Medical Conference Notes

These were some of the developments that were presented at an American College of Chest Physicians meeting that will be interesting to follow over the coming years.

A meeting of note at the ACCP conference was on smoking cessation.  This was led by pulmonologists Dr. Jill Ohar and Dr. Stephen Rennard as well as a psychiatrist, Dr. John Hughes.  They discussed the pitfalls of this difficult task.  Smoking cessation is a 2 step process:  physiologic withdrawal and then control of behavior afterwards.  Dr. Hughes discussed a few things people can do to help control behavior.  These include the following:  Identify high risk situations and avoid them.  Identify specific cues and triggers that may

Medical Conference Notes

At a recent conference of the American College of Chest Physicians held in Canada some of the topics discussed there were relevant to COPD.  With regard to the venue, one might ask why hold an “American” chest physician meeting outside the United States?  First, the ACCP meeting is an international meeting where people from all over the world come to exchange information about the latest clinical aspects of respiratory illness.  Canada, itself, has a rich history of outstanding contributors to the understanding of

Insomnia, that is, the inability to fall asleep and stay asleep at appropriate times is a very common problem. I venture to say that nearly every person has had some degree of sleeplessness at one time or another. I am not talking about the restlessness of anticipation, such as just before holidays, big trips, or other special events. I am talking about when there is nothing particularly on your mind, either good or bad, and you just can’t sleep.

As a clinician and clinical scientist, and one who likes to speak to public groups, I am often asked the question, which is the title of this month’s newsletter. Yes, friends, there will be cures to most diseases, but let’s limit the discussion to the common problem of pulmonary disease.

Almost everyone knows of the harmful effects of tobacco smoke. It has been conservatively estimated that regular smokers of cigarettes sacrifice seven years of life. If one divides the number of cigarettes smoked in a lifetime on the average into this seven years loss, it turns out to be 5 ½ minutes for each cigarette! What an astonishing statistic. The premature loss of life is primarily due to doubling the risk of heart attack, lung cancer, and emphysema. There are other cancers such as bladder, larynx, esophagus, pancreas, and uterus which are also caused by tobacco. Thus, it becomes pretty clear that stopping smoking is critical to future health. Never starting, of course, is better.

Theophyllines are important drugs for patients with asthma as are inhaled bronchodilators and the corticosteroids discussed in earlier communications. Theophyllines are in a class of drugs called methylxanthines. They are closely related to caffeine. Theophyllines are potent bronchodilators, and they also stimulate clearance of mucus, just as the inhaled bronchodilators do. In addition to being bronchodilators, theophyllines strengthen the breathing muscles of the diaphragm and chest wall. Thus, they may help prevent muscle fatigue when air flow is quite limited. Theophyllines also have a mild beneficial effect in improving heart function, and they act as a mild stimulant to respiration by affecting the respiratory center in the brain. In addition, theophyllines may stimulate the secretion of gastric acid. This can cause heartburn if the connection between the stomach and esophagus becomes relaxed, another action of theophyllines. This can be undesirable in certain patients. The heart and brain stimulation may also be undesirable in some people. So you can see that theophyllines have a number of effects on the body, both good and bad.