Standard Care In Bronchiectasis
There are few high-quality clinical trials in bronchiectasis, and much of the therapy is empiric as recently concluded by a Cochrane overview.,, There are however significant spends on unproven therapies without a good evidence base. For example, UK national audits have demonstrated that inhaled corticosteroids , 30% received long-term antibiotics, and nebulized antibiotics were used in 10% however, the use of long-term antifungals reported was not reported. The effect of these empiric therapies on the lung microbiome and the susceptibility to fungal infections is unknown., Recently, a European registry of adult patients with bronchiectasis has been launched. In an exploratory analysis of the EMBARC data set of 2,031 patients in this cross European registry revealed a rate of reported ABPA of 4%. In the 81 patients recorded as having ABPA, 79 were receiving inhaled corticosteroids, 27 were receiving current treatment , and 27 received oral corticosteroids with 9 receiving itraconazole . No other conazole drugs were reported .
Additional strategies include the use of long-term systemic macrolides which reduce exacerbations in bronchiectasis., Undoubtedly they are associated with an increase in macrolide resistance. The effect of such therapy on long-term fungal infection or sensitization is unknown, but there are clear data that they alter the bacterial microbiome and may increase susceptibility to Pseudomonas.
Bronchiectasis Common In Patients With Severe Uncontrolled Asthma Greek Study Finds
Bronchiectasis is common among patients with severe uncontrolled asthma and might even make their asthma worse, concludes a study by the Sotiria Chest Diseases Hospital in Athens, Greece.
In fact, the type of inflammation seen in patients with both asthma and bronchiectasis might render them insensitive to typical asthma treatment, and testing bronchiectasis-type antibiotics in this group of patients might be a better approach, researchers suggested.
The study, Investigation of bronchiectasis in severe uncontrolled asthma, appeared in the Clinical Respiratory Journal.
Researchers recruited 40 patients 28 women and 12 men who had asthma for an average of 16.5 years. All were being treated with a combination of an inhaled corticosteroid and a long-acting beta-2 agonist, and 40 percent were also taking a leukotriene receptor blocker.
Despite treatment, all patients had uncontrolled disease, characterized by cough, wheezing, chest tightness and breathing difficulties.
Using high-resolution computed tomography, the research team found bronchiectasis in 27 of the 40 patients, or 67.5 percent of the group.
Earlier studies have suggested that asthma might cause bronchiectasis. Except for asthma, researchers could not find any specific cause of bronchiectasis in any of the patients.
Nevertheless, researchers said it is important to diagnose the presence of bronchiectasis in asthma patients, as the two conditions might need different treatment approaches.
How Bronchiectasis Is Treated
The damage caused to the lungs by bronchiectasis is permanent, but treatment can help relieve symptoms and stop the damage getting worse.
The main treatments include:
- exercises and special devices to help you clear mucus out of your lungs
- medicine to help improve airflow within the lungs
- antibiotics to treat any lung infections that develop
Surgery is usually only considered for bronchiectasis in rare cases where other treatments have not been effective, the damage to your bronchi is confined to a small area, and you’re in good general health.
Read more about the treatment of bronchiectasis.
Anxiety : : Xanax Xr Is Less Dangerous
My dr prescribed 0.5mg Xanax XR twice a day to keep my anxiety more level throughout the day. Does the XR keep the equivalent of 0.5 mg of instant release Xanax in your system constantly, or is it just .5mg spread out over 12 hours instead of maybe 1-2 hours compared to the instant release? Also, why would anyone take Xanax XR instead of Klonopin? Aren’t they basically the same? My dr said Xanax XR is less “dangerous” but is it? If I stop taking it for more than 1 day I start feeling some withdrawal symptoms. Scary. Is this normal? I thought withdraw was only a problem when you started getting into the 2,3,4mg daily range.
Cataflam Dangerous For Elderly People
I had problems with pain and inflammation in my right knee. It hurt like hell when I don’t take medicines. I have been prescribed with Cataflam two months ago. It have done wonders for me. I can walk, stand up and go upstairs without any pain. But I have heard that this medication is dangerous for elderly people. Is that true? I am 60 year old.
