People with Autism Spectrum Disorder May be More Likely to Suffer with Impaired Sleep

Man Unable to SleepAutism Spectrum Disorder, also referred to as ASD or simply “autism,” is a neurodevelopment disorder that affects between one and two percent of the world’s population. Those with ASD are known to have trouble with communication and reciprocal social interactions. Research suggests that they also have a higher likelihood of suffering with a sleep disorder.

Children

A study based on parental reports showed that 53 percent of children with ASD suffer with impaired sleep. Boys are four times more likely than girls to be diagnosed with autism. Problems include difficulty falling asleep, trouble waking up and various presentations of insomnia.

The child’s sleep problems have an impact on the entire family. Mothers are more likely to have high levels of stress and fathers are more likely to exhibit sleep disruption. The child’s daytime behaviors also become more challenging when their ASD causes them to suffer from lack of sleep.

Adults

Like children with ASD, adults with ASD are more likely to experience sleep disturbances than the general population.

One study conducted a meta-analysis of data from either objective data (i.e. actigraphy and polysomnography) or subjective data (i.e. sleep diaries and questionnaires). The analysis found that adults with ASD were more likely to lie awake in bed, have difficulty falling asleep and wake up in the middle of the night.

This study provided a good foundation of knowledge, but there is still a need for additional data. Future research will help the medical community better understand and treat sleep disturbances in adults with ASD.

Possible Causes and Solutions

Melatonin is a hormone our brains produce to help regulate our circadian rhythm. People with ASD may produce lower levels of melatonin, which leads to impaired sleep. Severe insomnia may also be linked with sensory hyper-reactivity to certain triggers, such as bright lights. For example, if a person with ASD avoids bright lights, it can affect their circadian rhythm.

Early and routine sleep assessments can help facilitate a lifetime of healthier sleep habits for those with ASD. If sleep impairments are detected, measures can be taken to remedy the problem, such as behavioral changes or medications.

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Improving Chronic Lung Diseases with Pulmonary Rehabilitation

Elderly patient using tri-ball spirometry to test lungs.Chronic lung diseases, such as COPD and emphysema, require ongoing medical attention to help manage symptoms and improve quality of life. One treatment option is pulmonary rehabilitation. Rehabilitation is uniquely tailored for each patient, aiming to improve both psychological and physical side effects of chronic lung disease.

Pulmonary rehabilitation is not a replacement for lung surgery and other medical treatments, but it can be a key component in the management of a chronic lung condition. This treatment is most effective in moderate stages of chronic lung disease, but it can also be beneficial for people in more advanced stages of disease progression. Two thirds of patients who participate in pulmonary rehabilitation report positive outcomes.

Pulmonary rehabilitation can help:

  • Reduce symptoms
  • Increase ability to be physically active
  • Enhance daily life function
  • Improve emotional health
  • Reduce hospitalizations

What to Expect During Treatment

Pulmonary rehabilitation is a comprehensive approach that has many layers. Your health care provider will form a treatment plan that is right for you. Your treatment plan could involve:

Education – One part of treatment is education on lung diseases and management. These classes help support lasting healthy behaviors. For example, patients learn to avoid lung irritants, use medications properly, and maintain healthy behaviors daily.

Exercise – Pulmonary rehabilitation also involves exercise training, where a patient will perform exercises appropriate to their level of physical fitness. This can improve sleep quality and circulation while increasing muscle tone for better balance. The ability to walk around is an important criterion for this type of treatment.

Breathing techniques – Respiratory therapists teach patients breathing techniques, helping them to manage shortness of breath day-to-day.

Emotional support – Group support and counseling are other important parts of pulmonary rehabilitation. Patients with a chronic lung condition can experience stress, depression and anxiety. An emotional support system can help to alleviate these conditions.

Quit smoking – For patients who smoke, part of rehabilitation therapy involves counseling to help assist in the quitting process.

Most pulmonary rehabilitation programs last only a few months. Based on progress from the beginning to the end of the treatment program, a health care provider will prescribe exercises, breathing strategies and other activities to continue doing after stopping your pulmonary rehabilitation treatment.

