Health Tips from Canada Pharmacy

At My Canadian Pharmacy, customers’ health is always put into perspectiveAt Canada Pharmacy, customers’ health is always put into perspective, instead of the company just trying to maximize profits as many others do. As a result, they try to make website a place where you can do a lot more than just shop for pharmaceuticals. They believe that it is highly important to know how can you maintain your health in good condition, and would like to help you do that. Of course, you could always purchase high-quality medications from us and treat most medical conditions, but isn’t it better to prevent as many health problems as possible?

The world around us sometimes gives us too much to deal with, so it is important to know how to relax, forget your problems for a while, and get some rest. However, it is not as simple as it might seem, and a healthy lifestyle is a lot more than just having a well-balanced diet and playing sports or exercising. The advice that you might find on some other websites is known to be controversial or confusing sometimes, but you can forget about that, because My Canadian Pharmacy experts are going to dispel the most popular health myths for you and give you some valuable advice that might motivate you to change your lifestyle completely.

Since there are many aspects of health, the questions will be sorted into several categories, such as:

  • Sport, fitness and working out
  • Most common diseases
  • Diets and weight loss
  • Sex and relationships
  • Mental health and well-being

Here’s a taste of what you are going to get from My Canadian Pharmacy Experts.

  1. Sports, fitness and working out

Do I have to measure my heart rate while exercising?

The answer is “no”. Unless you have been told to do so by a doctor because of your cardiac problems, there is hardly any need to know your exact heart rate during workout sessions. If you are a professional runner, cyclist or athlete, you might want to track your heart rate for the sake of making the most of your training sessions. If you’re just exercising to be fit and healthy, you won’t benefit from tracking your heart rate.

Some people might argue that it is useful to know their heart rate while exercising so that they can compare it with the “ideal” value. This value can be calculated according to several formulas, the most popular of which is “220 – one’s age in years”. However, few people are aware that these formulas don’t necessarily produce an accurate and representative value.

Conclusion: generally, there is no need to monitor your heartbeat when you exercise unless you are suffering from cardiac problems, and overstraining yourself might lead to dangerous consequences.

  1. Most common diseases

Do younger women face a smaller risk of heart diseases?

The answer is “no”. The stereotype that women aged under forty are highly unlikely to suffer from heart problems is persistent, but nonetheless false. While it is true that heart diseases tend to affect men at an age younger than women (about 10 years more of a “safety zone” for women, according to statistical data), the influence of risk factors is undeniably stronger as compared to the age factor. If a young woman is obese, has type II diabetes or hypertension (the most common risk factors for heart diseases), she is still likely to face cardiac problems. Women tend to be more resilient to heart diseases, particularly heart attacks, partly due to estrogen, which is known to be capable of preventing cardiovascular diseases. However, with the risk factors becoming more and more common even in younger generations, estrogen cannot be a safety guarantee for young women.

Conclusion: women and men are likely to start experiencing cardiac problems after their sixties and fifties, respectively, which does mean that women are less susceptible to heart diseases. However, younger women who are exposed to risk factors are as likely to suffer from cardiovascular diseases as the older generations.

  1. Diets and weight loss

I want to lose weight, should I go on a diet?

You are more likely to benefit from a complex lifestyle change

The answer to this eternal question is “no”. Some diets (mind you, not all of them) could indeed help you lose weight, maybe even in rather short terms. The problem is, it is not easy for many people to give up on their favorite foods, and when they finally see the desired number on the scales, they are very likely to forget about the diet. In many such cases, people resume their eating habits and quickly regain the weight lost that took such great effort. Another drawback of many diets is the fact that they are unbalanced, and often deprive your organism of many substances that it needs to function normally.

Conclusion: even though diets might turn out to be effective, they can also be a rather unhealthy way of losing weight, as it is stressful for the body. You are more likely to benefit from a complex lifestyle change: modify your eating habits to achieve well-balanced nutrition, join a gym, try to be as active as you can and always get enough sleep.

  1. Sex and relationships

        Is it always necessary to bring an argument to an end before going to bed?

The answer is “no”. The stereotype that you should try to resolve everything that bothers you before you go to bed might be practical, but sometimes, it will be a lot more detrimental to your mental health to continue an argument than to have a rest and possibly start a calmer discussion next morning. You might need some time to analyse your behaviour, and it might just so happen that your point of view will change completely by morning. The same is true for your partner. Even if you’re so upset or angry that you can’t fall asleep, it might be better to cool down than to go on with the argument when you and your partner are already so exhausted from the fight that any chance for objectivity on either side is long gone.

