The Effects of Indoor Air Pollutants on the Lung Health of Asthmatic Patients

Environmental studies have consistently shown an association between air pollution and exacerbations of illness in people with respiratory diseases such as Asthma (Zhengmin, 2010). Asthma, a chronic disorder in over 160 million people causing one death every twenty seconds, involves the interaction of airflow obstruction, bronchial hyper-responsiveness, and inflammation (WHO, 2005). Medical practitioners currently attribute any degradation in lung health to pathophysiological factors, and routinely suggest expensive steroids and other inhaler treatments to alleviate respiratory disorders. The goal of my research is to uniquely quantify the effect of airborne pollutants on the degredation in lung health of asthmatic patients enabling targeted remediation that incorporates both pathophysiological and environmental factors.

It was hypothesized that the Peak Expiratory Flow (PEF) rate of asthmatic subjects varies inversely with the concentration of each pollutant, including airborne particulate matter (PM10), carbon dioxide (CO2), carbon monoxide (CO) and total volatile organic compounds (TVOCs). In Phase 1, over 100 subjects were recruited to participate in this study. Using scientific and HIPPA compliant methods, over 4 million air quality and PEFR readings. Based on the Pearson R Correlation coefficient, a strong inverse correlation was determined between the degradation in the PEFR and the PM10 and TVOC levels, but not between the CO2 and CO concentration levels.

In Phase 2, I developed a novel mathematical model and an interactive online application to quantify the percent what percent of a subject’s PEF degradation is caused by the levels of PM10 and TVOC in each subject’s environment. Medical practitioners and Environmental specialists alike could use my mathematical model as it provides a better estimate for the PEF rate and supports targeted remediation of indoor air quality. I have written a letter to the Chairman of the EPA and the U.S. President asking them to allow me to present my findings to them and discuss possible amendment to the Clean Air Act needs to include TVOCs as a criteria pollutant. Possible ideas for future research include engineering a smart thermostat that monitors air quality real-time and studying the effect of TVOC on the endothilial lining of our lungs.

Peripheral nerve blocks (PNBs) in paediatric patients

Anaesthesia & Intensive Care Medicine
Volume 14, Issue 6, June 2013, Pages 245–250

Regional Anaesthesia

Paediatric anaesthesia
Peripheral and local anaesthetic techniques for paediatric surgery
Steve Roberts, Alasdair Howie
Steve Roberts MBChB FRCA is a Consultant Anaesthetist at the Royal Liverpool Children’s Hospital NHS Trust, UK. Conflicts of interest: none declared
Alasdair Howie BA BMBCh FRCA is a Specialist Trainee in Anaesthesia in the North West of England Deanery, UK. Conflicts of interest: none declared
http://dx.doi.org/10.1016/j.mpaic.2013.03.005, How to Cite or Link Using DOI

Abstract
Peripheral nerve blocks (PNBs) in paediatric patients are usually used as an adjunct to general anaesthesia, providing intra- and postoperative analgesia. These blocks provide good-quality analgesia preventing morbidity related to pain and reducing adverse effects from systemic analgesics. PNBs aid early patient recovery and discharge, which is essential in day-case surgery. Like all invasive techniques, PNBs are associated with complications and adverse effects. They should therefore be performed only after careful analysis of the risk:benefit ratio for each child. This article discusses a general approach to PNBs in children. It covers a small selection of limb and trunk blocks, and discusses the benefit of ultrasound guidance.

Keywords
Children; paediatrics; peripheral nerve blocks; regional anaesthesia
Figures and tables from this article:

Figure 1. A child having a block in a child-friendly environment.

Patients Can Receive Sinusitis Treatment PA Specialists Provide

By Ada A. Abshire

Infections can easily occur in the sinus cavities of people who experience colds, allergies and asthma that frequently require sinusitis treatment PA physicians can recommend after they perform a diagnosis. Some times sinusitis is not properly diagnosed or treated by a doctor because the symptoms mimic those of allergies and colds even though it is the most common health condition in America. People sometimes think they are experiencing a cold that simply will not go away or a lingering allergy attack. If it is actually sinusitis that demands a physician’s diagnosis, proper care and treatment is very important to prevent further complications.

