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Improving Mucus Clearance in COPD

Improving Mucus Clearance in COPD

The mucus hyper-secretion that characterizes COPD has been shown to contribute to disease-related morbidity and mortality. Currently available medications for COPD do not specifically address mucus clearance, making this phenomenon an area of unmet need for patients, says Sanjay Sethi, MD. In 2010, the FDA approved the Lung Flute (Medical Acoustics, LCC) to treat COPD and other lung diseases characterized by retained secretions and congestion following positive findings from an 8-week study involving 40 patients. The hand-held respiratory device produces a low frequency acoustic wave with moderately vigorous exhalation to increase mucus clearance. An Extended Look For a study published in Clinical and Translational Medicine, Dr. Sethi and colleagues sought long-term data to confirm observations from previous research showing that the Lung Flute benefits patients with COPD and chronic bronchitis. “Participants were randomized to the device as add-on therapy or to continue their standard COPD care,” says Dr. Sethi. “We assessed change in respiratory symptoms as measured with the Chronic COPD Questionnaire (CCQ) from baseline to 26 weeks in 69 patients.” Secondary endpoints included health status, BODE (BMI, Airflow Obstruction, Dyspnea, and Exercise Capacity) index score, and exacerbation frequency. Patients using the Lung Flute reported significant improvements from baseline on the CCQ as well as on the St. George’s Respiratory Questionnaire, which measures quality of life. Those using the device breathed better, coughed less, and experienced reductions in sputum production when compared with the control group, whose COPD symptoms remained stable in the study. The researchers also observed differences between groups on the BODE index. “Patients using the Lung Flute seemed to stabilize on the BODE index, whereas these...
AATS 2015

AATS 2015

New research was presented at AATS 2015, the annual meeting of the American Association for Thoracic Surgery, from April 25 to 29 in Seattle. The features below highlight some of the studies emerging from the conference. Pneumonectomy for NSCLC After Chemo-Radiation Therapy The Particulars: Previous research has shown that locally advanced non-small-cell lung cancer (NSCLC) is associated with a poor prognosis, meaning that effective treatment strategies are needed for the disease. Pneumonectomy after neoadjuvant concurrent chemo-radiation therapy may be beneficial in NSCLC patients, but research is lacking on this treatment strategy. Data Breakdown: For a study, researchers performed retrospective analyses of 16 patients who underwent pneumonectomy after neoadjuvant concurrent chemo-radiation therapy to treat NSCLC. Nearly 40% of patients obtained a pathologically complete response. Following treatment, all abnormal blood tumor marker levels were normal. At an average follow-up of about 40 months, all patients were alive and only two had recurrent tumors. Toxicity was manageable, and no serious complications were observed. Take Home Pearl: Pneumonectomy after neoadjuvant concurrent chemo-radiation therapy appears to be a feasible and effective treatment strategy for NSCLC. Supraventricular Tachycardia Following Pulmonary Lobectomy The Particulars: Few studies have assessed the rate of supraventricular tachycardia (SVT) in patients undergoing pulmonary lobectomy. Research is needed to determine if SVT is associated with length of stay (LOS) and to establish the incidence of stroke, mor­tality, and readmission in these patients. Data Breakdown: Researchers reviewed the cases of more than 20,000 lobectomies performed in 2009 to 2011. They found that 11.8% of patients had postoperative SVT. Clinical predictors of SVT included being 75 or older, male, and having COPD, congestive heart...
Is Medical Care Becoming Unaffordable?

Is Medical Care Becoming Unaffordable?

As the second enrollment period for insurance exchanges under the ACA opened in November, many people are feeling the squeeze of the financial burdens being placed on them. While the ACA (Obamacare, as it is commonly known) is pushing to eliminate the uninsured, it is doing so at the financial well-being of many Americans. The middle-class is especially bearing the brunt of this healthcare law. American citizens are now faced with tax penalties if they do not have medical coverage. While these penalties are currently minimal, they will increase over the next several years. Many people are purchasing insurance plans that they are not satisfied with just to avoid these penalties. I have seen many patients in my practice who simply cannot afford the premiums. With the economy in poor shape, many people don’t have extra cash to pay for a new added expense. Many are choosing to go without it and face the penalty. Others have purchased plans but are struggling to meet their monthly expenses. More people may be insured now, but many people are being burdened by this mandate. And it is not just the cost of the premiums that are assailing patients—many of the current plans have large deductibles. One of my patients canceled her appointment because her son got sick, and she could not afford to pay the deductible for herself and her son. I am seeing more and more of these high-deductible plans and patients self-rationing. It isn’t clear to many people until they are hit with a medical bill. And then they are left trying to get out from under this debt....
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