. If the fallopian tubes are damaged or the operation is not possible conception, in vitro fertilization for cutting tubes may be recommended. In the case of fallopian tubes are blocked and dilated, patients may consider surgery to remove the fallopian tubes are open or to increase their chances of conceiving. Abnormalities of the fallopian tubes, including tubal scarring or blockage prior abdominal surgery, and endometriosis. The fallopian tubes are initially evaluated by hysterosalpingogram and if necessary, will be more thoroughly evaluated with laparoscopy.
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Fallopian Tube Blockage |
The fallopian tube blockage play an important role in the process of ovulation and conception She had to track her cycle ovulation predictor kit carefully with fallopian tube blockage can prevent the egg and sperm from meeting, thus interfere with conception, or to prevent the fertilized egg into the uterus. The eggs can not be fertilized and the embryos can not reach the uterus for implantation without fallopian tubes. Using fluoroscopy or hysteroscopy to guide the instruments, a doctor inserts a catheter or cannula, through the cervix and uterus and into the fallopian tubes.
How effective is a fallopian tube blockage procedure?
This in turn causes rectal prolapse, which can be a cause of great discomfort. Excessive pressure in the rectum at the time of delivery can also cause rectal prolapse in women. The problem is when a woman has scar tissue that builds up in her fallopian tubes. As the scar tissue build up blocked fallopian tubes. This is also the reason that many women will get pregnant but the fertilized egg will implant into the fallopian tubes and lead to ectopic pregnancies. Constipation, which is nothing but the formation of hard stools is the main culprit behind the refugees rectum. Pushing hardened stool through the colon, placing an undue burden on the rectum. This excessive force during the evacuation of the colon to the rectum to release the pelvic portion of the rectum.
What are the risks of a fallopian tube blockage procedure?
The risk of fallopian tube surgery include: pelvic infection. Scar tissue (adhesions) form in the reproductive organs, causing them to bind to the abdominal wall or to other organs. Increased risk of tubal (ectopic) pregnancy after surgery. Blocked fallopian tubes can occur for several reasons. The most common reason is an infection that you may not even know you had. Pelvic inflammatory disease is one of the main reasons. When a woman has a pelvic infection he may not even be aware of it. Cases of pelvic inflammation can be so mild that a woman can go without the signs and then clean up
How can I get pregnant if I have fallopian tube blockage problems?
A laparoscopy can repair damaged fallopian tubes and increase fertility. If the fallopian tubes are damaged or the operation is not possible conception, in vitro fertilization for cutting tubes may be recommended. In the case of fallopian tubes are blocked and dilated, patients may consider surgery to remove the fallopian tubes are open or to increase their chances of conceiving. Abnormalities of the fallopian tubes, including tubal scarring or blockage prior abdominal surgery, and endometriosis. The fallopian tubes are initially evaluated by hysterosalpingogram and if necessary, will be more thoroughly evaluated with laparoscopy.
Vaginal Prolapse
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What is vaginal prolapse?
Vaginal prolapse is a common condition in which the bladder, uterus and bowel or protrudes into the vagina. The majority of women will have symptomatic improvement after surgery. This occurs as a result of the weakness of the pelvic floor. This can cause symptoms such as vaginal lump sensation, constipation, difficulty emptying the bowel or bladder or problems with intercourse. Treatment is only indicated when the prolapse is symptomatic. Pelvic floor is a sheet of muscle and connective tissue that stretches from the pubic bone to the tail bone and around the vagina, rectum, bladder and uterus. Pelvic floor holding the pelvic organs in their appropriate positons in the pelvis. If the pelvic floor is weak, these organs fall from their normal position and function normally.
What causes vaginal prolapse?
Risk factors for the development of vaginal prolapse is a pregnancy, vaginal delivery, hysterectomy, obesity, chronic cough, chronic constipation, repeated heavy lifting, menopause, and weakness of the genetic connective tissue. Vaginal prolapse occurs when the pelvic organs, including the bladder or rectum bulges into the vaginal wall due to the weakening of muscles and ligaments supporting important. The exact cause of vaginal prolapse is unknown. Greater than 40% of women showed some degree of prolapse. It is not understood why some women have prolapse while others with the same risk factors do not. However, risk factors include pregnancy, vaginal delivery, hysterectomy, obesity, chronic cough, chronic constipation, repeated heavy lifting, menopause and genetic connective tissue weakness.
How is vaginal prolapse diagnosed?
The presence and severity of vaginal prolapse is determined during a pelvic examination. Anterior vaginal wall, posterior vaginal wall, the vagina, and uterus respectively evaluated for prolapse. A stage from 0 to IV is assigned to each part of the vagina depending on how near the collapse coming to or through the vaginal opening. A stage 0 prolapse means no prolapse present. A stage I vaginal wall prolapse means that the bulge to three inches inside the vaginal opening. A phase II prolapse means that the vaginal wall or a little coming through the hole. A stage III prolapse is when the vaginal wall protrudes a few inches inside the vagina. A stage IV prolapse is when the vagina around the protruding through the hole.What are the symptoms of vaginal prolapse?
How is vaginal prolapse treated?