In order to better comprehend how and why this happens we can do a little physiology refresher course. An infection that is caused by bacteria and takes place in the sinus cavities is what is labeled as acute bacterial sinusitis. Normally mucus that is formed in the sinuses empties into the nasal passages as part of the usual procedure. However, when you encounter an allergy attack or have a cold, the sinuses are not able to drain properly because they become inflamed. Congestion and infection can happen if they cannot drain properly. A nasal drainage that is not clear in appearance and persists for up to four weeks and is accompanied by nasal obstruction, facial pain, facial pressure or fullness is often diagnosed by a physician as a sinus infection.

The sinusitis treatment PA professionals frequently recommend includes using antibiotics to clear a sinus infection that lasts for ten days or more is usually a bacterial infection that needs to have this treatment. Infections are considered to be a type of chronic sinusitis when they are frequently experienced by the patients or last for periods of time extending three months or longer.

The recommended treatment for bacterial sinusitis usually includes the appropriate type of antibiotic therapy and can also include a recommendation to use a nasal spray or drop decongestants to relieve the congestion as suggested by your doctor. Nonprescription nasal sprays or drops must not be administered for a prolonged period of time. It is possible to relieve the discomfort experienced in your sinuses by inhaling steam or with the application of saline nasal sprays or drops.

One major worry about antibiotic therapy is that a resistance can be developed that permits some infection-causing bacteria to become immune to certain antibiotic effects. Be certain to discuss this possibility with your doctor and follow his or her advice and instructions to help prevent this resistance from developing. Remember to always cautiously follow any instructions that are given by your doctor whether it is for the allergy treatment PA providers recommend or antibiotic therapy for infections.

About the Author:

More additional information is available for you to read when you visit sinusitis treatment PA and treatment for sinusitis.

Should patients with a COPD exacerbation be treated with antibiotics?

If mild (defined as not requiring mechanical ventilation and having only one of the three cardinal symptoms of increased dyspnea, sputum purulence or sputum production), NO.

If moderate to severe (defined as requiring mechanical ventilation or having at least two of the three cardinal symptoms), YES.

Which antibiotic?

If no risk factors for complicated COPD (age

Bottom line, most folks that show up in the ED with a COPD exacerbation should recieve an antibiotic. Which type depends on their risk for complications and pseudomonas.

Source

Bartless, J. MD. Sethi, S. MD. “Diagnosis and treatment of infection in acute exacerbations of chronic obstructive pulomonary disease.” Up to Date. Oct 2008.

Chapter for Pharmacist-To-be : Pharmaceutical Care Plan for Asthma Patients

Recently, final year pharmacy student or/also known as the pharmacist-to-be, asked me about some questions regarding management of an asthmatic patient.

So to summarise the discussion, When comes to asthmatic patients, there are few things you ned to make it clear before you jump into recommendation:

1) Patient’s compliance on inhaler techniques. If non-compliance, there is a bigger issue for u to address before you add in an extra med.

2)How to step up and to step down in asthma management? What parameters you look at ?
If to step up, which agent will you choose ? What monitoring parameters are you interested to look at?
- after corticosteroid, what is next in the list?
- can long acting beta-agonist be given alone?
- what are the up-coming innovation in management of asthma patients, that could improve compliance, improve efficacy and reduce side effect?

3) think about what is the pathophysiology of asthma?
- why we will step up to inhale corticosteroid instead of other agent?

4) How different is the management of asthma vs COPD? why is it so?

5) How the difference of management of acute exacerbation of asthma vs chronic asthma?

6) What is the differences in inhaler corticosteroid and oral corticosteroid?
- why do we have an invention of inhaler?
- When do we oral (systemic) corticosteroid in management of asthma patient?

7) Check the differences in each corticosteroid inhaler (Budesonide, beclomethasone, ciclesonide, fluticasone, betamethasone) By finding the differences, You will then understand why in the market, there is so many different corticosteroid inhalers, and why some inhale corticosteroid were phased out from the market already.

8) can asthma patient be given aspirin?
if can, what would be your concern?
if cant, what would you recommend to your doctor?

If you could find out all the answers, you will have a better understanding of how to manage an asthma patient! But dont forget about his/her other co-morbidity(ies).