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Vaping May Increase the Risk of Chronic Respiratory Disease

Vaping May Increase the Risk of Chronic Respiratory Disease

Vaping has become a controversial issue in the healthcare profession. Vapes and e-cigarettes have been touted as a safer alternative to smoking and can be used as a method to help smokers quit. There has recently been an influx of cases where vaping caused short-term health impacts. New findings indicate that vaping may also be responsible for some long-term health problems, such as:

  • Chronic obstructive pulmonary disease (COPD)
  • Chronic bronchitis
  • Emphysema
  • Asthma

A longitudinal analysis published by the American Journal of Preventive Medicine concluded that vaping is an independent risk factor for respiratory disease.

Researchers studied data collected between 2013 and 2016 that assessed participants based on their usage of traditional cigarettes and e-cigarettes. Dual use of e-cigarettes and smoking tobacco was shown to be the most common use pattern among participants, which carries a higher risk than using either product alone.

In theory, making the switch from smoking traditional tobacco products to vaping e-cigarettes could reduce the risk of developing respiratory disease. That theory doesn’t translate to reality because of the actual patterns of e-cigarette usage. Studies show most people who vape also smoke cigarettes or other tobacco products. For most smokers, using an e-cigarette does not increase the odds of successfully quitting. Instead, it leads to dual usage, which can cause more damage than just smoking cigarettes.

In addition to nicotine, e-cigarettes contain other toxins that have been shown to impair lung function. These toxins include propylene glycol, diacetyl and heavy metals. Studies involving animal subjects found that e-cigarettes increase pulmonary inflammation, inhibit immune responses and cause oxidative stress, an imbalance of free radicals and antioxidants.

Respiratory diseases are leading causes of mortality in the United States. Vaping further exacerbates conditions for patients with lung diseases like chronic bronchitis and COPD. For someone who has never smoked, vaping may be less harmful than traditional cigarettes. However, it can take decades for the effects of smoking to cause serious and measurable damage, so future research will be needed to confirm the long-term effects.

If you’re trying to quit smoking, talk with your doctor about tools and resources. Never smoking is the best way to protect your lungs from chronic disease but stopping now can help prevent further damage.

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How Athletes Can Control Breathing Difficulties During Winter Workouts

Cold winter weather can make exercise more difficult. This is especially true for people with asthma. It’s estimated that 300 million people worldwide are living with asthma, according to the World Health Organization. At least 15 to 25 percent of athletes have asthma symptoms but haven’t been diagnosed with the disorder. However, it’s not only asthmatics who have increased difficulty with winter sports.

Exercising in the Winter

Typically, people breathe through their nose, which allows the air to be warmed and humidified before reaching the lungs. When exercising, people are more likely to breathe through their mouths due to the increased need for oxygen. This means cold, dry air reaches the lungs more quickly, which can cause irritation and make it more difficult to breathe. Breat hing through the mouth also means that air isn’t filtered by cilia in the nose before reaching the lungs, so there may be a higher level of pollen or other pollutants.

Whether or not a person has a diagnosed case of exercise-induced asthma, their athletic performance may be hindered by exercise-induced bronchoconstriction (EIB). Within five to twenty minutes of exercising, people with EIB experience asthma symptoms like wheezing, chest tightness and shortness of breath.

Diagnosis and Treatment

It’s common for athletes to feel that they need to push through the pain but breathing problems can be serious. It’s best to consult a doctor as soon as symptoms present. Whether you exercise outdoors for pleasure or competition, it’s possible to keep symptoms under control so you can still enjoy your winter workouts. A medical professional can help formulate a plan to manage the symptoms. This may include the use of an inhaler.

For your own safety, here are a few steps to take during winter workouts if you’re prone to breathing difficulties:

  • Always have access to a phone in case of respiratory distress. A great alternative would be to exercise with a friend, so you have support in the event of an emergency.
  • Protect your airway by covering your nose and mouth with a scarf or mask during outdoor exercise. This increases the level of moisture in the air you breathe in.
  • Opt for indoor exercise if symptoms persist. It may also help to make outdoor exercises shorter and less vigorous.
  • Report any symptom changes to your doctor.

