Treatment is adjusted by the doctor according to the discomfort caused by asthma. - The occasional crises do not require continuous treatment. - More frequent crises forced to take treatment spray several times a day. - Frequent and severe crises require treatment for several days of tablets containing a derivative of cortisone. The use of cortisone for several weeks or several months is exceptional.

1. Treatment goals

It is important to distinguish the treatment of acute asthma attacks and daily treatment for preventive. The treatment of acute asthma is to find a quiet breathing, stop “choke”, and in severe cases, to avoid an evolution towards a state that imposes a hospitalisaition. It is therefore controlling the crisis to find a comfortable living standard. The chronic treatment of asthma are aimed at reducing the frequency of acute attacks using aerosol anti-inflammatory.

2. During an asthma attack

Try to keep up your cool. Stand up and aggrippez you something. Try to breathe slowly and deeply as possible (it’s blowing more than you can better fill your lungs then). Take one or two puffs of the aerosol that the doctor will prescribe for crises. This is a beta-2-mimetic: it will relax the small muscles of the bronchi to force them open again. The effect is fast: you must feel relief dramatically within fifteen minutes. The records of aerosol beta-2-agonists recommend not exceed 12-15 puffs in 24 hours. But if the crisis does not pass, do not hesitate to call your doctor, or alternatively, the duty doctor or the ambulance service: you may need an injection.

3. The preventive treatment of seizures

Still called “chronic treatment of asthma,” it depends on the frequency and severity of crises.

• Mild asthma, intermittent: no symptoms or discomfort more than three times a week, or two nights per month. If seizures are mild, it is often sufficient to treat each crisis (see previous paragraph): no treatment continuum is essential. It is a common case.
• Mild persistent asthma: symptoms are more frequent. The doctor usually provides an aerosol anti-inflammatory (a cromone or a derivative of cortisone) to be taken regularly, twice a day.Attention as aerosols of beta-2-agonists relieve immediate and dramatic effect of aerosol anti-inflammatory is impossible to feel at the moment. Only by using them regularly for several days we may start to notice a decrease in the frequency and severity of crises. It must be persevering to enjoy the remarkable effect of these drugs. In some cases, the doctor may recommend medication to the family theophyllines, swallowing the evening to avoid nocturnal seizures.
• More troublesome asthma: the doctor increases the dose, or uses drugs more powerful. As a last resort, and for periods as short as possible, he may prescribe cortisone derivatives to swallow.

In any case, once the symptoms have improved in recent months, we must seek to reduce the treatment. The key to the patient is to be … patient, and well take all these drugs, even if he does not feel any immediate effect. The only way to verify the effectiveness of treatment are to maintain records of the dates of crises and their severity, to see the evolution in time, and his breath test using a small device called a “flow-meter peak “, which measures the speed of air when you blow.

Whether your child is asthmatic, and although a land “atopic (allergic), resulting in coughing, effective prevention requires monitoring of its surroundings and, whenever possible, removingimmediate causes.

Asthma is a disease of the airways that do overreact to irritants. This hyperreactivity causes muscle contraction and bronchial inflammation of the bronchial wall. In certain circumstances (stress, illness, allergies, etc..), The bronchial muscles to contract suddenly and decrease the available passage for air. Then the attack of asthma, characterized by difficulty breathing (dyspnea), associated with cough and wheezing. To avoid these crises, in addition to the establishment of a DMARD should be put in place measures to immediate causes of foreclosure.

1. Your child has asthma found: adapt his environment!

Many agents in the environment (allergens or substances that determine the allergy, passive smoking, viral infections, air pollutants) are likely to trigger seizures more or less severe, which may be partly controlled by preventive measures. These include trying to reduce or even eliminate the causes that trigger contact. They are unfortunately many more of them may coexist in the life of the child, thereby increasing the risk of seizures.

