Childhood asthma is a chronic inflammatory lung disease characterized by recurrent symptoms, airway narrowing and hyperresponsiveness. It affects 13.5% of children and often begins before age 6. Risk factors include family history, allergy, smoking exposure and male gender. Symptoms include cough, wheeze and difficulty breathing. Diagnosis involves assessing symptoms, lung function testing and allergy testing. Management focuses on controlling triggers, pharmacotherapy including controllers for persistent asthma, and monitoring to prevent exacerbations. The goal is optimal asthma control and minimizing future risk.
- Asthma is a common chronic disease in childhood characterized by wheezing, coughing, chest tightness and difficulty breathing.
- There are different phenotypes of wheezing in preschool aged children including transient early wheezing typically associated with viral infections, non-atopic wheezing also triggered by viruses, and persistent atopic wheezing where children develop asthma.
- Episodic viral wheezing is very common in young children, with wheezing occurring only during viral respiratory infections. Most children outgrow this pattern, but some may develop multiple-trigger wheezing with other asthma triggers between episodes.
This document provides recommendations from the British guideline on the management of asthma. It recommends that the initial assessment of asthma in both children and adults should focus on taking a thorough clinical history and considering alternative diagnoses. For those with a high probability of asthma, treatment should be started, while further testing is reserved for poor responders. For intermediate probability cases, tests like lung function and a treatment trial can help determine if a diagnosis of asthma is appropriate. Self-management education and written asthma action plans are recommended to improve health outcomes.
A 3-year-old boy named Rohit has been brought to a doctor for recurrent cough over the past year. His cough worsens at night and after activities like running or laughing. He has also frequently had colds requiring nebulization. The doctor suspects Rohit may have asthma based on his symptoms. Asthma is characterized by wheezing, shortness of breath, coughing, and other symptoms that are often worse at night or with exercise. Through a medical examination and history, the doctor seeks to determine if Rohit displays signs of asthma and rule out other potential causes of his symptoms. If asthma is confirmed, the doctor outlines treatment and management strategies to control Rohit's condition.
This document provides guidelines from the Global Initiative for Asthma (GINA) and the British Thoracic Society on the management of asthma. It discusses the diagnosis and classification of asthma, the components of asthma care including developing a treatment plan, identifying and reducing risk factors, assessing control and monitoring the condition. It outlines a stepwise approach to pharmacological treatment based on disease severity and control. Controller medications include inhaled corticosteroids, long-acting beta agonists, leukotriene modifiers and oral corticosteroids. Reliever medications like short-acting beta agonists are used for acute symptoms. The guidelines provide guidance on monitoring control and adjusting treatment accordingly.
This document discusses paediatric asthma management from theory to clinical practice. It provides an overview of childhood asthma as a global health issue, outlines factors influencing prevalence, and discusses the burden of childhood asthma. It also covers evaluating asthma control, Global Initiative for Asthma treatment guidelines, and strategies for maintaining control or stepping up treatment in response to loss of control. Key studies comparing inhaled versus oral therapies and the efficacy of different controller medications are summarized.
Acute severe asthma exacerbations in children younger than 12 yearsDr. Ali Abdelrafie
- Childhood asthma is the most common chronic disease in children, affecting 5-10% worldwide and resulting in around 500,000 hospitalizations annually. While it cannot be cured, symptoms can be controlled with treatment to prevent lung damage.
- Status asthmaticus refers to an acute severe asthma exacerbation that does not improve with standard emergency department treatment and may progress to respiratory failure without aggressive intervention. It is characterized by severe airflow obstruction from airway inflammation, mucus production, and bronchospasm.
- Children presenting with acute severe asthma who do not improve with initial emergency department treatment should be admitted to the pediatric intensive care unit.
This document discusses childhood asthma, including its classification, epidemiology, etiology, pathogenesis, clinical features, complications, management, prognosis, and prevention. It provides case scenarios to demonstrate the diagnosis of asthma in children. Key points include that asthma is a chronic inflammatory condition of the airways causing episodic obstruction, it has a prevalence of 20% in Pakistani children, and is diagnosed based on a history of recurrent or intermittent respiratory symptoms and signs of bronchial obstruction on examination. Asthma is managed by avoiding triggers, using quick-relief and preventive medications, and treating exacerbations.
Bronchial asthma clinical pharmacist hebatallah m abdallatif,bcps (1)Heba Abd Allatif
Bronchial asthma is a chronic inflammatory disease characterized by airflow obstruction, airway hyperresponsiveness, and inflammation. The signs and symptoms include wheezing, cough, shortness of breath, and chest tightness. Diagnosis involves pulmonary function tests and demonstrating bronchodilator response. Treatment involves a stepwise approach using reliever medications for acute symptoms and controller medications like inhaled corticosteroids to reduce inflammation. Education, environmental control, pharmacologic treatment, and proper inhaler technique are important for long-term asthma management and control.
- Asthma is a common chronic disease in childhood characterized by wheezing, coughing, chest tightness and difficulty breathing.
- There are different phenotypes of wheezing in preschool aged children including transient early wheezing typically associated with viral infections, non-atopic wheezing also triggered by viruses, and persistent atopic wheezing where children develop asthma.
- Episodic viral wheezing is very common in young children, with wheezing occurring only during viral respiratory infections. Most children outgrow this pattern, but some may develop multiple-trigger wheezing with other asthma triggers between episodes.
This document provides recommendations from the British guideline on the management of asthma. It recommends that the initial assessment of asthma in both children and adults should focus on taking a thorough clinical history and considering alternative diagnoses. For those with a high probability of asthma, treatment should be started, while further testing is reserved for poor responders. For intermediate probability cases, tests like lung function and a treatment trial can help determine if a diagnosis of asthma is appropriate. Self-management education and written asthma action plans are recommended to improve health outcomes.
A 3-year-old boy named Rohit has been brought to a doctor for recurrent cough over the past year. His cough worsens at night and after activities like running or laughing. He has also frequently had colds requiring nebulization. The doctor suspects Rohit may have asthma based on his symptoms. Asthma is characterized by wheezing, shortness of breath, coughing, and other symptoms that are often worse at night or with exercise. Through a medical examination and history, the doctor seeks to determine if Rohit displays signs of asthma and rule out other potential causes of his symptoms. If asthma is confirmed, the doctor outlines treatment and management strategies to control Rohit's condition.
This document provides guidelines from the Global Initiative for Asthma (GINA) and the British Thoracic Society on the management of asthma. It discusses the diagnosis and classification of asthma, the components of asthma care including developing a treatment plan, identifying and reducing risk factors, assessing control and monitoring the condition. It outlines a stepwise approach to pharmacological treatment based on disease severity and control. Controller medications include inhaled corticosteroids, long-acting beta agonists, leukotriene modifiers and oral corticosteroids. Reliever medications like short-acting beta agonists are used for acute symptoms. The guidelines provide guidance on monitoring control and adjusting treatment accordingly.
This document discusses paediatric asthma management from theory to clinical practice. It provides an overview of childhood asthma as a global health issue, outlines factors influencing prevalence, and discusses the burden of childhood asthma. It also covers evaluating asthma control, Global Initiative for Asthma treatment guidelines, and strategies for maintaining control or stepping up treatment in response to loss of control. Key studies comparing inhaled versus oral therapies and the efficacy of different controller medications are summarized.
Acute severe asthma exacerbations in children younger than 12 yearsDr. Ali Abdelrafie
- Childhood asthma is the most common chronic disease in children, affecting 5-10% worldwide and resulting in around 500,000 hospitalizations annually. While it cannot be cured, symptoms can be controlled with treatment to prevent lung damage.
- Status asthmaticus refers to an acute severe asthma exacerbation that does not improve with standard emergency department treatment and may progress to respiratory failure without aggressive intervention. It is characterized by severe airflow obstruction from airway inflammation, mucus production, and bronchospasm.
- Children presenting with acute severe asthma who do not improve with initial emergency department treatment should be admitted to the pediatric intensive care unit.
This document discusses childhood asthma, including its classification, epidemiology, etiology, pathogenesis, clinical features, complications, management, prognosis, and prevention. It provides case scenarios to demonstrate the diagnosis of asthma in children. Key points include that asthma is a chronic inflammatory condition of the airways causing episodic obstruction, it has a prevalence of 20% in Pakistani children, and is diagnosed based on a history of recurrent or intermittent respiratory symptoms and signs of bronchial obstruction on examination. Asthma is managed by avoiding triggers, using quick-relief and preventive medications, and treating exacerbations.
