The FDA has just approved the first generic version of Lovenox, a popular blood thinner. The drug’s entry into the market could mean hundreds of dollars in savings for someone who depends on the drug for stroke/heart disease treatment.

Lovenox is used to treat and prevent deep vein thrombosis, a condition that, if left unchecked, can cause stroke or pulmonary embolism (blood clots in the lung).

Momenta, the company whose technology was used to produce the new generic (M-Enoxaparin), has been awaiting approval for five years. They’ve spent the last half-decade battling Sanofi-Aventis, makers of Lovenox, over the drug’s efficacy.

According to Sanofi-Aventis, the biologically derived drug is complex and difficult to reproduce, and that it could fail with even the slightest error. They argue that the new generic may not be safe for consumers. The U.S. District Court in Washington, D.C. is considering the company’s case, but for now Sandoz/Momenta’s M-Enoxaparin is legal and available for use.

“The approval of M-Enoxaparin marks a key milestone for Momenta, and we are extremely pleased,” said Momenta president and CEO Craig Wheeler in a press release. “This is the first product based on Momenta’s technology platform to be approved, and demonstrates our ability to characterize and develop a complex mixture drug like Lovenox.”

Read the original article in the New York Times, or read Momenta’s press release for more details.

You've heard of toning your abs and working your glutes, but what about your throat? As it turns out, throat exercises could relieve symptoms of sleep apnea.

Sleep apnea—apnea literally means “without breath” in Greek—affects more than 12 million Americans and causes on-again, off-again breathing throughout the night. People with sleep apnea may also experience loud snoring and/or feel tired despite getting a full night’s sleep.

There are two main types of sleep apnea—central sleep apnea, which occurs when the brain doesn’t send signals to the brain to breathe; and the more common obstructive sleep apnea, which occurs when throat muscles relax.

A person with obstructive sleep apnea syndrome (OSAS) usually experiences disrupted breathing and poor sleep quality. For this study, 15 people with moderate OSAS did breathing exercises every day for 3 months. Another 16 did what were known as oropharyngeal (throat) exercises using a breathing machine.

Not unlike a stair master that works your thighs, the breathing machine works your throat using what’s known as continuous positive airway pressure (CPAP). The machine continuously pumps air through a mask to force air passages open during inhalation. Each session lasts for roughly 30 minutes.

Participants who did the breathing exercises did not show any significant improvements at the end of the experiment, but those who used CPAP had a lower neck circumference, snored less frequently and intensely, and experienced better sleep quality. The overall severity of their condition was reduced by a whopping 39 percent.

“Oropharyngeal exercises significantly reduce OSAS severity and symptoms,” authors of the study concluded. “(These exercises) represent a promising treatment for OSAS.”

Learn more about sleep apnea from the American Sleep Apnea Association, or read the source article from the New York Times.

Do you suffer from recurring sinus problems? If so, a friend's cigarette could be to blame. Two out of five cases of chronic sinusitis may be due to exposure to secondhand smoke.

Sinusitis occurs when the sinuses become swollen or infected. According to Mayo Clinic, sinusitis is usually the result of a cold, allergies or other nasal problems, and can easily be treated with antibiotics, heat (to relieve sinus pressure) or a variety of over-the counter medications.

When the condition persists for more than eight weeks or recurs frequently, this is known as chronic sinusitis. Secondhand smoke contains over 50 known carcinogens; these chemicals can also cause heart problems, asthma attacks and nasal irritation.

Researchers from the Henry Ford Health System in Detroit, recruited 612 non-smokers to participate in a study investigating the relationship of secondhand smoke (SHS) and its source to chronic sinusitis. All had been exposed to SHS for five years prior to the study, and half had been diagnosed with chronic sinusitis (CRS).

Researchers focused on four locations where participants were primarily exposed—home, work, public places and social functions. All showed a marked relationship between secondhand smoke exposure and incidence of chronic sinusitis, especially at social functions (51 percent) and in public places (90 percent).

Although levels of exposure were significantly lower for nonsmokers who had not been diagnosed with chronic sinusitis, study co-author Amanda Holm, MPH, says even modest levels of exposure carry risk.

"The poisons found in secondhand smoke are quite an irritant to the sinus and nasal passages and are a major contributor to the development of rhinosinusitis," Holm said in a press release. “"Our findings reaffirm the health hazards of secondhand smoke."

Visit Mayo Clinic to learn more about chronic sinusitis, or learn more about Holm’s study in The Archives of Otolaryngology.

New software using cell phones may allow doctors to analyze coughs and diagnose respiratory illness, including pneumonia.

“A cough is one of the most common symptoms of illness and a common mode of disease spread,” says researcher Suzanne Smith, PhD, of STAR Analytical Services. “Yet we don’t use technology in any way to measure or understand what coughs mean.”

