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Causes of high ast levels: AST Test: MedlinePlus Medical Test

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HIGH AST or GOT – HIGH ASPARTATE AMINOTRASPHERASE

Aspartate aminotransferase (AST or GOT) is an enzyme found mainly in the liver and kidneys. The feedback from High AST in the context of high transaminases is indicative for the presence of a damage hepatic.

Normally, there are fairly low values of AST in the blood. The finding of a AST increase, and transaminases in general, is an indication of the presence of an insult that is causing damage to the liver.

AST, along with ALT, is also used to detect and / or monitor acute or chronic liver disease. Aspartate aminotransferase (also called AST, GOT or GOT) is usually measured in conjunction with another transaminase, alanine aminotransferase (also called ALT, GPT or GPT) as part of a “package” of tests that target to evaluate liver function, to determine the origin and extent of any liver tissue damage.

What are the transaminases? what is that the AST? AST is one of the transaminases, it is an enzyme found mainly in the liver and kidneys. As already mentioned, it is also referred to as GOT, GOT, aspartate aminotransferase, p-AST or s-AST.

L’AST it is a little less specific for detecting liver damage than ALT, as the aspartate aminotransferase AST is found in many organs besides the liver (heart, kidneys ..) and its rise is not necessarily a sign of liver damage. Alanine amyotransferase ALT, on the other hand, is found mainly in the liver and has a longer residence time in the blood.

In some liver diseases, AST is higher than ALT, for example in liver injury from alcohol abuse, in cirrhosis and hepatocellular carcinoma. In particular, an AST to ALT ratio greater than 2 is indicative of alcohol harm, and an AST / ALT ratio greater than 3 is highly suggestive of acute alcohol damage.

What does AST do? AST as already mentioned is an enzyme, which catalyzes (catalyzing means increasing the speed and effectiveness of the reaction) the conversion of aspartate and α-ketoglutarate to glutamate, according to the following formula

Aspartate (Asp) + α-ketoglutarate ⇌ oxaloacetate + glutamate (Glu)

The synthesis of AST, and in general the synthesis of transaminases, depends on vitamin B6 (pyridoxine) and is therefore decreased in all those situations in which there is a low vitamin B6, such as in malnutrition, severe renal insufficiency and advanced liver cirrhosis .

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Normal reference levels for AST aspartate transaminase are:

  • AST normal values in men: 6-34 IU / L (International Units per Liter)
  • AST normal values in women: 8-40 IU / L (International Units per Liter)

There are a number of conditions associated with the finding of got transaminases and high gpt, especially high levels of AST. Here are the most common causes of an increase in AST and ALT.

Very high transaminase levels

  • Acute liver damage: L’acute hepatitis it is an acute inflammation of the liver, which can lead to a simple increase in tranasminase (GPT / GOT or ALT / AST) and cholestasis indices (GGT / ALP), but also to an impairment of the protein synthesis function of the liver, up to terminal liver failure. The main forms of acute hepatitis are acute viral hepatitis (mostly hepatitis HAV, HEV and HBV, much rarer HCV hepatitis), l‘acute alcoholic hepatitis, hepatitis from substances such asdrug-induced hepatitis (eg paracetamol) olfungal hepatitis (for example amanita phalloides.) and theautoimmune hepatitis in the acute phase. Transaminase levels are not necessarily correlated with prognosis, i.e., paradoxically, patients with a significant increase in AST and ALT could have complete resolution of the problem without sequelae, while people with minimal transaminase alterations could already hide advanced liver disease. Note: In acute hepatitis, AST levels usually remain elevated for about 1-2 months, and it may take up to 3-6 months to return to normal.
  • Tumor necrosis: for example in the presence of a primary tumor of the liver (hepatocarcinoma or HCC) or secondary mtastases of other neoplasms (especially prostate and colon).

