Asthma brittle

Sudden severe attack Sudden severe attacks on a background of well controlled asthma Brittle asthma Type 2... 

Ayres JG, Mikes JF and Barnes PJ (1998) Brittle asthma. Thorax 53 315-321. 

Case study level Mb - Brittle asthma - see page 56... 

The term brittle asthma was first used in 1977 to describe patients who maintained a wide variation in PEER despite high-dose inhaled steroids. This has been reviewed and described by Ayres et al. (1998) based on the magnitude of diurnal PEFR variability, rather than the pattern of variability. They also describe two subclasses maintained wide PEF variability (type 1, >40% diurnal variation for >50% of the time over at least 150 days) or sudden onset of acute airway obstruction (type 2, occurring in less than 3 hours without obvious trigger). 

Soraya Dhillon and Andrzej Kostrzewski Case study level 1 - Asthma - community 49 Case study level 2 - Asthma - acute on chronic 50 Case study level 3 - Chronic obstructive pulmonary disease (COPD) -with co-morbidity 52 Case study level Ma - COPD 54 Case study level Mb - Brittle asthma 56... 

This ozone can be harmful to people, animals, vegetation and materials in different ways. It irritates the respiratory system, it can make asthma, emphysema and bronchitis worse, and it may even cause permanent lung damage. Ground-level ozone also hastens the aging of spruce needles and causes brittleness in polymer materials, such as plastics and rubber products. 

---