Noutati in astmul bronsic
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The document discusses several key points about asthma: 1) Impaired nasal function affects the lower airways through various mechanisms like aspiration, neural reflexes, and systemic inflammation. 2) There is evidence that the airway epithelium in asthmatics is defective, with enhanced permeability and impaired repair and antiviral responses. 3) Gender differences exist in asthma prevalence, physiology, and treatment responses, and sex-specific genetic factors are involved. Targeting these differences may lead to more personalized treatment approaches.
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A 64-year-old woman with a history of two previous myocardial infarctions comes to the emergency room with shortness of breath. In the previous 2 weeks, she has developed dyspnoea with exertion and swelling of her legs. She sleeps on three pillows because she coughs and gets shortness of breath if she tries to lie flat. In the emergency department, she is sitting upright, appears to be in moderate respiratory distress, and is tachycardic and hypertensive. She has jugular venous distension to the angle of her jaw. On auscultation of her lungs, wet rales are heard bilaterally. She has pitting edema of both lower legs up to her knees. A chest X-Ray confirms the diagnosis of pulmonary edema. She is placed on oxygen and immediately given an IV injection of furosemide.
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A 67-year-old man presents with fever, chills, rigors, shortness of breath, and a productive cough of dark yellow sputum for 2 days. He has a history of alcoholism and a recent binge. On examination, he has a fever of 39.5°C, tachycardia, tachypnea, and crackles in his right lower lung. A chest X-ray shows consolidation in the right middle and lower lobes. Laboratory tests reveal leukocytosis. The patient is diagnosed with pneumonia based on his symptoms, signs, chest X-ray findings, and leukocytosis.
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This document contains 10 multiple choice questions about various pulmonary diseases and conditions:
1. A 65-year-old man develops pulmonary embolism after prostate surgery.
2. A 60-year-old man with cough and blood-streaked sputum is found to have a lung mass, and smoking is identified as the likely cause.
3. A 66-year-old man with dyspnea and radiologic findings is determined to have likely been exposed to asbestos through his construction work.
The document continues with additional pulmonary disease presentation and identification questions.
Epistaxis
- Epistaxis, or nosebleed, presents as an emergency and is a sign of an underlying local, general, or idiopathic disease.
- It can be caused by trauma, infections, foreign bodies, neoplasms, atmospheric changes, deviated nasal septum, adenoiditis, and other local or general conditions.
- Treatment involves identifying the cause, controlling bleeding, and addressing any underlying medical issues through measures like applying pressure, cauterization, nasal packing, or arterial embolization.
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Asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and cough. It involves intermittent and reversible airway obstruction, chronic bronchial inflammation with eosinophils, and increased mucus secretion. The hallmarks are bronchial smooth muscle hypertrophy/hyperreactivity and excessive TH2 reactions against environmental allergens leading to airway remodeling. Characteristic morphologic changes in asthma include thickening of the airway wall, sub-basement membrane fibrosis, increased vascularity, and increased mucus production.
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Bronchial asthma in children is a chronic inflammatory disorder of the airways. It is characterized by recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or in the early morning. These episodes are usually associated with reversible airflow obstruction. The document discusses the pathogenesis, diagnosis and treatment of bronchial asthma in children. It outlines the goal of treatment as achieving and maintaining clinical control by preventing acute symptoms and disease recurrence while avoiding side effects. Treatment follows a step approach of increasing medication according to asthma severity.
Pulmonary Diseases 2009 copy
This document reviews pulmonary diseases including COPD, asthma, and tuberculosis. It describes COPD as consisting of chronic bronchitis and emphysema, both causing difficulty exhaling air. Asthma is defined as a chronic inflammatory lung disease causing recurrent breathing issues. Tuberculosis is caused by the Mycobacterium tuberculosis bacteria, which primarily attacks the lungs. It can spread through airborne droplets when coughing or sneezing. The document outlines symptoms, diagnostic tests, and treatments for each disease.
Pulmonary Diseases
This document provides an overview of pulmonary diseases including Chronic Obstructive Pulmonary Disease (COPD), asthma, and tuberculosis. It describes the pathophysiology, signs and symptoms, diagnosis, and treatment of each condition. COPD is characterized by difficulty exhaling air and includes chronic bronchitis and emphysema. Asthma involves constricted airways, swollen bronchial linings, and excess mucus production. Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and primarily affects the lungs, transmitted via airborne droplets.