Moderately elevated transaminase levels

The conditions associated with moderate levels instead elevated AST They are the following:

  • Chronic liver disease (chronic viral hepatitis such as chronic hepatitis HCV, chronic hepatitis HBV with or without HDV co-infection, chronic alcoholic liver disease, hemochromatosis, autoimmune liver disease). In chronic hepatitis, AST levels usually do not exceed 3 or 4 times the normal threshold.
  • Alcohol abuse with an intake of more than 3 alcoholic units per day (one alcoholic unit corresponds more or less to a glass of wine, a small beer or a glass of spirits)
  • Cholestasis (for example when a stone occludes the biliary tract, causing a major increase in GGT, ALP and bilirubinemia, but often only a modest increase in GOT and GPT). Also going on pancreatitis there may be coexisting cholestasis and
  • Cardiac damage (myocadic infarction, heart failure such as in an episode of heart failure): in acute heart infarction, transaminases are released for damage to the heart muscle, but also for the possible ischemic damage secondary to the hypo-inflow of blood in the liver. In heart failure, on the other hand, the major cause of transaminase release is hepatic suffering linked to congestion of venous blood which is not pumped sufficiently and stagnates upstream of the right ventricle (liver from stasis)
  • Acute kidney damage: in acute renal failure (AKI, Acute Kidney Injury) there may be an increase in liver enzymes, partly due to release from the renal parenchyma, partly due to the reduced elimination of those already present in the blood.
  • Muscle damage or injuries: in the event of intense physical exertion or muscle trauma, there may be an increase in ALT and AST transaminases.
  • Hemolysis: when, for various reasons, so many circulating red blood cells are destroyed in a short time, there may be an increase in bilirubin and, less frequently, also in transaminases and cholestasis indices,
  • Heat stroke: in heatstroke, if very intense, there may be tissue damage with release of alanine aminotransferase and apsartate transaminase (ALT and AST).
  • High consumption of vitamin A
  • Leptospirosis: Leptospirosis is an infectious disease caused by bacteria of the Leptospira genus and is called field fever, ditch fever or seven-day fever. It contracts when it comes into contact with water contaminated with feces or urine from rodents or other infected animals. Typical mode of infection is bathing in stagnant water. In the acute phase it simulates a viral hepatitis and causes an increase in transaminases.
  • Mononucleosis: secondary infection to the Epstein Barr virus (EBV), can also temporarily affect the liver and spleen, enlarging their volume and causing an increase in transaminases.
  • CMV Cytomegalovirus Infection: As with mononucleosis, CMV can also affect the liver and cause high GPT and GOT.

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Mildly elevated transaminase levels

Conditions associated with just high levels of ALT They are the following:

  • Fatty liver: also called fatty liver, reflects an increase in intrahepatic lipids.
  • Moderate use of alcohol without exceeding 3 alcoholic units per day.
  • Low-activity cirrhosis of the liver.
  • Pregnancy: ASTs in pregnancy usually remain normal or decrease a little. Nonetheless, the finding of high transaminases in pregnancies it is frequent, and often benign, linked to weight gain with consequent fatty liver disease during gestation. In any case, in the event of high AST and ALT transaminases during pregnancy, the treating physician or gynecologist must always be notified and promptly investigated to identify the cause.
  • Celiac disease: celiac disease is often diagnosed following investigations carried out for the finding of high transaminases. Although the organ damage in celiac disease is not hepatic but intestinal, it is not uncommon to have moderate increases in ALT and ALT during celiac disease.

THE medications how can they cause an increase in ALT and AST?

Hepatocellular damage caused by drugs can be transient and / or minor, but also very serious, and of a definitive nature.

Here is a list of very common medications that can cause ALT and AST to rise:

