SlideShare une entreprise Scribd logo
1  sur  74
Télécharger pour lire hors ligne
*Does this child get
Asthma?
*A ,10 mon old male infant present with coryza ,
,cough , shortness of breath and poor feeding
*O/E he had :
Tachypnea and tachycardia
Hyperinflated chest
Intercostal and subcostal recession
Wheeze and crepitations
Pallor
*Chest X-ray showed:
Hyperinflation
Patchy collapse
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
2
*E ,2 year old female child present with:
Recurrent chest infections
Not put much weight since she was born
Frothy cough especially at night
Shortness of breath and poor feeding
Bulky , greasy ,difficult -to-flush stools
Malnutrition
*O/E she had :
Failure to thrive
Wheeze and crepitations
*Chest X-ray showed:
Hyperinflation & Patchy lesions
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
3
*L ,8 year old girl gives a 6- month history of a
progressive cough .
* In the past she had dry cough lasted several weeks
after each cold .
*A tentative diagnosis of asthma has been made and
stepping up anti-asthma therapy along with oral
antibiotics with eventual improvement of each
coughing episodes.
*She was hospitalized for acute pneumonia on
several occasions to give I.V. antibiotics
*Her present cough is productive of purulent
phlegm
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
4
*N ,a 4 year old boy who has been referred by his
GP.
*He has suffered frequent wheezing episodes in
winter associated with cold
*He get day-to day symptoms of cough and he is
breathless with exercise
*Last month he was up all night wheezing after
having “pillow fight” with his sister
*His mother has hay fever ,and his older sister had
frequent wheezing in infancy with eczema
*He has mild eczema
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
5
*
*
*“Asthma is probably overdiagnosed by
a factor of 5 ”
Michael Seear ,MD
pediatrician, respirologist, and instructor with the University of
British Columbia Certificate in International Development, Vancouver
.
Miles Weinberger, MD
professor of pediatrics at the University of Iowa Children’s Hospital, Iowa City,
* Although asthma is at times
overdiagnosed ,it is also at times
underdiagnosed
* Preschool-aged children have the
highest hospitalization rate for
asthma, reporting that 5% to 10% of
all hospitalizations for US children
are for asthma
*Asthmatic aged younger than 5
years has twice the number of
hospitalizations as school-aged
asthmatics and 5 times the number
as teenaged asthmatics.
*“There are other studies that suggest that
patients are being overdiagnosed with
pneumonia, and very often when you look
at those studies, probably a lot of what’s
called pneumonia in young kids is actually
manifestations of asthma,”
Miles Weinberger
*
*A chronic respiratory disease,
often arising from allergies,
that is characterized by sudden
recurring attacks of :
Labored breathing
Chest constriction
Coughing
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
12
*An estimated 25.9 million people,
including almost 7.1 million children,
have asthma
National Health Interview Survey (NHIS) Data, 2011
http://www.cdc.gov/asthma/nhis/2011/data.htm
*
*Asthma prevalence is higher among
persons with family income below the
poverty level
Akinbami, L., et al. Trends in Asthma Prevalence, Health Care Use, and Mortality
in the United States, 2001-2010 http://www.cdc.gov/nchs/data/databriefs/db94.pdf
*Asthma accounts for more than 15
million physician office and hospital
outpatient department visits
National Ambulatory Medical Care Survey: 2010 Summary Tables
http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf
And nearly 2 million emergency department
visits each year
National Hospital Ambulatory Medical Care Survey: 2010 Outpatient Department Summary
Tables http://www.cdc.gov/nchs/data/ahcd/nhamcs_outpatient/2010_opd_web_tables.pdf
National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables
http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf
*An average of 1 out of every 10 school-
aged children have asthma
United States Environmental Protection Agency. Asthma Facts. March
2013. http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf.
*Asthma is the third-ranking cause of
hospitalization in children
United States Environmental Protection Agency. Asthma Facts. March
2013. http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf
*In 2009, 1 in 5 children with asthma
went to the emergency department
CDC. National Center for Environmental Health. Asthma’s Impact on
the Nation: Data from the CDC National Asthma Control Program.
*Boys are more likely to have asthma
than girls
United States Environmental Protection Agency. Asthma Facts. March
2013. http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf.
*
*The annual economic cost of asthma,
including direct medical costs from
hospital stays and indirect costs such as
lost school and work days, amount to
more than $56 billion annually
Centers for Disease Control and Prevention, (May 2011) Asthma in the
U.S. Vital Signs http://www.cdc.gov/vitalsigns/asthma/
Abstract:
About 334 million people worldwide suffer from asthma, and this figure may be an
underestimation. It is the most common chronic disease in children. Asthma is among
the top 20 chronic conditions for global ranking of disability-adjusted life years in children;
in the mid-childhood ages 5–14 years it is among the top 10 causes. Death rates from
asthma in children globally range from 0.0 to 0.7 per 100 000. There are striking global
variations in the prevalence of asthma symptoms (wheeze in the past 12 months) in
children, with up to 13-fold differences between countries. Although asthma symptoms
are more common in many high-income countries (HICs), some low- and middle-income
countries (LMICs) also have high levels of asthma symptom prevalence. The highest
prevalence of symptoms of severe asthma among children with wheeze in the past 12
months is found in LMICs and not HICs. From the 1990s to the 2000s, asthma
symptoms became more common in some high-prevalence centres in HICs; in many
cases, the prevalence stayed the same or even decreased. At the same time, many
LMICs with large populations showed increases in prevalence, suggesting that the
overall world burden is increasing, and that therefore global disparities in asthma
prevalence are decreasing. The costs of asthma, where they have been estimated, are
relatively high. The global burden of asthma in children, including costs, needs ongoing
monitoring using standardised methods.
Asthma is among the top 20 chronic conditions for global
ranking of disability-adjusted life years in children
In the mid-childhood ages 5–14 years it is among the top 10
causes
Int J Tuberc Lung Dis. 2014 Nov;18(11):1269-78. doi: 10.5588/ijtld.14.0170.
Global burden of asthma among children.
Asher I1, Pearce N2.
* *Episodic viral-associated
wheezing
*Classic atopic asthma
*Cough variant asthma
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
23
*Episodic
viral-
associated
wheezing
*Episodes are more frequent
in winter
*Almost always associated
with colds
*Usually completely
asymptomatic between
episodes
*Response to regular anti-
inflammatory therapy is
poor
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
24
*Classic
atopic
asthma
*An Atopic background
(allergies or eczema)
*Positive family history of atopy
and asthma
*Day-to-day symptoms
triggered with exercise or
occurring at night when no cold
*Response well to regular anti-
inflammatory asthma therapy
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
25
*Cough
variant
asthma
*Nocturnal and/or exercise –induced
cough when free from cold
*Wheezing may never been heard
*Personal of family history of other
atopic disorders
*Response rapidly to anti- asthma
therapy
*Symptoms relapse when therapy
withdrawn
6/12/2015
Does this child get Asthma Prof.Dr.Saad S Al
Ani Khorfakkan Hospital
26
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
27
Chronic inflammatory disease of the airways
Airways spasm and swelling
Obstruction to air flow
Wheezing or gasping for air
Resolves spontaneously
Responds to a wide range of treatments
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
28
*
*Continuing inflammation makes the airways
hyper-responsive to stimuli such as:
* Cold air
* Exercise
* Dust mites
* Pollutants in the air
* Stress
*Anxiety
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
29
*
www.giglig.com
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
30
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
31
*
*Asthma is the most common chronic disease of
childhood in industrialized countries
*Boys are more likely than girls to have asthma
*Children with asthma have symptoms of:
 Coughing
 Wheezing
 Shortness of breath or rapid breathing
 Chest tightness
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
32
*Nighttime symptoms are common
*
*Physical examination may show evidence of other
atopic diseases such as eczema or allergic rhinitis
*Many childhood conditions can cause wheezing
and coughing of asthma
*Not all cough and wheeze is asthma
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
33
*
*Asthma can be aggravated by:
 Rhinosinusitis
 Gastroesophageal reflux
 Nonsteroidal anti-inflammatory drugs
(especially aspirin)
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
34
*
*Presentation during acute episodes:
 Tachypnea
 Tachycardia
 Cough
 Wheezing
 Prolonged expiratory phase
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
35
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
36
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
37
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
38
is used to:
 Monitor response to treatment
 Assess degree of reversibility with therapeutic intervention
 Measure the severity of an asthma exacerbation
*
*Children older than 5 years of age can perform
spirometry maneuvers.
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
39
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
40
*
*Repeat chest radiographs are not needed with new
