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Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...
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Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
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Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
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Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
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Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
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Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
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Aspirin-Exacerbated Respiratory Disease.

Evan S Walgama1, Peter H Hwang1

  • 1Department of Otolaryngology/Head and Neck Surgery, Stanford School of Medicine, Stanford Sinus Center, 801 Welch Road, Palo Alto, CA 94304, USA.

Otolaryngologic Clinics of North America
|November 28, 2016
PubMed
Summary

Aspirin-exacerbated respiratory disease (AERD) involves asthma, nasal polyps, and aspirin sensitivity. Diagnosis is confirmed via aspirin challenge, and aspirin therapy is a unique treatment for AERD patients.

Keywords:
Aspirin-exacerbated respiratory diseaseChronic rhinosinusitisNasal polyposisSinus surgery

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Area of Science:

  • Immunology
  • Pulmonology
  • Otolaryngology

Background:

  • Aspirin-exacerbated respiratory disease (AERD) is a clinical triad of asthma, chronic rhinosinusitis with nasal polyposis, and hypersensitivity to aspirin.
  • A key feature is elevated cysteinyl leukotriene production via the 5-lipoxygenase pathway, which is further aggravated by aspirin ingestion.
  • Patients with AERD frequently experience recurrent nasal polyposis after surgical intervention.

Purpose of the Study:

  • To summarize the key characteristics, diagnostic methods, and therapeutic considerations for Aspirin-Exacerbated Respiratory Disease (AERD).

Main Methods:

  • Diagnosis is typically confirmed through a controlled aspirin provocation test administered by an allergist.
  • The study reviews the pathophysiology involving leukotriene pathways and clinical presentation of AERD.
  • It also considers the impact of surgical outcomes and the role of aspirin therapy.

Main Results:

  • Despite high rates of polyp recurrence post-surgery, patients with AERD report similar quality-of-life improvements as aspirin-tolerant individuals after surgery.
  • Aspirin provocation tests are crucial for securing the diagnosis of AERD.
  • Aspirin therapy presents a unique treatment strategy for AERD.

Conclusions:

  • Aspirin-Exacerbated Respiratory Disease requires careful diagnosis, often involving aspirin challenge tests.
  • While surgery may not prevent polyp recurrence, it can improve quality of life.
  • Aspirin therapy is a distinctive and important treatment option for AERD patients.