Breathing Problem Sometimes Misdiagnosed in Athletes

FRIDAY, April 12 (HealthDay News) -- A vocal cord problem that restricts athletes' breathing is often misdiagnosed as exercise-induced asthma, a small new study suggests.

Researchers looked at 46 college athletes who were newly diagnosed with paradoxical vocal fold motion disorder (PVFMD), a condition that can be brought on by stress, anxiety or increased exertion. It causes the vocal cords to constrict and obstruct breathing.

An estimated 5 percent of athletes have the vocal cord disorder, which can severely affect their performance, according to the researchers at the Ohio State University Medical Center.

"There isn't a lot in the literature about PVFMD in elite athletes, and our study shows that because of their high level of conditioning they may be more difficult to diagnose and treat than non-athletes," lead investigator Dr. Brad deSilva, residency program director for the department of otolaryngology--head and neck surgery, said in a medical center news release.

For example, only 30 percent of the athletes in the study consistently experienced PVFMD symptoms, such as coughing during exercise.

"PVFMD symptoms can often mimic asthma, and as many as 40 percent of people with asthma also have PVFMD -- so it's typical for an athlete to get the asthma diagnosed correctly, but not the vocal cord dysfunction," study co-author Dr. Anna Marcinow, a senior resident in the otolaryngology program in the College of Medicine, said in the news release.

The researchers also assessed a number of treatments for the vocal cord disorder, ranging from biofeedback to Botox injections. Biofeedback is a technique that teaches people how to control their body's responses.

The investigators found that vocal cord retraining therapy helped reduce or eliminate breathing problems and allowed many athletes to stop using asthma inhalers.

"Because PVFMD can have both physical and emotional impacts, using tactics that help athletes gain a sense of control over their breathing can be really effective," Marcinow said. "Athletes may also need additional alternative forms of therapy such as biofeedback or intervention from a sports psychologist."

While the disorder often occurs in athletes who have recently intensified their activity and training, it can also occur in non-athletes who are starting a more demanding exercise program, the researchers noted.

The study was scheduled for presentation Friday at the annual meeting of the Triological Society, in Orlando, Fla. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Ohio State University Medical Center, news release, April 12, 2013

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I have a problem reading

That problem is that I can't find a title that strikes my interest. I use to be into magic, the gathering (remember that card game?). But, I only read 4 of the books before I grew up. Now, nothing seems to strike my interest.

Any suggestions on what to read? I like magic, sci fi and medieval type stuff. Thank you everyone.

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Pain a Common Problem for People With COPD

Narcotic pain relievers frequently used by patients with chronic lung condition, study finds

By Alan Mozes

HealthDay Reporter

TUESDAY, May 21 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) patients experience a significant amount of pain, new research suggests.

Pain levels are nearly on par with the kind of discomfort experienced by many osteoarthritis and rheumatoid arthritis patients, according to the study, which is scheduled for presentation Tuesday at the American Thoracic Society annual meeting in Philadelphia.

"Several studies have found high rates of pain medication use among COPD patients, and pain has also been an important determinant of overall health status and quality of life in COPD," study author Melissa Roberts, a senior research associate at the Lovelace Clinic Foundation in Albuquerque, N.M., said in a society news release.

The researchers analyzed data on nearly 8,000 COPD patients over the age of 40. Nearly 16,000 other men and women not diagnosed with COPD also were included in the study. All were enrolled between 2006 and 2010 in the same managed-care insurance system in the southwestern United States.

Pain levels among the participants were determined by reviewing diagnostic codes and pain medication prescriptions as noted in their medical records. COPD patients were found to have more chronic pain indicators and used more pain meds, including both long- and short-acting opioid (narcotic) drugs.

The pain experienced among COPD patients did not appear to be a direct function of their airflow obstruction.

"We found the prevalence of chronic pain among adults with chronic disease to be almost twice as high as among individuals without chronic disease," Roberts said. "Among those with chronic disease, individuals with COPD were similar to those with rheumatoid arthritis or osteoarthritis in their experience of pain, but with even greater use of opioids."

Because this study is being presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

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Regular Aspirin Use May Boost Eye Problem Risk

Dec. 18, 2012 -- Taking aspirin regularly appears to slightly raise the risk of the eye condition known as age-related macular degeneration or AMD, new research suggests.

The increased risk only occurred with people who had taken aspirin regularly 10 years before they were diagnosed with the potentially blinding eye disease. They had taken aspirin at least twice a week for more than three months, says researcher Barbara E.K. Klein, MD, MPH.

The risk was for the type of macular degeneration known as wet or neovascular AMD, says Klein, professor of ophthalmology and visual sciences at the University of Wisconsin School of Medicine, Madison.

