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 COPD Support News March 16, 20067
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Posted - Mar 13 2011 :  12:15:20 PM  Show Profile  Reply with Quote
Volume 7, Issue 14
March 16, 2007

Combining the two most common COPD drug therapies is a more effective
treatment for patients with a severe case of the disease than either of the
drugs alone, confirms a new Canadian study published online in the Annals of
Internal Medicine. The randomized, double-blind trial followed 449 patients
from across Canada for one year and is the first trial to measure the safety
and effectiveness of a combination of tiotropium (Spiriva) and
fluticasone/salmeterol (Advair) for severe COPD, an incurable but manageable
respiratory illness.

At first glance... findings don't even look relatively dramatic. The study
revealed that a tiotropium and fluticasone/salmeterol combo only slightly
improved lung function in patients with severe COPD and it failed to reduce
the number of disease exacerbations experienced. But, significantly, the
drug combo did reduce the number of hospitalizations over a year by a
whopping 47%. This indicates that although treatment-group patients still
had the same number of exacerbations as those on placebo or tiotropium
alone, those exacerbations were less serious, requiring fewer emergency
visits as well (down 19%). Reducing hospitalizations for COPD exacerbations
is a boon both for patients and the healthcare system; such hospitalizations
last an average of 10.5 days and cost hospitals up to $11,000 per stay, so
the economic benefits of halving the number of hospital stays are enormous.

(Researchers) admit that the combination treatment did not result in much of
an increase in lung function: just a 5% improvement. "It's modest by any
standard...But it's nice to know that after a year their breathing tests are
better than when they started. And the quality of life measurements were
also important Ś they came out positive." Reducing the severity of
exacerbations is a major step forward for COPD treatment. (Doctors
caution)..."Family physicians shouldn't be extrapolating from this study for
their less severe patients. The danger is that GPs will be using this as
first-line primary maintenance therapy, but the study only looked at people
with severe disease."


SOURCES: News items summarized in The COPD-NEWS are taken from secondary
sources believed to be reliable. However, the COPD Family of Services does
not verify their accuracy.

Paul G. Donohue, M.D. To Your Good Health: Dear Dr. Donohue: In the past you
wrote: "There are many things that can make life with emphysema more
livable." However, you didn't mention what those things are. I would sure
like to know them. A.B.

A. Emphysema is the destruction of air sacs, the delicate lung structures
through which oxygen passes into the blood. With emphysema, oxygen cannot
get into the blood. Its principal symptom, therefore, is breathlessness even
on minor physical activity. Emphysema's twin is chronic bronchitis, an
irritation of the bronchi (the airways). Its identifying symptom is
persistent cough with thick yellow sputum. Most people have both conditions
simultaneously, and they are referred to as COPD, chronic obstructive
pulmonary diseases. The treatments I discuss apply to both.

Drugs that soothe and open irritated airways filled with mucus improve
breathing and lessen coughing. Most are taken as mists generated by a mouth
inhaler. Albuterol, terbutaline, tiotropium and ipratropium are a few
examples. A prednisone inhaler is used when there's a flare-up of symptoms.
Prednisone is a cortisone drug, and it's a powerful inflammation fighter and
irritation soother. Oxygen is, of course, an important adjunct in treating

Exercise is essential for all COPD patients. That sounds like a mindless
piece of advice for people who have a hard time getting enough air. But it
has to be done, if possible. Muscles quickly become deconditioned when they
aren't exercised, and deconditioned muscles add to the burden of not being
able to breathe easily. Even if people start out by taking only 20 extra
steps a day, they can build on that gradually until they are walking for 10
or more minutes at a time. COPD patients can help themselves by adopting a
different breathing technique. They should inhale slowly for about four
seconds and exhale even more slowly, taking six seconds and doing so with
lips pursed as though they were going to whistle. By leaning slightly
forward when they breathe, they permit the lungs to expand more and to hold
more air.

