Tuesday, March 31, 2009
Saturday, March 28, 2009
Friday, March 27, 2009
Thursday, March 26, 2009
Wednesday, March 25, 2009
I posted this 5 days ago....
Tuesday, March 24, 2009
Mycobacterium abscessus in cystic fibrosis lung transplant recipients: report of 2 cases and risk for recurrence.
Airway Delivery of Low Dose Miglustat Normalizes Nasal Potential Difference in F508del Cystic Fibrosis Mice.
Monday, March 23, 2009
Saturday, March 21, 2009
So check out the site to see if your clinic will be participating and keep on them to make sure you're right there when they begin trials. :)
Thursday, March 19, 2009
Wednesday, March 18, 2009
Tuesday, March 17, 2009
Superbug complicates treatment of infections in cystic fibrosis
The unexpected behaviour of a family of "superbugs" called the Burkholderia cepacia complex (Bcc) could have implications for the treatment of cystic fibrosis (CF) patients. CF patients produce large quantities of sticky mucus in their lungs that is difficult to expel and is easily infected by bacteria. A recent treatment for CF, inhalation of a sugar called mannitol, works by attracting moisture into the lungs. This thins the mucus making it easier to disperse. However, recent research by Professor John Govan and colleagues at the University of Edinburgh, published in the journal Microbiology has shown that when Bcc bacteria are grown on mannitol they produce a sticky substance called exopolysaccharide (EPS) which could contribute to the very problem that the mannitol therapy was designed to solve.
Infections caused by slime-producing bacteria are particularly difficult to treat in CF patients. The bacterial slime combines with the debris of the body's own defence cells to form a biofilm which protects the bacteria against both natural defences and antibiotics. And Bcc is an especially virulent bug.
"Burkholderia make other superbugs look like wimps", said Professor Govan, "They not only have larger genomes (hence genetic potential) and are resistant to almost all antibiotics, they can even use antibiotics such as penicillin as a nutrient. One of the problems is that when they are grown under normal laboratory conditions they do not produce the exopolysaccharide slime so their potential for causing serious infection may have been underestimated. We grew them on onion tissue – they were first identified in the 1950's as the cause of onion rot – and found that then they produced copious amounts of slime. Onion tissue contains a lot of simple sugars, including mannitol".
Since Professor Govan's work was published, further potential complications in CF patients caused by the Burkholderia bacteria have been identified. Commenting on the work in the current issue of Microbiology, Dr David Reid, from the Menzies Research Institute, Hobart, Australia, and Dr Scott Bell from The Prince Charles Hospital, Brisbane, Australia, have suggested that the increased levels of sugar in the blood of CF patients with diabetes could contribute to Burkholderia infections.
"CF-related diabetes affects almost one-third of adults with CF", said Dr Reid, "But no comprehensive studies have been carried out to investigate the effect of diabetes on Burkholderia infection. We will need international collaboration to ensure there are sufficient patient numbers to make any survey statistically significant".
"CF patients known to have Burkholderia infections have been excluded from the clinical trials of mannitol therapy", he went on, "But the obvious concern is that, despite Professor Govan's findings, patients with Burkholderia infections will be prescribed mannitol – because mannitol works very well for CF patients with infections caused by a bug called Pseudomonas aeruginosa which consitute the vast majority of the CF population".
In a further twist to the tale, one of the most virulent strains of Burkholderia lacks the gene that causes the bacterium to produce slime – and so CF patients infected with this particular variety might be able to benefit from mannitol therapy. However less virulent Burkholderia strains can use the mannitol to produce slime and make the infections they cause much more severe.
Multiple evidences indicate that inflammation is an event occurring prior to infection in patients with cystic fibrosis. The self-perpetuating inflammatory cycle may play a pathogenic part in this disease. The role of the NF-kappaB pathway in enhanced production of inflammatory mediators is well documented.
The pathophysiologic mechanisms through which the intrinsic inflammatory response develops remain unclear. The unfolded mutated protein cystic fibrosis transmembrane conductance regulator (CFTRdeltaF508), accounting for this pathology, is retained in the endoplasmic reticulum (ER), induces a stress, and modifies calcium homeostasis.
Furthermore. CFTR is implicated in the transport of glutathione, the major antioxidant element in cells. CFTR mutations can alter redox homeostasis and induce an oxidative stress. The disturbance of the redox balance may evoke NF-kappaB activation and, in addition, promote apoptosis. In this review, we examine the hypotheses of the integrated pathogenic processes leading to the intrinsic inflammatory response in cystic fibrosis.
