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Chronic Obstructive Pulmonary Disease. Copd
By Dr. D.S. Merchant

Plan of Attack
•Definitions
•Epidemiology
•Goals of Management
•Diagnosis
•Managing Stable COPD
•Managing Acute Exacerbations of COPD

“A disease state characterized by airflow limitation that is not fully reversible. Airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Symptoms, functional abnormalities, and complications of can all be explained on the basis of this underlying inflammation and the resulting pathology.”
Definitions
•Chronic Bronchitis (clinical)
•Sputum production more days than not for at least 3 months a year for at least 2 years
•Emphysema (pathologic)
•Parenchymal destruction airspace walls distal to terminal bronchioles, without fibrosis
•Important: You can have either, but to have you MUST demonstrate obstruction (thus the “O” in COPD)

Epidemiology
•Fourth leading cause of death in U.S.
•100,000 American deaths each year
•15-20% of chronic smokers develop COPD
•2.5% mortality for hospital admissions
•COPD with acute respiratory failure:
•24% in hospital mortality
•59% one year mortality
•If you have and PaCO2 > 50mmHg:
•67% chance of being alive in 6 months
•57% chance of being alive in 12 months

Diagnosis
•Symptoms
•Dyspnea
•Sputum production (especially in the morning)
•Recurrent acute chest illnesses
•Headache in the morning – possible hypercapnia
•Cor pulmonale (Right heart failure)

Goals Of Management
•Identifying and ameliorating (if possible) the cause of the acute exacerbation
•Optimizing lung function by administering bronchodilators and other pharmacotherapy
•Assuring adequate oxygenation and secretion clearance
•Averting the need for intubation, if possible
•Preventing complications of immobility, such as thromboemboli and deconditioning
•Addressing nutritional needs – at the time of the acute illness, most patients are in negative nitrogen balance, which is exacerbated by steroid therapy

Diagnosis:
•Signs
•Prolonged expiratory time
•Expiratory wheezes
•Increased AP diameter of chest
•Decreased breath sounds (especially upper lung fields)
•Distant heart sounds
•End stage: accessory muscles, pursed lip breathing, cyanosis, enlarged liver and pedal edema (in case of cor pulmonale).

Diagnosis
•Radiology
•Chest X-ray
•Hyperinflated lung fields more radiolucent
•Bullae, often bilateral upper lobes in smokers
•Flat diaphragms (best seen on lateral) and retrosternal airspace can indicate air trapping
•High Resolution CT of Chest
•Most sensitive to detect above changes
•No role in routine care of patients
•Can be useful for giant bullous disease surgeries or lung volume reduction surgery planning

Diagnosis
•Pulmonary Function Testing
•Spirometry: Decreased FEV1/FVC
•FEV1 percent predicted defines severity
•Lung volumes: Increased TLC, RV, RV/TLC
•DLCO: Decreased

Gold Staging Criteria
•Stage O: Normal spirometry; chronic sx
•Stage 1 (Mild):
•FEV1/FVC < 70%; FEV1 > 80% predicted
•Stage 2 (Moderate):
•FEV1/FVC < 70%; FEV1 30-80% predicted
•2A: FEV1 50-80% predicted
•2B: FEV1 30-50% predicted

Diagnosis
•Stage 3 (severe):
•FEV1/FVC < 70% AND:
•FEV1 < 30% predicted OR:
•FEV1 < 50% predicted and clinical evidence of Right heart failure

Diagnosis
American Thoracic Society – Spirometry
•Low FEV1/FVC defines obstruction
•FEV1%predicted Category
•< 35% Very Severe
•35-50% Severe
•50-60% Moderately Severe
•60-70% Moderate
•70-80% Mild
•80-100% Mild vs. Normal variant
•> 100% Normal

Managing Stable COPD
•Smoking Cessation Is KEY!
•YOUR intervention will make a difference – must address at each visit
•Medication
•Two therapies ONLY have been shown to improve mortality in stable COPD:
•1) Smoking Cessation
•2) Oxygen Therapy

