Is asthma a disease of sunlight/vitamin D deficiency?

Yes. Asthma, to a great extent, is caused by sun avoidance and consequent vitamin D deficiency.

Asthma, a devastating respiratory illness, is increasing rapidly in the US. The latest statistics I have show that the overall prevalence of asthma increased 75% from 1980-1994, and asthma rates in children under the age of five increased more than 160%.[1]

There is little doubt that the profound increase in asthma in the last few decades has been caused to a great extent by our societal exodus from sunlight exposure along with the increased use of sunscreen, which can inhibit up to 99% of vitamin D production by the skin.[2]

Drs Litonjua and Weiss, in a medical hypothesis presented in 2007, made a strong case for vitamin D deficiency as a major player in the increase in asthma incidence among both children and adults.[3] They hypothesized the following:

1. “… as populations grow more prosperous, more time is spent indoors, and there is less exposure to sunlight, leading to decreased cutaneous vitamin D production.”
2. “Vitamin D has been linked to immune system and lung development in utero, and our epidemiologic studies show that higher vitamin D intake by pregnant mothers reduces asthma risk by as much as 40% in children 3 to 5 years old.”
3. “Vitamin D deficiency has been associated with obesity, African American race (particularly in urban, inner-city settings), and recent immigrants to westernized countries, thus reflecting the epidemiologic patterns observed in the asthma epidemic.”

Other research demonstrates that vitamin D reduces the production of inflammatory chemicals (chemokines) in the respiratory passages,[4] which would dampen the asthmatic response.

Another study assessed the asthma risk of children whose mothers had the highest vitamin D consumption during pregnancy, and compared them to children whose mother had the lowest levels. The high-vitamin D group showed an impressive reduced risk of asthma of 52-67%.[5] The researchers believe that inadequate vitamin D levels in the fetus leads to improper development of the lungs and immune system.

Still other research, conducted on three-year old children whose mothers were in the highest quartile (fourth) of vitamin D consumption during pregnancy, showed them to have a 61% reduced risk of a “recurrent wheeze,” a symptom of asthma, when compared to those whose mothers were in the lowest quartile.[6] Each 100-IU increase in vitamin D consumption resulted in a 19% risk reduction. That’s about the amount that could be produced in the summer sunlight in one minute, or a good tanning bed in half a minute! How sad that these women have been frightened out of the sunlight, the natural way to produce vast quantities of vitamin D.

[1] Centers for Disease Control. Surveillance for Asthma – United States, 1960-1995, MMWR. 1998; 47 (SS-1).
[2] Matsuoka, L. et al. sunscreens suppress cutaneous vitamin D3 synthesis. Journal Clini Endocrinol Metab 1987; 64:1165-68.
[3] Litonjua AA, Weiss ST. Is vitamin D deficiency to blame for the asthma epidemic? J Allergy Clin Immunol 2007;120:1031–1035.
[4] Banerjee, A. et al. Vitamin D and glucocorticoids differentially modulate chemokine expression in human airway smooth muscle cells. Br J Pharmacol 2008; 155: 84–92.
[5] Devereux, G. et al. Maternal vitamin D intake and early childhood wheezing. Am J Clin Nutr 2007;85:853-59.
[6] Camargo, C. et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y. Am J Clin Nutr 2007;85:788-95.

Introducing Asthma

      Asthma is a disease that effects the lungs due to inflammation of the airways. Symptoms of asthma are episodes of breathlessness, chest tightness, and wheezing. These symptoms make breathing a challenge and in the United States this affects nearly 25 million individuals, this accounts for both adults and children alike (CDC, 2009.) While there is no cure for asthma right now there are ways to limit the severity of the onset of asthma “attacks.” Some ways of doing this are through awareness of possible asthma triggers as pertaining to the individual and with the help of medicine which will further be discussed.

Clinical implications suggest that examining the ecological context may enable practitioners to identify social and environmental factors that challengethe management of childhood asthma. (Yinusa-Nyahkoon 2007)

Asthma: “Inflammation of the air passages resulting in the temporary narrowing of the airways that transport air from the nose and mouth to the lungs. Asthma symptoms can be caused  by allergens or irritants that are inhaled into the lungs, resulting in inflamed, clogged and constricted airways. Symptoms include difficulty breathing, wheezing, coughing tightness in the chest. In severe cases, asthma can be deadly.”
(AAFA; Asthma and Allergy Foundation of America)

• There is no cure for asthma, but asthma can be managed with proper prevention and treatment.


• Asthma has a genetic component. If only one parent has asthma, chances are 1 in 3 that each child will have asthma. If both parents have asthma, it is much more likely (7 in 10) that their children will have asthma.


• More Americans than ever before say they are suffering from asthma. It is one of this country’s most common and costly diseases.

Every person who struggles with asthma needs to recognize the catalyst of an attack via coughing, chest tightness, wheezing, and trouble breathing (symptoms.) Every person has their own personal triggers that set off an asthma attack. It is important for individuals to be knowledgeable of their particular triggers in order to avoid or at least reduce attack situations.(CDC)

Common triggers:

                           Dust mites

                           Secondhand smoke

                           Strenuous Physical Activity

                           Outdoor air pollution

                           Cockroach allergen

                           Pets

                           Mold

Here is an interesting link that will guide to a well done and informative brochure titled “You Can Control Asthma” CLICK HERE

Parent-Child:
Overall, four routines are looked at and managed by both the children and parents of the children with asthma. These routines are adapted by both the children and adults to which they adjust treatment recommendations to be utilized within their personal ecological context.
          1. Child with asthma given responsibility for medication use
          2. School nurse availability monitored
          3. Air quality analyzed managed at best efforts
          4. Home environment cleaned often

(Yinusa-Nyahkoon, 2007)

Family/Friends:
The education of family and friends on the topic of asthma is very important. If an individual diagnosed with asthma is surrounded by people unaware of the triggers of that individual then that individual will suffer. It is also important that the diagnosed individual is not the only person monitoring their use of medication/inhaler. The more aware and educated the family and friends are of the diagnosed individual the more likely that person will be able to live at a higher quality of life.