  • Paracetamol: paracetamol is the active ingredient of the very famous Tachipirina. Paracetamol hepatotoxicity is due to the toxic metabolite NAPQI, generated by cytochrome P-450-2E1. Alcohol and other drugs induce cytochrome P-450-2E1 and may contribute to increasing the severity of the toxic insult. In adults, a dose of paracetamol greater than 8 g is capable of producing hepatic necrosis. However, even doses of 4-8g per day can produce liver damage in people with alcohol problems or in individuals with liver disease.
  • Amoxicillin: Amoxicillin is one of the best known and most used antibiotics in the world. Amoxicillin causes a moderate increase in AST and ALT levels. Ongoing therapy with amoxicillin (whose most famous trade name is the Augmentin) various types of hepatic dysfunction have been reported, with jaundice, hepatic cholestasis and acute hepatitis.
  • Amiodarone: Amiodarone can cause impaired liver function up to 50 % of cases. The type of liver damage caused by amiodarone ranges from an isolated alteration of GPT and GOT (i.e. the transaminases AST and ALT) without real permanent liver damage, to fulminant hepatitis, which fortunately is very rare. Hepatotoxicity (liver damage) usually develops one year after starting amiodarone therapy, although high transaminases are not uncommon even after a few weeks of therapy. Usually the damage mediated by amiodarone (most famous trade name is Cordarone) is dose-dependent, i.e. increases with increasing overall amiodarone dose taken during treatment, and has a direct hepatotoxic effect.
  • Chlorpromazine: chlorpromazine is a phenothiazine neuroleptic, and is a drug that finds its place in the therapy of schizophrenia (best known trade name is Largactil). Hepatic damage from chlorpromazine is characterized by an increase in cholestasis indices (GGT and ALP, or gammaglutamyl transpeptidase and alkaline phosphatase) with possible cutaneous jaundice, much greater than the increase in transaminases, which may also be normal. Most cases occur 2-4 weeks after starting therapy.
  • Ciprofloxacin: ciprofloxacin is an antibiotic belonging to the quinolone class, and is known under the trade name of Ciproxin. These antibiotics can cause cholestatic damage with an increase in cholestasis and bilirubin indices, and consequent jaundice. About 2% of patients taking ciprofloxacin have elevated ALT or AST levels during therapy, which normalize upon termination of therapy.
  • Diclofenac: diclofenac is the active ingredient of the well-known Voltaren. It can cause elevation of ALT and AST transaminases, especially in older women who appear to be more prone to anti-inflammatory liver damage (NSAIDs). High transaminases are found in approximately 15% of patients treated with diclofenac. Significant elevations in ALT or AST (i.e., more than 3 times the upper limit of normal) affect approximately 2% of patients during the first 2 months of treatment.
  • Erythromycin: erythromycin is an antibiotic, still widely used in children, a little less in adults it can cause liver dysfunction, including an increase in liver enzymatic levels of AST (GOT) and ALT (GPT), as well as cholestatic hepatitis with an increase in GGT, ALP and total and fractionated bilirubin. A cholestatic reaction (i.e. with stagnation of bile, manifested by an increase mainly in bilirubin, GGT and ALP) is the most common adverse effect, usually starting within 2-3 weeks of starting therapy.
  • Fluconazole: fluconazole, known by the commercial name of Diflucan, is an antifungal drug, commonly used for example to fight urinary or genital candida. The spectrum of liver function abnormalities ranges from minimal changes, such as a slight transient increase in transaminase levels to the onset of hepatitis, cholestasis, and fulminant liver failure.
  • Isoniazid Isoniazid is an anti-tuberculosis drug: during therapy with isoniazid it is not uncommon to find alterations in liver function, up to severe fulminant hepatitis, potentially fatal. The risk of developing hepatitis is age-related, with an incidence of 8 cases per 1000 in people over the age of 65. Furthermore, the risk of hepatitis increases if there is significant daily alcohol consumption. Mild impairment of liver function or a transient rise in serum transaminase levels occurs in 10-20% of patients taking Isoniazid. In most cases, the enzyme levels return to the reference range without there being a need to stop the drug. Occasionally, however, damage occurs that progresses more and more. For this, people who are taking Isoniazid need to be closely monitored with blood tests at monthly intervals. Especially for people over the age of 35, liver enzymes should be measured before starting therapy, and then periodically during treatment.
  • Methyldopa: methyldopa is an antihypertensive drug, contraindicated for people with liver disease. Currently it is a little out of use, it is often used in pregnant women. During methyldopa therapy, periodic monitoring of liver function should be done during the first 6-12 weeks of treatment.
  • Oral contraceptives: oral contraceptives can cause intrahepatic cholestasis with itching and jaundice. Patients with a history of idiopathic jaundice in pregnancy, or who had severe pregnancy pruritus, or a positive family history for these disorders are more susceptible to liver damage.
  • Statins: statins, more correctly called HMG-CoA reductase inhibitors, are drugs used to control fats in the blood and in particular the cholesterol. The most commonly used statins are simvastatin is atorvastatin. The use of statins is often associated with abnormal liver function, as well as a frequent increase in creatinine kinase (CPK), an indicator of muscle damage. A moderate alteration in serum transaminase levels (less than 3 times the upper limit of the reference range) is often found after the start of therapy, and is in any case often transient. The finding of moderately elevated AST and ALT transaminases is not accompanied by any symptoms and usually does not require discontinuation of treatment. A persistent increase in serum transaminase levels (more than 3 times the upper limit of the reference range) occurs in approximately 1% of patients.
  • Rifampicin: Rifampicin is an antibiotic as well as an antituberculosis, and is generally administered together with Isoniazid. Rifampicin can also cause liver damage, usually mild, with elevation of ALT and AST. In patients taking rifampicin with other hepatotoxic agents, episodes of jaundice, liver failure and in some cases even death have occurred. For this reason, careful monitoring of the hepatic function of GPT and GOT (ALT and AST) is appropriate in patients receiving rifampicin.
  • Valproic acid and sodium valproate: Valproic acid generally causes hepatic steatosis, and it is not uncommon to notice an elevation in AST and ALT transaminases during treatment. This drug should not be given to patients with active liver disease.
  • Herbal products: very dangerous as they are often underestimated and are not considered potentially harmful. In reality they may contain hepatotoxic substances, and not being considered drugs, these are often not reported on the label, or if they are reported, however, the dosages are not known.