 

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The Latest in Lung Transplant Research

The Latest in Lung Transplant ResearchSometimes patients suffer with lung diseases that don’t respond to treatment. In those instances, a lung transplant could be the only way to extend their lifespan and improve their quality of life. The lung transplant procedure is especially common in patients with end-stage lung disease.

Although it is a risky surgery, advancements in pre- and post-transplant procedures have improved patient outcomes. Here are two examples of recent findings that could lead to further improvements.

EVLP Can Expand the Donor Pool

Ex vivo lung perfusion (EVLP) is an innovative therapy that is applied to lungs outside of the body before transplantation. Within the past decade, the treatment has been used to improve the quality of organs so they can become suitable for transplant. It also allows more time to assess if the lungs have persistent dysfunction, which minimizes the chance of transplanting organs that can’t function properly.

A study published in 2018 revealed that an acellular normothermic EVLP technique could reduce cell-specific leukocyte gene expression over a 12-hour period. The technique also identified potential biomarkers that could improve the process for selecting lungs on EVLP. This process would select lungs that are suitable to be transplanted and predict the risk of primary graft dysfunction, a serious complication. Although further research is needed to validate these findings, the technique could identify marginal lungs that would be viable for transplant while simultaneously eliminating potential donor lungs that aren’t suitable.

Drug Combination May Minimize Chronic Rejection

Patients are at the highest risk for life-threatening complications within the first year of undergoing a lung transplant. High risk patients are required to take medications for the rest of their life to suppress the immune system and help prevent the body from rejecting the new lungs. Even with standard precautions and medical treatment, the median survival rate after lung transplant is less than six years. The most common causes of death are chronic rejection, infection and cancer.

In August 2019, researchers at the University of Maryland School of Medicine conducted a study that analyzed a database of over 9,000 lung transplants. Their research led to the identification of a drug combination that appears to significantly extend patient survival. The combination of tacrolimus, an immunosuppressant, and sirolimus, a cell cycle inhibitor, was associated with a better median survival than the current standard treatment.

While every patient’s treatment and recovery are unique, the findings of this study could make a difference in outcome for lung transplant patients in the future.

 

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Cases of Black Lung Disease Increasing Nationwide

Black lung disease is a respiratory disorder caused by breathing coal mine dust. The disease is also called coal workers’ pneumoconiosis (CWP). The prevalence of black lung disease has increased since 2012, according to the Center of Disease Control and Prevention (CDC). Current statistics report one in ten coal miners who worked in coal mines for 25 years or more have been diagnosed with black lung.Cases of Black Lung Disease Increasing Nationwide

Black Lung Disease: Causes and History

In 1969, Congress passed the Federal Coal Mine Health and Safety Act, making the elimination of black lung a national goal. The National Institute for Occupational Safety and Health has been tracking black lung disease in miners since the 1970s through their Coal Workers Health Surveillance Program. The program collects data and offers periodic chest x-rays to detect the disease early.

In the late 1990s, black lung disease dropped to the lowest level on record. However, since 2000, the disease has been increasing throughout the nation, especially in the Appalachian area. Coal miners in the Appalachian region are more likely to be affected than workers elsewhere in the U.S. Currently, one in five workers from central Appalachia have been diagnosed with the disease.

Simple vs Complicated Coal Workers’ Pneumoconiosis

Coal miners are susceptible to either a mild or severe case of CWP.

  • Complicated CWP, also known as Progressive Massive Fibrosis (PMF), is diagnosed when a patient’s lungs are severely scarred due to inhaling large amount of coal dust for a longer period of time.
  • Simple CWP is the milder diagnosis. This means the lungs have less severe spots or scar tissues from coal dust particles.

Both types of the disease present similar symptoms. They include coughing, shortness of breath and chest tightness. It often takes decades for the disease to develop, so many people don’t have symptoms until after they retire.