Bronchodilator Technique
•MDI’s get better drug deposition than nebs
•Use a spacer device with MDI’s
•Technique is key – important for patient and doctor
•Inadequate dosing can hamper treatment

•Sympathomimetics
•Beta-2 selectivity is good
•Some additive vs. slightly synergistic effects of combining beta-2 agonist and ipratropium (Combivent)
•Some data to support decreased H.influenzae pneumonia incidence with Serevent
Anticholinergic Agents (Atrovent, glycopyrrolate)
•Similar ability to bronchodilate (in appropriate doses) as beta-agonists
•Also reduces sputum volume; no change in viscosity
•Usually under dosed
•Recommend 2 (36 mcg) puffs qid
•glycopyrrolate which is manufactured for IV/IM use for other indications, is available only "off label" for nebulized use in (1 to 2 mg every two to four hours).
•Aminophylline and theophylline are not recommended for the management of acute exacerbations of COPD. Randomized controlled trials of intravenous aminophylline in this setting have failed to show efficacy in excess of that afforded by therapy with inhaled bronchodilators and corticosteroids

Mucokinetic agents
•There is little evidence supporting the use of mucokinetic (mucolytic) agents, such as N-acetylcysteine or iodide preparations, in acute exacerbations of COPD. In fact, some drugs of this class may worsen bronchospasm.

•Oxygen. Yes.
•Demonstrated to improve exercise performance, symptom indices and mortality
•Goal

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Author Simon Singh Puts Up a Fight in the War on Science
<cite>Wired</cite> speaks to author Simon Singh, who has become a hero to those challenging the pseudoscience surrounding everything from global warming to evolution. <p><a href="http://feedads.g.doubleclick.net/~at/MVDN_gZ8NEUhKAiuH4LFR6VY-14/0/da"><img src="http://feedads.g.doubleclick.net/~at/MVDN_gZ8NEUhKAiuH4LFR6VY-14/0/di" border="0" ismap="true"></img></a><br/> <a href="http://feedads.g.doubleclick.net/~at/MVDN_gZ8NEUhKAiuH4LFR6VY-14/1/da"><img src="http://feedads.g.doubleclick.net/~at/MVDN_gZ8NEUhKAiuH4LFR6VY-14/1/di" border="0" ismap="true"></img></a></p><div class="feedflare"> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=jac1wJYc9zE:77qX8gJDxDc:cGdyc7Q-1BI"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?d=cGdyc7Q-1BI" border="0"></img></a> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=jac1wJYc9zE:77qX8gJDxDc:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?i=jac1wJYc9zE:77qX8gJDxDc:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=jac1wJYc9zE:77qX8gJDxDc:gIN9vFwOqvQ"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?i=jac1wJYc9zE:77qX8gJDxDc:gIN9vFwOqvQ" border="0"></img></a> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=jac1wJYc9zE:77qX8gJDxDc:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?d=yIl2AUoC8zA" border="0"></img></a> </div><img src="http://feeds.feedburner.com/~r/wired/medtech/health/~4/jac1wJYc9zE" height="1" width="1"/>
Secret of AA: After 75 Years, We Don't Know How It Works
Despite all that contemporary medicine knows about psychology, neurology and human behavior, it has yet to devise anything that works better than Alcoholics Anonymous to help drunks stay sober. <p><a href="http://feedads.g.doubleclick.net/~at/86UoHfGr4nmnvSC8LHwyVnBzZ5U/0/da"><img src="http://feedads.g.doubleclick.net/~at/86UoHfGr4nmnvSC8LHwyVnBzZ5U/0/di" border="0" ismap="true"></img></a><br/> <a href="http://feedads.g.doubleclick.net/~at/86UoHfGr4nmnvSC8LHwyVnBzZ5U/1/da"><img src="http://feedads.g.doubleclick.net/~at/86UoHfGr4nmnvSC8LHwyVnBzZ5U/1/di" border="0" ismap="true"></img></a></p><div class="feedflare"> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=IsmdPXSjTpo:vCInpSYoUAs:cGdyc7Q-1BI"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?d=cGdyc7Q-1BI" border="0"></img></a> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=IsmdPXSjTpo:vCInpSYoUAs:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?i=IsmdPXSjTpo:vCInpSYoUAs:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=IsmdPXSjTpo:vCInpSYoUAs:gIN9vFwOqvQ"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?i=IsmdPXSjTpo:vCInpSYoUAs:gIN9vFwOqvQ" border="0"></img></a> <a href="http://feeds.wired.com/~ff/wired/medtech/health?a=IsmdPXSjTpo:vCInpSYoUAs:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/wired/medtech/health?d=yIl2AUoC8zA" border="0"></img></a> </div><img src="http://feeds.feedburner.com/~r/wired/medtech/health/~4/IsmdPXSjTpo" height="1" width="1"/>

