50. Hundreds of questions and hundreds of answers on asthma(bronchial asthma)

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Figure 6~1. Illustration of cross-section and longitudinal section of the airway when an asthma attack is triggered.

a. larynx, b-trachea, c-bronchi, d-bronchiole (capillary bronchi), e-smooth muscle, f-alveoli, g-bronchiole wall, h-airway secretion (sputum)

Physical exercise, cold air, or other types of asthma attack triggers can cause airway constriction and blockage.

At this time, treatment with bronchodilators can make the abnormal airways to return normally.

When airway infections may trigger an asthma attack and then the airways may be swollen, but few asthma symptoms may develop and sometimes no signs and symptoms of asthma

If an asthma attack is already triggered by an asthma trigger factor such as airway infection, and exposure to allergens, another asthma attack trigger can lead to more severe airway inflammation, more swelling of the airways, increased mucus secretion, and consequently more obstruction of the airways. Used with permission from Hardy 1992

2. Normal low respiratory tract and lungs

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Figure 161. a-larynx, b-trachea, c-bronchus, d-bronchiole.

Used with permission from Hardy 1992

3. Normal airway

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Figure 162. Cross-section and longitudinal section of a normal low respiratory airway

a-bronchiole, b-alveoli. Used with permission from Hardy 1992

4. Airway constriction caused by mild asthma

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Figure 163.

a Normal bronchiole cross-section and longitudinal section

b: When a mild persistent asthma attack occurs, the bronchi and bronchioles contract, and the airway becomes narrows. Used with permission from Hardy 1992

5. Airway constriction caused by severe asthma

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Figure 164. Cross-section and longitudinal section of the airway with persistent asthma.

a. With moderate persistent asthma, the bronchi and bronchioles contracted and sputum was secreted in the airways.

Severe persistent asthma caused severe constriction of the bronchi and bronchioles, sputum secreted in the airways, and swelling of the airway walls (pictured below)

Source: Used with permission from Hardy 1992

6. Airway constriction caused by mild asthma attacks

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Figure 6-6. Normal bronchiole transverse and longitudinal sectional view

When a mild persistent asthma attack is triggered, the bronchi and bronchioles contract, resulting in narrowing of the airways (left and right a). Source: Used with permission from Hardy 1992

7. Mild asthma attack

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Figure 6~7. A cross-sectional view of the airway that triggered an asthma attack.

When a moderate persistent asthma attack is triggered, the bronchi and bronchioles partially contract more, the inside of the airway becomes narrower, and the inner wall of the airway becomes more swollen.

When a severe persistent asthma attack is triggered, the airways in the bronchi and bronchioles become more constricted and the inside of the airways becomes narrower, the inner wall of the airways becomes swollen, and the inflammation becomes more severe.

8. Mechanism of asthma attack

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Figure 6-8. Airway change and the cross-sectional drawing of the airway when an asthma attack is triggered

a-normal airway (bronchi),

b-acute bronchoconstriction,

c-chronic asthma constriction of the airways and inflammation of the walls of the bronchi, making the airways narrower,

D-subacute asthma or chronic asthma caused the bronchial wall to swell and become inflamed, resulting in a narrower airway.

e-inflammatory cells, histamine granules are secreted from m-mast cells.

T cells,

B cells,

p alveolar macrophages,

o Various mediators such as histamine, cytokines, leukotrienes, prostaglandins, etc., which are produced by activation of eosinophils and neutrophils, etc., are formed, which can cause asthma attacks.

MBP; Major basophil cytotoxic enzyme (basophil/Major basophilic protein) is secreted

PAF: Platelet-activating factor (PAF) Reference-Asthma, The Pediatric Clinics of North America, December 1992, W. B. Saunders

Here are some questions about asthma.

If correct, answer “yes”, if wrong, answer “no”, and refer to the hundred questions and answers for the answer to that.

Q. Childhood asthma is a common disease.

A. Yes

Q. Asthma is a disease that is mainly caused by emotional or mental problems.

A. No

Q. Asthma develops when parents raise their children incorrectly.

A. No

Q. When a severe persistent asthma attack is triggered acutely and breathing difficulties

occur, can it be dangerous to life if not properly treated?

A. Yes

Q. Without any prognostic symptoms, can an asthma attack be triggered suddenly?

A. Yes

Q. There is no treatment method that can cure asthma yet, but there are preventive treatment methods that can prevent the recurrence of asthma attacks. And whenever an asthma attack is triggered, are there any treatment options that can be treated.

A. Yes

Q. Are there several types of asthma medications used to treat asthma?

A. Yes

Q. During asthma treatment, Is it good to measure the peak expiratory flow rate (PEFR)

A. Yes

Q. Can newborns and infants also develop asthma?

A. Yes

Q. Can smoking lead to asthma attacks?

A. Yes

Q. If children have physical-exercise induced asthma, should children not exercise physically.

A. No

Q. Is it very helpful in treating asthma to a “personal asthma diary” written about the symptoms, signs, and treatment of asthma is.

A. Yes

Q. Can children’s parents treat their children’s asthma more effectively if children’s parents study about asthma a lot by getting asthma information about asthma attack triggers, diagnosis, treatment, and prevention from a doctor, and write a “patient asthma diary” to treat asthma?

What triggers an asthma attack
Asthma symptoms, signs, and severity can be identified
How to treat them depending on the severity of those symptoms
How to prevent asthma attacks from triggering
Why measure peak expiratory outflow rates daily with a peak flow meter (maximum flow meter)?
Types and pharmacological actions of drugs that can be used to treat asthma
When, how much, and how to use asthma medications to treat asthma
What are the side effects of asthma medication,
How to deal with such side effects
What to do when your asthma becomes more severe
etc

A regular pediatrician writes about the asthma treatment method and gives it to the patient, mother, father, or guardian, and the patient is treated according to the doctor’s instructions. Write down the journal and review the diary with a regular pediatrician, patient, mother, father, or guardian to treat asthma in order to effectively treat asthma.