Glutathione - our good friend. Make sure to check out my NAC posts
Monday, March 16, 2009
So this article isn't necessarily CF specific, other than the fact that as CFer's age it's super important to avoid cancer so we can get a tx when the time comes (have to be cancer free for 5 years to get a tx at most centers).
I myself have replaced all the milk I drink with organic, plain (no sugar) yogurt mostly for the pro-biotic reasons (so many abx, so many yeast infections!!!). I mix my yogurt in my cereal and sprinkle a bit of honey to make it sweet (honey is one of the best sweetners).
But this article points out another reason why milk is really meant for children of breast-feeding age, not adults. I have a feeling organic milk is better than traditional, but there's still properties of organic milk that might not be so wonderful. Check it out....
Source of the study: National Cancer Institute.... the US Governments main cancer research arm
Sunday, March 15, 2009
Saturday, March 14, 2009
Friday, March 13, 2009
Taiwanese sausage is an incredible dish. I've been eating it a little too much lately - I just can't get enough since I got back from my trip a few months back.
But man did this stuff just SIT in my stomach today. Yup, just sat there. So when it came to motivating for exercise this evening.... ya, wow. Didn't feel so good.
But I pushed myself anyway. So I'm 3/5 for cardio and 2/3 for weights for the week. And I might barf. No, I'm not joking. I do feel a little heavy in the yummy area and the water I'm drinking to re-hydrate isn't going down very easily.
Cheers! Here's to a great weekend guys :)
Thursday, March 12, 2009
Preliminary evidence for cell membrane amelioration in children with cystic fibrosis by 5-MTHF and vitamin B12 supplementation
Wednesday, March 11, 2009
VDs are now available of the presentations from this past weekend's Stanford Hospital/Lucile Packard Children's Hospital Cystic Fibrosis Education Day. You may or visit our website www.cfri.org for the DVD order form and return your order to our CFRI office. OR call us with your order at 650.404.9975.
Director of Programs & Operations
Cystic Fibrosis Research, Inc.
2672 Bayshore Parkway, Suite 520
Mountain View, CA 94043
34 Years of CF Research, Education and Support!
CFRI is a tax-exempt organization under 501 C(3) of the IRS.
Tax ID #51-0169988
- Multidose Safety and Tolerability Study of (Arikace™) for Inhalation In Cystic Fibrosis Patients in Alabama http://snipurl.com/dkr4e
- Assessment of Quadriceps Muscle Electrostimulation Used in Patients Suffering From Cystic Fibrosis (STIMUCO) in France http://snipurl.com/dkr8y
- Pharmacokinetics of Linezolid in Children With Cystic Fibrosis in Texas http://snipurl.com/dkrc0
- Treatment of Metabolic Alkalosis in Acute Exacerbations of Cystic Fibrosis in Australia http://snipurl.com/dkrgx
- Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of QAU145 in Patients With Cystic Fibrosis in Alabama http://snipurl.com/dkrl3
- Vitamin D3 for the Treatment of Low Vitamin D in Cystic Fibrosis in Penn http://snipurl.com/dkrpy
- Aztreonam Lysine for Inhalation in Patients With Cystic Fibrosis, Mild Lung Disease, and P. Aeruginosa (AIR-CF4) all over the US and Canada and Australia (yes, they're still recruting) http://snipurl.com/dkrrm
- Do Musculoskeletal Techniques Improve Forced Expiratory Volume in One Second in Adults With Cystic Fibrosis? in London http://snipurl.com/dkrug
- SD Cystic Fibrosis Study in Minnesota and and PA http://snipurl.com/dkrz1
- Short Term Safety and Efficacy of Lubiprostone in Adults With Cystic Fibrosis http://snipurl.com/dks0m
