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Brittle Asthma
Brittle asthma is a type of asthma distinguishable from other forms by recurrent, severe attacks. There are two subtypes divided by symptoms: Type 1 and Type 2, depending on the stability of the patient's maximum speed of expiration, or peak expiratory flow rate (PEFR). Type 1 is characterized by a maintained wide PEF variability despite considerable medical therapy including a dose of inhaled steroids, and Type 2 is characterized by sudden acute attacks occurring in less than three hours without an obvious trigger on a background of well controlled asthma. Brittle asthma is one of the "unstable" subtypes of "difficult asthma", a term used to characterize the less than 5% of asthma cases that do not respond to maximal inhaled treatment, including high doses of corticosteroids combined with additional therapies such as long-acting beta-2 agonists. Diagnosis Types The 2005 ''Oxford Textbook of Medicine'' distinguishes type 1 brittle asthma by "persistent daily chaotic variability i ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Asthma
Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise. Asthma is thought to be caused by a combination of genetic and environmental factors. Environmental factors include exposure to air pollution and allergens. Other potential triggers include medications such as aspirin and beta blockers. Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry lung function testing. Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. It may also be classified as atopic or non-atopic, ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Asthma Trigger
Asthma triggers are factors or stimuli that provoke the exacerbation of asthma symptoms or increase the degree of airflow disruption, which can lead to an asthma attack. An asthma attack is characterized by an obstruction of the airway, hypersecretion of mucus and bronchoconstriction due to the contraction of smooth muscles around the respiratory tract. Its symptoms include a wide range of manifestations such as breathlessness, coughing, a tight chest and wheezing. An asthma attack is usually mediated by an inflammatory pathway, where a trigger such as an allergen could lead to a series of immune response mediated by various types of immune cells. Common triggers for asthma include allergens like pet dander, dust mites, pollens and molds. Other types of triggers like exercise, air pollutants, tobacco smoke, humidity, cold air, or certain medicines may also play a role in triggering asthma. While it has been proposed that asthma triggers can be classified into three types: alle ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involved in a wide range of physiological processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Some common naturally occurring steroid hormones are cortisol (), corticosterone (), cortisone () and aldosterone (). (Note that cortisone and aldosterone are isomers.) The main corticosteroids produced by the adrenal cortex are cortisol and aldosterone. Classes * Glucocorticoids such as cortisol affect carbohydrate, fat, and protein metabolism, and have anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictive effects. Anti-inflammatory effects are mediated by blocking the action of inflammatory medi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Beta2-adrenergic Agonist
Beta2-adrenergic agonists, also known as adrenergic β2 receptor agonists, are a class of drugs that act on the β2 adrenergic receptor. Like other β adrenergic agonists, they cause smooth muscle relaxation. β2 adrenergic agonists' effects on smooth muscle cause dilation of bronchial passages, vasodilation in muscle and liver, relaxation of uterine muscle, and release of insulin. They are primarily used to treat asthma and other pulmonary disorders, such as Chronic obstructive pulmonary disease (COPD). Mechanism of action Activation of β adrenergic receptors leads to relaxation of smooth muscle in the lung, and dilation and opening of the airways. β adrenergic receptors are coupled to a stimulatory G protein of adenylyl cyclase. This enzyme produces the second messenger cyclic adenosine monophosphate (cAMP). In the lung, cAMP decreases calcium concentrations within cells and activates protein kinase A. Both of these changes inactivate myosin light-chain kinase and ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Oxford Textbook Of Medicine
The ''Oxford Textbook of Medicine'' is an international textbook of medicine. First published in 1983, it is now in its sixth edition. It is primarily aimed at mature physicians looking for information outside their area of particular expertise, but widely used as a reference source by medical students and doctors in training, and by others seeking authoritative accounts of the science and clinical practice of medicine. The ''Oxford Textbook of Medicine'' is available in print and online - where its contents are systematically updated. Description The ''Oxford Textbook of Medicine'' covers the scientific aspects and clinical practice of internal medicine and its subspecialties. It offers practical guidance on clinical management and the prevention of disease. Throughout the book, basic science and clinical practice are integrated, and the implications of research for medical practice are explained. Traditional specialty areas in clinical medicine are covered, and there are sec ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Dyspnea
Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathing, breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of its distinct sensations, the degree of distress and discomfort involved, and its burden or impact on the patient's activities of daily living. Distinct sensations include effort/work to breathe, chest tightness or pain, and "air hunger" (the feeling of not enough oxygen). The tripod position is often assumed to be a sign. Dyspnea is a normal symptom of heavy physical exertion but becomes disease, pathological if it occurs in unexpected situations, when resting or during light exertion. In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congesti ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Wheeze