Bronchial asthma clinical pharmacist hebatallah m abdallatif,bcps (1)Heba Abd Allatif
Bronchial asthma is a chronic inflammatory disease characterized by airflow obstruction, airway hyperresponsiveness, and inflammation. The signs and symptoms include wheezing, cough, shortness of breath, and chest tightness. Diagnosis involves pulmonary function tests and demonstrating bronchodilator response. Treatment involves a stepwise approach using reliever medications for acute symptoms and controller medications like inhaled corticosteroids to reduce inflammation. Education, environmental control, pharmacologic treatment, and proper inhaler technique are important for long-term asthma management and control.
Updates On Pharmacological Management Of Pediatric AsthmaAshraf ElAdawy
This document provides information on the pharmacological management of pediatric asthma. It discusses asthma diagnosis and phenotypes in children, the goals of asthma treatment, and a stepwise approach to pharmacological management. Inhaled corticosteroids are recommended as the most effective long-term controller medication for asthma and should be considered as initial treatment for children using reliever medications frequently or experiencing frequent daytime symptoms. The starting dose of inhaled corticosteroids is 200 micrograms of beclomethasone dipropionate per day for children.
This document reviews the emergency presentation and management of acute severe asthma in children. It discusses the pathophysiology, epidemiology, clinical assessment, and treatment of acute severe asthma attacks in children. The key points are:
1) Acute severe asthma is one of the most common medical emergencies in children and involves inflammation and bronchoconstriction of the airways.
2) The cornerstones of treatment are rapid administration of oxygen, inhalations with bronchodilators such as beta-2 agonists, and systemic corticosteroids.
3) Additional treatments may include intravenous bronchodilators, corticosteroids, magnesium sulfate, or non-invasive ventilation if medical treatment fails
Asthma is a chronic inflammatory disorder of the airways that causes recurrent wheezing, breathlessness, chest tightness and coughing. It is the most common chronic lower respiratory disease in children. This document discusses differentiating transient wheezing from asthma in young children, managing high-risk children, and prevention therapies. It also covers diagnosing and classifying asthma severity, recommended treatment steps based on severity including inhaled corticosteroids and reliever medications, and FDA-approved treatment options for children ages 4 and under.
The document summarizes key changes and recommendations from the 2015 Global Initiative for Asthma (GINA) update, including:
- Add-on tiotropium by soft-mist inhaler is a new treatment option for Steps 4 and 5 in patients ≥18 years with exacerbation history.
- Management of asthma in pregnancy includes monitoring for infections and using usual controllers during labor/delivery.
- Dry powder inhalers can deliver SABA in mild-moderate exacerbations but not for severe acute asthma.
- For life-threatening asthma in primary care, give SABA, ipratropium, systemic corticosteroids, and oxygen while arranging transfer.
This presentation is all about world asthma day which is celebrated every year. this year we celebrated it on 4th may 2021. here we can get information about when, why and how we celebrate along with signs & symptoms, diagnosis and prevention of asthama.
The document summarizes the Global Initiative for Asthma (GINA) strategy for managing asthma. It provides:
1) An overview of the GINA program, which takes a practical, evidence-based approach to managing asthma globally.
2) Details on key changes in the 2016 GINA strategy, including new treatment recommendations and a focus on low-resource settings.
3) Information on defining and diagnosing asthma, emphasizing the use of symptom history and tests to confirm variable airflow limitation.
Treatment of Asthma Exacerbations in the Pediatric Emergency Departmentjrhoffmann
This document discusses the treatment of asthma exacerbations in pediatric emergency departments. It begins with definitions of an asthma exacerbation and status asthmaticus. It then covers approaches to determining the severity of an exacerbation. The primary treatments discussed are bronchodilation with inhaled beta agonists and systemic corticosteroids. Delivery methods like nebulizers and metered dose inhalers are compared. Overall, the document provides an overview of assessing and treating pediatric asthma exacerbations in the emergency department.
The document provides guidelines for physicians on diagnosing and managing childhood asthma in children aged 0-11. It was developed by the Health Authority of Abu Dhabi to help primary care physicians successfully treat asthma. The guidelines cover diagnosing asthma, assessing control, developing treatment plans, and managing acute exacerbations. The goals are to achieve control of symptoms and prevent exacerbations through environmental control, education, and medication adherence. Treatment involves a stepwise approach starting with reliever medications and adding controller medications as needed.
Asthma is a chronic lung disease characterized by inflammation and narrowing of the airways. It commonly manifests as wheezing, chest tightness, coughing, and shortness of breath. While its exact causes are unknown, asthma is thought to involve both environmental and genetic factors. It affects around 13% of children and can be classified as either early childhood transient wheezing or chronic asthma associated with allergies. The main types of childhood asthma involve recurrent wheezing triggered by viral infections or chronic allergy-associated asthma. Management involves assessment, education, controlling triggers, and medications to reduce inflammation and bronchospasm.
Asthma 2010 new gina guidelines[pediatric]Pradeep Gc
This document provides information on asthma management guidelines and tools. It discusses the goals of asthma management, which include achieving control of symptoms, maintaining normal activity levels, pulmonary function, and preventing exacerbations and mortality. It outlines a six-part asthma management program involving education, assessment, avoiding triggers, medication plans, managing exacerbations, and follow-up care. Classification systems for severity are presented for children and adults. Peak flow meters, spirometry, inhaler devices, and stepwise treatment approaches are also summarized.
Updates In Bronchiolitis 23 2 2010 Dr HumaidEM OMSB
This document summarizes recent evidence on the diagnosis and management of bronchiolitis. It defines bronchiolitis and discusses causes such as respiratory syncytial virus (RSV) and human metapneumovirus. Clinical features include fever, cough, wheezing and respiratory distress. Risk factors for severe disease are described. Treatment is generally supportive with oxygen, fluids and respiratory support as needed. Bronchodilators and corticosteroids are not routinely recommended but may be considered in some cases.
The document discusses asthma triggers and diagnosing asthma. It provides information on the most common indoor asthma triggers like dust mites, pet dander, cockroaches, mold, and tobacco smoke. It notes that diagnosing asthma requires identifying recurrent symptoms like coughing, wheezing, and shortness of breath that are at least partially reversible with treatment. The diagnosis can be challenging for young children as lung function tests are difficult.
Asthma is a chronic lung disease characterized by inflammation of the airways. Common symptoms include wheezing, coughing, chest tightness, and shortness of breath. Risk factors for developing asthma include genetic characteristics like atopy and environmental exposures such as tobacco smoke, dust mites, and cockroaches. Diagnosis involves assessing symptoms and lung function through spirometry testing. Treatment focuses on long-term control medications like inhaled corticosteroids and quick-relief medications for acute episodes. Proper use of inhalers and peak flow meters is important for effective management along with developing an asthma action plan.
- Asthma is a chronic inflammatory disease of the airways that causes symptoms like wheezing, coughing, chest tightness and shortness of breath. It cannot be cured but can be controlled through medication.
- The document discusses guidelines for diagnosing and managing pediatric asthma, focusing on pharmacological treatments. It recommends inhaled corticosteroids as the most effective preventer medication and inhaled short-acting beta agonists for relief of symptoms.
- Proper asthma management involves classifying severity, providing controller medication to reduce inflammation, and reliever medication for symptoms. The goal is controlling asthma with the lowest effective medication doses.
Management of acute asthma or wheezing in pre-schoolersAshraf ElAdawy
This document provides guidelines for diagnosing and managing asthma exacerbations in children 5 years and younger. It discusses assessing the severity of symptoms, indications for immediate hospital transfer, initial treatment with inhaled short-acting beta-2 agonists and oxygen, and goals of asthma management in young children. Pulse oximetry is essential to evaluate oxygen saturation and determine the need for supplemental oxygen or hospitalization. Blood gas measurements may also be considered if symptoms are life-threatening and unresponsive to treatment.
This document provides information about bronchial asthma. It defines asthma as a chronic inflammatory airway disease characterized by variable airflow obstruction and bronchial hyperresponsiveness. Common symptoms include wheezing, coughing, chest tightness and shortness of breath. Triggers include allergens, infections, pollution, stress and certain drugs. The pathophysiology involves chronic inflammation and constriction of the airways. Diagnosis involves assessing symptoms and using tests like spirometry and imaging. Management consists of pharmacological treatments like bronchodilators and anti-inflammatories as well as nursing care focused on airway clearance, breathing exercises, nutrition, education and managing exacerbating factors.
