Day: July 3, 2024

Jul 03

Arterial stiffness may cause and worsen heart damage among adolescents by increasing blood pressure and insulin resistance

image: Arterial stiffness may cause premature cardiac damage in youth, but decreasing blood pressure and insulin resistance may reduce this effect by fifty percent. view more Credit: Andrew Agbaje. Arterial stiffness is a novel cause of premature heart damage among adolescents, according to a new follow-up study. The study was conducted in collaboration between Texas Children’s Hospital and Baylor College of Medicine in the US, the University of Bristol in the UK, the University of Exeter in the UK, and the University of Eastern Finland, and the results were published in Atherosclerosis. Left ventricular hypertrophy and left diastolic dysfunction are measures of structural and functional heart damage, which have been associated with an increased risk of cardiovascular-related death in adults. These cardiac measures are also used in the paediatric population as indicators of premature heart damage. Arterial stiffness estimated from carotid-femoral pulse wave velocity has been discovered as a novel cause of increased blood pressure, insulin resistance, and metabolic syndrome in adolescents and young adults. It was also recently shown that increased blood pressure in adolescence may cause premature heart damage, but it is not known whether arterial stiffness could independently cause structural and functional damage to the heart. The current study was conducted among 1,856 adolescents of whom 1,011 were female. The adolescents were 17 years old at baseline, and they were followed up for 7 years until young adulthood at age 24 years. Arterial stiffness, carotid intima-media thickness, and evidence of heart damage were assessed at baseline and follow-up. Signs of heart structure damage are left ventricular hypertrophy and high relative wall thickness, whereas signs of heart function damage are left ventricular diastolic dysfunction and increased left ventricular filling pressure. During the 7-year follow-up period, the prevalence of heart structural damage among adolescents doubled. With extensive control for fat mass, muscle mass, glucose, insulin, blood pressure, lipids, smoking status, sedentary time, physical activity, socio-economic status, and family history of cardiovascular disease, and using adults’ cut points for diagnosing heart damage, it was observed that adolescents in the highest tertile category of arterial stiffness and carotid intima-media thickness had a 23 – 27% increased risk of progressively worsening structural heart damage. Only arterial stiffness appears to independently cause both structural and functional heart damage, whereas increased carotid wall thickness does not seem to have a causal role. Increased carotid wall thickness is an early indicator of atherosclerosis, whereas increased arterial stiffness describes arteriosclerosis. The study further reported that arterial stiffness caused heart damage by increasing blood pressure and insulin resistance. The increase in blood pressure explained 34% of the heart damage caused by arterial stiffness. Moreover, insulin resistance explained 15% of the heart damage caused by arterial stiffness. “We are seeing for the first time that arterial stiffness is a novel cause of several diseases such as hypertension, insulin resistance, metabolic syndrome, and heart damage in the young population. Among adults, arterial stiffness is currently being established as a cause of type 2 diabetes. We discovered that approximately 50% of the deleterious role of arterial stiffness in causing heart damage is enhanced by the mechanism of increased blood pressure and insulin resistance. Thus, preventing and lowering blood pressure and insulin resistance may potentially diminish the negative impact of arterial stiffness on the heart, by up to half,” says Andrew Agbaje, a physician and clinical epidemiologist at the University of Eastern Finland. “Experimental and clinical intervention studies are urgently needed on comprehensive approaches to treating and reversing arterial stiffness from adolescence. At least, targeting blood pressure and insulin resistance leaves the problem half-solved,” Agbaje continues. Dr Agbaje’s research group (urFIT-child) is supported by research grants from Jenny and Antti Wihuri Foundation, the Finnish Cultural Foundation Central Fund, the Finnish Cultural Foundation North Savo Regional Fund, the Orion Research Foundation, the Aarne Koskelo Foundation, the Antti and Tyyne Soininen Foundation, the Paulo Foundation, the Yrjö Jahnsson Foundation, the Paavo Nurmi Foundation, the Finnish Foundation for Cardiovascular Research, Ida Montin Foundation, Eino Räsänen Fund, Matti and Vappu Maukonen Fund, and the Foundation for Pediatric Research. Journal Atherosclerosis Article Title Arterial Stiffness but not Carotid Intima-Media Thickness Progression Precede Premature Structural and Functional Cardiac Damage in Youth: A 7-Year Temporal and Mediation Longitudinal Study. Article Publication Date 3-Aug-2023 Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Jul 03

