SCHOLARLY ARTICLE - Inhaled corticosteroids as rescue medication in asthma exacerbations in children

The role of inhaled corticosteroids (ICS) as rescue medication for asthma exacerbations in children is controversial. ICS have the important potential advantage of direct delivery to the airways, which substantially reduces the risk of the adverse systemic effects that may be associated with oral corticosteroids. Oral corticosteroids are still prefered for severe attacks. Five randomized, controlled studies performed at home and six performed in the emergency department indicated that ICS are at least as effective as the oral route. Our pediatric out-patient asthma clinic has been using ICS for asthma exacerbations for more than 25 years. The key elements to success are the administration of repetitive doses at least four-times higher than the maintenance dose and parental adherence to the treatment plan.

SHOLARLY ARTICLE - Recent advances in the management of occupational asthma

Occupational asthma (OA) is the most common occupational lung disease in industrialized countries. This respiratory disorder remains poorly diagnosed and managed, and inadequately compensated for worldwide. The most appropriate treatment for OA remains early removal from exposure to ensure that the worker has no further exposure to the causal agent with preservation of income. However, various studies demonstrate that many workers with OA continue to remain exposed to the causative agent or suffer prolonged work disruption and discrimination, and may face unemployment. Despite removal from exposure, OA frequently turns into a chronic condition and requires intensive medical management, including appropriate pharmacotherapy and patient education and counseling. There are very few studies on allergen immunotherapy in OA. Subcutaneous immunotherapy with latex extract in healthcare workers and with wheat-flour extract in subjects with baker’s asthma, at adequate doses, appears to be a useful treatment in reducing cutaneous and respiratory symptoms, but should be considered as a high-risk treatment due to the appearance of systemic reactions.

Keys to managing childhood asthma

Asthma is one of the most chronic serious diseases in children and adolescents, affecting nearly nine million children under the age of 18. Fifty to 80% of children with asthma develop the symptoms of asthma before the age of 5.

Children suffering from asthma also miss more than 10 million school days each year due to complications of the disease. Asthma symptoms can result in poor academic performance, anxiety and further isolation from peers if not properly taken care of by an allergist/immunologist.

Asthma occurs when the main air passages of the lungs, the bronchial tubes, become inflamed. The muscles of the bronchial walls tighten and extra mucus is produced, causing the airways to narrow. The result could range from a frequent tendency for a cough to wheezing to severe difficulty in breathing. In some cases, breathing may be so labored, that an asthma attack becomes life-threatening.

The most common form of asthma among children is allergic asthma. In this form, otherwise harmless allergens, such as dust mites, cat and dog dander or other environmental allergens, can trigger an asthma attack. In addition to allergy symptoms brought on by exposure to these allergens-watery eyes, sneezing and itching-asthmatics can experience severe airway constriction. If left untreated, the disease can escalate to dangerous proportions, even resulting in trips to the emergency room to restore normal breathing.

Asthma also can have a non-allergic component and be triggered by cold, dry, polluted air or exercise. The variety of triggers, both allergic and non-allergic, that lurk all around us makes asthma nearly a universal risk for millions of people

Who is at risk to develop asthma?
Children whose immune systems are not fully developed are most at risk for developing the disease. However, there are no clear markers to predict who will develop asthma and who won't. Studies have shown that factors associated with the onset of asthma symptoms in children include:

* Infants and young children who wheeze with viral upper respiratory infections.
* Allergies. The relationship between asthma and allergies is very strong. If your child has allergies, be on the alert for potential signs of childhood asthma
* A family history of asthma and/or allergy
* Prenatal exposure to tobacco smoke and allergens

How do I know it's asthma?
Asthma can be a tricky disease to pinpoint for a number of reasons. There are other respiratory ailments with overlapping symptoms, and some children can seem symptom free for long periods of time but then experience intermittent asthma "attacks." If you think your child might have asthma, get him/her examined and tested by an allergist/immunologist.