What are the symptoms of a high aspartate aminotransferase? Symptoms of high AST are those that suggest liver disease, or another organ that may release transaminases, such as:

  • Asthenia (weakness and easy fatigue)
  • Loss of appetite (hyporxia or anorrxia)
  • Nausea and / or vomiting, typically characterizes acute hepatitis, but also viral infections such as mononucleosis and CMV.
  • Abdominal swelling, which could be bloating or the initial accumulation of fluid in the abdomen (ascites)
  • Abdominal pain, freuqnete in patients with cirrhosis and ascites due to the high incidence of urinary and peritoneal infections
  • Yellow discoloration of the eyes and skin (scleral and skin jaundice)
  • Dark urine (cola color)
  • Light-colored stools (greyish, like clay)
  • Very dark stools (blackish, coffee grounds type)
  • Itching (due to the increase in bile salts in the circulation)
  • Behavior changes, confusion, daytime sleepiness and sleeplessness at night
  • Chest pain, shortness of breath, need to sleep with two or three pillows, swelling in the legs and jugular veins in case of heart problems
  • Reduction of diuresis (little pee during the day)
  • Skin hematomas in case of a recent muscle trauma.

When is it worth doing blood tests for AST and ALT?

The transaminases GOT and GPT (ALT and AST) must be measured:

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      • when one suspects liver disease (i.e. in the presence of: jaundice, fatigue (asthenia), nausea, vomiting, light or very dark stools, dark urine, itching, ascites (water in the abdomen), mental changes, history of alcohol abuse, suspected paracetamol overdose, family history of liver disease, exposure to hepatitis viruses)
      • for monitor liver function if it is known that there are liver problems (ie in case of use of potentially hepatotoxic drugs, presence of fatty liver disease, chronic liver disease, cirrhosis, liver failure, Wilson’s disease, hemochromatosis).

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AST will be dosed using a small amount of blood usually drawn from the crook of the arm. You don’t need to be fasting to take the exam.

Tags: Laboratory medicine Blood

Aspartate aminotransferase (AST) blood test | Multimedia Encyclopedia | Health Information

Aspartate aminotransferase; Serum glutamic-oxaloacetic transaminase; SGOT

The aspartate aminotransferase (AST) blood test measures the level of the
enzyme
AST in the blood.

How the Test is Performed

A
blood sample
is needed.

How to Prepare for the Test

No special preparation is needed.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed

AST is an enzyme found in high levels in the liver, heart, and muscles. It is also found in lesser amounts in other tissues. An enzyme is a protein that causes a specific chemical change in the body.

This test is mainly done along with other tests (such as
ALT
,
ALP
, and
bilirubin
) to diagnose and monitor
liver disease
.

Normal Results

The normal range is 10 to 34 U/L.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your health care provider about the meaning of your specific test results.

What Abnormal Results Mean

An increased AST level is usually a sign of liver disease. Liver disease is even more likely when the levels of substances checked by other liver blood tests have also increased.