In certain situations, the dome of the vagina may be suspended at the back of the pelvic bone. Dr Tyagi has done laparoscopic and robotic procedures since 2005. A permanent graft sutured to the wall of the vagina and / or uterus and then permanently connected to the sacrum. Therapy is non-surgical and surgical treatments are available for pelvic floor prolapse consists of a series of visits to a physical therapist who has specialized training in the treatment of pelvic floor problems. Physical therapists use a technique to help women strengthen the pelvic floor muscles that hold the pelvic organs in position tepat.vagina. A hysterectomy is the removal of the uterus. This is done for severe uterine prolapse. A hysterectomy may be done through a vaginal or abdominal incision.
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vaginal prolapse |
Vaginal prolapse is a common condition in which the bladder, uterus and bowel or protrudes into the vagina. The majority of women will have symptomatic improvement after surgery. This occurs as a result of the weakness of the pelvic floor. This can cause symptoms such as vaginal lump sensation, constipation, difficulty emptying the bowel or bladder or problems with intercourse. Treatment is only indicated when the prolapse is symptomatic. Pelvic floor is a sheet of muscle and connective tissue that stretches from the pubic bone to the tail bone and around the vagina, rectum, bladder and uterus. Pelvic floor holding the pelvic organs in their appropriate positons in the pelvis. If the pelvic floor is weak, these organs fall from their normal position and function normally.
What causes vaginal prolapse?
Risk factors for the development of vaginal prolapse is a pregnancy, vaginal delivery, hysterectomy, obesity, chronic cough, chronic constipation, repeated heavy lifting, menopause, and weakness of the genetic connective tissue. Vaginal prolapse occurs when the pelvic organs, including the bladder or rectum bulges into the vaginal wall due to the weakening of muscles and ligaments supporting important. The exact cause of vaginal prolapse is unknown. Greater than 40% of women showed some degree of prolapse. It is not understood why some women have prolapse while others with the same risk factors do not. However, risk factors include pregnancy, vaginal delivery, hysterectomy, obesity, chronic cough, chronic constipation, repeated heavy lifting, menopause and genetic connective tissue weakness.
How is vaginal prolapse diagnosed?
The presence and severity of vaginal prolapse is determined during a pelvic examination. Anterior vaginal wall, posterior vaginal wall, the vagina, and uterus respectively evaluated for prolapse. A stage from 0 to IV is assigned to each part of the vagina depending on how near the collapse coming to or through the vaginal opening. A stage 0 prolapse means no prolapse present. A stage I vaginal wall prolapse means that the bulge to three inches inside the vaginal opening. A phase II prolapse means that the vaginal wall or a little coming through the hole. A stage III prolapse is when the vaginal wall protrudes a few inches inside the vagina. A stage IV prolapse is when the vagina around the protruding through the hole.What are the symptoms of vaginal prolapse?
How is vaginal prolapse treated?
In certain situations, the dome of the vagina may be suspended at the back of the pelvic bone. Dr Tyagi has done laparoscopic and robotic procedures since 2005. A permanent graft sutured to the wall of the vagina and / or uterus and then permanently connected to the sacrum. Therapy is non-surgical and surgical treatments are available for pelvic floor prolapse consists of a series of visits to a physical therapist who has specialized training in the treatment of pelvic floor problems. Physical therapists use a technique to help women strengthen the pelvic floor muscles that hold the pelvic organs in position tepat.vagina. A hysterectomy is the removal of the uterus. This is done for severe uterine prolapse. A hysterectomy may be done through a vaginal or abdominal incision.
27 Eylül 2012 Perşembe
Lung Cancer Treatment
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Bronchial benign tumors are usually removed surgically because they can clog the bronchi and long may become malignant.
Sometimes performed surgery on the cancer other than small cell carcinoma that has not spread. Approximately 10-35% of cancers can be removed surgically, but surgery does not always bring healing.
Approximately 25-40% of patients and isolated tumor grows slowly, has a life expectancy of up to 5 years after his illness was diagnosed. Patients should perform routine checks for lung cancer recurrence in 6-12% of patients who had undergone surgery.
Before surgery, performed lung function tests to determine whether the remaining lung can still perform its functions well or not. If the result is ugly, it is not possible to do surgery.
Surgery is not necessary if:
- The cancer has spread beyond the lung
- Cancer is too close to the trachea
- Patients have serus circumstances (such as heart disease or lung disease is severe).
Radiation therapy performed in patients who can not undergo surgery because they have other serious illnesses.
The purpose of radiation is to slow cancer growth, not for healing. Radiation therapy also can reduce muscle pain, superior vena cava syndrome and suppression of the spinal cord. But radiation therapy can cause inflammation of the lungs (pneumonitis due to radiation), with symptoms such as cough, shortness of breath and fever. These symptoms can be reduced by corticosteroids (eg prednisone).
At the time of diagnosis, small cell carcinoma almost always has spread to other body parts, making it impossible to do surgery. These cancers are treated with chemotherapy, sometimes radiation therapy disetai.
Patients with lung cancer who experienced a lot of lung function decline. To reduce respiratory problems may be given oxygen therapy and drugs that dilate the airways (bronchodilators).