More tomorrow when I finish my midterm :)
Done with the midterm. Here's some more:
- Ghrelin in Cystic Fibrosis (ghrelin) in Great Britain http://www.clinicaltrials.gov/ct2/show/NCT00763477?term=cystic+fibrosis&recr=Open&rank=16
- Early Intervention in Pulmonary Exacerbation in Cystic Fibrosis in Washington http://www.clinicaltrials.gov/ct2/show/NCT00850551?term=cystic+fibrosis&recr=Open&rank=18
- The Effect of Hypertonic Saline on the Lung Clearance Index in Patients With Cystic Fibrosis in Ontario http://www.clinicaltrials.gov/ct2/show/NCT00635141?term=cystic+fibrosis&recr=Open&rank=19
- Can Quantitative Ultrasound be Used for the Evaluation of Bone Health in Adolescents and Adults With Cystic Fibrosis in Belgium http://www.clinicaltrials.gov/ct2/show/NCT00221572?term=cystic+fibrosis&recr=Open&rank=20
- Inhaled Sodium Pyruvate for the Treatment of Cystic Fibrosis in Minnesota . http://www.clinicaltrials.gov/ct2/show/NCT00308243?term=cystic+fibrosis&recr=Open&rank=21
- Use of Formula Fortified With DHA in Infants With Cystic Fibrosis all over the US http://www.clinicaltrials.gov/ct2/show/NCT00530244?term=cystic+fibrosis&recr=Open&rank=23
- Non-Invasive Ventilation and Oxygen Therapy in Cystic Fibrosis Patients With Nocturnal Oxygen Desaturation Australia http://www.clinicaltrials.gov/ct2/show/NCT00157183?term=cystic+fibrosis&recr=Open&rank=24
- Coping Compliance and Adjustment in Adolescents With Cystic Fibrosis Ohio http://www.clinicaltrials.gov/ct2/show/NCT00577252?term=cystic+fibrosis&recr=Open&rank=25
- Prolonging the Duration of Peripheral Venous Catheters in Cystic Fibrosis People - Italy http://www.clinicaltrials.gov/ct2/show/NCT00418470?term=cystic+fibrosis&recr=Open&rank=26
- Capsule Endoscopy in Cystic Fibrosis - Israel http://www.clinicaltrials.gov/ct2/show/NCT00333957?term=cystic+fibrosis&recr=Open&rank=27
- The Effect of rhDNase on Ventilation Inhomogeneity in Patients With Cystic Fibrosis - Canada http://www.clinicaltrials.gov/ct2/show/NCT00557089?term=cystic+fibrosis&recr=Open&rank=28
- Utility of Induced Sputum Using Hypertonic Saline to Evaluate Infection and Inflammation in Cystic Fibrosis- Canada http://www.clinicaltrials.gov/ct2/show/NCT00721071?term=cystic+fibrosis&recr=Open&rank=29
- Anti-Pseudomonas IgY to Prevent Infections in Cystic Fibrosis (PseudIgY) - Sweden http://www.clinicaltrials.gov/ct2/show/NCT00633191?term=cystic+fibrosis&recr=Open&rank=32
- Treatment of Aspergillus Fumigatus (a Fungal Infection) in Patients With Cystic Fibrosis - Canada http://www.clinicaltrials.gov/ct2/show/NCT00528190?term=cystic+fibrosis&recr=Open&rank=33
- A Phase II , Placebo-Controlled Study to Assess Efficacy of 28 Day Oral AZD9668 in Patients With Cystic Fibrosis (INCA) - all around Europe http://www.clinicaltrials.gov/ct2/show/NCT00757848?term=cystic+fibrosis&recr=Open&rank=34
- Modulation by Sex Hormones of Inflammation and Susceptibility to Pseudomonas Aeruginosa in Cystic Fibrosis Airways - Canada http://www.clinicaltrials.gov/ct2/show/NCT00700050?term=cystic+fibrosis&recr=Open&rank=35
- Lancovutide (Moli1901) Inhalation Solution Study in Adolescents and Adults With Cystic Fibrosis - Austria http://www.clinicaltrials.gov/ct2/show/NCT00671736?term=cystic+fibrosis&recr=Open&rank=37
- Efficacy of Bucelipase Alfa (BSSL) in Patients With Cystic Fibrosis and Pancreatic Insufficiency- Netherlands and Poland http://www.clinicaltrials.gov/ct2/show/NCT00743483?term=cystic+fibrosis&recr=Open&rank=38
- Effect of Pioglitazone on Inflammation in Cystic Fibrosis - Los Angeles http://www.clinicaltrials.gov/ct2/show/NCT00719381?term=cystic+fibrosis&recr=Open&rank=39
