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What is a chest infection and what causes it? Acute bronchitis This is an infection of the large airways in the lungs (bronchi). Acute bronchitis is common and is often due to a viral infection. Infection with a germ (bacterium) is a less common cause. Pneumonia This is a serious infection of the lung. Treatment with medicines called antibiotics is usually needed. How common are chest infections? Chest infections are very common, especially during the autumn and winter. They often occur after a cold or flu. Anyone can get a chest infection but they are more common in: Young children and the elderly. People who smoke. People with long-term chest problems such as asthma. What are the symptoms of a chest infection? The main symptoms are a chesty cough, breathing difficulties and chest pain. You may also have headaches and have a high temperature (fever). The symptoms of an infection of the large airways (bronchi) in the lungs (acute bronchitis) and a serious lung infection (pneumonia) may be similar; however, pneumonia symptoms are usually more severe
Practical Recommendations for COPD: Evidence-Based Care The treatment of patients with chronic obstructive pulmonary disease (COPD) depends on symptoms and history of exacerbation. These elements define the treatment strategies within the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines' ABCD assessment tool • Although not taken into account in the ABCD tool, spirometry remains important for the diagnosis and assessment of airflow limitation. Bronchodilators are first-line treatment, either as a single or dual bronchodilator treatment. • The recently available combination of a long-acting beta agonist (LABA) and a long-acting muscarinic receptor antagonist (LAMA) into a single inhaler has demonstrated improvement in lung function, either in combination or with monotherapy. In the SPARK study evaluating indacaterol/glycopyrrolate vs glycopyrronium and tiotropium (LABA/LAMA vs LAMA alone) for the prevention of exacerbation in patients with COPD, the combination therapy was superior to a single bronchodilator as measured by the reduction of exacerbations. • LABA/LAMA was also shown to be superior in the ILLUMINATE study, which compared the patient-reported outcomes and the transition dyspnea index (TDI) for patients on LABA/LAMA with patients on LABA/ICS (inhaled corticosteroid). Data from multiple studies show that ICS-containing regimens can also effectively reduce exacerbation rates. Data from post-hoc analyses of clinical trials suggest that patients with high levels of blood eosinophils may respond better to ICS therapy, whereas patients with very low levels of eosinophils may not respond. ICS therapy is associated with serious side effects, such as pneumonia. In the WISDOM trial, patients who discontinued ICS experienced approximately 40 mL in forced expiratory volume over 1 second (FEV1), indicating that ICS should be withdrawn very carefully in some patients. As exacerbations are more frequent and often more severe in winter months, it is recommended to not withdraw steroids during that period Current evidence suggests that the combination of LABA/LAMA with ICS into a single inhaler will improve lung function, exacerbations, and symptoms Other treatment options besides triple therapy exist for patients who still experience exacerbations after LABA/LAMA treatment. • Roflumilast may be considered in patients with chronic bronchitis. • The use of long-term macrolides is possible in a particular profile subset of patients who have frequent exacerbations with bronchiectasis, bronchial colonization, and frequent bacterial infections.
severe obstructive sleep apnea was associated with depressive symptoms, especially among those who also had excessive daytime sleepiness
Severe allergy asthma Characterized by clinical features of allergy to specific aeroallergens and increased levels of total or specific immunoglobulin E (IgE). Therefore, allergic asthma is characterized by high IgE levels and positive skin prick tests or specific IgE in serum and clinical symptoms compatible with exposure to the allergen. House dust mite and cat sensitization are the most prominent allergens associated with asthma severity. severe sinus disease (odds ratio [OR] 3.7), gastroesophageal reflux (OR, 4.9), recurrent respiratory infections (OR, 6.9), psychological dysfunctioning (OR, 10.8) and obstructive sleep apnea (OR, 3.4). Moreover, control is difficult to achieve in obese patients and in patients who do not adhere to medication or healthy lifestyle recommendations.
Patients with high eosinophilic levels have a good response to biologics. Nasal polyps are associated with allergic asthma. In these patients, anti-immunoglobulin (Ig) E and anti-interleukin (IL)-5 have proven efficacy. In the Global Initiative for Asthma (GINA) guidelines, the severity of symptoms is one of the major criteria in choosing a treatment. ICS are prescribed at the initial steps of asthma management, but analysis of comorbidities helps to adapt the treatment
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