The American Academy of Pediatrics recommends the treatment of childhood asthma.

References; New asthma guidelines, Journal watch pediatrics, and adolescent medicine. vol 6, number 12. 12/2007

Q. How common is childhood asthma? About asthma statistics?

Asthma in children and adolescents is called childhood asthma.
Depending on the study and the country in which you live, your asthma statistics differ.
In the US, 10-15% of children and adolescents (ages 0-18) suffer from asthma.
Among the chronic respiratory diseases in children and adolescents, the most common chronic respiratory disease is asthma.
People of all ages, regardless of country, race, gender, or age, can develop asthma.
Eight to 12% of people of all ages in the United States have asthma.
A total of 14 million people in the United States have asthma.
10-15% of American boys suffer from asthma.
7 to 10% of girls in the US have asthma.
1 in 4 infants and younger children under the age of 5 have asthma
This is one of the most common reasons why children and adolescents are treated by visiting hospital emergency rooms.
Asthma can be a serious health problem for children and adolescents.
School-age children are absent for 5 to 7 days a year due to asthma in the US
Medical expenses of about $600 million a year
More than 500 people die annually.
In Korea, 1 in 4 infants aged 5 years old or younger suffers from asthma. It is almost the same as the statistics in the United States (recently reported by the Korean Asthma Allergy Association).

Q. Is Asthma a type of emotional disorder or mental illness.

A. Although asthma is neither an emotional disorder nor a mental illness, it may be more prone to asthma attacks in children and adolescents with mental and emotional problems such as depression, tension, anxiety, or stress.

In children with such mental problems, if an asthma attack is triggered, the symptoms may be worse and asthma may not be treated well.

Q. Why do some children have asthma and some do not have asthma?

A. Some children and adolescents with asthma are born with genetic factors that can cause asthma.

It is common for children with intermittent asthma to grow up and children do their daily routine just as well as other children without asthma, with while no signs, symptoms of asthma are present.

When children born with asthma genetic factors come into contact with asthma triggers or antigens, asthma attacks are triggered and symptoms of asthma appear.

Q. If parents raise their children incorrectly, can their children have asthma attacks?

A. Asthma attacks may occur in children more often when parents are anxious, stressed, or smoking, but this is not necessarily the case.

Asthma attacks are more prone to children and adolescents in the house when is dirty or when a lot of house dust mites are grown when pets such as dogs and cats are kept in the house, or when eating any food that can cause allergic diseases.

Q. Can life be at risk from asthma

A. Symptoms of asthma depending on the severity of symptoms and many other conditions, asthma can be divided into intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma.

In addition, there is acute asthma caused by an acute asthma attack, and there are chronic asthma suffering from chronic conditions.

The author has experience in treating children and adolescents suffering from asthma for decades but has not yet seen a child or adolescent who has died from asthma.

When a moderate or severe persistent asthma attack is triggered suddenly and severely, or persistent asthma (moderate asthma), if such asthma attack is not properly treated, it can be life-threatening and can lead to death. In the United States, more than 500 people die annually from asthma.

Q. Can asthma interfere with study at school?

A. American students are absent from school for 5 to 7 days a year due to asthma, and some students are unable to exercise physically with other students during school physical education.

However, most of the children with asthma can do school sports and school life normally.

Q. What signs, symptoms of asthma can predict before an acute asthma attack is triggered?

A. Before an asthma attack is triggered acutely, it is common for no obvious signs, symptoms to predict that an asthma attack will be triggered.

You may cough a little just before the acute asthma attack is triggered, you may have an itchy throat.

Signs. symptoms such as tightness in the chest and difficulty breathing may develop.

These symptoms can be considered the first symptoms of an asthma attack.

These symptoms can appear before an acute asthma attack.

However, even if infants and toddlers have symptoms similar to those of asthma, they may not complain about such symptoms.

School-age children or adolescence may complain of the previously described asthma symptoms just before the acute asthma attack.

When symptoms similar to those of asthma may occur before the acute asthma attack is triggered, an appropriate treatment with asthma medications may stop the further asthma attack or only mild asthma attack experience.

Q. Do children with intermittent asthma always have signs, symptoms of asthma?

A. Children with a past history of asthma attacks caused by intermittent asthma attacks with symptoms and signs such as cough, wheeze, and difficulty breathing, and then while they do not intermittent asthma attacks, they do not have any symptoms and signs such as cough, wheeze, breathe shortly, and difficulty breathing as long as the asthma attack is not triggered again. It is common the children with a history of intermittent asthma attacks to work and grow in the same way they normally do.

If children have a past history of an asthma attack but an asthma attack doesn’t trigger, there are usually no signs of asthma symptoms.

Q. What are the triggers of an asthma attack

1. If any of the siblings of the biological parents have atopic dermatitis, allergic rhinitis, food allergy, asthma, drug allergy, poison ivy contact dermatitis, insect allergy, or other allergic diseases, Siblings in the household are very likely to develop allergic diseases such as asthma, allergic rhinitis, or atopic dermatitis. Thus, asthma is a type of genetic disease.

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Picture 168. Asthma is a hereditary disease.

2. Physical exercise such as swimming, or running can trigger an asthma attack. Such an asthma attack caused by physical exercise is called physical exercise-induced asthma, or exercise-induced asthma.

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Picture 169. Physical exercise can trigger an asthma attack.

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Picture 170. Physical exercise can trigger an asthma attack.

3. Cold, viral upper respiratory tract infection, viral lower respiratory tract infection, and other viral infectious diseases can induce asthma attacks.

Asthma caused by viral upper respiratory infections such as colds is called virus-induced asthma.

It is reported that 70% of infants with a history of acute bronchiolitis develop asthma attacks. I don’t know for sure why.

