Asthma

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__Definition__:
"A chronic lung disease, characterized by sudden, potentially fatal attacks of breathing difficulty." p 219, HGD Chapter 9 p. 216-244.

__Examples__:
Most people don't know that the most frequent of school absences for 6-12 year olds is asthma, a chronic lung disease in which individuals experience sudden potentially fatal attacks of breath difficulty. According to health officials, 9% of school-aged children and teens in the United States have been diagnosed with asthma.

Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by. In affected people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens a.k.a. triggers). Common asthma "triggers" include: Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients. Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.
 * Animals (pet hair or dander)
 * Dust
 * Changes in weather (most often cold weather)
 * Chemicals in the air or in food
 * Exercise
 * Mold
 * Pollen
 * Respiratory infections, such as the common cold
 * Strong emotions (stress)
 * Tobacco smoke


 * //__Types of Asthma__//**


 * Bronchial asthma; Exercise-induced asthma

Asthma is a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.

Asthma is a common chronic disease worldwide and affects approximately 24 million persons in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children, and it is a common cause of hospitalization for children in the United States.



__Extra Information__:
__Symptoms__: Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom. Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted. Symptoms include: __**Emergency symptoms:**__ __ Signs and tests __ Allergy testing may be helpful to identify allergens in people with persistent asthma. Common allergens include: Common respiratory irritants include: The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes. Tests may include:
 * Cough with or without sputum (phlegm) production
 * Pulling in of the skin between the ribs when breathing (intercostal retractions)
 * Shortness of breath that gets worse with exercise or activity
 * Wheezing, which:
 * Comes in episodes with symptom-free periods in between
 * May be worse at night or in early morning
 * May go away on its own
 * Gets better when using drugs that open the airways (bronchodilators)
 * Gets worse when breathing in cold air
 * Gets worse with exercise
 * Gets worse with heartburn (re-flux)
 * Usually begins suddenly
 * Bluish color to the lips and face
 * Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack
 * Extreme difficulty breathing
 * Rapid pulse
 * Severe anxiety due to shortness of breath
 * Sweating
 * __Other symptoms that may occur with this disease:__**
 * Abnormal breathing pattern --breathing out takes more than twice as long as breathing in
 * Breathing temporarily stops
 * Chest pain
 * Tightness in the chest
 * Cockroach allergens
 * Dust mites
 * Molds
 * Pet dander
 * Pollen
 * Fumes from burning wood or gas
 * Pollution
 * Tobacco smoke
 * Arterial blood gas
 * Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
 * Chest x-ray
 * Lung function tests
 * Peak flow measurements

__Mnemonics__:
CAUSES of an asthma attack:

C-Cold air

A-Allergens/Atopy

U-Upper respiratory tract infections

S-Smoking

E-Exercise

S-Stress/excitement

=__In the news:__=

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 * Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing (constriction) of the airways. The result is difficulty breathing. The bronchial narrowing is usually either totally or at least partially reversible with treatments.

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 * The latest Respiratory News & Asthma News articles published daily. Includes news on Asthma, BPD, Bronchitis, COPD, Emphysema, Pneumonia, Tuberculosis, and more.

__ References __

 * 1) Lugogo N, Que LG, Fertel D, Kraft M. Asthma. In: Mason RJ, Broaddus VC, Martin TR, et al. //Murray & Nadel's Textbook of Respiratory Medicine//. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 38.
 * 2) Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76.
 * 3) National Asthma Education and Prevention Program Expert Panel Report 3: //Guidelines for the Diagnosis and Management of Asthma.//Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publication 08-4051.
 * 4) Wechsler ME. Managing asthma in primary care: putting new guideline recommendations into context. //Mayo Clin Proc//. 2009;84:707-717.
 * 5) Fanta CH. Asthma. //N Engl J Med//. 2009;360:1002-1014.

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