Wet macular degeneration is generally more severe than another version, known as dry macular degeneration.

Although people taking aspirin regularly were two times more likely to get the condition, Klein says the absolute risk is still low because the condition is not common. About 1% of people aged mid-40s and older get wet macular degeneration, she says.

Klein studied nearly 5,000 men and women, ages 43 and older. She followed them for 20 years, although not all of them stayed in the study that long.

The research is published in the Journal of the American Medical Association.

Previous research findings about aspirin use and macular degeneration risk have been mixed.

As aspirin use and macular degeneration are increasing, Klein decided to follow men and women over many years to see if she could find a link.

Nearly 20% of adults, or 1 in 5, take aspirin regularly. Some use it for temporary relief of pain or fever. Others take it daily to prevent heart attacks.

The macula is a small area of the retina, the tissue lining the back of the eye, that is responsible for central vision.

Klein looked at wet (late) and dry (early) macular degeneration for the study. Both are potentially blinding conditions.

Over the course of the study, 512 people were diagnosed with early AMD and 117 with late AMD.

Although regular use of aspirin 10 years before the diagnosis was linked with late macular degeneration, aspirin use five years before the diagnosis was not linked with an increased risk of either form of AMD.

Klein can't explain the link and says it requires more study. "The absolute risk of this is small," she says. "There are so many folks who have been put on aspirin for [heart disease] prevention. ... The [heart] protective effect is still primo."

One co-author, Ronald Klein, MD, MPH, has served as a consultant for Pfizer, which makes AMD medicine. The study was funded by the National Institutes of Health and support from Research to Prevent Blindness.

"This study is suggestive that there may be a relationship but it is by no means definitive," says George Williams, MD, professor and chair of the department of ophthalmology at Oakland University's William Beaumont School of Medicine in Rochester, Mich.

Williams says a weakness in the study is that the men and women self-reported the aspirin use, so it may not have been totally accurate.

If a cardiologist has recommended aspirin for heart disease protection, Williams says, "I would not take anyone off it."

People who take aspirin regularly should consider their risk of macular degeneration and the benefits of taking aspirin, says Michael Tolentino, MD, medical director of the Macular Degeneration Association and an ophthalmologist in Lakeland, Fla.

People at higher risk for the disease include those with a family history, those with light eyes, and smokers.

"Everything is a risk-benefit ratio," he says.

He reports serving as consultant for Novartis, Genentech, Alarcon, and other companies involved in eye drugs.

View the original article here

Regular Aspirin Use May Boost Eye Problem Risk

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WebMD Health News Reviewed byLaura J. Martin, MD

Dec. 18, 2012 -- Taking aspirin regularly appears to slightly raise the risk of the eye condition known as age-related macular degeneration or AMD, new research suggests.

The increased risk only occurred with people who had taken aspirin regularly 10 years before they were diagnosed with the potentially blinding eye disease. They had taken aspirin at least twice a week for more than three months, says researcher Barbara E.K. Klein, MD, MPH.

The risk was for the type of macular degeneration known as wet or neovascular AMD, says Klein, professor of ophthalmology and visual sciences at the University of Wisconsin School of Medicine, Madison.

Wet macular degeneration is generally more severe than another version, known as dry macular degeneration.

Although people taking aspirin regularly were two times more likely to get the condition, Klein says the absolute risk is still low because the condition is not common. About 1% of people aged mid-40s and older get wet macular degeneration, she says.

Klein studied nearly 5,000 men and women, ages 43 and older. She followed them for 20 years, although not all of them stayed in the study that long.

The research is published in the Journal of the American Medical Association.

Aspirin & Eye Problems: Study Details

Previous research findings about aspirin use and macular degeneration risk have been mixed.

As aspirin use and macular degeneration are increasing, Klein decided to follow men and women over many years to see if she could find a link.

Nearly 20% of adults, or 1 in 5, take aspirin regularly. Some use it for temporary relief of pain or fever. Others take it daily to prevent heart attacks.

The macula is a small area of the retina, the tissue lining the back of the eye, that is responsible for central vision.

Klein looked at wet (late) and dry (early) macular degeneration for the study. Both are potentially blinding conditions.

Over the course of the study, 512 people were diagnosed with early AMD and 117 with late AMD.

Although regular use of aspirin 10 years before the diagnosis was linked with late macular degeneration, aspirin use five years before the diagnosis was not linked with an increased risk of either form of AMD.

Klein can't explain the link and says it requires more study. "The absolute risk of this is small," she says. "There are so many folks who have been put on aspirin for [heart disease] prevention. ... The [heart] protective effect is still primo."

One co-author, Ronald Klein, MD, MPH, has served as a consultant for Pfizer, which makes AMD medicine. The study was funded by the National Institutes of Health and support from Research to Prevent Blindness.

