Asthma (Asthma: breathing short) describes it back to Homer in the Epic, in the verses which speak of Hector, wounded hero in the plain, with panting breath and give quick blood from his mouth. Today, unlike what happened in the past when we talk about asthma, we refer to a chronic inflammatory disease of the airways, where the bronchi are affected by inflammation. Not to be confused with asthma, cardiac asthma, wheezing or breathlessness that is by involving patients with heart failure. The bronchi are the ways of communication through which air enters and leaves the lungs during respiration.
Definition.
When a person suffering from asthma, the bronchi are inflamed, and their wall is thickened and red and is overactive, that the smooth muscle that constitutes the respiratory bronchioles is able to contract in an intense and inappropriate, causing the narrowing of bronchiole same phenomenon that is called "bronchospasm". The inflammatory process underlying asthma, take part in the white blood cells, particularly families of cells: mast cells, eosinophils and T lymphocytes (all'emocromo these subjects are often the Arneth formula increased eosinophils) . We have spoken on this website the role pollutants play in the genesis of asthma (see photochemical smog) in susceptible individuals this inflammation, in which they have recurrent episodes of wheezing (whistling sounds dry, "have kittens inside" (!)), difficulty breathing, chest tightness and cough (see auscultation of the chest). These signs, fortunately, are associated with broncoostruzione reversible, ie the bronchioles, with smooth muscle after contraction, then you drop and do go over the air, unlike in chronic bronchitis which the process is irreversible and 'obstruction of the bronchi solved with great Difficulty and intensive care, until this is possible (see treatment of chronic bronchitis). Given the problems associated with increasing pollution in our cities (see Environment and photochemical smog) it is estimated that 100 million people worldwide have asthma, including children and even athletes, where sports is a basic care.
CAUSE
The triggers the asthma attack may be many and are mainly represented by the following allergenic substances and conditions:
Allergy: inhalation of aero-allergens such as pollens (grasses: seasonality of events (from May to July with a second peak in September, weeds, for example Lanciuola, Artemisia, Parietaria: seasonality of events from July to September; Trees: seasonality of events from February to April.
micofiti mold, Cladosporium, Alternaria: molds that grow in warm and humid (found in homes). The peak production of fungal spores occurs in late summer or early autumn.
see Allergy, allergens!
The air hunger, the patient breathless!
The patient with cough, diagnosis and treatment
Chronic bronchitis and exacerbations
With no smoke!
Spit blood

house dust, dust mites
food allergy triggered by milk proteins, egg, sausages preservatives, eg. MSG
Viral infections (respiratory syncytial virus, common cold virus) and bacterial
Gastroesophageal reflux continued regurgitation of material into the airway.
Chemicals: photochemical smog photos, isocyanates and epoxy resins: polyurethane and plastic workers, painters, designers and printers; formaldehyde plastics workers, health personnel; ethylenediamine: photographers. wheat and flour: bakers, millers, farmers, animal laboratory personnel exposed to mice, guinea pigs, rabbits, etc., wood (eg oak, mahogany, red cedar, nut): carpenters; drugs: the employees of manufacturers, metals ( such as chromium, nickel, mercury, cobalt) metal workers, welders.
systemic stress: situations of great physical stress especially in the sport can cause bronchial constriction
improved hygienic conditions, such as children living at home in aseptic environments.

.... The triggers the asthma attack can be many and are mainly represented by the following allergenic substances and conditions:

Allergy: inhalation of aero-allergens such as pollens (grasses: seasonality of events (from May to July with a second peak in September, weeds, for example Lanciuola, Artemisia, Parietaria: seasonality of events from July to September; Trees: seasonality of events from February to April.

micofiti mold, Cladosporium, Alternaria: molds that grow in warm and humid (found in homes). The peak production of fungal spores occurs in late summer or early autumn.

see Allergy, allergens!

The air hunger, the patient breathless!

The patient with cough, diagnosis and treatment

Chronic bronchitis and exacerbations

With no smoke!

Spit blood



house dust, dust mites

food allergy triggered by milk proteins, egg, sausages preservatives, eg. MSG

Viral infections (respiratory syncytial virus, common cold virus) and bacterial

Gastroesophageal reflux continued regurgitation of material into the airway.

