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| Volume 8, No. 23 |
Provided To You By COPD-Support, Inc. | May 09, 2008 |
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PENTAGON EFFORT AIMS TO REBUILD BODY PARTS Eric Bland, Discovery. A new five-year, $250 million Defense Department initiative aims to heal soldiers and civilians by using a patient's own cells to regenerate lost body parts, starting with skin and ending with entire limbs. "Humans can regenerate ourselves, but only up to a certain point," said Anthony Atala, a doctor at Wake Forest University who is involved in the new Army initiative, called the Armed Forces Institute of Regenerative Medicine (more happily known as AFIRM). "Army doctors already make use of existing regenerative medicine to help heal soldiers wounded in battle. Using a human patient's own cells, scientists can regenerate simple tissues like skin, cartilage, bladders, ears, noses, blood vessels and other body parts. Regenerating the heart, lungs and entire limbs, however, becomes more complex, although promising studies have already been done, including creating a beating rat heart in a petri dish. The ultimate goal -- a new arm or leg -- is still many years away, according to scientists, but eventually even these parts will be regenerated. " Atala points out that all parts of the body have reserves of cells that can regenerate when injury occurs. The idea is to take these cells and trigger them to regenerate outside the body. The newly grown living cells can then be placed over biodegradable material and shaped in the form of the missing body part.One reason scientists are pushing so hard for regeneration technology is that since the replacement tissue or organs are made from a patient's own cells, the risk of rejection is virtually nonexistent. It takes six to eight weeks to regenerate the lost tissue, said Atala. Speeding up that process is another goal of AFIRM. While the research is Army-funded, civilians will also benefit from AFIRM. http://dsc.discovery.com/news/2008/04/29/limb-regeneration.html  ALSO IN THIS ISSUE NO VENT, DNR, OR FULL
CODE...?
COMPUTER-CONTROLLED BREATH TRAINING MAY IMPROVE EXERCISE ABILITY PATIENTS WIN IN NEW AIRLINE RULING NEW DELPHI PORTABLE OXYGEN CONCENTRATOR DOCTORS HOPE STUDY WILL HELP PATIENTS WITH COPD RESEARCHERS CLAIM COPD MAY BE HEREDITARY SYNTHETIC LUNG COULD FURTHER ASTHMA RESEARCH MISTAKENLY SWALLOWING INHALER CAPSULES MISCELLANEOUS
NO VENT, DNR, OR FULL CODE...? A lengthy article written by a respiratory therapist which may make you rethink your Health Power of Attorney or Advance Directive. The decision of whether or not you want to be placed on a ventilator, or whether or not you want to make a decision for your loved one, is one of the most difficult decisions one can make. In fact, this is the basis of some very deep ethical discussions, and one of which may never be answered by society, only by the person who has to actually make that decision. First let us note here that a majority of patients who go on a ventilator do so only for temporary purposes. If you have surgery, if you have severe asthma, pneumonia, or failing heart, you may need to be placed on a ventilator short term. If a person is involved in a trauma, or if CPR is performed, then a person may be intubated and placed on a ventilator. Those are easy decisions, especially when we are in emergent situations and are trying to save a life. However, there are also times when the decision to intubate or not to intubate can be complicated as complicated can get, and very stressful, and often disappointing. In some cases you can plan ahead and write in your advanced directives that you do not want to be placed on a vent, however, sometimes I have seen this declaration over-ruled at the point of impact when a person is in the emergency room and they have to decide, "Do I want to risk dying now, or do I want to let these good people here in the emergency room help me breathe by placing a tube into my airway and assisting me with my breathing. Do I want to do that? Do I want to allow them to place me on a ventilator? Here I will provide some examples for you. All of these come from real life examples as I have actually seen them in my eleven years as a registered respiratory therapist. One of the most frustrating examples to me is when a person has decided they do not want to be placed on life support because "I don't want to spend the rest of my life on one of those," or "because I don't want to become a vegetable." In thinking this way, many people choose the following in their advanced directives: Full Code and not Vent. I have to cringe when I see that. I cannot believe any lawyer or doctor would or advisor would recommend that option, because when a person's heart stops, and we have