Allergy is indeed a very important risk factor for allergens responsible for asthma are present in the everyday environment of the child. The most frequently involved are the cockroaches, pet dander (dog, cat, hamster, rabbit) and especially mites contained in house dust (microscopic animals that are found mostly in bedding, tapestries, carpets, stuffed animals, etc..). Their proliferation is favored by heat and humidity, it is necessary to aerate often the child’s room, regularly clean bedding (mattress and pillow case) and avoid too much heat your house. Also note that the vacuum is more effective than the broom to remove dust, if your model has a filter.Otherwise, use a damp cloth is very powerful.

2. Food allergy is increasingly common

The allergenic substance may be hidden in many foods (eggs, fish, cereals, peanuts, chocolate …). This allergy is sometimes more difficult to control if the child takes food away from home (crèche, canteen, recreation center …). Think about that in doubt, particularly in cases of asthma attacks, of course, but also itching with or without skin involvement (urticaria or eczema).

3. Some allergens are seasonal

These are the pollens that occur mainly in spring and summer. Avoid prolonged so walks in the fields during the flowering grasses.

4. Viral infections of the respiratory tract are the cause of 75% of asthma attacks!

The asthmatic child is particularly susceptible to these infections (colds, bronchiolitis, bronchitis). Moreover, asthma beginning often leads not only by recurrent bronchitis. It is certain that the collective care arrangements increase the frequency of viral infections in young children.The withdrawal of the crib or the choice of a more individualized care may be recommended to recurrent infections. However, it must weigh the benefits of this type of measurement depending on the child’s environment, which may be exposed at home to other contaminants, such as smoking family.

5. Think of your children: do not smoke!

Passive smoking is indeed a particularly negative impact on both symptoms and lung function of children. Unfortunately, despite all the warnings, the removal of smoking family is not always obtained! In the absence of a complete cessation of smoking, parents absolutely must stop smoking at home and smoke outside on the balcony for example.

The impact of smoking is much higher than that of air pollutants (fuel cars, factory smoke) and other irritants such as sprays or household paint products, which may nevertheless intervene in triggering asthma attacks . Their removal is more difficult to control …

6. A child with asthma can play sports

It is true that some children, stress can trigger asthma attacks. But a few simple rules can help prevent or limit them. It is important not to prevent asthmatic children to play sports, quite the contrary. Moreover, many Olympic champions and elite athletes were or are asthmatic! The choice of a sport must first be made according to the tastes of the child. Avoid, however, if possible, exercise indoors (judo, dance, volleyball …) and riding (risk awareness to the horse or other allergens in the straw). The preparation of physical activity should be gradual, particularly in the case of an endurance activity, making it a good warm-Smart and muscle effort.

Your child is not asthmatic, but he has a predisposed (parent asthmatic cough in children, atopic or allergic): Be careful!
All these preventive measures must then be discussed on a case by case basis. Ask your doctor, who will make a precise assessment of the situation and advise you if necessary an anti-allergy treatment and preventive measures.

7. If necessary asthma should be treated daily

The environmental monitoring of asthmatic children is a prerequisite, but not always sufficient: it may be associated with a DMARD monitoring well, which will control the disease and preserve lung function of children.

If, despite preventive treatment adapted and monitored, combined with the systematic eviction of triggers, seizures persist, then there should always refer to a physician and pulmonologist or allergist to adapt the treatment if necessary and complete the survey your home. Simple test for identifying allergens may be prescribed.

8. Allergy should be treated early

The anti-allergy should be started as soon as possible at the onset of symptoms or better, if you are allergic recognized before exposure to allergens (pollens, house dust during weekends in the cottage ,…). The aim is to prevent the airway inflammation of durable, it is much harder to treat. It is easier to hold the reins of a horse to stop when it starts to gallop! More treatment and prevention measures are implemented, the sooner the child is likely to escape the consequences of his illness.

Association Asthma – Gastro Reflux Disease (GERD) is common. It has been confirmed that such reflux is very common in patients who do not exhibit signs.

We consider now that asthma is a chronic inflammation of the bronchi may be responsible is typical of asthma (difficult breathing and wheezing), or chronic cough. This inflammation can be maintained by phenomena irritants, such as a reflux disease (GERD). In this case, the gastric juice, particularly acid, could head up towards the mouth, falling partly in the bronchi.

It is a fact that in many cases, both diseases are associated, patients with both symptoms of asthma, and those of their GERD. But what about those who do not complain of heartburn of GERD? To answer this question, the acidity in the esophagus of 30 patients corresponding to the latter was measured during 24H00 (pH monitoring) and compared with that of 30 other patients with asthma and for their hand GERD.

The results tell us that 62% of asthma patients not reporting symptoms of GERD have been a pathological pH monitoring, that is to say they suffer from silent reflux. Their pH monitoring is also impaired than those patients with clinical GERD, and asthma is the same intensity. This new data confirms the value of screening for GERD in asthmatic patients.

A major criterion associated with three indices to the choice, would be the formula to predict the child’s asthma. Tested on a large workforce, this method is satisfactory.

Asthma is a disease increasing in industrialized countries, affecting between 2 and 5% of the population. Characterized by attacks of dyspnoea (breathing difficulty), with at the time of expiry whistling feature, this disease affects the lungs and respiratory system. It occurs most often between the ages of 5 and 15 years, but the child’s asthma may appear in the first months of life. It often becomes intermingled with bronchiolitis. Moreover, we can consider that a child has asthma when he presented more than three bronchiolitis before the age of two years.

Interest predict asthma in children is to take charge quickly. In addition, he must know that asthma treated early can be cured in most cases, there are now effective DMARDs.

1. How to predict childhood asthma?

The authors of this study suggest the following method:
o recognize a major criterion: difficulty breathing (dyspnea), wheezing, frequent in the first three years of life and / or a family history of asthma or eczema;
o associated with at least two of the three following criteria: eosinophilia (increased blood of a type of white blood cells called eosinophils), allergic rhinitis (hay fever), wheezing (wheezing) associated ENT without affection.
Tested on a very large number, the negative predictive value (lack thereof) would be 90% and positive prediction of 45% approximately.

Recognize these signs earlier than expected to the introduction of a preventive treatment of asthma. Becoming by crises, fits of coughing in the evening or at night are also part of the warning symptoms of asthma. Furthermore, the lifestyle is just as important, eliminate the factors of allergies in the house and especially to save your child a smoking atmosphere.

In 30% of asthmatic patients the coexistence of the manifestations of asthma and signs of hyperventilation is found. According to one study, learning breathing techniques can be useful to limit the association.

Physicians often see patients arrive in consultation with asthma who seem short of breath, breathing with deep breaths and with a whistle. For many of them, simple breathing exercises allow them to regain a normal breath. Asthma symptoms are indeed often associated with these signs of hyperventilation usually due to anxiety, sometimes accompanied by chest pain.

1. The Nijmegen questionnaire

To evaluate the respective contribution of these two types of events 220 asthmatics completed a questionnaire, called Nijmegen, evaluation of clinical symptoms. After analysis, the symptoms of hyperventilation were identified in 63 patients. These patients are mainly female, 35% of asthmatic women against 20% men, mean age 45 years. This percentage is not correlated with the severity of asthma.

This quick and simple questionnaire could be used in daily practice by physicians to detect the risk of developing signs of hyperventilation and implement appropriate behavioral strategies to reduce the respiratory dysfunction. Indeed, different types of care are likely to improve these conditions: exercise, relaxation training in breathing techniques based on the use of the diaphragm, scientific information, reassurance, reattribution of symptoms, etc.. These behavioral exercises specifically target patients most anxious.

The storms caused an increase in allergic asthma. Contrary to what was supposed, the trigger would not rain or electrical activity, but the currents of cold air near the ground, concentrate large amounts of allergens.