Dr. Roach: Heart attacks occur after treatment of infections

DEAR DR. ROACH: My mom had a throat and palate infection that was treated in 2017, and about two weeks later, she had a heart attack. In 2023, she had pneumonia, and was briefly hospitalized and treated, but again about two weeks later, she had another heart attack. We asked her cardiologist if there is a relationship between either the infections themselves or the treatment of infections and heart attacks, but he was not aware of any. This seems too unlikely to be a coincidence. What is your experience on this? — A.C.S. ANSWER: A heart attack happens when the demand for blood from the heart is greater than the ability of the blood vessels can provide. In practice, this almost always means that there are blockages in the blood vessels. However, an increase in the workload of the heart, such as strenuous exercise or an infection (fever tends to increase heart rate, and the blood flow from the heart usually increases with serious infection), can be what leads a person to have a heart attack. It’s possible that this is what happened with your mom. The timing of two weeks after the event is longer than expected, but it’s possible. Whether from chronic infection or inflammatory conditions like rheumatoid arthritis, inflammation in the blood increases the risk of heart disease in the long term, so if there is a connection, and it’s not just coincidental, that would be the most likely cause. DEAR DR. ROACH: You wrote about the dangers of testosterone replacement in men over 70 in your column a few months ago. Could you please describe the dangers of this again? My husband is 73 and injects testosterone every 10 days or so. He’s not feeling too well overall, but he doesn’t know why. He’s been to the cardiologist, but the studies came back fine. He says he feels nerves in his stomach and a bit of shortness of breath. He’s also tired and without much energy. — E.D. ANSWER: There are clear dangers with excess testosterone use, especially in older men. Some men use very high doses of testosterone or other androgens for muscle building, and this can cause heart damage, blood clots and stroke. I strongly do not recommend doing this, but it is generally used illicitly. By contrast, for men in whom testosterone therapy is given appropriately, the dangers are quite small, and in most men, the benefits outweigh the risks. Men should have a clear reason to receive testosterone therapy, such as having low bone density, low libido, loss of body hair, or development of breast tissue, in addition to repeatedly low testosterone levels (including a level taken between 8 a.m. and 10 a.m. when testosterone levels are highest). In these men, the goal is to stabilize the testosterone level, and the risks of the catastrophic outcomes listed above appear to be very small, or even zero. Testosterone levels should also be measured during therapy. I can’t speculate on the cause behind your husband’s symptoms. Nonspecific symptoms, such as low energy, can be caused by low testosterone, but unless there are more specific symptoms of low testosterone, I generally do not recommend testosterone replacement. Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].

Jul 03

Clinical Associates Reisterstown Offers Comprehensive Healthcare with Specialized Services

Industry: Healthcare Maryland residents can access a wide range of medical services under one roof in Reisterstown, including cardiology, endocrinology, gastroenterology, internal medicine, ophthalmology, optometry, and podiatry, ensuring timely care Reisterstown, MB (PRUnderground) August 15th, 2023 Clinical Associates, a leading provider of integrated medical care for over 50 years in Maryland, offers comprehensive and specialized care across multiple disciplines in its Reisterstown primary care location. The facility provides expert medical care in cardiology, endocrinology, gastroenterology, internal medicine, ophthalmology, optometry, and podiatry, ensuring that Maryland residents can access a range of medical services in a single location. Our goal is to provide our patients the highest quality of care. The services in the Reisterstown location enable us to offer a comprehensive range of medical specialties, making it more convenient for our patients to receive the care they need. Cardiology in Reisterstown Clinical Associates’ Cardiology department offers comprehensive diagnosis and treatment for heart conditions and disorders, including cardiac arrest, congenital heart defects, coronary artery disease, and heart arrhythmias. With a focus on preventive care and effective management of existing conditions, the medical team of cardiologists works closely with patients to promote heart-healthy lifestyles and provide personalized treatment plans tailored to their specific needs. Endocrinology in Reisterstown The Endocrinology department at Clinical Associates specializes in diagnosing and treating hormone-related conditions and disorders, such as Addison’s disease, adrenal gland disorders, diabetes, and thyroid disorders. The endocrinology team works closely with patients to develop personalized treatment plans that help them manage their conditions. Gastroenterology in Reisterstown The gastroenterology speciality group at Reisterstown provides screening, diagnosis, and advanced treatment options for gastrointestinal diseases and disorders. The gastroenterologists at Clinical Associates treat patients with celiac disease, Crohn’s disease, colitis, heartburn, peptic ulcer disease, and irritable bowel syndrome. Internal Medicine in Reisterstown Internal Medicine at Clinical Associates Reisterstown serves as a team of primary care providers for many patients. These internists specialize in treating common health concerns and chronic health problems like arthritis, asthma, diabetes, heart disease, high cholesterol, hypertension, and osteoporosis. In addition, the internists work in conjunction with on-site laboratory and radiology services to provide comprehensive care. Podiatry in Reisterstown Finally, the podiatry department provides medical diagnosis, treatments, and surgical options for foot and ankle problems. The podiatrists at Clinical Associates Reisterstown treat a wide range of issues, including Achilles tendon disorders, arthritic foot and ankle care, athlete’s foot, bunions, calluses, corns, diabetic foot care, flat feet, fungus treatment, geriatric foot care, hammertoes, heel spurs, ingrown toenails, and plantar fasciitis. The medical services at Clinical Associates Reisterstown provide Maryland residents with comprehensive and specialized healthcare in one convenient location. By supporting a wide range of medical services under one roof, Clinical Associates aims to ensure timely care and improved patient experiences, ultimately promoting the Reisterstown community’s well-being. For more information on services and physicians at the Clinical Associates Reisterstown location, please visit https://clinicalassociatesmd.com/locations/reisterstown/ To schedule an appointment at Clinical Associates at Reisterstown, call 410-526-7800 or visit the office at 750 Main Street, Reisterstown, MD 21136. About Clinical Associates Clinical Associates has been a premier provider of integrated medical care in Maryland for over 50 years, offering a wide range of specialties and comprehensive healthcare services. With a focus on patient-centered care, our team of over 50 physicians, specialists, and credentialed healthcare providers works together to deliver personalized treatment plans and coordinate care across multiple disciplines. Clinical Associates is dedicated to making healthcare more accessible and convenient for patients.

Jul 03

Hospital associated infections — a missing piece in Kerala’s antimicrobial resistance puzzle

An uptick in hospital-associated infections (HAI) has triggered questions about whether healthcare institutions in the state of Kerala are becoming a hotbed of antimicrobial resistance (AMR). A report on AMR, released by the state Health Department on 2 August, has set off concerns in this regard. Going by the data from the Kerala Antimicrobial Resistance Surveillance Network’s (KARS NET) Annual Report 2023, AMR is increasing in the state. And so is HAI. It is feared that the state has waged a losing battle against drug resistance as it overlooked HAI in its AMR strategy. What is hospital-associated infection (HAI)? According to the World Health Organisation (WHO), HAI is an infection occurring in a patient during the process of care in a hospital or other healthcare facilities that was not present or incubating at the time of admission. As HAI might result in prolonged hospital stays, misuse and overuse of antimicrobials (medicines used to prevent and treat infections) is also high. Increased resistance of micro-organisms like bacteria, viruses, fungi, and parasites to the antimicrobials could thereby increase the risk of disease spread, severe illness, and even death. According to the United States Centers for Disease Control and Prevention (CDC), HAIs comprise a range of infections like central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Infections may also occur at surgery sites, known as surgical site infections. Also Read: Why is IMA cautioning against use of antibiotics? Reasons for concern Trends of ESBL evidence from KARS NET over four years. (Supplied) As per the KARS NET Annual Report 2023, extended-spectrum beta-lactamases (ESBL) production as well as carbapenem resistance (CR) has been increasing over the years. It came to this conclusion after analysing the trend over the last four years, from 2018 to 2022. ESBLs are enzymes produced by Enterobacterales, a large order of different types of bacteria (germs) that commonly cause infections both in healthcare settings, and in communities. ESBLs can break down and destroy some commonly used antibiotics, including penicillin and cephalosporin, thereby making such drugs ineffective for treating infections. The most worrying trend is the CR, as carbapenems — considered as last-resort antibiotics — are used for the treatment of infections caused by multidrug-resistant microbes. Trends of Carbapenem resistance–evidence from KARS-NET over four years. (Supplied) The report tracked CR against four groups of bacteria: Acinetobacter (that can cause infections in the blood, urinary tract, and lungs, or wounds in other parts of the body) E. coli (strains that can cause illnesses like urinary tract infections) Klebsiella (causing HAI-like pneumonia, bloodstream infections, and meningitis) Pseudomonas (causing infections in the blood, lungs, or other parts of the body after surgery) It also traced the prevalence of Methicillin-resistant Staphylococcus aureus or MRSA (an infection in which Staphylococcus bacteria that causes a range of diseases including sepsis becomes resistant to Methicillin) and Vancomycin-resistant Enterococci or VRE (an infection in which Enterococci bacteria becomes resistant to Vancomycin) in the state from 2018 to 2022. Trends of MRSA and VRE–evidence from KARS NET over four years. (Supplied) As per the report, the apparent decrease in MRSA in 2021 may be attributed to the non-uniformity in data from some centres in the initial months of 2021, owing to the subsequent waves of the pandemic in the state and the majority of centres being Covid care centres. VRE rates have also increased over the last three years. However, the report also cited a limitation as the data mostly represents tertiary care centres and it may not be representative of the community. Also Read: Study finds prevalence of antibiotic resistance in rural Karnataka Other findings The KARS-NET report that covers the AMR data from 1 January to 31 December, 2022, was a result of information compiled from 23 surveillance laboratories spread across 11 districts in the state. Data of patients checked for priority pathogens. (Supplied) The data from 27,604 patients were analysed. Of these, 51 percent (13,962) were female patients and 49 percent (13,443) were male patients. Out of the 27,604 isolates, 49 percent (13,523) were in-patients (IPD), 35 percent (9,704) were out-patients (OPD), 13 percent (3,561) were patients admitted to the intensive care unit (ICU), and the remaining (816) of unknown origin. As per the report, the most isolated pathogen from IPDs and OPDs was E. coli, followed by Klebsiella. In IPD patients, it was 37 percent (5,004) and 26 percent (3,477), respectively. While in the case of OPD patients, it was 45 percent (4,360) and 22 percent (2,112). In ICU facilities, Klebsiella was the most isolated pathogen at 31 percent (1,102), followed by E. coli at 29 percent (1,019). Antibiotic resistance profile of Escherichia coli. (Supplied) The highest resistance to Carbapenem was observed in Klebsiella isolated from blood, that is 43 percent, compared to the other specimen types, while CR observed in E. coli isolates from blood was up to 10 percent. The highlight of the KARS-NET Report was for the first-time network sites submitted AMR surveillance data of 41 Salmonella enterica serovar Typhi and Paratyphi (bacteria causing enteric fever). It came out with the finding that such bacteria achieved low resistance to first-line antibiotics like ciprofloxacin, ampicillin, and chloramphenicol. Also Read: India bans 14 fixed-dose combination medicines used for cough, infections Healthcare institutions and community’s role Dr Aravind R, Convener of Kerala Antibiotic Resistance Strategic Action Plan’s (KARSAP) working committee, told South First that staff accountability and behavioural change are the prerequisites to fight AMR. “Healthcare institutions, as well as the community, must give due importance to infection prevention and control (IPC),” said Dr Aravind. Location-wise distribution of isolates. (Supplied) Take the case of E. coli. These bacteria can cause disease when they make a toxin called Shiga toxin. But it can be prevented by practicing proper hygiene, especially good handwashing, said Dr Aravind. “Washing fruits and vegetables well under running water, cooking meats thoroughly, avoiding cross-contamination and others are some steps that a common man can take to prevent E. coli,” he added. He stated, “It can’t be presumed that ESBL