in hypercapnic patients for SpO2 need not be greater than 88-90%
•Always test patients for oxygenation with ambulation if baseline at rest room air SpO2 ok

•Systemic Corticosteroids
•Never demonstrated to significantly impact mortality or exercise capacity
•Slight improvements in symptom indices
•Significant side effects
•Rarely of benefit, generally of harm to your patient
•Occasionally useful in a small subset failing other therapies AND with demonstrated bronchodilator response on PFT’s

•Inhaled Corticosteroids
•Jury still out
•Lots of recent research with some favorable data supporting its use
•May be part of standard regimens in the future

•Vaccines
•Pneumovax, annual flu shots
•Chronic antibiotic therapy – BAD IDEA
•Nutritional status – Important
•Pulmonary Rehabilitation
•Improved exercise capacity, symptom scores
•Lung Volume Reduction Surgery
•Transplant

Managing Acute Exacerbations of COPD
•Common precipitants:
•Infection – esp viral or bacterial
•Acute bronchospasm
•Sedation

•Who To Admit•
•Countless studies, few definite answers
•Worsening hypoxemia and/or hypercapnia
•Otherwise, mostly a clinical decision
•Key points to consider:
•Oxygen
•Bronchodilators
•Steroids
•Antibiotics

•Albuterol:
•Neb or MDI – neb MAY be better in acute setting, but MDI’s have better drug deposition overall
•Continuous nebulizer treatments confer no benefit over treatments every 1-2 hours
•Generally should avoid subcutaneous beta-agonists
•BEWARE: Hypokalemia, tachycardia (occasional)
•Levalbuterol still with weak clinical data – few situations where it is clinically indicated

•ATROVENT (anticholinergic bronchodilator)
•Bronchodilation
•May decrease secretions
•Few significant side effects
•Usually significantly under dosed – emerging data supports much higher doses than usually used currently

•Corticosteroids — Parenteral corticosteroids are frequently used in treating acute exacerbations of COPD. Methylprednisolone (60 to 125 mg intravenously, two to four times daily) or the equivalent glucocorticoid dose of other steroid preparations commonly is given.
•Corticosteroids Utilization in this setting was initially based upon small randomized trials in which only a minority of patients benefit and the degree of improvement is modest
•A randomized, placebo-controlled trial of 271 patients has confirmed the benefits of systemic corticosteroids given for up to 2 weeks to hospitalized patients with exacerbation

•Antibiotics
•“Winnipeg” Criteria (give for 2-3 of the following):
•Increased cough
•Increased purulence
•Increased sputum production
•Antibiotics accelerate improvement in peak expiratory flow rates and lessen the rate of recrudescence in this setting
•Amoxicillin, Doxycycline, TMP/SMX, Azithromycin, Clarithromycin, Levaquin for 10 days

•Mucokinetic Agents – JUST SAY NO.
•N-acetylcysteine is actually contraindicated in patients with airway obstruction
•No significant clinical benefit ever demonstrated
•Chest PT, intermittent positive pressure breathing and postural drainage may actually be harmful in the setting of acute obstruction