1. After the storm, asthma attacks are more

It all began with a statement: one evening in October 1997 on an island south of Australia, the occurrence of a severe storm coincided with a strong “epidemic” of asthma. Indeed, between evening and morning, nearly 215 people attended the emergency due to an asthma attack, 41 were hospitalized. The majority of patients had allergic asthma rye. This event has been observed simultaneously in other cities, pulmonologists Australians have studied the role of Storm in the onset of these crises. They left the following hypothesis: the storms and cold air currents they generate would cause a scan and pollen particles, which would be concentrated near the ground (cold air tends to stay near the ground) forming a zone of reflux. Thus, subjects allergic to grass after a storm inhale high levels of allergens can trigger asthma attacks.

2. Storms causing cold drafts focus allergens

To confirm this possibility, these researchers have confronted the number of trips to hospital emergency asthma in six Australian cities and the weather (storm in a radius of 80km, currents and fronts of cold air, wind speed, its direction changes , humidity, temperature). The pollen concentrations were also recorded and analyzed at 3 meters above the ground. In the end, half of epidemics of asthma attacks was preceded by a windy storm during the period of pollen, and on the third full year. Moreover, there is a link between the presence of cold drafts accompanying the storm and the increase in consultations for asthma in all cities studied. This association is more pronounced between late spring and early summer, or during the period of pollen. In 48% of cases, asthma flare-ups occurred on stormy days, as against 8% for other days. But when the storm did not cause air movement, the number of asthma attacks has remained the same as other days.

Thus, the authors validated their hypothesis. The increase in asthma is strongly linked to currents of cold air, rather than the electrical activity or rain. Unfortunately, the epidemic peaks can be provided for if we can predict the storms, however, we do not know which will be followed by movement of cold air. Thus, relying on the forecast storm would cause many false alarms.

Widely underestimated occupational asthma in industrialized countries represents about 10% of asthma cases in adults! Manifested by variable bronchial obstruction over time and due to inhaling dust or various products in the workplace, asthma has become the occupational lung disease the most common. This reflects the inadequate working conditions!

1. What are the risky jobs?

The National Observatory of occupational asthma in 1996 harvested more than 1,600 testimonies to specify the occupations most at risk and triggering agents. The bakers and confectioners are most frequently affected, with 20% of cases of occupational asthma. Then come the health professions, spray painters, hairdressers, cleaning workers and wood workers.The main causes are represented by the flour, isocyanates, latex, aldehydes, alkali persulfates and wood dust. However, more than 250 cases have been identified worldwide.

2. Bringing the diagnosis of occupational causes: a difficult task

The diagnosis of asthma is relatively easy, but the link to an occupational cause is a much tougher task. The interview is so considerable assistance. It attempts to link the onset of symptoms with the rhythms of work and with exposure to agents known asthmagens. It also allows searching for similar cases among colleagues. Some skin tests can be performed to detect a possible immunological sensitivity, but they are generally reliable only for a limited number of triggering agents.

3. How to treat?

The only truly effective treatment of occupational asthma is the risk of eviction. Indeed, early and completely eliminate the exposure, allows a complete recovery. But in practice, this occurs only in some cases, because in most cases, even after removing the cause, many patients still have symptoms. Drug treatments are identical to those of non-occupational asthma.

4. A social care is provided

The Social Security system and agriculture provide a remedy for occupational asthma and cover the majority of cases. Once recognized as an occupational disease, the patient is supported at 100% for medical care. They also receive per diem and professional higher than those of a work stoppage. The employer is obliged to seek redeployment within the company in correspondence with the proposals made by the doctor.

Many people are affected by respiratory diseases, chronic bronchitis and asthma in mind. If cons asthma treatments exist, in contrast to chronic bronchitis, outside of smoking cessation, very few drugs are truly effective. In France the figures are imprecise, but the United States, with 16 million affected individuals, chronic lung diseases are the fourth leading cause of mortality by 2010, they could easily take the lead. Thus, all scientific advances in understanding the mechanisms and management of these severe, particularly in the field of genetics, will be greeted with much hope.