This document provides guidelines for the management of acute asthma in adults. It defines acute asthma exacerbations and outlines triggers. It describes mechanisms of status asthmaticus and risk factors for death. It provides details on patient assessment and levels of severity. Initial management is discussed for moderate, severe and life-threatening asthma. Criteria for evaluation of treatment response and admission to the hospital or ICU are also outlined. The guidelines emphasize rapid reversal of airflow obstruction and reduction in recurrence through repetitive bronchodilator use and early systemic corticosteroids.
Pneumonia in children can be caused by viral or bacterial infections that lead to lung inflammation and fluid-filled alveoli. It is a common cause of death in children under 5 years old. Common bacteria that cause pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Clinically, pneumonia can be diagnosed by symptoms like fast breathing, chest indrawing, and coarse lung sounds. Chest x-rays can reveal lung infiltrates. Treatment involves antibiotics, oxygen, and managing symptoms. Vaccines help prevent acute respiratory infections that can lead to pneumonia.
This document provides guidance on the initial treatment of asthma exacerbations in preschool-aged children presenting to primary and secondary healthcare. It recommends:
1) Administering inhaled short-acting beta2-agonists (SABA) like salbutamol, which are the first-line treatment for acute asthma or wheezing.
2) Treating hypoxemia with supplemental oxygen to maintain oxygen saturations of 94-98%, especially for those with severe or life-threatening asthma.
3) Regularly assessing treatment response and oxygen needs, and considering adjunctive therapies like corticosteroids depending on the severity of symptoms.
bronchialasthma in children treatment.pptxssuser90ffff
Bronchial asthma in children is a chronic inflammatory disease of the airways characterized by episodic and/or chronic airway obstruction symptoms that are at least partially reversible. It has both environmental and genetic risk factors and most cases onset before age 6. There are three main types - early childhood viral-induced wheezing, allergy-induced chronic asthma, and obesity-associated asthma in females. Treatment involves assessment, education, trigger avoidance, and medications to reduce inflammation and bronchoconstriction including inhaled corticosteroids, bronchodilators, and leukotriene modifiers.
Asthma is a very common condition affecting around 1 in 11 children. It places a large disease burden due to associated morbidity and mortality. Effective management of asthma requires regular review to assess control, inhaler technique, patient understanding and compliance, and to question the accuracy of the diagnosis.
Bronchial Asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of coughing, wheezing, breathlessness, and chest tightness associated with airflow obstruction that is often reversible. Asthma affects over 2 million Saudis and prevalence is rising globally. Diagnosis involves assessing symptoms, examining for wheezing, and testing for variable airflow limitation via spirometry or peak flow monitoring. Management consists of environmental control, patient education, pharmacotherapy including inhaled corticosteroids and bronchodilators, and treatment of exacerbations.
Updates On Pharmacological Management Of Pediatric AsthmaAshraf ElAdawy
This document provides information on the pharmacological management of pediatric asthma. It discusses asthma diagnosis and phenotypes in children, the goals of asthma treatment, and a stepwise approach to pharmacological management. Inhaled corticosteroids are recommended as the most effective long-term controller medication for asthma and should be considered as initial treatment for children using reliever medications frequently or experiencing frequent daytime symptoms. The starting dose of inhaled corticosteroids is 200 micrograms of beclomethasone dipropionate per day for children.
This document reviews the emergency presentation and management of acute severe asthma in children. It discusses the pathophysiology, epidemiology, clinical assessment, and treatment of acute severe asthma attacks in children. The key points are:
1) Acute severe asthma is one of the most common medical emergencies in children and involves inflammation and bronchoconstriction of the airways.
2) The cornerstones of treatment are rapid administration of oxygen, inhalations with bronchodilators such as beta-2 agonists, and systemic corticosteroids.
3) Additional treatments may include intravenous bronchodilators, corticosteroids, magnesium sulfate, or non-invasive ventilation if medical treatment fails
Asthma is a chronic inflammatory disorder of the airways that causes recurrent wheezing, breathlessness, chest tightness and coughing. It is the most common chronic lower respiratory disease in children. This document discusses differentiating transient wheezing from asthma in young children, managing high-risk children, and prevention therapies. It also covers diagnosing and classifying asthma severity, recommended treatment steps based on severity including inhaled corticosteroids and reliever medications, and FDA-approved treatment options for children ages 4 and under.
The document summarizes key changes and recommendations from the 2015 Global Initiative for Asthma (GINA) update, including:
- Add-on tiotropium by soft-mist inhaler is a new treatment option for Steps 4 and 5 in patients ≥18 years with exacerbation history.
- Management of asthma in pregnancy includes monitoring for infections and using usual controllers during labor/delivery.
- Dry powder inhalers can deliver SABA in mild-moderate exacerbations but not for severe acute asthma.
- For life-threatening asthma in primary care, give SABA, ipratropium, systemic corticosteroids, and oxygen while arranging transfer.
This presentation is all about world asthma day which is celebrated every year. this year we celebrated it on 4th may 2021. here we can get information about when, why and how we celebrate along with signs & symptoms, diagnosis and prevention of asthama.
The document summarizes the Global Initiative for Asthma (GINA) strategy for managing asthma. It provides:
1) An overview of the GINA program, which takes a practical, evidence-based approach to managing asthma globally.
2) Details on key changes in the 2016 GINA strategy, including new treatment recommendations and a focus on low-resource settings.
3) Information on defining and diagnosing asthma, emphasizing the use of symptom history and tests to confirm variable airflow limitation.
Treatment of Asthma Exacerbations in the Pediatric Emergency Departmentjrhoffmann
This document discusses the treatment of asthma exacerbations in pediatric emergency departments. It begins with definitions of an asthma exacerbation and status asthmaticus. It then covers approaches to determining the severity of an exacerbation. The primary treatments discussed are bronchodilation with inhaled beta agonists and systemic corticosteroids. Delivery methods like nebulizers and metered dose inhalers are compared. Overall, the document provides an overview of assessing and treating pediatric asthma exacerbations in the emergency department.
The document provides guidelines for physicians on diagnosing and managing childhood asthma in children aged 0-11. It was developed by the Health Authority of Abu Dhabi to help primary care physicians successfully treat asthma. The guidelines cover diagnosing asthma, assessing control, developing treatment plans, and managing acute exacerbations. The goals are to achieve control of symptoms and prevent exacerbations through environmental control, education, and medication adherence. Treatment involves a stepwise approach starting with reliever medications and adding controller medications as needed.
Asthma is a chronic lung disease characterized by inflammation and narrowing of the airways. It commonly manifests as wheezing, chest tightness, coughing, and shortness of breath. While its exact causes are unknown, asthma is thought to involve both environmental and genetic factors. It affects around 13% of children and can be classified as either early childhood transient wheezing or chronic asthma associated with allergies. The main types of childhood asthma involve recurrent wheezing triggered by viral infections or chronic allergy-associated asthma. Management involves assessment, education, controlling triggers, and medications to reduce inflammation and bronchospasm.
Asthma 2010 new gina guidelines[pediatric]Pradeep Gc
This document provides information on asthma management guidelines and tools. It discusses the goals of asthma management, which include achieving control of symptoms, maintaining normal activity levels, pulmonary function, and preventing exacerbations and mortality. It outlines a six-part asthma management program involving education, assessment, avoiding triggers, medication plans, managing exacerbations, and follow-up care. Classification systems for severity are presented for children and adults. Peak flow meters, spirometry, inhaler devices, and stepwise treatment approaches are also summarized.
Updates In Bronchiolitis 23 2 2010 Dr HumaidEM OMSB
This document summarizes recent evidence on the diagnosis and management of bronchiolitis. It defines bronchiolitis and discusses causes such as respiratory syncytial virus (RSV) and human metapneumovirus. Clinical features include fever, cough, wheezing and respiratory distress. Risk factors for severe disease are described. Treatment is generally supportive with oxygen, fluids and respiratory support as needed. Bronchodilators and corticosteroids are not routinely recommended but may be considered in some cases.
The document discusses asthma triggers and diagnosing asthma. It provides information on the most common indoor asthma triggers like dust mites, pet dander, cockroaches, mold, and tobacco smoke. It notes that diagnosing asthma requires identifying recurrent symptoms like coughing, wheezing, and shortness of breath that are at least partially reversible with treatment. The diagnosis can be challenging for young children as lung function tests are difficult.
Asthma is a chronic lung disease characterized by inflammation of the airways. Common symptoms include wheezing, coughing, chest tightness, and shortness of breath. Risk factors for developing asthma include genetic characteristics like atopy and environmental exposures such as tobacco smoke, dust mites, and cockroaches. Diagnosis involves assessing symptoms and lung function through spirometry testing. Treatment focuses on long-term control medications like inhaled corticosteroids and quick-relief medications for acute episodes. Proper use of inhalers and peak flow meters is important for effective management along with developing an asthma action plan.