Lung Cancer Prevention
Tags : Lung Cancer, Lung Cancer Treatment, Treatment of lung cancer, treatment for cancer, treatment of cancer, chemotherapy treatment, cancer radiation treatment, radiation treatment, lung cancer chemotherapy, lung cancer survival
Lung Cancer Prevention
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There is no sure way to prevent lung cancer, but you can reduce the risk if you:
No smoking. If you have never smoked, do not start. Talk with your kids not to smoke so they could understand how to avoid the major risk factors of lung cancer. Many smokers start smoking in their teens. Start a conversation about the dangers of smoking with your children early so they know how to react to peer pressure.
Stop smoking. Stop smoking now. Quitting smoking reduces the risk of lung cancer, even if you have smoked for many years. Consultation with your doctor about smoking cessation strategies and assistance that can help you quit. Options include nicotine replacement products, medication and support groups.
Avoid cigarette smoke. If you live or work with smokers, encourage him to stop. At the very least, ask him to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and choose the smoke-free area.
Your home radon test. Check the levels of radon in your home, especially if you live in an area where radon is known to be a problem. High radon levels can be improved to make your home safer. For information on radon testing, call the health department.
Avoid carcinogens in the workplace. Precautions to protect themselves from exposure to toxic chemicals in the workplace. Your company must notify you if you are exposed to hazardous chemicals in your workplace. Follow these precautions your boss. For example, if you are given a mask for protection, always wear it. Ask your doctor what else can you do to protect themselves in the workplace. Risk of lung damage from carcinogens is increased if you smoke.
Eating foods containing fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be dangerous. For example, the researchers hope to reduce the risk of lung cancer in heavy smokers to give them beta carotene supplements. The results showed supplements actually increase the risk of cancer in smokers.
Drinking alcohol in moderation, if at all do not. Limit yourself to one drink a day if you're a woman or two drinks a day if you're a man. Any person age 65 or older should drink no more than one drink a day.
Sports. Achieve at least 30 minutes of sports on every day of the week. Check with your doctor first if you have not exercised regularly. Start slowly and keep adding more activities. Cycling, swimming and walking are good choices. Add to exercise throughout your day - through the park when she went to work and walk along the road or take the stairs instead of elevators.
Lung Cancer Treatment
Tags : Lung Cancer, Lung Cancer Prevention, Prevention Of Lung cancer, Prevention Of cancer
Tuberculosis
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Pulmonary tuberculosis is a disease of chronic bacterial infection caused by mycobacterium tuberculosis, an acid-fast bacilli are transmitted through the air. The disease is characterized by granuloma formation in infected tissues.
Patients with tuberculosis in the Asian region continues to grow. So far, Asia including the region with the highest spread of tuberculosis in the world. Every 30 seconds, there was one patient in Asia died from the disease. Eleven of the 22 countries with the highest numbers of TB cases are in Asia, including Bangladesh, China, India, Indonesia, and Pakistan. Four of five patients with TB in Asia, including the productive age group.
Etiology
Tuberculosis is caused by TB germs are mycobacterium tuberculosis measuring 0.3 x 2-4 cm. The nature of this bacteria is aerobic is more like living in a high tissue oxygen levels and also in cells that are dormant bacilli is not active but if the bacilli out of the cell will proliferate, the patient will experience a recurrence. Germs more resistant to acid more and more resistant to chemical and physical disorders, can not be seen by the naked eye, die in boiling water, easily killed when exposed to sunlight, survival in a humid room, can multiply in the cells (intra-cell and outside cell / extracellular). There are several factors that can influence the occurrence of TB infection, malignancy Namely tuberculosis bacillus. The number of bacilli are quite a lot, the source of infection, decreased body resistance caused by several factors of heredity, age, poor nutrition and diabetes mellitus.
Signs and Symptoms
A. Fever
Subfebris resemble influenza are fever, but sometimes the heat loss can reach 40-41° C. The first fever attack may recover briefly, but then can come back. This situation is greatly influenced by the immune system of patients and severity of infection of tuberculosis germs that enter.
B. Coughing / coughing up blood
Coughing occurs because of irritation of the bronchi, the nature of starting from dry cough (non - productive) then after the onset of inflammation to be productive (produces sputum). Circumstances are such as cough up blood occurs cavity, but the data also occur in the bronchial wall ulceration.
C. Asphyxiate
In bringan disease (emerging) has not felt shortness of breath. Shortness of breath will be found in the disease is advanced, which already includes the infiltration of the lungs.
D. Chest pain
Chest pain occurs when infiltration had come to the pleura, giving rise to pleurisy. Both pleural friction occurs when patients withdraw or release the breath.
E. Malaise
Symptoms of malaise found in the form of intake is inadequate, the more lean body, headache, chills, muscle aches, night sweats, etc.. Increasingly severe symptoms of this malaise is intermittent and occurs regularly.
Complications
- Complications are often experienced by people with TB are as follows:
- Hemoptysis
- Collapse of the lobe
- Pneumothorax
- Pleural effusion
- Bronchiectasis
- Fibrosis
- The spread of infection to other organs such as brain, bones, joints, kidneys, and others.
- Cardio pulmonary insufficiency or decreased function of the heart and lungs so that oxygen levels in the blood is low.
Occupational asthma
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Symptoms
Symptoms usually occur shortly after exposure to the allergen and is often reduced or disappear if the patient leaves his workplace.