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Picture 171. Viral upper respiratory tract infection such as a cold or flu, or viral lower respiratory tract infection can cause asthma attacks. In general, bacterial upper and lower respiratory tract infections do not cause asthma attacks.

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Picture 172. Asthma attacks can occur while sleeping, which is called sleep-induced asthma or night sleep asthma.

4.Cigarette smoke, smoke from factory chimneys, automobile exhaust gas, polluted air, gasoline, paint, odors, and vapors from volatile chemicals, toxic gases, perfumes, cosmetics, or cleaning chemicals can cause asthma attacks. This is not allergic asthma.

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Picture 173. Direct or second-hand smoke can trigger an asthma attack.

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Picture 174. Some types of drugs, such as aspirin, can trigger an asthma attack.

5. Aspirin, vaccine, penicillin, anesthetics, or other drugs can cause asthma attacks.

6. Food ingredients such as cow milk, eggs, nuts, peanuts, chocolate, fish, flour, or food

additives and artificial food coloring can trigger asthma attacks.

7. Cold air, changes in temperature, or humidity can trigger asthma attacks. Asthma induced by cold air is called cold-induced asthma.

coldinducedasthma.jpg

Photo 175. Cold air, changes in temperature, or changes in humidity can trigger an asthma attack.

Dogs, cats, bird hair, dandruff, saliva, urine can cause asthma attacks. Pillows or blankets made of animal hair or bird feathers can trigger asthma attacks. Sleeping on that type of pillow, especially when sleeping, can trigger nighttime asthma attacks.

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Photo 176. Dog hair, dandruff, and saliva can trigger asthma attacks.

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Photo 177. Cat hair, dandruff, and saliva can cause asthma attacks.

9. Asthma attacks can be caused by molds and/or fungus such as Alternaria.

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Photo 178. Mold or fungus that grows inside and outside the house can trigger an asthma attack.

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Photo 179. House dust or house dust mites, house mold can trigger an asthma attack.

10. Pollen from trees or grass, especially ragweed pollen, can cause asthma attacks.

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Photo 180. Plant pollen can also trigger asthma attacks.

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Photo 181. Plant pollen can also trigger asthma attacks.

11. House dust, house dust mites, or cockroaches can cause asthma attacks.

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Photo 323. Closeup of a house dust mite.

House dust mites are arthropods measuring 3 mm in size.

sauce; www.gazoontite.com

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Photo 183. Cockroaches can trigger asthma attacks.

12. Gastroesophageal reflux can cause asthma attacks.

Artificial nutrition, breast milk, or other types of food eaten by infants and toddlers can reflux from the stomach into the esophagus. Such gastroesophageal reflux can trigger asthma attacks.

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Figure 184. Gastroesophageal reflux can lead to asthma attacks

a-Gastroesophageal reflux (left), no gastroesophageal reflux (right), b-gastroesophageal sphincter, c-gas and gastric contents, d-duodenum, e-pylorus, g-gastroesophageal reflux

13.Bronchial asthma attacks can be triggered by discord and conflict between parents, siblings, conflicts between friends and peers, stress, or mental anxiety.

14. Asthma is more likely to be induced in children who have not grown up with their mother’s breast milk.

Source; Contemporary pediatrics, January 2009. p.16.

15. Other triggers can also trigger asthma attacks.

A. Factors that trigger asthma attacks are called asthma triggers. It has asthma predisposition factors that can cause asthma from birth.

List the factors that cause asthma

Viruses such as cold virus or flu virus that can cause upper and lower respiratory tract infectious diseases,
Tree or weed pollen,
Mold, fungus,
House dust mites, house dust,
Cockroach,
Change of weather,
Exposure to cold air,
Organic or inorganic chemicals,
Cigarette smoke,
Animal fur, dandruff, and saliva, feathers
Food such as cow milk, nuts, eggs,
Anger or stress,
Changes in emotions such as laughter or crying,
Physical exercise,
Drugs such as aspirin,
Gastroesophageal reflux
etc

All of the factors that can induce asthma attacks are called asthma attack triggers.

When children and adolescents with asthma predisposition, that is, genetic factors, encounter asthma attack triggers, asthma attacks can be triggered in children and adolescents.

Q. Can asthma be cured?

A. There is no cure for asthma yet.

However, there are many treatment methods and asthma medications that can well treat symptoms and signs such as cough, wheezing, shortness of breath, and difficulty breathing that occurs when an asthma attack is triggered.

It is possible to use the phrase “to cure asthma”, but many kinds of literature uses the term “asthma control” instead of asthma cure treatment.

If you control your asthma well, you can live healthy like people without asthma.

Q. Is there any way to prevent asthma attacks from triggering?

A. There are several preventive measures that can be prevented from triggering an asthma attack.

There are also ways to prevent asthma by avoiding or eliminating triggers that may trigger asthma attacks so that you are no longer exposed to asthma triggers.

There is also a way to prevent asthma attacks from triggering with drugs to prevent asthma attacks, such as sodium cromolyn.

However, there is still no way to completely prevent asthma from triggering an asthma attack.

Q. Why parents of children and adolescents with asthma have to study a lot about asthma attack mechanisms, asthma triggers, prevention, treatment, etc.

A. They said that “Parents education is the best medicine”.

Parental education is the best treatment and prevention.

In particular, parents need to study a lot about asthma.

When treating asthma, asthma can be treated more effectively if parents, children, doctors, nurses, school authorities, hospitals, the state, and society all become members of one asthma treatment team and treat them together.

If parents or their children have a current or past asthma history, they should study a lot about what asthma is, causes, triggers, symptoms, diagnosis, treatment, and prevention. In particular, Parents need to study more about the treatment and prevention of asthma.

When asthma attacks are acutely induced in children and adolescents, parents should also be familiar with how to treat acutely induced asthma attacks at home as the primary emergency treatment.