•Methylxanthines (Theophylline, Aminophylline)
•Not recommended for acute exacerbations
•No significant benefit ever demonstrated in large, prospective trials

•Oxygen: YES!
•Generally a good thing – cells like that stuff
•If requiring a significant increase in FiO2 over baseline requirement, start hunting for something other than just exacerbation
•BEWARE of CO2 RETAINERS! (goal SpO2 90%, PaO2 of 60 to 65 mmHg )
•1) Altered V/Q relationships
•2) Haldane effect (Hgb*O2 holds less CO2 – goes out into plasma)
•3) Decreased ventilatory drive (least impt mechanism)

•Non-Invasive Positive Pressure Ventilation
•BiPAP
•Set FiO2, inspiratory (IPAP) and expiratory (EPAP)
•Difference between IPAP and EPAP augments tidal volume, therefore improving minute ventilation. CO2 then gets blown off
•MORTALITY BENEFIT in patients who will tolerate

•Mechanical Ventilation
•Respiratory distress
•Acidemia that does not correct quickly with therapy
•Inability to oxygenate adequately
•Often a clinical decision relative to patient’s work of breathing

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Dr. D.S. Merchant is a Gold Medalist in (Anatomy & Histology), Resident AKUH, Pakistan. For more information on Gastroenterology or visit www.ezinevalley.com is a popular website that offers information on Endoscopy, Pulmonary Disease and VHF Medications.

