Chronic Coughs Need a Doctor's Attention

(HealthDay News) -- If you wake up due to coughing or have a cough that lasts for weeks, you may have a potentially serious problem that requires medical attention.

"Cough is the most common respiratory symptom for which patients seek medical attention," Dr. Alan B. Goldsobel, chairman of the American Academy of Allergy, Asthma & Immunology's cough committee, said in a prepared statement.

"Cough protects the body by removing mucus and irritating particles from the respiratory tract. Coughing is a useful function and does not always mean there is a problem ...," Goldsobel explained. "However, coughing at night, after going to sleep indicates the need for medical attention."

Common causes of coughing include: viral upper respiratory tract infections; asthma; nasal and sinus disease; stomach and esophageal problems; an inhaled foreign body; habit; and environmental irritants.

People should see an allergist/immunologist if they have:

• a cough that lasts three to eight weeks or more;
• a cough that coexists with asthma;
• coexisting chronic cough and nasal symptoms;
• a chronic cough and tobacco use or exposure.

More information
To learn more about cough and children, visit the American Academy of Allergy, Asthma & Immunology.

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Surgery Can Cut Sleep Apnea

(HealthDay News) -- A procedure that removes excess tissue in the throat or mouth to widen the airway can help improve or cure obstructive sleep apnea, a U.S. study finds.

Researchers followed 63 patients, ages 18 to 80, for seven years and found that the procedure, called uvulopalatopharyngoplasty (UPPP), eliminated obstructive sleep apnea in one-quarter to one-third of the patients, depending on the definition of success.

Of the patients who continued to have some obstructive sleep apnea and returned to the use of continuous positive airway pressure (CPAP) treatment, their required CPAP setting was somewhat lower. The researchers also found that UPPP reduced the mean apnea hyponea index in patients.

"The apnea-hyponea index basically tells us the number of times a patient with sleep apnea quits breathing per hour," lead author Dr. Akram Khan, assistant professor at the University of Florida, Jacksonville, explained in a prepared statement. "We found that the surgical procedure reduced patients' apenic (non-breathing) episodes by more than half."

The study was to be presented Wednesday at CHEST, the annual meeting of the American College of Chest Physicians, in Chicago.

Khan noted that CPAP "is a well-established treatment for sleep apnea, and while most patients tolerate it well, some are unable to tolerate it or don't want to, and these patients need alternative means of treatment."

UPPP, first described in 1981, has been widely used but produced varying results. Patients who have mild obstructive sleep apnea and are relatively young, healthy and lean, may have the best results with this procedure, researchers suggest.

More information
The American Sleep Apnea Association has more about sleep apnea assessment.

Trouble at Home Boosts Kids' Asthma

(HealthDay News) -- Poor family support and bad neighborhoods can aggravate asthma symptoms in kids, Canadian research suggests.

Edith Chen and colleagues at the University of British Columbia in Vancouver examined the degree of support that 78 children with asthma received from family and peers. They also looked at social problems, such as crime and violence, in the children's neighborhoods.

They then assessed the children's lung function, asthma symptoms, and certain behaviors that can affect asthma.

The results indicated a correlation between social environment and asthma symptoms and lung function. Children who reported less family support and lived in worse neighborhoods experienced greater asthma symptoms, the team said. Those who reported less family support had poorer lung function.

Further analysis revealed that low levels of family support were associated with greater lung inflammation which, in turn, was associated with poorer asthma outcomes. Family support did not appear to influence behaviors that can affect asthma.

The researchers also concluded that living in worse neighborhoods was associated with higher rates of child smoking and exposure to smoke, which is associated with poorer asthma outcomes.

"Poor family relations may foster psychological experiences with direct physiologic consequences, whereas problematic neighborhoods may operate by providing the role models for maladaptive behaviors," the study authors wrote.

Peer group support had no significant effect on asthma symptoms or lung function. The study was published in the first issue for October of the American Journal of Respiratory and Critical Care Medicine.

More information
The American Lung Association has more about childhood asthma.

Experts Publish New Lung Disease Guidelines

(HealthDay News) -- Experts have devised new standards for the diagnosis, management and prevention of a widespread, deadly lung ailment -- chronic obstructive pulmonary disease (COPD).

COPD affects 15 percent to 25 percent of adults over the age of 40 and is the fourth leading cause of death in the United States. It's expected to become the fifth leading cause of death worldwide by 2020.

Cigarette smoking and exposure to secondhand smoke are among the most common risk factors for COPD in the developed world. In developing countries, major risk factors include long-term exposure to smoke from indoor cooking and heating fires.

Now, a report released Sept. 14 by the Global Initiative for Chronic Obstructive Lung Disease is setting the standard for caring for COPD patients.

The new guidelines -- published in the American Journal of Respiratory and Critical Care Medicine -- emphasize the importance of proper diagnosis, assessment of disease severity, and the need for a better understanding of co-existing conditions in order to improve treatment of COPD.

"This is an absolutely up-to-date summary of all the available evidence on the diagnosis, management and prevention of COPD," report lead author Dr. Klaus Rabe, of the department of pulmonology at Leiden University Medical Center in the Netherlands, said in a prepared statement.

"One of the most important points is that we now say COPD is preventable and treatable," Rabe said. "There are steps we can take to prevent it, and it is no longer viewed with therapeutic nihilism."

More information
The American Academy of Family Physicians has more about COPD.

Scientists ID Likely Culprit in 'Popcorn Lung'

(HealthDay News) -- A key chemical ingredient in the buttery flavoring of microwave popcorn has been identified as a likely culprit in "popcorn lung," a lung disease that afflicts people who work in the microwave popcorn manufacturing industry, Dutch researchers report.

Publishing in the September issue of the American Journal of Respiratory and Critical Care Medicine, the team said that the chemical diacetyl may be responsible for more cases of bronchiolitis obliterans syndrome (BOS), otherwise known as "popcorn lung," at a diacetyl factory.

"Our study found a cluster of [previously undiagnosed] BOS cases in a diacetyl production plant," lead author Dr. Frits van Rooy, of the Division of Environmental Epidemiology at the Universiteit Utrecht, said in a prepared statement. "This supports the conclusion that an agent in the diacetyl production process has caused BOS."

The disease was first noticed in 2001 among workers at an American plant that made microwaveable popcorn. Diacetyl was identified early on as an indicator of exposure, but the chemical's role in the development of the lung disease was not known.

The research team in the Netherlands traced 196 former workers who were still alive and had been employed at the diacetyl production plant between 1960 and 2003. They identified 175 who agreed to fill out exposure and respiratory health questionnaires. The workers also took lung function tests and completed clinical assessments. Four cases of "popcorn lung" were identified in the 102 workers thought to be at risk for high exposure.

The authors noted that this was the first study of lung health among workers for a plant producing diacetyl. They acknowledged that they could not rule out the impact of other chemicals made at the same plant, but the data created a stronger case for diacetyl as a possible cause of "popcorn lung." Acetoin and acetyldehyde may also contribute, the researchers said.

An editorial accompanying the journal article expressed concern over the fact that none of the four cases had been diagnosed as an occupationally related lung disease or bronchiolitis obliterans specifically prior to the study.

More information
To learn more about bronchiolitis obliterans, visit Haz-Map: Occupational Exposure to Hazardous Agents.