It is the responsibility and duty of parents to know what triggers an asthma attack and to prevent the asthma attack from occurring any more by treating the child so that it does not come into contact with the trigger again.

Depending on the severity of asthma, parents should know how to treat asthma immediately, and also children and adolescents themselves should know well about the treatment of asthma.

Many parents gain more knowledge about asthma through the Internet or in special books for asthma, so they have more knowledge of asthma medicine than doctors.

Q. What asthma medications can be used to treat asthma

The treatment of asthma can be as follows.

A bronchodilator that can dilate the narrowed bronchi (airways) in an asthma attack.
Anti-inflammatory drugs can reduce inflammation of the bronchi caused by an asthma attack.
Asthma prevention drugs that can be used to prevent asthma attacks from triggering any more.
Bronchodilators include short-time effective bronchodilators that can expand the bronchi in a short time.
There are also long-effect bronchodilators that can dilate the narrowing bronchi for a long time.
Bronchodilators include oral syrup, pills, capsules, aerosol HFA for inhalation, and aerosol for inhalation.
Anti-inflammatory drugs include oral syrup, tablets, dry powder aerosol HFA for inhalation, and aerosol for inhalation spray.
Drugs that can be used for prophylaxis to prevent further asthma attacks include oral syrup, pills, inhaled gun powder aerosol HFA, and inhaled aerosol spray.

Q. Is there a device that can measure the maximum expiratory outflow flow rate that can be measured the peak expiratory outflow rate (PEFR) of children with asthma at home?

A. Peak flow meter makes it easy to measure the maximum expiratory flow rate (PEFR) at home, at school, or in a hospital.

Before an asthma attack is triggered, the maximum expiratory outflow rate is measured with a maximum flow meter in a condition that the asthma attack is not triggered and there are no symptoms of asthma.

The major drawback is that some of the children are immature and do not know exactly how to check the maximum expiratory outflow rate with a maximum flow meter so that this test cannot be done properly. The downside is that some adults and adolescents don’t know how to properly measure the maximum expiratory flow rate, so no one can use this test.

The pulmonary function can be measured with a spirometer in a pediatric and adolescent clinic or in a hospital emergency room.

Q. Can children with a past history of asthma as a child develop asthma after they become adults?

A. It is common for the majority of children born with asthma predisposition to develop asthma attacks before they reach adulthood, leading to asthma attacks in their adulthood.

Children and adolescents with a history of asthma in childhood may no longer develop asthma attacks but may lead to more severe asthma attacks after they grow up and become adults.

Children who have never had an asthma attack in childhood may have an asthma attack for the first time since they become adults.

It is common for most adults with a history of childhood asthma to develop asthma even after adulthood.

Most first asthma attacks are usually triggered before the first birthday, but the first asthma attack may occur after adulthood.

Q. Can Smoking stimulate their airway, and may cause asthma attacks?

A. Your own smoking can trigger an asthma attack for you, and you don’t smoke, but smoking around you, that is, secondary smoking, stimulates your airways, which can trigger an asthma attack. This is not an allergic asthma attack.

Q. Can contaminated air trigger an asthma attack?

A. Fireplace smoke, outdoor smoke, or contaminated air can trigger an asthma attack.

If children with mild persistent asthma smoke, breathing smoke, or contaminated air trigger the mild persistent asthma and they have suffered may worsen into moderate or severe persistent asthma, and chronic asthma worsens to acute asthma. And acute asthma can progress to chronic asthma.

Smoking in a person with a history of asthma or a previous history of asthma can lead to acute asthma attacks, and mild persistent asthma may worsen, may leading to severe persistent asthma, resulting in loss of life.

Q. My 13-year-old son has a history of intermittent asthma, but he is usually healthy, but when he does physical exercise, such as running or soccer, he said to be awkward and short of breath.

A. When healthy children without a history of asthma may suffer from physical induced asthma due to physical exercise such as running. If no physical exercise, they may be normal.

When children with a history of asthma in the past or present do physical exercises, such as running or soccer, there are times when they breathe faster than usual, cough more than usual, and cannot continue the exercise properly. Physical exercise like this can trigger an asthma attack.

If a child without any symptoms of asthma begins physical exercise, it may start coughing and shortness of breath, and tingle.

Peers who have no history of asthma and who do not suffer from asthma can continue to do such physical exercise normally to make the end. If a child with asthma begins physical exercise, an asthma attack can be triggered by physical exercise. There are times when you can’t continue. Asthma attacks during physical exercise is called physical exercise-induced asthma.

Q. Is there a way to prevent physical exercise-induced asthma?

A. Physical exercise-induced asthma is a minor asthma attack due to physical exercise, and most children are able to continue with the physical exercise.

Just because an asthma attack is triggered during physical exercise should not limit physical exercise. If do, they cannot do all of the usual physical exercise needed in their life.

It is not necessary for all children with a history of mild physical exercise-induced asthma to undergo routine preventive asthma treatment before starting exercise.

Physical exercise may induce physical exercise-induced asthma on many occasions. When children and adolescents who have severe asthma attacks during physical exercise must do inhalation of beta 2 agonist aerosol HFA 2 or 3 times at 15 minutes before starting the exercise. Physical exercise-induced asthma can be somewhat prevented by inhaling cromolyn aerosol HFA or nebulized cromolyn spray 30-60 minutes before the start of exercise or taking oral beta 2 agonists 30-60 minutes before the start of the exercise.

Athletes who have a history of physical exercise-induced asthma may become international athletes. Olympic athletes also prevent exercise-induced asthma with this kind of asthma prophylactic treatment.

Q. Can pregnancy trigger asthma attacks

A. Pregnancy can trigger asthma attacks.

So, asthma attacks during pregnancy is sometimes referred to as pregnancy-induced asthma.

If the asthma attack is severe during pregnancy, the pregnant woman may cough and breathe with shortness of breath and wheezing.