An increased AST level may be due to any of the following:

  • Scarring of the liver (
    cirrhosis
    )

  • Death of liver tissue
  • Heart attack

  • Too much iron in the body (
    hemochromatosis
    )

  • Swollen and inflamed liver (
    hepatitis
    )

  • Lack of blood flow to the liver (liver ischemia)
  • Liver cancer or tumor
  • Use of drugs that are toxic to the liver
  • Mononucleosis
    (“mono”)

  • Muscle disease or trauma
  • Swollen and inflamed pancreas (
    pancreatitis
    )

AST level may also increase after:

  • Burns (deep)
  • Heart procedures
  • Seizure
  • Surgery

Pregnancy and exercise may also cause an increased AST level.

Risks

Veins vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Risks associated with having blood drawn are slight, but may include:

  • Bleeding from where the needle was inserted
  • Fainting or feeling lightheaded
  • Hematoma (blood collecting under the skin)
  • Infection (a slight risk any time the skin is broken)

References

Pincus MR, Tierno PM, Fenelus M, Bowne WB, Bluth MH. Evaluation of liver function. In: McPherson RA, Pincus MR, eds.
Henry’s Clinical Diagnosis and Management by Laboratory Methods
. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 21.

Pratt DS. Liver chemistry and function tests. In: Feldman M, Friedman LS, Brandt LJ, eds.
Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management.
10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.

Aspartate Aminotransferase (AST) | HealthLink BC

Test Overview

An aspartate aminotransferase (AST) test measures the amount of this enzyme in the blood. AST is normally found in red blood cells, liver, heart, muscle tissue, pancreas, and kidneys. AST formerly was called serum glutamic oxaloacetic transaminase (SGOT).

Low levels of AST are normally found in the blood. When body tissue or an organ such as the heart or liver is diseased or damaged, additional AST is released into the bloodstream. The amount of AST in the blood is directly related to the extent of the tissue damage. After severe damage, AST levels rise in 6 to 10 hours and remain high for about 4 days.

The AST test may be done at the same time as a test for alanine aminotransferase, or ALT. The ratio of AST to ALT sometimes can help determine whether the liver or another organ has been damaged. Both ALT and AST levels can test for liver damage.

Why It Is Done

An aspartate aminotransferase (AST) test is done to:

  • Check for liver damage.
  • Help identify liver disease, such as hepatitis. Liver disease may produce symptoms such as pain in the upper abdomen, nausea, vomiting, and sometimes jaundice.
  • Check on the success of treatment for liver disease.
  • Find out whether jaundice was caused by a blood disorder or liver disease.
  • Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver.

How To Prepare

Tell your doctor:

  • All of the medicines and natural health products (such as echinacea and valerian) you are taking.
  • If you are allergic to any medicines.
  • If you are or might be pregnant.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form .

How It Is Done

The health professional taking a sample of your blood will:

  • Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
  • Clean the needle site with alcohol.
  • Put the needle into the vein. More than one needle stick may be needed.
  • Attach a tube to the needle to fill it with blood.
  • Remove the band from your arm when enough blood is collected.
  • Put a gauze pad or cotton ball over the needle site as the needle is removed.
  • Put pressure on the site and then put on a bandage.

How It Feels

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

Risks

There is very little chance of a problem from having blood sample taken from a vein.

  • You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
  • In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.

Results

An aspartate aminotransferase (AST) test measures the amount of this enzyme in the blood. Results are usually available within 12 hours.

Normal

The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what’s normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

High values

High levels of AST may be caused by:

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Taking large doses of vitamin A.
  • Taking some natural health products, such as echinacea and valerian.
  • Recent cardiac catheterization or surgery.

What To Think About

  • The aspartate aminotransferase (AST) test is more effective than the alanine aminotransferase (ALT) test for detecting liver damage caused by heavy alcohol use. The AST to ALT ratio may sometimes help determine if liver damage is related to alcohol use disorder. For more information, see the topic Alanine Aminotransferase (ALT).
  • The gamma glutamyl transferase (GGT) test is sometimes done along with other liver enzyme tests.
  • Many different conditions can raise AST blood levels, so other testing is usually needed to interpret an abnormal AST result.

References

Citations

  1. Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Other Works Consulted

  • Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.