Symptoms often get worse during the working day and improved on weekends or holidays.
Some patients experienced new symptoms within 12 hours after exposure to the allergen.
Symptoms include:
In the history of the disease, patients usually experience a worsening of symptoms when exposed to certain allergens in the environment where she worked.
On examination with a stethoscope would hear a wheezing (asthma, wheezing).
Other tests are usually performed:
Prevention
Industries that use substances that can cause asthma, must control dust and air, because to eliminate it is an impossible thing.
Workers with severe asthma, if possible, should change his occupation because of constant exposure will make asthma worse and are settled.
If the allergen / cause has been unknown, to prevent the occurrence of symptoms, patients should avoid the allergen.
How to Diagnose Occupational asthma
Management of Occupational asthma
Tags : Occupational asthma cause, Occupational asthma symptoms, Occupational asthma diagnose, Occupational asthma Prevention, Occupational asthma Treatment,
Occupational asthma is a respiratory disease characterized by attacks of shortness of breath, wheezing and coughing, which is caused by a variety of materials encountered in the workplace.
These symptoms usually occur due to spasm of the muscles lining the airways, so that the airway becomes very narrow.
Cause
Many substances (allergens, the cause of the symptoms) in the workplace that can cause asthma due to work. The most common are protein molecules (wood dust, grain dust, animal dander, mold particles) or other chemicals (especially diisocyanate).
Exact figures of the incidence of asthma because of the work is unknown, but suspected of approximately 20-20% of asthma in industrialized countries was asthma because of the work.
The workers who are at high risk for suffering from asthma because of the work is;
- Plastic workers
- Metal worker
- Firing workers
- Mill worker
- Workers grain
- Laboratory workers
- Woodworker
- Workers at the pharmaceutical
- Workers at the detergent factory.
Symptoms
Symptoms usually occur shortly after exposure to the allergen and is often reduced or disappear if the patient leaves his workplace.
Symptoms often get worse during the working day and improved on weekends or holidays.
Some patients experienced new symptoms within 12 hours after exposure to the allergen.
Symptoms include:
- Shortness of breath
- Asthma
- Cough
- Feel the tightness in the chest.
In the history of the disease, patients usually experience a worsening of symptoms when exposed to certain allergens in the environment where she worked.
On examination with a stethoscope would hear a wheezing (asthma, wheezing).
Other tests are usually performed:
- Pulmonary function tests
- Measurement of peak expiratory flow rates before and after work
- Chest radiograph
- Calculate blood type
- Bronchial provocation tests (to gauge reaction to the suspected allergen)
- Blood tests to find specific antibodies.
Prevention
Industries that use substances that can cause asthma, must control dust and air, because to eliminate it is an impossible thing.
Workers with severe asthma, if possible, should change his occupation because of constant exposure will make asthma worse and are settled.
If the allergen / cause has been unknown, to prevent the occurrence of symptoms, patients should avoid the allergen.
How to Diagnose Occupational asthma
Management of Occupational asthma
Tags : Occupational asthma cause, Occupational asthma symptoms, Occupational asthma diagnose, Occupational asthma Prevention, Occupational asthma Treatment,
Management of Occupational asthma
To contact us Click HERE
Tags : Occupational asthma Management, Occupational asthma treatment, Occupational asthma therapy
To prevent the occurrence of occupational asthma is a medical examination prior to employment, use of protective equipment, monitoring air pollutants in the working environment is highly recommended. If occupational asthma has occurred, then transfer to the outside of the work environment is important. If for some reason can not be moved then it must be the prevention and monitoring of lung function decline.
Periodic evaluation of lung function in workers who already suffer from occupational asthma are needed to prevent disability. Clinical asthma will persist until a few years even though the worker has been out of work environment.
Medical treatment in patients with occupational asthma such as bronchial asthma in general:
- Theophylline, a bronchodilator and may suppress neutrophil chemotactic factor. Effectiveness of the two functions above depend on the serum levels of theophylline.
- Beta agonists, bronchodilators are the most good for the treatment of occupational asthma in comparison with cholinergic antagonists (ipratropium bromid).
- The combination of beta-agonists with ipratropium bromid improve lung function is better than just a beta agonist alone.
- Corticosteroids, from various studies is known to prevent the bronchoconstriction caused by bronchial provocation with allergens. It will also improve lung function, decrease exacerbations and airway hiperesponsivitas and will ultimately improve the quality of life.
Tags : Occupational asthma Management, Occupational asthma treatment, Occupational asthma therapy
26 Eylül 2012 Çarşamba
Forest Labs Get FDA COPD Risk Treatment Approval
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Approximately 12 million people in the United States are currently diagnosed with chronic obstructive pulmonary disorder (COPD), and an additional 12 million are likely to have the disease and not know. This week Daliresp (roflumilast) was approved by the US Food and Drug Administration (FDA) as a treatment to reduce the risk of disease (COPD) exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations.
COPD is caused by noxious particles or gas, most commonly from tobacco smoking, which triggers an abnormal inflammatory response in the lung. The inflammatory response in the larger airways is known as chronic bronchitis, which is diagnosed clinically when people regularly cough up sputum. In the alveoli, the inflammatory response causes destruction of the tissues of the lung, a process known as emphysema. The natural course of COPD is characterized by occasional sudden worsening of symptoms called acute exacerbations, most of which are caused by infections or air pollution.