Jul 03

Recent traumas have taken a toll on the local blood supply

Tuesday, August 15, 2023–9:57 p.m.-News Release- In light of several recent traumas, Blood Assurance is calling on the public to roll up a sleeve and be someone’s hero. Over the last week, the community blood supply has significantly diminished. Multiple emergency room patients at area hospitals have required a considerable number of units in order to survive. As of Monday, the blood bank had about a one-day’s supply of O-positive blood on its shelves. “While we welcome everyone to donate at this time, we are in critical need of those with O-positive blood,” said Dr. Liz Culler, Blood Assurance’s chief medical officer. “38% of the population is O-positive, making it the most common blood type. We know plenty of those folks are out there and we need them now.” To encourage donations, all type-O donors who give double red cells through the end of the month will receive a $50 digital gift card. Additionally, any type-O donor who has given blood since May 1 will get the same gift card if they come back and donate now. To be eligible to donate, you must be at least 17 years old (16 years old with parental consent), weigh 110 pounds or more and be in good health. Donors are asked to drink plenty of fluids and eat a hearty meal prior to donating. Donors can visit www.bloodassurance.org/schedule, call 800-962-0628, or text BAGIVE to 999777, to schedule an appointment. Walk-ins are also accepted.

Jul 03

AJ Armstrong lawsuit against city of Houston emerges as jurors deliberate his fate in 3rd trial

HOUSTON, Texas (KTRK) — Even after AJ Armstrong’s time in a criminal courtroom concludes, he may have more matters to handle on the civil side of law. Eyewitness News obtained paperwork on Tuesday afternoon detailing Armstrong’s civil lawsuit against the city of Houston. He alleges one or more people inside the Houston Police Department planted his father’s blood particle on a T-shirt admitted as evidence in his third capital murder trial. Word of the lawsuit emerged as jurors began deliberating his fate. Armstrong’s defense team questioned the presence of blood on Armstrong’s clothing during the seventh day of the trial. SEE MORE: Father’s blood found on AJ Armstrong, DNA expert testifies at 3rd trial Celestina Rossi, a blood spatter and crime scene reconstruction expert, testified that she discovered the blood on June 2, 2023, days before Armstrong’s trial was supposed to start, when she went to the HPD’s property to view the bloody pillows collected from Antonio Sr. and Dawn Armstrong’s bed. Rossi told the jury that when she was given the list of all the Armstrong evidence while in the police property room, she noticed Armstrong’s T-shirt, pants, and sandals had been collected. Rossi said when she laid out Armstrong’s gray T-shirt, she “immediately saw what appeared to be an almost reddish, brown stain touching the bottom of the police sticker.” The video above is from the June 20, 2023, report that’s mentioned in the Armstrong civil lawsuit paperwork. Upon further testing of the blood, Courtney Head, with the Houston Forensics Science Center, confirmed the blood is “very likely” from Antonio Armstrong Sr. Rossi testified that when she received the shirt, part of the police nametag appeared to be peeling, revealing the first stain. She conceded on the stand that the stain could be from cross-contamination. In the lawsuit filed in the U.S. District Court for the Southern Division of Texas, the gray T-shirt AJ was wearing at the time of the murders was tested by the Houston Forensic Science Center and no DNA was found. Additionally, the suit stated officers testified no blood was found on AJ when he was arrested. The suit further alleges that “human action” after the shirt was taken from AJ caused his father’s blood particle to be there. SEE MORE: New evidence, likely blood, in AJ Armstrong’s murder case, subject of postponed hearing, sources say The lawsuit doesn’t mention a specific monetary amount Armstrong seeks. None of his criminal case attorneys are representing him. Instead, Houston attorney Randall Kalinen is taking up the civil case, which he will discuss during a news conference set for Wednesday morning. Neither the city nor the police department has weighed in on the new litigation. For more on this story, follow Jessica Willey on Facebook, Twitter and Instagram.

