(Data are for U.S.)
Mortality
Number of deaths: 64,954 (2002)
Deaths per 100,000 population: 22.5 (2002)
Percent of hospital inpatient deaths from pneumonia: 8.1 (2000)
Health Care
Number of discharges: 1.3 million (2002)
Average length of stay: 5.7 days (2002)
Home health care
Number of current patients with pneumonia as primary diagnosis: 20,300 (2000)
Percent of current patients with pneumonia as primary diagnosis: 1.5 (2000)
Survey
Nursing home care:
Number of residents with pneumonia: 46,000 (1999)
Percent of residents with pneumonia: 2.5 (1999)Average length of stay for discharges with pneumonia as primary diagnosis: 124 days (1999
Thursday, October 2, 2008
Monday, September 22, 2008
PREVENTIONS
PREVENTIONS
* Reduce exposure to environmental activators, such as molds, pollens, animal dander and secondhand tobacco smoke by:
1. Keeping the home cooled to 68-72 degrees Fahrenheit
2. Providing excellent ventilation with HEPA ( high-efficiency particulate air)filters, fans and other devices
3. Maintain humidity between 40 and 50 percent
4. Put on a mask when cleaning the house or doing yard work, or better yet, hand over these tasks to others
5. Combine mold inhibitor to paint, particularly in damp places like the bathroom
6. Replace carpets with hard flooring
7. Closely stay on the asthma action plan suggested by the doctor. Be sure to take all asthma medications as ordered.
8. Keep a healthy lifestyle that includes good nutrition, enough rest, and regular exercise.
9. Keep a healthy weight. Obese persons who lose weight often get rid of symptoms of asthma as well.
* Reduce exposure to environmental activators, such as molds, pollens, animal dander and secondhand tobacco smoke by:
1. Keeping the home cooled to 68-72 degrees Fahrenheit
2. Providing excellent ventilation with HEPA ( high-efficiency particulate air)filters, fans and other devices
3. Maintain humidity between 40 and 50 percent
4. Put on a mask when cleaning the house or doing yard work, or better yet, hand over these tasks to others
5. Combine mold inhibitor to paint, particularly in damp places like the bathroom
6. Replace carpets with hard flooring
7. Closely stay on the asthma action plan suggested by the doctor. Be sure to take all asthma medications as ordered.
8. Keep a healthy lifestyle that includes good nutrition, enough rest, and regular exercise.
9. Keep a healthy weight. Obese persons who lose weight often get rid of symptoms of asthma as well.
COMPLICATIONS
COMPLICATIONS
1. Pneumonia
2. Pneumothorax or pneumomediastinum
3.Respiratory failure needing intubation in severe aggravation of the condition
4. Complications associated with most medications used for asthma are relatively rare. Those found in patients on long-term corticosteroid use includes:
5. Osteoporosis
6. Cataracts
7. Immunosuppression
8. Weight gain
9. Myopathy
10. Thinning of skin
11. Addisonian crisis
12. Avascular necrosis
13. Easy bruising
14. Psychiatric disorders
15. Diabetes
1. Pneumonia
2. Pneumothorax or pneumomediastinum
3.Respiratory failure needing intubation in severe aggravation of the condition
4. Complications associated with most medications used for asthma are relatively rare. Those found in patients on long-term corticosteroid use includes:
5. Osteoporosis
6. Cataracts
7. Immunosuppression
8. Weight gain
9. Myopathy
10. Thinning of skin
11. Addisonian crisis
12. Avascular necrosis
13. Easy bruising
14. Psychiatric disorders
15. Diabetes
TESTS & TREATMENT
Test
* Spirometry—The most accurate breathing test for asthma where an instrument called a spirometer is used.
Doctors use spirometry to:
* help spot if a patient has asthma
* help work out how serious the asthma is
* see if the asthma is getting worse
* see if the asthma is getting better with treatment
Spirometry perfectly measures and documents the quantity of air inhaled and exhaled out of the lungs. The results illustrate how constricted the airways in the lungs are. Spirometry also helps the doctor to choose what drugs to recommend to the patient or whether the amount of the present medication needs to be increased or decreased.