Children with asthma cough, wheeze and experience chest tightness and shortness of breath. However a chronic cough may be the only symptom of asthma and a child does not have to wheeze to have asthma. Children with reactive airway disease, recurrent bronchitis or wheezy bronchitis probably have asthma.

Watch for the key symptoms that can clue you in to seek the advice of an allergist/immunologist. These include:

* Coughing. This could be constant or just intermittent. Not all children who have the disease exhibit symptoms each and every day
* Wheezing or a whistling sounds audible when your child exhales
* Shortness of breath or rapid breathing. This may or may not be associated with exercise
* Chest tightness. A young child may say his/her chest "hurts" or "feels funny"
* Fatigue. Your child may slow down, stop playing or become easily irritated
* Infants may have problems feeding and may grunt during suckling
* Older children may avoid activities such as sports or sleepovers
* A child may have problems sleeping because of nighttime coughing or difficulty breathing

Asthma symptoms are often worse in the morning and late at night. In between asthmatic episodes symptoms have been known to disappear or improve but that does not mean the asthma has gone away. Symptoms can be brought on by a number of different triggers such as: respiratory infections, exercise, stress, cold air and outdoor allergens such as pollen, mold, animal dander or dust mites.

Patterns of asthma symptoms are important. Pay close attention to when the asthma occurs. Does it occur:

* At night or early morning?
* During or after exercise?
* Seasonally?
* After laughing or crying?
* When exposed to possible asthma triggers at home, school or daycare?

No two children have exactly the same asthma symptoms or outcomes. It is a very individualized disease. The best way to determine if your child does have asthma, is to look and listen for clues or symptoms. If you suspect that your child might have asthma, take your child to an allergist/immunologist for a proper diagnosis. Allergists/immunologists are specialists who are specifically trained to manage the prevention, diagnosis and treatment of allergies and asthma.

For any child with asthma, the severity of the disease can change over time and it may result in a severe asthma exacerbation, or attack. If your child has asthma, it's important that an allergist/immunologist defines the severity because proper treatment will differ depending the classification.

Asthma management for children
Currently there is no cure for asthma. But for most children, asthma can be controlled with appropriate management and treatment. While asthma is a chronic illness, it should not be progressively debilitating disease. When appropriate treatments and careful avoidance measures are practiced, children with asthma can participate in regular activities.

Asthma and allergies
Most children with asthma also have allergies. Allergy testing is recommended for children with persistent asthma who are exposed to perennial indoor allergens. Allergy testing can be helpful for diagnosing relevant allergic factors that may contribute to asthma severity. This will help identify and prioritize recommendations for controlling exposure to allergens.

When allergies and asthma do strike, early treatment is essential. If allergies, and especially asthma, are left untreated and allowed to progress unchecked, permanent damage can be done to the airways. This makes it difficult to bring the condition under control and improve quality of life for the patient.

Research has proven that early treatment does prevent further progression and control allergies and asthma. For children, early treatment could mean the difference between sitting on the sidelines at soccer games and fully participating with their team.

It is important for your child to avoid his/her triggers, work with an allergist/immunologist to create a management plan, and take appropriate medications as prescribed. Together, you, your child and an allergist/immunologist can work to ensure that asthma does not take control.

Natural Asthma Remedies have no Side Effects

Are you getting scared of taking prescription meds with all of the serious side effects becoming known? Try a natural asthma remedy/relief instead. They have no side effects except maybe to get rid of your asthma.

There are a wide variety of natural asthma remedies available to treat your condition. It is estimated that over 20 million Americans have some degree of asthma and that number grows year after year. The medical community will tell you that there is no cure for asthma so they prescribe medications that treat the symptoms but do not even pretend that they are actual asthma cures.

