Saturday 16 October 2010

Laryngitis

What is laryngitis?

The larynx is the organ of voice. When we speak, two membranes in the larynx - the vocal cords - vibrate to make sound. Laryngitis refers to inflammation or irritation of the tissues of the larynx. It is the bane of performers and other professionals who depend on their voice for their art and livelihood.
What causes laryngitis?

Almost every person has experienced acute (sudden onset) laryngitis, usually associated with a viral infection of the upper airways. But the inflammation can be caused by any kind of injury including:

* infection
* vocal overuse
* smoking and other inhaled irritants
* drinking of spirits
* contact with caustic or acidic substances (including acid reflux from the stomach)
* allergic reaction
* direct trauma.

Why do the symptoms sometimes persist?

A more perplexing problem for professional voice users is laryngitis that is not associated with any signs of infection but which recurs or persists. This form of laryngitis, which lasts weeks or months, is termed chronic laryngitis.

Acute laryngitis may become chronic if the appropriate preventive measures are not adhered to rigidly.
What are the symptoms of laryngitis?

In acute laryngitis from a viral upper-respiratory infection, the voice becomes hoarse or is reduced to a whisper.

The most common symptom of early mild ‘irritative’ laryngitis is a feeling of postnasal drip with chronic throat clearing due to a sensation of secretions in the throat.

In chronic irritative laryngitis loss of voice quality with voice use, a feeling of irritation or of a lump in the throat, dryness or soreness (often worst in the morning upon wakening) may be features in addition to hoarseness (which often comes and goes).

Pain with laryngeal movements such as speaking or swallowing, is typical of more severe laryngitis. Chronic cough and wheeze brought on by exercise are signs of more advanced inflammation.
How is laryngitis diagnosed?

The diagnosis can be confirmed by inspection of the larynx by an ENT (ear, nose and throat) specialist. The earliest sign may be slight redness and dryness of the laryngeal lining with stringy mucus between the vocal cords. In chronic laryngitis the vocal cords often appear thickened.
How is laryngitis prevented or treated?

In acute laryngitis due to a cold the viral infection is almost always quickly conquered by the body’s immune system and lasts at most a few days. It is still best to rest the voice while the larynx is inflamed. This along with steam inhalations and avoidance of smoke and other irritants is usually sufficient. Antibiotics are rarely necessary.

Lifestyle changes are often the most important factor in the prevention of chronic laryngitis.

These should include:

* cessation of smoking and avoidance of smoky environments
* avoidance of food and liquids for two to three hours before retiring in order to prevent having active acid secretion by the stomach during sleep.
* raising the head of the bed, which protects the larynx from acid reflux from the stomach during sleep.
* medication to reduce acid production by the stomach if symptoms persist despite these measures.
* avoidance of throat clearing as this can worsen symptoms. It should be substituted by swallowing to clear bothersome throat secretions.

Voice therapy may be helpful in cases of faulty voice production.

Smoking and nutrition

Nicotine and the toxic substances found in cigarette smoke have a huge impact on the detoxification process of the body.

* Smoking causes cell damage, which leads to diseases such as cancer, high cholesterol levels, coronary and circulatory problems, respiratory disorders and an increased risk of osteoporosis.
* Smoking drains the body of many essential vitamins and minerals, affecting your ability to absorb these vital nutrients.

Smoking causes most problems for vitamin C.

Vitamin C is one of the body's main antioxidants. Antioxidants are linked to the prevention of a number of diseases.

The more you smoke, the more vitamin C you lose from your tissues and blood. But your body needs more vitamin C to counteract the damage that smoking causes to your cells.

To make up for this disturbance, a smoker needs to increase their vitamin C intake to around 2000mg a day. This can't be achieved by diet alone, so a supplement is needed.

Smokers should also try to increase their intake of antioxidants, mainly from fruit and vegetables. That said, no amount of supplements or antioxidants can protect the body against the damage caused by smoking.

