HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 30 No. 9, September 2009 Rapid Responses: Submit a response Rapid Responses: View responses Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Hill, V. L. Articles by Wood, P. R. PubMed PubMed Citation Articles by Hill, V. L. Articles by Wood, P. R. Related Collections Allergy and Related Disorders Respiratory Disorders Psychosocial Issues and Problems Social Bookmarking                         What's this?

Asthma Epidemiology, Pathophysiology, and Initial Evaluation

Vanessa L. Hill, MD^*
Pamela Runge Wood, MD

^* Assistant Professor of Pediatrics
Clinical Professor of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Tex

Abbreviations: ED: emergency department • FEV₁: forced expiratory volume in 1 second • Ig: immunoglobulin • IL: interleukin • RSV: respiratory syncytial virus • Th: T-helper • VCD: vocal cord dysfunction

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Describe the underlying pathophysiology of asthma.
   
2. Discuss the role of atopy in the development of asthma.
   
3. Identify risk factors for death from asthma.
   
4. List conditions to be considered in the differential diagnosis of wheezing in children.
   

	Introduction

 
Asthma is a disease of airway inflammation characterized by hyperresponsiveness and airflow obstruction that lead to symptoms such as cough and wheezing (Fig. 1). Childhood asthma continues to cause significant morbidity and burden in the United States. This article reviews the pathophysiology, epidemiology, and recommendations for initial evaluation of asthma. Recommendations are based on the 2007 Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma ("2007 Guidelines"). (1)

View larger version (14K):   Figure 1. Mechanisms underlying the clinical symptoms of asthma. Adapted from the National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. 2007.

	Epidemiology

 
     Prevalence and Burden of Disease
The prevalence of asthma rose steadily from 1980 until the late 1990s, when it reached a plateau. In 2007, 9% of children 0 to 17 years of age (6.7 million children) had asthma, according to data from the National Health Interview Survey. The lifetime prevalence of asthma in children is 13%. (2)

The burden of disease in the United States from pediatric asthma is alarming, according to a recent report based on national surveys. In 2003, 12.8 million days of missed school were attributed to asthma. In 2004, hospitalizations for asthma totaled 198,000 or 3% of all pediatric admissions. Asthma resulted in 750,000 emergency department (ED) visits in that same year (2.8% of all pediatric ED visits). Although children ages 0 to 4 years of age represent only a small proportion of the total asthma population, they account for a sizeable proportion of the hospitalizations and ED visits. (3. . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

Rapid Responses: