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Asthma Part 2 – Exploring Asthma
The author has no relationships with commercial interests related to the content of the presentation. A noted pulmonary specialist with a large clinical practice traces the incidence, epidemiology, and pathophysiology of this widespread and costly allergic disease of chronic airway inflammation. Providing clear illustrations showing normal versus asthmatic bronchial tubes, and the genetic and environmental factors that can trigger a disease that is the commonest chronic illness in children and affects up to 10% of the US population, the author notes that environmental factors have important implications. He also discusses why he feels genetics research will provide important insights into asthma treatment. Noting that "all that wheezes is not asthma" the author stresses the importance of differential diagnosis – and provides several examples. Incorporating detailed graphic material the author discusses the importance of symptoms, a detailed history including the patient's susceptibility to environmental factors, a physical exam, and testing in making the correct diagnosis. Overall the goal of treatment is to suppress airways inflammation, minimize symptoms, and maximize patient function and quality of life through limiting environmental exposure and optimizing pharmacologic therapy using a stepped approach. Illustrations provide examples of several types of such exposure and the control measures used to limit or eradicate them. Management is also a function of appropriate patient monitoring. On the pharmacologic front, the lecture provides details of what works and what doesn't among the various medications involved in treating asthma ... of which inhaled corticosteroids are the most useful, and theophylline the least, due to concerns about its toxicity. Use of beta agonists for mild forms of asthma is also discouraged. Finally, this lecture offers a helpful outline of the NIH Guidelines for asthma therapy and the accompanying excellent summary tables. |
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