Pediatric Asthma

 Introduction

Asthma is a lingering provocative disease that affects the lungs’ airways leading to the obstruction of the airflow. The disorder is a leading cause of death in the United States thus forcing the government to invest a lot in the health sectors. Additionally, the disease affects people in variable prevalence depending on age, gender, and race. The management of the disease is very critical and mostly depends on how one adheres to doctors prescriptions. The disease is characterized by sentient problems, which in thrilling conditions may constitute medical emergencies. Therefore, this paper contains a quantitative and qualitative discussion of asthma, by discussing the pathophysiology, diagnostics, treatment, symptoms, and the prognosis as well as the evaluation of the morbidity and mortality in the United States as a result of the disease.

Pathophysiology of Asthma

The airways are responsive to the intrinsic and extrinsic stimuli which lead to the narrowing and reduce airflow to the respiratory tract. For instance, the recent study has indicated that asthma is an inflammatory illness of the airways. The inflammation is usually characterized by growing numbers of the eosinophil, mast cells in the mucosa and the desquamation of the airways epithelium. Additionally, the formation of the goblet cells fibrosis, submucosal glands proliferation is an occasional soreness that modifies the airways, leading to asthma (Mims, 2015).  The inflammation mediators produced by the eosinophil interaction with cytokines play a significant role in increasing the responsiveness of the airways.

In asthmatic patients, there is a saturation of the fiery cells with vasodilation. The structural changes such as the desquamation of the epithelium, submucosal and mucosal edema and the subepithelial fibro cause the thickening of the basement membrane. However, all these features may not appear on the asthmatic patients but depend on the type of asthma, the history of the patient and the biopsy of the signing period. However, the infiltration of the eosinophilia, a prolific feature of asthma, occurs in both non-allergic and allergic asthma and its common even during the period of symptoms.

Signs and Symptoms of Asthma Attack

There are early and emergency signs that indicate the onset of asthma. Immediately after the symbol appears, one is expected to seek medical attention as soon as possible because the illness inhibits respiration and may probably lead to death due to difficulties in breathing. The early signs may comprise of the coughing which is persistent at night or during cold seasons, massive and tight chest and less playing in children due to the closure of the respiratory tract (King et al., 2018). These symptoms occur at early stages of an asthma attack, and one is expected to seek medical attention to minimize the persistence of coughing.

After asthma reaches a point where the signs get worse, and three things occur at the airways in the lungs. First, the airways swell because of the thickening of the walls hence narrowing the airways. Secondly, the airways become more mucous, a thick liquid on the body that moistens the nose, through and the airways. When the mucous is formed in excess, it plugs the airways impending the flow of gases in and out of the respiratory system. Thirdly, the mucous around the airways are squeezed tight when one is asthmatic, and such tightens the loose muscles that are on the respiratory tract (King et al., 2018). The effect of asthma is the narrow the respiratory pathways causing the wheezing and troubled breathing. Additionally, there are other physical signs of asthma such as the opening of the nose full to get sufficient air in, and the retraction, which is the pulling together of the skin amid ribs. As a result, the people with such signs should seek medical attention in advance which is termed as the asthma management plan which asserts that medication should commence immediately otherwise, the condition may become severe.

Diagnostics of Asthma

The diagnosis of an asthma attack depends on several factors comprising of physical examination, observation of the signs and symptoms, overall health test outcomes and individual patients medical history. The medical history provides the clinician with possible maladies based on the visible signs as well as the association of the patient with the predisposing factors such as the substance use like tobacco and carriers such as the pigeons and pet birds. The clinicians also get to know whether the patient has a blood relative who was diagnosed with asthma.

Similarly, the doctor may examine the nose and the airways. With the use of the stethoscope, the doctor may detect wheezing, high-pitched whistling sounds during breathing. The doctor also examines the skin to find allergic conditions such as hives and eczema (Seys, 2017). A spirometer is also used to detect the wellness of pulmonary functions; which is the effectiveness of the inhalation and exhalation. If the spirometer records positive results, the doctor may expose you to substances that trigger asthma such as methacholine. As well, doctors carry out lung test to children above five years of age and providing patients with machines that test the levels of the nitric oxide in the body, where high quantities of such indicate asthma conditions.

Treatment

The effectiveness of treating asthma relies on adherence to prescriptions and medication. A patient should keep the asthma diary where he/she should record the signs each day to help make the adjustments on the drug based on one’s asthma action plan. The doctor should keep individual patients results in breathing tests which helps them change the medication depending on the wellness of breathing. The medicines of asthma are either long-term or quick relief (Busse et al., 2016). The best cure is the use of the corticosteroids inhalers which keeps asthma under control. The drugs treat all the airways inflammation that causes the symptoms of asthma. The inhalers are used daily to do away with asthma flare-ups. The quick-relief inhalers are used for short-term treatment and comprise of the albuterol. They are needed to open the airways and ease breathing quickly. However, the quick relief inhalers do not offer a long term control of asthma, and therefore patients are advised to stick to the long-term approaches. For instance, the use of the long-term and quick relief inhalers should be under the doctor’s prescriptions, and the patients should keep in touch with the doctors. The medication should also be adjusted due to bothersome signs that should come to the awareness of the doctor, to reduce the drug if the conditions of the patients are progressively right and to increase the medication in case of the seasonal triggers of the allergy.