The only real solution is to quit smoking.

The Truth About Quitting

Why stop smoking?

We are all aware of the health risks of smoking.

Many smokers give up not only because of the health risks to themselves, but also to those around them, while others choose to give up in order to save money or to stop smoking from interrupting their daily routines. And some just want to feel better and for their clothes to smell better.

Whatever your reason for quitting, with NICORETTE® you are twice as likely to succeed compared to willpower alone.
What happens when you quit?

20 minutes: Your blood pressure and pulse rate return to normal

8 hours: Oxygen levels in your blood return to normal.

24 hours: Carbon monoxide has been eliminated from your body. Your lungs start to clear out mucus and other smoking debris.

48 hours: There is no nicotine left in your body. Your ability to taste and smell is greatly improved.

72 hours: Breathing becomes easier. Your bronchial tubes begin to relax and your energy levels increase.

2-12 weeks: Circulation improves throughout the body, making walking and running a whole lot easier.

3-9 months: Coughs, wheezing and breathing problems get better as your lung function is increased by up to 10%.

5 years: Heart attack falls to about half that of a smoker.

10 years: Risk of lung cancer falls to half that of a smoker. Risk of heart attack falls to same as someone who has never smoked.

Sunday 22 August 2010

Cigarette Smoke Causes Harmful Changes In The Lungs Even At The Lowest Levels

Casual smokers may think that smoking a few cigarettes a week is "no big deal." But according to new research from physician-scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, having an infrequent smoke, or being exposed to secondhand smoke, may be doing more harm than people may think. The findings may further support public smoking bans, say the authors.

According to a new study published today in the American Journal of Respiratory and Critical Care Medicine, being exposed to even low-levels of cigarette smoke may put people at risk for future lung disease, such as lung cancer and chronic obstructive pulmonary disease (COPD).

Epidemiological studies have long shown that secondhand smoke is dangerous, but there have never been conclusive biological tests demonstrating what it does to the body at a gene function level, until now.

"Even at the lowest detectable levels of exposure, we found direct effects on the functioning of genes within the cells lining the airways," says Dr. Ronald Crystal, senior author of the study and chief of the division of pulmonary and critical care medicine at NewYork-Presbyterian/Weill Cornell and chair of the department of genetic medicine at Weill Cornell Medical College in New York City.

Dr. Crystal explains that genes, commonly activated in the cells of heavy smokers, are also turned on or off in those with very low-level exposure.

"The genetic effect is much lower than those who are regular smokers, but this does not mean that there are no health consequences," says Dr. Crystal. "Certain genes within the cells lining the airways are very sensitive to tobacco smoke, and changes in the function of these genes are the first evidence of 'biological disease' in the lungs or individuals."

To make their findings, Dr. Crystal and his collaborators tested 121 people from three different categories: "nonsmokers," "active smokers" and "low exposure smokers." The researchers tested urine levels of nicotine and cotinine -- markers of cigarette smoking within the body -- to determine each participant's category.

The research team then scanned each person's entire genome to determine which genes were either activated or deactivated in cells lining the airways. They found that there was no level of nicotine or cotinine that did not also correlate with genetic abnormalities.

"This means that no level of smoking, or exposure to secondhand smoke, is safe," says Dr. Crystal. He goes on to say that these genetic changes are like a "canary in a coal mine," warning of potential life-threatening disease, "but the canary is chirping for low-level exposure patients, and screaming for active smokers."

Dr. Crystal says that this is further evidence supporting the banning of smoking in public places, where non-smokers, and employees of businesses that allow smoking, are put at risk for future lung disease.

Co-authors of the study include Yael Strulovici-Barel, Dr. Michael O'Mahony, Dr. Cynthia Gordon, Dr. Charleen Hollmann, Dr. Ann Tilley, Jacqueline Salit, Dr. Ben-Gary Harvey, all from NewYork-Presbyterian/Weill Cornell; Dr. Jason Mezey from Cornell University in Ithaca, New York and Weill Cornell Medical College in New York City; and Dr. Larsson Omberg from Cornell University.

