
Timber! Bless you: Video shows Georgia tree releasing plume of pollen when cut down
Timber! Bless you: Video shows Georgia tree releasing plume of pollen when cut down
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Massive pollen plume rises from fallen tree
A tree full of pollen had to be cut down due to construction in Georgia.
Yeah, that's going to cause some sneezing.
Video of construction workers in Southern Georgia caused a tree to release a plume of pollen when it was cut down.
The plume is an impressive addition of pollen to a region struck with the allergen.
The Atlanta Allergy & Asthma's Pollen Counting Station shows "extremely high" pollen counts for three out of the four days this week.
The Climate Prediction Center says that the south is likely to see "well-above-average temperatures" in April, which would contribute to the pollen count rising.
Why is there so much pollen?
An unforeseen side effect of climate change is increased pollen counts.
Recent climate change has caused weather patterns to shift. There are more days without frost or freezes, warmer seasonal air temperatures and more carbon dioxide in the atmosphere, all of which can contribute to higher pollen counts and earlier pollen seasons.
Warmer temperatures and more carbon dioxide allow plants to grow more aggressively, which can account for more pollen in the air. Allergy season will likely continue to worsen for many individuals with tree, grass or weed allergies.
According to the Proceedings of the National Academy of Sciences of the United States of America, pollen amounts between 1990 and 2018 increased by up to 21%.
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3 days ago
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Diabetes Plus Asthma Equals Greater Metabolic Risk
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The findings 'emphasize the need for integrated clinical strategies that simultaneously target both inflammation and metabolic dysfunction in patients with asthma-diabetes comorbidity,' the authors wrote. 'Routine screening for insulin resistance and inflammatory markers in [these] patients may aid in early intervention and risk reduction.' This points to the need for integrated clinical care, Aguree told Medscape Medical News . 'For managing these comorbid conditions, healthcare professionals need to work together. I think that's a better way to treat the person than working in silos.' Bidirectional Relationship Commenting on the findings, Tianshi David Wu, MD, assistant professor of pulmonary and critical care at Baylor College of Medicine in Houston, told Medscape Medical News that these findings align with current evidence. 'Diabetes and asthma have a bidirectional relationship,' Wu explained. 'Population studies have shown that patients with diabetes are at higher risk of developing asthma later on, and vice versa. What's still unknown are the mechanisms that explain this finding.' Wu added that the researchers had put forth a reasonable hypothesis — that systemic inflammation may play a key role in this association. 'The best way to prove this would be with a trial that specifically targets the type of inflammation you think is driving both asthma and diabetes to see how it affects these conditions.' As a possible blueprint, he pointed to cardiology, where patients with heart failure and diabetes are preferentially treated with sodium-glucose cotransporter-2 inhibitors, which are effective at treating both conditions. 'In the asthma world, I don't think the evidence is there yet to recommend any specific diabetes medication, but there is plenty of real-world data suggesting some benefit, and there are two clinical trials ongoing testing semaglutide and metformin to see if they can improve asthma,' Wu said. Surprising Impact on Insulin Resistance The study included 18,370 nationally representative US adults. Among them, 8.2% had diabetes without asthma, 7.4% had asthma without diabetes, 83.3% had neither (controls), and 1.2% had both. BMI was highest in the combined asthma-diabetes group (35.9 kg/m2 vs. 28.2 kg/m2 in controls, P < .001), as was waist circumference (117.6 cm vs. 97.3 cm, P < .001). Insulin resistance, defined as a homeostasis model assessment of insulin resistance (HOMA-IR) > 2.5, was present in 41% of controls, 46.8% with asthma only, 77.3% with diabetes only, and 85.6% with both conditions. The HOMA-IR score in the asthma-diabetes group was significantly higher than in controls (9.85 vs. 2.96, P < .001). Logistic regression analysis confirmed that the odds of insulin resistance were nearly eight times higher in the asthma-diabetes group than in the control group (odds ratio [OR], 7.89, P < .001), even after adjusting for BMI, sex, and medication use. 'We didn't expect insulin resistance to be that much higher in the combination of asthma and diabetes. That shocked us,' Aguree said. Asthma alone was not significantly associated with insulin resistance (OR, 0.76, P = .220), 'underscoring the additive impact of coexisting diabetes,' the authors wrote in their poster. Additional Metabolic Outcomes Absolute values of LDL cholesterol were 115.9 mg/dL and 114.5 mg/dL, respectively, for controls and asthma only, vs 98.9 mg/dL and 104.8 mg/dL for diabetes only and asthma-diabetes groups, respectively. The lower value in those with diabetes is likely due to greater use of statins, Aguree noted. In contrast, compared with controls, those in the asthma-diabetes group had significantly lower levels of HDL cholesterol, while triglycerides and the triglyceride/HDL ratio were higher ( P < .001 for all). Systolic blood pressure was also significantly higher in the comorbid group ( P < .001), as was diastolic blood pressure, although to a lesser extent ( P = .012). A1c levels were 5.41% in controls and 5.46% in the asthma-only group, both significantly lower than levels in the diabetes group (7.34%) and the comorbid group (7.11%), Aguree said. Log-CRP values were 0.530 units higher in the asthma-diabetes group than in controls ( P < .001), as were hs-CRP (1.70 mg/L vs 0.60 mg/L, P < .001). Aguree and colleagues are now expanding their analysis to include longitudinal data and evaluate integrated interventions, such as combined anti-inflammatory and glucose-lowering medications, as a means of reducing the burden of both conditions. Aguree had no disclosures. Wu declared receiving funding from the National Institutes of Health and the American Lung Association.