episodes unless:
 There is fever (suggesting pneumonia)
 Localized findings on physical examination
should be performed with:
 The first episode of asthma
 Recurrent episodes of undiagnosed cough or wheeze to exclude
anatomic abnormalities
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
41
*
*In vitro serum tests are generally:
 Less sensitive in defining clinically pertinent
allergens
 More expensive
 Require several days for results compared to
several minutes for skin testing
Such as:
 Radioallergosorbent test ( RAST)
 Fluorescentenzyme immunoassay ( FEIA)
 Enzymelinkedimmunosorbent assay (ELISA)
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
42
*
Positive skin tests results:
*Identifying immediate hypersensitivity to aeroallergens
*Correlate strongly with bronchial allergen provocative
challenges
Should be included in the evaluation of all children with persistent
asthma but not during an exacerbation of wheezing.
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
43
*
*The most common causes of wheezing
in children include:
 Asthma
 Allergies
 Infections
 Gastroesophageal reflux disease
 Obstructive sleep apnea
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
44
*Less common causes include :
Congenital abnormalities
Foreign body aspiration
Cystic fibrosis
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
45
*
*Optimal medical treatment of asthma
includes several key components:
 Environmental control
 Pharmacologic therapy
 Patient education, including
attainment of self-management skills
 Steps to minimize allergen exposure
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
46
*
*Asthma medications can be divided into:
Long-term control medications
Quick-relief medications
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
47
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
48
*
Are:
*The most effective anti-inflammatory
medications for the treatment of chronic,
persistent asthma
*The preferred therapy when initiating
long term control therapy
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
49
*
*Early intervention with inhaled corticosteroids
reduces morbidity but does not alter the natural
history of asthma
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
50
*
*Regular use of inhaled corticosteroids reduces:
 Airway hyperreactivity
 The need for rescue bronchodilator therapy
 Risk of hospitalization
 Risk of death from asthma
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
51
*
*Do not have clinically significant adverse
effects on:
 Hypothalamic-pituitary-adrenal axis function
 Glucose metabolism
 Subcapsular cataracts or glaucoma
When used at low-to-medium doses in children
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
52
*
*Two classes of leukotriene modifiers include :
 Leukotriene receptor antagonists
(zafirlukast and montelukast)
•Leukotriene synthesis inhibitors (zileuton)
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
53
*
*Usefulness of leukotriene :
Modifiers in mild asthma
•Attenuation of exercise-induced
bronchoconstriction
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
54
*
*Long-acting β2-agonists:
Formoterol and Salmeterol, have:
 Twice-daily dosing
 Relax airway smooth muscle for 12hours
*Do not have any significant anti-inflammatory
effects
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
55
*
*Is approved for use in children older than 5
years of age for:
 Maintenance asthma therapy
 Prevention of exercise-induced asthma
*It has a rapid onset of action similar to
albuterol (15 minutes).
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
56
*
 Is approved for children 4 years of age
or older
• Has an onset of 30 minutes
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
57
*
 It is mildly to moderately effective as a
bronchodilator
•Is considered an alternative, add-on
treatment to low- and medium-dose inhaled
corticosteroids
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
58
*
 Humanized anti-IgE monoclonal antibody
that prevents binding of IgE to high-affinity
receptors on basophils and mast cells
 It is approved for moderate to severe allergic
asthma in children 12 years of age and older.
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
59
*
•Xolair is delivered by subcutaneous injection
every 2 to 4 weeks, depending on body
weight and pretreatment serum IgE level
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
60
*
Quick-Relief Medications
Short-Acting β2-
Agonists
Anticholinergic Agent Oral Corticosteroids
6/12/2015
Asthma Prof. Dr. Saad S Al Ani
Khorfakkan Hospital
61
*
*Short-acting β2-agonists, such as albuterol,
levalbuterol, and pirbuterol, are:
 Effective bronchodilators that exert their effect
within 5 to 10 min
 They last for 4 to 6 hours.
*Is prescribed for acute symptoms and as
prophylaxis before allergen exposure and
exercise
6/12/2015
Asthma Prof. Dr. Saad S Al Ani
Khorfakkan Hospital
62
*
*Ipratropium bromide is an anticholinergic
bronchodilator that:
 Relieves bronchoconstriction
 Decreases mucus hypersecretion
 Counteracts cough-receptor irritability
*It seems to have an additive effect with β2-
agonists when used for acute asthma
exacerbations.
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
63
*
* Short bursts of oral corticosteroids (3 to 10
days) are administered to children with
acute exacerbations
*The initial starting dose is 1 to 2 mg/kg/day of
prednisone followed by 1 mg/kg/day over the
next 2 to 5 days
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
64
*
*Prolonged use of oral corticosteroids
Can result in systemic adverse effects such as:
 Hypothalamic- pituitary-adrenal suppression
 Cushingoid features
 Weight gain
 Hypertension
 Diabetes
 Cataracts& glaucoma
 Osteoporosis
•Growth suppression
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
65
*Status asthmaticus
*Is an acute exacerbation of asthma that
does not respond adequately to therapeutic
measures and may require hospitalization
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
66
*
 Significant respiratory distress
 Dyspnea
 Wheezing
 Cough
•Decrease in peak expiratory flow rate
(PEFR)
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
67
*
*During severe episodes of wheezing, pulse
oximetry is helpful in monitoring
oxygenation
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
68
*
*In status asthmaticus, arterial blood gases
may be necessary for measurement of
ventilation
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
69
*
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
70
*
*For children younger than 3 years of age who
are at risk for asthma include:
• Eczema
• Parental asthma
or
• Two of the following:
1.Allergic rhinitis
2.Wheezing with a cold
3.Eosinophilia of greater than 4%
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
71
*Successful education
*Involves:
 Teaching basic asthma facts
 Explaining the role of medications,
 Teaching environmental control measures
• Improving patient skills in the use of
spacer devices for metered dose inhalers and
peak flow monitoring
*Underdiagnosis and undertreatment of asthma in children: a tertiary hospital's
experience
Ioanna Vasilopoulou*, Irene Papakonstantopoulou, Katerina Salavoura, Nikoletta
Laliotou,Athanasios Kaditis and Vasiliki Gemou-Engesaeth
Methods
We studied 82 children (age 2-15y) that were referred to our clinic during 2013-2014 and their history and/or physical
examination revealed a clinical suspicion of asthma, according to GINA. Children were evaluated by personal/family
history, physical examination, skin prick tests to common allergens, total/specific IgE levels. Lung function tests were
carried out where possible. Chest X-ray and sweat test were performed if needed. Children were divided into three
groups: children with asthma diagnosed for first time, children with asthma whose symptoms were uncontrolled and
children with severe/persistent asthma.
Results
32/82 children were diagnosed with asthma for the first time in our Unit and had never received treatment before
despite pediatric follow up. 12/32 came for a reason other than asthma, such as Food Allergy (3), Urticaria (2), Drug
allergy (1), Eczema (1), Allergic Rhinitis (1) and hospitalization due to foreign body aspiration (1). Of the 37/82 children
who already had a diagnosis of asthma, 31 had poorly controlled symptoms despite treatment. Reasons for
uncontrolled asthma in 21/31 were low doses of Inhaled Corticosteroids or intermittent use, 7/31 had improper inhaler
technique and 3/31 had poor adherence to treatment. 9/82 children were referred for severe asthma; 4/9 had improper
inhalation technique. Non-adherence to treatment and co-morbid conditions also contributed to persistent symptoms.
Patients were treated individually. After 6 months, symptoms were well controlled in 67 children. 3 children were well
controlled at the 3 months follow up while 7 children's follow up is pending. 1 child did not return, 1 child followed
alternative therapies and 3 were not compliant to our advice.
Conclusions
Asthma in children is still often underdiagnosed. For correct diagnosis/treatment a detailed clinical history is mandatory
and lung function tests should be performed in children with associated comorbidities such as AR. Studies have shown
that one demonstration of the inhaler technique is not enough. It is essential to educate clinicians, patients and parents
and to promote compliance.
Conclusions
Asthma in children is still often underdiagnosed. For correct
diagnosis/treatment a detailed clinical history is mandatory and lung
function tests should be performed in children with associated
comorbidities such as AR. Studies have shown that one
demonstration of the inhaler technique is not enough. It is essential to
educate clinicians, patients and parents and to promote compliance
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
73
*
* www.uic.edu
* www.scienceopen.com
* faculty.washington.edu
* http://www.aafp.org
6/12/2015
Asthma Prof.Dr. Saad S Al Ani
Khorfakkan Hospital
74
*

