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from COPD. Men are affected about twice as often as women because male smokers have outnumbered female smokers. COPD is not curable, but it is treatable. Lifestyle changes and medication |
can help people cope with chronic lung disease and live longer, fuller lives. But as you'll see, most cases of COPD can be prevented. Back to top What Is COPD? |
COPD refers to chronic illnesses that block the flow of air and make breathing difficult. The two major forms of COPD are chronic bronchitis and emphysema. In both, narrowed air |
passages or bronchi make it hard to exhale. (Bronchi are wider during inhalation and narrow during exhalation.) Narrowed bronchi also cause asthma, but the narrowing is temporary and reversible. In |
COPD, it's permanent. In chronic bronchitis, the mucous glands in the air passages are enlarged and produce too much mucous, which narrows the bronchi. In emphysema, the narrowing of the |
bronchi is caused by damage to the lung tissue and is more severe than in chronic bronchitis. Most patients with COPD have a mixture of chronic bronchitis and emphysema. Inflammation |
triggered by irritants that are inhaled also contributes to COPD. White blood cells try to fight off the irritation, but instead of controlling the damage caused by the irritant, they |
release chemicals that damage and eventually destroy lung tissue. Smoking causes about 85% of COPD cases. Heavy smokers have the highest risk of developing COPD. Secondhand smoke and other inhaled |
toxins can cause COPD in some nonsmokers. In others, an inherited protein deficiency is to blame. But in some cases, no cause is apparent. Back to top What Are the |
Symptoms of COPD? COPD starts gradually and progresses slowly over time. That's why the number of cases of COPD continues to increase years after many American men quit smoking. At |
first, there are no symptoms. But little by little, symptoms appear, usually in middle age. A morning "smoker's cough" is often the first complaint. The cough gradually gets worse and |
occurs throughout the day. Next, shortness of breath develops. In the beginning, it only occurs during exercise, but as the disease progresses, breathing becomes a chore even at rest. Wheezing |
is another common symptom. Most patients also become tired and weak. Patients with chronic bronchitis have a recurrent cough that brings up large amounts of thick, discolored phlegm almost every |
day for three months or longer. Over time, the lung disease puts a strain on the heart and men may develop cor pulmonale, a form of congestive heart failure. As |
a result, they accumulate fluid and gain weight. Their lips and skin may eventually turn bluish due to low blood oxygen levels. Men with emphysema have a scant and dry |
cough, severe shortness of breath and they breathe faster than normal. Their skin stays pink and they dont retain fluid, but their appearance changes: they lose weight, their muscles tend |
to waste away, and they develop large, barrel-shaped chests. Most patients with COPD have symptoms of both chronic bronchitis and emphysema. In addition to daily symptoms, most patients have two |
to three exacerbations each year. These are abrupt flares that are often triggered by lung infections. Symptoms get much worse and aggressive treatment is needed. Back to top How Is |
COPD Diagnosed? The best way to diagnose COPD is with a simple, safe lung-function test, called the forced expiratory volume at one second (FEV1). It measures the amount of air |
you can breathe out with maximum effort in one second. Doctors can also use this test to check the results of treatment. X-rays, blood oxygen mearurements, and other tests may |
also help. Back to top People with COPD can take steps to control symptoms, and minimize complications and disability. The first rule is the most important: Avoid tobacco and secondhand |
smoke. This is a hard and fast rule. There are no exceptions. Good nutrition is also important. A diet high in fruits, vegetables, and fish may actually help the lungs. |
There is no evidence that vitamin supplements help. In fact beta-carotene actually increases a male smoker's risk of lung cancer. Patients with chronic bronchitis and heart strain must avoid sodium |
(salt). Men with severe emphysema may benefit from high-calorie nutritional supplements. Drinking plenty of fluids will help keep phlegm loose and make it easy to clear out by coughing. A |
program of low-to-moderate intensity exercise can help the muscles get the most from the oxygen that damaged lungs can deliver. Walking is best. Start with 5 just minutes of walking |
three to four times a day and build up to 45 minutes a day. Patients with severe COPD or heart disease may also need a structured pulmonary rehabilitation program, which |
can teach breathing exercises that strengthen chest muscles. Preventing infection is essential. Be sure your flu and pneumonia shots are up to date. Keep your distance from folks with respiratory |