A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract in an asthmatic attack), or airflow velocity within the respiratory tree must be heightened. Wheezing is commonly experienced by persons with a lung disease; the most common cause of recurrent wheezing is asthma, though it can also be a symptom of lung cancer, congestive heart failure, and certain types of heart diseases. The differential diagnosis of wheezing is wide, and the reason for wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician. Characteristics Wheeze Wheezes occupy different portions of the respiratory cycle depending on the site of airway obstruction and its nature. The fraction of the respiratory cycle during ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Margaret Turner-Warwick
Dame Margaret Elizabeth Turner-Warwick (; 19 November 1924 – 21 August 2017) was a British medical doctor and thoracic specialist. She was the first woman president of the Royal College of Physicians (1989–1992) and, later, chairman of the Royal Devon and Exeter Health Care NHS Trust (1992–1995). Family Margaret Turner-Warwick was born on 19 November 1924. Her birth was registered in St George, Hanover Square, London. She was the daughter of William Harvey Moore, Q.C., and his wife, Maud Kirkdale Baden-Powell, who were married on 23 March 1920. Dame Margaret was the granddaughter of Sir George Baden-Powell and Frances Wilson. She married urologist Richard Turner-Warwick in 1950. They had two daughters, Lynne and Gillian. Education Turner-Warwick was educated at the City of London School for Girls and Walthamstow Hall, before attending The Maynard School in Exeter from the age 12 to the age 18. While at Maynard, she became friends with Audrey Jane Pinsent, who late ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Compliance (medicine)
In medicine, patient compliance (also adherence, capacitance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance. Access to care plays a role in patient adherence, whereby greater wait times to access care contributing to greater absenteeism. The cost of prescription medication also plays a major role. Compliance can be confused with concordance, which is the process by which a patient and clinician make decisions together about treatment. Worldwide, non-compliance is a major obstacle to the effective delivery of health care. 2003 estimates from the World Health Organization indicated that only about 50% of patients with ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Beta Agonist
Beta adrenergic agonists or beta agonists are medications that relax muscles of the airways, causing widening of the airways and resulting in easier breathing. They are a class of sympathomimetic agents, each acting upon the beta adrenoceptors. In general, pure beta-adrenergic agonists have the opposite function of beta blockers: beta-adrenoreceptor agonist ligands mimic the actions of both epinephrine- and norepinephrine- signaling, in the heart and lungs, and in smooth muscle tissue; epinephrine expresses the higher affinity. The activation of β1, β2 and β3 activates the enzyme, adenylate cyclase. This, in turn, leads to the activation of the secondary messenger cyclic adenosine monophosphate (cAMP); cAMP then activates protein kinase A (PKA) which phosphorylates target proteins, ultimately inducing smooth muscle relaxation and contraction of the cardiac tissue. Function Activation of β1 receptors induces positive inotropic, chronotropic output of the cardiac muscle, lead ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Long Acting Beta-adrenoceptor Agonist
Long-acting β adrenoceptor agonists (LABAs, more specifically, long-acting β2 adrenergic receptor agonists) are usually prescribed for moderate-to-severe persistent asthma patients or patients with chronic obstructive pulmonary disease (COPD). They are designed to reduce the need for shorter-acting β2 agonists such as salbutamol (albuterol), as they have a duration of action of approximately 12 hours in comparison with the 4-to-6-hour duration of salbutamol, making them candidates for sparing high doses of corticosteroids or treating nocturnal asthma and providing symptomatic improvement in patients with COPD. With the exception of formoterol, long-acting β2 agonists are not recommended for the treatment of acute asthma exacerbations because of their slower onset of action compared to salbutamol. Their long duration of action is due to the addition of a long, lipophilic side-chain that binds to an exosite on adrenergic receptors. This allows the active portion of the molecul ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
MedicAlert
The MedicAlert Foundation is a non-profit company founded in 1956 and headquartered in Turlock, California. It maintains a database of members' medical information that is made available to medical authorities in the event of a medical emergency. Members supply critical medical data to the organization and receive a distinctive metal bracelet or necklace tag which is worn at all times. It can be used by first responders, such as emergency medical personnel or law-enforcement agents, to access wearers' medical history and special medical needs. The name ''MedicAlert'' may be interpreted either as the two separate words "medic alert" or as a blended form of the phrase "medical alert". Protocol and publicity The MedicAlert IDs worn by members are designed to mimic regular jewelry (such as bracelets, necklaces, ID tags, etc.) with the addition of the distinctive MedicAlert engraved tag. The personalized jewelry bears the words "Medic Alert" and the Staff of Asclepius, the universa ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