to do CPR on the patient, we also have to pump in quite a bit of medicine, and 99.9% of the time the patient does not survive a code breathing on his own: he has to be placed on a ventilator. Thus, if we do CPR, we have to put you on a vent -- there is no other option. If you get CPR and live, you bought yourself a vent, unless you are a DNR. However, if the people working on you don't know you are a DNR, you will end up on a vent regardless. However, I do think the decision not to become a vegetable on a vent is a valid issue for most people, one also has to consider the definition of a vegetable. Are you a vegetable when you have no body, but your brain is fully functional as would be the case with ALS (Lou Gehrig's Disease) or multi system atrophy, which is a disease my grandma suffered from at the end of her life, and is a disease like ALS in that the person loses control of his muscles and basically becomes a brain without a body. Some people might value life so much that they would want to live so long as they have control of their brain. That was my grandmas wishes, and I totally understood those wishes, as she loved life and wanted to continue on as long as she could. More examples at:
http://respiratorytherapycave.blogspot.com/2008/05/no-vent-dnr-or-full-code-whats-your.html COMPUTER-CONTROLLED BREATH TRAINING MAY IMPROVE EXERCISE ABILITY Computer-controlled breath training may improve the ability to exercise for patients with COPD. Exercise-induced dynamic hyperinflation is a major contributor to decreased exercise tolerance in COPD. The technique involves learning to slow down breathing to prevent the dynamic hyperinflation of the lungs that is a major contributor to decreased exercise tolerance. In a randomized controlled trial, the so-called ventilation feedback combined with exercise allowed patients to exercise for 40 minutes on average, compared with 31.5 minutes for those who had only exercised and 16.1 minutes for those who had only used ventilation feedback, Dr. Collins and colleagues reported in the April 15 issue of the American Journal of Respiratory and Critical Care Medicine...(T)he technique, once learned, continued to have an effect on breathing patterns during exercise, the researchers said. "COPD is a double-edged sword," Dr. Collins said. On one hand, exercise is rendered difficult, while on the other hand, the most effective intervention is simply exercise, she said. Patients with the worst disease are likely to be unable to exercise long enough for the workout to benefit them, Dr. Collins said, mainly because dynamic hyperinflation "diminishes the patient's breathing efficiency." http://www.medpagetoday.com/Pulmonary/SmokingCOPD/tb/9125
PATIENTS WIN IN NEW AIRLINE RULING Oxygen patients will have easier travel, thanks to a new ruling by the U.S. Department of Transportation (DOT) that says airlines must accept certain approved portable oxygen concentrators onboard flights. These are the concentrators approved by the DOT that patients may carry aboard aircraft. AirSep FreeStyle AirSep LifeStyle Inogen One Respironics EverGo Sequal Eclipse AARC was a major player in the effort to get a nationwide ruling that would require air carriers to board passengers with any of the DOT-approved concentrators. AARC joined with other groups in the Airline Oxygen Council of America (AOCA), which spearheaded the effort to ease access to medical oxygen for passengers. Other organizations in the AOCA include the Alpha-1 Foundation and the U.S. COPD Foundation. "For a couple of years now, airlines could choose whether to allow DOT-approved oxygen concentrators and many chose not to," said Cheryl West, director of government affairs. "This ruling makes it mandatory for all airlines to let patients aboard with their approved devices." Miriam O’Day, who heads the AARC’s legislative efforts in Washington DC, was a key player in the fight to get a mandatory ruling from the DOT. O’Day represented the AOCA’s positions to the DOT. "This is great news for the patients who must travel with oxygen," she said. "Travel will be so much more accessible and convenient for them. It’s safe, it’s secure and it opens many possibilities for those who have been reluctant to travel in the past." The rule will apply to U.S. air carriers worldwide and to foreign air carriers whose flights begin or end in the U.S. The new rule takes effect in one year to give airlines time to implement the regulation. You can read the final rule at www.regulations.gov, docket number DOT-OST-2004-19482. http://www.aarc.org/headlines/08/05/airline_ruling.cfm NEW DELPHI PORTABLE OXYGEN CONCENTRATOR I have no interest in this company and my only purpose in giving them space is informational. Delphi Medical Systems, a subsidiary of Delphi Corp. is introducing its new