BOOK
Asthma: Screening, Diagnosis, Management, An Issue of Otolaryngologic Clinics of North America, E-Book
(2014)
Additional Information
Book Details
Abstract
Asthma as seen by Otolaryngologists as part of the patient workup, diagnosis, and treatment of the spectrum of disorders of asthma is presented. Otolaryngologists are frequently the de facto allergy specialist for patients presenting with asthma. ENT physicians will find current information for Data gathering and Interpretation (screening and testing), Diagnosis, combined surgical and non-surgical Treatment, and Basic Science related to Asthma in this publication.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Asthma: Screening,Diagnosis, and Management | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Otolaryngologic Clinics\rOf North America\r | xi | ||
| Preface\r | xiii | ||
| Why Otolaryngologists and Asthma Are a Good Match | 1 | ||
| Key points | 1 | ||
| Introduction | 1 | ||
| AR and asthma defined | 2 | ||
| Epidemiology | 2 | ||
| Asthma-Rhinitis Link | 2 | ||
| Genetics | 3 | ||
| Geography | 3 | ||
| Disease Severity | 4 | ||
| Environmental Factors Beyond Allergens | 4 | ||
| Pathophysiology | 4 | ||
| Inflammatory Response | 5 | ||
| Autonomic Response | 5 | ||
| Histopathology | 5 | ||
| Asthma and atopy | 6 | ||
| Diagnosis | 6 | ||
| Treatment | 7 | ||
| Summary | 8 | ||
| References | 8 | ||
| What is Asthma? Pathophysiology, Demographics, and Health Care Costs | 13 | ||
| Key points | 13 | ||
| What is asthma? | 13 | ||
| Diagnosis | 14 | ||
| The Unified Airway, Asthma, and the Otolaryngologist | 15 | ||
| Pathophysiology | 15 | ||
| Inflammation and Airway Remodeling | 15 | ||
| Bronchoconstriction and Airway Hyperresponsiveness | 16 | ||
| Genetics of Asthma | 16 | ||
| Risk Factors for Asthma | 17 | ||
| Demographics and epidemiology | 17 | ||
| Prevalence Internationally | 17 | ||
| Prevalence in the United States | 18 | ||
| Costs | 18 | ||
| Summary | 19 | ||
| References | 19 | ||
| Asthma | 23 | ||
| Key points | 23 | ||
| Overview | 23 | ||
| Symptoms | 23 | ||
| Wheezing | 24 | ||
| Cough and Mucus Production | 25 | ||
| Chest Tightness | 25 | ||
| Dyspnea | 25 | ||
| History Taking | 25 | ||
| Asthma by age group | 26 | ||
| Infants/Preschoolers | 26 | ||
| Elderly | 27 | ||
| Differential diagnoses | 27 | ||
| Neonates and Children | 27 | ||
| Adults | 28 | ||
| Classification of acute asthma exacerbations | 28 | ||
| Mild | 28 | ||
| Moderately Severe | 28 | ||
| Severe | 28 | ||
| Imminent Respiratory Arrest | 29 | ||
| Physical examination | 29 | ||
| Risk factors | 30 | ||
| Summary | 30 | ||
| References | 30 | ||
| Asthma Diagnosis in Otolaryngology Practice | 33 | ||
| Key points | 33 | ||
| Peak flow measurement | 33 | ||
| Pulmonary function testing | 34 | ||
| Spirometry | 34 | ||
| Bronchoprovocation | 36 | ||
| Diffusing Capacity | 37 | ||
| Lung Volume | 37 | ||
| Summary | 37 | ||
| Reference | 37 | ||
| Interpreting Spirometry | 39 | ||
| Key points | 39 | ||
| Introduction | 39 | ||
| Indications: who should be tested? | 40 | ||
| Spirometry measurements | 40 | ||
| Graphic representation of data | 41 | ||
| Flow-Volume Loops | 41 | ||
| Volume-Time Graph | 46 | ||
| Equipment | 46 | ||
| Quality Control/Calibration | 47 | ||
| Patient Participation/Contraindications | 47 | ||
| Procedure | 49 | ||
| Patient Data Entry/“Normative” Data | 49 | ||
| Office Personnel/Patient Instruction/Encouragement | 49 | ||
| Test Adequacy | 49 | ||
| Interpretation | 50 | ||
| Postbronchodilator Spirometry | 50 | ||
| Bronchoprovocation Challenge | 52 | ||
| Summary | 52 | ||
| References | 52 | ||
| Asthma Pharmacotherapy | 55 | ||
| Key points | 55 | ||
| Introduction | 55 | ||
| Beta-2 agonists | 55 | ||
| Short-Acting Beta-2 Agonists | 55 | ||
| Long-Acting Beta-2 Agonists | 56 | ||
| Anticholinergics | 57 | ||
| Corticosteroids | 57 | ||
| ICS | 58 | ||
| Oral Corticosteroids | 59 | ||
| Leukotriene modifiers | 60 | ||
| Theophylline | 60 | ||
| Mast cell stabilizers | 60 | ||
| Anti–immunoglobulin E therapy | 61 | ||
| Specific immunotherapy | 61 | ||
| Future therapy | 62 | ||
| Summary | 62 | ||
| References | 62 | ||
| Stepwise Treatment of Asthma | 65 | ||
| Key points | 65 | ||
| Critical changes in the third revision | 67 | ||
| Stepping through the process of stepwise care | 71 | ||
| The Asthma Diagnosis | 71 | ||