The World Health Organization (WHO) predicts that total deaths from COPD could increase by more than 30% in the next 10 years unless urgent action is taken to reduce the underlying risk factors, especially smoking. Approximately half of COPD patients treated by a physician with controller medications have severe COPD. Of the patients diagnosed with severe COPD, almost three quarters, or 2.8 million, have chronic bronchitis.
COPD is projected to be the fourth leading cause of death worldwide by 2030 (an increase from sixth in 2009) due to an increase in smoking rates and demographic changes in many countries. COPD is the fourth leading cause of death in the U.S. and the economic burden of COPD in the U.S. in 2007 was $42.6 billion in health care costs and lost productivity.
COPD remains a significant area of unmet medical need. It is a progressive and irreversible lung disease resulting in difficulty in breathing. The disease is characterized by severe episodes of worsening, called exacerbations or lung attacks.
Forest expects Daliresp to be available to wholesalers in the second calendar quarter of 2011.
Guido Oelkers, Executive Vice President, Commercial Operations at Nycomed, Forest's parent, said:
"Nycomed is very pleased with the US approval of Daliresp by the FDA. With Forest we have an ideal partner, who is absolutely committed to make this innovative treatment available in the United States for the many patients suffering from severe COPD. The approval of Daliresp offers clinicians and patients a much needed new treatment option alongside existing inhaled therapies."
Roflumilast has been approved in the European Union and Canada in 2010 and it is marketed under the brand name Daxas. In February 2011 it received marketing authorisation from the Brazilian National Health Surveillance Agency (ANVISA). Daxas has been launched in several countries already, as for example Germany, Denmark, Sweden, UK, Canada and Spain. It is scheduled to be launched in other markets in 2011.
Professor Stephen Rennard, M.D., University of Nebraska Medical Center and clinical trial investigator continues:
"The introduction of Daliresp as an additional treatment option to reduce the risk of COPD exacerbations is an important development for patients with severe COPD associated with chronic bronchitis and a history of exacerbations. Reducing the risk of COPD exacerbations is an important goal of COPD treatment."
COPD is caused by noxious particles or gas, most commonly from tobacco smoking, which triggers an abnormal inflammatory response in the lung. The inflammatory response in the larger airways is known as chronic bronchitis, which is diagnosed clinically when people regularly cough up sputum. In the alveoli, the inflammatory response causes destruction of the tissues of the lung, a process known as emphysema. The natural course of COPD is characterized by occasional sudden worsening of symptoms called acute exacerbations, most of which are caused by infections or air pollution.
The World Health Organization (WHO) predicts that total deaths from COPD could increase by more than 30% in the next 10 years unless urgent action is taken to reduce the underlying risk factors, especially smoking. Approximately half of COPD patients treated by a physician with controller medications have severe COPD. Of the patients diagnosed with severe COPD, almost three quarters, or 2.8 million, have chronic bronchitis.
COPD is projected to be the fourth leading cause of death worldwide by 2030 (an increase from sixth in 2009) due to an increase in smoking rates and demographic changes in many countries. COPD is the fourth leading cause of death in the U.S. and the economic burden of COPD in the U.S. in 2007 was $42.6 billion in health care costs and lost productivity.
COPD remains a significant area of unmet medical need. It is a progressive and irreversible lung disease resulting in difficulty in breathing. The disease is characterized by severe episodes of worsening, called exacerbations or lung attacks.
Forest expects Daliresp to be available to wholesalers in the second calendar quarter of 2011.
Guido Oelkers, Executive Vice President, Commercial Operations at Nycomed, Forest's parent, said:
"Nycomed is very pleased with the US approval of Daliresp by the FDA. With Forest we have an ideal partner, who is absolutely committed to make this innovative treatment available in the United States for the many patients suffering from severe COPD. The approval of Daliresp offers clinicians and patients a much needed new treatment option alongside existing inhaled therapies."
Roflumilast has been approved in the European Union and Canada in 2010 and it is marketed under the brand name Daxas. In February 2011 it received marketing authorisation from the Brazilian National Health Surveillance Agency (ANVISA). Daxas has been launched in several countries already, as for example Germany, Denmark, Sweden, UK, Canada and Spain. It is scheduled to be launched in other markets in 2011.
Professor Stephen Rennard, M.D., University of Nebraska Medical Center and clinical trial investigator continues:
"The introduction of Daliresp as an additional treatment option to reduce the risk of COPD exacerbations is an important development for patients with severe COPD associated with chronic bronchitis and a history of exacerbations. Reducing the risk of COPD exacerbations is an important goal of COPD treatment."
Different Dosing, Administration Of Corticosteroids For Severe COPD Shows Comparable Outcomes
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In contrast to clinical guidelines, new research finds that the vast majority of patients hospitalized for severe symptoms of chronic obstructive pulmonary disease (COPD) were initially treated with higher doses of corticosteroids administered intravenously, with analysis indicating that these patients had outcomes comparable to patients who received the recommended and lower-cost, less-invasive treatment of low doses of steroids administered orally, according to a study in the June 16 issue of JAMA.
