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  • Asthma Pathophysiology Fisiopatología Del Asma Natural History of Asthma

    Hochgeladen von

    Juan Herrera Salazar
    74 Ansichten37 Seiten
    Asthma is a chronic inflammatory disease of the airways. In the United States, asthma affects more than 22 million persons. It is one of the most common chronic diseases of childhood, affecting more than 6 million children (current asthma prevalence, National Health Interview Survey (NHIS), National Center for Health Statistics, Centers for Disease Control and Prevention, 2005) (NHIS 2005). There have been important gains since the release of the first National Asthma Education and Prevention Program (NAEPP) clinical practice guidelines in 1991. For example, the number of deaths due to asthma has declined, even in the face of an increasing prevalence of the disease (NHIS 2005); fewer patients who have asthma report limitations to activities; and an increasing proportion of people who have asthma receive formal patient education (Department of Health and Human Services, Healthy People 2010 midcourse review). Hospitalization rates have remained relatively stable over the last decade, with lower rates in some age groups but higher rates among young children 0–4 years of age. There is some indication that improved recognition of asthma among young children contributes to these rates. However, the burden of avoidable hospitalizations remains. Collectively, people who have asthma have more than 497,000 hospitalizations annually (NHIS 2005). Furthermore, ethnic and racial disparities in asthma burden persist, with significant impact on African American and Puerto Rican populations. The challenge remains to help all people who have asthma, particularly those at high risk, receive quality asthma care.

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    Asthma Pathophysiology Fisiopatología del Asma natural History of asthma

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    Asthma is a chronic inflammatory disease of the airways. In the United States, asthma affects more than 22 million persons. It is one of the most common chronic diseases of childhood, affecting more than 6 million children (current asthma prevalence, National Health Interview Survey (NHIS), National Center for Health Statistics, Centers for Disease Control and Prevention, 2005) (NHIS 2005). There have been important gains since the release of the first National Asthma Education and Prevention Program (NAEPP) clinical practice guidelines in 1991. For example, the number of deaths due to asthma has declined, even in the face of an increasing prevalence of the disease (NHIS 2005); fewer patients who have asthma report limitations to activities; and an increasing proportion of people who have asthma receive formal patient education (Department of Health and Human Services, Healthy People 2010 midcourse review). Hospitalization rates have remained relatively stable over the last decade, with lower rates in some age groups but higher rates among young children 0–4 years of age. There is some indication that improved recognition of asthma among young children contributes to these rates. However, the burden of avoidable hospitalizations remains. Collectively, people who have asthma have more than 497,000 hospitalizations annually (NHIS 2005). Furthermore, ethnic and racial disparities in asthma burden persist, with significant impact on African American and Puerto Rican populations. The challenge remains to help all people who have asthma, particularly those at high risk, receive quality asthma care.

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    Attribution Non-Commercial (BY-NC)
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    74 Ansichten37 Seiten

    Asthma Pathophysiology Fisiopatología Del Asma Natural History of Asthma

    Hochgeladen von

    Juan Herrera Salazar
    Asthma is a chronic inflammatory disease of the airways. In the United States, asthma affects more than 22 million persons. It is one of the most common chronic diseases of childhood, affecting more than 6 million children (current asthma prevalence, National Health Interview Survey (NHIS), National Center for Health Statistics, Centers for Disease Control and Prevention, 2005) (NHIS 2005). There have been important gains since the release of the first National Asthma Education and Prevention Program (NAEPP) clinical practice guidelines in 1991. For example, the number of deaths due to asthma has declined, even in the face of an increasing prevalence of the disease (NHIS 2005); fewer patients who have asthma report limitations to activities; and an increasing proportion of people who have asthma receive formal patient education (Department of Health and Human Services, Healthy People 2010 midcourse review). Hospitalization rates have remained relatively stable over the last decade, with lower rates in some age groups but higher rates among young children 0–4 years of age. There is some indication that improved recognition of asthma among young children contributes to these rates. However, the burden of avoidable hospitalizations remains. Collectively, people who have asthma have more than 497,000 hospitalizations annually (NHIS 2005). Furthermore, ethnic and racial disparities in asthma burden persist, with significant impact on African American and Puerto Rican populations. The challenge remains to help all people who have asthma, particularly those at high risk, receive quality asthma care.

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    Attribution Non-Commercial (BY-NC)
    Als PPT, PDF, TXT herunterladen oder online auf Scribd lesen
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    Programas Educativos " Control del Asma Bronquial"

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    Programas Educativos " Control del Asma Bronquial"

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    Programas Educativos " Control del Asma Bronquial"


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    NEW !
    Clnica de Asma y Alergia Managua, Nicaragua.
    Programas Educativos " Control del Asma Bronquial" 28/02/2012

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    Latest Revision Oct 2007 (EPR-3) Adaptaciones para la prctica en Nicaragua , febrero 2012.

    Programas Educativos " Control del Asma Bronquial"

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    Evidencias de un nuevo paradigma

    Remodelamiento.