| Summary | 75 | ||
| References | 75 | ||
| Bronchial Thermoplasty | 77 | ||
| Key points | 77 | ||
| Introduction | 77 | ||
| Severe asthma | 77 | ||
| Pathophysiology | 78 | ||
| Results and efficacy | 79 | ||
| Preclinical Studies | 79 | ||
| Human Studies | 79 | ||
| Lung cancer, no asthma | 79 | ||
| Mild to moderate asthma | 79 | ||
| Technique | 82 | ||
| Practical applications | 83 | ||
| Patient Selection | 83 | ||
| Follow-Up | 84 | ||
| Potential Safety Concerns | 84 | ||
| Summary | 85 | ||
| Supplementary data | 85 | ||
| References | 85 | ||
| The Role of Fractional Exhaled Nitric Oxide in Asthma Management | 87 | ||
| Key points | 87 | ||
| FeNO: Why should I care? | 87 | ||
| What is FeNO? | 87 | ||
| What else affects FeNO measurement? | 90 | ||
| What other diseases affect FeNO? | 90 | ||
| How good is FeNO as a screen for asthma? | 90 | ||
| Can FeNO assist in choosing appropriate medications? | 92 | ||
| Is FeNO useful for assessing patient compliance and control? | 92 | ||
| Can following FeNO anticipate exacerbations and help prevent them? | 93 | ||
| Bottom line | 93 | ||
| References | 94 | ||
| Should Vitamin D Supplementation Be a Regular Part of Asthma Care? | 97 | ||
| Key points | 97 | ||
| Introduction | 97 | ||
| Calcitriol | 97 | ||
| Illnesses associated with calcitriol deficiency | 98 | ||
| Measuring vitamin D | 99 | ||
| Vitamin D affects immune function | 99 | ||
| Genetic control of vitamin D levels and the relation to asthma | 100 | ||
| Concomitant effects of vitamin D and calcium | 100 | ||
| Vitamin D effects on allergy and asthma | 100 | ||
| Vitamin D effects on immunotherapy and tolerogenesis | 101 | ||
| Vitamin D effects on inflammation and bronchial remodeling | 102 | ||
| Evidence of safety and efficacy of vitamin D supplements | 102 | ||
| Summary | 104 | ||
| Acknowledgments | 105 | ||
| References | 105 | ||
| Identifying Asthma Triggers | 109 | ||
| Key points | 109 | ||
| Introduction | 109 | ||
| Inhalant triggers | 109 | ||
| Inhalant allergy | 111 | ||
| Viral triggers | 111 | ||
| GERD or LPR | 112 | ||
| Medication triggers and aspirin-exacerbated respiratory disease | 112 | ||
| Paradoxic vocal fold dysfunction | 114 | ||
| Emotional triggers | 114 | ||
| Obesity | 115 | ||
| Rhinosinusitis | 115 | ||
| Summary | 115 | ||
| References | 115 | ||
| Exercise-induced Bronchoconstriction | 119 | ||
| Key points | 119 | ||
| Introduction | 119 | ||
| Diagnosis | 120 | ||
| Pharmacologic therapy | 123 | ||
| Nonpharmacologic therapy | 123 | ||
| Summary | 124 | ||
| References | 124 | ||
| Patient Education and Designing an Asthma Action Plan | 127 | ||
| Key points | 127 | ||
| Introduction | 127 | ||
| The oto-allergy clinic asthma assessment | 128 | ||
| Asking the right questions | 128 | ||
| The asthma control test | 129 | ||
| Using fractional exhaled nitric oxide | 130 | ||
| Peak expiratory flow | 130 | ||
| Spirometry | 130 | ||
| Asthma trigger avoidance education | 131 | ||
| Patient education folders | 133 | ||
| Customized asthma symptom and medication use tracking sheets | 133 | ||
| Further readings | 134 | ||
| Paradoxic Vocal Fold Movement Disorder | 135 | ||
| Key points | 135 | ||
| Introduction | 135 | ||
| Nature of the problem | 135 | ||
| Terminology | 137 | ||
| Epidemiology | 137 | ||
| Diagnosis and clinical findings: history | 138 | ||
| Diagnosis and clinical findings: physical examination | 138 | ||
| Diagnosis and clinical findings: diagnostic modalities | 139 | ||
| Management goals | 141 | ||
| Treatment: LCT with a speech language pathologist | 141 | ||
| Treatment: addressing underlying psychiatric issues | 142 | ||
| Treatment: elite athletes | 142 | ||
| Treatment: investigational therapies | 142 | ||
| Treatment: comorbid conditions | 142 | ||
| Treatment: self-management strategies | 143 | ||
| Treatment: recurrence | 143 | ||
| Summary | 143 | ||
| References | 143 | ||
| Other Asthma Considerations | 147 | ||
| Key points | 147 | ||
| Introduction | 147 | ||
| Aspirin-exacerbated respiratory disease | 149 | ||
| Foreign-body aspiration | 150 | ||
| Cough variant asthma or nonasthmatic eosinophilic bronchitis | 150 | ||
| Work-related asthma | 151 | ||
| HP | 153 | ||
| Churg-Strauss syndrome | 155 | ||
| Allergic bronchopulmonary aspergillosis | 157 | ||
| Summary | 158 | ||
| References | 158 | ||
| Index | 161 |