Contenu connexe

Tendances

Childhood asthma 2021
Childhood asthma 2021Childhood asthma 2021
Childhood asthma 2021Imran Iqbal
 
Bronchiolitis final 1
Bronchiolitis final 1Bronchiolitis final 1
Bronchiolitis final 1HabibKhan132
 
Day 1 | CME- Trauma Symposium | Bronchiolitis pittenger
Day 1 | CME- Trauma Symposium | Bronchiolitis pittengerDay 1 | CME- Trauma Symposium | Bronchiolitis pittenger
Day 1 | CME- Trauma Symposium | Bronchiolitis pittengerNorton Healthcare
 
Pneumonia in children 2021
Pneumonia in children 2021Pneumonia in children 2021
Pneumonia in children 2021Imran Iqbal
 
Recognizing bronchiolitis in children
Recognizing bronchiolitis in childrenRecognizing bronchiolitis in children
Recognizing bronchiolitis in childrenSmart Medical Buyer
 
Cough management issues in pediatric uri - Dr Gaurav Gupta
Cough management issues in pediatric uri - Dr Gaurav GuptaCough management issues in pediatric uri - Dr Gaurav Gupta
Cough management issues in pediatric uri - Dr Gaurav GuptaGaurav Gupta
 
Acute respiratory Infection & IMNCI
Acute respiratory Infection & IMNCIAcute respiratory Infection & IMNCI
Acute respiratory Infection & IMNCIRishabh Nahar
 
Rsv bronchiolitis ppt
Rsv bronchiolitis pptRsv bronchiolitis ppt
Rsv bronchiolitis pptPediatrics
 
Community acquired pneumonia in children (1)
Community acquired pneumonia in children (1)Community acquired pneumonia in children (1)
Community acquired pneumonia in children (1)Dr. Saad Saleh Al Ani
 