Chemicals: photochemical smog photos, isocyanates and epoxy resins: polyurethane and plastic workers, painters, designers and printers; formaldehyde plastic workers, health personnel; ethylenediamine: photographers. wheat and flour: bakers, millers, farmers, animal laboratory personnel exposed to mice, guinea pigs, rabbits, etc., wood (eg oak, mahogany, red cedar, walnut): carpenters; drugs: the employees of manufacturers, metals ( such as chromium, nickel, mercury, cobalt) metal workers, welders.

systemic stress: situations of great physical stress especially in the sport can cause bronchial constriction

improved hygienic conditions, for example, children living with them in aseptic environments.

..

Etiopathogenesis.

When an allergen, whether it be a pollen, a mold is inhaled and reaches the respiratory tree, it happens that the substance be inherited by cells called macrophages, that is "processed", ie reduced infinitesimally small portions that have a function antigenic and is then presented in this manner to other immunocompetent cells, called lymphocytes, they realize that the substance is "not self", that is unknown to those belonging to the human body and therefore must be combated through the activation of white cells, B cells, as it were by "missile" which are special proteins called "immunoglobulins". In the case of these allergic process called IgE, or immunoglobulin reagins (dell'atopia phenomenon) and are tied to particular sites in the same mast cells to be transmitted around the body. When an allergen binds to these immunoglobulins are free of allergy mediators, including vasoactive substances such as histamine. It acts causing vasodilation, tissue edema and hence of the bronchioles, bronchial constriction, mucus production and various secretions and difficulty breathing. Also produced are other substances, such as basic proteins that can damage the bronchial epithelium.

.
The pathological changes in the course of bronchial asthma can be summarized as follows:

infiltration of eosinophils and lymphocytes (cells that cause inflammation);

destruction of the epithelium (the surface of the bronchus loses its integrity);

vasodilatation and protein extravasation (the bronchus is "bloated" and tends to close);

increased smooth muscle mass (microscopic muscles surrounding the bronchial swell and tighten the bronchus reducing the lumen);

angioneogenesi (creates new capillaries);

mucipare increase in the number of cells (the cells that produce mucus);

collagen deposition in the region below the epithelium (basement membrane thickening).

Diagnosis
Takes advantage of and approach to patient visit, which may have exacerbations of asthma, and must submit these signs:

bronchospasm

dyspnea expiratory

cough

dyspnea

But the fundamental question is spirometry (see also chronic bronchitis) that measure air flow and the speed with which this is possible in the first second or FEV 1. This measure is possible with a tool called "spirometry cabin, where a patient is seated which is connected to a tube and must breathe through it, while a computer measures the air flow, and provides information on the airway obstruction . A simple test how important is the "survivor test," which is to perform spirometry two in one before and one after administration of a bronchodilator drug spray. In asthmatics this administration causes of changes in spirometry that allow diagnosis.

Differential Diagnosis
The D.D. for asthma should be placed with other patients who have dyspnea:

Those with chronic obstructive bronchitis, typical of mature while asthma is usually a problem for young people

Heart failure (also called "cardiac asthma") due to insufficient strength of contraction of heart

Bronchitis Acute transient inflammation of the bronchi usually based infectious.

Panic Attack

Therapy
Asthmatic disease usually requires continued treatment. It makes use of medications in aerosol spray or powder inhalation to contain within the bounds of normal state of inflammation of the airways and therefore does not incur the stress of 'bronchial hyperreactivity. The most important drugs for the treatment of asthma remain the anti-inflammatory preparations based steroids: beclomethasone, budesonide the flunisolide, fluticasone.

One group of anti-inflammatory drugs are particularly antileucotrienici. These drugs are currently made only orally.

Not belong to the category "drugs" so-called "allergy vaccines" or, more correctly, specific immunotherapies. These products are an indication only allergic asthma when the causative allergen has been well identified. They are involved in desensitization against allergenic substances and, when properly administered, may be able to gradually reduce, in a few years, bronchial inflammation.

In a crisis, however, the person may resort to another class of medications called bronchodilators short (salbutamol) duration of action, as the name suggests, dilate the bronchial tubes where an episode of asthma has made the block.


.......

e- mail E-MAIL here

>>>see first page

>>>see also RICERCA