Social Support:
The more support and understand that surround the diagnosed individual the more they will accept their condition themselves. As an adolescent it can be viewed as embarrassing to be wheezing and struggling to breath in front of their peer group. With this embarrassment can come the lack of using an inhaler and being physically active (if a trigger.)

Support groups for both adults and children are much more readily active and available then one might think. Through the Asthma and Allergy Foundation a variety of support groups can be found. By clicking on SUPPORT GROUPyou will be able to find out more about support groups and what they offer as well as locate a possible local and convenient support group for yourself or someone you know.

In response to the growing asthma problem the United States Environmental Protection Agency (EPA) created a national asthma education and outreach program.While there is no cure, asthma can be controlled through medical treatment and management of environmental triggers.

THE GOAL: Reduce exposure to indoor asthma triggers and improve the quality of life for 6.5 million people by 2012.

Asthma Awareness and Education:
The month of May is “Asthma Awareness Month”

Follow the provided link to access the Asthma Awareness Month Event Planning Kit (February, 2010) to kick off your activities. The Kit includes tips for:

• Holding an asthma awareness event at a school, local hospital or clinic, library, or your state’s capitol building;


• Distributing asthma materials and educating parents on the risks of second-hand smoke;


• Partnering with local organizations to pool resources and increase publicity for your event;


• Collaborating with local leaders/celebrities to boost awareness for your campaigns;


• Garnering media attention for your event; and Much more

The growing awareness of asthma is great but it is important that those who have been made aware continue their duty by making others aware! They can do so by contributing to any of the previously listed bullet points.

Asthma in the Schools:Asthma awareness in school should be of great focus. Being aware that asthma is the most common chronic condition among children (AAFA) and knowing that children spend almost half of their days in a school setting shows that schools and their facilities can essentially contribute to half of the problem that is asthma. With that said, taking these preventative measures in the school settings can only make a positive impact.

1. Establish and Continuously Evaluate an Indoor Air Quality – IAQ – Management Program in Your School or District.

2. 
   Develop an Asthma Management Plan in Your School or District.
   Incorporate school policies to encourage a safer and more stable environment for students with asthma. This could range from access to inhalers to faculty education training on the topic of asthma.
   
   

3. 
   Reduce Environmental Asthma Triggers.
   This can be done by inspecting the school facilities thoroughly on a regular basis. Topics of focus should be mold, moisture, and source of indoor air pollutants.

(EPA)

Facilities:
As widely discussed with asthma it is very important that individuals with asthma recognize and avoid their personal triggers. Many possible triggers can be found indoors such as mold, pets, and chemical odors. With this knowledge it is important that thorough inspections are given in any facility that the individual who has asthma finds themselves spending amounts of time in.

Racial/Demographic:
In regards to asthma and the racial disparities of outcomes of the chronic disease African-American children demonstrate poorer clinical outcomes that any other racial group. Among children with asthma a higher level of quality of life is typical for the children who live in rural areas in comparison with those from cities.

• African Americans are three times more likely to be hospitalized from asthma. [13]


• African Americans are three times more likely to die from asthma.  African American Women have the highest asthma mortality rate of all groups, more than 2.5 times higher than Caucasian women.
  

(AAFA)

The American Lung Association (ALA) worked with partners to develop the National Asthma Public Policy Agenda to reduce the suffering and death from asthma. The ALA hope that groups and individuals who care about asthma will embrace the recommendations found in the Agenda and push to get them put in place nationwide.

This agenda focuses on health-care, homes, outdoor air, public health infrastructure, schools, and workplaces. I list both health-care and home agendas to give you, the readers, an idea of the direction of ALA while you can find information on the rest of the categories and sub categories by following this link …

National Asthma Public Policy Agenda

Health-Care:
1.All health-care systems, including public and private providers, purchasers and payers, should provide access to services and medications consistent with the National Asthma Education and Prevention Program (NAEPP) guidelines. 
The health-care needed is not provided to many people with asthma as a means of controlling it. Asthma is an individualized disease and each person needs a specific diagnosis and plan of attack in order to properly control their struggle with asthma. With that said each asthma patient should be given acces to adequate care, medications, and education.

2. Standardized national performance measures should be adopted for monitoring and evaluating asthma quality of care.
Monitoring performance measures will allow for the tracking of hopeful progress of asthma patients. In doing so not only will the patients be looked after but the quality of care for these patients will be studied.

3. Promote quality improvement activities and develop and disseminate tools that support achievement of performance goals. 
Support for these activities can help make sure the quality of care is at its best.

Homes:
1. Housing code ordinances should protect people with asthma against indoor air problems. Housing codes are an established tool that can and should be used to reduce asthma triggers in homes. However, these codes vary considerably in their requirements and are often underused.

2. Housing code enforcement should be strengthened to reduce prevalence of indoor air quality problems.  Unhealthy indoor air can be a threat to anyone at home, especially those with asthma. Reducing these risks can lead to better management of the disease.