Conclusion: sometimes, putting an argument off till next morning is a much better option than taking it further into the night. If you happen to fight over some petty things, during such pauses, you might realize that they weren’t worth it at all.

  1. Mental health and well-being

                Are most mental illnesses untreatable?

The answer is “no” again. Mental illnesses are rather common (about 20% of the Earth’s population have suffered from a mental health disorder at least once in their lives), but fortunately, the majority of them can be addressed. Even if the condition is not completely cured, it is often possible to relieve its symptoms and stop the disorder from progressing. It is highly important that mental health patients acknowledge their problem and do their best to deal with it. Support from their friends and family often means a lot to them, and just by being a good listener and showing some empathy, you might be able to help your friend or relative get back on track faster.

Conclusion: mental illnesses are obviously very complicated and hard to analyse, but medical science has been able to come up with some ways of treating them. People diagnosed with a mental disorder won’t have to remain in that condition for the rest of their lives, as there is a variety of therapies available to address their mental health issues.

Article by Andrew Simons MD from My Canadian Pharmacy Team:

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Health Care Mall: Therapy for BaSO4

Therapy for BaSO4 aspiration depends upon its severity. Initial management includes aggressive bronchoscopic suctioning and postural drainage. BAL is controversial since the contrast medium can be diluted and dispersed into other areas. Patients should be closely monitored for respiratory distress after the procedure. Broad-spectrum antibiotic treatment can be initiated for fever or leukocytosis. Therapy for BaSO4

In addition to the liquid form of BaSO4, its tablet form has been used to evaluate swallowing function, and its accidental aspiration has been experienced, but not yet reported.

Alternate agents are also used to evaluate swallowing. Diatrizoic acid has been used as an oral contrast for CT scanning. However, diatrizoic acid is a hypertonic solution. It is a strong irritant and can induce severe pulmonary edema when aspirated into the lungs. Therefore, this contrast medium should not be considered as a substitution for BaSO4 in patients at risk for aspiration.

3,5-Diiodo-4-pyridone (Hytrast) and propyliodone (Dionosil) are commonly used for diagnostic bronchography. 3,5-Diiodo-4-pyridone is considered to have minimal pulmonary reaction, yet it has the tendency to cause alveolization and can result in fever, cough, and nausea. In addition, it causes significant pulmonary inflammation in animal models.

3.5- Diiodo-4-pyridone crystals caused an extensive polymorphonuclear reaction in the peribronchial alveolar spaces on the first day of exposure.

On the other hand, the use of propyliodone caused insignificant histologic changes in postmortem animal models. Only a slight macrophage reaction occurred on the first day after the exposure. Propyliodone should be preferred if aspiration is a concern.

Alendronate sodium (alendronate) has been commonly used for the treatment of osteoporosis and hypercalcemia of malignancy. Alendronate inhibits osteoclast-mediated bone resorption. Erosive esophagitis is a common complication of alendronate. However, the report of aspiration of alendronate pills is very rare. Alendronate was reported to cause severe tracheobronchitis, which progressed over several days after aspiration. Necrotic injury of bronchial mucosa and pseudomembranous formation, which resulted in airway obstruction, was described in this type of injury. Extensive debridement with rigid bronchoscopy was performed to remove necrotic debris from the airway. Thus, the use of alendronate in patients with aspiration risk should be cautious.

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Canadian Health Care Mall: Evaluation and Management of Pill Aspiration

Pill aspiration represents a unique type of foreign body aspiration requiring a distinct diagnostic and therapeutic approach. In many cases, the “foreign body” itself may no longer be present, whereas the airway manifestations may persist for months to years. Limited data exist to guide management decisions. We report two cases of severe airway injury secondary to pill aspiration and provide a review of the literature. Endobronchial surveillance may be important to identify impending airway obstruction via secretions, edema, granulation tissue, or fibrotic stricture. In many cases, the airway sequelae of pill aspiration can be effectively managed with bronchoscopy.

Pill Aspiration

Pill Aspiration

Aspiration of iron tablets is well documented to result in airway injury, including mucosal damage and bronchial stenosis. However, there are few reports of other pills resulting in airway damage. Here, we describe two cases of severe airway injury following pill aspiration. Prior reports of pill aspiration are also discussed, including presentation, diagnostic features, and outcomes.