- 18FDG-PET Imaging to Detect Changes in Airways Inflammation in Cystic Fibrosis Patients - Canada http://www.clinicaltrials.gov/ct2/show/NCT00684346?term=cystic+fibrosis&recr=Open&rank=41
- Aztreonam for Inhalation Solution Versus Tobramycin Nebuliser Solution in Patients With Cystic Fibrosis and P. Aeruginosa, Followed by an Open-Label, Single Arm Extension - all over Europe http://www.clinicaltrials.gov/ct2/show/NCT00757237?term=cystic+fibrosis&recr=Open&rank=42
- Nutritional, Metabolic and Respiratory Status in Cystic Fibrosis- France http://www.clinicaltrials.gov/ct2/show/NCT00476281?term=cystic+fibrosis&recr=Open&rank=43
- Aztreonam Lysine for Inhalation in Patients With Cystic Fibrosis and Pseudomonas Aeruginosa Airway Infection - all over the United States (still actively recruiting!!!!!!) http://www.clinicaltrials.gov/ct2/show/NCT00499720?term=cystic+fibrosis&recr=Open&rank=45&show_locs=Y#locn
- Study Evaluating Fosfomycin/Tobramycin for Inhalation in Cystic Fibrosis Patients With Pseudomonas Aeruginosa Lung Infection- Alaska, Nevada, Oklahoma http://www.clinicaltrials.gov/ct2/show/NCT00794586?term=cystic+fibrosis&recr=Open&rank=46
- An Exploratory Study to Assess Multiple Doses of Omalizumab in Patients Aged 12 Years and Older With Cystic Fibrosis Complicated by Allergic Bronchopulmonary Aspergillosis - Belgium http://www.clinicaltrials.gov/ct2/show/NCT00787917?term=cystic+fibrosis&recr=Open&rank=47
- Do Physiotherapy Techniques Improve Posture During Admission for a Chest Infection in Adults With Cystic Fibrosis? - Great Britain http://www.clinicaltrials.gov/ct2/show/NCT00806884?term=cystic+fibrosis&recr=Open&rank=48
- 18FDG- PET/CT Contribution to the Assessment of Lesion Severity in Cystic Fibrosis (CF) - Israel http://www.clinicaltrials.gov/ct2/show/NCT00363402?term=cystic+fibrosis&recr=Open&rank=49
- A Study of the Efficacy and Tolerability of Pancrelipase Microtablet (MT) Capsules for the Treatment of Cystic Fibrosis-Dependent Exocrine Pancreatic Insufficiency - Oklahoma http://www.clinicaltrials.gov/ct2/show/NCT00662675?term=cystic+fibrosis&recr=Open&rank=50
- Dissection of Staphylococcus Aureus Infection From Colonization in Cystic Fibrosis Patients (StaphCI) - Germany http://www.clinicaltrials.gov/ct2/show/NCT00669760?term=cystic+fibrosis&recr=Open&rank=51
- Dose Escalation Study of KB001 in Cystic Fibrosis Patients Infected With Pseudomonas Aeruginosa - all over the US http://www.clinicaltrials.gov/ct2/show/NCT00638365?term=cystic+fibrosis&recr=Open&rank=52
- ALTU-135 Efficacy Trial in Patients With Cystic Fibrosis-Related Exocrine Pancreatic Insufficiency - all over the US http://www.clinicaltrials.gov/ct2/show/NCT00449878?term=cystic+fibrosis&recr=Open&rank=54
- Magnetic Resonance Imaging (MRI) for Early Diagnosis of Cystic Fibrosis (CF) - Germany http://www.clinicaltrials.gov/ct2/show/NCT00760071?term=cystic+fibrosis&recr=Open&rank=55
- IGF-1 Therapy in Patients With Cystic Fibrosis New York http://www.clinicaltrials.gov/ct2/show/NCT00566241?term=cystic+fibrosis&recr=Open&rank=56
- Choline Nutrition in Children With Cystic Fibrosis (CF) - Canada http://www.clinicaltrials.gov/ct2/show/NCT00686361?term=cystic+fibrosis&recr=Open&rank=57
- Infant Study of Inhaled Saline in Cystic Fibrosis - all across the US http://www.clinicaltrials.gov/ct2/show/NCT00709280?term=cystic+fibrosis&recr=Open&rank=58
- FDG-PET Imaging in Young Cystic Fibrosis Patients - Missouri http://www.clinicaltrials.gov/ct2/show/NCT00846053?term=cystic+fibrosis&recr=Open&rank=59
- Ocular Surface Changes in Patients With Cystic Fibrosis - Poland http://www.clinicaltrials.gov/ct2/show/NCT00345280?term=cystic+fibrosis&recr=Open&rank=61