- Asthma is a chronic inflammatory disease of the airways that causes symptoms like wheezing, coughing, chest tightness and shortness of breath. It cannot be cured but can be controlled through medication.
- The document discusses guidelines for diagnosing and managing pediatric asthma, focusing on pharmacological treatments. It recommends inhaled corticosteroids as the most effective preventer medication and inhaled short-acting beta agonists for relief of symptoms.
- Proper asthma management involves classifying severity, providing controller medication to reduce inflammation, and reliever medication for symptoms. The goal is controlling asthma with the lowest effective medication doses.
Management of acute asthma or wheezing in pre-schoolersAshraf ElAdawy
This document provides guidelines for diagnosing and managing asthma exacerbations in children 5 years and younger. It discusses assessing the severity of symptoms, indications for immediate hospital transfer, initial treatment with inhaled short-acting beta-2 agonists and oxygen, and goals of asthma management in young children. Pulse oximetry is essential to evaluate oxygen saturation and determine the need for supplemental oxygen or hospitalization. Blood gas measurements may also be considered if symptoms are life-threatening and unresponsive to treatment.
This document provides information about bronchial asthma. It defines asthma as a chronic inflammatory airway disease characterized by variable airflow obstruction and bronchial hyperresponsiveness. Common symptoms include wheezing, coughing, chest tightness and shortness of breath. Triggers include allergens, infections, pollution, stress and certain drugs. The pathophysiology involves chronic inflammation and constriction of the airways. Diagnosis involves assessing symptoms and using tests like spirometry and imaging. Management consists of pharmacological treatments like bronchodilators and anti-inflammatories as well as nursing care focused on airway clearance, breathing exercises, nutrition, education and managing exacerbating factors.
This document provides guidelines for the management of acute asthma in adults. It defines acute asthma exacerbations and outlines triggers. It describes mechanisms of status asthmaticus and risk factors for death. It provides details on patient assessment and levels of severity. Initial management is discussed for moderate, severe and life-threatening asthma. Criteria for evaluation of treatment response and admission to the hospital or ICU are also outlined. The guidelines emphasize rapid reversal of airflow obstruction and reduction in recurrence through repetitive bronchodilator use and early systemic corticosteroids.
Pneumonia in children can be caused by viral or bacterial infections that lead to lung inflammation and fluid-filled alveoli. It is a common cause of death in children under 5 years old. Common bacteria that cause pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Clinically, pneumonia can be diagnosed by symptoms like fast breathing, chest indrawing, and coarse lung sounds. Chest x-rays can reveal lung infiltrates. Treatment involves antibiotics, oxygen, and managing symptoms. Vaccines help prevent acute respiratory infections that can lead to pneumonia.
This document provides guidance on the initial treatment of asthma exacerbations in preschool-aged children presenting to primary and secondary healthcare. It recommends:
1) Administering inhaled short-acting beta2-agonists (SABA) like salbutamol, which are the first-line treatment for acute asthma or wheezing.
2) Treating hypoxemia with supplemental oxygen to maintain oxygen saturations of 94-98%, especially for those with severe or life-threatening asthma.
3) Regularly assessing treatment response and oxygen needs, and considering adjunctive therapies like corticosteroids depending on the severity of symptoms.
bronchialasthma in children treatment.pptxssuser90ffff
Bronchial asthma in children is a chronic inflammatory disease of the airways characterized by episodic and/or chronic airway obstruction symptoms that are at least partially reversible. It has both environmental and genetic risk factors and most cases onset before age 6. There are three main types - early childhood viral-induced wheezing, allergy-induced chronic asthma, and obesity-associated asthma in females. Treatment involves assessment, education, trigger avoidance, and medications to reduce inflammation and bronchoconstriction including inhaled corticosteroids, bronchodilators, and leukotriene modifiers.
Asthma is a very common condition affecting around 1 in 11 children. It places a large disease burden due to associated morbidity and mortality. Effective management of asthma requires regular review to assess control, inhaler technique, patient understanding and compliance, and to question the accuracy of the diagnosis.
Bronchial Asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of coughing, wheezing, breathlessness, and chest tightness associated with airflow obstruction that is often reversible. Asthma affects over 2 million Saudis and prevalence is rising globally. Diagnosis involves assessing symptoms, examining for wheezing, and testing for variable airflow limitation via spirometry or peak flow monitoring. Management consists of environmental control, patient education, pharmacotherapy including inhaled corticosteroids and bronchodilators, and treatment of exacerbations.
Bronchial Asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness and coughing, especially at night or in the early morning. These episodes are usually associated with reversible airflow obstruction. Asthma is classified based on age of onset, triggers, and severity. The pathophysiology involves chronic airway inflammation and airway hyperresponsiveness leading to recurrent symptoms. Diagnosis is based on symptoms, examination findings, and confirmation of reversible airflow obstruction on spirometry. Treatment involves a stepwise approach using inhaled corticosteroids and bronchodilators to control symptoms and prevent exacerbations. The goals are to maintain normal lung function and activity levels while
This document provides an outline and overview of childhood asthma. It covers the epidemiology, etiology, types, clinical manifestations, diagnosis, differential diagnosis, management, and prognosis of childhood asthma. Some key points include:
- Asthma is a common chronic inflammatory lung disease in children that causes episodic airflow obstruction.
- It affects boys more than girls and children from low socioeconomic backgrounds. Prevalence has increased about 50% per decade.
- Causes include both environmental and genetic factors. Recurrent viral infections can trigger wheezing in early childhood.
- Symptoms include wheezing, coughing, difficulty breathing, and limited activity. Diagnosis is based on clinical history and improvement with bronchodil
This document provides an outline and overview of childhood asthma. It discusses the epidemiology, etiology, clinical manifestations, diagnosis, management, and prognosis of asthma in children. Key points include that asthma is among the most common chronic diseases in children, affecting boys more than girls and those from low socioeconomic backgrounds. The causes are multifactorial involving both environmental and genetic factors. Clinical diagnosis is based on symptoms of wheezing, coughing, and difficulty breathing. Management involves controlling symptoms and exacerbations through medication and addressing triggers.
Bronchiolitis is a common viral infection in infants characterized by inflammation and congestion of the small airways. The most common cause is RSV. Symptoms include wheezing, cough, and difficulty breathing. Diagnosis is clinical based on symptoms and exam findings. Treatment is supportive with oxygen and fluids. Most cases are mild and self-limiting but some infants may require hospitalization for respiratory support. Antibiotics are not effective as this is primarily a viral illness.
This document discusses the management of chronic asthma. It begins with definitions and prevalence, noting that asthma is a heterogeneous disease characterized by chronic airway inflammation that affects over 300 million people worldwide. It then covers factors that affect the development and expression of asthma such as genetic, environmental, and host factors. The document delves into the pathophysiology of asthma and methods for diagnosing asthma, including initial clinical assessment, investigations like spirometry, and measuring allergic status. It concludes with an overview of the goals and roles in asthma management.
- Asthma is the most common chronic disease in childhood. It can range from mild to life-threatening.
- The document outlines guidelines for diagnosing and differentially diagnosing asthma in children ages 0-4 and 5-12. It also discusses evaluating severity and providing treatments accordingly, including bronchodilators, steroids, magnesium sulfate. For mild-moderate cases discharge with medications and follow-up may be appropriate, while severe or life-threatening cases should receive additional treatments and be considered for admission.
Bronchial Asthma_C I medical students lecture.pptxyilkalmossie1
Bronchial Asthma is a common chronic disease characterized by airway inflammation and variable airflow obstruction. It affects 300 million people worldwide. The goals of asthma management are to achieve symptom control and minimize future risks through a partnership between patient and healthcare providers using a stepwise treatment approach. Initial controller treatment for most asthmatics is a low-dose inhaled corticosteroid. The addition of a long-acting beta agonist to an inhaled corticosteroid provides better asthma control, lung function and reduces exacerbation risk compared to higher dose corticosteroid alone.
Asthma is a chronic inflammatory disease of the airways characterized by episodic obstruction, bronchial hyperresponsiveness, and reversibility of airflow obstruction. It affects 9.6 million US children and is more common in boys, children in poor families, and those with onset before age 6. Treatment involves assessment, education, trigger identification, and medications to reduce inflammation and bronchoconstriction. The goal is optimal asthma control through a stepwise treatment approach based on severity. Prognosis depends on severity, with milder cases often improving over time. Prevention focuses on avoiding tobacco smoke, prolonged breastfeeding, active lifestyles, and immunizations.