Funding for the study came from grants from the National Institutes of Health, The Flight Attendant's Medical Research Institute, and the Cornell Center for Comparative and Population Genomics.

Finland Bans Tobacco Display In Europe's Toughest Tobacco Control Law

ASH congratulates the Finnish president who signed a new law putting tobacco displays out of sight in shops. Finland joins a growing number of countries including Ireland, Canada and Norway that have adopted the measure to protect young people from tobacco marketing. [1] In several jurisdictions, including Scotland and England, tobacco manufacturers have initiated legal challenges to defend this highly effective marketing asset. [2]

The Finnish law does not stop at ending tobacco displays: it also makes it an offence for under 18s to possess tobacco products. Buying cigarettes on behalf of a minor becomes an offence punishable by up to 6 months in prison.

Martin Dockrell, Director of policy and research at the health charity Action on Smoking & Health said:

"Across the UK those who make and sell cigarettes have been fighting tooth and nail to overturn this legislation but the tide is running against them. Laws for smokefree public places started in a few small jurisdictions and rapidly spread across the globe. We are seeing exactly the same process here, the only question is: Will the UK be one of the first major economies to implement a display ban or will it be the first to cave in to tobacco industry pressure and reverse a law that has already been passed by parliament?"

Notes:

[1] To date 5 countries have implemented tobacco display bans: Australia, Canada, Iceland, Ireland and Norway. The ban on tobacco displays in Finland will come into effect on 1 January 2012. A ban on the sale of tobacco products from vending machines will be implemented from 1 Jan 2015.

[2] Legal challenges have been issued in England, Scotland and Norway.

The following is a summary of the new Finnish tobacco law:

The new objective of the Tobacco Act is to put an end to the use of tobacco products in Finland. The purpose is to achieve this aim by preventing in particular children and adolescents from taking up smoking. Finland is the first country to lay down the aim of putting an end to smoking in a law. The Government proposed passing the bill on Wednesday 18 August. The purpose is that the President of the Republic will approve the proposed Act on Friday.

The purpose of the Act is to restrict the marketing and supply of tobacco products especially in the everyday life of children. Not only shops but also private persons may not sell or supply tobacco products to persons under 18. According to the Act, even selling one cigarette or fetching a packet of cigarettes from a shop to a minor person should be interpreted as a tobacco selling violation, for which the person can be fined or sentenced to prison for a maximum of six months. It is also forbidden to offer tobacco without payment to minor persons, but this is not punishable however.

People under 18 are forbidden to import and possess tobacco products. A fine can be imposed on import of tobacco products, but possession is not punishable under the law. In the future, also sellers of tobacco products must be aged at least 18 years.

There will be a total ban on the sale of snuff in Finland, as the ban on import and sale will be extended to also apply to private persons. Ordering snuff e.g. via the Internet will also be forbidden. A maximum of 30 packets, each containing 50 grams snuff, may however be imported for one's own use. It will be forbidden to import snuff as a gift.

The prohibitions against smoking will be extended e.g. in facilities used by children and young people, the joint facilities of apartment house companies, events organised outdoors and hotel rooms.

In the future, tobacco products or their trademarks may not be displayed in retail sale facilities. Customers can at their request be shown a catalogue or be given a printed list of the prices of the tobacco products on sale. Furthermore, the sale of tobacco products from vending machines will be forbidden. The Medicines Act is amended to the effect that nicotine preparations can be sold, besides in shops, kiosks and gas stations, also in restaurants.

The Act enters into force as soon as on 1 October this year. The prohibition on display of tobacco products as well as the restrictions on smoking in hotel rooms enter into force at the beginning of 2012. The vending machines for tobacco products will be forbidden as from the beginning of 2015.