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Overall Goals Of Treatment
The main goals of treatment are to reduce exacerbations, preserve lung function and improve the patientâs quality of life. A disease management schematic is shown in Fig. . Patients with bronchiectasis should be instructed in how to improve airway clearance using physiotherapy techniques at home or at a physiotherapy clinic. Treatments, both pharmacological and non-pharmacological, should focus on reducing inflammation and preventing exacerbations. Because bronchiectasis involves a permanent change in lung structure, the condition is chronic and the patientâs quality of life may be severely impacted. Care is best managed by a stepwise multidisciplinary team approach, including respiratory/chest physiotherapy.
Can Cannabis Help Asthma Patients
Does the idea of using medical marijuana to treat asthma symptoms leave you scratching your head? Due to the fact that the most popular method of recreationally consuming cannabis is smoking, it may seem like an unlikely medical treatment for a respiratory condition. Any doctor will tell you that smoking cigarettes is not a good idea for asthma sufferers , but evidence is showing that cannabis may have beneficial effects for those with asthma or other respiratory conditionseven when smoked.
Asthma is a lung disease that causes a persons airways to narrow and swell during an attack, which leads to wheezing, shortness of breath, and coughing. If not managed, attacks can be fatal. Asthma often becomes evident in children and there is no cure for the disease, though treatment can keep complications to a minimum. For many people symptoms are limited, but in the U.S. over 3000 people still die from asthma-related causes every year. Management of the disease is complicated by the sudden onset of the attacks they can be triggered by everyday activities like and the fact that they are being increasingly linked with allergies.
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How Severe Is My Condition
If your bronchiectasis is well controlled, you should have few symptoms and be able to lead a normal life. This is the goal of treatment, wherever possible.
When bronchiectasis symptoms start to interfere with daily activities, this is a sign that your bronchiectasis is more severe. Bronchiectasis is a complicated condition and there is not one single test or sign that will tell you whether your condition is mild, moderate or severe.
Factors known to be linked with more problems are:
These are only a guide and some people may have several of these and still live a normal life, while some people may have none of the above, but may have other important factors that impact upon their quality of life.
Many of these factors can be improved with effective treatment. Even if your bronchiectasis is considered to be severe, it can be greatly improved with treatment.
How Bronchiectasis Affects Your Body
Bronchiectasis is a long-term condition that can be treated but cannot be cured. The abilities of your lung slowly worsens over years. People with bronchiectasis have good and bad phases. During bad times, they have flare-ups, known as exacerbations. Flare-ups can last days or weeks. They vary in severity. The sooner people receive treatment, the less damage the infection does to the lungs. Along with medications, other treatments can help prevent worsening lung function.
Living Well Patient Guide
These symptoms are often worse during flare-ups.
Other symptoms include:
- A wheezing or a whistling sound while you breathe
- Coughing up blood or mucus mixed with blood, a condition called hemoptysis
- Chest pain from increased effort to breathe
- Thickening of skin under nails, known as clubbing
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What You Need To Know About Smoking Weed With Asthma
More states are legalizing the use of medical marijuana. Some states are going beyond just medical use and legalizing weed for recreational use. But is using marijuana safe for people with chronic diseases, such as asthma and can it help the condition? The answer may depend on the form of marijuana used, dose and the frequency.
Before deciding if smoking weed with asthma is the right choice for you, its helpful to learn a little more about marijuana. Marijuana is often referred to by different names, such as pot, weed, and grass. Regardless of what you call it, marijuana is derived from the cannabis plant. Cannabis contains various cannabinoids. Cannabinoids are compounds that bind to specific receptors in the central nervous system.
Tetrahydrocannabinol is probably the most well-known cannabinoid and is primarily responsible for the high or psychoactive effects. But other lesser known cannabinoids that are non-psychoactive may also have a therapeutic effect. Many factors influence the effects of marijuana including the types of cannabis used, the dosage and a persons experience using the drug.