A 77 year old man with a history of obesity hypoventilation syndrome, hypertension, and rhinosinusitis was referred for evaluation of cough productive of black sputum of 1 week in duration. The cough began immediately following aspiration of a capsule of concentrated pomegranate.

On physical examination, the pulse oximetry was 93% on room air. Examination of the chest revealed diffusely rhon-chorous breath sounds and wheezing over the left side of the chest. The remainder of the examination was unremarkable. A chest radiograph (CXR) showed linear atelectasis in the left lower lobe. CT scan of the chest was notable for diffuse thickening of the trachea, left mainstem bronchus, and left upper and lower lobe bronchi.

Flexible bronchoscopy revealed adherent yellow mucosa extending down the left side of the trachea and into the left mainstem bronchus. The left mainstem bronchus was circumferentially stenotic to approximately 8 mm because of thick, irregular-appearing dark brown tissue. The following day, rigid bronchoscopy with debridement of sloughing necrotic tissue and balloon dilation of the left mainstem bronchial stenosis was performed. Tissue biopsies revealed “necrotic plant material,” a known component of the capsule of the pill.

Three additional rigid bronchoscopies with balloon dilation were required over the next 4 weeks to maintain patency of the left mainstem bronchus. Over the ensuing 6 months, surveillance bronchoscopy revealed gradual healing of the airway injury and patency . No additional interventions were required.

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VKA therapy

First, the experiments of Wessler and Gitel over 40 years ago using a stasis model of thrombosis in rabbits showed that the antithrombotic effect of warfarin requires 6 days of treatment, whereas an anticoagulant effect develops in 2 days. The antithrombotic effect of warfarin requires the reduction of prothrombin (factor II), which has a relatively long half-life of about 60 to 72 h, compared with 6 to 24 h for other vitamin K-dependent factors that are responsible for the more rapid anticoagulant effect. VKA therapy

Second, in a rabbit model of tissue factor-induced intravascular coagulation the protective effect of warfarin was mainly a result of lowering prothrombin levels. Third, Patel and associates demonstrated that clots formed from umbilical cord plasma containing about half the prothrombin concentration of plasma from adult control subjects generated significantly less fibrinopeptide A than clots formed from maternal plasma. The view that warfarin exerts its antithrombotic effect by reducing prothrombin levels is consistent with observations that clot-bound thrombin is an important mediator of clot growth, and that reduction in prothrombin levels decreases the amount of thrombin generated and bound to fibrin, thereby reducing thrombogenicity.

The suggestion that the antithrombotic effect of warfarin is reflected in lower levels of prothrombin forms the basis for overlapping the administration of heparin with warfarin until the PT or INR is prolonged into the therapeutic range during the treatment of patients with thrombosis. Since the half-life of prothrombin is about 60 to 72 h, at least 4 days of overlap is necessary. Furthermore, the levels of native prothrombin antigen during warfarin therapy more closely reflect antithrombotic activity than the PT.

The PT test is the most common test used to monitor VKA therapy. The PT responds to a reduction of three of the four vitamin K-dependent procoagulant clotting factors (ie, II, VII, and X) that are reduced by warfarin at a rate proportional to their respective half-lives. Thus, during the first few days of warfarin therapy the PT reflects mainly a reduction of factor VII, the half-life of which is approximately 6 h. Subsequently, the reduction of factors X and II contributes to prolongation of the PT. The PT assay is performed by adding calcium and thromboplastin to citrated plasma.

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Thromboplastins vary in responsiveness to a reduction of the vitamin K-dependent coagulation factors. An unresponsive thromboplastin produces less prolongation of the PT for a given reduction in vitamin K-dependent clotting factors than a responsive one. The responsiveness of a thromboplastin can be measured by assessing its international sensitivity index (ISI) [see below]. Highly sensitive thromboplastins (ISI, approximately1.0) that are composed of human tissue factor produced by recombinant technology and defined phospholipid preparations are now available.