COPD is the fourth leading cause of death in the United States, affects more than 6 percent of adults in the U.S., and accounts for $32 billion in direct health care costs. "In 2006, there were approximately 600,000 hospital admissions for acute exacerbation COPD, making this 1 of the 10 leading causes of hospitalization nationwide," the authors write. "Systemic corticosteroids are beneficial for patients hospitalized with acute exacerbation of COPD; however, their optimal dose and route of administration are uncertain."
Peter K. Lindenauer, M.D., M.Sc., of Baystate Medical Center, Springfield, Mass., and colleagues investigated the use of corticosteroids among patients hospitalized for acute exacerbation of COPD at 414 U.S. hospitals in 2006 and 2007. The researchers compared the outcomes of those initially treated with low doses of steroids administered orally to those initially administered steroids at higher doses intravenously during the first 2 hospital days. Among the outcomes the researchers analyzed included a composite measure of treatment failure, defined as the initiation of mechanical ventilation after the second hospital day, inpatient mor-tality, or readmission for acute exacerbation of COPD within 30 days of discharge.
Of 79,985 patients, 73,765 patients (92 percent) were initially treated with higher doses of steroids administered intravenously, while 6,220 (8 percent) began low doses of steroids given orally. A total of 1.4 percent of patients initially treated with intravenous steroids died during the hospitalization and 10.9 percent experienced the composite treatment failure outcome, whereas 1.0 percent of orally treated patients died during the hospitalization and 10.3 percent experienced the composite outcome. A total of 1,356 patients (22 percent) initially treated with low-dose oral steroids were later switched to intravenous therapy.
The researchers found that in analysis that adjusted for various factors including patient, hospital, and physician characteristics, the risk of treatment failure among patients given low doses of steroids orally was not significantly different from those treated with high-dose steroids intravenously. Also, patients treated with low doses of steroids administered orally had shorter lengths of hospital stay and lower costs.
"In this large observational study, we found that, in sharp contrast to the recommendations contained in leading clinical guidelines, the vast majority of patients hospitalized for acute exacerbation of COPD were initially treated with high doses of corticosteroids administered intravenously. This practice does not appear to be associated with any measurable clinical benefit and at the same time exposes patients to the risks and inconvenience of an intravenous line, potentially unnecessarily high doses of steroids, greater hospital costs, and longer lengths of stay," the authors write.
"In light of the greater risks and higher costs associated with high-dose intravenous treatment, opportunities may exist to improve care by promoting greater use of low-dose steroids given orally. Given the large numbers of patients hospitalized with COPD each year in the United States, a clinical trial comparing these 2 approaches to management would be valuable."
JAMA .
2010;303[23]:2359-2367.
Source
Journal of the American Medical Association
COPD is the fourth leading cause of death in the United States, affects more than 6 percent of adults in the U.S., and accounts for $32 billion in direct health care costs. "In 2006, there were approximately 600,000 hospital admissions for acute exacerbation COPD, making this 1 of the 10 leading causes of hospitalization nationwide," the authors write. "Systemic corticosteroids are beneficial for patients hospitalized with acute exacerbation of COPD; however, their optimal dose and route of administration are uncertain."
Peter K. Lindenauer, M.D., M.Sc., of Baystate Medical Center, Springfield, Mass., and colleagues investigated the use of corticosteroids among patients hospitalized for acute exacerbation of COPD at 414 U.S. hospitals in 2006 and 2007. The researchers compared the outcomes of those initially treated with low doses of steroids administered orally to those initially administered steroids at higher doses intravenously during the first 2 hospital days. Among the outcomes the researchers analyzed included a composite measure of treatment failure, defined as the initiation of mechanical ventilation after the second hospital day, inpatient mor-tality, or readmission for acute exacerbation of COPD within 30 days of discharge.
Of 79,985 patients, 73,765 patients (92 percent) were initially treated with higher doses of steroids administered intravenously, while 6,220 (8 percent) began low doses of steroids given orally. A total of 1.4 percent of patients initially treated with intravenous steroids died during the hospitalization and 10.9 percent experienced the composite treatment failure outcome, whereas 1.0 percent of orally treated patients died during the hospitalization and 10.3 percent experienced the composite outcome. A total of 1,356 patients (22 percent) initially treated with low-dose oral steroids were later switched to intravenous therapy.
The researchers found that in analysis that adjusted for various factors including patient, hospital, and physician characteristics, the risk of treatment failure among patients given low doses of steroids orally was not significantly different from those treated with high-dose steroids intravenously. Also, patients treated with low doses of steroids administered orally had shorter lengths of hospital stay and lower costs.
"In this large observational study, we found that, in sharp contrast to the recommendations contained in leading clinical guidelines, the vast majority of patients hospitalized for acute exacerbation of COPD were initially treated with high doses of corticosteroids administered intravenously. This practice does not appear to be associated with any measurable clinical benefit and at the same time exposes patients to the risks and inconvenience of an intravenous line, potentially unnecessarily high doses of steroids, greater hospital costs, and longer lengths of stay," the authors write.