The program is designed to distinguish different coughs using acoustic vocalization analysis, a way to distinguish different audio tones. Researchers hypothesize that the sound of coughing varies by illness, and that these subtle differences may be enough to determine which illness a patient has.

If this is true, it could mean greater accessibility to medical services for individuals who live far from a doctor. An early diagnosis would also help determine what treatments are necessary and ensure that patients receive the proper medications they need to recover.

Efforts are currently focused on pneumonia,  a disease that kills 1.8 million children every year. Most of them live in developing countries. Software capabilities, if initially successful, are likely to grow. Cell phones could potentially be used to diagnose everything from the common cold to influenza.

The project is in its beginning stages, but the possibility of such a program could save millions of lives, not to mention billions of dollars in health care costs.

Dr. Tachi Yamada, president of the Global Health Program says that this is the exact sort of thinking it will take to tackle the world’s health challenges.

"I'm excited about their ideas and look forward to seeing some of these exploratory projects turn into life-saving breakthroughs," he says.

Your showerhead may be home to some very dangerous bacteria. A new study from the University of Colorado at Boulder may have you cringing rather than singing in the shower. People with compromised immune systems may want to take a bath.

Researchers studying the microbiology of water systems at 45 sites in seven different states across the U.S. found unusually high levels of bacteria in showerheads—almost 100 times more than any other place in the home. Although bacteria levels were high in all showerheads, some sample sites in the New York City and Denver areas had large amounts of Mycobacterium avium, a relative of the bacteria that causes tuberculosis and leprosy.

“If you’re getting a face full of water when you first turn your shower on, that means you are probably getting a particularly high load of Mycobacterium avium,” says study author Norman Pace, professor of biology at the University of Colorado.

Mycobacteria are found in soil, water, and decaying matter. Certain Mycobacteria, such as Mycobactrium avium, can cause digestive, lymphatic, and pulmonary infections. In the shower, these bacteria are delivered as aerosols. Particles are small enough to get into the lungs, and when inhaled or swallowed, can lead to a host of pulmonary problems.

The study, part of a bigger study that began as a class project, used DNA barcode testing to extract rRNA (bacterial DNA) from different parts of the shower and showerhead. Researchers sampled water flowing from the showerhead and obtained swab samples from the inside of the showerhead. Finally, samples were collected from water flowing out of the pipe after the showerhead was removed.

Homes with well water systems did not have Mycobacteria in their showerheads, a factor authors believe may be due to Mycobacteria’s chlorine resistance. Although they suggest that bathing may be safer, researchers assure that it’s not dangerous to shower.

“We did see some organisms that might be of concern if you have immune issues (such as) cystic fibrosis, AIDS, recent organ transplant, substance abuse, or are pregnant or otherwise immune compromised,” the authors wrote.

Click for more information on pulmonary disease.

New laws in Louisiana, Connecticut, Georgia and Pennsylvania give students the right to carry and self-administer their own medications, including an asthma inhaler.
At this back-to-school time, find out how to tell if your child with asthma is ready to carry and use an inhaler on his or her own. Age and grade-level matter less than individual readiness, according to the Allergy&Asthma Network Mothers of Asthmatics (AANMA).

Parent/Child Asthma Inhaler Quiz
See how your answers to the following questions match up with your child’s answers. These are the best clues to determining your child’s readiness to self-manage asthma symptoms at school:

1. Does your child use an inhaler (preferably with a holding chamber) correctly at home? 

2. Does she know the name of her medication and when to use it? 

3. Does he stay calm when having asthma symptoms? 

4. Does she tell you when she is having symptoms or when she has used the inhaler? 

5. Does he use a peak flow meter? 

6. Does your child carry the inhaler at all times? 

7. Does he understand that the inhaler is not a toy and should not be shared with friends? 


If you and your child answer “Yes” to most of these questions, you have a child ready to learn about and take responsibility for his or her inhaler.
 
Asthma self-management begins at home. Parental instruction should be backed up by plenty of low-pressure practice. At school, teachers should be aware of the condition and supportive of the process.
Students who self-manage symptoms must be willing to notify teachers, the school nurse or designated administrator when they need to use their inhalers to treat symptom. They must be willing to tell their parents about all medication use or symptoms experienced while away from home.

Back-to-School Asthma To-Do List for Parents
Ensure that backup medication is available in the school clinic should the child become separated from his medication at any time.
Complete required forms and keep them updated during the school year if contact information or emergency treatment plans change.
 

