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Is Asthma A Chronic Lung Condition

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Treating COPD, Asthma & Other Chronic Lung Disease – HealthCasts Episode 8

The NHLBI is part of the U.S. Department of Health and Human Services National Institutes of Health the Nations biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including asthma. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.

Is Chronic Asthma The Same As Copd

Chronic asthma and COPD can have similar symptoms, but they are considered distinct conditions. COPD refers specifically to chronic bronchitis, emphysema or both.

Other differences include the fact that asthma tends to start during childhood, while COPD is more likely to appear among adults who smoke.

Chronic Lung Diseases: Causes And Risk Factors

National Heart, Lung, and Blood Institute .

These types of lung diseases may affect your airways, lung tissues, or circulation of blood in and out of your lungs. Here are the most common types, their causes and risk factors, and potential symptoms that may signal the need for medical attention.

Asthma is one of the most common types of chronic lung disease. When triggered, your lungs become swollen and narrow, making it harder to breathe. Symptoms include:

  • wheezing
  • being unable to take in enough air
  • coughing
  • feeling tightness in your chest

If you experience these symptoms, its important to see a doctor right away. Triggers may include allergens, dust, pollution, stress, and exercise.

Asthma usually starts in childhood, though it can begin later. It cant be cured, but medications can help control symptoms. The disease affects about 26 million Americans and tends to run in families.

Most people with asthma can manage it fine and enjoy full and healthy lives. Without treatment, though, the disease can be deadly. It kills about 3,300 people annually in the United States.

Doctors dont know yet why some people get asthma and others dont. But they believe that genetics play a large role. If someone in your family has it, your risk goes up.

Other risk factors include:

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Asthma And Copd: What’s The Difference And Is There A Link

Asthma and chronic obstructive pulmonary disease are lung diseases. Both cause swelling in your airways that makes it hard to breathe.

With asthma, the swelling is often triggered by something youâre allergic to, like pollen or mold, or by physical activity. COPD is the name given to a group of lung diseases that include emphysema and chronic bronchitis.

Emphysema happens when the tiny sacs in your lungs are damaged. Chronic bronchitis is when the tubes that carry air to your lungs get inflamed. Smoking is the most common cause of those conditions .

Asthma gets better. Symptoms can come and go, and you may be symptom-free for a long time. With COPD, symptoms are constant and get worse over time, even with treatment.

Testing And Diagnosis Of Asthma

Asthma: Chronic respiratory disease

Your child’s asthma specialists will first look for classic asthma symptoms. It’s important to know that not everyone with asthma will have wheezing. This is a common reason for failure to diagnose asthma. Also, when the airways get very narrow and tight, wheezing may stop. When this happens, the patient is worse, not better. Using “wheeze” alone to diagnose and follow asthma attacks can be unreliable and tricky.

Your asthma specialist will also look at how your child’s symptoms cause a typical pattern of problems. Do they come in cycles or attacks? Do asthma medicines help relieve the symptoms? Sometimes this provides your asthma provider with enough information to make the diagnosis.

We will also check for other conditions that might look like asthma. For example, we will evaluate your child for cystic fibrosis, disorders of the immune system and others if your child’s history and lung function tests hint that other problems might be present.

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Airflow Limitation In Copd

The chronic airflow limitation of COPD is caused by a mixture of small airway disease and parenchymal destruction , the relative contributions of which vary from person to person . Chronic inflammation causes structural changes and narrowing of small airways. Destruction of the lung parenchyma, also by inflammatory processes, leads to the loss of alveolar attachments to the small airways and decreases lung elastic recoil in turn these changes diminish the ability of the airways to remain open during expiration .

So in COPD inflammation causes small airway disease and parenchymal destruction that all lead to airflow limitation .

What Is An Asthma Action Plan

Your healthcare provider will work with you to develop an asthma action plan. This plan tells you how and when to use your medicines. It also tells you what to do if your asthma gets worse and when to seek emergency care. Understand the plan and ask your healthcare provider about anything you dont understand.