3.  Multi-unit housing should be smoke-free. Second hand smoke is a threat for people with asthma and a serious indoor air pollutant that should be eliminated. Having smoke-free housing is an important step to help those with lung disease.
(ALA)




REFERENCES

Asthma Facts and Figures. Retrieved November 13, 2010 from Asthma and Allergy Foundation of America Website: http://www.aafa.org/display.cfm?id=8&sub=42

 

CDC - Asthma - Basic Information. (2009, October 20). Centers for Disease Control and Prevention. Retrieved November 11, 2010, from http://www.cdc.gov/asthma/faqs.htm  

Yinusa-Nyahkoon, L., Cohn, E., Tickle-Degnen, L., Cortés, D., Lieu, T., & Bokhour, B. (2007). Examining
     routines to understand the ecological context: managing childhood asthma. OTJR: Occupation,
     Participation & Health, 2797S-99. Retrieved from CINAHL with Full Text database.

(2010, October 5). May is Asthma Awareness Month. Retrieved     November 14, 2010 from U.S. Environment Protection Agency     Website: http://www.epa.gov/asthma/awm/index.html

 

(2010). Health-Care Systems and Financing. Retrieved November 14, 2010 from American Lung Association Website: http://www.lungusa.org/lung-disease/asthma/advocacy/reports/health-care-systems.html 

(2010, October22). Managing Asthma in School Environment. Retrieved November 13, 2010 from U.S. Environmental Protection Agency Website: http://www.epa.gov/iaq/schools/managingasthma.html

 

(2009, April 24). Asthma. Retrieved November 13, 2010 from Center for Disease Control and Prevention Website: http://www.cdc.gov/asthma/ 

 

Asthma, -little information...

Asthma is a common disease which affects the respiratory system. It constricts the airways and they become inflamed and lined with mucus. It can be managed well.

Many children develop asthma, which eventually they grow out of. The triggers associated with asthma include:

• Allergies
• Stress
• Exercise
• Cold air

Genes may also play a role who is getting asthma and who not.

The symptoms of asthma include:

• Wheezing
• Coughing
• Chest tightness
• Short of breath

Early detection, diagnosis and treatment is important, otherwise asthma could become a life-threatening disease.

25% of the children will develop asthma and the percentage is not increasing, but only staggering.

The children must get enough breast milk as long as possible. The antibodies and the combination itself is the best for the infant to develop its immune system. Try to avoid cow milk for the infants till 12 months and here we observe these children get less allergies and asthma. If you are not having enough breast milk, select other food, but not milk or milk powder based formulas. Now-a-days without any problems this could be done.

Good medicines are available. Theophylline is the medicine used and it belongs to the group of thioxanthenes. Caffeine also belongs to this group and is good for persons who have asthma. But there is no cumulative effect from both. If we find theophylline values in toxic levels we ask the patient to drink four cups of strong coffee and the caffeine present there helps for the quick excretion of theyphylline.

Asthma is one of the fastest growing health problems in all developed countries.

This a short article to give you quick information.

Allergy asthma

Allergy asthma

Asthma and allergy  can often go hand in hand. Asthma is a disease of the branches of the trachea (bronchi) that carry air in and out of the lungs. There are several different types of asthma. Allergic asthma is a type of asthma that is triggered by allergies (eg pollen or mold spores). According to the American Academy of Allergy, Asthma and Immunology, half of the 20 million Americans with asthma suffer from allergic asthma

Family history of allergies is an important risk factor for allergic asthma. Another risk factor is to have hay fever or other allergies. More than one in four people with hay fever also develop asthma. Although allergic asthma is the most common are other forms of asthma and active asthma such as exercise-induced asthma and allergic asthma triggered by infections or cold air or gastroesophageal reflux disease (GERD). Some people have asthma caused by more than one type of trigger.
If you have a bothersome allergy and asthma symptoms, talk with your doctor. Recognize the relationship between immune system and how the airways react has improved asthma symptoms for many. Knowing that you start, when the measures to avoid them, and work with your doctor to find the right treatment to manage symptoms to help maintain both the symptom control of asthma and allergies.

Warning signs of asthma attack

The first signs begin before symptoms most influential of asthma and are the first signs of a person’s asthma. Signs and symptoms of asthma are:

• Frequent cough, especially at night.


• Taber breath easily or shortness of breath.


• Feeling very tired or weak when exercising.


• In addition to wheezing, coughing, shortness of breath rates or changes in peak expiratory flow is a measurement of air speed of your lungs when you breathe heavily signs of a cold or other respiratory infections or allergies.


• Sleep disorders.


• If you have any of these symptoms of asthma, seek treatment as soon as possible to avoid suffering a severe asthma attack.

Some medications for allergies and asthma, but may be different. For example, corticosteroids reduction you spray in your nose inflammation from hay fever. Corticosteroid creams applied to the skin, reduce inflammation of allergic skin reaction. And inhaled corticosteroids, which you breathe into the lungs using an inhaler device, reduce inflammation of the bronchi caused by asthma. Taken in pill form, montelukast (Singulair) is used to help with symptoms caused by allergies and asthma. Called leukotriene modifier, this drug helps regulate the immune system chemicals released during an allergic reaction. Some other drugs are much more effective for a condition for a second. Antihistamines, for example, are commonly used to treat hay fever, but does not function well in the treatment of asthma. bronchodilator inhalers, which open congested airways, are a big part of asthma treatment, but they are used to treat hay fever.