Jul 03

Can You ‘Outgrow’ Asthma Symptoms?

Numerous Americans are diagnosed with asthma each year. According to the Asthma and Allergy Foundation of America (AAFA), over 25 million Americans have asthma. That’s about one in every 13. Women have a higher risk of developing asthma than males do, and the AAFA reports that more children than any other chronic ailment are affected by asthma. But can you “outgrow” your asthma, and does it ever really go away? The answer is yes, sort of and occasionally. Although this is more common in children, some adults also experience remission of their asthma symptoms and go on to have normal, symptom-free lives. It’s not always possible to “outgrow” asthma, though. Symptoms may return on their own accord, sometimes even years later. Learn more about asthma, how symptoms improve, and who has the best chance of seeing remission in this informative article. What Is Asthma? Asthma is indeed a chronic lung condition characterized by inflammation and narrowing of the airways. This inflammation and constriction can lead to various symptoms, including wheezing, coughing (particularly during specific times of the day), chest tightness, and shortness of breath. The severity and frequency of these symptoms can determine the type of asthma a person has. The classifications of asthma include intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma. Each type is characterized by different symptom patterns and their impact on daily life. While asthma cannot be cured, it can be effectively managed with appropriate treatments. Inhalers are the most commonly prescribed form of treatment. Reliever inhalers provide immediate relief by relaxing the airway muscles, while preventer inhalers are used regularly to control inflammation and prevent symptoms. Combination inhalers contain both a reliever and a preventer medication. In more severe cases of asthma, medications such as steroids may be prescribed to reduce inflammation. Certain surgeries or procedures may also be considered as treatment options. So Does Asthma Ever Go Away Completely? It is possible for children to outgrow asthma symptoms as they age. Some children, particularly those who started wheezing at a young age, may see their symptoms improve or completely resolve over time. However, it is not entirely clear why this happens in some children and not others. Similarly, in adults, asthma symptoms can become less frequent or transition from persistent to intermittent. The persistence of asthma in adults is influenced by various factors, and the individual nature of the condition makes it difficult to predict how it will progress in each person. While some individuals may experience remission or a decrease in symptoms, it’s important to note that asthma is a chronic condition, and for many people, it remains a lifelong condition that requires ongoing management. Regular monitoring, adherence to prescribed medications, and avoidance of triggers are still crucial for individuals with asthma, even if their symptoms have improved. What Is Asthma Remission? Remission in asthma refers to a period of time when symptoms decrease or disappear entirely for at least 12 months. There are two main types of remission: symptomatic remission and total or complete remission. It is indeed possible for asthma to naturally go away on its own, particularly for those who developed asthma during childhood. Studies have reported varying rates of spontaneous remission, ranging from 2% to 52% of individuals experiencing a resolution of asthma symptoms without treatment. However, it’s important to note that even individuals who have outgrown asthma may still experience relapse later in life. The exact reasons why some people experience remission while others do not are not fully understood. It could be influenced by various factors, including genetics, environmental exposures, and individual immune responses. It is essential for individuals who have experienced remission of their asthma symptoms to continue monitoring their respiratory health and maintain regular follow-ups with their healthcare provider. Asthma can be a complex and unpredictable condition, and proper management is crucial even during periods of remission to ensure the best possible long-term outcomes. Who Is Most Likely To Achieve Remission? Achieving remission in asthma is not guaranteed, but certain factors have been identified to increase the likelihood of being symptom-free, as highlighted in a 2022 European Respiratory Journal study: The study also reported that certain medications, such as biologics (monoclonal antibodies) and macrolide antibiotics like azithromycin, may aid in achieving remission. While these medications are known to be effective for other conditions like rheumatoid arthritis, their potential to control asthma symptoms and potentially slow down airway remodeling requires further research. Additionally, a treatable traits approach focusing on managing underlying conditions, including comorbidities, smoking, anxiety and depression, physical inactivity, and obesity, can improve asthma symptom management and potentially enhance the chances of remission. Early intervention and seeking medical help upon the first onset of asthma symptoms were highlighted as essential in the study. Timely treatment can help mitigate the progression of airway remodeling in the early stages, potentially promoting remission. A Quick Review While some individuals may experience complete remission of asthma symptoms and no longer require inhaled treatments, others may see their symptoms become less frequent. According to Dr. Li, the diagnosis of asthma may still remain with the patient, as there is a risk of symptom recurrence. However, if the symptoms are intermittent or mild, daily controller therapy may not be necessary. As of November 2022, there is limited research available regarding who is likely to achieve remission and who should continue with asthma treatment. Therefore, it is important to maintain contact with an asthma specialist and seek their guidance before making any decisions to discontinue treatments. Dr. Li advises individuals to consult with a specialist to determine the type of asthma they have and develop an appropriate treatment plan. With personalized therapy and regular follow-up, an individual’s asthma action plan can be tailored to their specific needs. It is crucial to note that asthma is a complex condition, and its management should be done under the guidance of healthcare professionals who can provide individualized recommendations based on each person’s unique circumstances.