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  • Chronic obstructive pulmonary disease is the collective term for a number of lung diseases that prevent proper breathing.
  • Two of the most common types of COPD are emphysema and chronic bronchitis.
  • Cigarette smoking is the most significant risk factor for COPD.
  • There is no cure for COPD, but disease management can slow disease progression, relieve symptoms and keep you out of hospital.
  • Treatment aims to prevent further damage, reduce the risk of complications and ease some of the symptoms.
  • Treatment options include pulmonary rehabilitation, medicines and oxygen therapy.

Similarities And Differences In Regular Standard Treatment Of Asthma And Copd

Asthma and COPD – An introduction
  • In both diseases the adequate treatment may reduce symptoms and number of exacerbations and improve the quality of life.

  • Treatment of asthma is characterized by suppression of inflammation.

  • Treatment of COPD is characterized by decreasing of symptoms.

The GOAL of treatment in ASTHMA is to: reduce inflammation and to achieve¸total control . The GOAL of treatment in COPD is to: reduce symptoms, prevent exacerbations and decrease mortality . In both asthma and COPD almost the same drugs are used, but not in the same order and the same efficiency in treatment.

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Are There Rehabilitation Programs For Copd

The goals of COPD rehabilitation programs include helping the patientreturn to the highest level of function and independence possible, whileimproving the overall quality of the persons physical, emotional, andsocial life. Attaining these goals help people with COPD live morecomfortably by improving endurance, providing relief of symptoms, andpreventing progression of the disease with minimal side effects.

In order to reach these goals, COPD rehabilitation programs may include thefollowing:

  • Medication management

  • Exercises to decrease respiratory symptoms and improve muscle strength and endurance

  • Respiratory treatments to improve breathing ability

  • Assistance with obtaining respiratory equipment and portable oxygen

  • Methods to increase independence with activities of daily living

  • Exercises for physical conditioning and improved endurance

  • Stress management, relaxation exercises, and emotional support

  • Smoking cessation programs

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Copd In The Canadian Population

CCDSS Case Definitions

Prevalent COPD Case Definition

The case definition of diagnosed COPD is: an individual aged 35 years and older having at least one visit to a physician with a diagnosis of COPD in the first diagnostic field, or one hospital separation with a diagnosis of COPD in any diagnostic field ever, coded by ICD-9 491-492, 496 or ICD-10-CA J41-44. This case definition for COPD was validated by Gershon and colleagues.Footnote 44

Only the first diagnostic field was used in physician billing claims data as not all provinces and territories had more than one diagnostic field. All fields were included from the hospital separation file as this database allows for the recording of up to 25 diagnoses.

Based on this definition, once a case is detected, it is a prevalent case for life regardless of future contact with health services. Consequently, once someone is identified as a case, they are always included in the database as a case. All jurisdictions identified cases occurring as of 1995, with the exception of Quebec which began in 1996 and Nunavut which began in 2005.

Incident COPD Case Definition

Incident COPD cases were identified in the year where an individual met the case definition for the first time. A run-in period of five years, where data were collected and not reported, was employed to partially account for the prevalence pool effect i.e., to ensure that an incident case was not a pre-existing prevalent case. .

Denominator Definition

Prevalence

Incidence

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Inflamatory And Immunological Profile

BA and COPD are characterized by chronic inflammation of the respiratory tract although the nature of the inflammation and localization are different . In both there are two groups of cells that are activated. One group is inflammatory cells recruited from peripheral blood to the lungs by chemotactic factors released locally, and the other group is airway and lung structural cells such as epithelial cells, endothelial cells, fibroblasts and smooth muscle cells, which also release inflammatory mediators and actively participate in the inflammatory process. In both, BA and COPD, the inflammatory response involves innate immunity and adaptive immunity .