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    Reality of pulmonary biochemistry


    Mucosal layer x Potential for secretions Sub-mucosal layer x Potential for mucosal edema x Potential for bronchospasm

    Most common causes of narrowed airways


    Secretions, mucosal edema, and

    bronchospasm

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    Airway Inflammation Bronchial Hyperresponsiveness Bronchoconstriction Bronchial Wall Edema Excess Mucous Secretions Airway Remodeling

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    TRIGGER q INFLAMMATORY RESPONSE q AIRWAY CHANGES q RESPIRATORY SYMPTOMS


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    Type I Hypersensitivity
    Immediate Type Hypersensitivity Involves IgE antibody on mast cell

    Type IV Hypersensitivity
    Delayed Type Hypersensitivity Involves T cell mediated response Other immune system cells activated

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    Early Phase Response


    Involves Type I Hypersensitivity IgE antibody with Mast Cells

    Late Phase Response


    Involves Type IV Hypersensitivity T cell mediated response activates

    eosinophils, B cells, others

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    Airway hyperresponsivenessan exaggerated bronchoconstrictor response to a wide variety of stimuliis a major, but not necessarily unique, feature of asthma
    Defined by contractile responses to challenges with methacholine correlates with the clinical severity of asthma Influenced by inflammation, dysfunctional neuro-regulation, and structural changes

    Treatment directed toward reducing inflammation can reduce airway hyperresponsiveness and improve asthma control.
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    Dominant physiological event leading to clinical symptoms Allergen-induced acute bronchoconstriction results from an IgE-dependent release of mediators from mast cells Non-IgE dependent bronchoconstriction can be caused by other stimuli including

    Irritants Exercise Cold air Aspirin and other nonsteroidal anti-inflammatory drugs

    Stress may also play a role in precipitating bronchoconstriction


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    As the disease becomes more persistent and inflammation more progressive, other factors further limit airflow These include edema, inflammation, mucus hypersecretion and the formation of inspissated mucus plugs, as well as structural changes including hypertrophy and hyperplasia of the airway smooth muscle. These latter changes may not respond to usual treatment.
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    Vascular Dilation Subbasement Membrane Thickening Mucus Mucous Gland Hypertrophy

    Edema

    Subepithelial Fibrosis Epithelial Damage Inflammatory Cell Infiltration


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    Smooth Muscle Hypertrophy


    Programas Educativos " Control del Asma Bronquial" 28/02/2012

    In some persons who have asthma, airflow limitation may be only partially reversible
    The process of repair and its regulation are

    likely to be key events in explaining the persistent nature of the disease and limitations to a therapeutic response Structural changes can include thickening of the sub-basement membrane, subepithelial fibrosis, airway smooth muscle hypertrophy and hyperplasia, blood vessel proliferation and dilation, and mucous gland hyperplasia and hypersecretion
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    Taken together, these longitudinal epidemiological studies and clinical trials indicate that the progression of asthma, as measured by declines in lung function, varies in different age groups. Declines in lung function growth observed in children appear to occur by 6 years of age and occur predominantly in those children whose asthma symptoms started before 3 years of age. Children 512 years of age who have mild or moderate persistent asthma, on average, do not appear to experience declines in lung function through 1117 years of age, although a subset of these children experience progressive reductions in lung growth as measured by FEV1.
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    START study As knowledge of the various phenotypes of inflammation become apparent, it is likely that treatment also will also have greater specificity and, presumably
    The

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    Wheezing
    tightness noisy breathing

    Cough
    especially if after exertion breathing cold air at night after colds paroxysmal

    Dyspnea
    (Breathlessness)

    Asthma

    especially if: intermittent or variable after exertion at night

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    Early warning signs are changes that happen just before or at the very beginning of an asthma episode. These changes start before the well-known symptoms of asthma and are the earliest signs that a persons asthma is worsening. In general, these signs are not severe enough to stop a person from going about his or her daily activities. By recognizing these signs, you can stop an asthma episode or prevent one from getting worse.
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    Frequent cough, especially at night Losing your breath easily or shortness of breath Feeling very tired or weak when exercising Wheezing or coughing after exercise Feeling tired, easily upset, grouchy, or moody Decreases or changes in a peak expiratory flow

    Know These Warning Signs!

    Signs of a cold, upper respiratory infection, or allergies (sneezing, runny nose, cough, congestion, sore throat, and headache)

     

    Trouble sleeping or Restless Tickle in throat


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    Managua , Nicaragua Email: jhsdoctor@hotmail.com

    Tel

    2278 1169 2270-3359 8846-5022 8882-5513


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    Gracias por la oportunidad


    Clnica de Asma y Alergia, Dr. Juan Herrera SalazarFacebook

    Managua , Nicaragua. Tel 22781169, 22703359, 88825513

    Dr. Juan Herrera Salazar


    Favor ver la III Parte

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    Clnica de Asma y Alergia, Dr. Juan Herrera SalazarFacebook.

    Foro Mdico Nicaragense Portales Mdicos

    Medbook Mi blog de Asma y Alergia

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