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'If you see multiple patients a day, that 5 minutes really adds up,' said Edward Len, MD, a pulmonologist with the Mid-Atlantic Permanente Medical Group in Largo, Maryland. Social determinants of health that affect medication adherence may also need addressing, said Len. For example, physicians may need to determine if their patients have transportation to and from a pharmacy to pick up medications, as well as money for the copays. Medication Use Challenges Some treatable traits may be harder than others to manage from a primary care setting. Each type of inhaler requires a specific inhalation technique , and some patients must use multiple different types of inhaled medications to manage their obstructive lung disease — which requires them to master different techniques. Edward Len, MD Additionally, age and cognitive function can also affect a patient's ability to use their inhaled medications correctly, according to research. 'They don't recognize that they don't have optimal inhaler technique,' LaBedz said. 'They think they're doing it correctly.' Perhaps not surprisingly, perfect inhalation technique by patients is rare, which means that patients may not be receiving as much benefit from their inhaled medication as they should. And that's assuming that they're diligent about trying to use their medications. Theaforementioned study cited people forgetting to use their medication as one of its treatable traits. According to LaBedz, medication adherence among patients with COPD is below 50%. In fact, some research estimates that adherence among patients with obstructive lung disease is between 10% and 40%, even though they're more likely to experience exacerbations that lead to hospitalization when they're not properly taking their meds. 'If they're not using the inhaler, it's not going to work,' said Len. LaBedz said she would not expect a primary care provider to handle insufficient inhaler technique — at least not all by themselves. As a pulmonary specialist, she can offer an in-depth assessment of inhaler technique education and training. However, while primary care physicians may not always have time, primary care practices can designate and train a nurse to educate patients on proper inhalation technique, Pace suggested. 'Well-running primary care practices try to make sure that everyone is working at the peak of their license,' he said. Having in-house staff to work with patients on inhaler technique could also reduce the burden on the patient since they wouldn't have to make an additional visit elsewhere to receive training, Pace said. It may also reduce the likelihood that a patient would be a no-show at their follow-up visit, which research suggests is a common phenomenon among patients who receive a referral from a primary care physician to see a specialist. 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4 days ago
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Top Things Your Patients Need to Know About Asthma
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As a physician, you should encourage patients not to ignore asthma symptoms — no matter what they are. 'Keep an eye on your cough, wheezing, shortness of breath, and chest pain,' is what Diane Cymerman, MD, who specializes in allergy, asthma, and immunology at Stony Brook Medicine in Stony Brook, New York, says patients should be told. 'It's also important that you aren't relying solely on albuterol-type inhalers. If you need an albuterol-type inhaler more than 2 times per week, it's time to see a physician to begin asthma controller medications.' Here are five important things patients should know about asthma: 1. Watch for Early Symptoms If a patient has never been officially diagnosed with asthma, one sign that they might be developing the condition is long-term or persistent dry coughing, particularly at night or upon waking up. Routinely experiencing shortness of breath or chest tightness may also be an early sign of asthma. 'Cough is the most common symptom of asthma and usually starts long before asthma advances to wheezing,' said Angela Duff Hogan, MD, chair of the asthma committee of the American College of Allergy, Asthma, and Immunology. 'Recognizing this early symptom can help stop a full-blown asthma attack.' 2. Learn the Triggers While asthma triggers can sometimes depend on one's age, the long list of factors that can prompt asthma include bacterial sinus and respiratory infections — especially common viral infections. High on the list as well: Pollution, smog, strong odors or fumes, and lung irritants, including cigarette smoke or even sitting near a campfire. 'Exercise and taking aspirin or NSAIDs can also play a role in worsening asthma symptoms,' Hogan said. 'Emotional triggers, including stress, can also prompt asthma.' Other triggers that can exacerbate asthma symptoms include al lergens such as dust mites, roaches, pet dander, pollen, and mold spores. Allergy testing can identify what exactly a patient is allergic to, although that may require a referral to a specialist. Also, Nejat said, suggesting patients keep a diary of symptoms can be extremely helpful, especially when preparing for an appointment with an asthma specialist. 3. Fluctuating Weather It's normal to feel a worsening of asthma symptoms during extreme weather changes. In addition, damp weather spreads pollen and mold, which is yet another asthma trigger. Climate change, including longer pollen seasons and wildfires, have also contributed to breathing issues for those with the condition. ' The weather can certainly affect asthma,' Hogan said. 'Very cold air can cause the muscles that line your lung airways to tighten, and extremely hot temperatures can cause dehydration, which worsens asthma by thickening mucus, making it harder to breathe.' 4. Age of Diagnosis While one can develop asthma at any age, a family history of asthma and the presence of other allergy conditions could play a pivotal role. In addition, adult-onset asthma (meaning a diagnosis in anyone older than 20 years) is currently being studied due to the increase in adults developing asthma. The reasons for the connection aren't exactly clear but may relate to having a history of allergies (around 30% of adult asthma is triggered by allergies), acid reflux, or being exposed to certain irritants or air pollution. 5. Always Be Prepared Treatments for asthma can vary. For patients with well-controlled asthma, treatments can include maintenance inhaler therapy (or a rescue inhaler) for symptoms like coughing or wheezing. Inhaled corticosteroids may also be beneficial. Patients should always have their medicines handy — and never use expired medication. It's also critical that patients both know how to correctly use an inhaler and have an asthma action plan. A patient should never wait until their wheezing to get some relief. 'Let your inhaler be your bestie,' Hogan tells patients. 'Make sure you have it available and use it when you should.' If, however, a patient feels like their usual medications aren't effective, they shouldn't hesitate to seek out another option. 'You'll want to make sure your asthma specialist assesses the cause and offers you the best management of your symptoms,' Cymerman said. One final note for patients: 'Just because you feel 'well' doesn't mean that your asthma is gone or that you should stop your controller medicine,' Hogan said.