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The Pathophysiology of Asthma: Inflammation of Airways

While the bronchoconstriction observed following acute antigen challenge in the guinea pig is not associated with airway edema, inflammatory edema probably plays an important role in human disease. Analysis of the protein in the bronchial mucus plugs from asthmatic patients shows large amounts of albumin and large numbers of inflammatory cells which strongly suggest that an inflammatory exudate enters the airways lumen. The study of nonimmunologically-induced inflammatory reaction in the airways of animals has provided several insights

The Pathophysiology of Asthma: Smooth Muscle Spasm

For the purpose of this discussion, the pathophysiologic features of asthma will be divided into muscle spasm, airways inflammation with edema, and mucus hypersecretion. While all three are relatively constant features of asthma, their proportionate contribution to the abnormal physiology may vary considerably with the state of the disease. For example, smooth muscle spasm is probably the feature that accounts for rapid reversibility of the airways obstruction , while inflammatory edema and mucus plugging of the airways

Observations Concerning Expiratory Flow and Bronchodilator Response in Asthma

Isoproterenol acts directly on the smooth muscles, which are distributed throughout the large as well as small airways, by stimulating the cyclic AMP system resulting in bronchodilation. On the other hand, atropine dilates the airways by inhibiting parasympathetic nerve endings responsible for bronchoconstriction via cyclic GMP system. As the nerve supply is densest in the large airways, it is likely that the large airways are the major site of action of atropine. This is supported

Outlet Concerning Expiratory Flow and Bronchodilator Response in Asthma

Patients were divided into two groups depending upon the change in the degree of density dependence of the MEFV curve in response to isoproterenol. Patients showing a decrease in density dependence as measured by a more than 15 percent rise in VisoV and/or a similar fall in the percentage ratio of Vmaxso breathing-Helox to that breathing air (Vmax5o Helox/air) were assigned to group 1. Subjects showing an increase in density dependence of airflow after administration

Research Concerning Expiratory Flow and Bronchodilator Response in Asthma

Thirty subjects complaining of episodic increase in shortness of breath with wheezing and at least 15 percent variability in forced expiratory volume in one second (FEV1) documented by spirometry were considered appropriate subjects for the study. All had persistent respiratory symptoms without an appreciable change in their frequency or severity during the week preceding the study. Five subjects did not complete the study, four of them for reasons not related to the study. The fifth

Density Dependence of Expiratory Flow and Bronchodilator Response in Asthma

Atropine is a potent bronchodilator and has been used in children as well as adults with asthma and chronic bronchitis. Some of these studies have shown it to be useful especially in the presence of chronic bronchitis. Other workers have found it to be inferior to adrenergic agents. Most of these studies refer only to the acute bronchodilator effects of atropine, and its role in the long term treatment of asthma remains unclear. The uncertainty

Observations about Management of Asthma and COPD in Clinics

Incorporation of spirometry testing into these family medicine practices led to spirometry testing with acceptable levels of technical quality and concordant interpretation and was followed by management changes for almost half of the patients. Poor technical quality and low rates of concordant interpretations were limited primarily to two practices (G and J in Fig 2). Our results support previous work demonstrating moderate-to-high levels of technical adequacy and ability to accuracy interpret spirometry in primary care.

Outcomes about Management of Asthma and COPD in Clinics

The 12 practice investigators were all family physicians working in communities with populations <100,000. The 382 patients were mainly women (63%) and adults (76%) with a mean age of 46.1 years (SD, 19.9 years; range, 7 to 89 years). Overall, 248 patients (65%) had a previous diagnosis of asthma only, 100 patients (26%) had COPD only, and 32 patients (8%) had both asthma and COPD. Of the 382 patients, 2 patients withdrew before testing and

Spirometry Can Be Done in Family Physicians Offices and Alters Clinical Decisions in Management of Asthma and COPD

Primary care physicians diagnose and care for a significant portion of the millions of Americans with asthma and COPD. Yet, debate continues regarding the appropriateness, value, and barriers related to in-office spirometry in primary care practices for management of obstructive lung diseases. Studies show that technically adequate spirometry is possible, that screening spirometry of all primary care patients who smoke can identify COPD and modify some COPD treatment and that spirometry in children can be

Deliberation of Sympathoadrenal Reactivity in Exercise-induced Asthma

EIA is usually defined as a postexercise decrease in FEVi of 15 percent or a decrease in Sgaw of 35 percent compared with basal preexercise values. In the present study, all asthmatic patients had postexercise bronchoconstriction, but the severity of this reaction varied. When using a less sensitive parameter, such as FEVi, to evaluate bronchial tone, the postexercise measurements of the NEIA patients did not differ from those of the C group. With the more