Jul 03

What Is Asthma?

Asthma is a chronic lung disease characterized by inflammation and narrowing of the airways, leading to breathing difficulties. It affects a significant number of people worldwide, with an estimated 262 million individuals living with asthma. This condition can occur at any age and is believed to result from a combination of genetic and environmental factors. Allergens, respiratory infections, and physical exertion are common triggers for asthma symptoms. Symptoms of asthma often include difficulty breathing, wheezing, coughing, and a sensation of tightness in the chest. Diagnosing asthma typically involves a thorough physical examination, review of medical history, lung function tests, and sometimes allergy testing. Although asthma can significantly impact a person’s life, there are various effective treatments available. Medications and lifestyle modifications can help control symptoms and reduce the risk of asthma attacks, which are sudden and potentially life-threatening exacerbations of asthma symptoms. With proper management, individuals with asthma can lead active and fulfilling lives. Types Asthma is a complex condition that can manifest in various forms, categorized based on the underlying cause and triggers. Identifying the specific type of asthma a person has can aid healthcare providers in tailoring an appropriate treatment plan. The most common types of asthma include: 1. Allergic asthma: This type is triggered by exposure to allergens like dust mites, pollen, mold, or pet dander. Allergic reactions provoke the airway inflammation and narrowing. 2. Non-allergic asthma: Unlike allergic asthma, this type is not primarily triggered by allergens. It can be caused by irritants such as smoke, air pollution, strong odors, cold air, or respiratory infections. 3. Occupational asthma: This form of asthma is caused by exposure to harmful substances in the workplace. Prolonged contact with irritants like chemicals, dust, fumes, or gases can lead to the development of occupational asthma. 4. Exercise-induced bronchoconstriction: Some individuals experience asthma symptoms during or after physical activity. Exercise-induced bronchoconstriction occurs due to the loss of heat and/or water from the airways during exercise, resulting in airway narrowing and breathing difficulties. 5. Pediatric asthma: This type of asthma specifically affects children and often has genetic and environmental factors as underlying causes. It requires specialized management to address the unique needs of young individuals. It’s important to note that individuals with asthma may experience a combination of these types, as asthma is a complex and heterogeneous condition. Proper diagnosis and understanding of the asthma type can guide healthcare professionals in developing personalized treatment strategies. Asthma Symptoms Asthma symptoms can vary from person to person, with some experiencing mild and occasional symptoms, while others may have more severe and persistent symptoms. Here are some common symptoms associated with asthma: What Causes Asthma? Asthma is a complex condition influenced by a combination of genetic and environmental factors. While the exact cause of asthma is not fully understood, there are several known factors that contribute to its development: In addition to these factors, certain risk factors can increase the likelihood of developing asthma: It’s important to note that having these risk factors does not necessarily mean that someone will develop asthma. It is a complex interplay of factors, and individual experiences may vary. Diagnosis To determine if you have asthma, your healthcare provider will assess your symptoms, medical history, and may conduct various diagnostic tests. The process typically involves the following steps: Treatments for Asthma While there is currently no cure for asthma, there are various treatment options available to effectively manage the condition and control symptoms. The primary goals of asthma treatment are to: Medications Asthma medications are available in different forms and are used to control symptoms, reduce inflammation, and keep the airways open. The types of medications used to treat asthma include: Lifestyle Modifications Lifestyle modifications play a crucial role in managing asthma and reducing the frequency of asthma attacks. Here are some important lifestyle modifications for asthma management: How to Prevent Asthma Attacks While it is not possible to completely prevent asthma, there are measures you can take to minimize the occurrence and intensity of asthma attacks. Asthma Action Plan After receiving an asthma diagnosis, you and your healthcare provider will collaborate to create an asthma action plan (AAP) tailored to your specific needs. The AAP serves as a guide to help you identify the factors that trigger your symptoms and provides clear instructions on how to manage and prevent asthma attacks. In addition to outlining your personalized medication regimen and the correct administration methods, the AAP will also specify when it is necessary to seek emergency medical care in the event of severe symptoms. Furthermore, your AAP may include the baseline results of peak flow monitoring, which helps gauge the effectiveness of your asthma management. Use a Peak Flow Meter A peak flow meter is a compact handheld device that measures the rate at which air flows out of your lungs when you exhale forcefully into it. By regularly using a peak flow meter, you can monitor your lung function and detect any narrowing of the airways even before asthma symptoms manifest, providing an early warning system. Monitoring your peak flow readings enables you to determine when it’s necessary to use your quick-relief medications and serves as an indicator of how well your asthma is being managed. This information is crucial for optimizing your asthma treatment plan and ensuring that your condition remains under control. Comorbid Conditions There are several health conditions that can coexist with asthma, known as comorbid conditions, which can worsen asthma symptoms and make asthma management more challenging. It is common for individuals with asthma to have one or more of the following comorbid conditions: 1. Allergies: Allergic reactions to substances like pollen, pet dander, mold, or certain foods can increase the risk of asthma and trigger asthma symptoms. 2. Chronic obstructive pulmonary disease (COPD): COPD is a chronic lung disease that shares similar symptoms with asthma, such as difficulty breathing and coughing. 3. Rhinitis: Inflammation of the nose can result in excess mucus production, leading to postnasal drip. This can irritate the airways and

