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Morning MEDtalks with Dr KK Aggarwal
New Delhi, November 22, 2018:
“NIH-supported studies aim to reduce the burden of COPD.”
World COPD Day 2018, the National Institutes of Health unites with millions of people to renew our long-standing commitment to reducing the burden of chronic obstructive pulmonary disease (COPD), a serious and debilitating lung disease. A leading cause of death, COPD impacts an estimated 251 million people worldwide. While many have been diagnosed with the disease, millions more are believed to have it and not know it. In the United States, 16 million people have COPD, and each year more than 150,000 people die because of it.
The numbers tell only part of the story, however. For many who live with the disease, getting through each day is often a struggle. COPD (also known as emphysema or chronic bronchitis) can make it difficult to breathe or perform even the most basic tasks. And because COPD symptoms develop slowly and worsen over time, many who have the disease delay getting diagnosed until they need aggressive treatment or hospitalization. This further compounds the toll on their lives — and on the nation’s health care system: COPD-related care cost Americans more than $32 billion in 2010, a number expected to increase to $49 billion by 2020.
Through its large research portfolio, the NIH is working hard to make inroads into the fight against this crippling disease.
In 2017, NIH’s National Heart, Lung, and Blood Institute (NHLBI) developed the COPD National Action Plan in collaboration with federal and nonfederal partners. This comprehensive, unified plan now serves as a guiding document for those affected by COPD and for those invested in doing something about it.
At NIH, intensive COPD research is being conducted and supported at all stages, from the laboratory to clinical trials. Some of it has improved our understanding of COPD and resulted in effective treatment strategies that are used in practice today.
The Nocturnal Oxygen Therapy Trial has given researchers insight into ways long-term oxygen therapy can improve the life expectancy of patients with advanced COPD. The Lung Health Study is helping researchers understand how smoking cessation interventions impact the long-term survival of COPD patients. TheNational Emphysema Treatment Trial is showing how lung volume reduction surgery might improve the quality of life in certain groups with severe COPD.
NIH also supports other studies, many conducted through the NIH COPD Clinical Research Network, that are exploring the effectiveness of various pneumococcal vaccines in COPD patients; the usefulness of azithromycin, an antibiotic, in reducing the severity and occurrence of COPD exacerbations; and the role statin drugs might play in preventing or eliminating those exacerbations.
In cooperation with the Centers for Medicare and Medicaid Services, NIH is also supporting the Long-Term Oxygen Treatment Trial, which builds on previous studies that looked at whether supplemental oxygen is beneficial to patients with mild COPD. Other studies are aimed at improving knowledge about the biologic basis of COPD and its biomarkers.
These studies are critical to the research activities of NHLBI-supported scientists, who focus on advancing understanding of the disease process, identifying crucial points in its onset and progression, and sharing the knowledge necessary for early intervention and prevention. The COPDGene Study is currently investigating why some smokers develop COPD while others do not. (Smoking accounts for 75 percent of COPD cases; secondhand smoke, environmental pollutants, and genetic factors also play a role.) Other studies are evaluating how various pharmaceutical medications affect the treatment of COPD. NHLBI also funds research to find out if a proven weight loss and physical activity program can improve COPD symptoms for those with a high body mass index (BMI). Finally, scientists are continuing their research on the CAPTURE tool, a case-finding mechanism that involves a simple questionnaire and breathing test, that can help health care providers identify people at risk for developing COPD before their symptoms get severe.
To further advance the awareness and understanding of COPD nationwide, NHLBI – through its COPD Learn More Breathe Better program – is working with health care providers to facilitate discussions with patients in the exam room to make earlier diagnosis more possible. To reach the greatest number of patients, the program collaborates with a large network of partners.
The NIH is thankful for all these collaborators, as well as the many other individuals and entities — from researchers to advocates — who are helping advance the care and management of COPD. By working together to improve awareness and early diagnosis of the disease, we can have a lasting — and positive — impact on the health of the millions who struggle with COPD in the United States and around the world.