CWP Diagnosis and Treatment

Most CWP patients are over the age of 50 when they are diagnosed. During diagnosis, a doctor will take a detailed history to assess the patient’s exposure to coal dust. They will also order a chest x-ray or a CT scan. The patient may be asked to complete a pulmonary function test to show how well the lungs are working.

Black lung treatments can ease symptoms, but there is no cure for the disease. Since breathing coal mine dust is the only cause, the disease is highly preventable through dust control methods and proper protection to reduce exposure.

Early detection is also key to managing the disease. Current and retired coal miners should monitor their health regularly and consult their doctor if they notice respiratory symptoms.

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Obesity Strongly Linked to COPD in Non-Smokers

An estimated 15 million Americans live with chronic obstructive pulmonary disease (COPD), and it is the third leading cause of death in the United States. The most common cause of COPD is cigarette smoking; however, 23 percent of COPD patients have never smoked. New research indicates that obesity may be one contributing factor to those idiopathic cases of COPD.Obesity Strongly Linked to COPD in Non-Smokers

A study, published in the Journal of Obesity, was led by researchers at the University of Toronto to research the relationship between COPD and obesity in nonsmokers. The study included 76,004 women and 37,618 men aged 50 and older who had never smoked. They were categorized as being normal weight, overweight or with one of three classes of obesity.

Researchers discovered a higher prevalence of COPD in participants with higher BMIs. For example, women with class I or II obesity were twice as likely to have COPD than women of normal weight. This was still the case after statistically adjusting the results for factors like age, education and income, all of which have potential to cause COPD.

Explaining the Complex Relationship

There are three possible explanations for the link between obesity and COPD:

  • Obesity impairs diaphragm movement and compresses walls of the chest
  • Inflammation associated with obesity causes or worsens COPD
  • COPD predisposes patients to obesity because the symptoms result in decreased mobility

Although further research is needed to provide more insight into the correlation between obesity and COPD, the study was an important step in analyzing the cause of COPD in patients who have never smoked.

This study provided further evidence of obesity and COPD’s complex relationship. Previous research indicated that obesity has a protective effect on late-stage COPD. Patients who are underweight have a higher risk of dying from COPD than someone who is obese or average weight. However, both diseases can lead to further complications and worsened overall health.

Prevention and Treatment

Exercise is encouraged for COPD patients, especially those who are overweight or obese. For safety, it’s best to start with an exercise regimen guided by a medical professional.

It’s also important for healthcare professionals to routinely screen obese patients for COPD, even when they have no history of smoking.

 

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Vitamin C Could Help Infant Lungs if Mother Smoked During Pregnancy

Smoking cigarettes is an unhealthy habit that is especially dangerous for women who are pregnant. Despite these risks, smoking during pregnancy is still a common problem. More than 12% of women who smoke are unable to quit while they are pregnant.

Women who are unable to quit smoking during their pregnancy put themselves and their baby at greater risk for medical complications, such as:

  • Fetal tissue injury, specifically in the lungs and brain
  • Preterm delivery
  • Low birth weight
  • Miscarriage
  • Sudden Infant Death Syndrome (SIDS)

Although it is recommended that women kick their smoking habit while pregnant, researchers have discovered that vitamin C may help combat lung problems in babies born to pregnant smokers.

The Research

In a double-blind study, one group of smokers took 500 mg of vitamin C supplementation daily during pregnancy. The second group was given a placebo tablet. All mothers in the study were encouraged to quit smoking for the duration of their pregnancy. Those who didn’t quit smoked an average of seven cigarettes a day. Both groups also took a prenatal vitamin.

Infants born to mothers who took vitamin C showed improved pulmonary function 48 hours after birth compared to infants whose mothers took placebo tablets. The vitamin C group also had fewer incidents of wheezing throughout their first year of life.

The study will continue until children from the study are six years old. This will provide data on their long-term respiratory health, specifically whether children born to smokers who took vitamin C are less likely to develop asthma. Future trials may examine whether benefits are greater if supplementation begins earlier in a pregnancy and continues in the infants after birth.

Researchers think vitamin C has this effect on infant respiration because of the vitamin’s ability to replace ascorbic acid that is depleted by cigarette usage.