Credits

Current as of:
September 23, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Anne C. Poinier MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine
Jerome B. Simon MD, FRCPC, FACP – Gastroenterology

Current as of: September 23, 2020

Author: Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Anne C. Poinier MD – Internal Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Kathleen Romito MD – Family Medicine & Jerome B. Simon MD, FRCPC, FACP – Gastroenterology

Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Comparative Study of the Change in Liver Enzymes After General or Spinal Anesthetic Techniques in Patients With Preoperatively Elevated Liver Enzymes. – Full Text View

Surgery and anesthesia are stressful events, thus there is a possibility that liver enzymes and bilirubin may increase postoperatively. Mild elevations of serum aminotransferase, alkaline phosphatase, or bilirubin levels are frequent after surgical procedures, whether performed under general or spinal anesthesia. Anesthesia causes an initial reduction in hepatic arterial blood flow of 35-42% in the first 30 min of induction of anesthesia. During surgery, The liver blood flow returns to baseline. It is possible that either the initial hypoperfusion or reperfusion injury, or both, may contribute to postoperative liver dysfunction when it occurs.

The type of surgery is potentially an important factor of postoperative hepatic dysfunction. Intra-abdominal operations are more likely than extra-abdominal surgeries to cause reflex systemic hypotension and to subsequently reduce hepatic blood flow.This could be due to traction on abdominal viscera. Hypercarbia-induced splanchnic vasoconstriction is also a threat to hepatic perfusion in laparoscopic surgery. Surgeries that result in a large amount of blood loss increase the risk for ischemic hepatic injury, as can intraoperative hypotension.

Liver disease is important to recognize preoperatively because the risk of surgery in patients with advanced disease can be grave. Patients with liver disease are more likely than patients without liver disease to experience hepatic decompensation with anesthesia. Measurement of serum Bilirubin levels is central to the evaluation of hepatobiliary disorders. Liver disease is a challenging condition for the anesthesiologist, However, the risk could be diminished by careful consideration of the patients’ condition preoperatively and choosing suitable anesthetic procedure and drugs for these patients.Meanwhile, The effect of performing spinal anesthesia on patients with liver disease has not been investigated properly as most studies excluded patients with preoperatively elevated liver enzymes. Studies on patients undergoing general anesthesia with normal preoperative liver function tests showed a transient increase in the level of AST& ALT, with a mild increase in postoperative bilirubin levels

90,000 Dissertation for defense 2021 – Scientific Research Institute of Occupational Medicine named after Academician N. F. Izmerova

23 November 2021

Konshina Tatiana Alexandrovna

SCIENTIFIC SUBSTANTIATION OF THE INTEGRATED METHOD OF HYGIENIC ASSESSMENT OF PERSONAL PROTECTION FROM INDUSTRIAL FREQUENCY ELECTRIC FIELDS

dissertation for the degree of candidate of biological sciences in specialty 3.2.4 – Occupational medicine. Dissertation Council 24.1.176.01 (D.001.012.01). Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “

105275, Moscow, Budenny prospect, 31, tel. +7 (495) 365-02-09; e-mail: [email protected]


18 October 2021

Announcement of the protection of Olga Vyacheslavovna Naumova

Dissertation Council 24.1.176.01 (D.001.012.01) at the Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “(105275, Moscow, Budyonny prospect, 31; tel. 365-02-09; web: www. irioh.ru; e-mail: [email protected]) announces that Olga Vyacheslavovna Naumova presented her thesis “MOLECULAR-BIOCHEMICAL MARKERS OF ENDOTHELIAL DYSFUNCTION IN CHRONIC EXPOSURE OF MERCURY” for the degree of candidate of biological sciences, specialty 3.2.4 – Occupational medicine.

The defense of the thesis will be held December 22, 2021 in the conference hall of the institute.

Chairman of the Dissertation Council 24.1.176.01 (D.001.012.01) – Igor Valentinovich Bukhtiyarov.

13 September 2021

Naumova Olga Vyacheslavovna

MOLECULAR-BIOCHEMICAL MARKERS OF ENDOTHELIAL DYSFUNCTION UNDER CHRONIC EXPOSURE
MERCURY

dissertation for the degree of candidate of biological sciences in specialty 3.2.4 – Occupational medicine. Dissertation Council 24.1.176.01 (D.001.012.01). Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “

105275, Moscow, Budenny prospect, 31, tel. +7 (495) 365-02-09; e-mail: [email protected]


September 16, 2021

Announcement of the protection of Rusanova Dina Vladimirovna

Dissertation Council 24.1.176.01 (D.001.012.01) at the Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “(105275, Moscow, Budenny prospect, 31; tel. 365-02-09; web: www.irioh.ru; e-mail: [email protected]) announces that Rusanova Dina Vladimirovna has presented the thesis “MECHANISMS AND REGULARITIES OF FORMATION OF LESIONS OF THE CONDUCTING WAYS OF THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM UNDER THE EXPOSURE OF METHODOLOGICAL SCIENCES OF BIOLOGICAL SCIENCES” specialty 3.2.4 – Occupational medicine.