Appendix linked to toxic Parkinson’s protein: A team led by Dr. Viviane Labrie at the Van Andel Research Institute sought to explore whether the gut could be involved in triggering Parkinson’s disease. They focused on the appendix. The team analyzed the records of nearly 1.7 million people whose health information was tracked for up to 52 years. They compared the chances of developing Parkinson’s disease among those who’d had their appendix removed with those who hadn’t.
People who’d had their appendix removed had a 19.3% lower chance of Parkinson’s disease. Those who lived in rural areas and had an appendectomy had an even lower chance, 25.4%. People who’d had an appendectomy and developed Parkinson’s showed a delayed onset of the disease relative to those who still had their appendix, an average delay of 3.6 years for those who’d had an appendectomy at least 30 years prior.
The team also found a build-up of the toxic form of alpha-synuclein in the appendixes of healthy volunteers suggesting that the appendix may be a reservoir for the disease-forming protein and may be involved in the development of Parkinson’s disease.
“We were surprised that pathogenic forms of alpha-synuclein were so pervasive in the appendixes of people both with and without Parkinson’s. It appears that these aggregates—although toxic when in the brain—are quite normal when in the appendix. This clearly suggests that their presence alone in the gut cannot be the cause of the disease,” Labrie said.
One in four US adults sits for more than 8 hours a day, according to a new study from the US Centers for Disease Control and Prevention (CDC). Four in 10 adults do not exercise to either a vigorous or even moderate degree each week. Add to that, one in every 10 Americans reports both behaviors — sitting for more than eight hours a day and being physically inactive, according to the study, published online in in JAMA on Tuesday.
536 AD revealed as the worst year to be a human by researchers: A team of historians and scientists has identified A.D. 536 as the beginning of a terrible sequence of events for humankind. A massive volcanic eruption spewed a huge cloud of ash that shrouded the Northern Hemisphere in darkness and caused a drop in temperatures that led to crop failure and starvation, said co-lead study author Professor Christopher Loveluck of the University of Nottingham in the UK. Then the misery was compounded in A.D. 542 as cold and hungry populations in the eastern Roman Empire were struck by the bubonic plague. The eruption and the 542 plague outbreak caused economic stagnation in Europe, which lasted more than 30 years until 575, when there were early signs of recovery … (CNN).
7 fast facts about toilets (UNICEF)
- Toilets save lives! Without toilets, deadly diseases spread rapidly. Over 750 children under five die every day from diarrhoea caused by unsafe water, sanitation, and poor hygiene.
- Globally, 1 in 3 schools do not have adequate toilets, and 23% of schools have no toilets at all.
- Schools without toilets can cause girls to miss out on their education. Without proper sanitation facilities, many are forced to miss school when they’re on their period.
- Toilets are a great investment. Every dollar spent on sanitation has a return of US$5.50, according to WHO research.
- But still, 892 million people worldwide practise open defecation, meaning they go outside – on the side of the road, in bushes or rubbish heaps.
- It’s often a matter of where they live: 90% of people who practice open defecation live in rural areas.
- It’s time to make a stink! In order to get everyone in the world using toilets, we need to triple our current efforts. That doesn’t just mean more toilets, but creating the desire for people to use them.
European Testing Week 2018 (23–30 Nov, 2018) is a European-wide campaign that encourages public and partner organizations, including communities, and public health care institutes throughout the WHO European Region to unite for 1 week to scale up voluntary testing. The campaign promotes awareness of the benefits of earlier diagnosis of HIV and viral hepatitis infections and linkage to treatment and care, while respecting the principle of confidentiality. The primary goal is to make more people aware of their HIV and/or hepatitis status and reduce late diagnosis.
People with migraine with aura were 30% more likely to develop atrial fibrillation (AF) than people who did not have headaches and 40% more likely to develop AF than people with migraine with no aura… (Neurology, Online Nov. 14, 2018).
Video to watch: TEDx Video: Doctor-patient relationship www.youtube(dot)com/ watch?v=i9ml1vKK2DQ
Dr KK Aggarwal
Padma Shri Awardee
President Elect CMAAO
President Heart Care Foundation of India