Not yet time for self-use of an inhaler? School personnel will need to ensure that the student’s medication travels with him from one classroom to the next to prevent treatment delays in times of need. Your child’s allergy or asthma management plan should specify this.
• For answers to common asthma questions, check the Healia Health Guide to Asthma.
• Test your knowledge of asthma—take this informative asthma quiz.
• Student-athletes with asthma and allergies can thrive on the playing field as long as they’re careful and follow these tips.

A little bee venom may be a good thing. Some people are so allergic to bee stings and other insect bites that they are in danger of potentially lethal anaphylactic shock. Such shock can be fatal if obstruction of the airway occurs, blood pressure drops, or heart rate or heart rhythms are interrupted. One method of treatment involves injecting small, periodic doses of venom from bees and other stinging insects to help the patient build up immunity. Venom therapy was developed in the 1970s at Johns Hopkins.

In a recent study by Johns Hopkins and published in the June 2009 Journal of Allergy and Clinical Immunology, the same venom shots can help treat non-fatal but serious allergic reactions to insect stings. While not dangerous, large local allergic reactions can be painful and inconvenient. People who have jobs or hobbies such as landscaping, gardening and golfing are likely to be adversely affected by painful reactions that may cause severe swelling that lasts for days. Until now, if the reaction was not life-threatening, they were typically denied venom therapy.

“We just didn’t know if venom therapy would work or cause problems for these patients,” says David Golden, M.D., an associate professor of medicine at the Johns Hopkins University School of Medicine.
To find out, he and his colleagues recruited volunteers who were subject to unavoidable frequent stings owing to outdoor jobs or hobbies. From that group, Golden selected those whose reactions were marked by extremely large swellings of at least 16 cm—about the size of a football.

Golden’s team subjected the subjects to an initial sting to rigorously measure their response, then separated them into two groups: 19 who would get venom shots once a week for seven to 11 weeks over a summer, and 10 who would get no shots. While the control group members’ responses to stings stayed the same, those in the treatment group showed 50 percent less swelling on average.

After the first summer, both groups received venom therapy for up to four years. Following two or more years of treatment, both groups had swellings about 60 percent smaller on average than initial measurements, though the response to treatment varied.

Golden and his team plan to investigate why some patients experienced almost complete elimination of their allergic reaction whiler others still experienced moderate swelling. Click to read more about the study.

Post your questions about allergies and chat with other allergy sufferers at Healia Allergy Online Health Community and Support Group.

If pollen and other outdoor allergens—rather than stinging insects—cause your allergic reactions, find out more about how to treat them in the Healia Outdoor Allergies Guide.

Every year, the Asthma and Allergy Foundation of America (AAFA) evaluates conditions in the 100 largest cities in America and ranks them based on the quality of life in each city for people living with asthma. Researchers at AAFA review 12 factors that impact the quality of life for people with asthma, including: the estimated prevalence of adult and pediatric asthma; the crude death rate for asthma; risk factors, such as air pollution, pollen counts and public smoking; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. Below is a list of the cities that rank best in quality of life for people with asthma in 2009.

This year’s top 10 best cities in the U.S. to live in if you have asthma are:

1. Cape Coral, FL
2. Seattle, WA
3. Minneapolis, MN
4. Colorado Springs, CO
5. Portland, OR
6. Palm Bay, FL
7. Daytona Beach, FL
8. San Francisco, CA
9. Portland, ME
10. Boise City, ID

No matter where you live, having uncontrolled asthma significantly impact your life and lead to missed school or work, emergency room visits, hospitalization, and even death. If your asthma is poorly controlled, talk to your doctor about making changes to your asthma action plan include adjustments in your current asthma prevention medications. Not sure if your asthma is well controlled? Take the Asthma Quiz Challenge and find out how much you know about uncontrolled asthma symptoms. Learn more by reading the Healia Health Guide to Uncontrolled Asthma.

<sub>Source: Allergy and Asthma Foundation of America, Asthma Capitals 2009, Jan 2009. http://www.aafa.org/pdfs/2009ACPublicList.PDF 

Photo: pink_Fish13, Flickr, Creative Commons</sub>

For the past six years, the Asthma and Allergy Foundation of America (AAFA) has evaluated conditions in the 100 largest cities in America and ranked them based on the quality of life each affords for people with asthma. Researchers at AAFA review 12 factors that impact the quality of life for people with asthma, including: the crude death rate for asthma; the estimated prevalence of adult and pediatric asthma; risk factors, such as air pollution, pollen counts and public smoking; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. Below is a list of the cities that rank worst in quality of life for people with asthma in 2009.

This year’s top 10 worst cities in the U.S. to live in if you have asthma are:

1. St. Louis, MO. This Midwest city tops the list this year after coming in ninth last year, due to a variety of factors, including poor air quality and a rise in the percentage of uninsured residents.
   