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Health&Care: Bronchial Dilatation in Asthma

The present study can also be criticized due to the lack of objective measurement of drug compliance; however, we asked the compliance during every visit and always encouraged the patients to take their medication regularly. We believe that if someone is motivated to visit our laboratory as many as 10 times during 6 months, he/she is probably also motivated to take the prescribed medication regularly. Bronchial Dilatation in Asthma

In conclusion, mannitol challenge is both a sensitive and valid test to demonstrate the effects of ICS in asthma. If this challenge will be used to monitor the effect of ICS in asthma, the goal of treatment Viagra NZ should be unresponsiveness. Histamine challenge seems also to be a sensitive test for this purpose, but its validity may be lower than that of mannitol challenge. Cold air challenge, in turn, seems to be a valid test to demonstrate the effects of ICS, but its sensitivity may be lower than that of mannitol and histamine challenges.

Background: Investigations using high-resolution CT (HRCT) show that bronchial dilatation (BD) is found in many patients with asthma. However, the pathogenesis and pathophysiologic relevance of BD in asthma are poorly understood. A balance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) may control the remodeling of extracellular matrix, and excess MMPs have been associated with destruction or dilatation of airways in patients with bronchiectasis. – this store specializes in the sale of Sublingual Viagra.

Objectives: To study the prevalence of BD as assessed by HRCT according to standard subjective criteria in 37 patients with stable asthma and 10 healthy control subjects, and to examine the relation of BD in asthmatic patients to clinical characteristics and sputum indices, including MMP-9 and TIMP-1 levels.

Design: A prospective cohort study.

Results: At least one dilated bronchus was present in 23 asthmatic subjects (62%) and 2 control subjects (20%) [p = 0.030]. The ratio of dilated bronchi to all eligible bronchi in each subject (individual BD%) was higher in the asthmatic patients than in the control subjects (11.4 ± 16.1% vs 1.3 ± 3.0%, p = 0.011) [mean ± SD]. Asthmatic patients with (n = 23) and those without BD (n = 14) were similar with regard to age, duration and severity of asthma, atopy, pulmonary function, sputum eosinophil or neutrophil count, and sputum levels of MMP-9 or TIMP-1 and their molar ratio. Individual BD% of asthmatic patients was also unrelated to these clinical and sputum variables. When analysis was confined to the 23 patients with BD, however, individual BD% correlated with the severity score of asthma (r = 0.49, p = 0.023). The results of follow-up HRCT obtained from 19 patients suggested that BD was a fixed rather than transient phenomenon.

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Enzyme-Inducing Drug Interactions With Warfarin

Italics indicates those drugs that have supporting level I evidence from both patients and volunteers. tIn a small number of volunteer subjects, an inhibitory drug interaction occurred. j Level II evidence of potentiation in patients.

Table 3—Enzyme-Inducing Drug Interactions With Warfarin

Inducing Agent Isoenzyme Inducedt Expected Onset, d Anticipated Dosage Adjustments, % Expected Offset, d
Carbamazepine CYP3A4 10-35 100j 42
Barbiturate§ CYP3A 7-30 12.5-25 j > 42
Phenytoin Nonspecific NA j| NA
Rifampin CYP3A4 < 7 100-200j 21
Griseofulvin^ Unknown 60 40j NA
Nafcillin NA < 7 100-400j 7-28
Dicloxacillin NA < 7 2-30j NA
Aminoglutethimide# CYP2B1 14 50-75j 14
Smoking CYP1A1, 1A2 NA jj NA
Health care mall CYP2E1 NA tt
41-54 gjj 250 g§§ j NA

NA = not available.

tInformation regarding induction of cytochrome-450 isoenzymes is limited. Current literature supports specific isoenzyme induction by the listed agent.

jAn increase in warfarin dosage is anticipated with initiation of the inducing agent.

§Class effect, although time course and extent may vary with the individual barbiturate.

A decrease in warfarin dosage is anticipated with initiation of the inducing agent.

Interaction is more likely with the ultramicrocrystalline formulation of griseofulvin.

Dose-response relationship, so that 250 mg four times/d showed greater induction than 125 mg four times/d.

Warfarin clearance increased, but a corresponding change in PT was not reported. See text for further details. ttNo change in warfarin dosage appears necessary based on available data.

jjRepresents ingestion of 41 to 54 g ethanol consumed either as a single dose or daily for 21 days.

§§Represents ingestion of large amounts of ethanol (250 g) consumed daily for more than 3 months.

Doses of salicylates of > 1.5 g per day and acetaminophen may augment the anticoagulant effect of warfarin, possibly by interference with the P450 en-zymes. Heparin potentiates the anticoagulant effect of warfarin, but in therapeutic doses produces only a slight prolongation of the PT. The mechanisms by which eryth-romycin and some anabolic steroids potentiate the anticoagulant effect of warfarin are unknown. Sulfonamides and several broad-spectrum antibiotic compounds may augment the anticoagulant effect of warfarin in patients consuming diets that are deficient in vitamin K by eliminating bacterial flora and aggravating vitamin K deficiency.

