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Immunology of Allergic Diseases
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
For centuries manifestations of allergic diseases such as asthma, anaphylaxis and food allergy were described eloquently but its mechanism remained a mystery. The discovery of IgE antibody, its relationship to mast cells and kinetics mediator release elucidated clinical phenotypes of allergic responses. Understanding Innate immune responses and adaptive CD4+TH2 responses ushered in the era of immune regulation. Therapeutic approaches evolved from modulating bronchoconstriction and bronchialreactivity to more targeted approaches. These include anti-IgE therapy, allergen immunotherapy, role of anti-cytokine receptor modulation. Understanding the role of microbiota and targeting aberrant adaptive immune responses to stop the atopic march are in progress and is the subject matter of this chapter.
The patient with acute renal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Auscultating a patient’s chest can also reveal useful information. The frothy secretions that occur in pulmonary oedema create adventitious breath sounds, and coarse crackles can be heard when a stethoscope is placed appropriately on the chest wall. Wheezing may also be heard if there is a degree of bronchoconstriction present.
Morphometric Analysis of Casts of Branching Structures
Published in Joan Gil, Models of Lung Disease, 2020
Casts may be made from excised lungs, or from lungs in situ in the thorax. In either case, it is the responsibility of the author to state clearly the conditions under which the cast was made, and the responsibility of the user of the data so obtained to take account of these conditions. In general, airways change dimensions approximately as cube lung root of volume (Hughes et al., 1972), so an appropriate correction to the dimensions obtained from measuring a cast can be made as required for lung volume. This, or course, does not take into account bronchoconstriction.
Development and assessment of a low literacy, pictographic asthma action plan with clinical automation to enhance guideline-concordant care for children with asthma
Published in Journal of Asthma, 2023
Patrick T. Reeves, Timothy M. Kenny, Laura T. Mulreany, Michael Y. McCown, Jane E. Jacknewitz-Woolard, Philip L. Rogers, Sofia Echelmeyer, Sebastian K. Welsh
Asthma is a serious, potentially lethal, clinical syndrome with wide-ranging phenotypes of lung reactivity and inflammation that affects approximately 300 million people worldwide (1). Asthma is distinguished by chronic airway inflammation, increased bronchoconstriction, and a history of reversible symptoms including: cough, wheezing, dyspnea, and chest tightness. Asthma frequently causes missed school and workdays lost, and is a top 10 cause of Disability adjusted Life years (DALYs) for children age 5–14 years (2,3). This represents a significant healthcare economic burden (1). Inhaled corticosteroids, long acting beta agonists (LABA), rescue Short-acting Beta-2 Agonist (SABA), and patient education initiatives have each been employed to varying degrees of success in an attempt to control symptoms and improve outcomes in patients with asthma (4–6).
Advances in phosphoproteomics and its application to COPD
Published in Expert Review of Proteomics, 2022
Xiaoyin Zeng, Yanting Lan, Jing Xiao, Longbo Hu, Long Tan, Mengdi Liang, Xufei Wang, Shaohua Lu, Tao Peng, Fei Long
Chronic obstructive pulmonary disease (COPD) is characterized by not fully reversible airflow limitation, varying with cough, phlegm, wheezing, breathlessness, and comorbidities in clinical manifestations. The typical COPD phenotype is mainly chronic airway inflammation, and emphysema type, while special patients will have a more refined inflammatory phenotype. Fibrotic lesions can be found in the small airways and can contribute to small airway obstruction in COPD [4]. This can cause difficulties in breathing and can lead to more severe symptoms of COPD. Different phenotypes of patients have different degrees of expiratory airflow limitation [5]. Asthma is characterized by airway narrowing due to bronchoconstriction and airway inflammation. Asthma may be a risk factor for COPD. In severe asthma, structural changes such as airway remodeling can lead to airway obstruction and a narrower inner diameter of the airway. Approximately 15–20% of COPD patients have features of both of these diseases [6], which is termed asthma-COPD overlap (ACO). Whether COPD, asthma, or ACO, they are all characterizes as heterogeneous diseases, which means more disease burden and challenges to current diagnostic and therapeutic strategies.
Applications of oscillometry in clinical research and practice
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Lennart K. A. Lundblad, Salman Siddiqui, Ynuk Bossé, Ronald J. Dandurand
A core element of diagnosing lung disease is establishing the presence or absence of reversibility of bronchoconstriction. This is typically done comparing lung mechanics measurement before and after bronchodilation with an inhaled drug such as albuterol or terbutaline. The reversibility of lung function is a characteristic of asthma frequently determined with spirometry as a change of FEV1 of 12% following inhalation of a bronchodilator. In a paper by Oostveen et al.88 a positive response in asthmatic patients as the 95th percentile of the bronchodilator response in healthy adults was established. The 95th percentiles for the absolute and relative changes in Rrs and Xrs at low frequencies due to bronchodilation were established. For example, the 95th percentile response in Rrs at 5 Hz was −1.37 hPa.s.L−1 (−1.40 cmH2O.s.L−1), corresponding to a relative decrease of 32%, for Xrs at 5 Hz it was 0.55 hPa.s.L−1 (0.56 cmH2O.s.L−1), corresponding to −43%, and finally AX was −3.90 hPa.s.L−1 (−3.98 cmH2O.L−1), corresponding to −65%.