Approach to Chronic wheezing & asthma an update 2013avicena1
This document provides an overview of asthma diagnosis and management. It discusses the prevalence of wheezing in children, worldwide asthma prevalence, and a systemic review of asthma surveys in Iran. It then outlines a diagnostic approach for asthma that includes clinical suspicion based on history and symptoms, physical examination, pulmonary function tests like spirometry and bronchoprovocation, allergy testing, and assessing response to treatment. Differential diagnoses for wheezing and cough in children under 5 and over 5 are also reviewed. Key points on differentiating bronchiolitis from asthma in infants are presented.
This document provides an overview of bronchial asthma, including:
- Definitions of asthma and its heterogeneous nature.
- Asthma is a common disease worldwide, affecting over 334 million people. Prevalence is increasing.
- Diagnosis involves assessing symptoms, family history, physical exam, and lung function tests. Differential diagnosis considers other conditions.
- Management focuses on controlling symptoms, maintaining normal activity and lung function, preventing exacerbations and side effects. It involves treatment, environmental control, and patient education.
Epidemiology, pathogenesis of asthma(1).pptxImanuIliyas
Here are the key steps in asthma management for adults and adolescents at the primary health care level in Ethiopia:
1. Assess asthma control and severity. This involves evaluating symptoms, limitations, rescue inhaler use, and risk factors.
2. For mild intermittent asthma (Step 1), use a low-dose inhaled corticosteroid (Beclometasone 100μg) as needed with a short-acting beta agonist (SABAs) like Salbutamol.
3. For mild persistent asthma (Step 2a), use a standing dose of daily Beclometasone inhaler 100μg twice daily plus SABA as needed.
4. For moderate persistent asthma (
This document discusses female bronchial asthma, including its definition, pathophysiology, diagnosis, monitoring, treatment during pregnancy and effects of pregnancy on asthma. It is a reversible chronic obstructive lung disease characterized by recurrent wheezing and coughing alternating with normal breathing. Hormonal changes during the menstrual cycle, pregnancy, delivery and menopause can impact asthma symptoms. Treatment aims to prevent exacerbations and control symptoms using inhaled corticosteroids and bronchodilators. Close monitoring is important during pregnancy to balance controlling asthma and minimizing medication risks for the mother and baby.
1. Abdul Hamid, a 7-year old boy, presents to the emergency department with cough and trouble breathing from an asthma exacerbation triggered by an upper respiratory infection.
2. On examination, he has signs of moderate respiratory distress including fast breathing and wheezing.
3. The document outlines guidelines for assessing, diagnosing, and managing acute asthma exacerbations in children, including criteria for admission, treatment with bronchodilators and corticosteroids, and educating patients and families.
This document discusses asthma in children. It defines asthma as a chronic lung disease that causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing due to inflammation and narrowing of the airways. It notes that while the exact cause is unknown, environmental exposures and genetic factors likely play a role. It describes the types, symptoms, diagnosis, and treatment of childhood asthma, including the use of quick-relief medications and long-term control medications to manage symptoms and reduce inflammation. It also discusses reviewing treatment response, adjusting medications, and the generally poor prognosis for complete remission of childhood asthma.
This document discusses asthma in children and provides guidelines for diagnosis and management. It notes that most childhood asthma starts in the preschool years and can be classified into different phenotypes based on risk factors and symptoms. The goals of treatment are to control symptoms and prevent exacerbations. Spirometry can help diagnose and monitor asthma in children over 6 years old, while other tools like peak flow meters and exhaled nitric oxide can help in younger children. Treatment involves a stepwise approach starting with reliever medications and adding controller medications like inhaled corticosteroids based on symptom severity and risk of exacerbations. Close monitoring is important to maintain control and reduce medication doses if possible.
Pediatric asthma is a chronic inflammatory disease characterized by recurrent episodes of airflow obstruction caused by edema, bronchospasm, and increased mucus. It commonly occurs with allergic rhinitis and eczema as the atopic triad. Symptoms include wheezing, cough, chest tightness, and shortness of breath. Both genetic and environmental factors contribute to its unclear etiology. Treatment involves avoiding triggers, inhaled corticosteroids in a stepwise approach, and managing exacerbations with nebulized bronchodilators and steroids.
- Spinal anesthesia involves injecting local anesthetic into the cerebrospinal fluid surrounding the spinal cord. This blocks sensation from the lower half of the body.
- The document outlines the anatomy of the spinal cord and meninges, the technique for performing spinal anesthesia including patient positioning and injection site selection, and the spread of the analgesic solution in the cerebrospinal fluid. Potential complications are also briefly mentioned.
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printablegishabay
Isoflurane is a halogenated methyl ethyl ether that has a pungent odor. It permits rapid induction and recovery from anesthesia due to its intermediate solubility in blood and high potency. It has great popularity due to its virtual absence of serious hepatic toxicity, minimal biotransformation, and ease of administration. Isoflurane causes minimal depression of the cardiovascular system and decreases arterial blood pressure through direct myocardial depression and peripheral arterial vasodilation. It also causes selective coronary vasodilation and decreases cerebral metabolism with low concentrations not changing cerebral blood flow.
Halothane is a volatile liquid anesthetic that was commonly used but is now rarely used due to the risk of halothane hepatitis. It provides rapid smooth induction of anesthesia when used with nitrous oxide. While induction is fast due to its low blood gas solubility, emergence from halothane anesthesia is slow due to its high solubility in fat and tissues. Prolonged use of halothane can damage metal, rubber, and plastic components of anesthesia machines. Precautions must be taken with halothane due to its cardiovascular depressant effects and ability to trigger malignant hyperthermia.
The document discusses the pharmacodynamics of inhaled anesthetics. It defines minimal alveolar concentration (MAC) as the concentration needed to prevent movement in 50% of patients during surgery. Inhaled anesthetics primarily act on the spinal cord to cause immobility, with only minor effects on the brain. MAC values allow comparison of anesthetic potency between agents. Factors like age, temperature, and medications can impact MAC values. The document then discusses specific inhaled agents like halothane, their properties, effects, metabolism, and complications.
This document discusses cardiac antidysrhythmic drugs. It notes that the use of these drugs is limited due to the potential to depress heart function and trigger new arrhythmias. The drugs are principally used to treat atrial fibrillation and flutter. They work by blocking sodium, potassium, and calcium ion channels in the heart. The drugs are classified into four classes based on their mechanism of action and effects on cardiac action potentials. Common side effects include worsening arrhythmias, heart block, and prolonged QT interval with risks of torsades de pointes.
Uterine myomas, or fibroids, are benign tumors that arise from the smooth muscle cells of the uterus. They are the most common tumors of the uterus and female pelvis. Fibroids can cause heavy bleeding, pelvic pressure and pain, and reproductive issues like infertility. While the exact cause is unknown, risk factors include age, race, obesity, and reproductive history. Treatment options depend on symptoms and fertility goals, and may include medical management, surgical removal of the fibroids (myomectomy), or hysterectomy.
This document discusses urinary tract infections (UTIs). It notes that UTIs affect 10 million people per year in the United States, with higher rates in females and young children. The most common causative bacteria is E. coli. Risk factors include female anatomy, lack of circumcision, neurological issues, and sexual activity. Symptoms vary based on infection location but can include fever, pain, urgency, and frequency. Diagnosis involves urine culture and analysis. Treatment consists of antibiotics for 3-5 days for cystitis and 10-14 days for pyelonephritis. Complications can include sepsis, abscesses, kidney damage, and kidney stones if left untreated.
1) Seizures are caused by abnormal excessive synchronous firing of neurons in the brain. They can be classified as partial or generalized seizures. Status epilepticus refers to continuous or recurrent seizures without regaining consciousness.
2) Evaluation of seizures involves a detailed history, neurological exam, and diagnostic tests like EEG, MRI and bloodwork to identify underlying causes. Treatment depends on seizure type and includes antiepileptic drugs, adrenocorticotropic hormone for infantile spasms, and surgery for refractory cases.
3) Febrile seizures are common in young children and usually resolve without complications, but complex febrile seizures and other risk factors increase risk of developing epilepsy later in life. Proper management of
Central nervous system infections can cause fever and signs of neurological dysfunction. The most common types are meningitis (inflammation of the meninges) and encephalitis (inflammation of the brain). Acute bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b. Clinical manifestations include fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture and CSF analysis. Treatment involves supportive care, antibiotics, and management of increased intracranial pressure. Complications can include hearing loss, seizures, and intellectual disability. Prevention is through vaccination and chemoprophylaxis of close contacts for certain bacteria.