Community Acquired Pneumonia in Children (for undergraduate studens)
Community Acquired Pneumonia in Children (for undergraduate studens)Community Acquired Pneumonia in Children (for undergraduate studens)
Community Acquired Pneumonia in Children (for undergraduate studens)Dr Anand Singh
 
Bronchial asthma in children
Bronchial asthma in childrenBronchial asthma in children
Bronchial asthma in childrenAsnaShareen
 
Childhood Asthma
Childhood AsthmaChildhood Asthma
Childhood AsthmaMansi Tyagi
 
Pneumonia, paediatric perspective
Pneumonia, paediatric perspectivePneumonia, paediatric perspective
Pneumonia, paediatric perspectiveDhan Shrestha
 

Tendances (20)

Childhood asthma 2021
Childhood asthma 2021Childhood asthma 2021
Childhood asthma 2021
 
Bronchiolitis final 1
Bronchiolitis final 1Bronchiolitis final 1
Bronchiolitis final 1
 
Day 1 | CME- Trauma Symposium | Bronchiolitis pittenger
Day 1 | CME- Trauma Symposium | Bronchiolitis pittengerDay 1 | CME- Trauma Symposium | Bronchiolitis pittenger
Day 1 | CME- Trauma Symposium | Bronchiolitis pittenger
 
Pneumonia in children 2021
Pneumonia in children 2021Pneumonia in children 2021
Pneumonia in children 2021
 
Croup
CroupCroup
Croup
 
Recognizing bronchiolitis in children
Recognizing bronchiolitis in childrenRecognizing bronchiolitis in children
Recognizing bronchiolitis in children
 
Cough management issues in pediatric uri - Dr Gaurav Gupta
Cough management issues in pediatric uri - Dr Gaurav GuptaCough management issues in pediatric uri - Dr Gaurav Gupta
Cough management issues in pediatric uri - Dr Gaurav Gupta
 
Acute respiratory Infection & IMNCI
Acute respiratory Infection & IMNCIAcute respiratory Infection & IMNCI
Acute respiratory Infection & IMNCI
 
Rsv bronchiolitis ppt
Rsv bronchiolitis pptRsv bronchiolitis ppt
Rsv bronchiolitis ppt
 
Bronchiolitis
BronchiolitisBronchiolitis
Bronchiolitis
 
Bronchiolitis
BronchiolitisBronchiolitis
Bronchiolitis
 
Pneumonia in peadiatrics
Pneumonia in peadiatricsPneumonia in peadiatrics
Pneumonia in peadiatrics
 
Acute bronchiolitis
Acute  bronchiolitisAcute  bronchiolitis
Acute bronchiolitis
 
Community acquired pneumonia in children (1)
Community acquired pneumonia in children (1)Community acquired pneumonia in children (1)
Community acquired pneumonia in children (1)
 
COMMON COLD IN CHILDREN
COMMON COLD IN CHILDRENCOMMON COLD IN CHILDREN
COMMON COLD IN CHILDREN
 
Community Acquired Pneumonia in Children (for undergraduate studens)
Community Acquired Pneumonia in Children (for undergraduate studens)Community Acquired Pneumonia in Children (for undergraduate studens)
Community Acquired Pneumonia in Children (for undergraduate studens)
 
Bronchial asthma in children
Bronchial asthma in childrenBronchial asthma in children
Bronchial asthma in children
 
Childhood Asthma
Childhood AsthmaChildhood Asthma
Childhood Asthma
 
Bronchiolitis overview
Bronchiolitis   overviewBronchiolitis   overview
Bronchiolitis overview
 
Pneumonia, paediatric perspective
Pneumonia, paediatric perspectivePneumonia, paediatric perspective
Pneumonia, paediatric perspective
 

En vedette (20)

Myocarditis
MyocarditisMyocarditis
Myocarditis
 
Attention Deficit Hyperactice Disorder
Attention Deficit Hyperactice DisorderAttention Deficit Hyperactice Disorder
Attention Deficit Hyperactice Disorder
 
Acute rheumatic fever
Acute rheumatic feverAcute rheumatic fever
Acute rheumatic fever
 
Kawasaki disease
Kawasaki diseaseKawasaki disease
Kawasaki disease
 
Acute Rheumatic Fever in children
Acute Rheumatic Fever in childrenAcute Rheumatic Fever in children
Acute Rheumatic Fever in children
 
ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASEACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
 
upper air way obstruction
upper air way obstruction upper air way obstruction
upper air way obstruction
 
Myocarditis
MyocarditisMyocarditis
Myocarditis
 
Febrile seizures
Febrile seizuresFebrile seizures
Febrile seizures
 
Mushroom &Potato poisoning
Mushroom &Potato poisoningMushroom &Potato poisoning
Mushroom &Potato poisoning
 
Acute Rheumatic Fever
Acute Rheumatic FeverAcute Rheumatic Fever
Acute Rheumatic Fever
 
Infectious diseases in children
Infectious diseases in childrenInfectious diseases in children
Infectious diseases in children
 
Croup
CroupCroup
Croup
 
Acid-Base Balance : Basics
Acid-Base Balance : BasicsAcid-Base Balance : Basics
Acid-Base Balance : Basics
 
Acute rheumatic fever
Acute rheumatic feverAcute rheumatic fever
Acute rheumatic fever
 
Bronchiolitis, croup
Bronchiolitis, croupBronchiolitis, croup
Bronchiolitis, croup
 
croup
croupcroup
croup
 
Myocarditis
MyocarditisMyocarditis
Myocarditis
 
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
 
Effective powerful presentation
Effective powerful presentation Effective powerful presentation
Effective powerful presentation
 

Similaire à Does this child get asthma

How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?
How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?
How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?JackBrown161
 
Respi Endo DIgestive
Respi Endo DIgestiveRespi Endo DIgestive
Respi Endo DIgestiveShelah Lontoc
 
Guides for asthma management and prevention for children 5 and younger(be a g...
Guides for asthma management and prevention for children 5 and younger(be a g...Guides for asthma management and prevention for children 5 and younger(be a g...
Guides for asthma management and prevention for children 5 and younger(be a g...Hussain Okairy
 
Asthma Prevalence in HK Nurture, Not Nature
Asthma Prevalence in HK Nurture, Not NatureAsthma Prevalence in HK Nurture, Not Nature
Asthma Prevalence in HK Nurture, Not Naturepacificprimehk
 