"In light of the greater risks and higher costs associated with high-dose intravenous treatment, opportunities may exist to improve care by promoting greater use of low-dose steroids given orally. Given the large numbers of patients hospitalized with COPD each year in the United States, a clinical trial comparing these 2 approaches to management would be valuable."
JAMA .
2010;303[23]:2359-2367.
Source
Journal of the American Medical Association
Few People Realize Persistent Cough Is A Key Symptom Of Lung Cancer
To contact us Click HERE
A new survey timed to coincide with Lung Cancer Awareness Month found that only a small minority of people in the UK
realize that a persistent cough is a key symptom of lung cancer.
In a bid to raise awareness of early symptoms of lung cancer as the season for flus and colds sets in, people are urged to seek help
if they find themselves unable to shake off a persistent cough: it could be a sign of something more serious.
A Royal Pharmaceutical Society/YouGov survey of over 2,000 adults in the UK found that only 33 per cent of people questioned
identified a cough as a warning sign or symptom of lung cancer, while as few as a further 11 per cent specifically mentioned a
"persistent cough", which is a key symptom.
In the UK, lung cancer is the second most common cancer in men, after prostate cancer, and also the second most common in
women, after breast cancer. It accounts for more than 1 in 5 cancer deaths, that is more than 35,200 people a year or 95 people
a day.
Worldwide, lung cancer is the most common cancer: in 2008 it is estimated that 1.6 million new cases were diagnosed and 1.38
million people died of the disease.
However, early detection of lung cancer can save lives, says Graham Phillips, who is a community pharmacist and Board member
of the Royal Pharmaceutical Society.
"When symptoms are present and recognised at an early stage, treatment is much more likely to be successful," he added, which
is why the Society is trying to get people to realize the importance of getting a persistent cough checked out.
When people get a cough that won't clear up, they tend to buy cough medicines, or even iron tablets if they also find themselves
feeling tired and low in energy.
Phillips urges people to talk to their pharmacist if they find themselves doing this.
"We can discuss your symptoms with you and help you understand you may have an underlying problem that needs checking out
with your GP," he explained in a press statement.
Phillips said pharmacists have an important role to play in helping to spot the early signs of lung cancer and other serious lung
problems.
This role appears to be welcome by the public too, because nearly 4 out 5 people surveyed said they would like their local
pharmacists to talk to them if they were showing any signs of lung cancer before they had noticed them, and over 9 out of 10
acknowledged that catching the disease in the early stages is important to ensure treatment is effective.
Phillips said whatever the time of year, if you have symptoms of cold or flu that won't go away, such as a persistent cough, chest infection, or keep losing your voice, or you feel breathless, tired and lacking in energy, then instead of reaching for the over-the-counter remedy, you should ask your pharmacist's advice.
The key signs of lung cancer
A cough that does not clear and persists for more than three weeks.
A long-standing cough that gets worse or changes.
Persistent or repeated chest infections.
Persistent and unexplained breathlessness.
Coughing up blood, or blood in the phlegm.
Feeling tired or lacking in energy for no apparent reason.
Unexplained and persistent weight loss.
Persistent pain in the chest and/or shoulder.
Persistent and unexplained hoarseness or loss of voice.
Unexplained swelling of the face or neck.
Lung Cancer Top 5 Myths
Myth: coughing up blood is usually the earliest sign of lung cancer.
Fact: the first symptoms of lung cancer are often a persistent cough or persistent breathlessness.
Myth: if you smoke there is no point in giving up because the damage is already done.
Fact: as soon as you quit you are already starting to reduce your risk of developing lung cancer and other serious health
problems like stroke or heart attack, and giving up before you hit middle age avoids most of the risk of smoking-related lung
cancer.
Myth: lung cancer is predominantly a male disease.
Fact: while this may have true in the 1950s, when there was only 1 female case of lung cancer for every 6 male cases,
nowadays the ratio is 3 cases of lung cancer in women to every 4 cases in men.
Myth: lung cancer is a death sentence.
Fact: over three quarters of lung cancer cases are diagnosed at an advanced stage: when it is found early, the treatment is
40 times more likely to be successful.
Myth: only smokers get lung cancer.
Fact: 1 in 10 cases of lung cancer are not linked to smoking.
The Roy Castle Lung Cancer Foundation is working with the Royal Pharmaceutical Society to promote lung cancer awareness.
The Foundation's Medical Director, Dr Jesme Fox, said:
"Pharmacy staff can play a key role in the fight against lung cancer and we hope this campaign will help to increase early
detection of the disease as this can save lives."
While most medical professionals would agree that a persistent cough should be checked out, many would say that other
problems were more likely to be the cause, not necessarily cancer.
One of these is Chronic Obstructive Pulmonary Disease (COPD), a progressive, irreversible lung disease that kills about 30,000
people a year in the UK: more than breast, bowel or prostate cancer.
COPD is an umbrella term for a number of conditions, including chronic bronchitis and emphysema.
Every year the British Lung Foundation focuses its campaigning around World COPD Day, which this year was on 17
November.
Their chief executive, Dame Helena Shovelton, told the BBC that while a persistent cough can be an early sign of lung cancer, it
can also be a sign of COPD.
She said their research shows that 28 per cent of smokers would class their cough as just a "smoker's cough", and that nearly 3.5
million people in the UK are at high risk of developing COPD and similar lung conditions.