- The Short Term Safety and Efficacy of Inhaled L-Arginine in Patients With Cystic Fibrosis - Canada http://www.clinicaltrials.gov/ct2/show/NCT00405665?term=cystic+fibrosis&recr=Open&rank=64
- Efficacy and Safety Study of Inhaled Glutathione in Cystic Fibrosis Patients - Germany http://www.clinicaltrials.gov/ct2/show/NCT00506688?term=cystic+fibrosis&recr=Open&rank=65
- NAC Phase IIB: A Multi-Center, Phase IIB, Randomized, Placebo-Controlled, Double-Blind Study Of The Effects Of N-Acetylcysteine On Redox Changes and Lung Inflammation In Cystic Fibrosis Patients - CA http://www.clinicaltrials.gov/ct2/show/NCT00809094?term=cystic+fibrosis&recr=Open&rank=66
- Sleep in Patients With Cystic Fibrosis (Sommeil) - France http://www.clinicaltrials.gov/ct2/show/NCT00804661?term=cystic+fibrosis&recr=Open&rank=68
- Prevalence of Chronic Rhinosinusitis, Germ-Colonisation and Ability to Smell in Cystic Fibrosis - Germany http://www.clinicaltrials.gov/ct2/show/NCT00803881?term=cystic+fibrosis&recr=Open&rank=69
- Effects of Vitamin D Supplementation on Lung Function in an Acute Pulmonary Exacerbation of Cystic Fibrosis - Georgia http://www.clinicaltrials.gov/ct2/show/NCT00788138?term=cystic+fibrosis&recr=Open&rank=72
- Study on the Efficacy of Slow Release Insulin in Cystic Fibrosis Patients With Glucide Intolerance and Clinical Decay- Italy http://www.clinicaltrials.gov/ct2/show/NCT00687466?term=cystic+fibrosis&recr=Open&rank=73
- Genetic Modifiers of Cystic Fibrosis: Sibling Study - Maryland http://www.clinicaltrials.gov/ct2/show/NCT00037778?term=cystic+fibrosis&recr=Open&rank=76
- Early Diagnosis of Diabetes Mellitus in Patients With Cystic Fibrosis - all over Europe http://www.clinicaltrials.gov/ct2/show/NCT00662714?term=cystic+fibrosis&recr=Open&rank=78
- Miglustat in Cystic Fibrosis- Belgium http://www.clinicaltrials.gov/ct2/show/NCT00742092?term=cystic+fibrosis&recr=Open&rank=80
- Nasal Inhalation of Tobramycin in Patients With Cystic Fibrosis and Pseudomonas Aeruginosa Colonization - Germany http://www.clinicaltrials.gov/ct2/show/NCT00774072?term=cystic+fibrosis&recr=Open&rank=82
- Study About Complications of Totally Implanted Venous Access Devices (TIVADs) in People With Cystic Fibrosis (CF) - Italy http://www.clinicaltrials.gov/ct2/show/NCT00670579?term=cystic+fibrosis&recr=Open&rank=83
- Biodistribution of Neutrophile Proteases in the Sputum of Patients Affected by Cystic Fibrosis (Pro-Muco) - France http://www.clinicaltrials.gov/ct2/show/NCT00750932?term=cystic+fibrosis&recr=Open&rank=84
- Phase II Study of the Safety and Efficacy of Inhaled Alpha-1 Antitrypsin (AAT ) in Cystic FibrosisPatients - Israel http://www.clinicaltrials.gov/ct2/show/NCT00499837?term=cystic+fibrosis&recr=Open&rank=90
- CFF Biomarkers of Exacerbation - all over the US http://www.clinicaltrials.gov/ct2/show/NCT00788359?term=cystic+fibrosis&recr=Open&rank=91
- Study of Tauroursodeoxycholic Acid for Hepatobiliary Disease in Cystic Fibrosis - Colorado, Ohio and Italy http://www.clinicaltrials.gov/ct2/show/NCT00004441?term=cystic+fibrosis&recr=Open&rank=94
- Study of Hepatic Glucose Production and De Novo Lipogenesis in Patients With Cystic Fibrosis - Texas and Utah http://www.clinicaltrials.gov/ct2/show/NCT00014781?term=cystic+fibrosis&recr=Open&rank=95
- Randomized Study of Alendronate in Adult Patients With Cystic Fibrosis Related Osteoporosis - North Carolina http://www.clinicaltrials.gov/ct2/show/NCT00004489?term=cystic+fibrosis&recr=Open&rank=96
