12, December 2014

Vitamin D reduces lung disease flare-ups

Vitamin D supplements can reduce lung disease flare-ups by over 40 percent in patients with a vitamin D deficiency, show a clinical trial.

Flare-ups are when a COPD (chronic obstructive pulmonary disease) patient's usual symptoms (coughing, excess mucus, shortness of breath, tightness in chest) get worse and stay worse, sometimes resulting in hospitalisation.

"Our research has shown how an inexpensive vitamin supplement can significantly reduce the risk of flare-ups for patients who are vitamin D deficient, which could have a major public health benefit," said lead author Adrian Martineau, professor at Queen Mary University of London.

This is the first clinical trial to investigate the impact of vitamin D supplementation on severity and duration of COPD symptoms.

The trial included 240 patients with COPD in and around London.

Half of the patients received vitamin D supplements and the other half received an equivalent placebo.

Patients with a vitamin D deficiency benefited dramatically from taking the supplements but the striking reduction in flare-ups was not seen among patients who had a higher vitamin D status at the start of the trial.

However, researchers did find vitamin D supplementation modestly reduced the severity and duration of flare-up symptoms in all patients in the vitamin D group.

"Our findings suggest that patients with COPD should have their vitamin D status tested and should begin taking supplements if their levels are found to be low," Martineau added.

The findings appeared in the journal Lancet Respiratory Medicine.

Source: www.timesofindia.com

12.12.2014

Why most doctors wish to die in peace

Unlike what they actually practice - pursuing aggressive, life-prolonging treatment for terminally-ill patients - most physicians would like to forgo it for themselves, a new study reveals.

Most physicians would choose a do-not-resuscitate or "no code" status for themselves when they are terminally ill, according to a study from Stanford University School of Medicine.

"Why do we physicians choose to pursue such aggressive treatment for our patients when we would not choose it for ourselves?" asked V.J. Periyakoil, lead author of the study.

The reasons likely are multifaceted and complex.

An overwhelming percentage of the 2,013 doctors surveyed - 88.3 percent - said they would choose "no-code" or do-not-resuscitate orders for themselves.

In the study, Periyakoil and her colleagues set out to determine how physicians' attitudes have changed toward advance directives since passage of the US Self-Determination Act in 1990 - a law designed to give patients more control over determining end-of-life-care decisions.

"More than 80 percent of patients say they wish to avoid hospitalisation and high-intensity care at the end of life, but their wishes are often overridden," the authors noted.

At the core of the problem is a biomedical system that rewards doctors for taking action, not for talking with their patients.

"Our current default is 'doing,' but in any serious illness there comes a tipping point where the high-intensity treatment becomes more of a burden than the disease itself," emphasised Periyakoil who trains physicians in palliative medicine.

The study appeared in the journal PLOS ONE.

Source: www.timesofindia.com

12.12.2014

No one can climb the ladder of success, with both hands in the pocket