Inhaled Steroids May Not Be as Effective in COPD Treatment: Inhaled
corticosteroids (ICS) are commonly used in the treatment of COPD. However, a
new study reveals that ICS may not be as effective in treating the disease
as previously thought. In a pooled study, researchers from the University of
Minnesota and Oregon Health and Science University, along with researchers
from Canada, United Kingdom, and Europe analyzed data from nearly 4,000
patients with COPD, who were randomized and treated with either ICS or a
placebo. Results showed that ICS use was associated with a significant FEV1
increase within the first 6 months of use and that they were more effective
in improving lung function in ex-smokers than in current smokers. However,
researchers found that after 6 months, there was no significant difference
between placebo and ICS in modifying FEV1 decline. This study appears in the
March issue of CHEST.

Bronchodilators Show No Benefit in Bronchoscopy Patients: A new study
suggests that patients with COPD, who are undergoing bronchoscopy, should
not be premedicated with bronchodilators. Researchers from the University
Hospital Basel, Switzerland, gathered 120 patients with COPD and randomized
them into three groups to receive salbutamol, placebo, or nothing prior to
bronchoscopy. Pulmonary function tests were performed on all patients both
before and after the procedure. Results showed that in all groups, FEV1
decreased significantly postbronchoscopy and that the percentage of patients
experiencing postbronchoscopic deterioration was similar. Researchers
conclude that patients with COPD do not need to be premedicated with
short-acting ▀-agonists prior to bronchoscopy.

While the number of respiratory rehabilitation programs in Canada has
doubled in the last five years, a new study by researchers shows that less
than two per cent of people with a debilitating lung disease could access
programs proven to significantly improve their lives. The study, published
in the Canadian Respiratory Journal, examined the national capacity for
rehabilitation of patients with COPD.

The study, based on a 2005 survey of healthcare facilities across Canada,
concluded that 60 facilities offered 98 pulmonary rehabilitation programs,
with 41 of those programs located in Ontario. The total capacity for all of
the programs was 8,927 people per year - about 1.2 per cent of the estimated
750,000 Canadians diagnosed with COPD. "Despite this improvement, Canada is
still woefully under-serviced in rehabilitation programs that are vital to
people living with COPD," says Nora Sobolov, President and CEO of the
Canadian Lung Association. "This study highlights the urgent need for
continued investment in rehabilitation programs throughout Canada."

Study still recruiting. The University of Colorado Hospital is launching a
statewide test program to track the well-being of emphysema patients from
the comfort of their own homes. The technology potentially could curb health
care costs to treat a condition that affects as many as 460,000 Coloradans.
The initial phase of the test showed the electronic monitoring system can
save nearly $3,200 per patient over just a 12-week period, largely by
alerting health care providers to signs of developing problems before they
balloon into larger complications like pneumonia. "A lot of times patients
will have symptoms that wax and wane," said Dr. William Vandivier, project
director. "They don't come in nearly as often as they should because for a
lot of them, it's difficult to access the health care system."

Treatment for COPD - the technical name for emphysema - costs as much as $70
million a year. The study was funded by $1.8 million in tobacco tax money.
The system works like this: Each participant receives an electronic
communication device, a pedometer, a pulse oximeter that measures blood
oxygen levels and a spirometer to monitor exhaled breath. The equipment
gathers information on a daily basis, which is transmitted to nurses and
respiratory therapists. If the results are questionable, they get in touch
with the patient. Gale Swope, a 73-year-old Denver resident who was
diagnosed with the lung impairment in his mid-60s, said he's cut down his
routine doctors visits to once every three months from two months since he
started the program. The system "asks you questions about your health that
make you more aware about how you're doing," said Swope, a former Air Force
mechanic. The program, which is being administered by the University of
Colorado Hospital and Kaiser Permanente Colorado, still is accepting
applicants. Visit or call 303-372-8378.

COMMERCIAL FREE: We do not accept any paid advertising. Any corporations,
products, medicines (prescription or non) mentioned in this newsletter are
for informational purposes only and not to be construed as an endorsement or
condemnation of same.

Not me...YouTube has a few video's on COPD. Thanks to DennyT for posting the
info to the COPD list. When you're finished with the "awareness" there are
more on the right side of page.