Asthma in child case write-up
Asthma in child case write-upAsthma in child case write-up
Asthma in child case write-upChris Andrew
 
Children with recurrent chest infection
Children with recurrent chest infectionChildren with recurrent chest infection
Children with recurrent chest infectionThorsang Chayovan
 
Cleaning for Allergy and Asthma Control
Cleaning for Allergy and Asthma ControlCleaning for Allergy and Asthma Control
Cleaning for Allergy and Asthma ControlMedicineAndHealth
 
Viêm xoang ở trẻ nhỏ | Venus Global
Viêm xoang ở trẻ nhỏ | Venus GlobalViêm xoang ở trẻ nhỏ | Venus Global
Viêm xoang ở trẻ nhỏ | Venus GlobalVENUS
 
0042_0044_stephenson.pdf
0042_0044_stephenson.pdf0042_0044_stephenson.pdf
0042_0044_stephenson.pdfsheriftaha22
 
Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...
Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...
Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...Brandon_Crum
 
All About Asthma
All About AsthmaAll About Asthma
All About Asthmamelissaax
 
Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...
Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...
Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...ijtsrd
 

Similaire à Does this child get asthma (20)

How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?
How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?
How Harmful is Childhood Asthma- Can it Permanently Damage Your Lungs?
 
Respi Endo DIgestive
Respi Endo DIgestiveRespi Endo DIgestive
Respi Endo DIgestive
 
Guides for asthma management and prevention for children 5 and younger(be a g...
Guides for asthma management and prevention for children 5 and younger(be a g...Guides for asthma management and prevention for children 5 and younger(be a g...
Guides for asthma management and prevention for children 5 and younger(be a g...
 
Pediatric Asthma
Pediatric AsthmaPediatric Asthma
Pediatric Asthma
 
Asma
AsmaAsma
Asma
 
Asthma Prevalence in HK Nurture, Not Nature
Asthma Prevalence in HK Nurture, Not NatureAsthma Prevalence in HK Nurture, Not Nature
Asthma Prevalence in HK Nurture, Not Nature
 
Asthma in child case write-up
Asthma in child case write-upAsthma in child case write-up
Asthma in child case write-up
 
Children with recurrent chest infection
Children with recurrent chest infectionChildren with recurrent chest infection
Children with recurrent chest infection
 
Cleaning for Allergy and Asthma Control
Cleaning for Allergy and Asthma ControlCleaning for Allergy and Asthma Control
Cleaning for Allergy and Asthma Control
 
Viêm xoang ở trẻ nhỏ | Venus Global
Viêm xoang ở trẻ nhỏ | Venus GlobalViêm xoang ở trẻ nhỏ | Venus Global
Viêm xoang ở trẻ nhỏ | Venus Global
 
Asthma Part 1
Asthma Part 1Asthma Part 1
Asthma Part 1
 
What You Need to Know About Asthma
What You Need to Know About AsthmaWhat You Need to Know About Asthma
What You Need to Know About Asthma
 
0042_0044_stephenson.pdf
0042_0044_stephenson.pdf0042_0044_stephenson.pdf
0042_0044_stephenson.pdf
 
Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...
Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...
Significant Exposure to Mold During Infancy may Increase Respiratory Disease ...
 
Acute bronchiolitis ppt
Acute bronchiolitis pptAcute bronchiolitis ppt
Acute bronchiolitis ppt
 
All About Asthma
All About AsthmaAll About Asthma
All About Asthma
 
Association between Bronchial asthma and Allergic Rhinitis: A Cross-sectional...
Association between Bronchial asthma and Allergic Rhinitis: A Cross-sectional...Association between Bronchial asthma and Allergic Rhinitis: A Cross-sectional...
Association between Bronchial asthma and Allergic Rhinitis: A Cross-sectional...
 
Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...
Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...
Homoeopathic Therapeutic Approach and Treatment of Non Communicable Disease B...
 
Asthma, Children and Pesticides
Asthma, Children and PesticidesAsthma, Children and Pesticides
Asthma, Children and Pesticides
 
Pneumonia Pediatric
Pneumonia PediatricPneumonia Pediatric
Pneumonia Pediatric
 

Plus de Dr. Saad Saleh Al Ani

Childhood protein energy malnutrition
Childhood protein energy malnutrition Childhood protein energy malnutrition
Childhood protein energy malnutrition Dr. Saad Saleh Al Ani
 
Erythema infectiosum (fifth disease)
Erythema infectiosum (fifth disease)Erythema infectiosum (fifth disease)
Erythema infectiosum (fifth disease)Dr. Saad Saleh Al Ani
 
An Introduction to childhood Kingella Kingae infections
An Introduction to childhood Kingella Kingae infectionsAn Introduction to childhood Kingella Kingae infections
An Introduction to childhood Kingella Kingae infectionsDr. Saad Saleh Al Ani
 
Nonalcoholic fatty liver disease NAFLD in children
Nonalcoholic fatty liver disease NAFLD in childrenNonalcoholic fatty liver disease NAFLD in children
Nonalcoholic fatty liver disease NAFLD in childrenDr. Saad Saleh Al Ani
 
Food protein induced enterocolitis syndrome (FPIES)
Food protein induced enterocolitis syndrome (FPIES)Food protein induced enterocolitis syndrome (FPIES)
Food protein induced enterocolitis syndrome (FPIES)Dr. Saad Saleh Al Ani
 
High lights on pulmonary tuberculosis
High lights on pulmonary tuberculosisHigh lights on pulmonary tuberculosis
High lights on pulmonary tuberculosisDr. Saad Saleh Al Ani
 

Plus de Dr. Saad Saleh Al Ani (20)

Childhood protein energy malnutrition
Childhood protein energy malnutrition Childhood protein energy malnutrition
Childhood protein energy malnutrition
 
Erythema infectiosum (fifth disease)
Erythema infectiosum (fifth disease)Erythema infectiosum (fifth disease)
Erythema infectiosum (fifth disease)
 
An Introduction to childhood Kingella Kingae infections
An Introduction to childhood Kingella Kingae infectionsAn Introduction to childhood Kingella Kingae infections
An Introduction to childhood Kingella Kingae infections
 
Congenital nephrotic syndrome
Congenital nephrotic syndrome   Congenital nephrotic syndrome
Congenital nephrotic syndrome
 