Aspirin & Eye Problems: Perspective

"This study is suggestive that there may be a relationship but it is by no means definitive," says George Williams, MD, professor and chair of the department of ophthalmology at Oakland University's William Beaumont School of Medicine in Rochester, Mich.

Williams says a weakness in the study is that the men and women self-reported the aspirin use, so it may not have been totally accurate.

If a cardiologist has recommended aspirin for heart disease protection, Williams says, "I would not take anyone off it."

People who take aspirin regularly should consider their risk of macular degeneration and the benefits of taking aspirin, says Michael Tolentino, MD, medical director of the Macular Degeneration Association and an ophthalmologist in Lakeland, Fla.

People at higher risk for the disease include those with a family history, those with light eyes, and smokers.

"Everything is a risk-benefit ratio," he says.

He reports serving as consultant for Novartis, Genentech, Alarcon, and other companies involved in eye drugs.

View Article Sources

SOURCES:

Klein, B. Journal of the American Medical Association, Dec. 19, 2012.

Barbara E.K. Klein, MD, MPH, professor of ophthalmology and visual sciences, University of Wisconsin School of Medicine, Madison.

George Williams, MD, spokesman, American Academy of Ophthalmology; professor and chair of ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, Mich.

Michael Tolentino, MD, medical director, Macular Degeneration Association; associate professor of ophthalmology, University of Central Florida, Orlando; ophthalmologist, Lakeland, Fla.

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Fake Marijuana Use Is a Serious Problem for Teens

ByDenise Mann
WebMD Health News Reviewed byLouise Chang, MD

Dec. 4, 2012 -- Close to 11,500 people were treated in emergency rooms in 2010 for nausea, vomiting, dizziness, and other symptoms related to the use of synthetic or fake marijuana products such as "K2" or "Spice."

Three-quarters of these people were aged 12 to 29, and 78% in this group were male. Most did not receive follow-up care after they were sent home from the ER.

The new data were released by the Substance Abuse and Mental Health Services Administration (SAMSHA), as part of their Drug Abuse Warning Network. There were 2.3 million ER visits involving drug misuse or abuse in 2010, and of these, 11,406 involved fake marijuana products.

What Is Synthetic Marijuana?

Synthetic marijuana is marketed to have marijuana-like effects in the brain.

"Spice,” “K2,”  “Mr. Smiley,” “Red X Dawn,” and “Blaze” are just some of the street names for synthetic marijuana drugs.

Until July 2012, they were available online and in convenience stores. Then the Drug Enforcement Administration (DEA) stepped in and banned five chemicals found in Spice and K2. This does still leave some wiggle room for creative manufacturers.

“I believe people are still able to get these products in different ways,” says Rear Admiral Peter Delany, PhD. He is the director of the Center for Behavioral Health Statistics and Quality at SAMSHA in Rockville, Md. “You can ban chemicals, but if manufacturers modify the chemical format, they are no longer on the banned list.”  

The group plans to have some data available next year as to what has happened since the DEA’s ban.

Until then, parents need to understand what fake marijuana products are and the lingo that kids use to discuss these substances.

“This is a drug and it can have repercussions, especially if it is mixed with other things,” Delany says.  

According to the new report, in almost 60% of emergency room visits involving synthetic marijuana in people ages 12-29, no other substances were involved.

Symptoms of fake marijuana use may include:

Agitation Anxiety Nausea Vomiting Paranoia Seizures Hallucinations Increased heart rate and blood pressure Tremors

“Kids are coming in intoxicated with nausea and dizziness more frequently than in the past, and synthetic marijuana is something that we consider when we see these symptoms,” says Robert Glatter, MD, an emergency medicine doctor at Lenox Hill Hospital in New York City. “They present in ways that you would think they were using mind- or mood-altering substances.”

These products can’t be detected on drug screens, which is why some kids are drawn to them and why it is challenging to capture solid information on their use and abuse, he says.

Paul Hokemeyer, PhD, says fake marijuana use is a real crisis. He is a therapist at Caron Treatment Center's New York City Office.  “Adolescent boys are always looking for new ways to get high.” Here,  “they get high off of toxic chemicals, and this may have long-term risks,” he says. “We don’t know what they are putting into their body.”

View Article Sources

SOURCES:

Rear Admiral Peter Delany, PhD, director, Center for Behavioral Health Statistics and Quality (CBHSQ), SAMSHA, Rockville, Md.

Robert Glatter, MD, emergency medicine dcotor, Lenox Hill Hospital, New York City.

Paul Hokemeyer, PhD, therapist, Caron Treatment Center, New York City.

SAMSHA: "The Dawn Report."

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