portable oxygen concentrator, the Central Air, which can help patients gain increased freedom and independence by providing exceptional durability in a lightweight package. Delphi also announced that it has entered an exclusive agreement with evo Medical Solutions to distribute the device in North America for millions of adults who require supplemental oxygen treatment after being diagnosed with COPD. Currently, the device has 510(k) clearance from the U.S. FDA. Delphi's design delivers concentrated oxygen in a compact size and convenient format, and boasts the smallest footprint and package size in its class. Measuring under a foot high and weighing less than 10 pounds, the unit allows premium portability so that patients can participate in more mobile lifestyles. The unit features a patented Delphi process that separates oxygen from room air using a unique PSA (pressure swing adsorption) cycle made practical for the first time with the use of Delphi's advanced electronics control capabilities. This design results in improved durability. Delphi's exclusive rotary compressor technology and design also enables the device to operate with less vibration than conventional compressors...the device contains several options for power so that users can conveniently access oxygen from most locations. It can be powered by the included conventional AC power supply or rechargeable battery, or via DC power, such as an automotive 12-volt power receptacle. Included accessories, such as a carrying case and pull cart, increase the device's versatility and allow patients to move around more readily by providing a means for safe and easy transport. The carrying case features a shoulder strap, a fabric enclosure and a clear protective cover that allows access to the control panel. With the Delphi custom fold-up cart, which features large easy-roll wheels, users can simply pull the concentrator along wherever they go. The Central Air is available now and will be distributed in the U.S. exclusively through evo Medical Solutions' nationwide network. evo's president. http://www.marketwire.com/mw/release.do?id=852574 So far, treatments (for COPD) can control symptoms, but local researchers at the University of Pittsburgh are trying to figure out how to keeping the disease from worsening...the condition makes it hard for people to get air in or out of the lungs. As a result, oxygen can't get into the blood stream, and symptoms can worsen over time. "More short of breath, more cough, to the point where they were near incapacitated, they were bed bound," said Dr. Steven Duncan, a lung specialist at UPMC. "Ideally, we'd like to get somebody before they get to that stage." Doctors say the most common cause is cigarette smoking. "How much is autoimmunity versus how much is the effect of the cigarette itself versus how much is due to effects of infection, we don't know," he adds. "We think the autoimmune response is somewhat substantial." Because of their findings, the doctors say they are looking for patients to take part in another study, to see if drugs to suppress the immune system can stop the lung damage. "We have no expectation that it will reverse disease, but again, even if we could stop progression, that would be a wonderful thing." But not everyone agrees that COPD is an autoimmune disease. Other researchers say they are waiting for the results of studies in people, and not just the proteins found in a lab to give them a clearer picture. http://kdka.com/seenon/COPD.health.research.2.705329.html RESEARCHERS CLAIM COPD MAY BE HEREDITARY It follows findings that siblings of COPD patients have a much greater risk of developing the disease than spouses. Although smoking is known to be the most common cause of COPD, previous studies have suggested that there may be a genetic element. Data on over 14,000 patients who had been hospitalized for COPD in Sweden from 1986 to 2004 was analyzed for the study. In this, 604 affected siblings were identified. Standardized incidence ratios (SIRs) of COPD among siblings, twins and spouses were also calculated. Overall, the risk of COPD was found to be much higher in siblings (SIR of 11.87) than in spouses (SIR of 1.6). http://www.healthcarerepublic.com/news/GP/804060/Researchers-claim-COPD-may-hereditary/ Familial risks for COPD among siblings based on hospitalizations in Sweden, the study at: http://jech.bmj.com/cgi/content/abstract/62/5/398