* Peak flow meter—This provides an image of how narrow the airways are by computing the highest (or peak) rate at which one can blow air into it. Peak flow aids one to see how much one’s airways are changing.
If a patient has asthma medications every day, the doctor may advise him/her to use a peak flow meter to assist in checking one’s asthma at home. Normally children over the age of seven are adept at learning how to use a peak flow meter properly. Peak flow measurement is most often employed to help one identify:
* when the asthma is getting worse
* when one may need to increase medication
Treatment
Most people use a mixture of long-term control medicines and fast relief medications. A doctor must be consulted to decide which option is best for the patient based on age and the seriousness of symptoms. In general, the major types of asthma medications are:
* Long-term-control medications—These are taken daily on a long-term basis to manage chronic symptoms and foil asthma attacks.
1. Inhaled corticosteroids—anti-inflammatory drugs that stop blood vessels from leaking fluid into the airway tissues.
2. Long-acting beta-2 agonists (LABAs)—part of a set of medications called bronchodilators, which open up tight airways. Salmeterol (Serevent Diskus) and formoterol (Foradil), which last at least 12 hours, are used to control average and serious asthma and to stop nighttime symptoms.
3. Leukotriene modifiers—lessen the production or obstruct the action of leukotrienes--substances discharged by cells in the lungs during an asthma attack
4. Cromolyn and nedocromil—though not helpful for everyone, everyday use of nedocromil (Tilade) or inhaled cromolyn (Intal) may help put off attacks of mild to moderate asthma as well as asthma prompted by exercise.
5. Theophylline—a bronchodilator in pill form to be taken every day. It relieves nighttime symptoms of asthma.
* Quick-relief medications—Short-acting bronchodilators, which are often, called "rescue" or "quick-relief" drugs to stop the symptoms of an asthma attack in progress.
1. Short-acting beta-2 agonists—bronchodilators which begin acting within minutes and last 4-6 hours.
2. Ipratropium (Atrovent).
3. Oral and intravenous corticosteroids for asthma attacks—Prednisone, methylprednisolone, hydrocortisone and others may be taken to deal with acute asthma attacks or very serious asthma.
* Spirometry—The most accurate breathing test for asthma where an instrument called a spirometer is used.
Doctors use spirometry to:
* help spot if a patient has asthma
* help work out how serious the asthma is
* see if the asthma is getting worse
* see if the asthma is getting better with treatment
Spirometry perfectly measures and documents the quantity of air inhaled and exhaled out of the lungs. The results illustrate how constricted the airways in the lungs are. Spirometry also helps the doctor to choose what drugs to recommend to the patient or whether the amount of the present medication needs to be increased or decreased.
* Peak flow meter—This provides an image of how narrow the airways are by computing the highest (or peak) rate at which one can blow air into it. Peak flow aids one to see how much one’s airways are changing.
If a patient has asthma medications every day, the doctor may advise him/her to use a peak flow meter to assist in checking one’s asthma at home. Normally children over the age of seven are adept at learning how to use a peak flow meter properly. Peak flow measurement is most often employed to help one identify:
* when the asthma is getting worse
* when one may need to increase medication
Treatment
Most people use a mixture of long-term control medicines and fast relief medications. A doctor must be consulted to decide which option is best for the patient based on age and the seriousness of symptoms. In general, the major types of asthma medications are:
* Long-term-control medications—These are taken daily on a long-term basis to manage chronic symptoms and foil asthma attacks.
1. Inhaled corticosteroids—anti-inflammatory drugs that stop blood vessels from leaking fluid into the airway tissues.
2. Long-acting beta-2 agonists (LABAs)—part of a set of medications called bronchodilators, which open up tight airways. Salmeterol (Serevent Diskus) and formoterol (Foradil), which last at least 12 hours, are used to control average and serious asthma and to stop nighttime symptoms.