This document provides an overview of evaluating and treating anemia in children. It begins with definitions of anemia and an overview of erythropoiesis. Anemias can be classified based on pathophysiology or red blood cell morphology. Evaluation involves history, physical exam, complete blood count, peripheral smear, and iron studies. The most common causes of anemia in children are iron deficiency anemia, hemolytic anemias, and physiologic anemia of infancy. Iron deficiency presents with pallor and is treated with oral iron supplementation. Hemolytic anemias result from premature red blood cell destruction.
Childhood asthma is a chronic inflammatory disease of the lung airways characterized by symptoms like coughing, wheezing and shortness of breath. It affects approximately 14% of children and onset is usually before age 6. Risk factors include family history, allergy, low socioeconomic status, male gender and exposure to environmental tobacco smoke. Diagnosis involves assessing symptoms, lung function testing and allergy testing. Treatment involves controlling triggers, pharmacotherapy including long-term controllers and quick-relief medications, and managing exacerbations.
This document discusses acquired heart disease, including infective endocarditis and rheumatic heart disease. Infective endocarditis is an inflammation of the heart valves caused by bacteria, viruses or fungi. It is associated with conditions like intravenous drug use or structural heart defects. Rheumatic heart disease results from rheumatic fever, an immune response to a streptococcal infection that damages the heart valves. It presents with manifestations like migratory polyarthritis, heart valve involvement, and Sydenham's chorea. Both require long-term antibiotic treatment and prevention of recurrent infections to avoid further valve damage.
This document discusses optimal nutrition for infants and children. It covers the essential macronutrients of carbohydrates, proteins, fats, vitamins, minerals, and water. Breast milk is identified as the best source of nutrition for newborns, providing all necessary nutrients. The document outlines best practices for breastfeeding, including exclusive breastfeeding for the first 6 months and positioning and attachment techniques. Key signs of nutrient deficiencies like rickets and vitamin A deficiency are also summarized.
1. The normal menstrual cycle is tightly regulated by the hypothalamic-pituitary-ovarian axis and results in the maturation and release of a single egg each month.
2. During a cycle, multiple follicles begin growing under the influence of FSH but normally only one follicle becomes dominant and ovulates, releasing an egg.
3. Ovulation is caused by an LH surge near the middle of the cycle which causes the dominant follicle to rupture and forms the corpus luteum.
This document provides information on protein-energy malnutrition (PEM). It discusses the causes, risk factors, pathophysiology, clinical manifestations, classifications, laboratory findings, and management of PEM. PEM results from inadequate protein and energy intake and can range from mild growth retardation to more severe forms like marasmus (wasting), kwashiorkor (edema), or a combination of the two. Management involves inpatient or outpatient therapeutic feeding programs depending on severity. The goal of initial treatment is stabilization using a low-energy milk formula before transitioning to a higher calorie diet. Complications are also treated and monitored closely.
Growth and development assessment in children (2)gishabay
This document provides an overview of growth and development assessment in children. It defines growth and development, outlines the objectives and principles of growth and development assessment. Key factors affecting growth such as biological, psychological and social influences are described. The document then details the typical patterns of physical, motor, cognitive, language and social development from infancy through toddlerhood. Growth is assessed using growth charts and development is assessed through observation of milestones.
This document provides an overview of diarrhea in children including definitions, epidemiology, etiology, pathophysiology, clinical manifestations, complications, evaluation, management, and prevention. Some key points include:
- Diarrhea is defined as 3 or more loose stools per day. It is a leading cause of death in children under 5 years old.
- Common causes are viral (e.g. rotavirus), bacterial (e.g. E. coli), and parasitic (e.g. Giardia).
- Management involves oral rehydration with WHO ORS and zinc supplementation. Intravenous fluids may be needed for severe dehydration.
- Complications can include dehydration, malnutrition,
Acute respiratory tract infections (ARI) are the leading cause of morbidity and mortality in children under 5 years of age globally and in Ethiopia. ARI can involve both the upper and lower respiratory tracts. Nearly 20% of ARI cases develop into acute lower respiratory tract infections like pneumonia. Common upper respiratory tract infections include acute pharyngitis, retropharyngeal/parapharyngeal abscesses, and peritonsillar abscesses. Croup (laryngotracheobronchitis) is characterized by a barking cough, hoarseness, and inspiratory stridor in young children and results from inflammation in the upper respiratory tract sometimes spreading lower. Viruses like parainfluenza
The document provides an overview of normal labor, including its definition, physiology, mechanisms, and management. Labor is defined as the process by which a fetus is expelled from the uterus, and is diagnosed based on regular contractions and cervical changes. It involves three stages: first stage from onset to full dilation; second stage from full dilation to delivery; third stage from delivery to expulsion of the placenta. The cardinal movements describe the positions and rotations of the fetal head through the birth canal. Management of normal labor includes monitoring contractions and fetal heart rate during each stage.
This document provides a summary of the gross anatomy of the female pelvis and perineum. It describes the pelvic girdle as consisting of the right and left hip bones and sacrum. The pelvis is divided into the greater pelvis above the inlet and lesser pelvis below. The pelvic cavity contains pelvic organs like the bladder, uterus and rectum. The perineum lies below and includes the anus and external female genitalia. Key female internal organs are the ovaries, uterine tubes, uterus and vagina.
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
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2. Out line
• Definition
• Epidemiology
• Etiology / Risk factors
• Natural history & pathogenesis
• Clinical presentation
• Laboratory studies
• Treatment
3. CHILDHOOD ASTHMA
• Definition
Asthma is a chronic, inflammatory disease of
lung airways characterized by:
• Symptoms of cough, wheezing, dyspnea, &
chest tightness that occur in paroxysms
• Airway narrowing, often reversible, and
• ↑se in the existing bronchial hyper-
responsiveness
4. Epidemiology
The CDC's 2006 National Health Interview Survey
estimated
• a lifetime asthma prevalence of 13.5%, and
prevalence of 9.6% among children ≤18yrs in
2009
– But ranges from 1.6 to 36.8 in different locale
5. Epidemio…
• 80% of all asthmatics report disease onset
prior to 6yr of age.
• Allergy in young children has emerged as a
major risk factor for the persistence of
childhood asthma.
6. Epidemiologic risk factors
• Gender – boys > girls (14 vs 10%) but in
adults F>M = 8.9 vs 5.6
• Race / ethnicity : high in African-Americans
& Puerto Ricans
• Socioeconomic status : more prevalent in
poor …
• Locale : urban > rural
7. Etiology
Not clearly determined but multifactorial
• Environmental exposures
– Recurrent viral infections of the airways
– Other airways exposures – tobacco smoke, indoor
allergens … and
• Inherent biological and genetic
vulnerabilities.
– More than 22 loci on 15 autosomal chromosomes
11. MAJOR CRITERIA MINOR CRITERIA
Parent asthma Allergic rhinitis
Eczema Wheezing apart from colds
Inhalant allergen
sensitization
Eosinophils ≥ 4%
Food allergen sensitization
Asthma Predictive Index for Children
For preschool age children with frequent wheezing in the
past year, one major criterion OR two minor criteria
provide a high specificity (97%) and positive predictive
value (77%) for persistent asthma into later childhood
12. Types of asthma
• There are 2 main types of childhood asthma:
(1) Recurrent wheezing in early childhood; and
(2) Chronic asthma associated with allergy that
persists into later childhood and often
adulthood
• A 3rd type typically emerges in females who
develop obesity and early-onset puberty (by
11yr of age).
13. Natural history
Wheezing during the first six years
1. intermittent symptoms at an early age - viral
illnesses
2. Later-onset with more persistent symptoms -
cxzed by
• Atopy and
• A positive family history of asthma, and
• Are at an increased risk for asthma later in life.
14. Natural history
Wheezing in later childhood
• Patients younger than 15years diagnosed with
severe asthma had, when compared to older
patients, significantly higher five-year rates of
improvement (80 vs 61%) and remission (23 vs
14%).
• Patients diagnosed with mild disease were
unlikely to develop severe disease within five
years, regardless of age
15. Pathophysiology
• Asthma is an inflammatory process
– mediated by helper T lymphocytes and
other immune cells.
• Airways inflammation is linked to
– AHR or hypersensitivity of airways
smooth muscle to numerous provocative
exposures that act as triggers,
16. Pathophysiology
• Airways inflammation…
– airways edema,
– basement membrane thickening – type IV
collagen,
– Desquamation of the epithelial lining,
– smooth muscle and mucous gland
hypertrophy, &
– mucus hypersecretion
17. Clinical manifestations
• Approximately 80% of children with asthma
develop symptoms before 5yrs of age
• Intermittent dry coughing & wheezing
• Breathlessness, chest tightness or pressure –
older
• Intermittent, nonfocal chest “pain” – younger
children.
