Tag Archives: lung disease

Goodpasture Syndrome

Kidney

Goodpasture syndrome is a rare autoimmune disease first discovered in 1919. It affects less than one in 500,000 people—according to some estimates, as few as one in two million people. The condition occurs when the immune system attacks the the glomeruli, or lining, of the lungs and kidneys. In the kidneys, the glomerular cells are part of the apparatus responsible for the first stage in filtering the blood, which is the function of the kidneys. When this cell layer is mistaken for an infectious agent, the immune system can cause significant damage.

In particular, this disease can result in patients coughing up blood. They will also experience shortness of breath and chest pain. Once the condition moves to the kidneys—or when it starts there—symptoms include swelling of the limbs, a puffy face, high blood pressure, or blood or protein in the urine, due to the disease harming kidney function. Goodpasture syndrome generally starts in the lungs first, and moves to the kidneys afterward. However, in 10 percent of cases it stays in the lungs, and about three times as often, it never affects the lungs at all.

It is not entirely clear what causes Goodpasture disorder. It is likely that some people are particularly susceptible to the illness, because there is a long list of possible triggers, things that damage the blood vessels in the lungs and draw the attention of the immune system, some of them quite common, but the disease remains rare.

These triggers include cigarette smoke, high oxygen levels, sepsis, cocaine, infections such as flu, metal dust, hydrocarbons, and organic solvents. There appears to be a genetic component, and certain gene mutations are themselves triggers. Recently, scientists found that the element bromine plays an important role in protecting the kidneys from the immune system.

It is important for Goodpasture syndrome to be treated quickly, because it can progress rapidly, and soon become fatal if let alone. Treatment generally means suppressing the immune system long enough for it to become acclimate again to the kidneys. Another treatment is blood purification, in which unwanted antibodies—to the body’s own organs—are removed. However, even once the disease is cured, the damage it has done remains.

The Great American Smokeout

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The biggest single thing a smoker can do to improve their health is to quit. In fact, in any given year, more than half of all smokers make at least one attempt to quit, and it is one of the most common New Year’s resolutions. Many people take this step about a month earlier—the Great American Smokeout on the third Thursday of November. Today, tens of thousands of Americans are smoking their last cigarette. Since 1977, millions of Americans have taken the challenge to not light up for 24 hours, and many of them never did again.

In fact, 24 hours is enough to start to see some improvement. Health benefits actually begin within 20 minutes, and after 12 hours without a cigarette, most of the immediate physical effects have dissipated. The 24-hour period of the challenge roughly coincides with the time it takes to reach the peak of mental distress as well—24 hours after a person’s last cigarette, the anxiety is at or past it’s highest level, and it will only improve from that point on.

Even long-term effects of smoking generally begin to reverse themselves over time. Nicotine usually completely clears the body after 72 hours, and the cravings start to reduce in frequency and duration. After 10 days, most former smokers have no more than two episodes per day. Quitting-related anxiety and irritability go away entirely after less than four weeks. The lungs begin to recover in as little as a month. All in all, while some health effects are permanent, most are completely cleared up within about a decade of quitting.

There are a number of resources available to help people quit smoking. There are options besides quitting cold turkey—substitutes and alternative nicotine delivery systems such as patches can help quitters ease off and help reduce cravings. Prescription medications can also help with cravings by helping to get the brain used to not having nicotine. Other things that can help people quit are substitute activities, to help break the habit of having a cigarette in the hand at certain times.

Support groups can also help—life improvement projects can be easier with accountability. Even writing down the intention to quit smoking privately can be a motivator.

COPD And The Body

Emphysema

Chronic obstructive pulmonary disease, or COPD, is one of the most common respiratory illnesses among Americans, affecting almost 12 million people—one in every 35 people—and it is caused by smoking. Every smoker is at risk for COPD, the risk goes up the longer he or she smokes, and while quitting will reduce the risk it will most likely never be as low as it was before the person started smoking. Nearly every case of COPD can be traced back to tobacco smoke. Most of the rest are caused by long-term occupational exposure to particles and pollutants.

COPD itself raises the risk of several other conditions. People who develop COPD are more likely to also develop other medical problems. One estimate claims three percent of all disability throughout the world is due to COPD. The disorder in particular raises he risk for high blood pressure, lung cancer, and heart failure. In fact, there is significant overlap between the symptoms of the two conditions. People with COPD in one study were more than twice as likely to experience heart failure. Among people under 60, COPD patients were nearly four times as likely. Moreover those with both heart failure and COPD had longer hospital stays than the people with heart failure alone.