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	Copd And Insomnia Copd Case Studies For Nurses Copd Course Of Treatment Copd Disability Malaria kills more people worldwide than once thought, study says In an alarming statistical turn, the number of malaria deaths every year may be vastly underestimated, according to new research re-examining mortality rates from 1980 to 2010.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c63602e/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Malaria+kills+more+people+worldwide+than+once+thought%2C+study+says&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-malaria-kills-twice-adults-lancet-20120203%2C0%2C630065.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Malaria+kills+more+people+worldwide+than+once+thought%2C+study+says&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-malaria-kills-twice-adults-lancet-20120203%2C0%2C630065.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123996038159/u/49/f/622900/c/34253/s/1c63602e/a2.htm"><img src="http://da.feedsportal.com/r/123996038159/u/49/f/622900/c/34253/s/1c63602e/a2.img" border="0"/></a> Posting simple signs might get people to take the stairs more often What does it take to make people more physically active? 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Komen for the Cure about Planned Parenthood is a good lesson in bad crisis management, say consultants who have been watching the events unfold.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c62d711/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Consultants+weigh+in+on+how+Komen+for+the+Cure+handled+the+crisis&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-crisis-management-20120203%2C0%2C44911.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Consultants+weigh+in+on+how+Komen+for+the+Cure+handled+the+crisis&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-crisis-management-20120203%2C0%2C44911.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123996034522/u/49/f/622900/c/34253/s/1c62d711/a2.htm"><img src="http://da.feedsportal.com/r/123996034522/u/49/f/622900/c/34253/s/1c62d711/a2.img" border="0"/></a> Komen's decision to aid Planned Parenthood again sparks reactions As soon as Susan G. 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But for those who suffer from low self-esteem, it appears to be a rather nasty trap, luring such people into self-disclosures that prompt many a Facebook friend to agree with their low opinion of themselves.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c607217/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Facebook%3A+Is+this+any+place+for+the+not-so-self-assured+to+make+friends%3F&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-facebook-friends-depression-20120202%2C0%2C3935735.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Facebook%3A+Is+this+any+place+for+the+not-so-self-assured+to+make+friends%3F&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-facebook-friends-depression-20120202%2C0%2C3935735.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123996061157/u/49/f/622900/c/34253/s/1c607217/a2.htm"><img src="http://da.feedsportal.com/r/123996061157/u/49/f/622900/c/34253/s/1c607217/a2.img" border="0"/></a> Congress members ask Komen to rethink Planned Parenthood fund cuts Some members of the House and Senate are getting involved in the flap over the recent decision of Susan G. Komen for the Cure to cut back funding of Planned Parenthood. They're inviting colleagues to sign letters asking Komen to reconsider its stance and calling the organization out for being politically motivated.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5bff80/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Congress+members+ask+Komen+to+rethink+Planned+Parenthood+fund+cuts&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-house-senate-letter-komen-20120202%2C0%2C4555405.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Congress+members+ask+Komen+to+rethink+Planned+Parenthood+fund+cuts&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-house-senate-letter-komen-20120202%2C0%2C4555405.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995991371/u/49/f/622900/c/34253/s/1c5bff80/a2.htm"><img src="http://da.feedsportal.com/r/123995991371/u/49/f/622900/c/34253/s/1c5bff80/a2.img" border="0"/></a> Eating together may put diners' bites in sync, a study finds The next time you're sitting across from someone, eating with them, take note: Are you both taking bites at the same time?<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5bb9ba/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Eating+together+may+put+diners%27+bites+in+sync%2C+a+study+finds&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-eating-behavior-mimicry-20120202%2C0%2C2282334.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Eating+together+may+put+diners%27+bites+in+sync%2C+a+study+finds&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-eating-behavior-mimicry-20120202%2C0%2C2282334.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995981979/u/49/f/622900/c/34253/s/1c5bb9ba/a2.htm"><img src="http://da.feedsportal.com/r/123995981979/u/49/f/622900/c/34253/s/1c5bb9ba/a2.img" border="0"/></a> Komen officials say it's not about abortion Officials for the Susan G. Komen for the Cure foundation defended its decision to eventually end grants to Planned Parenthood for breast-health activities and suggested that the Komen money might be better spent elsewhere.