18. Clinical manifestations
• Daytime symptoms, often linked with physical
activities or play
• Poor school performance and fatigue
– May be due to sleep deprivation from nocturnal
symptoms.
• Response to asthma medications
(bronchodilators)
• Symptoms can be triggered by numerous events
19. Clinical manifestations
PHYSICAL EXAMINATION
• Normal in the absence of an acute exacerbation.
• Abnormalities that may be observed include :
– An increased A-P diameter of the chest - air
trapping.
– Decreased air entry or wheezing on
auscultation.
– A prolonged expiratory phase on auscultation.
20. Clinical manifestations
• Crackles (or rales) and rhonchi
• Signs of rhinitis and sinusitis - nasal
discharge, inflamed nasal mucosa, sinus
tenderness,
• Eczema/atopic dermatitis.
• Nasal polyps (glistening, gray, mucoid
masses within the nasal cavities)
21. Laboratory findings
Pulmonary Function Testing
• Forced expiratory airflow measures
– in diagnosing and monitoring asthma and
– in assessing efficacy of therapy.
• Spirometry – for children > 6 yrs
22. • Spirometric volume-time
curves
1. FEV1 -
2. FVC - total volume of air
exhaled during a forced
expiratory effort.
• Note that subject 2's FEV1 &
FEV1/FVC ratio are smaller than
subject 1's --- airflow limitation.
• Also, subject 2's FVC is very
close to what is expected
Subject 1 – non-asthmatic
Subject 2 - asthmaric
23. Spirometry (in clinic)
1. Airflow limitation
• Low FEV1 (relative to percentage of predicted
norms)
• FEV1/FVC ratio <0.80
2. Bronchodilator response (to inhaled β-agonist)
• Improvement in FEV1 ≥12% or ≥200 mL*
3. Exercise challenge
• Worsening in FEV1 ≥15%*
4. Daily peak flow or FEV1 monitoring: day to day
and/or AM-to-PM variation ≥20%*
Lung Function Abnormalities in asthma
* Main criteria consistent with asthma
24. Laboratory findings
• Bronchoprovocation
• Can be helpful in diagnosis & management.
• inhaled methacholine, histamine, and cold or
dry air.
– The degree of AHR correlates with asthma severity
and airways inflammation.
• A negative study may exclude a diagnosis of
asthma
25. Laboratory findings
Exercise challenges
• aerobic exertion or “running” for 6–8 min
• identify children with exercise-induced
bronchospasm.
– FEV1 typically decreases during or after exercise by
>15%.
26. Laboratory findings
Measuring exhaled nitric oxide (FENO),
• a marker of airway inflammation in asthma,
Peak expiratory flow (PEF)
• PEF variation >20% is consistent with asthma
Allergy tests
Sweat chloride test
27. Radiology - Chest radiogram
• Findings consistent with asthma, such as
– hyperinflation,
– peribronchial thickening, and
– mucoid impaction with atelectasis.
– Complications
28.
29. Radiology – chest CT
• Bronchiectasis is clearly seen on CT scan and
• implicates an asthma masquerader such as
– cystic fibrosis,
– allergic bronchopulmonary mycoses
(aspergillosis),
– ciliary dyskinesias…
30. Asthma management
• National Asthma Education and Prevention
Program - NAEPP.
– 4 principle components to optimal asthma
mgt
1. Regular assessment & monitoring
2. Control of factors contributing to asthma
severity
3. Asthma pharmacotherapy
34. Asthma management
1. Regular assessment & monitoring
• Asthma checkups Every 2 - 4 wk until good
control
• 2 - 4 per yr to maintain good control
• Lung function monitoring
– Annually, or more often
35. Asthma mgt – regular ass’t
• Assess the optimal goals by determining the:
(1) frequency of asthma symptoms during the
day, at night, and with physical exercise;
(2) frequency of “rescue” SABA use and refills;
(3) number and severity of asthma exacerbations
since the last visit; and
(4) participation in school, sports, and other
activities
36. Asthma mgt – regular ass’t
Lung function testing (spirometry)
• PEF (Peak expiratory flow) monitoring at home if
– children with poor symptom perception,
– other causes of chronic coughing,
– moderate to severe asthma, or
– history of severe exacerbations
37. Asthma mgt – regular ass’t
PEF
• 80–100% of personal best - good control;
• 50–80% necessitates increased awareness
& Rx;
• <50% poor control & increased likelihood
of an exacerbation, requiring immediate
intervention.
• The NAEPP guidelines recommend at least
once-daily PEF monitoring
38. Asthma management
2. Control of factors contributing to asthma
severitiy
• Eliminate or reduce problematic
environmental exposures
• Treat co-morbid conditions: rhinitis, sinusitis,
gastroesophageal reflux
• Annual influenza vaccination
39. Asthma management
3. ASTHMA PHARMACOTHERAPY
• Long-term-control Vs quick-relief medications
• Classification of asthma severity
• Step-up, step-down approach
• Asthma exacerbation management
The “three strikes” rule for determining if an
asthmatic child should receive controller
therapy
40. Asthma mgt - pharmacotherapy
The “three strikes” rule
• If an asthmatic child
– has symptoms or uses quick-relief
medication at least 3 times per wk,
– awakens at night due to asthma at least 3x /
mo,
– requires a refill for a quick-relief inhaler
prescription at least 3 times per yr,
41. Asthma mgt - pharmacotherapy
The “three strikes” rule
• if an asthmatic child…
– experiences asthma exacerbations > 3x/ yr,
or
– requires short courses of systemic
corticosteroids >3 x/yr, then
• That patient should receive daily controller
therapy.
42. Asthma mgt - pharmacotherapy
Principles of Asthma Pharmacotherapy
• For younger children (<5 yr of age),
management is primarily based on symptoms
• A major objective of this approach is to
identify and treat all “persistent” asthma with
anti-inflammatory controller medication.
43. Asthma mgt - pharmacotherapy
Principles of Asthma Pharmacotherapy
• The classification of asthma severity is based
on the parameters:
(1) frequency of daytime and
(2) nighttime symptoms,
(3) degree of airflow obstruction by spirometry,
and/or
(4) PEF variability
44. CLASSIFN
STEP
DAYS WITH
SYMPTOMS
NIGHTS
WITH
SYMPTOMS
FOR ADULTS AND
CHILDREN AGE > 5 YEARS
WHO CAN USE A
SPIROMETER OR PEAK
FLOW METER
FEV1 or PEF[*] %
Predicted
Normal
PEF
Variability
(%)
Severe
persistent
4 Continual Frequent ≤60 >30
Moderate
persistent
3 Daily >1/wk >60–<80 >30
Mild
persistent
2
>2/wk, but <1/day
>2/mo ≥80 20–30
Mild
intermitte
nt
1 ≤2/wk <2/mo ≥80 <20
Classification of Asthma Severity
From NAEPP Expert Panel Report
NIH publication no: 02–5075
46. For all patients – quick relief
Bronchodilator as needed for symptoms:
-Preferred treatment:
-inhaled SABA by nebulizer or face mask and
space/holding chamber
-Alternative treatment: Oral β2-agonist
Managing Infants and Young Children (≤5Yr)
with Acute or Chronic Asthma
47. For all patients – quick relief
With viral respiratory infection
-Bronchodilator q 4–6 hr up to 24 hr;
-Consider systemic corticosteroid if exacerbation is
severe or history of previous severe exacerbations
-Use of SABA >2x/wk in intermittent asthma (daily, or
increasing use in persistent asthma) need to initiate
(increase) long-term-control therapy.
Managing Children (≤5Yr) with Acute or Chronic
Asthma
48. Step down
Review treatment every 1 to 6 mo;
a gradual stepwise reduction in treatment may
be possible.
Managing Infants and Young Children (≤5 Yr of
Age) with Acute or Chronic Asthma
49. ↑Step up
If control is not maintained,
Review patient medication technique, adherence, and
environmental control.
• Classify severity: assign patient to most severe step in
which any feature occurs.
• There are very few studies on asthma therapy for
infants.
• Gain control as quickly as possible (a course of short
systemic corticosteroids may be required)
Managing Infants and Young Children (≤5 Yr of Age) with
Acute or Chronic Asthma
51. Managing Asthma in Children >5Yr of Age
Quick Relief - All Patients
• inhaled SABA: 2–4 puffs as needed for symptoms.
• Intensity of treatment will depend on severity of
exacerbation;
•up to 3 treatments at 20-minute intervals or
•a single nebulizer treatment as needed.
