The asthma

The asthma is an illness increasingly more frequent between the children and the youths. It is calculated that the 10 percent of the childlike population in countries industrialized suffers it, and in many cases the illness appears in response to you determined stimuli as the pollen, the dust mites or certain particles of the skin of the dog and of the cat.

This illness is the answer to you determined stimuli that produce allergy: pollen, mites of the dust, particles of the skin of cat and of the dog, smoke, certain, cold air food or alimentary additives. It is characterized for the respiratory difficulty episodes apparition (crisis or attack), generally associated to other symptoms as cough, honks al to breathe and sensation of I drown.

The symptoms vary according to the age. In this manner, in the children the cough prevails mainly, especially during the night, while in the adults the three main symptoms are inflexibility in the chest, whistles and fatigue in the night. In recent years a greater prevalence has been registered and a progressive increase of cases in children and adolescents, which shows the need to take preventive measures.

The healing of the asthma can only be reached in some cases of allergic asthma or related to the place of work of the patient, provided that the causal agent can be avoided.

Which is his incident?

This illness is a problem of public health that affects to 10 percent of the children and young, and to 5 percent of the adult population in the countries industrialized. In Spain two million individuals suffer asthma, and in the world they surpass the 150 million. As for the rate of mortality by this pathology, in our country they pass away for this cause 2 x 100.000 h/to, and in the world 100.000 deaths are produced per year. The deaths are caused for sharp attacks that cannot be controlled, although other factors exist that impede the approach of the mortal crisis.

A study multi centric sponsored by the Spanish Company of Respiratory Pathologies (Separ) has shown that exists a relation among passing away or to suffer a crisis almost mortal by asthma and the alexitimia, a psychological inconvenience that affects al 10 percent of the healthy population and that impedes to perceive and to express well the emotions and physical sensations.

The work verifies that the asthmatic with alexitimia, around 38 percent of the patients that took part in the investigation, they suffer with more frequency almost mortal crisis, since al not to perceive correctly the symptoms of the asthma are not capable of acting consequently. “The alexitimia could also be one of the causes of the low fulfillment of the processing that is registered among the asthmatic patients”, has indicated Vicente Plaza, of the Service of Etymologist of the Hospital San Pablo, of Barcelona.

The asthma is the most frequent cause of visit to ER in pediatric age and the fifth cause of consultation in primary attention. 60 percent of the ER attended in the services of neumología are sharpening of asthma caused, the majority of the times, by non-fulfillment of the processing prescribed. This confirms that the illness is not well controlled, since more than the half of the asthmatic diagnosed, despite be low processing, has to utilize medicación of rescue to alleviate the exacerbation of its symptoms.

The non-fulfillment would be able to be resolved with more comfortable medicines, a better communication between doctor and patient and the education of the sick one. “Al patient should be reported about all the relating to its illness and to coach him for the correct utilization of the medicación, creating an active relation and continued among the doctor, the patient and its environment. Thus, through the acceptance and comprehension of the illness the patient itself corresponsabiliza of its processing, and does not need to lie al medical neither to be felt guilty by continue not the processing”, indicates Santiago Nevot, leader of the Service of Pediatrics of the General Hospital of Manresa. Up to now it has been verified that the fulfillment is better with oral medicines that inhaled, and enlarges if is a matter of daily a single dose.

Characteristics of the asthma

During the asthmatic crisis the bronchial mucous membrane that covered the respiratory conduits is inflamed and a thick mucus is produced that blocks the conduits of the air mail. As consequence, the muscles that surround these conduits contract and they tighten diminishing their diameter, they stand in the way of the air and they complicate the respiration. The basic characteristics of the illness are the following:

• Inflammation: Enlarges the bronchial sensibility and the obstruction. From time to time its origin is allergic. It produces an increment of the secreciones and the contraction of the bronchial musculature.
• Increase of the bronchial sensibility: After the exposition to diverse stimuli (smoke, gases, smells, cold air or exercise), the bronchial tubes of the asthmatic contract producing the narrowing of the air mail.
• bronchial Obstruction: Variable and reversible in a spontaneous way or with processing. During the crisis the air circulates with difficulty producing honks and sensation of fatigue or I drown. At the moment in which the crisis is resolved the air can be moved normally by the bronchial tubes and they disappear the symptoms.