- Long-Term Study, Comparing Vest Therapy to Positive Expiratory Pressure (PEP) Therapy in the Treatment of Cystic Fibrosis - Canada (maybe a chance for you Canadians to get a hold of a Vest!!!) http://www.clinicaltrials.gov/ct2/show/NCT00817180?term=cystic+fibrosis&recr=Open&rank=97
- Zinc Homeostasis and Kinetics in Children With Cystic Fibrosis (CF) - Texas http://www.clinicaltrials.gov/ct2/show/NCT00104494?term=cystic+fibrosis&recr=Open&rank=99
- Cystic Fibrosis (CF) Leukocyte Genes as Biomarkers for Novel Therapies - Colorado http://www.clinicaltrials.gov/ct2/show/NCT00727285?term=cystic+fibrosis&recr=Open&rank=103
- Quantification of Pulmonary Neutrophil Activity in Cystic Fibrosis Using Radiolabeled Fluorodeoxyglucose and PET Imaging - Missouri http://www.clinicaltrials.gov/ct2/show/NCT00023465?term=cystic+fibrosis&recr=Open&rank=104
- Role of Toxins in Lung Infections Caused by Pseudomonas Aeruginosa - Maryland, Washington and Wisconsin http://www.clinicaltrials.gov/ct2/show/NCT00027183?term=cystic+fibrosis&recr=Open&rank=105
- Use of a Biofilm Antimicrobial Susceptibility Assay to Guide Antibiotic Therapy - Canada http://www.clinicaltrials.gov/ct2/show/NCT00786513?term=cystic+fibrosis&recr=Open&rank=112
- Safety, Tolerability and Efficacy of MP-376 Given for 28 Days to Cystic Fibrosis (CF) Patients - all over the US, Germany and the Netherlands http://www.clinicaltrials.gov/ct2/show/NCT00677365?term=cystic+fibrosis&recr=Open&rank=114
- Investigating Mucinase Activity in Airway Disease - CA http://www.clinicaltrials.gov/ct2/show/NCT00596232?term=cystic+fibrosis&recr=Open&rank=128
Tuesday, March 10, 2009
I snuck in some exercise today (cardio.... 2/5). Tuesdays aren't usually my exercising days because I'm so darn busy, but I wanted to sneek it in in homes to increase my chances of reaching 5/5 for cardio. It's HARD. But I can do it.
Tomorrow I get re-scanned for my DVT (can you believe it's been 6 weeks already???). Hopefully we have shown some progress. As I've told many of you, swelling and tenderness went down 10 hours after my very 1st Lovenox dose 6 weeks ago and I haven't seen any symptoms since.
The Lovenox hasn't been too hard to remember - I just do what I do with all my other meds - set an iCal appointment on my computer and have it pop up 2x a day to remember to take the shot. I've had quite a bit of bruising from the shots on both sides but it doesn't really hurt and goes away quickly.
I'll let you know the verdict tomorrow.
Monday, March 9, 2009
Sunday, March 8, 2009
Oh and I just did my eliptical and weights right now so that's 5/5 and 3/3. Yey!!!!
Hop everyone is doing great with their exercise goals. I'd love any updates if you have them. I follow some of you on your blogs so I get them that way.
Here's to a great week!
Friday, March 6, 2009
Some of my biggest CF issues throughout my life have been inflammation - mostly from allergies but the past few years it's also due to residual inflammation from colds. Oh yes and having a company retreat in Vegas where I was dealing with cig smoke EVERYWHERE and perfume pumped in to cover the cig smell. Ugh.
I have a long, tortuous history with coughing so hard I barf from bronchospasm due to inflammation.
For years (like 1989-2004) I tried various techniques like hot tea, eating food, breathing through my nose and out through my mouth. The highlight was always lettuce coming out of my nose from coughing so hard, throwing up, and now catching it in my mouth.
I was in the ER in 2004 due to bronchospasm (and not being able to catch my breath) after cleaning my house (I hired a house cleaner from there on out) and the doc gave me what I now call my secret weapon: benzonatate (or tessalon pearls, their brand name).