Domestic pollution, industrial and smoking are the three major risk factors involved in the occurrence of chronic lung diseases, mainly represented by chronic bronchitis and asthma.Genetic factors also exist and the first susceptibility genes are beginning to be identified. Thus, we are not all equal before the respiratory disease. In addition, faced with the same pollutant, certain sensitive subjects develop bronchitis, asthma other.

Despite anti-inflammatory drugs, antibiotics, bronchial dilators associated with chest physiotherapy, we remain relatively powerless in the fight against this major congestion of the lungs.
Moreover, these respiratory diseases prevalent after middle age, affecting more and more young adults under 45 years.

1. Tobacco, singled

Prime accused tobacco! The likelihood of being affected by chronic bronchitis before age 45 is multiplied by 3.5 for “light smokers” (one pack a day for 14 years or two packs a day for 7 years) and 17 among the “big intoxicated ”(three packs per day for 15 years).

Besides smoking, passive smoking also plays a role, but let us not forget the occupational exposure to bronchial irritants.

Corticosteroids are known to promote bone loss. However, they are used as active ingredient in prescription drugs against asthma. For the oral forms, the risk was known, but in regard to inhaled formulations, the subject was still open to debate. Today, new research shows a slight bone loss induced by inhaled corticosteroids. These drugs are therefore likely to expose patients to greater risk of osteoporosis and fractures. Far from calling into question the use of these treatments, these data are taken into account in the daily care of asthma.

Products containing corticosteroids can improve the control of chronic asthma. Studies on their effects on bone mineralization are not intended to question the current recommendations regarding their employment, but to know exactly what risks, if any, to the counter, to warn patients and Building preventive measures.

This analysis involved 109 women aged 18-45 years followed for three years. Depending on the type of treatment taken against asthma, it appears that unlike children, in whom corticosteroids do a delayed transient growth without long-term effect on bone density, adults experience a lossbone. While small but worrisome because dose-dependent and some forms are prescribed inhaled at high doses.

Further studies are needed to confirm these results and define the exact losses, particularly in terms of products administered. Meanwhile, it is important to optimize treatment (use the lowest possible dose needed for effective control of symptoms) and patients using high doses must be educated in regular monitoring of sports activity and nutrition (calcium and vitamin D) so that they adopt a preventive a healthy life.

Analysis of sounds emitted during respiration is a good indicator of the activity of asthma.According to original study, the mobile phone placed on the neck to the trachea can easily save respiration and differentiate patients with asthma who are not. One can therefore imagine the use for patient monitoring or to study the effects of pollution on respiratory function.

Analysis of breath sounds transmitted via a mobile phone to a computer can recognize the characteristic abnormalities, opening a new way of monitoring respiratory disorders.

This hypothesis was tested among 20 patients, including seven asthmatics. He was asked for volunteers to apply the microphone of a mobile phone absolutely classic in the neck in contact with the trachea, and then from home to breathe through your mouth for at least five cycles. The signal was recorded using a free service available on the Internet. The audio file was then sent directly by e-mail to a specialized laboratory to be analyzed by a computer. A computer program can then establish a sound spectrogram in just five minutes.

The comparison of different spectra recorded under the same protocol allowed detection of respiratory dysfunction in 5 patients. It was mostly poorly controlled asthmatic subjects and their treatment of patients with exercise-induced asthma.

These encouraging results show that it is quite possible to get away from recordings of breathing quality, transmission via the Internet and analyze them quickly, without having to move in a specialized laboratory. It now remains to validate the usefulness of this technique on the medical plan. It could for example be particularly interesting for monitoring patients with exercise-induced asthma, but also to measure the effects of peak pollution on respiratory function.