Breakthrough discovery will change treatment for COPD patien

[gerald]

This discovery is interesting in that it found, by the time the diagnosis of mild COPD is made 40% of the lung damage has already occured.  Few symptoms would have been present and most will not even know a problem exists.  This makes it clearer why most are only diagnosed once it becomes  Moderate to Severe COPD given the difficulty in getting medical people to take the symptoms seriously,

Hopefully this does help them discover a cause and better treatments

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Breakthrough discovery will change treatment for COPD patients
July 10, 2018, University of British Columbia


Permanent lung damage caused by chronic obstructive pulmonary disease (COPD) starts much earlier than previously thought, even before patients are showing symptoms.

These are the findings of a new study recently published in The Lancet Respiratory Medicine. The breakthrough discovery, led by Dr. Tillie-Louise Hackett, associate professor in the University of British Columbia's faculty of medicine, will dramatically change how patients are treated for COPD, the leading cause of hospital admissions in B.C. and Canada.

Hackett, who is also a principal investigator at St. Paul's Hospital Centre for Heart Lung Innovation (HLI), and her research team found that even patients diagnosed with mild COPD have already lost a significant portion of their small airways—more than 40 per cent—on average.

COPD is a chronic, progressive condition that slowly damages the tissues of the lungs. Currently, patients with mild disease, as determined by a lung function test, are given minimal or no treatment.

"These patients often have little to no symptoms, so it was believed their lungs were relatively undamaged," said Hackett. "Now that we know the severity of the damage, we need to look at earlier intervention to ensure the best outcomes for COPD patients."

The new findings also suggest previous large clinical trials testing new COPD treatments may have failed because patients already had substantial lung damage.

"If the same drugs were tested on patients with more mild forms of the disease, and less tissue damage, the results could be very different," said Hackett.

Lung samples from 34 patients were analyzed using an ultra-high resolution microCT scanner, one of only three scanners of this kind in the country. The special scanner, funded by the Canada Foundation for Innovation and St. Paul's Foundation, was instrumental to Hackett's research. Though the HLI Lung Tissue Registry Biobank at St. Paul's has been collecting specimens for more than 30 years, the recent addition of the microCT scanner made it possible to image samples that are embedded in paraffin in extreme detail.

It is estimated approximately one in 10 people over the age of 40 may suffer from COPD. Martin Mannette has been living with the disease for eight years. He is managing well with a careful combination of medication, but the 68-year-old is excited about how this research could impact future patients.

"I worry about COPD taking over as the number one killer," said Mannette, "so anything we can do for the next generation so they can avoid COPD is so important."

Dr. Don Sin, the Canada Research Chair in COPD and a St. Paul's respirologist, said the findings have significant implications. By 2020, COPD is expected to be the third leading cause of death worldwide.

"This breakthrough finding will allow us to develop new drugs to treat patients with COPD at the earliest stages of their disease when the disease is reversible," said Sin. "This will prevent disease progression in thousands of patients and help them stay out of the hospital and remain healthy in their own homes."

medicalxpress.com/news/2018-07-breakthrough-discovery-treatment-copd-patients.html

[gnott]

We have all known this for quite awhile, but useful to get some hard numbers for the unbelievers.

We also know it is next to impossible to tell if the average acute symptoms are from a bad chest cold (pneumonia?), severe asthma, COPD, or heart disease, or ... a zillion other things, while sitting in a Doctor's office - you need tests: Stress, blood workups, xRays, ...

And there is the major issue blocking early discovery - the costs of the tests necessary to confirm any suspicions.

It wasn't that long ago (well 30 years for some of us, ancient history for others) people were up in arms about all the *wasteful* and *greedy billing* by doctors for *unnecessary tests*. Insurance companies leading the parade (and for you 'free healthcare' the agencies). And they got their wish - No Tests unless "necessary*, AND who gets to determine if a test or treatment is necessary? The government or Insurance clerk paying the bill.

[The doctor gets to over-ride, BUT he has to be darn certain - mistakes goes on his "permanent -record". Smile]

Take just the simplest of complaints ...

You walk in over-weight or still smoking complaining of SoB, fatigue, chronic cough, ... You will walk out with some brochures and stern advice. If you are lucky you might get something for the cough or an inhaler.

If you walk in otherwise seemingly fit, you will get the brochures and something for the cough.

So short answer, except for the rich, patient or government agency (the latter ain't ever going to happen - salaries go up and the speeding goes down) early detection ain't happening without cheaper "tests".

[gnott]

And then comes the final kicker - No Insurance company or Government agency wants cheaper and/or earlier tests. Why? Because early detection only means early treatments which only means more expense.  That is unless early detection can lead to an early cure.

That unfortunately is not currently the case with COPD. So we are still in a stand-off until the actual cause is discovered and either a complete cure or at least an effective (inexpensive) maintenance treatment is found

[gerald]

Some of the latest equipment for Spirometry that can be run off a PC at least makes it much more affordable.
But even that is only in the specialists office and you need a referral to get into to see them!

We now have affordable pulse oxymeters! But not the ones that measure CO2, those still costs $2000+ and even most of the hospitals don't use them.

Unfortunately there is still too much money in keeping the illness around instead of curing it.

[gnott]

I fought against that idea for a long time. Somehow connecting it with the battle Against Evil Large Pharmaceutical Companies. (There is some merit to both sides in that particular battle there but it is so convoluted with miss-information, lies, d**n lies, and the occasional truth. Smile)

Anyway I was reluctant to extend the conversation to medical devices - BUT I have finally realized it is very much the same problem. The exact same issue. Multiple factors at play, but the major one is technology, as You noted. Every main business is finally having to give up old ways (translate = Known Profits) to a brand new world with eager new people and entities ready to cut into their pieces of the pie. But they don't do that without a fight - dragging this out as long as they can.

The "Technology Race" I call the Race for the Tricorder. Those of you who didn't watch Start Trek; a Tricorder (an abbreviation of the device's full name, the "TRI-function reCORDER", referring to the device's primary functions: sensing, computing, and recording. That instantly diagnosis diseases and collected bodily information along with a zillion other uses - this information was then fed it to a ship board computer that resolved everything.)
A fun pure fictional device in the 80's but becoming fact and smarter every month with new technology. It is obvious that there WILL BE TRICORDERS.

In addition to the toys Gerald mention there are now EKG hand-held devices (Much aligned) with the capability to be as accurate as the average unit in a EM vehicle with a computer that can interpret as well as the average certified EM tech.

We could put accurate conservers an every tank (portable) that can read and instantly change pulse to match YOUR breathing rate and Activity and even drop to constant flow if medically required, give audio updates, or cell phone to tell you when to change tanks. Can produce complete accurate data matching blood pressure and pulse - to proved accurate summary reports for you doctor. The magical control center for these devices - A $29 Pie Raspberry available to anyone. However, cost of the current protyped device to consumer is an estimated MRP $3,700. And then you will still have to find a doctor willing to look at data. 

On it goes.

[lavishgail]

Great topic Gerald. Thank you!

Gnott, I can really relate to the on this topic. If "being Poor" meant you're the richest person on earth, that be me! I make less than 800.00 a month, bc I am a mother, AND what ever Job I had back in the black and white day's meaning my kids have no clue that when I was growing up, their really was a Gray area . Anyway, I was always paid *under the table* came in handy back then, but in the long run ruined it for me come time I got onto disability! So sucks, I can never win, booo..