Seeking Help

Vitamin C is a safe and inexpensive treatment that could potentially help infants born to mothers who can’t or won’t quit smoking. The top priority is to encourage women to quit smoking during their pregnancy.

If you or a loved one is trying to quit smoking, the dedicated team at PCCMA is here to help. Call us today at (717) 234-2561.

 

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Inhaled Chemotherapy: A Promising Treatment for Lung Cancer

Inhaled Chemotherapy: A Promising Treatment for Lung CancerGlobally, lung cancer is responsible for more than 1.7 million deaths each year, according to the World Health Organization. Although cancer treatments have become increasingly personalized and precise in recent years, current treatments still expose large portions of a patient’s body to toxicity. Therefore, traditional treatment options like radiation and chemotherapy often lead to unpleasant side effects.

For decades, researchers have successfully developed inhaled treatments for ailments like asthma, chronic bronchitis, COPD and emphysema. Because pulmonary drug delivery is the standard treatment for many lung diseases, it’s possible that the same treatment delivery system may someday be applicable for treating lung cancer.

Researchers are only in the beginning stages of exploring this new treatment possibility, but their efforts have shown promising results. About a decade ago, clinical trials started to examine the use of anticancer compounds designed for inhalation. These trials demonstrated moderate results, and they showed reduced toxicity in tissues that weren’t targeted for cancer treatment. This means a greater number of compounds could be safely delivered to lungs while killing cancer cells without extensive damage to healthy cells in other parts of the body.

As of 2018, anti-sense oligonucleotides (ASO) and protein therapies are being developed and used in clinical trials. The therapies use nanocarriers that are designed and tested by researchers, so they can find the optimal carriers for delivering anticancer drugs to the lungs. While research for this treatment is still in the early stages, it has been demonstrated that lipid-based nanocarriers are most suitable to effectively treat lung cancer.

This technology won’t be available anytime soon, but recent progress is still a great testament to the continuous advancement of lung cancer treatment. In the future, there is a good possibility that inhaled treatments could be used to successfully treat lung disease. These treatments could lead to better patient compliance and a higher percentage of successful outcomes.

 

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Wasp Venom May Combat Lung Diseases

Wasp Venom May Combat Lung Diseases

When you think of wasp venom, you typically associate it with disrupting a person’s breathing, not improving it. However, along with toxic properties, some insect venom is full of compounds that kill bacteria.

The venom’s toxicity makes it impossible for us to use it as an antibiotic drug, but variants of a peptide with antimicrobial properties could be an alternative to some antibiotic-resistant bacterial strains.

Researchers at the Massachusetts Institute of Technology have repurposed peptides from Brazilian wasp (Polybia paulista) venom to make an antibiotic drug that isn’t toxic to humans.

One study tested the wasp venom peptides on mice with Pseudomonas aeruginosa, a deadly bacteria strain that is resistant to most antibiotics. This bacteria causes infections in the respiratory system that could spread throughout the body. Pseudomonas aeruginosa is also known to cause pneumonia and urinary tract infections in people with weak immune systems, a complication that is common for patients with cystic fibrosis.

Prior to being tested on the mice, the refined peptides were tested for toxicity on human kidney cells that were grown in a lab. The most promising peptides were then tested on mice with Pseudomonas aeruginosa.

The presence of the bacteria was significantly reduced after several peptides were tested against it. The infection was eliminated by a high dosage of variant peptides.

Comparison to Traditional Antibiotics

Antibiotics we use today must be taken for one or two weeks to clear an infection. The compound derived from wasp venom cleared an infection in just four days. However, researchers are still testing whether the drug is equally as effective with a lower—and therefore safer—amount of wasp venom. They are hopeful that infections could be cleared with lower doses once additional variants are created.

In the United States alone, the CDC reports that antibiotic-resistant bacteria causes over 2 million illnesses and 23,000 deaths each year. The World Health Organization has long warned of the threat these bacteria pose.

One of the most important parts of this discovery is the precedent it sets. Principles that were discovered in this study could be applied to other peptides derived from nature, which improves our ability to discover new treatments for diseases that were previously untreatable.

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