infections. Wash your hands carefully with an alcohol-based hand rub. Back to top Medications for COPD Prescription medications can do a lot for patients with COPD. Your doctor will explain |
the benefits and possible side effects. Here is a summary of the major groups of medications. - Bronchodilators - These relax the muscles in the walls of the bronchi, widening |
the tubes and easing the passage of air. The most popular short-acting bronchodilator is albuterol (Proventil). It is inhaled through a metered-dose inhaler (MDI) up to four times a day |
for quick relief of wheezing, coughing, or shortness of breath. Patients with mild COPD may need only a short-acting bronchodilator, but patients with more advanced disease also benefit from a |
long-acting bronchodilator. They help prevent symptoms rather than provide immediate relief. Salmeterol (Serevent) or formoterol (Foradil) can be inhaled twice a day as a spray or from a dry powder |
inhaler (DPI). Patients taking salmeterol or formoteral should continue using their short-acting albuterol MDI for that purpose. - Anticholinergics - These are drugs that widen the bronchial tubes and reduce |
the amount of mucus without making it thick and difficult to bring up. They provide long-term control and are the most important medication for many men with COPD. The newer |
drug tiotropium (Spiriva) can be used just once a day, while ipratropium (Atrovent) requires more frequent use . Because anticholinergics and bronchodilators work in different ways, patients can benefit from |
using both types of drugs. - Corticosteroids ("steroids") - These medications reduce inflammation in the bronchial tubes. Inhaled steroids can help many, but not all, patients with moderate-to-severe COPD. They |
are most effective for patients who are also taking long-acting bronchodilators. A combination of a steroid (fluticasone ) and a long-acting bronchodilator (salmeterol) is available for twice-a-day dry powder inhalation. |
- Antibiotics - These can be critically important for flare-ups but are not helpful for maintenance therapy. Notify your doctor right away if your breathing becomes worse, if you develop |
a fever, or if your phlegm becomes thicker, discolored, or more plentiful. Back to top Does Oxygen Really Help? People with COPD who have low blood oxygen levels can benefit |
greatly from long-term, round-the-clock oxygen therapy. At home, oxygen can be stored in cylinders or generated by machines called oxygen concentrators. Portable tanks can provide several hours of oxygen away |
from home. Oxygen therapy needs careful supervision by a physician. Because oxygen can be a fire hazard, patients and household members need to follow certain safety precautions. Back to top |
The Bottom Line The average person will take some 600 million breaths during a lifetime. Most men can keep their lungs healthy simply by avoiding tobacco smoke and other harmful |
fumes. Early diagnosis and treatment can slow the damage, ward off complications, and improve the quality of life. New therapies are on the way, but simple prevention is the best |
treatment of all. And, after all, what's more important than preserving the breath of life? Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and |
a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer |
health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). |
Ask The Expert December 20, 2011 No, they will not damage your heart. And your doctor may have prescribed a blood pressure medicine for reasons other than lowering your blood pressure. Many blood pressure medicines can treat conditions other than hypertension. And for some heart conditions, they can help keep the heart... |
pressure is on the low side of normal. Here are examples of blood pressure medicines that have other uses: Diuretics, such as chlorthalidone and hydrochlorothiazide, are excellent blood pressure drugs. But they can also decrease leg swelling and improve the symptoms of heart failure even with normal blood pressure. Ang... |
better, even if their blood pressure is a little low. These drugs also help prevent kidney failure in people with diabetes. Examples of ACE inhibitors include lisinopril and ramipril. Beta blockers, such as propranolol and metoprolol, have many uses, including: Calcium channel blockers, such as diltiazem and verapamil,... |
Hearing Loss in Adults What Is It? Hearing loss is a decrease in the ability to perceive sounds. It can be partial or total, sudden or gradual, temporary or permanent. It can affect one ear or both. In general, the risk of hearing loss increases with age. Sound enters the |
ear and strikes the eardrum. This causes the eardrum to vibrate. The eardrum's vibrations are amplified through the middle ear by three tiny bones. Inside the ear, the vibrations are transformed into nerve impulses. These nerve impulses travel to the brain, where they are interpreted as sounds. The outer ear |