You probably couldn't find a handful of people who had previously been taking prescription medications who suddenly found themselves cured of their insomnia. Since there is no cure for asthma in the prescription drug world, these people usually have to keep taking their drugs forever which can lead to some very nasty complications. A perfect example would be the use of an inhaler. Some of the side effects from the long term use of corticosteroids can be blood glucose problems, acne, hairiness, stunted growth increased appetite, weight gain and particularly high doses of steroids may even cause osteoporosis!

Here is another example. A study published in the Annals of Internal Medicine in 2006, found that long-acting beta-agonists increased the risk for asthma hospitalizations and asthma deaths 2- to 4-fold, compared with placebo. Other potential side effects of beta-agonists are jitters, tremors, flushing, headaches, rapid and/or irregular heart rate. These are just a couple examples, there are many, many more. It's no wonder that as people become aware of these unwanted side effects, more and more of them are seeking out a non-prescription all natural asthma relief.

The official medical opinion on asthma is that there is no cure for asthma. That is probably true regarding prescription drugs. However, many people have found a natural cure for their asthma using processes such as:

Acupuncture - Uses needles for the stimulation of chemical reactions in the body to correct existing imbalances.

Yoga - Using particular exercises and body positioning to cure problems inside the mind and body.

Hypnosis - Listed as a natural cure for insomnia.

The use of herbal and homeopathic treatments can eliminate the need for prescription drugs and inhalers.

If you would like to find out even more information about asthma including specific natural asthma remedies and reliefs, visit my website at: http://www.greatasthmainfo.com

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What causes Asthma - Are you prone to Asthma attacks

Asthma is caused by spasmodic contraction of the muscular walls of the bronchial tubes. It is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing. Asthma attacks can last minutes to days and can become dangerous if the airflow becomes severely restricted. Asthma symptoms can also be triggered by respiratory infections, exercise, cold air, tobacco smoke and other pollutants, stress, food, or drug allergies. This disease is a significant health problem in the United States affecting more than 20 million individuals, including five million children.

Asthma is a condition that makes the bronchial tubes of the lung overly sensitive and easily inflamed. Apart from medications used to treat the ailment, there is a little known approach to asthma treatment. Asthma symptoms can be substantially reduced by avoiding known allergens and respiratory irritants. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swell. Most people with this ailment have wheezing attacks separated by symptom-free periods. In sensitive individuals, the symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).

Aspirin and other non-steroidal anti-inflammatory medications provoke asthma in some patients. Many people with asthma have an individual or family history of allergies, such as hay fever (allergic rhinitis) or eczema. A person with asthma may experience varying symptoms that can include coughing, wheezing, chest tightness or difficulty breathing. The changes in hormonal levels that accompany puberty or pregnancy can also play a role in this ailment. Exposure to certain substances in the work place can also cause asthma symptoms. The tendency to develop this disease is hereditary and can often be traced to other family members. A few of the risk factors for developing asthma have been identified; they include having parents with this disease, having a personal history of nasal allergy, having eczema or food allergy, exposure to dust mites in the house, or growing up with parents who smoke.

The number of people developing asthma has been increasing. The treatment of this disease begins with proper evaluation, to determine its severity and possible causes. Medications for asthma are used in a stepped manner, according to its severity. Most importantly, this disease has to be closely monitored. Individuals who have asthma should not ignore their symptoms, as it can flare up unexpectedly and can lead to long-term loss of lung function due to lung injury.

Asthma Natural Treatment

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Asthma Signs and Symptoms- When to consult Asthma doctor

Some persons may have asthma only when they exercise or have a viral infection. The doctor can help you identify which things affect your disease and ways to avoid them. Different people have different signs and symptoms of asthma People with this ailment often have one or more the symptoms like wheezing, chest tightness, coughing, feeling short of breath etc. If you have these signs and symptoms of asthma consult with your doctor immediately.