Physician Prescribed Reading: All of iVillage's patient guides are edited by
their Physician Advisory Board. Guides available:

Pulmonary System Overview
Pulmonary Hypertension
Sleep Apnea
Pulmonary Function Test

If you currently have prescription drug coverage through your employer or
through Medicare or Medicaid, you will need to confirm the copay that
applies to the HFA quick-relief albuterol inhaler. If you self-pay for your
prescription drug coverage, the cost of your HFA quick-relief asthma
inhalers may be higher than what you currently pay since there are no
generic versions of HFA quick-relief inhalers. If you require financial
assistance, contact The Partnership for Prescription Assistance by calling
1-888-477-2669 or see their Web site for more information. Return to Menu

Patients needing further information on making the transition to an HFA
quick-relief inhaler should contact the Asthma and Allergy Foundation of
America (AAFA) at or by calling 1-800-7-ASTHMA.

To get a voucher for a free inhaler from Teva Pharmaceuticals:
ProAir« HFA Inhaler

MEDICAL DECISIONS. Your physician should be consulted on all medical
decisions. New procedures or drugs should not be started or stopped without
such consultation. While we believe that our accumulated experience has
value, and a unique perspective, you must accept it for what it is...the
work of COPD patients. We vigorously encourage individuals with COPD to take
an active part in the management of their disease. They do this through
education and by sharing information and thoughts with their primary
physician and pulmonologist. However, medical decisions are based on complex
medical principles and should be left to the medical practitioner who has
been trained to diagnose and advise.

In her dorm at the University of Michigan, Denise Rowe looks as much like a
sick patient as a student. Before she eats a meal, goes to sleep at night or
even kisses her boyfriend, she first has to slip off the blue surgical mask
that covers her nose and mouth and hooks around her ears. Around the Ann
Arbor campus this winter, 1,400 students have been participating in a study
to learn whether wearing masks makes a difference in who gets the flu. About
830 of them are assigned to wear the apparatus for six weeks, while the rest
take no precautions. Some of the mask wearers also use hand sanitizer. The
$2 million study, funded by the U.S. Centers for Disease Control and
Prevention, is one of several worldwide intended to evaluate the feasibility
and effectiveness of non-pharmaceutical measures in containing the next
deadly flu pandemic. Scientists have been saying the world is due for the
next flu epidemic...In the case of such a pandemic, federal officials have
said a vaccine may not be available until six months after an outbreak,
making it more important to know the effectiveness of other measures, such
as masks and hand washing, in controlling the disease. But the first year of
the CDC study, which ends this week, may reveal as much about slacker
students as it does about science...students have been filling out online
weekly surveys about their health, the amount of time spent wearing the
masks and the reasons for not wearing them, including embarrassment and
discomfort. Observers also are stationed in the dorms and cafeterias to
watch how many students are wearing the masks. Researchers said the project
will be valuable even if some of the students don't wear the protection. The
study may find that while masks help prevent the spread of respiratory
illnesses, they may not be a viable option because people won't use them.

JOIN US? Subscription to this Newsletter is free and we hope that it serves
your needs. For more Newsletter information, go to:

The Newsletter, like all the other endeavors of the Family of COPD Support
Programs, is provided to you by COPD-Support, Inc. a non-profit
member organization with IRS designation 501(c)(3). If you would like to be
involved and help us provide these programs to the individuals who
benefit from them, please consider joining us as a member. Further
information is available at:

Irish Cooking

70's and 80's Trivia

Some Luck of the Irish Slot Machines


Irish Index

Irish Blessings
When the first light of sun- Bless you
When the long day is done- Bless you
In your smiles and your tears- Bless you
Through each day of your years- Bless you.

Until next Friday,

Joan Costello, Editor

Web version of the News:
Archives at:

To contact List Management write
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To see other programs provided in the Family of COPD Support
Programs, examine our web site at
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Please keep in mind that all posts are from COPD patients / caregivers
and not medically trained professionals - consult your medical team
for your personal medical needs.

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