and middle ear conduct sound. Any injury to this part of the hearing pathway is called conductive hearing loss. Sensorineural hearing loss is injury to the inner ear, eighth cranial nerve and brain. These structures produce, transmit and interpret nerve impulses. Some of the most important causes of hearing loss |
in adults are: - Middle ear disease. A bacterial infection of the middle ear can: - Injure the eardrum - Disrupt the middle-ear bones - Cause fluid buildup - Noise. Loud sounds can injure delicate cells within the ear. This is a form of sensorineural hearing loss. Noise-induced hearing loss |
can happen because of a single brief burst of an extremely loud sound. It more often results from long-term exposure to loud sounds of slightly lower intensity. - Otosclerosis. An abnormal overgrowth of one or more bones in the middle ear prevents the small bones from moving normally. This is |
a type of conductive hearing loss. Otosclerosis often runs in families. - Acoustic neuroma. This noncancerous tumor grows on part of the eighth cranial nerve. This nerve carries signals to the brain. Acoustic neuroma often causes dizziness and equilibrium problems in addition to gradual hearing loss. - Meniere's diseas... |
typically causes dizziness, hearing loss, ringing in the ears (tinnitus), and a sensation of fullness or stuffiness in one or both ears. Meniere's disease occurs when excess fluid causes swelling in the inner ear. - Trauma. Many types of accidents can cause hearing loss. Hearing loss can result when the |
eardrum is injured from the force of an explosion. Or it can result from a Q-tip that ruptures the eardrum during an attempt to clean the ear canal. - Sudden sensorineural hearing loss. This is a medical emergency. A person loses hearing over a period of three days or less. |
In most cases, only one ear is affected. The underlying problem may be a viral infection. - Drugs. Many prescription and nonprescription medications can damage the ear and cause hearing loss. These include: - Anticancer chemotherapy drugs - Antimalaria drugs - Age. Age-related hearing loss (presbycusis) is not a single |
disease. Rather, it is a category for the cumulative effects of aging on the ears. Hearing loss usually begins after age 60. Both ears are affected. It is typically harder to hear high-pitched tones (women's voices, violins) than low-pitched ones (men's voices, bass guitar). Hearing loss usually occurs gradually over |
a period of years. The person may not realize that he or she has difficulty hearing. - Other causes. There are more than 100 different causes of hearing loss in adults. The most common reversible causes are severe buildup of earwax in the ear canal and acute infections of the |
external ear or middle ear. If you have sudden, severe hearing loss, you will notice immediately that your ability to hear has decreased dramatically or disappeared totally in the affected ear. If your hearing loss is gradual, your symptoms may be more subtle. You may have difficulty understanding conversations. Family |
members may complain that you play the radio or television too loudly. You may ask them to repeat what they say or frequently misunderstand what they are saying. Some diseases and conditions that cause hearing loss may produce additional symptoms, including: - Ringing in the ears (tinnitus) - Discharge or |
bleeding from the ear - Deep earache, or pain in the ear canal - Pressure or a "stuffy" feeling inside the ears - Dizziness or problems with balance or equilibrium Your doctor will ask you to describe your symptoms. He or she will ask if anyone in your family had |
or has hearing loss. Your doctor will want to know if you have been exposed to loud noises, trauma of the ear or head, or ear infections. Your doctor will want to rule out the possibility that medications may be causing your hearing loss. He or she will review the |
prescription and over-the-counter drugs you take. Your doctor will examine you, and look closely at your ears. This ear exam may include: - An examination of your ear canal and eardrum using a lighted instrument. - The Rinne test. A vibrating tuning fork is placed on the bone behind your |
ear. This tests for conductive hearing loss. - The Weber test. A vibrating tuning fork is placed in the middle of your forehead to help diagnose one-sided hearing loss. - Audioscopy testing. The doctor uses a hand-held device to generate tones of various intensities to find out if you can |
hear them. If you are diagnosed with hearing loss, your doctor will refer you to an audiologist. The audiologist will test your hearing sensitivity. He or she will check for middle-ear problems by measuring your eardrum's ability to reflect sounds. Further testing and treatment will follow. The duration of hearing |
