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Here’s some good news for patients with chronic obstructive pulmonary disease (COPD) and other conditions with chronic mucus production. A new device called the Lung Flute, which has just been approved by the FDA, can vibrate away mucus by simply blowing into it. Blowing into the instrument sends a steady 16-hertz vibration into the user’s chest which breaks up mucus and allows the body to better expel the sticky substance. Although there are other devices that also use vibration to loosen mucus, the Lung Flute costs a great deal less at $40 a piece, making it much more accessible. See a video of the device in action here.  [via PopSci.com]

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Best of What’s New 2009: Playing the Lung Flute from PopSci.com on Vimeo.

According to the World Health Organization the number of reported cases of H1N1 influenza has increased by at least 24,000 in just the past two weeks. And with the new H1N1 vaccine just recently being distributed to the public the CDC is reaffirming the current vaccination guidelines. The groups most at risk, and therefore should be vaccinated are:

Please note that the  H1N1 vaccine is not intended to replace the seasonal flu vaccine. The seasonal flu and H1N1 vaccines may be administered on the same day.  [via CDC]

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The New York Times is reporting that the first injectable H1N1 vaccines have shipped from vaccine maker Sanofi-Aventis. Previously, the first H1N1 vaccinations were to be the live virus type, in the form of a nasal spray. However, live virus vaccines are not recommended for certain groups including pregnant women, people with health problems, and adults over the age of 50 – some of the groups most at risk should they contract H1N1 infection. Sanofi-Aventis has a contract with the US government to provide 75 million doses of the vaccine, which will be provided free to physicians and health care workers. Health officials say there will eventually be enough vaccine for anyone who wants one, but priority will be given to high-risk groups first. The seasonal flu vaccine is currently distributed in sufficient quantity to the general public. Stay tuned to for up-to-date recommendations for the H1N1 vaccine as it becomes more widely available. [via Kaiser Health News]

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Historically, pregnant women have been one of the groups least likely to get the flu vaccine for a variety of reasons. Not surprisingly, their reluctance to take any medication during pregnancy is one of the reasons for the low vaccination rates. Additionally, the majority of obstetricians do not routinely vaccinate their patients due to costs involved and that it’s not part of routine obstetrician training. Therefore, the CDC and American College of Obstetrics and Gynecology are urging obstetricians to partner with hospitals or drugstores to guarantee their patients a place to get the flu shot. A vaccine is a two-for-one deal during pregnancy. It can protect both mom and baby because the flu-fighting antibodies made by mom will cross the placenta to the fetus and can help protect the baby during its first few months of life. This is why health officials are working on increasing the number of vaccinated pregnant women this year, especially since pregnant women make up 6% of H1N1-confirmed deaths even though they account for only 1% of the population. [via NBC News]

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This is going to be a busy flu season, especially considering that there will be two different flu vaccines available – one for the seasonal flu and the other for H1N1 (swine) flu. There are different recommendations for both vaccines, but only the seasonal flu vaccine is currently available. The Centers for Disease Control and Prevention recommends any adult who wants to reduce their risk of becoming ill with influenza to get the vaccine. However, if you are on the fence about the decision here is an up-to-date list from the CDC of high risk groups that should not think twice about getting the vaccine:

• persons aged 50 years and older;
• women who will be pregnant during the influenza season;
• persons who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematological or metabolic disorders (including diabetes mellitus);
• persons who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus;
• residents of nursing homes and other long-term care facilities;
• health-care personnel;
• household contacts and caregivers of children aged <5 years and adults aged 50 years and older, with particular emphasis on vaccinating contacts of children aged <6 months; and
• household contacts and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

*If you have concerns about thimerosal or other vaccine preservatives, this year’s flu vaccine only comes in two flavors – latex-containing and latex-free. Neither contains thimerosal.

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If you have doubts that lack of health insurance can have deadly consequences, consider these new findings from the American Journal of Public Health: Americans without health insurance are 40% more likely to die than those with private insurance. The Harvard study reiterates a 1993 Institute of Medicine study, which found a 25% higher death risk among those without insurance compared with privately insured adults. Why does the uninsured face this greater risk? The Institute of Medicine identifies three factors that influence health outcomes: not getting care when needed, not having a regular source of care, and not getting continuity of coverage – all of these are difficult goals to accomplish for the uninsured. Approximately 45,000 Americans of working age die each year because they lack health insurance. [via Yahoo! News]

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I’ve had quite a number of patients come in lately for general check-ups because they will soon be losing their job-sponsored health insurance coverage. I commend them for coming in. After all, late is sometimes better than never. Therefore, for today’s post I’d like to share some tips on things you should consider when your coverage is about to end.