You Can Exercise, Even If You Have Asthma | Asthma Treatment Tips ...

If we have asthma, we substantially can not use properly or safely. Contrary to what many consider of this issue, there have been ways we can get fit as well as exercise, even if we have asthma.

Asthma is a chronic lung disease, which is marked with features such as coughing, wheezing, crispness of breath as well as chest tightness. Asthma tends to start in people who have been genetically or environmentally presdisposed is okay.

Some triggers which might initiate or have an conflict worse include exposure to allergens, viral respiratory infections, airway irritants, use as well as exposure to things similar to dirt mites or cockroaches.

You can forestall asthma attacks as follows:

1. Rinse your pet upon a weekly basis.

2. Do not smoke or smok
ing in your home.

3. When I imitation or Pollentia is great, we should stay indoors with air conditioning.

4. Wash bedding as well as stuffed toys weekly in hot water.

5. Wash your hands every time we get.

6. Get a influenza shot.

7. Use a headband over his mouth as well as nose in a winter months.

8. Be proactive as well as know your triggers as well as how we should avoid.

Now which we know what we know about asthma, we might wonder if a use is similar to most doctors will discuss it you, do not give up in sport or use at all. Just be smart about how to play as well as take special precautions to forestall attacks before.

Almos
t all doctors determine which a most appropriate approach to forestall attacks during use is to keep your inhaler as well as medication tighten by. You should never use a inhaler more than 3 times during a game session or practice. If we have been up a previous night with coughing as well as wheezing, it is regularly most appropriate to go light your use a next day.

Something known as IEA (exercise induced asthma), symptoms have been somewhat different, which demeanour similar to after 6-10 minutes of physical activity as well as is mostly worse in cold air or dry.

If we have IEA, there have been several activities we can enjoy such as swimming, walking, cycling, skiing as well as team sports based. There have been many activities for we to select to safeguard we get a use we need as well.

Remember which a condition of asthma is not all in your
head, is a real physiological healing diagnosis which requires diagnosis for a impediment as well as treatment. Even if a doctor is your most appropriate friend for a diagnosis of asthma, six a usually one who can equivocate a symptoms.

There is regularly a leg, take drugs as well as be proactive. Do not let which have living in misery how can we enjoy exercising similar to everyone else

weslo cadence treadmill

Asthma inhalers

The New York Times has an excellent piece today on the phasing out of old asthma inhalers, which has already begun. However, the old asthma inhalers will completely unavailable by the end of the year. Many asthma inhalers are pressurized metered dose inhalers (pMDI’s) which means that when you push down on them, the medication sprays out like an aersol spray. Not all inhalers are pMDI’s. Some of the newer inhalers are dry powder inhalers (DPI’s) where the medicine is not sprayed out, but simply inhaled (Advair and Pulmicort are both DPI’s). However, all the rescue medication products available in the US (which is almost always albuterol) are only available in pMDI’s. The problem is that the propellant in these sprays was a CFC, which is bad for the enviornment. CFC’s have been banned by the government, and the asthma inhalers are the last remaining consumer products to have them. The new pMDI’s are made with another propellant, that is more environmentally friendly, HFA. However, there are several differences between the CFC pMDI’s and the HFA pMDI’s.

There is no generic albuterol HFA
The FDA considers the HFA inhalers new drugs, even though the active ingredient is off patent.
Issue #1- if the physician just writes albuterol, the pharmacist will likely dispense the CFC pMDI which will not be available in January 2009, and more importantly may not be available now because supplies are limited
Issue #2- if the physician writes albuterol HFA, since this product does not exist, the pharmacist will likely substitute one of the 3 branded products (ProAir, Ventolin HFA, and Proventil HFA). However, it may matter to you which one of these you get because………
Issue #3- each insurance company has a different policy regarding the CFC to HFA transition. The HFA inhalers are much more expensive. On the other hand, insurers worry that increasing the cost of the co-pay may decrease the use by patients and land them in the Emergency Room. Some insurers have picked one of the 3 products and assigned it a generic co-pay while others have no preference and assign all products the same higher co-pay.

There are some differences between the old CFC inhalers and the new HFA inhalers
The spray from the HFA inhalers is weaker. Inhalers require more priming (wasting the first few pumps) before the first use. Patients may feel a difference in the force and taste of the spray ( and confuse this for the medication not working). The HFA inhalers also require a slower and deeper inhalation.

There are some differences between the new inhalers
ProAir, Ventolin HFA, and Proventil HFA are all albuterol products. Ventolin HFA (made by GSK) has one advantage in that it has a dose counter. Research has shown that many asthmatic patients incorrectly estimate how much medication is left in their inhaler. Most inhalers will continue to spray propellant even when the active ingredient has been used up.
Finally, there is a 4th product called Xopenex, which is levalbuterol. The medication is very similar, but because of its structure may have fewer side effects such as shaking or rapid heart beat. Though the branded Xopenex HFA is currently more expensive than the generic albuterol CFC, when compared to the other three albuterol HFA’s, Xopenex may be the same or even less of a co-pay then the others, depending on your insurance.

What you should do
1. If you have asthma, disccus the CFC to HFA conversion with your doctor to make sure you are getting the right medication.

2. Know the co-pay level that your insurance will charge you for ProAir, Ventolin HFA, Proventil HFA and Xopenex HFA. If any of these are a generic co-pay, switch now. All things being equal, Ventolin (dose counter) and Xopenex (fewer side effects) may be preferred.