loss depends on its cause. Sensorineural hearing loss tends to be permanent. You can help prevent hearing loss: - Wear protective earplugs or earmuffs if you are often exposed to loud noise at work or during recreational activities. - Never put cotton swabs or other foreign objects in your ears. |
- Wear a seatbelt while driving. Wear a protective helmet while riding a bicycle. - Know the possible side effects of your medications. Both age-related and noise-related hearing loss tend to be permanent. Your doctor may recommend a hearing aid or an implant to improve your ability to communicate with |
others. A hearing aid amplifies sounds electronically and is effective for many people with age-related hearing loss. Hearing aids today are very small, so small that other people often do not notice you are wearing them. A cochlear implant translates sounds into electrical signals that can be carried to the |
brain. Certain other forms of hearing loss may be treated medically or surgically: - Otosclerosis. For mild cases, a hearing aid is usually the first option. In severe cases, one of the small bones is surgically replaced with a tiny prosthesis. - Acoustic neuroma. Treatment includes surgery or highly focused |
radiation therapy. - Meniere's disease. There is no cure. The goal of treatment is to relieve pressure in the ears to reduce symptoms. Some people improve by limiting intake of salt, caffeine or alcohol or quitting smoking. Medications to reduce fluid retention in the ear may help. In some cases, |
surgery may be considered. - Traumatic hearing loss. A damaged eardrum can sometimes be repaired surgically. - Drug-induced hearing loss. Stopping the problem medication may reverse hearing loss or prevent it from getting worse. - Sudden sensorineural hearing loss. When the cause is unknown, this condition is usually t... |
steroids. - Other. A dense plug of earwax can be dissolved or gently removed by your doctor. Antibiotics can treat hearing loss caused by ear infections. When To Call a Professional Call your doctor immediately if you have sudden hearing loss. This is a medical emergency. Also, make an appointment |
to see your doctor if: - You are an older adult, and hearing loss interferes with your quality of life. - You work in a high-noise environment, and you have trouble hearing. - You have hearing loss together with: - An earache - Discharge from your ears - Dizziness or |
balance problems The prognosis is highly variable. In many cases, hearing loss cannot be treated with medications or surgery. But your quality of life may improve significantly with a hearing aid. A cochlear implant may also be an option. National Institute on Deafness and Other Communication Disorders National Institu... |
Health 31 Center Drive, MSC 2320 Bethesda, MD 20892-2320 American Academy of Otolaryngology -- Head and Neck Surgery 1650 Diagonal Road Alexandria, VA 22314-2857 American Speech-Language-Hearing Association (ASHA) 10801 Rockville Pike Rockville, MD 20852 National Institute for Occupational Safety and Health 1600 Clifto... |
Futures Fundamentals: The Players |Sponsor: At last, an easy way to predict stock trends – get your FREE copy of 5 Chart Patterns You Need to Know.| The players in the futures market fall into two categories: hedgers and speculators. Farmers, manufacturers, importers and exporters can all be hedgers. A hedger buys or s... |
the future price of a commodity intended to be sold at a later date in the cash market. This helps protect against price risks. The holders of the long position in futures contracts (the buyers of the commodity), are trying to secure as low a price as possible. The short holders of the contract (the sellers of the comm... |
want to secure as high a price as possible. The futures contract, however, provides a definite price certainty for both parties, which reduces the risks associated with price volatility. Hedging by means of futures contracts can also be used as a means to lock in an acceptable price margin between the cost of the raw m... |
of the final product sold. A silversmith must secure a certain amount of silver in six months time for earrings and bracelets that have already been advertised in an upcoming catalog with specific prices. But what if the price of silver goes up over the next six months? Because the prices of the earrings and bracelets ... |
extra cost of the silver can\'t be passed on to the retail buyer, meaning it would be passed on to the silversmith. The silversmith needs to hedge, or minimize her risk against a possible price increase in silver. How? The silversmith would enter the futures market and purchase a silver contract for settlement in six m... |
at a price of $5 per ounce. At the end of the six months, the price of silver in the cash market is actually $6 per ounce, so the silversmith benefits from the futures contract and escapes the higher price. Had the price of silver declined in the cash market, the silversmith would, in the end, have been better off |