Clinical Features Of Bronchiectasis
Common clinical symptoms of bronchiectasis include cough productive of sputum, fatigue, hemoptysis, and episodic infective exacerbations. Other important symptoms such as wheeze, chest pain, and sinusitis are common in bronchiectasis. These are diagnostically challenging as they could arise due to the bronchiectasis, the etiology leading to bronchiectasis, for example, asthma or Aspergillus-associated comorbidities . Bronchiectasis can be a progressive disease that leads to hospitalizations, premature mortality, and leads to poorer quality of life. As a result bronchiectasis is also associated with increased healthcare utilization and cost.,, Recent data suggest an increasing mortality rate rising 3% year after year with increased mortality especially seen in the elderly.
Major factors associated with bronchiectasis disease progression include recurrent exacerbations, extremes of age, and persistent infection with pathogens particularly Pseudomonas aeruginosa.,,, The presence of P. aeruginosa in bronchiectasis patients clearly defines a specific clinical phenotype and leads to worse clinical outcomes including not only exacerbations but also quality of life and mortality.,, Recurrent exacerbations irrespective of Pseudomonas appear to drive progression. Because up to 40% of bronchiectasis patients suffer from two or more exacerbations per year, a large proportion of patients are therefore at risk of disease progression.,
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Does Smoking Weed Cause Asthma
If you are allergic to cannabis, exposure to it could cause you to develop asthma. In those who are not allergic, it does not appear that weed causes asthma. However, smoking weed could potentially aggravate symptoms and prompt asthma attacks. There are a few other respiratory conditions that have similar symptoms to asthma that are also worsened by exposure to marijuana smoke.
Q: Can smoking weed cause asthma?A:Unless you are allergic to cannabis, it does not appear that marijuana causes asthma. However, exposure to marijuana smoke does have the potential to exacerbate asthma symptoms, up to and including asthma attack, whether you are allergic to cannabis or not.
What Is Allergic Bronchopulmonary Aspergillosis
Bronchiectasis can be caused by a bad allergyto a fungus that is found everywhere in the environment called Aspergillus. Theimmune system responds in an overly aggressive way to this fungus, causingdamage to the lungs and symptoms that are like an asthma attack. This is calledallergic bronchopulmonary aspergillosis . Individuals with thiscondition often have a history of asthma in the past.
The treatment for this condition is to dampendown the immune system with steroid tablets. Sometimes, antifungal tablets are also added tohelp reduce the reliance on steroid tablets.
If bronchiectasis has developed, the damage isoften not reversible, and so after the ABPA has been successfully treated, youwill need treatment for the bronchiectasis over the long term.
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What Causes Bronchiectasis
For up to half of people diagnosed with bronchiectasis, theres no clear underlying cause. This is called idiopathic bronchiectasis.
Some illnesses linked to bronchiectasis include:
- having had severe lung infections such as pneumonia, whooping cough or tuberculosis in the past, for example when you were a child
- inflammatory bowel disease, also called ulcerative colitis and Crohns disease
- immune system deficiencies
- some types of arthritis, such as rheumatoid arthritis
- a problem with the normal structure or function of your lungs, such as primary ciliary dyskinesia
How The Lungs Are Affected
The lungs are full of tiny branching airways known as bronchi. Oxygen travels through these airways, ends up in tiny sacs called alveoli, and from there is absorbed into the bloodstream.
The inside walls of the bronchi are coated with sticky mucus, which protects against damage from particles moving down into the lungs.
In bronchiectasis, one or more of the bronchi are abnormally widened. This means more mucus than usual gathers there, which makes the bronchi more vulnerable to infection.
If an infection does develop, the bronchi may be damaged again, so even more mucus gathers in them and the risk of infection increases.
Over time, this cycle can cause gradually worsening damage to the lungs.