1. Get an annual physical exam, including a skin check for possible skin cancers. It could get pricey should you need a biopsy and subsequent treatment.

2. Get your routine tests done. Those over 50 years of age should get a colonoscopy every 10 years. Women over 40 should have an annual mammogram. Women should also get annual pap smears.

3. Know your numbers: check your blood pressure, cholesterol, basic chemistries, urine analysis.

4. If you’re a smoker, speak to your doctor about ways to help you quit. Quitting smoking greatly reduces your risk of cancers and cardiovascular disease.

5. Ask your doctor about your risk for osteoporosis. In general all women over the age of 65 should get a DEXA bone densitometry scan at least once.

6. Speak to your doctor about weight loss. Keeping your weight under control can reduce your risk of diabetes, heart disease, high blood pressure, osteoarthritis, and high cholesterol, among a multitude of other diseases.

7. Get a flu shot and update your vaccinations. For adults these may include hepatitis A and B, herpes zoster (shingles), Tdap, chickenpox. If you are aged 65 or older you should have a pneumovax vaccination as well.

8. Refill your medications. Depending on the medicine, it may be possible for your physician to give you more refills. Similarly, if you are diabetic make sure your doctor gives you plenty of refills for glucose testing supplies.

*There are always exceptions to the rules. These are only general guidelines. Speak to your doctor to find out what is appropriate for you.

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Whether you know it or not, our nation’s health care system is gearing up for a fight with the H1N1 flu this fall. Health officials estimate that as students return to school, the number of infections could increase by ten-fold every two weeks. This has led authorities to expedite vaccine research and production. Right now, the target date for vaccine distribution is mid-October. However, the vaccine is still under testing. For example, it is as yet unclear what the exact dosage should be. Some experts, including Health and Human Services Secretary, Kathleen Sebelius, believe that in order to prevent infections from skyrocketing the vaccine should get the go ahead and be used even though full testing is not completed. Just as many experts say we should not risk using the vaccine without full and proper testing. What is agreed upon are who should get the first doses of the vaccine – namely, high risk groups that include pregnant women, health care and emergency personnel, people who live with or care for children younger than 6 months, people 6 months to 24 years old, and people age 25 to 64 who are at high risk due to chronic health disorders or compromised immune systems. [via ABC News]

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As the start of another school year is upon us, parents are asking what to do should their children come down with symptoms of influenza. The World Health Organization just released updated guidelines with regards to children and the H1N1 (swine) flu. The current recommendation is prompt treatment for children who show severe or deteriorating illness, and those at risk of more severe or complicated disease. This includes all children under 5 years of age because this age group is at an increased risk of severe H1N1 infection. Children who are otherwise healthy and older than the age of 5 do not need to be given antiviral medication unless their illness persists or worsen. Most patients, including children, who are infected with the pandemic H1N1 virus will experience typical influenza symptoms and fully recover within a week, even without any form of medical treatment. The two antivirals currently used are oseltamivir and zanamivir. They can help to reduce disease severity and reduce the need for hospitalization. [via WHO]

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The results of a game of historical epidemiology has been published in the Annals of Internal Medicine. The question: What did Wolfgang Amadeus Mozart die of? His early death at the age of 35 has intrigued historians around the world, and now researchers from Austria and the UK believe they may have solved the puzzle. According to eyewitnesses, Mozart’s body was very swollen before he died, suggesting he had edema (swelling due to excessive fluid build up in bodily tissues). By looking at historical death records around the time of Mozart’s death, the most common cause of death during that period that would have been associated with edema is streptococcal infection that led to kidney dysfunction, otherwise known in medical speak as acute poststreptococcal glomerulonephritis. During an infection with strep throat, your immune system can sometimes react in such a way that causes inflammation of the kidneys, leading to kidney failure, edema and even death (if left untreated). [ via Medical News Today]

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