"We would urge anyone with symptoms such as nasty cough, wheezy chest or breathlessness to ask their GP for a lung function
test or to take our online breath test," said Shovelton.
-- Take the
BLF Breath Test
realize that a persistent cough is a key symptom of lung cancer.
In a bid to raise awareness of early symptoms of lung cancer as the season for flus and colds sets in, people are urged to seek help
if they find themselves unable to shake off a persistent cough: it could be a sign of something more serious.
A Royal Pharmaceutical Society/YouGov survey of over 2,000 adults in the UK found that only 33 per cent of people questioned
identified a cough as a warning sign or symptom of lung cancer, while as few as a further 11 per cent specifically mentioned a
"persistent cough", which is a key symptom.
In the UK, lung cancer is the second most common cancer in men, after prostate cancer, and also the second most common in
women, after breast cancer. It accounts for more than 1 in 5 cancer deaths, that is more than 35,200 people a year or 95 people
a day.
Worldwide, lung cancer is the most common cancer: in 2008 it is estimated that 1.6 million new cases were diagnosed and 1.38
million people died of the disease.
However, early detection of lung cancer can save lives, says Graham Phillips, who is a community pharmacist and Board member
of the Royal Pharmaceutical Society.
"When symptoms are present and recognised at an early stage, treatment is much more likely to be successful," he added, which
is why the Society is trying to get people to realize the importance of getting a persistent cough checked out.
When people get a cough that won't clear up, they tend to buy cough medicines, or even iron tablets if they also find themselves
feeling tired and low in energy.
Phillips urges people to talk to their pharmacist if they find themselves doing this.
"We can discuss your symptoms with you and help you understand you may have an underlying problem that needs checking out
with your GP," he explained in a press statement.
Phillips said pharmacists have an important role to play in helping to spot the early signs of lung cancer and other serious lung
problems.
This role appears to be welcome by the public too, because nearly 4 out 5 people surveyed said they would like their local
pharmacists to talk to them if they were showing any signs of lung cancer before they had noticed them, and over 9 out of 10
acknowledged that catching the disease in the early stages is important to ensure treatment is effective.
Phillips said whatever the time of year, if you have symptoms of cold or flu that won't go away, such as a persistent cough, chest infection, or keep losing your voice, or you feel breathless, tired and lacking in energy, then instead of reaching for the over-the-counter remedy, you should ask your pharmacist's advice.
The key signs of lung cancer
A cough that does not clear and persists for more than three weeks.
A long-standing cough that gets worse or changes.
Persistent or repeated chest infections.
Persistent and unexplained breathlessness.
Coughing up blood, or blood in the phlegm.
Feeling tired or lacking in energy for no apparent reason.
Unexplained and persistent weight loss.
Persistent pain in the chest and/or shoulder.
Persistent and unexplained hoarseness or loss of voice.
Unexplained swelling of the face or neck.
Lung Cancer Top 5 Myths
Myth: coughing up blood is usually the earliest sign of lung cancer.
Fact: the first symptoms of lung cancer are often a persistent cough or persistent breathlessness.
Myth: if you smoke there is no point in giving up because the damage is already done.
Fact: as soon as you quit you are already starting to reduce your risk of developing lung cancer and other serious health
problems like stroke or heart attack, and giving up before you hit middle age avoids most of the risk of smoking-related lung
cancer.
Myth: lung cancer is predominantly a male disease.
Fact: while this may have true in the 1950s, when there was only 1 female case of lung cancer for every 6 male cases,
nowadays the ratio is 3 cases of lung cancer in women to every 4 cases in men.
Myth: lung cancer is a death sentence.
Fact: over three quarters of lung cancer cases are diagnosed at an advanced stage: when it is found early, the treatment is
40 times more likely to be successful.
Myth: only smokers get lung cancer.
Fact: 1 in 10 cases of lung cancer are not linked to smoking.
The Roy Castle Lung Cancer Foundation is working with the Royal Pharmaceutical Society to promote lung cancer awareness.
The Foundation's Medical Director, Dr Jesme Fox, said:
"Pharmacy staff can play a key role in the fight against lung cancer and we hope this campaign will help to increase early
detection of the disease as this can save lives."
While most medical professionals would agree that a persistent cough should be checked out, many would say that other
problems were more likely to be the cause, not necessarily cancer.
One of these is Chronic Obstructive Pulmonary Disease (COPD), a progressive, irreversible lung disease that kills about 30,000
people a year in the UK: more than breast, bowel or prostate cancer.
COPD is an umbrella term for a number of conditions, including chronic bronchitis and emphysema.
Every year the British Lung Foundation focuses its campaigning around World COPD Day, which this year was on 17
November.
Their chief executive, Dame Helena Shovelton, told the BBC that while a persistent cough can be an early sign of lung cancer, it
can also be a sign of COPD.
She said their research shows that 28 per cent of smokers would class their cough as just a "smoker's cough", and that nearly 3.5
million people in the UK are at high risk of developing COPD and similar lung conditions.
"We would urge anyone with symptoms such as nasty cough, wheezy chest or breathlessness to ask their GP for a lung function
test or to take our online breath test," said Shovelton.
-- Take the
BLF Breath Test
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