In BA the inflammation is located from trachea to peripheral airways. In COPD the inflammatory process is located in peripheral pathways and parenchyma and is associated with systemic inflammation. Bronchial obstruction in BA occurs due to smooth muscle contraction, vascular congestion , remodeling of the airway and impaction of mucus . This inflammation also leads to bronchial hyperresponsiveness, a physiological abnormality of asthma that is characterized by variable symptoms including nocturnal worsening. In COPD, the predominantly peripheral obstruction, due to fibrosis and collapse due to loss of pulmonary elasticity , leads to gas trapping, which is an irreversible mechanism. However, there is an added cholinergic contraction that is reversible .

Signs Symptoms And Complications

Asthma2014.ppt

How often signs and symptoms of asthma occur may depend on how severe, or intense, the asthma is and whether you are exposed to allergens. Some people have symptoms every day, while others have symptoms only a few days of the year. For some people, asthma may cause discomfort but does not interfere with daily activities. If you have more severe asthma, however, your asthma may limit what you are able to do.

When asthma is well controlled, a person shows few symptoms. When symptoms worsen, a person can have what is called an asthma attack, or an exacerbation. Over time, uncontrolled asthma can damage the airways in the lungs.

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How Are Asthma And Copd Diagnosed

COPD and asthma can have a lot of overlap when it comes to making a diagnosis, says Dr. Ogden. A specialist will make the diagnosis based on your clinical history, including symptoms and pulmonary function testing.

Breathing tests to see how well your lungs function include:

  • A spirometry test: Youll take a deep breath in . Then youll blow all that air into the tubing attached to a small machine called a spirometer as forcefully as you can. This measures how much air you blow out and how fast you can do so, according to the National Heart Lung and Blood Institute. Youll also perform a range of other inhalation and exhalation techniques so your doctor can assess your lung function.
  • Peak expiratory flow test: While spirometry tests can tell you a range of different things about your lung function, this test only measures how fast you can blow out air using maximum effort. It can be done during spirometry or by breathing into a separate device, called a peak flow meter. This is a small, plastic hand-held device that you can use at home or on the go to help you determine if you are having an asthma attack.
  • Fractional exhaled nitric oxide test: This one might sound like a science experiment gone wrong, but it simply measures how much inflammation you have in your lungs.

How Different Lung Diseases Affect The Lung

An analysis of how different lung diseases affect the lungs functionsThe lungs are essential respiratory organs in humans which enable us to breathe. Our lungs are specialised structures that allow us to exchange gases. We require oxygen from the air to enter our blood, as all cells need it to function. We also need to get rid of carbon dioxide which is a product of many metabolic reactions within our cells. Our lungs allow this gas exchange so we can get rid of carbon dioxide and acquire oxygen

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Cdcs National Asthma Control Program

NACP was created in 1999 to help the millions of people with asthma in the United States gain control over their disease. The programs goals include reducing the number of deaths, hospitalizations, emergency department visits, school days or workdays missed, and limitations on activity due to asthma. The NACP collects data on state-specific levels to focus efforts and resources where they are needed.

The NACP leads national initiatives and provides state funding for a variety of activities focuses on surveillance, intervention, partnerships and evaluation. The NACP funds states, cities, school programs, and non-government organizations to help them improve surveillance of asthma, train health professionals, educate individuals with asthma and their families, and explain asthma to the public. The program has improved asthma treatment, management, and control in the U.S.

Type I And Type Iii Ifns

HBP 010- How asthma, emphysema, chronic bronchitis cause High Blood Pressure

Type 1 IFNs and type III IFNs play an important role in innate immunity against viral infections, but IFN- and IFN- show reduced expression in epithelial cells of asthmatic patients and are associated with increased rhinovirus replication, which may predispose these patients to viral exacerbations of asthma . The molecular mechanism for these defects in innate immunity is not yet understood. Low-dose IFN- seems to give marked benefit in patients with severe corticosteroid-resistant asthma but again the mechanism is unknown .

