By Kian Fan Chung; Andrew Bush
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Additional resources for Clinicians' guide to asthma
High levels of stress also predict higher overall asthma morbidity in children, and has been associated with a higher frequency of upper respiratory tract infections, which are a known cause of asthma exacerbations. Severe negative life events increase the likelihood of new asthma exacerbations. Adverse psychosocial factors, including domestic and financial stresses, have been recognized as important risks associated with near-fatal asthma and asthma deaths. The mechanisms are not clearly understood.
The characteristic pathological picture includes a variable patchy loss of the surface epithelium, a thickening of the epithelial reticular basement membrane and an increased cellular infiltrate in the mucosa, represented by activated eosinophils and also by mast cells and T cells. However, fibreoptic bronchoscopy remains a research technique used in a few research centres, and cannot presently be recommended as a routine test for measuring airway inflammation. INDUCED SPUTUM Induction of sputum by inhalation of hypertonic saline has proved to be a reliable and reproducible method for analysing inflammatory cells from the major airways of patients.
Use as part of an overall self-management plan with stepping up of treatments at specific values of PEFR measurements. INVESTIGATIONS AND LABORATORY ASSESSMENT how soon prior to the measurement of PEFR he has taken bronchodilator therapy, since a post-bronchodilator PEFR measurement may mask the severity of asthma. PEF meter readings may change with extended use, and significant errors may occur in the reading range of many devices, with some over-reading in the middle flow range and under-reading at high flow ranges.
Clinicians' guide to asthma by Kian Fan Chung; Andrew Bush