There is also evidence that it can lead to cognitive impairment. Memory is usually relatively unaffected, but other cognitive functions are diminished by COPD. It only causes what doctors refer to mild cognitive impairment, but it nonetheless affects functioning. All the people in the study were healthy before developing COPD. Another affect COPD can have on he brain is depression. More than just mourning for oneself such as a person might do who was told they have an incurable and often terminal illness, but full-on depression. COPD can lead to a sense of helplessness that can make it difficult to enjoy life, leading to depression.

The damage of COPD is irreversible, but there are things a person can do to manage the illness. Research shows that a two-mile daily walk can reduce the severity and number of attacks, thus reducing the amount of time spent in the hospital. Stress management techniques are also important.

Surgery For Lung Cancer

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Everyone knows that smoking is a risk factor for lung cancer. It’s not just cigarettes; regardless of what a person smokes and what they use to smoke it, the act of drawing smoke into the lungs is a lung cancer risk. The risk is inherent to smoking, not something in the cigarettes, and particularly not something in commercial cigarettes, or cigarettes from major producers. Other risk factors include any exposure to sort of air pollution or particulate matter, radon gas found particularly in older buildings, and a family history of the disease.

Because, as with most cancers, treatment is effective in early stages but far less effective later on, early detection is important. People with lung cancer tend to have respiratory symptoms such as a new chronic cough—someone who is a smoker will tend to have a chronic cough anyway, but a change can be a bad sign—shortness of breath, wheezing, and hoarseness. Coughing up blood is often a sign of lung cancer, and in any case it is clearly a sign of something.

Early stage lung cancer is normally treated surgically. In the later stages, however, there is usually too much cancerous tissue for it to be safely removed. When treatment is still possible at this stage, it will be chemotherapy or radiation therapy, on their own or together with surgery. In one study, surgery had better outcomes than radiation treatment in patients with certain types of cancer. Counter-intuitively, another study found that removal of an entire lobe of the lung is more effective over the long term than simply removing the tumor—even though lung cancer is one of the deadliest cancers. The more drastic surgery removes portions of the lung that are not cancerous but are likely to become cancerous, parts that removing only the tumor leaves intact.

Lung transplants are also possible, but as with other transplant procedures, the use of this approach is hampered by a need to ensure the transplanted organ is not rejected, and a perpetual shortage of donors. Scientists now think the shortage of long donors can be alleviated slightly by including transplants from donors who drowned or asphyxiated—that is, where death was due to an acute injury, but who did not have chronic lung problems.

Pneumonia Risks And Prevention

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Pneumonia occurs when the lungs become infected and the air sacs fill with fluid. It is often overlooked, even though it kills more people each year than influenza. In fact, worldwide, 18 percent of deaths among children under five are caused by pneumonia. Symptoms of pneumonia include coughing, headache, nausea, vomiting, fever and sweating, fatigue, chest pain, and shortness of breath. Pneumonia can be caused by viruses, bacteria, or fungi in the atmosphere. It can also be caused by inhaling food or saliva into the lungs—the gag reflex usually prevents this foreign matter from reaching the lungs, but if it is disturbed in some way, pneumonia can result. The risk of pneumonia can be reduced by avoiding indoor pollution. This includes cigarette smoke, cooking fumes, mold, and dust.

Researchers recently found evidence that sleep apnea may be a risk factor for pneumonia. Sleep apnea is a chronic condition in which people briefly stop breathing during sleep. People who are overweight, people who use sedatives, smokers, people with thick necks, people over 60, and men are all at risk for sleep apnea. In the study, sleep apnea patients were found to be 20 percent more likely to develop pneumonia. Some of the risk factors for apnea are themselves risk factors for pneumonia, and people with apnea often also have diabetes, which also makes incidents of pneumonia more likely. Furthermore, people with sleep apnea are more at rick of inhaling fluid from the throat into the lungs, which can contribute to the development of pneumonia.

Nearly a million Americans get pneumonia each year, but vaccination can help lower this number. Nowadays most children in the Unites States are given the DTaP vaccine, which in addition to covering the namesake diphtheria, tetanus, and pertussis, often also provides protection against pneumonia. If it’s not certain, or for older folks, influenza vaccines often prevent pneumonia as well. The Centers for Disease Control and Prevention also recommend that people over 65 get vaccinated against pneumonia specifically. In particular, seniors are urged to get a combination of two different vaccines, with the newer of the two filling in some of the gaps in the protection provided by the single vaccine previously recommended.