Drugs such as aspirin, nonsteroidal antiinflammatory drugs, penicillins in high doses, and moxalactam increase the risk of warfarin-associated bleeding by inhibiting platelet function. Of these, aspirin is the most important because of its widespread use and prolonged effect. Aspirin and nonsteroidal antiinflammatory drugs can also produce gastric erosions that increase the risk of upper GI bleeding.

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Bilateral diaphragmatic paralysis

Severe diaphragm weakness producing respiratory failure in a MS patient has been reported. A 41-years old man with a three-year history of relapsing progressive MS acutely developed positional dyspnea, marked sensory loss in a C2-C5 distribution and urinary hesitancy. Esophageal and gastric pressure monitoring revealed no pressure gradient during tidal breathing, confirming the diagnosis of diaphragm weakness. Fifteen days later the patient developed increased limb paresis, tongue fasciculations and greater respiratory compromise, necessitating ventilatory support. This patient shared some features with the present case. Initially, signs indicated an incomplete high cervical cord lesion. Diaphragmatic pathways were affected, but considerable corticospinal tract functions remained.

The literature also contains two reports of central disturbances of respiration in MS referable to the brain stem. In 1977, Boor et al described reversible paralysis of automatic respiration on a background of acute bulbar dysfunction. The patient subsequently died and autopsy revealed a discrete plaque involving dorsomedial and central regions of the lower medulla. In contrast, Noda and Umezald have reported loss of voluntary breathing with preservation of automatic breathing in the setting of acute quadriplegia.

The present case differs substantially from previous reports of respiratory dysfunction in MS. The patient exhibited corticospinal dysfunction but no brain stem abnormalities. Limb paresis did not significantly interfere with ambulation or performance of ADL. The only disabling symptom was dyspnea, which developed insidiously and has now been present for over one year without increase in other neurologic signs. The MRI revealed extensive involvement of the upper cervical spinal cord, confirming the clinical impression. This is the first such case in which MRI is available to corroborate the diagnosis in vivo.

The diagnosis of bilateral diaphragmatic paralysis was made clinically at the bedside. Fluoroscopy alone may be unreliable, but the chest x-ray film findings, the patients spirometry result, inspiratory and expiratory muscle strength as well as the patients buy Viagra and Cialis clear history with the absence of other conditions that can give similar symptoms facilitated confirmation of the diagnosis.

The patients pulmonary symptoms were present for six months before the etiology was diagnosed. Diaphragmatic weakness is frequently overlooked in neurologic disease states. Careful evaluation of pulmonary dysfunction in MS patients may lead to earlier detection and intervention.

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Health News: Discontinuing smoking

Although our study demonstrates that airway inflammation persists in ex-smokers and is associated with increased extent of COPD-E 4 years later, there are several limitations in the study design, including the small number of subjects studied, the duration of having quit smoking before entering the study, the limited number of time-points studied, and the absence of a control group of study subjects with COPD-E who continued to smoke to compare the extent of airway inflammation and rate of decline in COPD-E in persistent vs ex-smokers. Although no sputum bacterial counts were assessed, subjects Viagra in Canada had no history of recent infection. Levels of mediators of inflammation may also be influenced by whether the sputum was spontaneous in subjects with chronic sputum production or induced as in this study, as well as by day to day variability in sputum mediator levels and the stability of mediators stored in a — 80°C freezer.

Because some mediator levels were lower at the first visit compared with the second visit, it is possible that either the stability of mediators in the freezer or bacterial colonization of sputum were the cause of changes in sputum mediator levels with time. An alternative explanation is that the day-to-day variability of sputum mediator levels in an individual subject contributed to the change in levels of sputum mediators noted. However, despite these limitations, in contrast to previous studies a significant strength of this study is the phenotyping of all subjects as having COPD-E based on chest CT scan at entry into the study and documenting changes in extent of COPD-E following 4 years of tobacco smoke cessation (documented by cotinine levels). This longitudinal biomarker study design differs from previous biomarker studies in COPD-E in which serial CT scans, biomarkers, and cotinine levels to verify smoking status were not obtained. In addition, prior studies have predominantly examined the effect of discontinuing smoking on end points other than emphysema (such as symptoms associated Viagra Australia Pharmacy with chronic bronchitis, lung function, and airway hyperresponsiveness).