Second Hand Smoke More Harmful Than People Think

Being exposed to second hand smoke, also known as passive smoking - non-smokers breathing in smoke from lit cigarettes around them - may significantly increase the long-term risk of developing lung disease, such as lung cancer and COPD (chronic obstructive pulmonary disease), according to a report published in the American Journal of Respiratory and Critical Care Medicine. The same applies to casual (occasional) smoking.

This is the first study to demonstrate what passive or occasional smoking does to the body at a gene function level, say the authors.

Study author, Dr. Ronald Crystal, head of pulmonary and critical care medicine at NewYork-Presbyterian/Weill Cornell and chair of the department of genetic medicine at Weill Cornell Medical College in New York City, said:

Even at the lowest detectable levels of exposure, we found direct effects on the functioning of genes within the cells lining the airways.



The genes which are usually activated in the cells of regular heavy smokers may also be turned on/off in individuals with very low-level exposure, Dr. Crystal explained.

Dr. Crystal added:

The genetic effect is much lower than those who are regular smokers, but this does not mean that there are no health consequences. Certain genes within the cells lining the airways are very sensitive to tobacco smoke, and changes in the function of these genes are the first evidence of 'biological disease' in the lungs or individuals.



The researchers tested 121 individuals from three different categories:

* Non-smokers
* Currently active regular smoker
* Low exposure smokers

To determine what category they were, participants' urine levels of nicotine and cotinine were measured - these are markers of cigarette smoking within the body.

Each participant's entire genome was scanned to find out which genes were either activated or deactivated in the cell linings of the airways. The researchers discovered that there was no level of nicotine or cotinine that did not also correlate with genetic abnormalities.

Dr. Crystal said:

This means that no level of smoking, or exposure to secondhand smoke, is safe.



Dr. Crystal added that the genetic changes act like a canary in a coal mine warning of latent life-threatening conditions and diseases..

..but the canary is chirping for low-level exposure patients, and screaming for active smokers.



This is further compelling evidence in favor of banning smoking in public places where non-smokers may be at risk of future lung disease, Dr. Crystal says.

Second hand smoke - also known as passive smoking or environmental tobacco smoke (ETS) is environmental tobacco smoke that is inhaled involuntarily by a non-smoker.

Sunday 13 June 2010

Passive smoking link to mental health problems

PASSIVE smoking has been linked to mental health problems for the first time by a scientific study that suggests those exposed to cigarette fumes are three times more likely to be admitted to psychiatric hospital than those free from nicotine exposure.
A study of more than 8,000 Scots also found that passive smokers were more likely to report depressive moods than non-smokers who steered clear of inhaling other people's cigarette smoke.

The research was conducted by scientists at University Co
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llege London, who examined a sample of 5,560 non-smoking adults and 2,595 smokers drawn from the Scottish Health Survey, a database representative of the general population.

Non-smokers were tested for second-hand smoke exposure by testing participants' saliva for cotinine –- a substance that acts as a marker that can reveal how much smoke a person has been exposed to.

Participants also filled out a questionnaire designed to measure mental health by examining happiness levels, experience of depressive and anxiety symptoms and sleep disturbance over four weeks.

The questionnaire revealed how many members of the sample had suffered "psychological distress" – an episode defined as a low mood that fell short of clinical depression but could develop into a more serious condition. Analysis of the data found that passive smokers were more likely to suffer "psychological distress" than those free from tobacco smoke.

In the non-smokers with very low levels of passive smoke exposure, the rate of psychological distress was nine per cent. Among the non-smokers who experienced high exposure, the rate was 14 per cent.

"We found quite a strong association between passive smoke exposure and poorer mental health," said Dr Mark Hamer, the head of research.

Sheila Duffy, chief executive of Ash Scotland, said:

"We have known about links between active smoking and mental health problems, but this new research suggests that second-hand smoke is even more harmful than we thought."