He asthma It is a disease that affects the respiratory tract and continues to be of concern in Argentina due to its increasing prevalence in the smallest population. Although this condition can appear in people of any age, it is more common in children and in anyone with a personal or family history of allergies.
In addition, anxiety is exacerbated by the fact that its manifestations are difficult to determine, since they vary from person to person, at the same time, they can change in the same patient throughout his life. However, this disease affects more 10% Argentine childrensome of its symptoms are coughing, shortness of breath (shortness of breath), a feeling of tightness or tightness in the chest, and wheezing (wheezing) in the chest.
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“Like many other chronic diseases, asthma cannot be cured, but optimal control can be achieved, which is the key to a good quality of life. People with asthma can lead normal lives even in the most severe cases. it is always important to have an adequate diagnosis that also takes into account the origin of the asthma, the precipitating factors and the severity of the condition, as well as adherence to the treatment regimen prescribed by the attending physician,” explained Dr. Jorge Maspero, specialist in allergology and clinical immunology, Medical Director of the Foundation CIDEA.
The following are factors to consider in order to fully understand if you are experiencing asthma and determine how it manifests in each patient in order to prevent complications and better control the disease.
1. Symptoms and severity of episodes: it is necessary to establish the method of their occurrence, both at the beginning and in development, duration, intensity, hourly variability and nature (permanent or seasonal); frequency, attendance on duty, hospitalizations, need for and response to medications.
“One of the main objectives of the treatment of bronchial asthma, especially in severe cases, is the prevention of exacerbations, which are conditions that require medical attention, often emergency care. Early recognition of the onset of symptoms and their deterioration due to the fault of the patient and his family will allow for early therapeutic intervention, prevent the progression of the crisis and reduce the likelihood of hospitalization, ”said Dr. Veronica Jubergia, pediatric pulmonologist at Garrajan Hospital.
2. Development of the disease: It is related to age of onset, progressive or not, previous and current diagnoses and treatments. “The diagnosis of asthma is mostly clinical and is confirmed by spirometry and bronchodilator testing. In young children (preschoolers), the diagnosis is more difficult because lung function tests such as spirometry are more difficult to perform. However, in children over the age of 6, they are usually achieved in the same way as in adults,” explained Dr. Jubergia.
There are children with asthma who reach adulthood without a diagnosis, although in many cases symptoms suggestive of asthma appear in the first years of life. About 4 out of 10 children with respiratory infections will eventually be diagnosed with asthma in later years. On the other hand, determining the severity of asthma in each patient is critical. Long-term follow-up of children with asthma between the ages of 7 and 10 years seems to confirm that the severity of their condition persists over time: those who develop severe asthma in early school age tend to have severe asthma in adulthood. age. . “Severe asthma, by definition, is uncontrollable despite adherence to adequate therapy at maximum doses, or asthma, even if controlled, worsens when treatment is reduced at high doses; it affects 5 to 10% of cases,” Dr. Maspero described.
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3. Triggering or aggravating factors: Whether the episodes are associated with respiratory infections, exposure to environmental allergens (mites, animal skin, fungal spores or pollen) or environmental pollutants (tobacco smoke or other pollutants), association with environmental changes (travel, other place of residence), emotional factors (crying, laughing), food and supplements, medications (aspirin), gastroesophageal reflux, and factors such as cold air, exercise, or climate change. This is also true if the home is urban or rural, home or department; geographic location and heating. Description of the bedroom (type of mattress, pillows, rugs, soft toys, books). Pets (cat, dog, etc.). Family smoking (number of smokers, frequency if smoking indoors).
Dr. Maspero pointed out: “There are various etiological agents, such as indoor allergens, mites, animal epithelium, fungi or pollen, that affect exacerbations. It is necessary to assess the patient’s allergic sensitization and the influence of the environment, which in many cases should be agreed with a specialist.
4. Impact of disease: the pathology can create difficulties for the patient, such as absenteeism from school, unwillingness to participate in games and sports, disturbances in sleep, development, growth and behavior, and also affect the family with changes in daily routine, loss of work time and economic costs. That’s why it’s also important to understand what periods without seizures are like, whether you also have symptoms, exercise tolerance, occasional or frequent need for medication, etc.
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“It is necessary to consider the impact on a child’s life when he cannot run or play with his peers; how much it affects the child and his entire family if he does not rest at night due to symptoms and for fear that the difficulty in breathing will worsen and should go to the emergency room. That is why it is so important to find ways to achieve the best control of the disease in order to cope with its impact on various lifestyles,” said Dr. Jubergia.
5. Training: Involving the family and the patient in informing about the disease, its chronic course, establishing and monitoring an asthma control plan, together with a healthcare professional, which also includes the proper prescription of medications, is key. advice on how to act in a crisis situation.
“Those children who cannot control their disease with conventional therapies will be at risk for more crises, hospitalization and repeated courses of systemic corticosteroids, the sum of which can pose long-term health risks,” the specialist said. . . .