Full Description
Although the mechanisms and triggers that stimulate and are responsible for the natural history ofasthma are steadily being more clearly defined, uncertainties still surround both the genetic basis and the etiologyofone of the most common syndromes in the world. In fact, it is ofconsider- able concern and interest that the incidence of asthma today appears to be rising. These statistical increments may only reflect an increasing awareness of the disease, or its earlier and more sophisticated diagnosis. More important, however, asthma mortality appears to be increasing. This increase has occurred despite the continuing expansion of a diag- nostic and management information base, and the developmentofnovel andevermoreeffective therapeutic modalities.
Severalexplanations have been offered for this increase in mortality, including that it may result from a statistical artifact [based on a change in the coding criteria for asthma from the International ClassificationofDiseases Version 8(ICD- 8) to ICD-9], worsened pollution, delays in seeking medical help, behav- ioral changes, deficits in the asthma education of both patients and primary careproviders, toxicity ofbeta-agonists, and noncompliance with instructions for the proper use of medications. It should also be empha- sized that the increases in both incidence and mortality may be a reflec- tion of accumulating body burdens of environmental toxicants and of increased oxidativedamage. There has clearly beenadegradation ofenvi- ronmental quality. And although considerableattention has been focused on this possibility in both the scientific and lay press, more research in this area is definitely needed.
Contents
I: Definitions and Host Responses to Bronchospasm.- 1 The Genetics and Epidemiology of Asthma.- 2 Pathogenesis of Asthma: Mediators and Mechanisms.- 3 The Role of Mast Cells and Eosinophils in Asthma.- 4 Morphologic Basis of Airflow Obstruction.- 5 The Role of the Pulmonary Function Laboratory in Patients with Bronchial Asthma.- 6 The Interrelations Between Asthma, Pregnancy, and Lactation.- 7 Differential Diagnosis of Asthma in Children: Bronchial Asthma, Occult Asthma, and Pseudoasthma.- 8 Differential Diagnosis of Asthma in Adults: Bronchial Asthma, Occult Asthma, and Pseudoasthma.- II: Patient Management.- 9 Allergic Evaluations and Management Considerations of Patients with Asthma.- 10 Clinical Laboratory Assessment of the Bronchial Asthma Patient.- 11 Radiological Considerations in Asthma.- 12 Treatment of Asthma in Children.- 13 The Pharmacological Treatment of Asthma in Adults.- 14 Management of Status Asthmaticus in Childhood.- 15 Management of Status Asthmaticus in Adults.- 16 Role of Immunotherapy in Asthma.- 17 Management of the Pregnant Asthmatic.- 18 Unconventional Therapy in Asthma.- 19 Treatment Aspects of Asthma in Japan.- 20 Treatment Aspects of "International" Asthma: Europe.- III: Special Clinical Problems.- 21 Respiratory Tract Infections and Asthma.- 22 Diagnosis and Management of Exercise-Induced Asthma.- 23 Chronic Sinus Disease and Asthma.- 24 Aspirin, Related Nonsteroidal Anti-Inflammatory Agents, Sulfites, and Other Food Additives as Precipitating Factors in Asthma.- 25 Air Pollution and Asthma.- 26 Allergic Bronchopulmonary Aspergillosis.- 27 Occupational Asthma.- IV: Living with Asthma.- 28 Anesthetic Considerations in Asthmatic Patients.- 29 Use of Prospective Disease Management to Minimize Asthma Symptoms and Maximize Potential.- 30Asthma in School Children: Reducing the Impact on Education.- 31 Sports, Athletes, and Asthma: Winning the Fame with Asthma.- 32 The Psychology of Asthma: Implications for Treatment.- 33 Disability/Legal Issues for Asthmatics.