   
2. Milwaukee, WI. Climbing up one spot from last year, Milwaukee has rates of self-reported asthma and estimated asthma prevalence that are higher than average, poor air quality, and only below average use of asthma control medications.
   
   
3. Birmingham, AL. Jumping all the way up from number 13 on the list last year, Birmingham saw an increase in estimated asthma prevalence and ranks poorly in air quality and public smoke free laws. In fact, all of the cities that make the top 10 lack public smoking bans.
   
   
4. Chattanooga, TN. Rising twelve spots from last year, this Appalachian city saw an increase in the crude asthma death rate and a decline in the use of rescue medications from last year. Chattanooga also ranks below average in air quality.
   
   
5. Charlotte, NC. While this Southern city has an above average rate of estimated asthma prevalence, Charlotte saw a jump in its annual pollen score, which accounts for its rise from last years position in the number seven spot.
   
   
6. Memphis, TN. A small bright spot on the list, Memphis improved in self-reported asthma incidence, annual pollen score, and uninsured rate from last year, causing it to drop one spot from last year’s list. High crude death rates from asthma and poor air quality still negatively impact people living with asthma in Memphis.
   
   
7. Knoxville, TN. Home to the University of Tennessee, Knoxville improved its ranking considerably over last year when it held the top spot. Knoxville improved because both the estimated and self-reported prevalence of asthma decreased, and reported pollen levels were lower than the national average. However, poor air quality and low adherence to asthma medications keep Knoxville in the top 10.
   
   
8. McAllen, TX. Perhaps not a household name, this border town near Brownsville jumps all the way up from number 26 last year. While the air quality ranking actually improved from last year, increases in the estimated and self-reported asthma prevalence and the annual pollen score are responsible for the precipitous rise.
   
   
9. Atlanta, GA. The "Jewel of the South" improved its ranking from last year, moving down from the number four spot thanks to improvements in crude asthma death rate, poverty rate, rate of uninsured people, and use of quick-relief asthma medications. Below average air quality and low numbers of asthma specialists are still a problem in Atlanta.
   
   
10. Little Rock, AK. Rounding out the top 10, Little Rock rose 12 spots from last year to just make the list. Increases in the annual pollen score, air pollution levels, and self-reported asthma rates offset a nice improvement in crude asthma death rate.

No matter where you live, having asthma that is uncontrolled can significantly impact your life and lead to missed school or work, emergency room visits, hospitalization, and even death. If your asthma is poorly controlled, talk to your doctor about making changes to your asthma action plan include adjustments in your current asthma prevention medications. Not sure if your asthma is well controlled? Take the Asthma Quiz Challenge and find out how much you know about uncontrolled asthma symptoms. Learn more by reading the Healia Health Guide to Uncontrolled Asthma.

_{Source: Allergy and Asthma Foundation of America, Asthma Capitals 2009, Jan 2009. http://www.aafa.org/pdfs/2009ACPublicList.PDF}

_{Photo: IllinoisHorseSoldier, Flickr, Creative Commons}

The State of the Air report is an annual publication of the American Lung Association (ALA) that ranks cities and counties based on their levels of air pollution. The following is a list of the cleanest cities for air pollution from that report, based on the annual PM2.5 concentration, a measure of the yearly concentration of particles in the air that are less than 2.5 micrometers in size (PM2.5), which are thought to be the most harmful to human health. The ALA used the Environmental Protection Agency’s database to obtain the data, calculated the concentration of a pollutant, and ranked cities based on the EPA’s determination of the number of days that violated the national ambient air quality standard for annual PM2.5 of 15 µg/m³. The list below represents the cities with the best annual PM2.5 measures over the years 2004-2006 followed in parentheses by the total population that inhabits each area. Note that mostly small and medium-sized cities make the list.

The top 10 cities with the cleanest air in the U.S. are:

1. Cheyenne, WY (85,384)
2. Santa Fe-Espanola, NM (183,356)
3. Honolulu, HI (909,863)
4. Great Falls, MT (79,385)
5. Farmington, NM 126,473
6. Tucson, AZ (946,362)
7. Bismarck, ND (101,138)
8. Flagstaff, AZ 124,953
9. Anchorage, AK (359,180)
10. Salinas, CA (410,206)

To find out more about diseases caused by air pollution, join the Healia Health Community for Lung Diseases or the Healia Health Community for Heart Diseases.

Related blog posts: Study Finds Cleaner Air Lengthens American Lives by Nearly Five Months

        The Top 10 Most Polluted Cities in America

_{Source: American Lung Association, State of the Air 2008, Table 2. http://www.stateoftheair.org/2008/key-findings/SOTA08_Table2.pdf}

_{Photo: Reba Rear, Flickr, Creative Commons}