Jul 03

People With Asthma May Have a Higher Risk of Cancer—And Not Just Lung Cancer

Recent research has indicated a potential link between asthma and an increased risk of developing cancer. According to a study conducted by researchers at the University of Florida, individuals with asthma have a 36% higher likelihood of developing cancer compared to those without respiratory disease. Specifically, the study found a higher risk of lung, blood, melanoma, kidney, and ovarian cancers among asthma patients. The study aimed to explore the association between asthma and subsequent cancer risk by analyzing electronic health records and claims data from a large database called the OneFlorida+ clinical research network. The data encompassed over 90,000 adult patients with asthma and more than 270,000 adult patients without asthma. Using Cox proportional hazards models, the researchers examined the relationship between asthma diagnosis and the risk of developing cancer. It is important to note that this study only established an association between asthma and cancer risk and does not imply a causal relationship. Further research is necessary to investigate potential causal relationships and the underlying mechanisms that may contribute to this association. The findings of this study contribute to the existing knowledge on the topic and highlight the need for more extensive research in this area. It is essential to understand the implications of these findings and to conduct further studies to examine the causal relationships and risk factors involved. At present, these results do not have any immediate impact on clinical care. The Impact of Inhaled Steroids While the study suggests an overall elevated cancer risk in asthma patients, the results also indicate that asthma patients using inhaled steroids have a relatively lower cancer risk compared to those not using inhaled steroids. The analyses revealed that cancer risk was higher for several types of cancer in asthma patients without inhaled steroid use but lower for a smaller number of cancer types in those using inhaled steroids. This suggests a potential protective effect of inhaled steroid use on cancer development. However, it is important to note that the study did not have a comprehensive measure of “managed asthma.” Further research is needed to examine the causal relationship between asthma, inhaled steroid use, and cancer risk. While the findings support the potential role of chronic inflammation in cancer risk, it is still necessary to investigate other factors that could contribute to the association. Previous studies have also suggested that inhaled steroid use may lower the risk of certain lung cancers. The current study’s findings are promising but inconclusive, particularly regarding the potential association between inhaled steroids and a lower risk of non-lung cancers. Further focused studies are required to determine the validity of this association. It is crucial for individuals with asthma not to modify their use of inhaled corticosteroids based solely on the results of this study. Inhaled corticosteroids are essential controller therapies for persistent asthma, and their positive benefits in reducing asthma exacerbations, hospitalizations, and mortality far outweigh any modest effect on cancer risk suggested by this study. But Additional Research Is Needed Dr. Evans highlighted that previous studies have explored the potential increased risk of lung cancer in people with asthma, with most studies suggesting a small elevated risk for certain types of lung cancer. However, he emphasized the importance of recognizing the limitations of each study in providing definitive answers. Regarding the University of Florida study, Dr. Evans pointed out certain features that may limit its ability to draw firm conclusions. The analysis was conducted retrospectively, meaning the researchers relied on previously collected data for their assessments. This approach introduces challenges such as missing data and the inability to assess certain risk factors. Additionally, the patients with asthma in the study differed from the non-asthma group in significant ways. For example, the asthmatic patients were more likely to have other known risk factors for cancer, such as smoking or a diagnosis of chronic obstructive pulmonary disease (COPD). While these issues do not invalidate the study’s conclusions, they indicate the need for further investigation to verify the results. Lowering Your Risk of Cancer Despite the current uncertainties surrounding the connection between asthma and cancer, Dr. Evans remains optimistic that ongoing research efforts will contribute to the development of definitive studies in the future. In the meantime, he advises individuals with asthma to prioritize smoking cessation and stay up-to-date with vaccinations to prevent asthma exacerbations and minimize their risk of cancer. Dr. Evans emphasized the significance of addressing the question of whether asthma influences cancer development, considering the substantial number of people affected by asthma and the profound impact of cancer as a disease.

