Medicines use for severe asthma
Peri J. Ballantyne, Kath Ryan in Living Pharmaceutical Lives, 2021
Respiratory conditions impose an immense global heath burden and are leading causes of mortality and morbidity (Forum of International Respiratory Societies, 2017). Of all chronic respiratory conditions, asthma and chronic obstructive pulmonary disease (COPD) are the most common. Asthma is a condition of the lungs, affecting people of all ages (Masoli, Fabian, Holt, & Beasley, 2004; Papi, Brightling, Pedersen, & Reddel, 2018) and can range from mild to severe, based on the level of treatment required to control symptoms and prevent asthma attacks. Mild, moderate and severe asthma affects approximately 330 million people worldwide with approximately 250,000 annual deaths (Lenzen, Daniëls, van Bokhoven, van der Weijden, & Beurskens, 2017; Pinnock, 2015; Williams, Steven, & Sullivan, 2011). Severe asthma is a complex and heterogeneous disease that affects 3-10% of individuals with an asthma diagnosis. It accounts for high morbidity and is estimated to contribute to half the healthcare costs associated with asthma (McDonald et al., 2017; Sadatsafavi et al., 2010).
Anxiety and depression in patients with chronic respiratory disease
Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein in Pulmonary Rehabilitation, 2020
Chronic respiratory diseases are common and diverse in their phenotypes. Chronic obstructive diseases include chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and cystic fibrosis; restrictive diseases include thoracic restriction, neuromuscular conditions and parenchymal conditions such as idiopathic pulmonary fibrosis and sarcoidosis (1). Chronic respiratory diseases have common clinical characteristics such as cough, exertional dyspnoea, excessive fatigue and unexpected episodic exacerbations frequently leading to emergency care or hospitalization. In addition, the daily frustration and inability to cope with the disease as well as lingering (persistent) symptoms of dyspnoea may predispose individuals to an increased risk of elevated comorbid psychiatric symptoms such as anxiety and depression. These symptoms are often associated with increased physical disability, persistent stressful situations, diminished social interaction and foregoing of lifetime pleasurable activities.
Cutaneous Porphyrias
Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk in Photodermatology, 2007
Fluid-filled vesicles develop most commonly on the backs of the hands (Fig. 2), and also on the forearms, face, ears, neck, legs, and feet. These commonly rupture, leading to chronic, crusted lesions, and denuded areas that heal slowly and may become infected. The sun-exposed skin is also friable, and bullae or denudation of skin may result from minor trauma. Milia may precede or follow vesicle formation. Facial hypertrichosis and hyperpigmentation are particularly troubling in women (Fig. 3). Affected areas of skin sometimes become severely thickened, scarred and calcified. These findings have been termed pseudoscleroderma. Identical skin lesions can occur in VP and much less commonly in HCP. Skin findings in CEP and HEP resemble PCT but are usually much more severe and mutilating. Mild or moderate erythrocytosis is common in PCT, and is not well explained. Chronic lung disease from smoking may contribute.
Comparisons of acute inflammatory responses of nose-only inhalation and intratracheal instillation of ammonia in rats
Published in Inhalation Toxicology, 2019
Linda Elfsmark, Lina Ågren, Christine Akfur, Elisabeth Wigenstam, Ulrika Bergström, Sofia Jonasson
Human exposure to NH3 can lead to tissue break-down in the airways and destruction of cilia and the mucosal barrier, that causes inflammation and an increased risk of secondary infections (Arwood et al. 1985; Amshel et al. 2000). Major clinical manifestations and pathological findings in humans after exposure to NH3 include respiratory symptoms, such as hypoxia, secretions, sloughed epithelia, emphysema, edema, reactive smooth muscle contractions in the airways, hypovolemia and burns to the skin and eyes (Wiklund et al. 2001; Brautbar et al. 2003). The respiratory symptoms may lead to clinical impairment of respiratory function and damaged epithelia is often replaced by new connective tissue, which may be one of the causes of chronic lung disease following NH3 inhalation injury (Hatton et al. 1979; Flury et al. 1983; George et al. 2000). The chronic lung disease is similar to e.g. chronic obstructive lung disease (COPD), bronchiectasis, airway respiratory distress syndrome (ARDS), and bronchiolitis obliterans disease (BO). Complications after NH3 exposure could also progress into the need of prolonged ventilator support, or in the worst scenario, death (Kass et al. 1972; Sobonya 1977; Flury et al. 1983; Lessenger 2004; Makarovsky et al. 2008; Kerger and Fedoruk 2015).
High mortality from viral pneumonia in patients with cancer
Published in Infectious Diseases, 2019
Youn-Jung Kim, Eu Sun Lee, Yoon-Seon Lee
Patient clinical and demographic characteristics were collected from the de-identified clinical database, which included age, sex, comorbid diseases including malignancy, chronic lung disease, chronic kidney disease, congestive heart failure, and diabetes mellitus, vital signs at ED admission, laboratory findings and outcome. Malignancy was defined as cancer receiving treatment including chemotherapy, radiotherapy, or surgery; cancer diagnosed within recent 6 months; and metastatic cancer. Chronic lung disease included chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and pulmonary hypertension. CURB-65, a pneumonia severity score with criteria of Confusion, Urea, Respiratory rate, Blood pressure and age ≥ 65, was also calculated [6]. Specifically, we extracted laboratory data for detecting respiratory pathogens.
Clinical features of Legionnaires’ disease at three Belgian university hospitals, a retrospective study
Published in Acta Clinica Belgica, 2022
Marco moretti, Sabine D. Allard, Nicolas Dauby, Deborah De Geyter, Bhavna Mahadeb, Véronique Y. Miendje, Eric V. Balti, Philippe Clevenbergh
The diagnosis of LD was established when patients had acute onset of respiratory symptoms (cough or dyspnoea or pleural chest pain), a consolidation on chest X-ray (CXR) and a positive LUA or RT-PCR on a respiratory sample. Hospital-acquired LD definition was determined following the definite HA LD diagnosis definition of the Centres for Disease Control and Prevention (CDC) [10]. HA LD was considered whenever the onset of symptoms was reported at 10 or more days after admission. Patients diagnosed within 10 days from admission were considered as affected by CA LD. The variable ‘chronic respiratory disease’ was defined as the presence of asthma or chronic obstructive pulmonary disease (COPD). CXR findings were collected at LD diagnosis and bilateral lung consolidation was defined as bilateral opacification on CXR, with or without pleural effusion presence. Blood gas analyses at diagnosis were recorded and severe respiratory insufficiency was defined as partial oxygen pressure less than 60 mmHg. Antibiotic regimens were recorded. The variable ‘non-respiratory fluoroquinolones’ was defined as treatment with an antibiotic or a combination of antimicrobials not containing levofloxacin or moxifloxacin.
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