3. Leukotriene modifiers—lessen the production or obstruct the action of leukotrienes--substances discharged by cells in the lungs during an asthma attack
4. Cromolyn and nedocromil—though not helpful for everyone, everyday use of nedocromil (Tilade) or inhaled cromolyn (Intal) may help put off attacks of mild to moderate asthma as well as asthma prompted by exercise.
5. Theophylline—a bronchodilator in pill form to be taken every day. It relieves nighttime symptoms of asthma.
* Quick-relief medications—Short-acting bronchodilators, which are often, called "rescue" or "quick-relief" drugs to stop the symptoms of an asthma attack in progress.
1. Short-acting beta-2 agonists—bronchodilators which begin acting within minutes and last 4-6 hours.
2. Ipratropium (Atrovent).
3. Oral and intravenous corticosteroids for asthma attacks—Prednisone, methylprednisolone, hydrocortisone and others may be taken to deal with acute asthma attacks or very serious asthma.
DIAGNOSIS & SYMPTOMS
Diagnosis
A doctor deduces asthma based principally on a person's report of typical symptoms. A diagnosis of asthma can be established by means of spirometry tests.
For the duration of an asthma attack, the test divulges reduced airflow, but for more than hours or days, narrowing advances and is consequently reversible.
More frequently, the doctor carries out spirometry or pulmonary function tests prior to and after giving the patient an inhaled beta-adrenergic agonist. If outcomes are considerably better after the person gets the beta-adrenergic agonist, asthma is believed to be present. If the airways are not constricted at the moment of the first test, a diagnosis can be established by a test in which the person breathes in a chemical (generally methacholine but histamine may be utilized also) in doses very low to distress a normal person but which causes airway contraction in a person who has asthma.SymptomsAsthma signs and symptoms can vary from mild to severe. One may have only sporadic asthma episodes with mild, brief symptoms such as wheezing. Amid episodes, one may feel normal and have no trouble breathing. Some people with asthma have persistent coughing and wheezing combined with harsh asthma attacks.
A good number of asthma attacks are led by warning signs. Identifying these warning signs and dealing with symptoms early on can help thwart attacks or keep them from becoming worse.
Adults must be conscious of some warning signs and symptoms of asthma including:
Troubled sleep caused by coughing, shortness of breath, or wheezing
Heightened shortness of breath or wheezing
Bigger need to use bronchodilators or drugs that open up airways by soothing the surrounding muscles
Chest rigidity or pain
A drop in peak flow rates as gauged by a peak flow meter, a simple and low-cost device that lets one monitor his/her own lung function
Children frequently have an audible whistling or wheezing sound when exhaling and recurrent coughing spasms.
A doctor deduces asthma based principally on a person's report of typical symptoms. A diagnosis of asthma can be established by means of spirometry tests.
For the duration of an asthma attack, the test divulges reduced airflow, but for more than hours or days, narrowing advances and is consequently reversible.
More frequently, the doctor carries out spirometry or pulmonary function tests prior to and after giving the patient an inhaled beta-adrenergic agonist. If outcomes are considerably better after the person gets the beta-adrenergic agonist, asthma is believed to be present. If the airways are not constricted at the moment of the first test, a diagnosis can be established by a test in which the person breathes in a chemical (generally methacholine but histamine may be utilized also) in doses very low to distress a normal person but which causes airway contraction in a person who has asthma.SymptomsAsthma signs and symptoms can vary from mild to severe. One may have only sporadic asthma episodes with mild, brief symptoms such as wheezing. Amid episodes, one may feel normal and have no trouble breathing. Some people with asthma have persistent coughing and wheezing combined with harsh asthma attacks.
A good number of asthma attacks are led by warning signs. Identifying these warning signs and dealing with symptoms early on can help thwart attacks or keep them from becoming worse.