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5bb718/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Komen+officials+say+it%27s+not+about+abortion&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-response-20120202%2C0%2C5376242.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Komen+officials+say+it%27s+not+about+abortion&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-response-20120202%2C0%2C5376242.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995981603/u/49/f/622900/c/34253/s/1c5bb718/a2.htm"><img src="http://da.feedsportal.com/r/123995981603/u/49/f/622900/c/34253/s/1c5bb718/a2.img" border="0"/></a> Nonprofits react: Dr. Susan Love says she's saddened by Komen decision In the wake of Tuesday's announcement that the Susan G. Komen for the Cure will be ending grants for breast cancer screening and other breast-health services to Planned Parenthood, other women's health organizations have decried the move, calling it politically motivated and linking it to the abortion debate. <img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5b0c0b/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Nonprofits+react%3A+Dr.+Susan+Love+says+she%27s+saddened+by+Komen+decision&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-susan-love-komen-planned-parenthood-20120202%2C0%2C2399560.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Nonprofits+react%3A+Dr.+Susan+Love+says+she%27s+saddened+by+Komen+decision&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-susan-love-komen-planned-parenthood-20120202%2C0%2C2399560.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995977911/u/49/f/622900/c/34253/s/1c5b0c0b/a2.htm"><img src="http://da.feedsportal.com/r/123995977911/u/49/f/622900/c/34253/s/1c5b0c0b/a2.img" border="0"/></a> Komen CEO says politics didn't cause break with Planned Parenthood Susan G. Komen for the Cure's decision to stop giving money to Planned Parenthood for breast health services was not politically motivated, said the group's founder and chief executive in a new video posted on the organization's site and YouTube.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5b0502/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Komen+CEO+says+politics+didn%27t+cause+break+with+Planned+Parenthood&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-statement-video-20120202%2C0%2C1601650.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Komen+CEO+says+politics+didn%27t+cause+break+with+Planned+Parenthood&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-statement-video-20120202%2C0%2C1601650.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995977068/u/49/f/622900/c/34253/s/1c5b0502/a2.htm"><img src="http://da.feedsportal.com/r/123995977068/u/49/f/622900/c/34253/s/1c5b0502/a2.img" border="0"/></a> In Komen fallout, abortion-breast cancer myth is resurrected The long-debunked idea that abortions can contribute to breast cancer is reappearing amid the outpouring of comments this week on Susan G. Komen for the Cure's decision to stop funding Planned Parenthood breast-health programs.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5b0503/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=In+Komen+fallout%2C+abortion-breast+cancer+myth+is+resurrected&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-abortion-20120202%2C0%2C535763.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=In+Komen+fallout%2C+abortion-breast+cancer+myth+is+resurrected&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-abortion-20120202%2C0%2C535763.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995977067/u/49/f/622900/c/34253/s/1c5b0503/a2.htm"><img src="http://da.feedsportal.com/r/123995977067/u/49/f/622900/c/34253/s/1c5b0503/a2.img" border="0"/></a> Sugar can harm like alcohol and tobacco; regulate it, article says Move over salt. Step aside, saturated fat. There’s a new public enemy in the pantry, and it’s … sugar.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c54fbac/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Sugar+can+harm+like+alcohol+and+tobacco%3B+regulate+it%2C+article+says&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-added-sugar-tax-lustig-20120201%2C0%2C7380295.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Sugar+can+harm+like+alcohol+and+tobacco%3B+regulate+it%2C+article+says&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-added-sugar-tax-lustig-20120201%2C0%2C7380295.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995946635/u/49/f/622900/c/34253/s/1c54fbac/a2.htm"><img src="http://da.feedsportal.com/r/123995946635/u/49/f/622900/c/34253/s/1c54fbac/a2.img" border="0"/></a> Showing kids photos of vegetables may get them to eat a bit more Kids don't always eat their vegetables, but does showing them photos of veggies make them consume more?<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c54d0ba/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Showing+kids+photos+of+vegetables+may+get+them+to+eat+a+bit+more&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-school-lunch-vegetables-20120201%2C0%2C2923892.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Showing+kids+photos+of+vegetables+may+get+them+to+eat+a+bit+more&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-school-lunch-vegetables-20120201%2C0%2C2923892.