Severe persistent or severe persistent asthma during pregnancy can be treated with inhaled corticosteroid aerosol HFA.

It is said that treatment with such an appropriate inhaled corticosteroid aerosol HFA prescribed by your doctors do not cause any specific side effects to the fetus or pregnant woman.

If necessary, asthma can be treated during pregnancy with albuterol, a bronchodilator.

Q. If parents have asthma, what is the probability that their children will have asthma?

A. If either one parent has a history of asthma in the past or present, the child born to both parents has a 25% chance of developing asthma,

If both parents have a history of asthma in the past or present, children born to both parents have a 50% chance of developing asthma.

Q. Is there any way to prevent asthma in children born to two parents who currently have asthma or have a history of asthma in the past?

A. The triggers should be eliminated or avoided asthma attack triggers as much as possible so as not to trigger asthma attacks in children born to parents with a history of asthma.

From the newborn period, instead of feeding artificial nutrition, breastfeeding is performed. Breastfeeding can be continued until at least 9-12 months old.

Or, Breastfeeding for longer than 9 months, and baby foods should not be given before 6 months of age.

Do not feed if possible allergic foods, such as cow milk, eggs, nuts, chocolate, etc. that can cause food allergies.

Clean the house environment control and cleaning to prevent the growth of house dust mites and fungus.

Wrap your mattresses well with plastic covers,

Do not keep pets, such as dogs and cats, in the house,

Do not smoke,

Use wooden hardwood floors instead of fastening carpets,

Eat a balanced diet,

Regular exercise and good health care can lead to fewer asthma attacks.

Q. My 5-month-old son had atopic dermatitis on his face and the neck, and after applying corticosteroid ointment according to the doctor’s instructions, dermatitis completely healed but recurred a few weeks later. However, if he catches a cold, the cold lasts more than 10 days. Why is that?

A. When children with an atopic constitution or a history of asthma catch a cold, it is easy to induce asthma attacks. At this time, it can be misdiagnosed as coughing from asthma or coughing from a cold.

Unless treated with bronchial asthma medications, it is common to cough day and night for 2-3 weeks. Sometimes when he breathes, you may hear a wheezing breathing sound in his chest, he may have wheezing, and atopic dermatitis may recur.

Q. Are atopic dermatitis and asthma-related?

A. Asthma and atopic dermatitis are a type of hereditary allergic disease.

It is common for 70% of children with atopic dermatitis to have an asthma attack.

Most children with a history of asthma usually have both atopic dermatitis and allergic rhinitis.

It is nothing wrong to presume that children with atopic dermatitis in their past or current medical history will have asthma attacks sometime in the future and will have asthma again.

Children with a past or current history of allergic rhinitis are also very likely to develop asthma.

Q. What is allergy shinner

A. After 1 to 2 days later the bruising caused by physical contusion trauma on the face, the color of the bruising skin color can be turned darkish.

This kind of skin color change is referred to as shinners.

Allergic shinners are referred to as “darkish skin spots under the eyes”, ” darkish skin color circles under the eyes” or “suborbital edema and cyanosis,” It is also called “hyperpigmentation under-eye”.

In children and adults with allergic rhinitis, the color of the skin under the lower eyelid becomes darkish.

The venous blood vessels at the edge of the orbital area under the eyes are narrowed due to an allergic reaction, so venous blood at the edge of the orbital area does not circulate properly, and venous blood at the edge of the orbital area accumulates more than usual in the venous blood vessels, resulting in an allergic shinner.

Allergic shinner does not appear in all children or adults with allergic rhinitis, but it is relatively common.

It is a sign of allergic rhinitis.

When there is allergic rhinitis, the allergic shinner usually appears temporarily, and when the rhinitis is over, the shinner disappears naturally.

Allergic shinner is usually more pronounced if children catch a cold while suffering from allergic rhinitis and have both allergic rhinitis and cold, or if they are more tired for some other reason.

The majority of children who have atopic dermatitis, allergic rhinitis, and/ or asthma in the past or present, whether together may have allergic shinner

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Photo: The allergic shinner at the left lower eyelid

Q. My 9-month-old son coughs mainly at night. And for a few weeks, he runs a yellowish runny nose. His doctor said that when a child sleeps, a runny nose mucosa can flow into the nasopharyngeal airway in the back of the nasal cavity instead of flowing through the front nostrils and that the runny nose mucosa flows into the pharyngeal airway in the throat and coughs due to the irritation. Is it true?

A. When children with colds, sinusitis, allergic rhinitis, or other upper respiratory tract infections are lying down, runny nose secretions usually flows into the nasopharynx.

If that runny nose secretion irritates his nasopharynx, he may cough.

In this case, it is common to have a mild cough and not to have a severe cough from the chest and usually no phlegm.

Most children with mild asthma may cough a little or no more during the day when they are up around physically active and behaving. But lying down at night can increase cough and make asthma symptoms worse.

There are many misdiagnosed cases of coughing with night-induced asthma at night as coughing with a cold.

You may have a cold, sinusitis, allergic rhinitis, and asthma at the same time, and you may cough mainly at night.

Q. What causes coughing?

A. Common causes of coughing are colds, sinusitis, allergic rhinitis, asthma, pneumonia, croup, and bronchiolitis.

Often, the cause of coughing is not known for certain.

Find out the cause of coughing and treat the cough according to the cause.

Q. Is it true that long-term treatment of asthma with oral systemic corticosteroids can lead to life-threatening systemic side effects?

A. If treated with an oral-systemic corticosteroid within 7 to 10 days duration, systemic side effects may not usually occur, but treatment with an oral-systemic corticosteroid for a long period more than 7 to 10 days or more longer may cause the following side effects such as obesity, growth retardation, cataract, infectious diseases that are critical to life and others.

Systemic side effects can occur from treatment with systemic corticosteroids such as osteoporosis.