Timing Treatment For Lung Disease

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How you sleep could be affecting how you breathe. Medical researchers say they’ve found a link between the circadian rhythm—the body’s internal clock that is primarily responsible for regulating sleeping and waking cycles—and certain types of lung disease. This body clock is found in nearly all complex living things, even plants. In many mammals, including humans, it regulates how ready the lung is at various times throughout the day for the onslaught of airborne pollutants it must cope with.

While there is no immediate application of this research in preventing lung disease, researchers say it can be used to determine the best time to administer medication for respiratory problems, providing the greatest effectiveness while minimizing side effects. For example, inhaled long-acting beta agonists are often used for treating asthma. Unfortunately, these medications can present a risk of causing an asthma attack if care is not taken. By timing the dose based on when the patient’s body clock is getting the lungs ready to handle particulate mater in the air, it may be possible to get the same results with a lower dose of the medication, minimizing the risks.

Research is being done on other forms of treatment as well. Lung transplants are increasing as a last-ditch treatment for end-stage lung disease. Over the last 26 years, deaths as a result of these procedures have dropped by half as it is performed more frequently. However, the transplanted organs are rejected by the bodies of about one in three recipients, meaning the lung triggers an immune response. Other complications are also common, if often not fatal.

Rejection is a result of foreign matter—the donated lung—being implanted in the body. One solution is to do transplants without foreign mater using lungs constructed using the patient’s own stem cells. These are cells found in bone marrow that are in a base state, not specialized to work only in certain parts of the body. Being from the recipient’s body, stem cells do not draw the attention of the immune system, and they can be induced to grow into any form for which a structure can be provided. For lungs, research s ongoing into providing that structure, finding ways to create scaffolds for stem cells to cause them to grow into a fresh, undamaged replacement lung. An approach that has been explored with some success is to take a posthumously donated lung and replace the cells in it, row by row, with stem cells from a transplant patient, so the cells take the proper shape.

The Great American Smokeout

quit smoking

Quitting is possibly the biggest single thing a smoker can do to protect and improve their health. For example, within a year after quitting, an ex-smoker’s risk of coronary heart disease is cut in half. That’s why tomorrow, November 21st, is the Great American Smokeout. Here are some tips for breaking the habit:

  • Plan ahead. Consider what your triggers are and what is likely to cause a relapse, and prepare ahead of time to deal with the temptation.
  • Don’t quit during a stressful time in your life. Quitting smoking is itself stressful, and if it’s also crunch time at work or school or something like that, you’re more likely to fall off the wagon.
  • Tell your friends. Let people know you’re trying to quit, and have them help hold you accountable.
  • Look for support. If you know another smoker who is interested in quitting, try getting together. There are also support groups for quitters in many places, or on the internet.
  • Don’t be afraid to take advantage of resources that are available. Quitting smoking doesn’t only count if you do it all on your own cold turkey. The point is for you to break the habit, and any way you can do that is good.
  • Don’t set yourself up for failure. Your goal shouldn’t be to quit forever, only for one day. And the next day. And the next day. As with any addiction, short-term success is still success.
  • Nicotine affects the digestive system, and your body has grown used to it. To ease the transition, drink cranberry juice or other acidic fruit juices for your first few days without cigarettes.

The most intense cravings are usually in the first week. Once you’re past those, it may not be smooth sailing, but staying smoke-free becomes substantially easier very quickly. Good luck!

Pneumonia Still A Mystery

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A drug trial intended to determine if statin drugs improve outcomes in pneumonia patients found that it doesn’t work. Doctors at a French hospital gave 300 volunteers with pneumonia either statin drugs—drugs used to lower cholesterol—or an inert placebo in addition to standard treatment. What they found was that there was no evidence of any significant improvement in outcomes between the two groups, and that the addition of statins to the treatment regimen has no effect on the effectiveness of that treatment.

There had been previous studies suggesting that the drugs were beneficial for patients with pneumonia, but that had been patients taking statins for high cholesterol or other conditions for which the drugs are currently used. While statins do have anti-inflammatory properties, they did not prove useful against pneumonia.