Jul 03

What You Need to Know About Asthma and COVID-19, According to Experts

During the early stages of the COVID-19 pandemic, concerns arose regarding the potential impact of the virus on individuals with asthma. Given that asthma is a respiratory condition that can cause breathing difficulties, it was reasonable to assume that asthma patients might be at a higher risk of severe illness if infected with the SARS-CoV-2 virus. The virus can lead to respiratory complications, including pneumonia and acute respiratory distress syndrome, which can be more severe in individuals with underlying respiratory conditions like asthma. However, as more research has been conducted and data has emerged, it is now believed that having asthma does not necessarily increase the risk of contracting COVID-19. People with asthma are not more likely to be infected with the virus compared to the general population. Nevertheless, it is important for individuals with asthma to remain vigilant in taking preventive measures to avoid COVID-19 transmission, as the long-term effects of COVID-19 on asthma patients are not yet fully understood. While the risk of acquiring the virus may not be higher for asthma patients, the potential impact of COVID-19 on the long-term health of individuals with asthma is still being investigated. It is crucial for individuals with asthma to continue following public health guidelines, such as practicing good hand hygiene, wearing masks, maintaining physical distancing, and getting vaccinated, to reduce the risk of infection and potential complications. As more research and data become available, healthcare professionals and experts will gain a better understanding of the specific effects of COVID-19 on individuals with asthma. In the meantime, it is important for individuals with asthma to stay informed, maintain open communication with their healthcare providers, and adhere to recommended preventive measures to protect their health and well-being. How do the symptoms of an asthma flare-up compare to those of COVID-19? It can be challenging to differentiate between symptoms of an asthma flare and those of a COVID-19 infection, as both conditions can affect the respiratory system. Dr. Samuel Gurevich explains that sometimes an infection, including COVID-19, can trigger an asthma flare, making it possible to experience both conditions simultaneously. However, one of the key distinctions between asthma and COVID-19 symptoms is that asthma flare symptoms typically improve with the use of an inhaler, whereas COVID-19 symptoms generally require further treatment with medications like monoclonal antibodies, dexamethasone, and remdesivir for moderate to severe cases. Symptoms of an asthma flare or attack commonly include chest tightness, wheezing, shortness of breath, and coughing. On the other hand, according to the CDC, COVID-19 symptoms can include fever, chills, cough, shortness of breath, fatigue, muscle aches, loss of taste or smell, headaches, nausea/vomiting, diarrhea, and nasal congestion/runny nose. While there may be some overlapping symptoms, such as shortness of breath and cough, asthma is more likely to present with wheezing and typically occurs after exposure to a known trigger, such as pollen or smoke. Fever, body aches, and loss of taste or smell are not associated with asthma but are common in COVID-19 cases. Is asthma a risk factor for COVID-19 or severe illness? Recent studies and data have provided reassurance that asthma is not necessarily associated with an increased risk of COVID-19 diagnosis, hospitalization, severity, or mortality. However, it is still important for individuals with asthma to keep their symptoms under control, especially considering the ongoing circulation of COVID-19. While asthma itself may not increase the likelihood of getting COVID-19 or experiencing worse outcomes, poorly controlled asthma or any lung deficiency can leave individuals with reduced respiratory reserve, making them potentially more vulnerable to respiratory infections like COVID-19. Dr. Mandal advises patients with moderate to severe asthma to keep their asthma well-managed, as uncontrolled asthma could potentially lead to worse respiratory symptoms if affected by COVID-19. Additionally, there have been anecdotal reports of patients experiencing asthma-like symptoms after recovering from COVID-19, suggesting a possible impact on the immune system that may require further investigation. Should people with asthma get the COVID-19 vaccine? Practicing good hygiene, such as regular handwashing and wearing masks in public, can reduce the risk of COVID-19 infection. However, it is evident that higher vaccination rates are closely associated with a decreased risk of infections and hospitalizations, making vaccination the most effective way to combat the virus and restore a sense of normalcy. Initially, the impact of asthma on COVID-19 complications was not well understood. Experts recognized that patients with moderate to severe uncontrolled asthma may experience worsened respiratory symptoms if infected with COVID-19. Consequently, individuals with asthma were prioritized for COVID-19 vaccination. While they may not have required priority over the general public, it is crucial for asthma patients not to forgo vaccination due to the potential risk of increased asthma symptoms following COVID-19 recovery. Dr. Mandal emphasizes that although we now know that having asthma does not necessarily increase the risk of COVID-19 complications, it was a prudent decision to prioritize asthma patients until further research was conducted. With the exception of individuals allergic to vaccine components or those who have experienced a previous allergic reaction to the vaccine, it is recommended that everyone receives the COVID-19 vaccine at this stage. Vaccination plays a pivotal role in controlling the spread of the virus and moving towards a return to normalcy.