By M. Eric Gershwin, Timothy E. Albertson
A completely up to date variation of a greatly revered vintage at the prognosis and administration of bronchial asthma in a number of sufferer subpopulations. even though this 5th version maintains to stress the definition, medicinal drugs, and use of bronchial asthma cures, it additionally makes a speciality of the certain wishes sufferer, together with the pediatric sufferer, the pregnant sufferer, and the sufferer present process surgical procedure, in addition to at the perennial problems with workout and bronchial asthma, pulmonary aspergillosis, profession, leisure drug use, and psychological/social issues. Highlights for the 5th variation contain a liberal use of tables and charts to make the e-book more effective and hassle-free, updates at the many new prescribed drugs used to regard bronchial asthma, and first-time sections on nutrition sensitivity and the prognosis of bronchial asthma.
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Additional info for Bronchial Asthma: A Guide for Practical Understanding and Treatment, 5th edition (Current Clinical Practice)
SKIN TESTS Allergy skin tests are probably the most important diagnostic test in identifying allergic asthma but RAST is equally reliable (see Tables 7 and 8). Skin tests are accurate and reproducible (61). A positive, histamine, and negative saline test must always be used to compare the test allergens. If the histamine test does not elicit a classic positive test, then the testing is not valid. This usually occurs when patients have not stopped taking antihistamines within the prior allotted time period.
Food allergy testing is usually done both as a screening procedure during 38 Klein routine skin testing and for specific food allergies that were elicited during the allergy history. RAST tests can also be used instead of skin testing, but they are not as accurate as a properly applied and interpreted skin test (57). However, if a severe food allergy is suspected, a RAST test is safer than a skin test. Once a food is suspected by history and skin or RAST test, a diagnostic challenge should occur, except for when severe food allergy reactions have occurred or are suspected by previous testing.
The Close Association of Respiratory Infection and BHR It has been known for many years that a common rhinovirus infection in normal people may result in increased airway reactivity to methacholine for up to 4–6 wk, long after the symptoms of the respiratory infection have cleared. Some virus infections in a patient with asthma not only results in increased BHR to methacholine but also is frequently the cause of severe exacerbation. Eosinophilia The eosinophilia that occurs in asthma is consistent with the observation that epinephrine and isoproterenol produce eosinopenia, and this catecholamine effect is blocked by propranolol.