In summary, in this study we have demonstrated that in subjects with GOLD stage IIb COPD-E, even after at least 4 years of not smoking, airway inflammation persists and that this is associated with continued airspace destruction as revealed by increased emphysema on CT scan.

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Subjects with COPD-E

Repeat visit cotinine assays confirmed that all the subjects with COPD-E were not smoking (cotinine levels at year 4 visit <10 ng/mL), and that the current smokers without COPD-E continued to be smokers (cotinine level at 2 years, 315 ± 84 ng/mL vs cotinine level at baseline, 224 ± 51 ng/mL).


This study demonstrated that ex-smokers with GOLD Stage IIb COPD-E who were followed for 4 years while not smoking have persistent airway inflammation Propecia in Canada detectable in sputum and progression of emphysema. The mediators of inflammation that persisted at elevated levels in sputum included mediators associated with neutrophil-mediated inflammation (MPO, LTB4, IL-8), mediators associated with recruitment of mononuclear cells (MCP-1), and mediators associated with extracellular matrix remodeling (MMP-9), all of which have been implicated in the pathogenesis of COPD. Interestingly, the subjects with COPD-E entered into this study were all ex-smokers who by history had not smoked for at least 2 years and had a history of not smoking for 15 ± 7 years. Although their past history of quitting smoking prior to entering the study was not verified by cotinine levels, we were able to verify by cotinine levels that they were not smoking at the baseline and 4-year follow-up visit. Thus, the persistent inflammation in sputum of subjects with moderate to severe COPD-E who have quit smoking is likely to be of even longer duration than the 4 years we have followed these subjects.

Although these mediators of inflammation have been detected at increased levels in sputum in several past cross-sectional studies of COPD, the majority of cross-sectional studies have not examined levels of these mediators in subjects phenotyped as having emphysema based on was done in this study. In addition, previous studies have not examined whether levels of mediators of inflammation persist in subjects with COPD-E phenotyped by repeat CT scans over a 4-year period. We are aware of a limited number of cross-sectional studies of biomarkers in BAL or sputum in subjects with COPD-E phenotyped by CT scan, including studies from our group and others, but none of these studies has evaluated changes in biomarkers of inflammation over time in relation to changes in the extent of COPD-E on chest CT scan in subjects with COPD-E who have quit smoking.

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Сhronic bronchitis and smoking

A longitudinal study by Parr et al of subjects with chronic bronchitis has demonstrated in a subgroup analysis that sputum MPO correlated with decline in FEV/ , sputum LTB4 with Dlco decline, and IL-8 with progression of lung densito-metric changes. In our study, no correlation of baseline inflammatory markers with progression of CT scan densitometry was observed. This difference from the study reported by Parr et al may reflect differences in patient phenotype or the number of subjects studied. However, in the current study there was a significant correlation between the change of sputum biomarker level and change in CT scan score for MPO and MCP-1 (e-Appendix 1, Figure 6). There was also a significant correlation between the baseline sputum mediator levels of either MPO or MCP-1 and change in volume-adjusted Dlco from baseline to year 4, as well as a correlation between the baseline sputum mediator level of MMP-9 and change in FEVfrom baseline to year 4 (e-Appendix 1, Fig 6 / .

The volume-adjusted Dlco correlated better than the non-volume-adjusted Dlco with the biomarkers measured (e-Appendix 1). The importance of using CT scans to phenotype subjects in studies of COPD-E and control subjects (such as current smokers without COPD-E) is the demonstration that, unlike the normal current smokers in this study, control “healthy” smoking subjects with near-normal FEV1 may have emphysematous lesions on CT scan and, thus, be misclassified if only pulmonary function studies and not CT scans are performed. Chest CT scans are providing an important method of documenting the extent of emphysema and have demonstrated canadian viagra online that the area of the lung with chest CT scan attenuation values below —910 HU and —950 HU correlates significantly with macroscopic and microscopic pathologic features of emphysema. Although there are many cross-sectional studies demonstrating the association of low attenuation on chest CT scan and emphysema, more recent longitudinal studies have investigated the progression of emphysema on chest CT scan over time periods ranging from 6 months to 5 years but have not examined longitudinal changes in levels of biomarkers of inflammation in relation to longitudinal changes in CT scans in ex-smokers.

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