Mortality and Morbidity

The number of people dying of asthma in the United States has been worrying since 2009. The prevalence of the asthma attack varied based on gender, age, and race. Evidence suggests that health utilization and mortality has been going lofty as a result of asthma, where the data collected in 2009 showed 27% higher asthma prevalence compared to the one gathered in 1999 (Nunes et al. 2017). However, the tally has been reducing since 2009 where the rate of the hospital discharges have decreased by 24% amid 2003 and 2010. The prevalence rate has continued to plateau, with an increase of 2.7% in 1997. Based on the American Lung Association Asthma Clinical Research Centers, about 25.9 millions of Americans were diagnosed with asthma in 2011, which was an increase of 11.4 million people in 2008 (Glick et al., 2016). Many children and civil servants lost their learning and working opportunities respectively as a result of contracting asthma disease. Indeed, asthma is one of the leading causes of death and activity limitations which have cost the health care industry in the United States more than $56.0 every year.

Similarly, results indicate that children between 5-17 years are prevalent to the asthma attack than adults. The females have a higher possibility of contracting asthma compared to men of the same age. For instance, about 8 million females in the United States had asthma attack relative to the 5.1 million men according to the research carried out in 2011 (Glick et al. 2016). As well the black Americans were susceptible to asthma attack compared to the white Americans. The variations between the races were statistically significant were in 2012, there were 47% more black Americans with asthma relative to the whites.

Prognosis of Asthma

Asthma prognosis is excellent. The present therapies are quite satisfying, and there is an easy accomplishment of asthma control. The prescribed treatments of the asthma work best for most of the patients with only a few cases of worsened situations among the patients under asthma control. Primarily, asthma is not related to the long term severe respiratory results. The lung functionalism reduces with age and the rate of the decrease in increased by the use of substances such as smoking (Westerhof et al., 2018). The loss of the respiratory functions results in the attack by asthma in the areas with several predisposing factors such as draught and allergies such as dust and smokes. Most of the patients using the asthma control drugs are interested with the zeal to recover and show less concern to the side effects that the medication may impart to the body. The reason for keeping in touch with the doctor when one is under asthma control is to ensure that the medication is adjusted based on the progress of the conditions (Fergeson et al., 2017). When the situations are growing good, the doctor should reduce the medication as the excess of the drug poses threats to the entire respiratory systems. The effectiveness of the medication is depended on the avoidance of agents such as smoking and exposure to dust.

Conclusion

Asthma is a disease that is a threat to the populations if not well managed by the health sectors. The United States is one of the regions in the world where asthma has posed a threat to the people. The disease is heritable from one generation to another, and the qualified clinicians easily detect the signs of the disease. The treatment of the disease mainly entails the use of the inhalers which is done with close supervision by the physician. Indeed, statistics show that women, children, and smokers are more prone to the attack. As a result, health care in the countries within the world should prioritize handling the disease to prevent the rapid rise in the mortality rates in the world.

 

References

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Del Giacco, S. R., Bakirtas, A., Bel, E., Custovic, A., Diamant, Z., Hamelmann, E. … & Seys, S. (2017). Allergy in severe asthma. Allergy72(2), 207-220.

Fergeson, J. E., Patel, S. S., & Lockey, R. F. (2017). Acute asthma, prognosis, and treatment. Journal of Allergy and Clinical Immunology139(2), 438-447.

Glick, A. F., Tomopoulos, S., Fierman, A. H., & Trasande, L. (2016). Disparities in mortality and morbidity in pediatric asthma hospitalizations, 2007 to 2011. Academic Pediatrics16(5), 430-437.

King, G. G., James, A., Harkness, L., & Wark, P. A. (2018). Pathophysiology of severe asthma: we’ve only just started. Respirology23(3), 262-271.

Mims, J. W. (2015, September). Asthma: definitions and pathophysiology. In the International forum of allergy & rhinology (Vol. 5, No. S1, pp. S2-S6).

Nunes, C., Pereira, A. M., & Morais-Almeida, M. (2017). Asthma costs and social impact. Asthma research and practice3(1), 1.

Westerhof, G. A., Coumou, H., de Nijs, S. B., Weersink, E. J., & Bel, E. H. (2018). Clinical predictors of remission and persistence of adult-onset asthma. Journal of Allergy and Clinical Immunology141(1), 104-109.