Basically, it numbs the stretch sensors in the lungs. Yes, I know our docs don't like us to take cough suppressants but sometimes you need HELP to cut off the cycle of bronchospasm. Benzonatate works in 15-20 minutes (although my experience is more like 2 minutes) and lasts for 3 hours. Drowsiness can be a side effect but I've never experienced it. Oh yes, and it's been on the market since 1954 (it's an Rx - FDA approved!)
My CF doc is OK with Rx-ing me it now because he knows I use it responsibly and only in those horrible situations. I do enough mucus clearance with the Vest and exercise that of course I'm not surpressing mucus clearance ....
Not sure why more CF docs (and even mine) don't talk about this. But it's a true God-send.....
Thursday, March 5, 2009
That post-cost tickle nearly sidelined me from working out today. But I snuck in a 1/2 hour of cardio when I felt the tickle monster wouldn't totally dominate me. That's 3/5 for cardio and 2/3 for weights.
In addition to my cardio, I did plee's (however you spell it) to mix things up. Oooooooh my inner thighs will feel it tomorrow!
So I did my cardio today (2/5) and weights (2/3). I'm still battling the remants of this cold (you know how that goes, right? The virus is gone but the inflammation in the lungs certainly is not... and neither are the accompanying bronchospams ugh!!!).
But I managed a decent work out despite eating an inappropriate amount of dates today. I have no idea why I ate so many... they taste SO GOOD. so sweet. man.
Ya and I did that two days ago too. I don't think it's necessarily too too bad for me other than the fact that it's taking the place of other healthy food I normally eat and I think diversity in food is probably a good thing. Anyway.
TOO MANY DATES :) But not too much exercise. Hope everyone is well!
Tuesday, March 3, 2009
- Paediatr Drugs. 2005;7(6):353-63.
Leukotriene receptor antagonists in children with cystic fibrosis lung disease : anti-inflammatory and clinical effects.
Department of Pediatrics, University of Bonn, Bonn, Germany. firstname.lastname@example.org
Cystic fibrosis (CF) lung disease is characterized by chronic endobronchial infection resulting in progressive pulmonary destruction; this is a major cause of mortality and morbidity. Neutrophils are the primary effector cells responsible for the progressive deterioration of lung function. Peptido-leukotriene B4 antagonists, new anti-inflammatory agents that block the neutrophil-dominated inflammation, could have had the potential for long-term use.
A trial on the pharmacokinetics of amelubant administered orally as a single dose of up to 75 mg in pediatric patients with CF and 300 mg in adults, and as a repeated dose of 75 mg and 150 mg, respectively, once daily for 15 days provided evidence that amelubant metabolism in adult and pediatric patients with CF is similar to that in healthy adults. In another study using the same dosage regimen, amelubant appeared to be safe and well tolerated.
Safety measures included physical examination, vital signs, spirometry, oximetry, ECG, and clinical laboratory testing. However, a randomized, double-blind, placebo-controlled, multinational, phase II trial (Boehringer Ingelheim 543.45) was conducted to investigate the clinical efficacy of 24 weeks of treatment with amelubant in patients with CF with mild-to-moderate lung disease. Two doses of amelubant (75 and 150 mg) were tested in adult patients (> or = 18 years) and one dose of amelubant (75mg) was tested in pediatric (6-17 years) patients. The trial was terminated early due to a statistically significant increase in the risk of pulmonary-related, serious adverse events in adults receiving amelubant.
Cysteinyl leukotrienes, eosinophilic inflammation, and viral infections also contribute to progressive pulmonary destruction in CF. Cysteinyl leukotrienes are potential targets for cysteinyl leukotriene receptor antagonist use. A study on the pharmacokinetics of montelukast in children with CF provided evidence that the dose of montelukast and the administration interval does not need to be modified if the goal is to mimic the serum concentrations used to treat asthma.
In a randomized, double-blind, crossover, placebo-controlled study, 16 children with mild CF (median age 9.5 years; vital capacity [VC] >70%) were treated with montelukast (5 to < or ="14">14 years; 10 mg) or placebo as a once-daily tablet for 21 days. There was a significant (p < or = 0.02) reduction in serum eosinophil cationic protein levels and eosinophils (p < or = 0.027) with montelukast. However, neither lung function tests (VC, forced expiratory volume in 1 second [FEV1], maximum expiratory flow at 25% of forced VC), nor clinical symptom scores changed significantly.