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995990622/u/49/f/622900/c/34253/s/1c54d0ba/a2.htm"><img src="http://da.feedsportal.com/r/123995990622/u/49/f/622900/c/34253/s/1c54d0ba/a2.img" border="0"/></a> Komen, Planned Parenthood and Congress: What's the status? What's the status of the congressional investigation of Planned Parenthood?<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c550011/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Komen%2C+Planned+Parenthood+and+Congress%3A+What%27s+the+status%3F&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-planned-parenthood-congressional-investigation-20120201%2C0%2C4337608.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Komen%2C+Planned+Parenthood+and+Congress%3A+What%27s+the+status%3F&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-planned-parenthood-congressional-investigation-20120201%2C0%2C4337608.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div> Planned Parenthood: Sen. Alex Padilla a Komen 'Pink Tie Guy' no more Now it's real serious. California state Sen. Alex Padilla says he's severing ties -- and taking off his own tie -- with Susan G. Komen for the Cure. The announcement comes a day after the Komen foundation announced it was ending grants to Planned Parenthood for breast-cancer screening and other breast-health services.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c54e0cf/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Planned+Parenthood%3A+Sen.+Alex+Padilla+a+Komen+%27Pink+Tie+Guy%27+no+more&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-alex-padilla-pink-tie-komen-planned-parenthood-breast-cancer-20120201%2C0%2C5270689.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Planned+Parenthood%3A+Sen.+Alex+Padilla+a+Komen+%27Pink+Tie+Guy%27+no+more&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-alex-padilla-pink-tie-komen-planned-parenthood-breast-cancer-20120201%2C0%2C5270689.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995939668/u/49/f/622900/c/34253/s/1c54e0cf/a2.htm"><img src="http://da.feedsportal.com/r/123995939668/u/49/f/622900/c/34253/s/1c54e0cf/a2.img" border="0"/></a> In wake of Komen-Planned Parenthood rift, eyes turn to Karen Handel As pro-choice supporters sound off over the decision by Susan G. Komen for the Cure to pull grants to Planned Parenthood for funding breast-cancer screening and other breast health services, some have suggested a link between Tuesday's announcement and Komen's hiring of a self-described "pro-life Christian" last year to a prominent position within the foundation.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c54959a/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=In+wake+of+Komen-Planned+Parenthood+rift%2C+eyes+turn+to+Karen+Handel&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-susan-komen-planned-parenthood-breast-cancer-20120201%2C0%2C7491587.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=In+wake+of+Komen-Planned+Parenthood+rift%2C+eyes+turn+to+Karen+Handel&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-susan-komen-planned-parenthood-breast-cancer-20120201%2C0%2C7491587.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995943798/u/49/f/622900/c/34253/s/1c54959a/a2.htm"><img src="http://da.feedsportal.com/r/123995943798/u/49/f/622900/c/34253/s/1c54959a/a2.img" border="0"/></a> Sleep apnea may make people more prone to silent strokes Having severe sleep apnea may make people more at risk for silent strokes and small brain lesions, researchers found.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5483b3/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Sleep+apnea+may+make+people+more+prone+to+silent+strokes&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-stroke-sleep-apnea-20120201%2C0%2C2331742.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Sleep+apnea+may+make+people+more+prone+to+silent+strokes&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-stroke-sleep-apnea-20120201%2C0%2C2331742.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995937564/u/49/f/622900/c/34253/s/1c5483b3/a2.htm"><img src="http://da.feedsportal.com/r/123995937564/u/49/f/622900/c/34253/s/1c5483b3/a2.img" border="0"/></a> Wake-up stroke victims can receive clot-busting drugs, study says Stroke victims who are treated with blood-clot dissolving medications often recover better than people who don't receive the drugs. The medications, called tissue plasminogen activators, must be given within 4.5 hours of the first symptoms of stroke. Many people arrive at the hospital too late for the therapy.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c546313/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Wake-up+stroke+victims+can+receive+clot-busting+drugs%2C+study+says&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-stroke-20120201%2C0%2C2920091.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Wake-up+stroke+victims+can+receive+clot-busting+drugs%2C+study+says&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-stroke-20120201%2C0%2C2920091.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995986534/u/49/f/622900/c/34253/s/1c546313/a2.htm"><img src="http://da.feedsportal.com/r/123995986534/u/49/f/622900/c/34253/s/1c546313/a2.img" border="0"/></a> Internet heats up over Komen's Planned Parenthood decision The recent announcement from Susan G. Komen for the Cure to cut funds to Planned Parenthood has prompted lively discussions on public message boards, Twitter and Facebook arguing both for and against the decision.