COPD.ppt
This document provides an overview of chronic obstructive pulmonary disease (COPD), including its definition, pathophysiology, epidemiology, and clinical correlates. It describes the main types of COPD such as chronic bronchitis and emphysema. Key points include that COPD is mainly caused by cigarette smoking and is characterized by irreversible airflow limitation. The document discusses the role of inflammation, proteinases, oxidative stress and genetic factors in COPD pathogenesis. It also outlines how COPD affects lung function and physiology through changes in volumes, capacities, elastic recoil and gas exchange.
COPD First Session
This document provides an overview of COPD (chronic obstructive pulmonary disease). It defines COPD and discusses its burden, risk factors, pathology, and history. It notes that COPD is characterized by airflow limitation caused by an inflammatory response in the lungs to noxious particles. The document outlines the learning objectives which are to understand COPD definition, burden, risk factors, and pathogenesis. It also discusses the prevalence of COPD internationally, underdiagnosis in the US, and the economic and social burden of the disease.
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Asthma pathogenesis
Asthma is a chronic inflammatory airway disease characterized by recurrent episodes of wheezing, breathlessness, chest tightness and coughing. The chronic inflammation causes airway hyperresponsiveness and airflow obstruction. Genetic and environmental factors contribute to its pathogenesis. Key features include eosinophilic inflammation, mast cell activation, cytokine production, and airway remodeling over time. Ongoing research seeks to better understand the complex immune and structural changes involved in order to develop new targeted treatments.
Corticosteriods
Corticosteroids are the most effective treatment for asthma. They work by suppressing the chronic inflammation in the airways that is characteristic of asthma. This inflammation is mediated by increased expression of inflammatory genes regulated by transcription factors like NF-κB. Corticosteroids suppress these inflammatory genes by reversing the histone acetylation that activates them. This involves binding of glucocorticoid receptors to coactivators and recruitment of histone deacetylases, switching off the inflammatory gene expression. Understanding this molecular mechanism of corticosteroid action may help develop new anti-inflammatory therapies for asthma.
Asthma
This document provides an overview of asthma including its definition, epidemiology, etiology, pathophysiology, clinical manifestations, investigations, and management. It defines asthma as a chronic inflammatory lung disease characterized by variable and recurring symptoms of wheezing, breathlessness, chest tightness, and coughing. Key points include that over 334 million people worldwide currently suffer from asthma, environmental factors like allergens and infections contribute to its development, and treatment involves management of symptoms and inflammation.
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Noutati in astmul bronsic
- 1. ?
- 3. GJ Braunstahl • Impaired nasal function affects the lower airways of asthmatic patients. • Various alternative mechanisms play a role in nasobronchial interactions: – Aspiration of nasal contents – Neural reflexes – Systemic inflammation • Most human and animal data point towards a systemic pathway linking the upper and lower airways, involving both bloodstream and bone-marrow. importance of an integrated approach involving both ends of the respiratory tract
- 4. E Wouters • The hypothesis of systemic inflammation as spill-over of the local inflammatory process.
- 5. S.Holgate • In asthma there is evidence that both structural and functional aspects of the airway epithelium are defective. • Epithelial cells cultured from asthmatic airways fail to develop fully functional tight junctions enhanced permeability (as a consequence of altered cell cycling with nuclear translocation of P21Waf and related cell cycle inhibitors).
- 6. S.Holgate • Asthmatic epithelium from children with asthma is defective in its ability to repair after injury or to generate primary interferons when exposed to common cold viruses. (a defective signaling through toll-like receptor 3 to activate interferon regulatory functions that induce the production of IFNβ and λ).
- 7. S Hirst • Functional ( vasodilatation, hyper- perfusion, increased microvascular permeability, oedema formation, inflammatory cell recruitement) and • Angiogenic structural changes in airway blood vessels in asthma have potentially important therapeutic implication for targering these alterations.
- 8. R. Gosens • Inflammation is important but.. it is not the whole story!!! • (maybe is just a marker of the remodeling of the airway smooth muscle bundle)
- 9. P.Barnes • Low concentrations of theophylline specifically inhibit oxidant-activated PI3- kinase-σ and have the capacity to reverse corticosteroid resistance in severe asthma and smoking asthmatics targe the epigenome in the treatment of asthma!
- 10. Dirkje Postma • Gender differences in: asthma prevalence, risk of asthma by age, physiology (bronchial eNO, air trapping), response to treatment etc • There exist sex-specific genetic influences on asthma for IL-9R, IL-1-beta, COX-2, CXCR-3 and ESR-1 • Gender differentiatic therapy could be common in the future!
- 12. • Poze