In another study, 26 patients aged 6-18 years with moderate CF (VC between 40% and 69% predicted) received montelukast or placebo for 8 weeks in a 20-week, randomized, double-blind, crossover, placebo-controlled trial. After treatment with montelukast there was a significant improvement in FEV1, peak expiratory flow, and forced expiratory flow between 25% and 75%, and a significant decrease in cough and wheezing scale scores (p <>
- Ann Allergy Asthma Immunol. 2005 Oct;95(4):372-80.
Effects of montelukast treatment on clinical and inflammatory variables in patients with cystic fibrosis.
Department of Pediatrics and Allergy, M Curie Hospital, Zgierz, Poland. email@example.com
BACKGROUND: In cystic fibrosis (CF), the inflammatory process contributes to progressive lung tissue damage. Cysteinyl leukotrienes have been found in the sputum of patients with CF at high concentrations sufficient to cause potent biological effects. OBJECTIVE: To evaluate the effect of anti-inflammatory treatment with montelukast sodium in patients with CF.
METHODS: Twenty-six patients aged 6 to 18 years were recruited to this 20-week, randomized, double-blind, placebo-controlled, crossover trial. Patients received montelukast or placebo for 8 weeks in addition to their regular CF treatment. Before and after treatment, findings from spirometry, whole-body plethysmography, and the clinical wheezing and cough scales were evaluated. At the same time, serum and sputum samples were obtained for the measurement of eosinophil cationic protein, interleukin 10 (IL-10), IL-8, and myeloperoxidase levels.
RESULTS: Twenty-three patients completed the study. Compared with placebo use, montelukast treatment significantly improved forced expiratory volume in I second, peak expiratory flow, and forced expiratory flow between 25% and 75% and significantly decreased cough and wheezing scale scores (P < .001 for all). There were no significant changes in vital capacity, thoracic gas volume, airway resistance, and residual volume after treatment. Compared with placebo use, montelukast treatment decreased serum and sputum levels of eosinophil cationic protein and IL-8, decreased sputum levels of myeloperoxidase, and increased serum and sputum levels of IL-10 (P < .001 for all).
CONCLUSIONS: Montelukast may have measurable anti-inflammatory properties in patients with CF.
- Ann Allergy Asthma Immunol. 2002 Dec;89(6):599-605.
- Comment in:
- Respir Med. 2007 Mar;101(3):684.
Anti-inflammatory effects of montelukast in mild cystic fibrosis.
Children's Hospital Medical Center, University of Bonn, Bonn, Germany. firstname.lastname@example.org
BACKGROUND: Immune-mediated inflammation contributes to progressive pulmonary damage in cystic fibrosis (CF). Sputum cysteinyl leukotriene levels, eosinophil cationic protein (ECP), and interleukin-8 (IL-8) are significantly related to disease severity.
OBJECTIVE: The aim of this study was to evaluate the anti-inflammatory and clinical effects of the cysteinyl leukotriene receptor antagonist montelukast in children with CF.
METHODS: A double-blind, randomized, crossover design was used. Patients received montelukast (6 to < or =" 14"> 14 years, 10 mg) or placebo as a once-daily tablet for 21 days and then, after a washout period of at least 4 weeks, crossed over to receive the alternative treatment. Blood and native nasal fluid were taken on days 1 and 21 of each treatment block, and WBC count, ECP, and IL-8 were analyzed using a chemiluminescent immunometric assay.
RESULTS: Sixteen CF patients (10 boys, 6 girls; age, 5 to 18 years, median 9.5 years) completed the trial. There was a significant (P < or = 0.02) reduction of serum ECP (median reduction: montelukast 7.7 microg/L vs placebo 0.15 microg/L) and eosinophils (P < or = 0.027; median reduction: montelukast 85/microL vs placebo 0/microL). There was no significant change in nasal ECP, IL-8, or serum IL-8 after a 21-day course of montelukast. Clinical symptom scores did not change significantly.
CONCLUSIONS: Montelukast reduces eosinophilic inflammation in CF patients. Multicenter trials providing more patients to create more data to prove the hypothesis that montelukast is an effective tool to cut down disease severity in CF patients are needed.
Monday, March 2, 2009
It took lots of talking myself into it, but I exercised with this cold. I'm always glad I do it after the fact - I get up lots of junk and I swear the hard breathing forces my constricted air open!
I didn't exercise like I was supposed to this weekend because I was sleeping the whole dang time.
I'm glad you guys liked my CF Story post.... I hope some of the rest of you will do it too!