Adults must be conscious of some warning signs and symptoms of asthma including:
Troubled sleep caused by coughing, shortness of breath, or wheezing
Heightened shortness of breath or wheezing
Bigger need to use bronchodilators or drugs that open up airways by soothing the surrounding muscles
Chest rigidity or pain
A drop in peak flow rates as gauged by a peak flow meter, a simple and low-cost device that lets one monitor his/her own lung function
Children frequently have an audible whistling or wheezing sound when exhaling and recurrent coughing spasms.
CAUSES
CAUSES:- Asthma is almost certainly due to a mixture of environmental and genetic aspects. A person is more likely to acquire asthma if it runs in his/her family and if one is sensitive to allergens or irritants in the environment. Initial, recurrent infections and constant exposure to secondhand smoke or specific allergens may boost the probability of developing asthma.
Exposure to a range of allergens and irritants may set off asthma symptoms. The following are common things that activate asthma symptoms:
Allergens (pollen, animal dander or mold)
Air pollutants, irritants
Cockroaches, dust mites
Strong odors, scented products, chemicals
Smoke
Physical hard work, including exercise
Respiratory infections (for example, the common cold)
Cold air
Intense emotions and stress
Sinusitis
Sulfites, preservatives put in some perishable foods
Specific medications (beta blockers, aspirin and other non-steroidal anti-inflammatory drugs) Gastroesophageal Reflux Disease (GERD)--a state in which stomach acids reverse into the esophagus. GERD may set off an asthma attack or make an attack worse.
Exposure to a range of allergens and irritants may set off asthma symptoms. The following are common things that activate asthma symptoms:
Allergens (pollen, animal dander or mold)
Air pollutants, irritants
Cockroaches, dust mites
Strong odors, scented products, chemicals
Smoke
Physical hard work, including exercise
Respiratory infections (for example, the common cold)
Cold air
Intense emotions and stress
Sinusitis
Sulfites, preservatives put in some perishable foods
Specific medications (beta blockers, aspirin and other non-steroidal anti-inflammatory drugs) Gastroesophageal Reflux Disease (GERD)--a state in which stomach acids reverse into the esophagus. GERD may set off an asthma attack or make an attack worse.
ASTHMA
Asthma, also known as Reactive Airway Disease is a chronic disease that renders it hard to breathe. At its most terrible, asthma can be fatal. Case in point, in 2003, asthma took the lives of 287 Canadians. Asthma can't be cured, but it can be managed. With appropriate treatment, people with asthma can lead ordinary, active lives.Asthmatic people have airways (breathing passages) that are extra sensitive. When they are around certain things, the ultra-sensitive airways can become:
Red and swollen, as the airways get inflamed inside and fill up with mucus. The swelling and mucus make the airways more constricted, so it's more difficult for the air to pass through.
"twitchy" and go into seizures. The muscles around the airways press together and constrict. This causes the airways to tighten, leaving less space for the air to pass through.The more red and inflamed the airways are, the more “twitchy” they become. Several different things can activate asthma symptoms. Every person with asthma has hi/her own group of asthma inducers and asthma activators. Asthma inducers are things one is allergic to that are breathed, for example, pollen or dust. Asthma activators are things that trigger asthma like smoke or cold air.
About Pulmonology
In medicine, pulmonology is the specialty that deals with diseases of the lungs and the respiratory tract. It is called chest medicine and respiratory medicine in some countries and areas. Pulmonology is generally considered a branch of internal medicine, although it is closely related to intensive care medicine when dealing with patients requiring mechanical ventilation. Surgery of the respiratory tract is generally performed by specialists in cardiothoracic surgery (or thoracic surgery). Chest medicine is not a specialty in itself but is an inclusive term which pertains to the treatment of diseases of the chest and contains the fields of pulmonology, thoracic surgery, and intensive care medicine. Pulmonology is concerned with the diagnosis and treatment of lung diseases, as well as secondary prevention (tuberculosis). Physicians specializing in this area are called pulmonologists. In the United Kingdom, Ireland, South Africa and Australasia the term "respiratory physician" is used rather than pulmonologist
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