Information for Doctors

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Thoracic Medicine

Think you might have a breathing disorder or just looking for more information?

Sleep Medicine

Think you might have a sleeping disorder or just looking for more information?

Latest News

jetlagged2 One in three Australians suffer from poor quality sleep.  New research suggests sleep deprivation is costing the Australian economy more than $5.1 billion a year in both direct and indirect costs.

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january2012asthmalung  Many people with asthma have sensitivities to certain drugs that can precipitate an asthma attack. If you have asthma, you need to be aware of which medications may be triggers. You do not need to avoid these medications unless you know they are asthma triggers for you. If these medications have never triggered your asthma, it is still best to take the medications with caution because a reaction can occur at any time.

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asthmatic

Study suggests occasional treatment is effective and may reduce risk of decrease in growth.

Recent research now contests that the current recommended daily dosing of inhaled steroids for children under the age of five may be just as effective as less frequent treatments with a higher dose of inhaled steroids, leading to an overall reduced exposure to the drug.

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sleep_restriction

Plan charts course for future sleep and circadian research identifying opportunities for collaboration.

Recently the NIH has updated its plan for research into new approaches to the prevention and treatment of sleep disorders.  Over the next three to five years, the institute has recommended research initiatives to include looking at the connection between sleep and circadian systems, studying the influence of genetic and environmental factors that could influence a person’s sleep health, and conducting more comparative effectiveness trials to improve treatments for sleep and circadian disorders.

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ptsdcancer11 in 2 Australians will be diagnosed with cancer by the age of 85, with more than 60% of cancer patients surviving more than five years after diagnosis.According to a recent US study the hidden psychological scars caused by the diagnosis of cancer can leave scaring akin to that inflicted by war, with the impact in some cases lasting for years.

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ALZHEIMER’S AUSTRALIA MARCHES ON PARLIAMENT HOUSE

A group of 500 people marched on parliament on October 13 in the fight against dementia.  The assemblage gathered to demand a $500 million Dimentia Action Plan over five years in the next federal budget.  Alzheimer’s Australia president, Ita Buttrose led the march and warned there will be 75 000 baby boomers with dementia in 2020, just eight short years away. READ MORE

Atypical Mycobacterium

What is Atypical Mycobacterium Infection?

Mycobacteria is a type of bacteria that can cause infection within the body.  Atypical mycobacterium is any mycobacterium other than Tuberculosis mycobacterium.  The most common form of atypical mycobacterium, which also most commonly affects the lungs is the mycobacterium avium intracellulare complex.  Mycobacterium avium complex (MAC) has been isolated in freshwater and saltwater worldwide, with other common sources including aerosolized water, piper hot water systems, bathrooms, house dust, soil, birds, farm animals and cigarette components such as tobacco, filters and paper.  

What is MAC?

Mycobacterium avium complex (MAC) consists of two species— M avium and M intracellular -these species are difficult to differentiate.   It is thought that MAC is acquired by exposure to soil, air, or water, especially in temperate and sub tropical areas. People who are affected are usually those with low immune systems (patients with AIDS), or those suffering from chronic lung conditions (bronchiectasis, heavy smoking, or cystic fibrosis)  MAC causes 2 general patterns of lung disease, one pattern involves nodules and cavities, whilst the other involves nodules and bronchietasis.

How is MAC transmitted?

MAC is transmitted into the body through inhalation via the respiratory tract or digestion via the GI tract.  There is no known human to human transmission therefore the mycobacterium avium intracellular complex is considered NOT contagious.

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Treatment

Medication

Treatment can involve a range of drugs but often includes Rifampicin, Ethambutol and Clarithromycin.


Exercise

Regular daily exercise including walking, Yoga, Pilates, and strength training is highly recommended. MAC patients must remember that effort is required to maintain exercise due to chronic and sometimes extreme fatigue. It is very easy to become tired and not feel up to exercising. However, the continued plan will eventually contribute to improving daily quality of life.


Diet

Proper nutrition and adequate caloric intake to prevent weight loss and even encourage weight gain is helpful for MAC patients. Regular rest periods and sleep patterns assist to lessen fatigue. There may be some benefit for regular counseling visits and taking prescribed medications for depression and anxiety due to the stress of chronic illness. MAC patients can help themselves by maintaining a proactive stance and keeping up to date regarding current knowledge about the disease.


Seek Help

A major issue with MAC disease is fatigue or tiredness. Routines may need to be altered and assistance with activities of daily living may be required. Enlistment of others’ help and support is essential.


Keep on top of it!

Patients must pay attention to symptoms, take medications indefinitely, exercise regularly, and provide good nourishment to maintain a healthy weight. It is essential to envelope rigorous pulmonary hygiene, providing sputum cultures or getting bronchoscopes as needed. It is also important to avoid exposure to known infections, rest periodically as needed, and promote good sleep patterns. It is possible to maintain a good quality of life by following these suggestions.

MAC lung patients are initially treated for 15-18 months. Monthly follow up visits are recommended that include blood work. Less frequent testing is done via sputum samples, CT scans, chest films, and pulmonary function studies about every 6 months. Bronchoscopy may be required for those patients unable to produce sputum samples for culture.
Patients whose sputum remains culture positive for MAC after 12 months of drug treatment are considered treatment failures. Patients whose sputum cultures become negative for MAC almost always do so within 6 months of starting their drugs. If the condition worsens with symptoms or if the tests appear to change, then the physician would need to reevaluate the treatment plan and possibly consider another regimen of antibiotic therapy.

Lady Windermere Syndrome.

Mycobacterium avium complex (MAC) has also been associated with pulmonary infection and bronchiectasis in middle-aged women without a preexisting lung disease. Pulmonary MAC infection in this population is believed to be due to voluntary cough suppression that results in stagnation of secretions, which creates a suitable environment for growth of the organisms.

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