3. Use these medications for rescue only. The medications are really only for bad symptoms and emergencies. Current guidelines state that if you are using these medications more that two times a week, your asthma is not well controlled, and you need a better maintenance inhaler, which is an inhaler you take every day to control your asthma.

4. Recognize the differences between the HFA and CFC inhalers. As above, the spray will feel different, and will require some adjustments (priming, slower inhalations) than your previous albuterol pMDI.

5. Do not use Primatene Mist to save a few bucks. This is an over the counter asthma inhaler. It is dangerous and would never be approved by the FDA today. Older medications that are currently over the counter need to have been proven to kill or severely injure people before they will be pulled from the market. This is hard for Primatene Mist, because hard to say whether or not it was the inhaler or the asthma. The active ingredient is epinephrine which has a lot of side effects.

Asthma - refine your technique

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   I was reading the Australian Prescriber catching up with the latest advice for Doctors on controlling asthma, and was disturbed by some of the information I found there. Thankfully the number of deaths has fallen over the years and yet asthma still causes considerable health problems and impacts on the lives of many millions around the world.

Although medications haven’t changed fundamentally over the years, the way they are used and the way patients should be reviewed has. But we are falling dramatically short of good and effective care partly due to poor education and partly due to poor compliance by the asthmatics themselves: ” more than half of the people aged 15–34 years (who have asthma) .. (pick up their) medications only once in a year. Most patients use their inhalers incorrectly, and only 22% of patients have a written asthma action plan”. These are not encouraging findings!

Picking up on the poor technique of most asthmatics, I’ve cut and pasted the suggestions from the Oz Prescriber so that those of you with asthma, or who have children/adolescents with asthma, can review what you are/they are doing and see if you can do it better.

                                                     Common problems with inhaler devices

• breathing out through the inhaler mouthpiece leads to condensation and clogging of the nozzle


• difficulty actuating inhaler (for patients with arthritis, an aid may be available and fitted around the inhaler to ensure easier use)


• failure to coordinate actuation with inhalation. At its worst, medication will be seen to escape from the top of the inhaler.


• too fast an inhalation


• failure to hold breath after inhalation


• multiple actuations without shaking between doses, or on the same breath


• failure to replace cap on inhaler (leaves patient at risk of inhaling foreign bodies from pocket or handbag)


• failure to use a spacer with an inhaled corticosteroid-containing medication (the spacer increases lung deposition and hence efficacy, and reduces the risk of local adverse effects)

                                              Pressurized metered dose inhaler with spacer

• failure to prepare spacer before first use, to reduce the static charge which will otherwise prevent medication reaching the airways (wash in warm detergent water, do not rinse, allow to air dry,


• reassemble; there is no need to prime with puffs of a salbutamol inhaler)


• too-frequent washing without detergent priming (regenerates the static charge)


• sticky valve (the spacer should be washed once a month as above, or if the valve sticks)


• multiple actuations of preventer inhaler into the spacer at one time


• delay between actuation and inhalation


• too-fast inhalation, without a breath-hold at the end

                                                                       Autohaler

• failing to lift the lever before inhaling


• stopping breathing in when the click is heard


• failure to hold breath

                                                                      Accuhaler

• breathing out into inhaler


• not loading dose (by pushing lever) before inhaling


• not holding breath after inhalation


• not closing inhaler cover after use

                                                                      Turbuhaler

• not holding Turbuhaler upright during priming (loading) of dose


• not twisting base both around and back (note: it does not matter whether the click is heard at the end of rotation around, or at the end of the rotation back, as long as the base is rotated in


• both directions)


• not breathing in strongly enough


• not holding breath after inhaling dose


• breathing out into inhaler

reference
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How To Save Someone From An Asthma Attack

Asthma is a condition that inflames the airways, making it difficult to manage normal breathing. There are a wide variety of ‘asthma triggers’ such as dust and fur from pets. These nuisances cause the body to release histamine, which inflames and narrows the airways. It usually takes a course of medication to alleviate the symptoms of an asthma attack. A small amount of training on the treatment protocol can go a long way in helping a sufferer.

One of the main symptoms of an asthma attack is an overall feeling of breathlessness. The resulting narrowing of the airways will also cause the chest to tighten up, whereby the sufferer may even be clutching on this region of the body. Bouts of coughing can accompany the above symptoms, alongside ‘wheezing noises’, which are caused by a blockage when breathing in and out.

Cyanosis is also quite common. This is visible by the skin taking a grey / blue appearance, and may also be evident in the extremities like the lips and finger tips. These symptoms are similar to other serious breathing disorders; therefore it is important to talk to the casualty and those around them to work out if they suffer from the condition.

The first port of call when treating a casualty is to sit them down, and allow for a period of rest. This is by no means the cure; however the sufferer will increase the pressure on the respiratory system by standing up, or by being in an agitated state. The next step after recognising an ‘asthma attack’ is to search for the sufferer’s medication. This usually takes the form of a small blue / brown cylinder, which should be carried at all times. The casualty should be encouraged to draw two puffs from this, every two minutes, for a maximum of ten puffs. The emergency services should be called if there is no access to medication, no improvement, or after ten puffs from the inhaler.

As with most conditions, the treatment protocol does not always go entirely to plan. The main issue that arises is insufficient access to the sufferer’s medication. This may be because they have forgotten to take it out with them, or possibly as a result of not being diagnosed with the condition. The inhalers are vital in alleviating the symptoms of an attack. A casualty’s breathing will become more and more laboured without medication, up to a point where they could even suffer from a cardiac arrest. Those who have received first aid training need to be prepared to start cardio pulmonary resuscitations (CPR) in the event of a cardiac arrest.

