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Emphysema and chronic bronchitis - known as chronic obstructive pulmonary disease or COPD - make their victims struggle for air. They are due mostly to smoking, and in some countries to the inhalation of other noxious particles such as those produced by burning coal. COPD didn't exist before tobacco use became popular and polluting fuels were used, says Prof. Paul Jones, a respiratory specialist at the University of London.
An expert in analyzing and quantifying symptom changes when COPD is exacerbated (patients never get better), Jones says: "Nicotine, whose concentration is purposely increased by cigarette manufacturers, is the most powerfully addictive drug in the world." But while most cases of COPD are due to what people do to themselves, he says it is "wrong to refuse treatment to people who have been addicted to smoking."
Until now, nothing could be done for COPD patients except drugs to reduce breathlessness somewhat, and in severe cases, surgery removes some diseased lung tissue.
"For many years, doctors didn't bother to treat COPD, because they thought nothing would help. Many patients have very restricted lives. They are breathless when they walk up some stairs. Some are confined to bed and breathe oxygen from tanks."
But Jones said a new three-year international study on 6,000 patients called TORCH shows the definite benefits of Seretide, an existing asthma drug made by GlaxoSmithKline. Seretide, said Jones, has shown promise in preventing the deterioration of COPD. According to the TORCH results, patients who take the inhaled steroid have fewer exacerbations, and declines that do occur are less dramatic. This means an improved quality of life. In addition, deaths were reduced by almost 18 percent.
Seretide, taken twice a day with an inhaler, is included in Israel's basket of health services.
CRIB DEATH RISE
Since the beginning of December, the number of crib deaths has been almost four times that during the same period a year ago, Magen David Adom reports. From December 1 to mid-January, there were 11 sudden infant death syndrome (SIDS) deaths. MDA did not offer any explanation, but the flu season is believed to be implicated.
MDA urges parents to minimize cot death by putting full-term babies to sleep on their backs on solid mattresses; not smoking; not overheating rooms; and dressing babies in layers of light clothing. It also recommends taking a first-aid course in resuscitating infants. One can register for courses by going to www.mdais.org. A first-aid guide, the first new edition in a decade, has been published by MDA and can be ordered by calling (03) 639-0396.
A SECOND ALZHEIMER'S GENE DISCOVERED
A gene that increases the risk for Alzheimer's disease in Israeli Arabs, North Europeans, Caribbean-Hispanics, African-Americans and some other ethnic groups has been discovered by scientists from the Technion and researchers in North America. It is only the second gene discovered relevant to Alzheimer's; APOE, the first, was identified in 1993.
The gene, called SORL1, has been linked to the type of this dementia whose symptoms appear relatively late in life, after 65. People who have this genetic variant do not produce enough of an enzyme in the brain. The gene's normal role is to transfer proteins through a cellular pathway and move an Alzheimer's protein called APP through its normal path. But the defective form of the SORL1 gene causes amyloid protein to accumulate in the brain and hamper communication among neurons.
This form of SORL1 increases risk by about 20%. People with the E4 form of the APOE gene - one of three varieties - are twice or three times more likely to get this dementia than those who lack it, but being a carrier of the gene doesn't automatically mean the person will get the disease.
The study will be published in the February issue of Nature Genetics, but a version has already been put online. The Israelis among the authors is Prof. Rivka Inzelberg of the Technion and Meir Medical Center in Kfar Sava; others are from Case Western Reserve University, Columbia University and the University of Toronto.