Can Marijuana Help Asthma
THC can suppress the immune system. Asthma is an allergic reaction that your lungs have, the immune system overreacts to something in the environment, and that is the reason for the asthma attack. In this instance, THC can aid in calming the immune system since it is an anti-inflammatory.
But the main method of consuming marijuana is smoking it. And for those with asthma that choose to smoke despite their condition, there are likely to be more complications. So, if cannabis can help with calming the immune system, but smoking it causes complications, how can one with asthma benefit from marijuana?
What Is The Difference Between Asthma And Bronchiectasis
Bronchiectasis is not the same as COPD or asthma.As both conditions can cause, cough, breathlessness, repeated chest infections and abnormal breathing tests, it is not surprising that they can also sometimes be mixed up.
can asthma cause bronchiectasis? Earlier studies have suggested that asthma might cause bronchiectasis. Except for asthma, researchers could not find any specific cause of bronchiectasis in any of the patients. Those with lung infections also had worse bronchiectasis and used more antibiotics.
Also know, which is worse bronchiectasis or COPD?
Bronchiectasis is caused by consistent inflammation and/or infection in the lungs whereas most COPD conditions result from smoking, allergies, or pollution. COPD can cause tightening in the chest and shortness of breath, but certain conditions that fall under the category of COPD do not necessarily create excess mucus.
What is the life expectancy of someone with bronchiectasis?
Most people diagnosed with bronchiectasis have a normal life expectancy with treatment tailored to their needs. Some adults with bronchiectasis developed symptoms when they were children and live with bronchiectasis for many years. Some people, who have very severe bronchiectasis, may have a shorter life expectancy.
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Why Have I Got Bronchiectasis
It is difficult to say exactly how many people have bronchiectasis. Estimates used to be between 26 and 50 thousand patients in the UK. A more recent study suggested that there are over 300,000 living with bronchiectasis in the UK. This is much less common than conditions such as COPD, yet much more common than conditions such as cystic fibrosis. In the North East of England, for example, there are approximately 1200 patients with a diagnosis of bronchiectasis.
Can You Treat Asthma With Cannabis
Asthma is a chronic health condition that affects the respiratory system. Asthma has been on the rise since the 1980s, and over 25 million people in the United States alone currently have asthma. Asthma causes a number of respiratory issues, including episodes of severe difficulty breathing, which can be fatal. There is no cure for asthma, but when properly managed, its effects can be dramatically reduced. In their search for effective asthma treatments, researchers have discovered a positive link between cannabis use and improvements in asthma symptoms.
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Rolling A Joint Or Spliff
This may be the most tried and definitely most tested method on this list. A spliff consists of mixing cannabis and another herb or tobacco and then rolling it up. We dont suggest using tobacco for obvious reasons, but if you must you must!
To use hash in a joint or spliff, youre going to want to roll the hash into a snake, using the same motions you would if you were a kid making a snake from Play-Doh. Once completed, lay it on top of your cannabis or tobacco, and proceed to roll the joint. Voila, you have yourself a hash filled spliff!
The Microbiology Of Bronchiectasis
Bronchiectasis is associated with lower airway bacterial infection based on studies of sputum or bronchoalveolar lavage. Common pathogens isolated from spontaneously expectorated sputa in bronchiectasis include those seen in other respiratory disorders such as COPD, pneumonia, and also cystic fibrosis. These include Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella spp. . Pseudomonas is also key pathogen., It is unclear if spontaneously expectorated sputa in bronchiectasis is sufficiently robust to detect fungal diseases some data suggest a better yield with physiotherapy and sputum induction regimens.
Cross-sectional studies have often focused on bacterial pathogens with limited or no description of mycology studies. One aspect of the bacterial prevalence studies using culture is that the majority are cross-sectional, and few longitudinal studies are available. When such studies are conducted, they show a variation over time in bacteria isolated from a single patient one therefore may presume that Aspergillus may be isolated on an intermittent basis. Current bronchiectasis guidelines do not include specific instructions on how frequently and which methodology should be used to conduct sputum mycology nor suggest specific therapy in the event of positive mycology cultures.
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