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c540f0f/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Internet+heats+up+over+Komen%27s+Planned+Parenthood+decision&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-planned-parenthood-comments-20120201%2C0%2C6599645.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Internet+heats+up+over+Komen%27s+Planned+Parenthood+decision&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-planned-parenthood-comments-20120201%2C0%2C6599645.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995985933/u/49/f/622900/c/34253/s/1c540f0f/a2.htm"><img src="http://da.feedsportal.com/r/123995985933/u/49/f/622900/c/34253/s/1c540f0f/a2.img" border="0"/></a> Komen affiliate 'frustrated' by Planned Parenthood decision Not everyone associated with the Susan G. Komen Foundation for the Cure is happy about the group's decision to sever ties with Planned Parenthood.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c5419f2/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Komen+affiliate+%27frustrated%27+by+Planned+Parenthood+decision&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-connecticut-planned-parenthood-20120201%2C0%2C7872409.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Komen+affiliate+%27frustrated%27+by+Planned+Parenthood+decision&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-connecticut-planned-parenthood-20120201%2C0%2C7872409.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995934224/u/49/f/622900/c/34253/s/1c5419f2/a2.htm"><img src="http://da.feedsportal.com/r/123995934224/u/49/f/622900/c/34253/s/1c5419f2/a2.img" border="0"/></a> Komen decision triggering petitions, donations The Susan G. Komen for the Cure Foundation's decision to yank its funding from Planned Parenthood has triggered a flood of donations to Planned Parenthood and at least two petitions aimed at reversing the decision.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c539e0a/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Komen+decision+triggering+petitions%2C+donations&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-planned-parenthood-20120201%2C0%2C689940.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Komen+decision+triggering+petitions%2C+donations&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-komen-planned-parenthood-20120201%2C0%2C689940.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995982019/u/49/f/622900/c/34253/s/1c539e0a/a2.htm"><img src="http://da.feedsportal.com/r/123995982019/u/49/f/622900/c/34253/s/1c539e0a/a2.img" border="0"/></a> Chronic conditions' toll tallied The sunny fact that Americans are living longer, more productive lives has a dark side: More of us than ever live with chronic illnesses that are not only a drag on sufferers' time and energy, but on the nation's pocketbook. The Institute of Medicine on Tuesday put a dollar figure on the cost of caring for chronic illness in the United States--$1.5 trillion yearly, fully three-fourths of annual healthcare spending.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c4deb61/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Chronic+conditions%27+toll+tallied&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-chronic-disease-toll-20120131%2C0%2C4463435.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Chronic+conditions%27+toll+tallied&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-chronic-disease-toll-20120131%2C0%2C4463435.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995895216/u/49/f/622900/c/34253/s/1c4deb61/a2.htm"><img src="http://da.feedsportal.com/r/123995895216/u/49/f/622900/c/34253/s/1c4deb61/a2.img" border="0"/></a> Olympian Natalie Coughlin on food: Eat healthfully, but enjoy it Swimmer Natalie Coughlin didn't earn 11 Olympic medals by eating junk food. The 29-year-old has been interested in food since her days at UC Berkeley, when she began to break out of her grilled chicken and broccoli habit and explore more appealing fare.<img width='1' height='1' src='http://ChicagoTribune.feedsportal.com/c/34253/f/622900/s/1c4db9d8/mf.gif' border='0'/><div class='mf-viral'><table border='0'><tr><td valign='middle'><a href="http://share.feedsportal.com/viral/sendEmail.cfm?lang=en&title=Olympian+Natalie+Coughlin+on+food%3A+Eat+healthfully%2C+but+enjoy+it&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-natalie-coughlin-food-nutrition-20120131%2C0%2C3357426.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/emailthis2.gif" border="0" /></a></td><td valign='middle'><a href="http://res.feedsportal.com/viral/bookmark.cfm?title=Olympian+Natalie+Coughlin+on+food%3A+Eat+healthfully%2C+but+enjoy+it&link=http%3A%2F%2Fwww.chicagotribune.com%2Fhealth%2Fla-heb-natalie-coughlin-food-nutrition-20120131%2C0%2C3357426.story%3Ftrack%3Drss" target="_blank"><img src="http://res3.feedsportal.com/images/bookmark.gif" border="0" /></a></td></tr></table></div><br/><br/><a href="http://da.feedsportal.com/r/123995900077/u/49/f/622900/c/34253/s/1c4db9d8/a2.htm"><img src="http://da.feedsportal.com/r/123995900077/u/49/f/622900/c/34253/s/1c4db9d8/a2.img" border="0"/></a>

	Copd: Respiratory Ailment Explained By EMMANUEL CHAVEZ Cigarette smoking has been strongly linked to health conditions like heart disease and lung cancer. Other than these two dreaded disease, heavy smoking may also cause chronic Read more...

	Copd: Respiratory Ailment Explained By EMMANUEL CHAVEZ Cigarette smoking has been strongly linked to health conditions like heart disease and lung cancer. Other than these two dreaded disease, heavy smoking may also cause chronic Read more...