Luckily there appears to be a new vaccination on the way, which could help stop asthma attacks all together. It has been dubbed the ‘supercharged’ vaccine as it fires electrical pulses through the skin, directly into the cells within the immune system. This then naturally increases the amount of helper cells, which fight against the harmful effects from mites and house dust. It may well be in the early stages, but this could be the answer that asthma sufferers have been searching for.

Bill Casserley is an experienced first aider, who truly believes “life is for learning”. Could you spot the signs of asthma? If not then visit the first aid training courses blog @ http://www.train-aid.co.uk for video tutorials.

Article Source: http://EzineArticles.com/?expert=Bill_Casserley

Acute Asthma with exacerbation

Case : เด็กหญิงไทย อายุ 12 ปี ภูมิลำเนา อ.จะนะ จ.สงขลา
Chief complaint : หอบเหนื่อย 2 ชม.ก่อนมาโรงพยาบาล
Present illness : แม่ให้ประวัติว่า ผู้ป่วย ไอแห้งๆช่วงกลางคืน 2-3 ครั้งต่อเดือน มา3 เดือน และยังมีอาการเหนื่อยง่าย เป็นมากขึ้นเรื่อยๆแต่หายได้เอง 2 ชม.ก่อนมาโรงพยาบาล ขณะเล่นกีฬาที่โรงเรียน ผู้ป่วยมีอาการหอบเหนื่อย ได้ยินเสียงหายใจ และมีอาการไอมากขึ้นแต่ไม่มีเสมหะ ไม่ไข้ อาการข้างต้นเป็นมากขึ้น จึงมาพบแพทย์ที่โรงพยาบาล
Past History : ปฏิเสธประวัติแพ้ยา , ปฏิเสธประวัติแพ้อาหาร , U/D asthma
Physical Examination
Vital sign : Body temperature 36.2 C Heart rate 85 /min
Respiratory rate 22 /min Blood pressure 90/80 mmHg
GA : a Thai girl, good consciousness, not pale ,no jaundice
HEENT : no conjunctivitis , nasal crease on the external nose , bulging and pale nasal turbinates with watery discharge on nasal speculum exam
Cardiovascular system : normal S1 S2 , no murmur
Respiratory system : Inspection of the chest does not show accessory muscle use or intercostal, suprasternal, or supraclavicular retractions. The antero-posterior diameter does not seem to be increased. Pulmonary auscultation reveals inspiratory and expiratory wheezing scattered throughout both lung fields
Abdomen: no distension, normal bowel sound, soft, not tender,
Nervous system
Motor power: gradeV all
Sensory : intact
Normal reflex
Cerebellar sign : normal finger to nose test
Diagnosis: Acute Asthma with exacerbation
Clinical Question
Among young children with acute asthma exacerbation, is a single dose of IM dexamethasone comparable to five days of oral prednisolone for resolution of asthma symptoms?
PICO
P : Among young children with acute asthma exacerbation.
I : single dose of IM dexamethasone.
C: five days of oral prednisolone.
O: resolution of asthma symptoms.

Ideas for Improving Asthma Control

If you have asthma, the airways inside your lungs are usually inflamed. Throughout an asthma flare-up these airways get much more swollen, and the muscles round the airways can tighten. This could trigger wheezing,

cough, chest tightness and difficulty breathing.

An allergist / immunologist, also known as an allergist, has specialized expertise to obviously identify your asthma triggers and also to develop a treatment plan that can minimize flare-ups and enhance your quality of life.

Take your medication as prescribed from your GP
Many patients have poor compliance with any preventative medicines they’re prescribed; it is essential to follow the regimen that’s been tailored to improve your symptoms.

Enhance your inhaler technique
It is estimated that 71% of all patients have below optimal inhaler technique, what this means is not all of the medication is reaching their lungs. Go to your pharmacist and have them demonstrate how to make the most of your inhaler.

Identify triggers
Usually there’s a trigger which sets off asthma symptoms for example dust, cold air and pet hair. You need to be familiar with which of these are likely to trigger your symptoms, after which find ways to reduce exposure.

Exercise
Being active is a key part of any healthy way of life. Symptoms that occur whilst exercising may suggest poor control – confer with your GP or Pharmacist how you can incorporate exercise to your lifestyle. It may be that slowly enhancing the stress or taking your reliever medication beforehand might help improve control.

Asthma Medications
Asthma is really a chronic disease, so it requires ongoing management. Including using proper medications to avoid and control symptoms and also to reduce airway inflammation.

There’s two general classes of asthma medications, quick-relief and long-term controller medications. Your allergist may recommend one or perhaps a combination of two or more of these medications.

Quick-relief medications are utilized to provide temporary relief of symptoms and, sometimes, used before exercise. These rescue medicines are bronchodilators, that really help to open up the airways to ensure that more air can flow through. Bronchodilators are primarily short-acting beta-agonists administered by an inhaler or perhaps a nebulizer machine. Another type of medicine called an anticholinergic can be utilized at times.

Long-term controller medications are essential for many people with asthma, and therefore are taken on a daily basis to control airway inflammation and treat symptoms in those who have frequent asthma symptoms.

Inhaled corticosteroids and leukotriene modifiers might help control the inflammation that occurs within the airways of most people who have asthma. One medication may go better for you than another. Your allergist might help guide you. 