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Causes And Risk Factors Of Copd

Some of the causes and risk factors of COPD include:

  • cigarette smoking the most significant risk factor. Around 20 to 25 per cent of smokers will develop COPD. Ex-smokers remain at risk and should be aware of symptoms of breathlessness
  • long-term exposure to lung irritants such as chemical vapours or dust from grain or wood. Severe air pollution can make COPD worse in smokers
  • genes a genetic disorder known as alpha-1-antitrypsin deficiency can trigger emphysema, even if no other risk factors are present.

Chronic Obstructive Pulmonary Disease Due To Occupational Exposure

The diagnosis of COPD is based on chronic productive cough, airflow limitation that is usually not fully reversible, and a progressive, abnormal inflammative response of the lungs mostly caused by long-term smoking and by other noxious particles or gases.

During ongoing causative exposures , airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs. Patients with COPD have greater number of neutrophils and alveolar macrophages in bronchoalveolar lavage fluid than healthy non-smokers. Sites of emphysema, which are frequently found in COPD patients, contain large numbers of lymphocytes, and the extent of lymphocyte accumulation correlates with reduction of FEV1.

In their summaries of the literature, Hnizdo et al., Trupin et al. and Balmes et al. found an occupational contribution in about 15% of COPD cases.

Occupational COPD is identified on epidemiological basis, by observing increased frequencies of COPD among certain working groups, e.g. in construction workers. Some occupational exposures may cause COPD associated with emphysema.

At later stages of OA, the condition of some subjects does not improve over weekends or during holidays and coincides with symptoms of COPD patients. This observation also applies to non-occupational obstructive airways diseases and indicates that a group with changing diagnoses as well as with some overlap between OA and occupational COPD, does exist.

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The Role Of Proinflammatory Cytokines In Asthma And Copd

Proinflammatory cytokines, such as TNF-, IL-1, and IL-6, are found in increased amounts in the sputum and BAL fluid in individuals with asthma and COPD and amplify inflammation, in part through the activation of NF-B, which leads to the increased expression of multiple inflammatory genes. In other chronic inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel diseases, blocking these cytokines has proven to be of clinical benefit, so there has been considerable interest in determining whether the same approach might also be useful in inflammatory airway diseases.

Similaraties And Differences In Acute Exacerbation Of Asthma And Copd

Tried and Tested Remedy That Can Treat Chronic Lung ...
  • Pathology is different in exacerbation of asthma and COPD

  • Causes of acute exacerbation of asthma and COPD are different.

  • Different role of LABA and ICS in prophylaxis of exacerbation of asthma and COPD.

  • Treatment of acute exacerbation is similar in asthma and COPD.

Acute exacerbation of Asthma

Triggers of acute exacerbation of asthma are usually: allergens, infections , GE reflux, other triggers, sometimes and co-morbidity .

Pharmacotherapy of acute asthma exacerbation

  • Bronchodilators

  • corticosteroids . Other therapy

  • oxygen therapy

  • non -invasive mechanical ventilation

  • antibiotics

  • epinephrine rarely in a very serious asthma attack

  • He/Ox rarely and MgSO4 intravenously rarely.

Acute exacerbation of COPD

Triggers of acute exacerbation of COPD are usually: infections , airpollution, GE reflux, sometimes and co-morbidity .

Pharmacotherapy of acute COPD exacerbation:

  • Bronchodilators

  • antibiotics in patients with severe exacerbation Other therapy:

  • oxygen therapy

  • non -invasive mechanical ventilation .

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What Are The Different Types Of Copd

The two most common conditions of COPD are chronic bronchitis and emphysema. Some physicians agree that asthma should be classified as a chronic obstructive pulmonary disease, while others do not. A brief description of asthma, is included below:

1

What is chronic bronchitis?Chronic bronchitis is a long-term inflammation of the bronchi , which results in increased production of mucus, as well as other changes.

These changes may result in breathing problems, frequent infections, cough, and disability.

1

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