Allergy and Asthma Improving Outcomes in Primary Care：过敏和哮喘的初级保健效果的提高.pptVIP

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2018-06-23 发布于浙江
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Allergy and Asthma Improving Outcomes in Primary Care：过敏和哮喘的初级保健效果的提高.ppt

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Allergy and Asthma Improving Outcomes in Primary Care：过敏和哮喘的初级保健效果的提高

Allergy and Asthma: Improving Outcomes in Primary Care The Etiology Challenge Common symptoms and diseaseshave many possible etiologies IgE-mediated allergies triggersymptoms from infancy into adulthood Identification of true underlying cause is essential for effective management The Allergic Inflammatory Response Common Childhood Diseases The illnesses of the Allergy March Atopic dermatitis (eczema) GI distress Recurrent otitis media Allergic rhinitis Allergic asthma The symptoms Inflammatory in nature Multiple etiologies Treated empirically The Allergy March: A Progression of Seemingly Unrelated Diseases Allergy March Allergy March Common Childhood Diseases Atopic dermatitis (AD)1 17%-20% prevalence in US, other western countries Not necessarily severe reaction (anaphylaxis) Driven by early exposure and sensitization 40% of AD caused by food sensitivity Empirical treatment: trials of topicals Common Childhood Diseases GI distress1 Colic, diarrhea, vomiting, constipation, reflux Multiple etiologies: atopy, infection, intolerance, malabsorption, inflammatory bowel, anatomic defect 10%-42% of symptomatic patients are atopic2,3 50%-60% of infants with food sensitivities show GI symptoms(not necessarily full-blown food allergy) – Empirical treatment: trials of formulas Common Childhood Diseases Recurrent otitis media (OM) 26% prevalence in US1 Key risk factors include attendance in daycare,cigarette smoke exposure2 40%-50% involve atopy3,4 Common underlying cause = eustachian tube dysfunction Caused by inflammation related to allergy or infection Recurrence = not treating the underlying cause Empirical treatment: antibiotics, surgery Atopy’s Long-Term Consequences Nearly 80% of children with AD go on to develop allergic rhinitis and/or asthma1 Children with early and long-lasting food sensitization: – 3x more likely to develop allergic rhinitis (AR) than those transiently sensitized2 – 5x more likely to develop asthma than those transiently sensitize