Corticosteroids are important anti-inflammatory drugs that are indispensable for the treatment of severe asthma attacks. If oral systemic corticosteroids are used for less than 7 to 10 days, side effects rarely occur and should be used only when necessary according to a doctor’s prescription.

Q. What kind of systemic side effects occur when long-term asthma treatment with inhaled corticosteroid aerosol HFA

A. Side effects may occur, but minor.

It is common to not have a fever when you have asthma due to an asthma attack.

When complications such as cold or other types of viral upper and lower respiratory tract infections, or other viral respiratory infections such as bronchiolitis or bacterial infections such as pneumonia and asthma occur simultaneously, fever due to an infectious disease occurs.

Q. My 13-year-old teenage daughter has moderate persistent asthma. She was prescribed to treat inhaled albuterol HFA by inhaling it into the lower airways every 4 to 6 hours. But she does not know how to inhale albuterol HFA for inhalation. Please explain how to do inhalation therapy correctly.

A. There are many children and adults who are not sure how to treat asthma by inhaling albuterol aerosol HFA for inhalation. Read the instructions carefully before inhaling the aerosol medicine in the HFA canister and treating it. If you don’t know how to use it, learn exactly how to use it from a pharmacist or your doctor.

Before performing inhalation treatment, hold an inhalation aerosol HFA canister near your ear and shake it three times to mix the aerosol medicine in it well.

Listen carefully for the movement of the drug in the suction aerosol HFA canister as it shakes and check if the drug is still in the canister.

While holding the suction aerosol HFA canister mouthpiece at a distance of 1~2cm from your lips

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Photo 248: One kind albuterol inhalation canister

Hold the albuterol inhalation canister such as photo 248, It can be held it about 1~2 cm distance from the upper and lower lips, Push down the canister to make the medicine inside the canister to come out thru the suction hole. Patients must inhale the medicine from an aerosol HFA canister thru the suction hole where the medicine comes out.

When the medicine in the suction aerosol HFA canister is sucked through the mouth and into the lower airways.

When operating the suction aerosol HFA canister as shown in photo 248, the inhalation aerosol HFA should be immediately inhaled into the lower respiratory tract. The ejected inhalation aerosol HFA from the inhalation aerosol HFA canister runs at a speed of 70 to 80 miles per hour.

When inhaling one dose each time, inhale once, and after 1 to 2 minutes, inhale 2 to 3 times. At this time, the time of activating the inhalation aerosol HFA canister by hand pressing and the time of inhaling into the airway must match.

As prescribed, dividing the amount of one serving two to three times and inhaling it, rinse your mouth with plain water.

As prescribed, inhale treatment every 4-6 hours or 3-4 times a day.

Prior to inhalation therapy, frequently check the inhalation hole(the suction hole) of the inhalation aerosol HFA canister from which the inhalation aerosol HFA drug is released. If the hole is clogged, the aerosol for inhalation in the HFA canister does not come out easily. If the hole seems to be clogged, it should be washed out with warm running water. (For reference, one hole is in the canister and the other hole is in the canister.)

Because of this complicated use, inhaled albuterol aerosol HFA treatment is sometimes not possible.

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Photo 248. She is going to inhale of inhaled albuterol aerosol HFA.

Q. Can inhalation medications come out of the mouth and nostrils, such as when cigarette smoke comes out of the mouth or nose when inhaled into the airways as prescribed for inhaled albuterol aerosol HFA? Even if you inhale as directed by your doctor. Can I inhale in other ways when receiving treatment using HFA for suction aerosol in the canister?

A. After inserting the albuterol aerosol HFA canister for inhalation into the “Inhalation Device (Suction Chamber)

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Photo 251., Inhalation Device (Suction Chamber)

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Photo 251. Inhalation Device (Suction Chamber) with Ventolin inhalation

aerosol HFA canister

Asthma can be treated by inserting the canister contained in the inhaled albuterol aerosol HFA into the inhalation aero chamber and inhaling the inhalation drug contained in the inhalation aerosol HFA canister through a mouthpiece attached to the Suction Chamber instrument.

Some adults and most children under 12 years of age have inhaled albuterol aerosol HFA as prescribed.

Even if I try to properly inhale albuterol aerosol HFA as prescribed,

I cannot properly inhale the aerosol medicine from the albuterol aerosol HFA canister for inhalation aerosol.

Before starting treatment with inhalation aerosol HFA, learn from a doctor or pharmacist how to properly inhale and treat, then start inhalation therapy with inhalation aerosol HFA, or insert only the inhalation aerosol HFA canister into the inhalation aero chamber(Suction Chamber) and then inhalation albuterol. Asthma can be treated by inhaling aerosol HFA with Suction Chamber.

If these two methods cannot be used for inhalation treatment, asthma can be treated with nebulizer spray instead of inhaled aerosol HFA, or syrup asthma medicine, or regular asthma medicine.

Q. My 7-year-old son coughed, wheezing, and laboring breathed for a few days starting 3 months ago. Then he coughed almost the same and took him to the hospital, and he was diagnosed with asthma.

When he was treated with prescribed asthma medication, all of those symptoms disappeared. Two months later, he had an asthma attack again for several days, almost the same as before. When running around or running fast at home or at school, he coughed, had shortness of breath, and had a sore chest. Is there anything wrong with his heart?

A. He seemed to have intermittent asthma and exercise-induced asthma. A severe acute asthma attack can be triggered, causing symptoms such as coughing, shortness of breath, and wheezing when he has asthma. When he has intermittent asthma, he may not have any symptoms such as difficulty breathing or wheezing intermittently.

They may be coughing a little and a little sore when they breathe in one or both chests.

The chest pain may be caused by a heart abnormality, but it is very rare for children and adolescents.

If he has a history of asthma with cough, chest pain during physical exercise, the symptoms disappear when he stoped physical exercising, and physical exercise-induced asthma hurts your chest.

