Asthma disease severity

Rhinitis is characterized by nasal stuffiness with partial or full obstmction, and itching of the nose, eyes, palate, or pharynx, sneezing, and rhinorrhoea. If left untreated it can lead to more serious respiratory diseases such as sinusitis or asthma. Although several types of dmgs are available for treatment, nasal spray topical corticosteroids are widely regarded as the reference standard in rhinitis therapy (250). 

TLR-9 has also been used to target asthma with several compounds in preclinical trials such as second generation CpG-ODNs and HYB2093. 1018 ISS has also been tested in asthma. Defence against infectious disease is also enhanced through TLR-9. CpGIOlOl was in phase II trails as a Hepatitis C target but has been discontinued. 

Blockers are contraindicated in patients with severe bradycardia (heart rate less than 50 beats per minute) or AV conduction defects in the absence of a pacemaker. (3-Blockers should be used with particular caution in combination with other agents that depress AV conduction (e.g., digoxin, verapamil, and diltiazem) because of increased risk for bradycardia and heart block. Relative contraindications include asthma, bronchospastic disease, severe depression, and peripheral vascular disease. (3,-Selective blockers are preferred in patients with asthma or chronic obstructive pulmonary... 

Asthma is also a significant economic burden in the United States, costing 12.7 billion in 1998 with direct medical expenditures accounting for 58% of the cost or approximately 7.4 billion.5 Hospital and emergency department care accounted for 45.1% of the direct medical expenditures, with prescription drugs and physician office visits accounting for 43.3% and 11.6%, respectively. Costs appear to increase with disease severity, and it has been suggested that fewer than 20% of asthma patients account for more than 80% of direct medical expenditures.5... 

In chronic asthma, classification of asthma severity is based on daytime and nighttime symptoms, physical activity, lung function (PEF or FEVfi, PEF variability, and reliever medication use. Because lung function is difficult to measure in preschool children (children 5 years of age or younger), it cannot be used to classify disease severity in this age group. Chronic asthma is classified as mild intermittent asthma, or mild, moderate or severe persistent asthma (Table 11-1). 

The intensity of pharmacologic therapy is based on the severity of the disease, and the least amount of medications necessary to meet the goals of asthma therapy should be used.1,3 Stepwise therapy for the treatment of chronic asthma based on disease severity is shown in Table 11—1. 

Injection - To relieve respiratory distress in bronchial asthma or during acute asthma attacks and for reversible bronchospasm in patients with chronic bronchitis, emphysema, and other obstructive pulmonary diseases severe acute anaphylactic reactions, including anaphylactic shock and cardiac arrest to restore cardiac rhythm. 

Bronchial asthma, a history of bronchial asthma, or severe chronic obstructive pulmonary disease sinus bradycardia second- and third-degree AV block overt cardiac failure cardiogenic shock hypersensitivity to any component of the products. 

Topical glucocorticoids are used extensively for the treatment of a variety of inflammatory diseases such as rhinitis, inflammatory bowel disease, asthma, and several dermatological diseases. 

Reactive aldehydes generated from hpid peroxidation are involved in CVD (266). Another example lies with the role of oxidative stress in the pathophysiology of asthma (267). Lipid peroxidation, as determined by plasma iso-prostanes, is related to disease severity in mild asthma. Tumor cell lines are sensitive to PUFA and to associated oxidation products (268). This sensitivity depends on the antioxidant defense mechanism, as well as on culture conditions. Hydroperoxy docosahexaenoic acid is a major metabolite, responsible for the cytotoxicity of DHA. 

Gemou-Engesaeth V Kay AB, Bush A, Corrigan CJ Activated peripheral blood CD4 and CDS T-lymphocytes in child asthma Correlation with eosinophilia and disease severity. Pediatr Allergy Immunol 1994 5 170-177. 

Walker C, Kaegi MK, Braun P, Blaser K Activated T cells and eosinophilia in bronchoalveolar lavages from subjects with asthma correlated with disease severity. J Allergy Clin Immunol 1991 88 935-942. 

With the role of S. aureus as disease modifier being established, a number of therapeutic approaches may be considered (fig. 2). The potential therapeutic effect of a treatment to eradicate S. aureus in polyp disease or asthma has not been studied yet, but large-scale double-blind placebo-controlled randomized studies are currently ongoing. From atopic dermatitis, a disease sharing the modifying effects of staphylococcal superantigens on inflammation and disease severity, we can deduce therapeutic approaches. The skin of up to 100% of patients with atopic dermatitis is colonized with S. aureus, of which up to 65% have been shown to produce enterotoxins with superantigenic properties. Ten patients were treated orally with antibiotics, chlorhexidine ointment was... 

Wood, L.G., Fitzgerald, D.A., Gibson, P.G., Cooper, D.M., and Garg, M.L. 2000. Lipid peroxidation as determined by plasma isoprostanes is related to disease severity in mild asthma, Lipids, 35(9), 961. 

They may be chronic which means that the health effects develop with time. It may take several years for the associated disease to develop and the effects may be slight (mild asthma) or severe (cancer). 

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