Nonalcoholic fatty liver disease NAFLD in children
Nonalcoholic fatty liver disease NAFLD in childrenNonalcoholic fatty liver disease NAFLD in children
Nonalcoholic fatty liver disease NAFLD in children
 
Neonatal listeriosis
Neonatal listeriosisNeonatal listeriosis
Neonatal listeriosis
 
Achondroplasia
AchondroplasiaAchondroplasia
Achondroplasia
 
Neonatal sepsis
Neonatal sepsisNeonatal sepsis
Neonatal sepsis
 
Bronchiolitis
BronchiolitisBronchiolitis
Bronchiolitis
 
Electrical burns in children
Electrical burns in childrenElectrical burns in children
Electrical burns in children
 
Food protein induced enterocolitis syndrome (FPIES)
Food protein induced enterocolitis syndrome (FPIES)Food protein induced enterocolitis syndrome (FPIES)
Food protein induced enterocolitis syndrome (FPIES)
 
High lights on pulmonary tuberculosis
High lights on pulmonary tuberculosisHigh lights on pulmonary tuberculosis
High lights on pulmonary tuberculosis
 
Henoch scholein purpura
Henoch scholein purpuraHenoch scholein purpura
Henoch scholein purpura
 
Infleunza
InfleunzaInfleunza
Infleunza
 
Parvovirus b19 infection
Parvovirus b19 infectionParvovirus b19 infection
Parvovirus b19 infection
 
Schistosomiasis
SchistosomiasisSchistosomiasis
Schistosomiasis
 
Guillain - Barré syndrome
Guillain -  Barré syndrome  Guillain -  Barré syndrome
Guillain - Barré syndrome
 
Allergic dermatitis in children
Allergic dermatitis in childrenAllergic dermatitis in children
Allergic dermatitis in children
 
Giardiasis
GiardiasisGiardiasis
Giardiasis
 
Nipah virus (ni v)
Nipah virus (ni v)Nipah virus (ni v)
Nipah virus (ni v)
 

Dernier

SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 

Dernier (20)