If there is no heart abnormality after a medical examination and if they are diagnosed with asthma pain, it is common for symptoms of asthma such as chest pain and cough to disappear after treatment with inhaled beta 2 agonist aerosol HFA.

If an asthma attack recurs when exercising afterward, the symptoms may reappear.

If you do a preventive treatment before starting exercise and start exercising, you will no longer develop exercise-induced asthma.

Q. My 6-year-old daughter was diagnosed with intermittent asthma two weeks ago. A neighbor girl was taken to the hospital emergency room whenever an acute asthma attack was triggered. I’m worried that my daughter will suffer from such severe asthma.

A. Of course, it can.

Asthma is divided into intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma as mentioned before.

There is no easy and sure way to know what kind of asthma attack your child will have and how badly your child will get sick or how long she will continue to get sick after an asthma attack is triggered.

Intermittent asthma is the most common type of asthma.

The girl next door seems to have had a moderate or persistent asthma attack.

Most children with a history of asthma who have had an intermittent asthma attack in the past will usually suffer from asthma attacks that have been triggered to about the same extent as they had in the past when the next asthma attack was triggered.

Your child is more likely to have asthma in the future by triggering an intermittent asthma attack in the future.

Q. My 13-year-old son has a history of mild persistent asthma three years ago. He has been coughing intermittently day and night in the last few days and not spitting out phlegm. When studying for a school test, he coughs more severely. He may breathe normally, and doesn’t produce a fever.

All physical examination could be normal, could my child have mild nocturnal asthma or does he cough because nervous?

A. Anxiety or stress can trigger an asthma attack.

Most of the adolescent children can be stressed by problems with the opposite sex, problems with adolescent children between their peers, school problems, future problems, and personal problems.

Some children are more stressed and more stressed than others, Stress may cause frequent asthma attacks and stress can lead to frequent asthma.

He probably has asthma from a mild, persistent asthma attack triggered by stress.

Q. Why does he have trouble breathing when he has asthma?

A. Difficulty breathing in asthma attack usually occurs, but not all the time.

When an asthma attack is triggered and he has asthma, his airways become a contract and become to be narrow.

Different types of asthma have different degrees of airway contraction.

When an asthma attack occurs, the airways such as the bronchi and bronchioles are abnormally contracted and narrowed, the airways become inflamed, and the mucous membrane layer of the airways wall is swollen.

In addition, mucus is secreted from the mucous membrane into the airways, and when mucus fills the airways, the airways become narrower or partially blocked.

When the airway becomes abnormally narrow due to asthma, the inhaled air passes through the narrowed airway and is not sufficiently inhaled into the alveoli, and carbon dioxide generated in the body passes through the inside of the alveoli, passes through the narrowed airway, and exits the body normally into the air.

Because of that, he has to breathe more often than usual and asthma can cause shortness of breath.

In other words, the air inhaled through the mouth and nasal cavity → the pharyngeal cavity → the larynx → the trachea → pass through the bronchi and bronchioles and enters the alveoli in the lung. The co2 with exhale air from the body metabolism will pass thru alveoli in the lungs → going out of the narrowed airways→ bronchioles -> the bronchi -> the trachea -> the larynx -> the pharyngeal cavity -> and then through the nose (nasal cavity) and the mouth occurs with each breath.

When an asthma attack is triggered and asthma occurs, the lower respiratory tract airway(the larynx, trachea, bronchi, and bronchi, etc.) is narrowed, making it difficult to breathe in and out often in breathing difficulties.

During mild intermittent asthma, the airways may contract a little, resulting in little or no breathing difficulties.

Q. What is wheezing and what is a stridor sound?

A.When air in the alveoli comes out of the nasal cavity and oral cavity violently through the lower respiratory tract, such as constricted bronchioles, bronchi, and trachea for any reason, the breathing sound may be abnormal something like a lower whistle sound.

That abnormal breathing sound is called wheezing.

Wheezing from asthma mainly occurs during exhalation.

Parts of the upper respiratory tract, such as the nasal and pharyngeal cavity can be narrowed due to allergic rhinitis and others.

When parts of the upper respiratory tract, such as the nasal cavity and pharyngeal cavity, become narrow, a snoring sound may be heard in sleeping, and when a part of the larynx is partially blocked, a rattling sound of inspiratory breathing, like the sound of a dog barking, stridor sounds may occur.

If the bronchi and bronchioles are narrowed due to asthma, exaltation wheezing, such as a mild wheezing sound or a fine whistling sound, may occur.

Most of the wheezing sound is about the same size on both sides of the chests, but sometimes it can only be heard on one chest only.

Wheezing is so loud that the person next to you can hear it with their bare ears, and sometimes it is so small that it can only be heard when a doctor listens carefully with a stethoscope.

Sometimes, exaltation wheezing can occur only when breathing hard, such as when exercising.

When wheezing occurs, it is common to have difficulty breathing.

Q. A 16-year-old daughter coughs quickly, sak-sack sounds breathes(called wheezing) when she smells bad odor such as perfumes, other types of cosmetics, or chemicals.

Why?

A. When she inhales or smells organic or inorganic chemicals, automobile fumes, perfumes, or cigarette smoke, her airways can contract and cause asthma attacks.

Eye allergies and nose allergies may also occur in asthmatic patients.

The smell of cosmetics, such as perfume, seems to have triggered an acute asthma attack.

Q. Every time my 12-year-old son runs or does heavy physical exertion, he is experiences shortness of breath, coughing, and tingling in the throat. Sometimes he said that the right chest hurts a lot. Why?

A. I have had almost the same questions and answers before.

It is normal for anyone to have some shortness of breath when just running or doing heavy physical exercise.

When children with a history of asthma in the past or present run or do other physical exercises, whether the exercise triggers an asthma attack, mild-lasting asthma they already have may get worse.