Road Traffic Pollution as Serious as Passive Smoke in the Development of Childhood Asthma

In a resent study, European scientists did a study on the link between chronic asthma and pollution. Their findings were shocking and scary. The results showed that about fourteen percent of Chronic Asthma in children was caused by pollution. The world health organization links another fourteen percent to passive smoking. The team of scientists also configured the percentage of cases that could be prevented in the ten cities if the children were not exposed to road pollution. The findings showed that a large percentage, twenty-five percent could have been prevented if they did not receive exposure. Because of this study the European Commission has declared 2013 the “Year of Air” They have pledged to focus on improving their air quality as well as finding ways to reduce the pollution output. Many American scientists feel like the same study should be done in the states in order to raise better awareness!

http://www.sciencedaily.com/releases/2013/03/130321205530.htm

Allergy and Asthma Practical Diagnosis and Management, 2008

Massoud Mahmoudi

ISBN: 0-07-159353-5

The McGraw-Hill Companies

Allergy and Asthma: Practical Diagnosis and Management consists of 42 chapters ranging from an introduction to immunology to the history and physical examination of the allergic patient, allergic diseases, diagnosis, and management.

Emergency Care: Primary care doctors often don"t know that a child sought care for asthma in the emergency department

Emergency Care
Primary care doctors often don’t know that a child sought care for asthma in the emergency department

When a patient with asthma seeks care for symptoms at an emergency department (ED), the ED staff should take steps to alert the patient’s primary care physician (PCP) so the PCP is aware of changes to medications and can avoid medical errors. However, a recent study finds that PCPs are not always informed that their patients visited EDs. Richard N. Shiffman, M.D., M.C.I.S., and his colleague at Yale University School of Medicine reviewed medical records of 350 children who regularly received care at community health centers (CHCs), but ended up in an ED after experiencing an asthma flareup.

Nearly 63 percent of patient records at the CHC contained faxed discharge summaries or a note from the ED provider, but the remaining 37 percent of records had no mention of the child’s ED visit. Faxes were the most common way (48 percent) EDs notified PCPs that a visit occurred. However, of the 168 faxes EDs sent, 98 percent did not state how long the asthma medications were to be used, 36 percent were missing dosing information, 34 percent did not include how often the drug was to be taken, and 11 percent lacked medication instructions or names. The authors suggest that e-mail and computerized notifications may be more reliable than faxes and phone calls for alerting PCPs of a patient’s ED visit. Further, nearly two-thirds of patients did not follow up with their PCP after an ED visit for asthma.

Automating notifications would remove the burden that falls on patients to arrange followup care and would transfer responsibility for initiating an office visit to the PCP, the authors suggest. This study was funded in part by the Agency for Healthcare Research and Quality (HS15420).

See “Dropping the baton during the handoff from emergency department to primary care: Pediatric asthma continuity errors,” by Allen L. Hsiao, M.D., and Dr. Shiffman in the September 2009 The Joint Commission Journal on Quality and Patient Safety 35(9), pp. 467-474.

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Asthma and Sitters

Dear Asthma – YOU VACUUM (get it vacuum’s suck?) and I STRONGLY DISLIKE YOU! YOU MAKE MY LIFE DIFFICULT and STRESS ME OUT. And I don’t even have you!

Since Parker’s ER visit on Dec. 21st I am finally starting to see his triggers, namely, this cold weather. He’d been fine, hadn’t need any treatments and had been breathing fine since we saw his doctor on Christmas Eve. Then Sunday, boom, it hit. Don’t think I didn’t try to stop it…I mean, I bundled him up a lot: huge puffy coat (that might weigh more than him), gloves, hat, layers…but no, by the time he woke up from his nap at 4 that afternoon…he needed a treatment. Then he needed another before bed. And I went to bed super frustrated and bitter about the whole thing.

I am trying to learn Park’s triggers…and it seems that the cold air outside is one. Which makes sense if you consider he started out with lung issues and the cold air can cause his lungs to be agitated and tighten. So thanks to this realization, I probably won’t take him out much at all. At least not until the weather is warmer. He’s always been fine when it’s in the high 30′s and higher, so until we see those days with little wind, we will stay in as much as possible. Don’t get me wrong, obviously I will have to take him out at least on Sunday, but I am going to try to do my best to keep the cold air away from him…blanket anyone?

Which leads me to my next predicament. A sitter. I am not going to trust just anyone with my Park, sorry, I can’t afford too. Which is making finding a sitter hard. I have plenty of friends who could watch him every now and then, but I would have to take him to them and I’d like to avoid that. I really would need someone that I could call up on a moments notice and be like, “Hey, need to do some grocery shopping, can you come play with Parker?” i don’t know whether it would be good to post a craigslist ad for one or not. I feel like an employer, I want references and I want them to be CPR and First Aid certified. I want them to have experience and feel comfortable with a child who likely has asthma and who is my everything. Is this too much to ask? I don’t want to sound harsh though… or no one will be interested. So what do you think, should I put up an ad and make sure that those interested know that I am going to be a bit picky in whom I choose.

Also, what’s a good rate for a sitter? I haven’t a clue on how much I should pay them. It’s only going to be a few days a month and 2-3 hours those days. I hate this. I wish it were easier.

Advice would be appreciated on this…I have no clue how to handle finding a sitter and figuring pay and knowing what to ask those who are interested….