without the futures contract. At the same time, however, because the silver market is very volatile, the silver maker was still sheltering himself from risk by entering into the futures contract. So that\'s basically what hedging is: the attempt to minimize risk as much as possible by locking in prices for future purch... |
securities future contract now can hedge against rising equity prices in three months. If at the time of the contract\'s expiration the equity price has risen, the investor\'s contract can be closed out at the higher price. The opposite could happen as well: a hedger could go short in a contract today to hedge against ... |
future. A potato farmer would hedge against lower French fry prices, while a fast food chain would hedge against higher potato prices. A company in need of a loan in six months could hedge against rising interest rates in the future, while a coffee beanery could hedge against rising coffee bean prices next year. Other ... |
aim to minimize risk but rather to benefit from the inherently risky nature of the futures market. These are the speculators, and they aim to profit from the very price change that hedgers are protecting themselves against. Hedgers want to minimize their risk no matter what they're investing in, while speculators want ... |
profits. In the futures market, a speculator buying a contract low in order to sell high in the future would most likely be buying that contract from a hedger selling a contract low in anticipation of declining prices in the future. Unlike the hedger, the speculator does not actually seek to own the commodity in questi... |
market into which information is continuously being fed, speculators and hedgers bounce off of - and benefit from - each other. The closer it gets to the time of the contract's expiration, the more solid the information entering the market will be regarding the commodity in question. Thus, all can expect a more accurat... |
the corresponding price. The U.S. futures market is regulated by the Commodity Futures Trading Commission (CFTC) an independent agency of the U.S. government. The market is also subject to regulation by the National Futures Association (NFA), a self-regulatory body authorized by the U.S. Congress and subject to CFTC su... |
order to issue or buy or sell futures contracts. Futures brokers must also be registered with the NFA and the CFTC in order to conduct business. The CFTC has the power to seek criminal prosecution through the Department of Justice in cases of illegal activity, while violations against the NFA's business ethics and code... |
company or a person from dealing on the futures exchange. It is imperative for investors wanting to enter the futures market to understand these regulations and make sure that the brokers, traders or companies acting on their behalf are licensed by the CFTC. In the unfortunate event of conflict or illegal loss, you can... |
INTELLECTUAL PROPERTY? "Intellectual Property" is a generic term used to describe products of the human intellect that have economic value. Computer software is one of the many forms of intellectual property. Other examples include books, music, movies, artwork, designs and |
other works of authorship, names, logos, as well as certain inventions. Intellectual property is "property" because a body of laws has been created that gives owners of such works legal rights similar in some respects to those given to owners |
of real estate or tangible personal property (such as cars). Intellectual property may be owned and bought and sold the same as other types of property. But in many important respects, ownership of intellectual property is very different from ownership |
of a house or a car. DEFINITIONS. Basic definitions are required before we can deal with the real business world issues involving intellectual property law. The principal types of intellectual property legal protection are listed and defined below: Trademark and |
Trade Name - Patent. Patent law protects inventions. Patent protection is available for any new and useful process, machine, method of manufacture, composition of matter, or any new, useful improvement. By filing for and obtaining a patent from the U.S. |
Patent and Trademark Office, an inventor is granted a monopoly on the use and commercial exploitation of an invention, for 20 years from the date of filing the application. In the U.S. patents are awarded to the first to invent. |
When multiple inventors file applications to patent the same invention, the U.S. Patent Office must decide who was the first inventor. Therefore, it is important that the engineers maintain development records establishing the events surrounding the invention process in order |
to prove the date of invention. Invention records may also be useful to challenge the validity of another's patent. - Copyright. A copyright provides protection for a limited time to authors for their "original works of authorship fixed in any |
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