A person who is middle-aged or older can sometimes develop asthma In some cases, the ailment continues into adulthood. In others, the childhood ailment clears up, only to reappear later in life as adult onset asthma If you weren't diagnosed with this disease in your childhood, perhaps your symptoms were misdiagnosed as bronchitis or some other illness. It is often hard to tell whether someone has adult onset asthma or some other kind of smoking-related illness because the symptoms can be similar. People with adult onset asthma are sensitive to the same kinds of triggers that bring on symptoms in younger people. Managing adult onset asthma means limiting the amount of exposure to your particular triggers.

Adult onset asthma in a person of middle-age or older can speed up the deterioration of lung functioning. Once lung functioning has deteriorated, it never recovers, so it is important that adult onset asthma be properly managed. People with adult onset asthma often need to take preventive medication to protect their lung function.When you have asthma you always have inflammation or swelling in the airways of your lungs. Uncontrolled inflammation makes your airways more sensitive to triggers like pollen, dust, and smoke. If you use asthma rescue medication more than twice a week, then you may not be in control of your asthma. The treatment does not aim to curea the disease but it is about managing the disease so you have few or no symptoms and signs of asthma in the first place.

Natural Remedy For Asthma

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Asthma Kids- Does your kid have Asthma

The main airways of the lungs, commonly referred to as the bronchial tubes, become swollen in asthma kids just as they do in adults. Unfortunately, it's often more difficult to diagnose with asthma kids. Why? Because the symptoms are often found in numerous other childhood illnesses, such as a cough or chest congestion resulting from a common cold.

So what should you look for if you're concerned that your child might have asthma?

In the case of infants (and yes, infants can have asthma), you'll want to take notice any time you encounter a rattling cough, rapid breathing, frequent chest colds, grunting when nursing, and/or a weak cry. Of course, these may be perfectly innocent symptoms of nothing more than a cold. That's why it's important to involve your pediatrician if you become concerned. He can work with you to determine if there's a problem or not.

In small children, you'll not only want to look for symptoms, you'll want to listen to what your child tells you. For instance, if your kid mentions that his or her "chest feels funny" or asks "why am I always coughing," these are clues that you need to note. Asthma kids can be especially challenging because no two children suffer asthma in exactly the same way or exhibit the exact same symptoms.

Other symptoms you should look for in your child include violent coughing after strenuous activity, rapid breathing, chest tightness, wheezing and shortness of breath, or consistent coughing at night. A lingering cough after a recent cold can also be a sign of asthma. If symptoms appear to be aggravated by changes in the weather, laughing or crying, or strong perfumes or odors ... these can all be indicators that should prompt a visit to your family physician.

In addition, there are some mild indicators that can be easy to overlook. For instance, waking up tired in the morning may be the result of coughing or having trouble breathing during the night. These occurrences can easily disturb your child's sleep and result in exhaustion. Or if your youngster is experiencing nightmares that involve asthmatic clowns or bears, this can often be a sign that his or her sleep is being disturbed by various asthma symptoms.

Some children may exhibit all of these symptoms, while other children may exhibit as few as one or two. That's why it can sometimes be challenging to diagnose asthma kids. However, by taking note of the little events in your child's health life (the lingering cough, the difficult nights, the shortness of breath), and sharing this information with your child's doctor, he can help you determine whether or not there's a problem.

If there is a problem, if it turns out that your child does have asthma, don't panic. Your doctor can help you develop a plan that can help minimize the occurrences of attacks and allow your youngster to live an active, rambunctious childhood. As he or she grows older, you may find that the symptoms become more pronounced or even less pronounced. So, you'll want to keep an eye on the situation. If the symptoms change, your doctor can adjust his treatments accordingly.

While the symptoms in asthma kids can be especially unsettling for a parent, there's no need to feel overwhelmed. Great advances have been made in recent years in the treatment of asthma. There's absolutely no reason your child can't still enjoy every moment of his or her childhood.

Receive a free, comprehensive guide asthma guide by visiting Understanding Asthma

And if you'd like to learn more about asthma kids, please visit: Pediatric Asthma

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