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Management of Asthma in Adults
Asthma is a common, non-communicable, and variable chronic disease that can cause episodic or persistent respiratory symptoms (such as shortness of breath, wheezing, chest tightness, and cough), as well as airflow limitation, the latter of which is brought on by bronchoconstriction, airway wall thickening, and increased mucus. It affects as many as 235 million people worldwide and is frequently misdiagnosed and undertreated, especially in low- and middle-income nations. Asthma is a chronic condition that requires continuing, comprehensive care aimed at reducing symptom burden (i.e., excellent symptom management while maintaining normal activity levels) and reducing the probability of adverse events such exacerbations, fixed airflow restriction, and side effects from therapy.
About the Speaker
Dr. Sherif Fayed
MBchB, Msc, MD, PhD, FRCP(Glasg), FCCP Internal Medicine, Pulmonary Consultant
Pulmonary Edema: Case presentation
Pulmonary edema is a medical condition characterized by the accumulation of fluid in the lungs. It can be a life-threatening condition and requires prompt medical attention. It is often caused by an underlying medical condition or as a result of heart failure. When pulmonary edema occurs, the lungs become filled with fluid, making it difficult to breathe. The excess fluid in the lungs interferes with the exchange of oxygen and carbon dioxide, leading to respiratory distress. Acute pulmonary edema can develop rapidly and requires immediate medical intervention. The most common cause of pulmonary edema is congestive heart failure, where the heart is unable to pump blood effectively. Other causes include kidney failure, pneumonia, exposure to high altitudes, and certain medications. Pulmonary edema can also be a complication of a heart attack or a heart valve disorder. The symptoms of pulmonary edema include shortness of breath, rapid breathing, coughing, wheezing, and chest pain. In severe cases, the patient may experience a frothy pink sputum and have a bluish tint to the lips and skin due to inadequate oxygenation. Diagnosis of pulmonary edema is typically done through a combination of physical examination, medical history review, and imaging tests such as chest X-ray or echocardiography. Treatment of pulmonary edema aims to remove the excess fluid from the lungs and address the underlying cause.
Pulmonary Hypertension: A Case-Based Approach
Pulmonary hypertension is a progressive and debilitating condition characterized by elevated blood pressure in the pulmonary arteries, leading to impaired functioning of the heart and lungs. This case-based approach focuses on individual patient scenarios to understand the diverse causes, clinical presentations, and management strategies for pulmonary hypertension. Diagnostic tools such as echocardiography, right heart catheterization, and pulmonary function tests play crucial roles in establishing the diagnosis and determining the severity of pulmonary hypertension. Regular follow-up and monitoring of patients are essential to evaluate treatment response, adjust therapy if needed, and address potential complications associated with pulmonary hypertension. Supportive care, including exercise training, supplemental oxygen, and psychological support, plays a crucial role in improving quality of life for patients with pulmonary hypertension. Case discussions also focus on the multidisciplinary approach involving pulmonologists, cardiologists, rheumatologists, obstetricians, and other specialists to provide comprehensive care for patients with pulmonary hypertension. Treatment approaches for pulmonary hypertension include vasodilator therapy, diuretics, anticoagulation, and in advanced cases, lung transplantation. Case-based management involves tailoring treatment to the specific underlying cause, assessing disease severity, and considering individual patient factors such as age, comorbidities, and response to therapy. Research and advancements in the understanding of pulmonary hypertension have led to the development of targeted therapies, such as endothelin receptor antagonists, phosphodiesterase-5 inhibitors, and prostacyclin analogs, offering new treatment options.
Beyond Breathless: Innovative Approaches to PAH Management
Pulmonary arterial hypertension (PAH) is a progressive and debilitating disease that affects the arteries in the lungs, leading to increased pulmonary arterial pressure and right heart failure. Despite significant advances in the management of PAH in recent years, it remains a challenging disease to treat, and many patients continue to experience significant symptoms and reduced quality of life. However, there are several innovative approaches to PAH management that are currently being explored and show promise in improving outcomes for patients. One such approach is the use of combination therapy. While single-agent therapy has traditionally been the first-line treatment for PAH, recent studies have shown that combining different classes of drugs can lead to better outcomes. For example, combining an endothelin receptor antagonist with a phosphodiesterase type 5 inhibitor has been shown to improve exercise capacity and reduce clinical worsening in patients with PAH. Another promising approach is the use of novel drugs that target specific pathways involved in the development of PAH. For example, selexipag, a prostacyclin receptor agonist, has been shown to improve exercise capacity and reduce hospitalization rates in patients with PAH. Similarly, macitentan, a dual endothelin receptor antagonist, has been shown to improve exercise capacity and reduce clinical worsening in patients with PAH.
Pulmonary embolism occurs when a blood clot or other substance travels through the bloodstream and becomes lodged in the pulmonary arteries, which supply blood to the lungs. The most common cause is deep vein thrombosis (DVT), a condition in which blood clots form in the veins of the legs or other parts of the body and travel to the lungs. Symptoms can vary depending on the size and location of the clot, but may include chest pain, shortness of breath, coughing, and rapid heartbeat. Risk factors include immobility, surgery or trauma, pregnancy, cancer, obesity, smoking, and taking certain medications like birth control pills or hormone replacement therapy. Diagnostic tests may include a chest x-ray, CT scan, ultrasound, or blood tests. Treatment of PE typically involves anticoagulant medications to prevent further clots from forming and possibly thrombolytic medications to dissolve existing clots. In some cases, surgical intervention may be necessary to remove a clot or repair damage to the lungs. Prevention of Pulmonary embolism involves measures such as maintaining a healthy weight, staying physically active, quitting smoking, and taking anticoagulant medications as prescribed.
“Yes! We can end TB! World Tuberculosis Day “
Tuberculosis is a leading cause of death worldwide, with an estimated 1.5 million deaths in 2020, and is particularly prevalent in low- and middle-income countries. The DOTS (Directly Observed Treatment, Short-Course) regimen is the recommended treatment for tuberculosis (TB) by the World Health Organization (WHO). It is a six-month course of four first-line drugs: Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide. The DOTS regimen is also cost-effective and feasible to implement in resource-limited settings, making it a critical component of global efforts to end TB.