SYNTHETIC LUNG COULD FURTHER ASTHMA RESEARCH UK researchers have started developing a 'lung in a test tube', that could aid research into respiratory diseases such as asthma and allergy and reduce the need for animal testing. The artificial airway is made using tissue engineering, with layers of the epithelial cells that make up the airway tissue grown inside a microfluidic device. The device is modified to allow lung cell growth by coating the inner surface with a membrane that will allow access to both sides (the 'air' and 'blood' surfaces) of the cells. "The device will allow researchers to fully understand how lung function is affected by air particles and allergens and to test their effects without animal testing," said the researchers, from the University of Southampton. In the UK, respiratory diseases account for 25 per cent of all medical admissions to hospital, and the majority are due to bronchial asthma or COPD...Unlike other disease areas such as cardiovascular where there have been significant new therapeutic treatments, COPD and asthma have not benefited from any recent major breakthroughs, according to Davies. Last year, researchers from the University of Michigan in the US led by Shuichi Takayama unveiled a similar research effort - dubbed the 'lung on a chip' - that is designed to allow lung epithelial cells to grow in an environment more similar to the body. Their research, published in the Proceedings of the National Academy of Sciences, found that the chip would allow lung cells to behave in ways not seen petri dishes, such as forming tissue connections and adopting 'normal' protein secretion patterns. http://www.labtechnologist.com/news/ng.asp?n=84971-university-of-southampton-microfluidics-asthma-copd MISTAKENLY SWALLOWING INHALER CAPSULES FDA has issued an advisory about the danger of mistakenly swallowing Spiriva (tiotropium bromide inhalation powder) and Foradil (formoterol fumarate inhalation powder) inhalation capsules. These capsules are intended to be used with inhalation devices to treat patients with asthma and COPD. FDA and the American Association of Poison Control Centers have received many reports of patients swallowing these capsules. This may occur because the capsules resemble those taken by mouth. Not many patients have suffered side effects from swallowing the capsules, but their respiratory problems will not be treated if the drugs are taken orally rather than inhaled. Do not swallow Spiriva or Foradil capsules. The capsules should be removed from the blister pack and placed in the inhalation device - for Spiriva, it's the HandiHaler, and for Foradil, the Aerolizer. If you swallow it you will not get the benefits of it. Additional Information: FDA MedWatch Safety Alert. Spiriva (tiotropium bromide inhalation powder) Capsules Foradil (formoterol fumarate inhalation powder) Capsules. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Spiriva
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MISCELLANEOUS How's your typing? From Kim Komando's Cool sites. http://www.komando.com/coolsites/ Studies have shown that computer games have unexpected benefits. For example, they can improve a surgeon's coordination. Well, most of us will never be a surgeon. But you can still refine your skills through computer games. So, if you're looking for a guilt-free game, try Typeracer. As you can probably guess, it is a racing game that involves typing. It's perfect for hunt-and-peck! Begin by practicing your typing skills. You'll be given a passage to type. When you're done, you'll see how fast you type. When you gain confidence, you can race others. It's a fun way to brush up your typing skills! http://play.typeracer.com:80/ Assemble a skeleton http://www.bbc.co.uk/science/humanbody/body/factfiles/skeleton_anatomy.shtml Eagle Eyes Do you have eagle eyes? Small changes in photographs can be difficult to see. Unless you really study a photograph, you may miss them. Of course, spotting differences in pictures is a popular child's game. And it is a good way to teach children to be attentive to life's details. With that in mind, check out Eagle Eyes. It's a game developed by Audubon and the Cornell Lab of Ornithology. You're presented with five groups of two photographs. You have to spot five differences in between the photos in each group. It's easier than it sounds. As you may have guessed, the photos are mostly of birds. The photos themselves are impressive. You can choose from several timed versions of the game. Or, you can play without time restrictions. Good luck, eagle eyes! You will be scored! 20 seconds is not enough. Allow yourself as much time as you can. http://audubon.org/gbbc/game/index.php Not Quite A Shot In The Dark This is a shooter game. However, you're not aiming at people. Rather, you're aiming at enemy outposts. The non-line-of-sight cannon used in the game simulates military technology. It is the future of U.S. field artillery. http://dsc.discovery.com:tv/future-weapons/games/cannon/cannon.html Printable Paper...Need a special type? http://www.printablepaper.net/ This page will be next updated on May 16, 2008 |
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