• Course of systemic corticosteroids may be needed.
52. Managing Asthma in Children >5Yr of Age
Quick Relief All Patients
• Use of SABA >2 times/wk in intermittent asthma
(daily, or increasing use in persistent asthma)
need to initiate (increase) long-term-controller
NB: SABAs are the recommended quick-reliever
medications for symptoms and exercise
pretreatment for all asthma severity levels.
53. Asthma Exacerbations and Their
Management
Asthma exacerbations
• acute or subacute episodes of progressively
worsening symptoms and airflow obstruction.
• Obstruction can become extensive life-
threatening respiratory insufficiency.
54. Asthma Exacerbations and Their
Management
… mgt
The optimal management of a child
comprehensive assessment
• Focused history
• Clinical assessment
• Risk factors for asthma morbidity & death
• Treatment
55. Asthma Exacerbations and Their
Management
Acute asthma exacerbations mgt
• SABAs - increase pulmonary blood flow with
increasing dosage and frequency.
• When airways obstruction is not resolved with
SABA use,
• Ventilation-perfusion mismatch significant
hypoxemia, which can perpetuate
bronchoconstriction and further worsen the
condition.
56. Home Management of Asthma
Exacerbations
• written action plan - recognition & mgt of
exacerbations
• immediate treatment with “rescue” medication
– inhaled SABA, up to 3 treatments in 1 hr.
– A good response
• resolution of symptoms within 1 hr,
• no further symptoms over the next 4 hr, and
• improvement in PEF to at least 80% of
personal best.
57. Home Management of Asthma
Exacerbations
If the child has an incomplete response i.e
• persistent symptoms &/or PEF <80% of
personal best,
– a short course of oral corticosteroid therapy
(prednisone for 4 days)
– Contact clinician
58. Home Management of Asthma
Exacerbations
• For patients with severe asthma and/or
• a history of life-threatening episodes,
– providing an injectable form of epinephrine and
– portable oxygen at home should be considered.
59. Emergency Department
Management of Asthma
Exacerbations
Primary goals:-
• correction of hypoxemia,
• rapid improvement of airflow obstruction, and
• prevention of progression or recurrence of
symptoms.
Interventions are based on
• clinical severity on arrival,
• response to initial therapy, and
• risk factors associated with asthma morbidity &
60. Emergency Department
Management of Asthma
Exacerbations
Indications of a severe exacerbation include
• Signs of severe respiratory distress
• a silent chest with poor air exchange,
• severe airflow limitation (PEF or FEV1 <50% of
personal best or predicted values), and
• mental status changes
61. Emergency Department
Management of Asthma
Exacerbations
Initial treatment includes
• supplemental oxygen,
• inhaled SABA every 20 min for 1 hr, &, if
necessary,
• systemic corticosteroids - oral or IV.
Inhaled ipratropium may be added if no significant
response is seen with the 1st inhaled β-agonist
Rx.
62. Emergency Department
Management of Asthma
Exacerbations
• An IM injection of epinephrine in severe cases.
– Oxygen continued for at least 20 min after the
last injection to compensate for possible
ventilation-perfusion abnormalities caused by
SABAs.
• monitor clinical status, hydration, and
oxygenation
63. Emergency Department
Management of Asthma
Exacerbations
Discharge to home if there is
– sustained improvement in symptoms,
– normal physical findings,
– PEF >70% of predicted or personal best,
– an oxygen saturation >92% on room air for 4 hr.
Discharge medications
– inhaled β-agonist up to every 3–4 hr plus
– a 3–7 day course of an oral corticosteroid.
Optimize controller therapy - addition of ICS
64. Hospital Management of Asthma
Exacerbations
Indication – status asthmaticus
• moderate to severe exacerbations not
improving within 1–2 hr of intensive treatment
• high-risk features for asthma morbidity or
death.
• severe respiratory distress, and concern for
potential respiratory failure and arrest.
65. Hospital Management of Asthma
Exacerbations
Interventions for status asthmaticus
1. Supplemental oxygen,
2. frequently or continuously administered
inhaled bronchodilator And
3. Systemic corticosteroid therapy
66. Hospital Management of Asthma
Exacerbations
SAβAs -
• Adverse effects - tremor, irritability, tachycardia,
and hypokalemia.
• Thus, ongoing cardiac monitoring, & oximetry
Inhaled ipratropium bromide
• is often added every 6 hr if no remarkable
improvement
• synergistic effect in relieving severe
bronchospasm
• beneficial in patients with mucous hypersecretion
67. Hospital Management of Asthma
Exacerbations
Monitoring
• arterial blood gas, complete blood cell counts,
• serum electrolytes, and chest radiograph to
monitor for
– respiratory insufficiency,
– co-morbidities, infection, and/or
– dehydration.
• especially important in infants and young
children
68. Hospital Management of Asthma
Exacerbations
• Several therapies, including parenterally
administered
– epinephrine,
– β-agonists,
– methylxanthines,
– magnesium sulfate (25–75 mg/kg, maximum dose
2.5 g, intravenously over 20 min)
have demonstrated some benefit as adjunctive
therapies in severe status asthmaticus patients
71. Epidemiology
• one-third of world population is infected with
M.TB.
• There were an estimated 0.5million TB cse among
children<15yr old
• Theree were 74000 TB death among HIV negative
children
• Number of TB death is unacceptably high given
that most are preventable
72. Continuing
• There are 22 high burden countries acounted for
82% of all estimated case worldwide .
• Ethiopia is the 7th burdened country.
73. Etiology
• Mycobacterium tuberculosis complex.
–M.Tuberculosis
–M.Bovis
–M.Africanum
–M.Microti
–M.Cantti
• M.TB
– Most important cause of human Tuberculosis
– non spor forming,non motil,slow growing,obligat
aerobic,grow best 37-41 degree
74. Transmission
• Transmission is person to person(usually by air
born mucus droplet nucli.
• Rarely occurs by diract contact with an infected
discharge or contaminated fomite.
• Risk of transmission increase with index case:
• smear positive TB
• Extensive upper lobe infiltration
• Copious production of sputum
• Sever and forcefull cough
• Not treated
75. Continuing
• Enviroment
– Poorly ventilation
– Overcrowding
– Intimacy
Younger children (<7yr) rarely infect others
M.Bovies transmited by ingestion of cow milk.
76. Continuing
• The risk of infection of susceptible individual is
high with close,prolonged,indoor exposure to
aperson with sputum positive pulmonary TB.
77. Pathogenesis
• lung is portal of entry in more than 98%of the
case.
• Bacilli multiply initially within alveoli and
alveolar duct.
• Most cleared by macrophages.
• Primary complex formed through portal of
entry and regional lymphe nodes.
78. Continuing
• Disseminated TB occurs if
– circulating number of bacilli is large.
– Host immune response is inadequet.
• Cell mediated immunity developes 2-12wks
after infection along with tissue
hypersensitivity.
79. Clinical presentation
• Pulmonary
• Commonest 70%
• all lobes of lung are at equaly risk of initial
infection
• cough,Fever,night sweat anorexia
,decreased appetit
• Failur to thrive
• Common site of reactivation is apex of
upper lobe
80. Continuing
• when Ag load is small and tissue hypersensitivity
is high granuloma will formed
• when both Ag and sensitivity are high incomplit
tissue necrosis results in formation of caseous
material.
• When degree of tissue sensitivity is low it results
in diffuse reaction
82. Continuing
• Common permanent disabilities are
– Blindness
– Deafness
– Paraplagia
– Diabetic insipidus
– Mental retardation
• Diagnosis is mainly by high degree of
suspension .
83. Continuing
• GI/peritoneal TB
– Most commonly affected areas are ileum,jejunum
and appendex.
– Presentas abdominal pain, diarrhea/constipation.
– I.testinal obstruction.
• Renal TB
• Urin cultur positive in 80-90%..
• Bone and Joint TB.
• Cutaneus TB.
84. Diagnosis
• Sputum AFB
• Chest X-ray
• CBC
• Sputum cultur
• TB could be smear positive and smear negative
85. Managment
• Chemotherapy/Anti TB 2RHZE/4RH
• Nutritional Rehablitation
• Sceaning of the family(index case, other
contacts).
• follow up(Adherance,responce,drug side
effact)
86. Continuing
• Steroid in TB indication
– Meningities.
– pericardities.
– Adrenal inssufficiency.
– airway obstruction.
– Bilateral pleurl effusion with respiratory problem
• 60 mg/ day for 4 wk then tper every 1-2 wk.
• Indication of pyridoxin
– breast feed infants.
– severly malnourished children.
– HIV infected Children.