How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
 
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 

Does this child get asthma

  • 1. *Does this child get Asthma?
  • 2. *A ,10 mon old male infant present with coryza , ,cough , shortness of breath and poor feeding *O/E he had : Tachypnea and tachycardia Hyperinflated chest Intercostal and subcostal recession Wheeze and crepitations Pallor *Chest X-ray showed: Hyperinflation Patchy collapse 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 2
  • 3. *E ,2 year old female child present with: Recurrent chest infections Not put much weight since she was born Frothy cough especially at night Shortness of breath and poor feeding Bulky , greasy ,difficult -to-flush stools Malnutrition *O/E she had : Failure to thrive Wheeze and crepitations *Chest X-ray showed: Hyperinflation & Patchy lesions 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 3
  • 4. *L ,8 year old girl gives a 6- month history of a progressive cough . * In the past she had dry cough lasted several weeks after each cold . *A tentative diagnosis of asthma has been made and stepping up anti-asthma therapy along with oral antibiotics with eventual improvement of each coughing episodes. *She was hospitalized for acute pneumonia on several occasions to give I.V. antibiotics *Her present cough is productive of purulent phlegm 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 4
  • 5. *N ,a 4 year old boy who has been referred by his GP. *He has suffered frequent wheezing episodes in winter associated with cold *He get day-to day symptoms of cough and he is breathless with exercise *Last month he was up all night wheezing after having “pillow fight” with his sister *His mother has hay fever ,and his older sister had frequent wheezing in infancy with eczema *He has mild eczema 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 5
  • 6. *
  • 7. *
  • 8. *“Asthma is probably overdiagnosed by a factor of 5 ” Michael Seear ,MD pediatrician, respirologist, and instructor with the University of British Columbia Certificate in International Development, Vancouver . Miles Weinberger, MD professor of pediatrics at the University of Iowa Children’s Hospital, Iowa City, * Although asthma is at times overdiagnosed ,it is also at times underdiagnosed
  • 9. * Preschool-aged children have the highest hospitalization rate for asthma, reporting that 5% to 10% of all hospitalizations for US children are for asthma
  • 10. *Asthmatic aged younger than 5 years has twice the number of hospitalizations as school-aged asthmatics and 5 times the number as teenaged asthmatics.
  • 11. *“There are other studies that suggest that patients are being overdiagnosed with pneumonia, and very often when you look at those studies, probably a lot of what’s called pneumonia in young kids is actually manifestations of asthma,” Miles Weinberger
  • 12. * *A chronic respiratory disease, often arising from allergies, that is characterized by sudden recurring attacks of : Labored breathing Chest constriction Coughing 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 12
  • 13. *An estimated 25.9 million people, including almost 7.1 million children, have asthma National Health Interview Survey (NHIS) Data, 2011 http://www.cdc.gov/asthma/nhis/2011/data.htm
  • 14. *
  • 15. *Asthma prevalence is higher among persons with family income below the poverty level Akinbami, L., et al. Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001-2010 http://www.cdc.gov/nchs/data/databriefs/db94.pdf
  • 16. *Asthma accounts for more than 15 million physician office and hospital outpatient department visits National Ambulatory Medical Care Survey: 2010 Summary Tables http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf And nearly 2 million emergency department visits each year National Hospital Ambulatory Medical Care Survey: 2010 Outpatient Department Summary Tables http://www.cdc.gov/nchs/data/ahcd/nhamcs_outpatient/2010_opd_web_tables.pdf National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf
  • 17. *An average of 1 out of every 10 school- aged children have asthma United States Environmental Protection Agency. Asthma Facts. March 2013. http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf.
  • 18. *Asthma is the third-ranking cause of hospitalization in children United States Environmental Protection Agency. Asthma Facts. March 2013. http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf
  • 19. *In 2009, 1 in 5 children with asthma went to the emergency department CDC. National Center for Environmental Health. Asthma’s Impact on the Nation: Data from the CDC National Asthma Control Program.
  • 20. *Boys are more likely to have asthma than girls United States Environmental Protection Agency. Asthma Facts. March 2013. http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf.
  • 21. * *The annual economic cost of asthma, including direct medical costs from hospital stays and indirect costs such as lost school and work days, amount to more than $56 billion annually Centers for Disease Control and Prevention, (May 2011) Asthma in the U.S. Vital Signs http://www.cdc.gov/vitalsigns/asthma/
  • 22. Abstract: About 334 million people worldwide suffer from asthma, and this figure may be an underestimation. It is the most common chronic disease in children. Asthma is among the top 20 chronic conditions for global ranking of disability-adjusted life years in children; in the mid-childhood ages 5–14 years it is among the top 10 causes. Death rates from asthma in children globally range from 0.0 to 0.7 per 100 000. There are striking global variations in the prevalence of asthma symptoms (wheeze in the past 12 months) in children, with up to 13-fold differences between countries. Although asthma symptoms are more common in many high-income countries (HICs), some low- and middle-income countries (LMICs) also have high levels of asthma symptom prevalence. The highest prevalence of symptoms of severe asthma among children with wheeze in the past 12 months is found in LMICs and not HICs. From the 1990s to the 2000s, asthma symptoms became more common in some high-prevalence centres in HICs; in many cases, the prevalence stayed the same or even decreased. At the same time, many LMICs with large populations showed increases in prevalence, suggesting that the overall world burden is increasing, and that therefore global disparities in asthma prevalence are decreasing. The costs of asthma, where they have been estimated, are relatively high. The global burden of asthma in children, including costs, needs ongoing monitoring using standardised methods. Asthma is among the top 20 chronic conditions for global ranking of disability-adjusted life years in children In the mid-childhood ages 5–14 years it is among the top 10 causes Int J Tuberc Lung Dis. 2014 Nov;18(11):1269-78. doi: 10.5588/ijtld.14.0170. Global burden of asthma among children. Asher I1, Pearce N2.
  • 23. * *Episodic viral-associated wheezing *Classic atopic asthma *Cough variant asthma 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 23
  • 24. *Episodic viral- associated wheezing *Episodes are more frequent in winter *Almost always associated with colds *Usually completely asymptomatic between episodes *Response to regular anti- inflammatory therapy is poor 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 24
  • 25. *Classic atopic asthma *An Atopic background (allergies or eczema) *Positive family history of atopy and asthma *Day-to-day symptoms triggered with exercise or occurring at night when no cold *Response well to regular anti- inflammatory asthma therapy 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 25
  • 26. *Cough variant asthma *Nocturnal and/or exercise –induced cough when free from cold *Wheezing may never been heard *Personal of family history of other atopic disorders *Response rapidly to anti- asthma therapy *Symptoms relapse when therapy withdrawn 6/12/2015 Does this child get Asthma Prof.Dr.Saad S Al Ani Khorfakkan Hospital 26
  • 27. * 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 27
  • 28. Chronic inflammatory disease of the airways Airways spasm and swelling Obstruction to air flow Wheezing or gasping for air Resolves spontaneously Responds to a wide range of treatments * 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 28
  • 29. * *Continuing inflammation makes the airways hyper-responsive to stimuli such as: * Cold air * Exercise * Dust mites * Pollutants in the air * Stress *Anxiety 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 29
  • 30. * www.giglig.com 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 30
  • 31. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 31 * *Asthma is the most common chronic disease of childhood in industrialized countries *Boys are more likely than girls to have asthma *Children with asthma have symptoms of:  Coughing  Wheezing  Shortness of breath or rapid breathing  Chest tightness
  • 32. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 32 *Nighttime symptoms are common * *Physical examination may show evidence of other atopic diseases such as eczema or allergic rhinitis *Many childhood conditions can cause wheezing and coughing of asthma *Not all cough and wheeze is asthma
  • 33. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 33 * *Asthma can be aggravated by:  Rhinosinusitis  Gastroesophageal reflux  Nonsteroidal anti-inflammatory drugs (especially aspirin)
  • 34. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 34 * *Presentation during acute episodes:  Tachypnea  Tachycardia  Cough  Wheezing  Prolonged expiratory phase
  • 35. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 35 *
  • 36. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 36 *
  • 37. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 37 *
  • 38. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 38 is used to:  Monitor response to treatment  Assess degree of reversibility with therapeutic intervention  Measure the severity of an asthma exacerbation * *Children older than 5 years of age can perform spirometry maneuvers.
  • 39. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 39 *