Chest pain can also occur when there is any other disease of the pectoral muscles, ribs, nerves, the wall of the chest, or the diaphragm.

Atelectasis of the lung, pneumothorax, pneumonia, pleural abnormalities, or heart disease can also cause chest pain.

However, asthma is the most common cause of chest pain in children and adolescents.

Asthma can cause chest pain when the airways are constricted.

Rarely, chest pain may occur due to complications such as atelectasis and pneumothorax that occur in asthma attacks, and chest pain may occur as a complication of asthma.

When you have asthma, you may have atelectasis or pneumothorax, which may cause you to breathe harder and your chest to hurt more.

My 11-year-old son eats well, sleeps well, and seems to be generally healthy. There is no other reason, but he may complain of fatigue several times a day.

He had a general physical examination at the pediatric office, but there is nothing wrong with it, and there is an allergy shinner. He was also diagnosed with mild allergic rhinitis and mild persistent asthma. It is said that fatigue is caused by such diseases. Why is that?

A. With asthma, his airways contract and he cannot breathe normally.

So he cannot get enough oxygen from the inhalation of air.

And the carbon dioxide produced in the body cannot be pumped out of the body normally.

With allergic rhinitis, the nasal airway narrows, so he cannot get enough oxygen through the narrowed nasal cavity due to rhinitis.

The majority of children with atopic predisposition develop tension fatigue syndrome and may feel more fatigued, and will be less fatigued with proper treatment of asthma and allergic rhinitis.

Q. Hands trembling when taking albuterol syrup or pills. Are the shakings because of something wrong with his brain?

A. When treating asthma with oral albuterol syrup or pills, or when treating asthma with inhaled albuterol aerosol HFA, their hands may shake a little and the heart may beat a little faster.

Such side effects usually occur temporarily and then disappear when the pharmacological action of the therapeutic drug disappears.

It is common to no longer have such side effects after several days of continued use.

If you experience such side effects, first consult your doctor.

If you have a slight hand tremor without any other abnormalities, it is okay to continue treatment with the drug.

When you have treatment for asthma with an inhaled albuterol aerosol HFA or albuterol spray, or oral albuterol tablets or syrup, severe side effects may not occurred usually.

Q. Can breastfeed a baby significantly reduce the rate of incidence of bronchial asthma attacks in babies and prevent bronchial asthma attacks?

A.That’s right.

It is said that the incidence of bronchial asthma attacks in children and adolescents raised by breastfeeding during infants has been significantly reduced, and the incidence of bronchial asthma attacks is significantly reduced, and the incidence of asthma attacks can be reliably prevented.

Q. Is it safe to treat asthma repeatedly with short-term oral corticosteroids as prescribed by a doctor?

A. As a result of a comparative study of bone density, bone metabolism, and adrenal function of children who repeatedly received asthma treatment with short-term oral corticosteroids and children who did not receive corticosteroid treatment in that way, even if they received repeated treatment with short-term oral corticosteroids and It was concluded that it was safe.

Side effects may vary depending on the severity and frequency of use to treat asthma.

Q. Can eating some fruit and some kind of fish reduce the incidence of bronchial asthma in children?

A.That’s right.

A Bulgarian scientist studied 20,000 children aged 7-11 years old and found that eating enough fruit foods and fish significantly reduced the chances of developing childhood asthma, chronic cough, and wheezing.

Children who ate smaller amounts of fish, fruits, and vegetables were reported to have more respiratory symptoms such as cough and asthma than children who ate more.

Omega-3 fatty acids in fish oil have anti-inflammatory properties,

Prevents oxidation in the body, such as vitamins, minerals, and fiber, which are abundant in vegetables and fruits, It supplies energy to fight and win bacteria and viruses, removes toxins produced in the body, Boosts immune function,

Makes the endothelial cells of the walls of each organ in each system strong to prevent bronchial asthma.

It is said to reduce respiratory problems.

Inadequate consumption of fish-like foods is said to lead to more chronic cough, wheezing, recurrent wheezing, and winter coughing.

Q. How many percent of children with chronic sinusitis (sinusitis) can have bronchial asthma.

A. It is 30-50%.

Q. How many percent of asthma patients are treated by a regular pediatrician.

A. Almost all children with asthma receive primary treatment for asthma from regular pediatricians.

Q. What kind of disease is asthma?

A.There is a problem with air entering and exiting the airways,

The airway is narrowing,

A lower respiratory tract disease with inflammation of the airway wall is called asthma.

Asthma is called a variable disease.

Q. What pathological changes occur when you have asthma?

The lower tract contracts

The airways wall is swollen

The airway wall is inflamed.

Mucus is secreted from the mucous membrane walls.

The smooth muscle of the airway wall is over-formed and enlarged.

The epidermis of the airway mucosa layer is peeled off.

In severe cases, hypoxemia occurs.

Carbon monoxidemia can develop.

Q. Is asthma usually treated with antibiotics?

A. When treating asthma without bacterial infectious complications, it is not usually treated with antibiotics.

However, a recent study showed that antibiotic treatment for acute recurrent asthma without bacterial infection has a good therapeutic effect.

Recently, the results of comparing the treatment effect of acute recurring asthma with appropriate asthma medications and Telithromycin antibiotics were compared with appropriate asthma medications without antibiotics.

The study found that treatment with appropriate asthma medications and Telithromycin antibiotics gave better treatment.

Other studies have shown that mycoplasma infection can trigger asthma attacks.

Q. What are bronchial asthma and other diseases that need to be differentially diagnosed?

A. yes, especially with following diseases such as allergic rhinitis, sinusitis, common cold, flu, bronchiolitis, croup, vocal cord insufficiency, anaphylactic reaction, acute bronchitis, chronic bronchitis, pneumonia, airway foreign body, gastroesophageal reflux, food allergy, bee allergy, nervous cough, etc.