Infammation - Arthritis, Asthma, Diabetes

Inflammation within the body may occur in response to cigarette smoking or eating large amounts of saturated fat and trans fat. In overweight or obese people, excess fat cells can float through the bloodstream and cause inflammation. Although inflammation can help the body it can also hurt.
Certain dietary fats cause more of an inflammation response than others. Trans fat and the saturated fat in animal foods stimulate inflammation. To a smaller extent, polyunsaturated fat in foods such as safflower oil, sunflower oil and corn oil trigger inflammation, as well. Again, this is where olive oil helps. Olive oil’s phytonutrients— in this case phenolic compounds called squalane, beta-sitosterol, and tryosol—don’t cause the inflammation that other fats do.
What is Inflammation?
Inflammation is the immune system’s first line of defense against injury and infection. When an injury occurs, such as a simple cut on the finger, a set of events take place within your body that forms a blood clot, fights infection, and begins the healing process. Inflammation is painful because blood vessels dilate upstream of the injury to bring more blood and nutrients to the injured area, but they constrict at the injury site. These actions result in fluids from the bloodstream pooling in tissue around the injury, which causes swelling and pressure that stimulate nerves and cause pain.
In some individuals the immune system gets confused and begins to view some of the body’s own healthy cells as “foreign invaders.” It therefore directs an immune response—complete with inflammation—at healthy tissues, harming or even destroying them. This misdirected attack results in what’s called an autoimmune disorder (“auto) meaning self). Rheumatoid arthritis and certain types of thyroid disease an autoimmune disorders. Asthma, too, is the result of inflammation gone awry.
When inflammation continues unabated for long periods of time, damage can occur in organs, such as the colon, or in the blood vessels. Indeed, chronic inflammation within the body is looking more and more like a serious contributor to cardiovascular (heart and blood vessel) disease. Inflammation may damage the inner lining of the blood vessels, which encourages plaque deposits to form. Inflammation may also cause plaque in arteries to break off and travel downstream, where it can become lodged and stop blood flow to a crucial artery that provides oxygen to important body parts, such as your heart or brain. When this happens, a heart attack or stroke (respectively) can occur.
Chronic inflammation within the body can wreak havoc on other body parts besides arteries. A team led by researchers at the Johns Hopkins Medical Institution found that chronic inflammation of the colon might increase the risk of colon cancer. A ten-year study of more than 20,000 patients suggested a link between chronic inflammation and this disease, although a direct cause-and-effect relationship has not yet been established. These preliminary findings were discussed in the February 2004 edition of the Journal of the American Medical Association.
Scientists have discovered that inflammation can be reduced with low daily doses of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), which in turn appear to reduce the risk of diseases caused by inflammation. Fortunately, not only does olive oil not prompt the kind of inflammation other types of fat can, it actually has some ability to reduce inflammation, thanks to those helpful phytochemicals (squalane, beta-situsterol, and tyrosol). So consuming olive oil on a regular basis may help decrease the risk of conditions linked to inflammation.
Yet another condition that appears to be linked to inflammation is type 2 diabetes, the most common form of diabetes that affects an estimate 20 million Americans. Having excess body fat seems to increase inflammation. As inflammation increases, so does insulin resistance. As insulin resistance increases, blood glucose levels rise and the risk of type 2 diabetes skyrockets.
An article published by Philadelphia researchers in the September 2005 issue of Nature identified a compound in olive oil called olecanthal that has anti-inflammatory action. Their studies revealed that this compound can act like ibuprofen and other anti-inflammatory medications.
Future research will probably tell us more about olive oil’s function in battling oxidation, inflammation, and all the multiple diseases and health conditions associated with them. In Spain, Italy and Greece, where olive oil is used in most households, cancer incidence is much lower than in norther Europe and the United States, where olive oil use isn’t as widespread.
A study published in the March 2005 issue of the Annals of Oncology showed that Oleic acid, the principal monounsaturated fat in olive oil, dramatically decreased the growth of aggressive forms of breast tumors in test tubes. When oleic acid was combined with the commonly used breast cancer drug Herceptin, the effectiveness of the drug was vastly improved. In addition, the researchers reported an inverse relationship between the disease and oleic acid: The more oleic acid a woman ate, the lower her risk of breast cancer.
For more information: The Healing Power of Garlic, Vinegar & Olive Oil by Gayle Alleman, M.S.,R.D. is recommended reading.

Kids" Eczema, Hay Fever Linked to Allergic Asthma Later

New research finds that adults who suffered from eczema as children especially if they also had hay fever are nine times more likely to have allergic asthma when they’re in their 40s. The findings are based on about 1,400 adults who have been followed for five decades as part of Australia’s Tasmanian Longitudinal Health Study. The study participants were assessed in 1968, when they were 7 years old, and then again in 2004 when they were about 44 years of age.

“In this study we see that childhood eczema, particularly when hay fever also occurs, is a very strong predictor of who will suffer from allergic asthma in adult life,” lead study author Pamela Martin, a University of Melbourne graduate student at the Murdoch Childrens Research Institute, said in a university news release. “The implications of this study are that prevention and rigorous treatment of childhood eczema and hay fever may prevent the persistence and development of asthma.”

Allergic asthma is airway obstruction and inflammation that’s triggered by inhaled allergens such as dust mites, pet dander, pollen and mold. According to Martin, the study is the first to examine childhood eczema and hay fever and their connection to allergic versus nonallergic asthma. The linkage between childhood illnesses and adult asthma is called the “atopic march.” “If successful strategies to stop the ‘atopic march’ are identified, this could ultimately save lives and health care costs related to asthma management and treatment,” Shyamali Dharmage, principal investigator of the Tasmanian Longitudinal Health Study.