That leaves antibiotics or antiviral medications—depending on whether the cause is bacteria or a virus—as the primary treatment for the lung disease. Patients who are old, who are young, or who have severe symptoms may need to be hospitalized. Hospitalization is also necessary in some cases in which there are complications, such as bacteria in the blood. Treatment can take as long as a month to show signs of completely clearing the infection.

Some vaccines help prevent pneumonia. Most forms of flu vaccine can keep it at bay, which is one reason it’s important to get flu shots every year. There is also a vaccine specifically for bacterial pneumonia, which only needs to be administered once. Several routine childhood vaccinations, such as for pertussis, varicella, and measles, are effective against pneumonia as well.

Another important preventative measure is avoiding indoor air pollution. That means not smoking, being careful about cooking and making sure there is adequate ventilation, and keeping down mold and dust. Hygiene in general is also important, washing your hands regularly and using hand sanitizer when needed. Keeping healthy generally—with a balanced diet, regular exercise, and enough sleep—will help you avoid opportunistic infections such as pneumonia.

COPD And Your Brain

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Chronic obstructive pulmonary disorder, or COPD, is an umbrella term for respiratory disorders in which the lungs are partly blocked. You might have a form of COPD, such as emphysema or chronic bronchitis, if you experience wheezing and shortness of breath, blue lips or fingernails, chronic coughing with clear, white, yellow or green sputum, low energy, respiratory infections, mucous in your lungs first thing in the morning, or tightness in your chest.

This is particularly likely if you have any of the risk factors. The main risk factor is smoking. If you are a smoker, you are at risk for COPD; the longer you smoke and the more heavily you smoke, the greater your risk; you are at risk from cigars and pipes as well as from cigarettes and from marijuana as well as from tobacco. After you quit smoking, your risk goes down. This is particularly true if you have asthma, or if you have some other COPD risk factor, such as exposure to chemical fumes or fine dust or a genetic predisposition to the disease. In the developed world, most cases of COPD are due to smoking.

Quitting smoking is the single biggest thing you can do to lower your risk of COPD. The condition develops over years, so the sooner you quit, the more it will help. If you’ve tried to quit unsuccessfully, try other methods until you find one that works for you. In addition to that, however, you should also use lung protection, such as a mask, if you live or work in a smoky or dusty environment, and if you have asthma, see to it that you’re getting proper treatment.

Another reason to make an effort to avoid COPD— on top of being able to breathe easier—is that it increases dementia risk. A recent study found that people with COPD are prone to tiny hemorrhages, known as microbleeds, in the brain. These microbleeds are associated with a condition called cerebral small vessel disease, which can cause or accelerate cognitive decline in old age. Study subjects with COPD were more likely to have these microbleeds than people without even after controlling for other factors, such as age, sex, cholesterol levels, general health, and even smoking status. COPD can also lead to high blood pressure, heart disease, or lung cancer, as well as heightened vulnerability to respiratory infections.

Hay Fever And Your Asthma

As the weather gets warmer, the flowers bloom, the trees show their leaves—and the pollen comes out. For close to 40 million Americans, spring is time for seasonal allergies. For most people, seasonal allergies just mean coughing, sneezing watery eyes, and generally cold-like symptoms that last for months. For people with asthma, however, allergens in the air make it worse.

Allergies are similar to autoimmune disease, in that the immune system is defending the body against something that isn’t a thread—the body’s own organs in autoimmunity, and allergens such as tree pollen in allergies. In addition to tree pollen, inhaled allergens can include dust or mold, and these may be more prevalent in different weather conditions or seasons.

Not all allergic reactions lead to asthma symptoms, and not every allergy sufferer has asthma, but in people with both conditions—around half of all asthma sufferers are believed to also be allergic to inhaled particles—allergic reactions can lead into asthma attacks. That’s because the inflammation characteristic of asthma makes the bronchial tubes in the lungs particularly sensitive to irritation, which worsens the inflammation and makes breathing difficult. Other things can also trigger asthma, such as colds—which can occur in spring and summer as well as in colder months—smog, and cigarette smoke. Even cold air, particularly dusty air conditioning, can trigger an attack.

There are some treatments that are used for allergies and asthma alike. Medications to stop the immune system from responding to harmless allergens work by preventing the release of chemicals that signal the inflammation that leads to an asthma attack, meaning the allergens won’t cause a reaction or trigger asthma. A different sort of medication, called a leukotriene modifier, also modifies the immune response, in this case by acting directly on the chemical compounds in the body that are responsible for inflammation.