  • 40. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 40 * *Repeat chest radiographs are not needed with new episodes unless:  There is fever (suggesting pneumonia)  Localized findings on physical examination should be performed with:  The first episode of asthma  Recurrent episodes of undiagnosed cough or wheeze to exclude anatomic abnormalities
  • 41. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 41 * *In vitro serum tests are generally:  Less sensitive in defining clinically pertinent allergens  More expensive  Require several days for results compared to several minutes for skin testing Such as:  Radioallergosorbent test ( RAST)  Fluorescentenzyme immunoassay ( FEIA)  Enzymelinkedimmunosorbent assay (ELISA)
  • 42. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 42 * Positive skin tests results: *Identifying immediate hypersensitivity to aeroallergens *Correlate strongly with bronchial allergen provocative challenges Should be included in the evaluation of all children with persistent asthma but not during an exacerbation of wheezing.
  • 43. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 43 * *The most common causes of wheezing in children include:  Asthma  Allergies  Infections  Gastroesophageal reflux disease  Obstructive sleep apnea
  • 44. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 44 *Less common causes include : Congenital abnormalities Foreign body aspiration Cystic fibrosis *
  • 45. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 45 * *Optimal medical treatment of asthma includes several key components:  Environmental control  Pharmacologic therapy  Patient education, including attainment of self-management skills  Steps to minimize allergen exposure
  • 46. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 46 * *Asthma medications can be divided into: Long-term control medications Quick-relief medications
  • 47. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 47 *
  • 48. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 48 * Are: *The most effective anti-inflammatory medications for the treatment of chronic, persistent asthma *The preferred therapy when initiating long term control therapy
  • 49. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 49 * *Early intervention with inhaled corticosteroids reduces morbidity but does not alter the natural history of asthma
  • 50. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 50 * *Regular use of inhaled corticosteroids reduces:  Airway hyperreactivity  The need for rescue bronchodilator therapy  Risk of hospitalization  Risk of death from asthma
  • 51. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 51 * *Do not have clinically significant adverse effects on:  Hypothalamic-pituitary-adrenal axis function  Glucose metabolism  Subcapsular cataracts or glaucoma When used at low-to-medium doses in children
  • 52. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 52 * *Two classes of leukotriene modifiers include :  Leukotriene receptor antagonists (zafirlukast and montelukast) •Leukotriene synthesis inhibitors (zileuton)
  • 53. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 53 * *Usefulness of leukotriene : Modifiers in mild asthma •Attenuation of exercise-induced bronchoconstriction
  • 54. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 54 * *Long-acting β2-agonists: Formoterol and Salmeterol, have:  Twice-daily dosing  Relax airway smooth muscle for 12hours *Do not have any significant anti-inflammatory effects
  • 55. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 55 * *Is approved for use in children older than 5 years of age for:  Maintenance asthma therapy  Prevention of exercise-induced asthma *It has a rapid onset of action similar to albuterol (15 minutes).
  • 56. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 56 *  Is approved for children 4 years of age or older • Has an onset of 30 minutes
  • 57. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 57 *  It is mildly to moderately effective as a bronchodilator •Is considered an alternative, add-on treatment to low- and medium-dose inhaled corticosteroids
  • 58. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 58 *  Humanized anti-IgE monoclonal antibody that prevents binding of IgE to high-affinity receptors on basophils and mast cells  It is approved for moderate to severe allergic asthma in children 12 years of age and older.
  • 59. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 59 * •Xolair is delivered by subcutaneous injection every 2 to 4 weeks, depending on body weight and pretreatment serum IgE level
  • 60. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 60 * Quick-Relief Medications Short-Acting β2- Agonists Anticholinergic Agent Oral Corticosteroids
  • 61. 6/12/2015 Asthma Prof. Dr. Saad S Al Ani Khorfakkan Hospital 61 * *Short-acting β2-agonists, such as albuterol, levalbuterol, and pirbuterol, are:  Effective bronchodilators that exert their effect within 5 to 10 min  They last for 4 to 6 hours. *Is prescribed for acute symptoms and as prophylaxis before allergen exposure and exercise
  • 62. 6/12/2015 Asthma Prof. Dr. Saad S Al Ani Khorfakkan Hospital 62 * *Ipratropium bromide is an anticholinergic bronchodilator that:  Relieves bronchoconstriction  Decreases mucus hypersecretion  Counteracts cough-receptor irritability *It seems to have an additive effect with β2- agonists when used for acute asthma exacerbations.
  • 63. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 63 * * Short bursts of oral corticosteroids (3 to 10 days) are administered to children with acute exacerbations *The initial starting dose is 1 to 2 mg/kg/day of prednisone followed by 1 mg/kg/day over the next 2 to 5 days
  • 64. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 64 * *Prolonged use of oral corticosteroids Can result in systemic adverse effects such as:  Hypothalamic- pituitary-adrenal suppression  Cushingoid features  Weight gain  Hypertension  Diabetes  Cataracts& glaucoma  Osteoporosis •Growth suppression
  • 65. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 65 *Status asthmaticus *Is an acute exacerbation of asthma that does not respond adequately to therapeutic measures and may require hospitalization
  • 66. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 66 *  Significant respiratory distress  Dyspnea  Wheezing  Cough •Decrease in peak expiratory flow rate (PEFR)
  • 67. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 67 * *During severe episodes of wheezing, pulse oximetry is helpful in monitoring oxygenation
  • 68. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 68 * *In status asthmaticus, arterial blood gases may be necessary for measurement of ventilation
  • 69. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 69 *
  • 70. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 70 * *For children younger than 3 years of age who are at risk for asthma include: • Eczema • Parental asthma or • Two of the following: 1.Allergic rhinitis 2.Wheezing with a cold 3.Eosinophilia of greater than 4%
  • 71. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 71 *Successful education *Involves:  Teaching basic asthma facts  Explaining the role of medications,  Teaching environmental control measures • Improving patient skills in the use of spacer devices for metered dose inhalers and peak flow monitoring
  • 72. *Underdiagnosis and undertreatment of asthma in children: a tertiary hospital's experience Ioanna Vasilopoulou*, Irene Papakonstantopoulou, Katerina Salavoura, Nikoletta Laliotou,Athanasios Kaditis and Vasiliki Gemou-Engesaeth Methods We studied 82 children (age 2-15y) that were referred to our clinic during 2013-2014 and their history and/or physical examination revealed a clinical suspicion of asthma, according to GINA. Children were evaluated by personal/family history, physical examination, skin prick tests to common allergens, total/specific IgE levels. Lung function tests were carried out where possible. Chest X-ray and sweat test were performed if needed. Children were divided into three groups: children with asthma diagnosed for first time, children with asthma whose symptoms were uncontrolled and children with severe/persistent asthma. Results 32/82 children were diagnosed with asthma for the first time in our Unit and had never received treatment before despite pediatric follow up. 12/32 came for a reason other than asthma, such as Food Allergy (3), Urticaria (2), Drug allergy (1), Eczema (1), Allergic Rhinitis (1) and hospitalization due to foreign body aspiration (1). Of the 37/82 children who already had a diagnosis of asthma, 31 had poorly controlled symptoms despite treatment. Reasons for uncontrolled asthma in 21/31 were low doses of Inhaled Corticosteroids or intermittent use, 7/31 had improper inhaler technique and 3/31 had poor adherence to treatment. 9/82 children were referred for severe asthma; 4/9 had improper inhalation technique. Non-adherence to treatment and co-morbid conditions also contributed to persistent symptoms. Patients were treated individually. After 6 months, symptoms were well controlled in 67 children. 3 children were well controlled at the 3 months follow up while 7 children's follow up is pending. 1 child did not return, 1 child followed alternative therapies and 3 were not compliant to our advice. Conclusions Asthma in children is still often underdiagnosed. For correct diagnosis/treatment a detailed clinical history is mandatory and lung function tests should be performed in children with associated comorbidities such as AR. Studies have shown that one demonstration of the inhaler technique is not enough. It is essential to educate clinicians, patients and parents and to promote compliance. Conclusions Asthma in children is still often underdiagnosed. For correct diagnosis/treatment a detailed clinical history is mandatory and lung function tests should be performed in children with associated comorbidities such as AR. Studies have shown that one demonstration of the inhaler technique is not enough. It is essential to educate clinicians, patients and parents and to promote compliance
  • 73. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 73 * * www.uic.edu * www.scienceopen.com * faculty.washington.edu * http://www.aafp.org
  • 74. 6/12/2015 Asthma Prof.Dr. Saad S Al Ani Khorfakkan Hospital 74 *