There are different types of asthma?

Different classifications of the asthma exist. As for its origin can be divided into intrinsic asthma and extrinsic or allergic asthma.

The origin of the intrinsic asthma is a stranger and he is detected with greater frequency in the adult age. He has a worse forecast than that of allergic character and he tends to be become chronic.

The extrinsic asthma, in turn, he consists of a reaction antigen-antibody that unchains the process. It affects mainly children and young adults, is characterized for attacks reversibles and brief of bronchospasms with whistles and respiratory difficulty, and is controlled with an adequate processing.

The allergy is an alteration of the defense mechanism of the agency that consists of an exaggerated reaction, through a special antibody (immunoglobulin AND), against substances that, in principle, they are not harmful (pollens, mites, epitelios, food or medicines). When these antibodies, that are found set in you determined cells, they join with the allergens, the liberation of certain substances is produced that, directly or through other cells, they cause the inflammation of the organ where they write down (bronchial tubes, nose, eyes or skin). A predisposition inherited exists to suffer allergy, but the exposition to the allergens is necessary for develop the illness.

The asthma can also be classified like light, moderate or serious, according to the frequency and intensity of the symptoms, the way in which results in the routine activity and the degree of bronchial obstruction. The light asthma can be controlled by means of pharmacological processing and does not be used to altering the everyday life of the sick; the asthma moderate requires more severe processing and interferes with the daily activities of the patients; and the serious asthma requires a continuous control and can endanger the life of the people that suffer it.

Which is the cause of the asthma?

Pollens: Although the pollination is produced during the spring, variations according to the climates they exist and types of plants. The symptoms are used to detecting with concentrations over 50 grains of pollen by cubic meter of air. The small size of the pollen favors that remain suspended in the air during long time and travel through large distances until penetrating in the respiratory conduits. In Spain the pollen of the grasses, the olive in the south zone and the parietaria in the Mediterranean zone prevails.

Acaros of the dust: They are microscopic parasites that live in the dust of the houses and they are fed of skin scales and other residues. They need some conditions you need to be developed: 25º C of temperature and 85 percent of humidity. In Spain the most important are the Dermatophagoides pteronyssinus and Dermatophagoides Farinae.

Food: The episodes of asthma related to food are frequent during the infancy and they go accompanied by other symptoms as urticaria and vomitings, for which they tend to be confused with eating intoxications. The products that greater reactions cause are the milk, the eggs and the fish. In the adult age this type of asthma is less frequent.

Mushrooms: Some mushrooms produce allergens that are placed in its spores, and the liberation of these depends on the humidity, the temperature and the existence of organic matter in its environment, like trash or curtains of bath. The most favorable epochs for their development are the spring and the autumn, and among the most common they emphasize the alternaria, the cladosporium, the penicillium, the aspergillus and the mucor.

Animal: The saliva and the urine of dogs, cats and hamsters can unchain important asthmatic reactions. The allergens of these animals remain with the dust of the houses even months after withdrawing the animal.

Other allergens: Some works favor the development of asthmatic processes due to that in the same damaging substances are inhaled. The professions in which a greater risk exists they are those related to the pharmaceutical industry, the bakery, the lumber industry and the works in which has contact with detergents or animal.

Besides these allergens, there are other factors that can unchain asthmatic crisis. Among the most common the following they are found:

Physical exercise: They should be avoided the abrupt exercises and extenuantes in cold environments, with dust or contaminated, so much in the periods of pollination as in which a crisis is suffering itself.

Contamination: The smoke, the tobacco, the irritating gases and the strong smells can cause episodes of asthma. – Medicines: Some analgesic (aspirin), anti-inflammatory and substances that contain betabloqueantes produce crisis in
the sick most sensitive.

Other emotional and physical stimuli that increase the risk of crisis are the climatic changes, the respiratory infections that are declared al margin of the asthma, the emotional situation of the sick one (anxiety, laughter or crying) and you determined hormonal alterations.