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Investigations in Asthma - Research Paper Example

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This research is being carried out to evaluate and present different investigations in asthma. The author has rightly presented that the initial investigation carried out in almost all patients presenting with asthma is the measurement of the peak expiratory flow rate…
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Investigations in Asthma
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Download file to see previous pages This research will begin with the statement that asthma is a clinical syndrome of unknown etiology characterized by three distinct components: (1) recurrent episodes of airway obstruction that resolve spontaneously or as a result of treatment; (2) exaggerated bronchoconstrictor response to stimuli that have little or no effect in nonasthmatic subjects, a phenomenon known as airway hyperresponsiveness; and (3) inflammation of the airways. This essay discusses that a large national study has revealed that in the UK the incidence rate of asthma has decreased in the last few years from 6.9 per 1000 patient years in 2001 to 5.2 per 1000 patient years in 2005. This decrease is most prominent in children under 5 years of age. This group also shows a decrease in the lifetime prevalence of asthma. In adults, however, the lifetime prevalence has increased with one person in every nine being diagnosed with asthma. These figures show that asthma is one of the major health problems we face today. This paper illustrates that the investigations carried out in a case of asthma depend upon the mode of presentation of the patient. The researcher’s patient presented with acute severe asthma, with a widespread expiratory wheeze. In such a patient, the initial investigations will be aimed at analyzing rapidly the condition of the patient and determining the emergency measures that need to be instituted....
e or a PEFR of less than 200L/min would be classified as severe asthma(Boon, Colledge, Walker & Hunter 2006), requiring iv steroids and nebulized salbutamol and terbutaline.
Because PEF meters are inexpensive and widely available, they also play an important role in confirmation of a diagnosis of asthma in patients with mild symptoms. The patients are told to record morning and evening values of PEF. Morning values 20 % lower than evening values are indicative of asthma, as is improvement in symptoms after administration of corticosteroids for a period of 3 weeks. (Boon, Colledge, Walker & Hunter 2006.)
Studies demonstrate that PEF meters are a patient friendly method of monitoring of disease progression although prolonged periods of measurement are met with decreased patient compliance. Compliance with PEF measurements was found to be good during the first month (63% of the measurements done) but even with regular reinforcement, fell to 50% at 6 months and to 33% at 12 months. (Cote, Cartier and Malo 1998). Furthermore it has been found that individualized action plans based on the patients best PEFR measurements consistently improve asthma health outcomes. (Gibson & Powell 2004).
PEFR measurements are also useful in the diagnosis of occupational asthma. If PEFR measurements are made every 2 hours over a period of 2 weeks, including a period of time away from work then the sensitivity and specificity of this test for the detection of occupational asthma are 71 and 84% respectively(Perrin & Lagier 1992).
PEFR measurement is useful however it also has certain shortcomings which may influence the investigation. Some degree of airflow obstruction may be present when the peak flow remains within the normal range. Peak flow measurements are not enough to distinguish upper ...Download file to see next pagesRead More
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