The defense of the thesis will be held December 22, 2021 in the conference hall of the institute.

Chairman of the Dissertation Council 24.1.176.01 (D.001.012.01) – Igor Valentinovich Bukhtiyarov.

28 June 2021

Rusanova Dina Vladimirovna

MECHANISMS AND REGULARITIES OF FORMATION OF
LESIONS OF THE CENTRAL AND
OF THE PERIPHERAL NERVOUS SYSTEM IN THE EXPOSURE OF
METALLIC MERCURY
(CLINICAL EXPERIMENTAL) 9000

dissertation for the degree of Doctor of Biological Sciences, specialty 3. 2.4 – Occupational Medicine. Dissertation Council 24.1.176.01 (D.001.012.01). Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “

105275, Moscow, Budenny prospect, 31, tel. +7 (495) 365-02-09; e-mail: [email protected]


15 September 2021

Announcement of the protection of Maria Sergeevna Bryleva

Dissertation Council 24.1.176.01 (D.001.012.01) at the Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “(105275, Moscow, Budyonny prospect, 31; tel. 365-02-09; web: www.irioh.ru; e-mail: [email protected]) announces that Bryleva Maria Sergeevna presented her thesis “SOCIAL AND HYGIENIC RESEARCH OF MORTALITY OF THE POPULATION OF INDUSTRIAL MONOCORTS OF THE ARCTIC” for the degree of candidate of biological sciences in specialty 3.2.4 – Occupational medicine.

The defense of the thesis will be held November 22, 2021 in the conference hall of the Institute.

Chairman of the Dissertation Council 24.1.176.01 (D.001.012.01) – Igor Valentinovich Bukhtiyarov.

28 June 2021

Bryleva Maria Sergeevna

SOCIO-HYGIENE STUDY OF MORTALITY OF THE POPULATION OF INDUSTRIAL MONOCORTS OF THE ARCTIC

dissertation for the degree of candidate of biological sciences in specialty 3.2.4 – Occupational medicine. Dissertation Council 24.1.176.01 (D.001.012.01). Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “

105275, Moscow, Budenny prospect, 31, tel. +7 (495) 365-02-09; e-mail: [email protected]


September 16, 2021

Announcement of the defense of Elizaveta Andreevna Finagina

Dissertation Council 24.1.176.01 (D.001.012.01) at the Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “(105275, Moscow, Budenny prospect, 31; tel. 365-02-09; web: www.irioh.ru; e-mail: [email protected]) announces that Elizaveta Andreevna Finagina presented her thesis “ANDROGENIC DEFICIENCY AND INDICATORS OF MEN’S HEALTH IN RAILWAY TRANSPORT ENGINEERS” for the degree of candidate of medical sciences, specialty 3.2.4.

The defense of the thesis will be held November 22, 2021 in the conference hall of the Institute.

Chairman of the Dissertation Council 24.1.176.01 (D.001.012.01) – Igor Valentinovich Bukhtiyarov.

June 24, 2021

Elizaveta Andreevna Finagina

ANDROGENIC DEFICIENCY AND INDICATORS OF MEN’S HEALTH IN RAILWAY MACHINERS

dissertation for the degree of candidate of medical sciences in specialty 3.2.4 – Occupational medicine. Dissertation Council 24.1.176.01 (D.001.012.01). Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “

105275, Moscow, Budenny prospect, 31, tel. +7 (495) 365-02-09; e-mail: [email protected]


March 17, 2021

Announcement of the protection of Kuzmina Svetlana Valerievna

Dissertation Council D 001.012.01 at the Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “(105275, Moscow, Budyonny prospect, 31; tel. 365-02-09; web: www.irioh.ru; e-mail: [email protected]) announces that Kuzmina Svetlana Valerievna has presented the thesis” RISKS IMPAIRMENTS OF MENTAL HEALTH OF WORKERS OF PRODUCTION OF CHEMICALS.CLINICAL AND EPIDEMIOLOGICAL FEATURES OF EARLY DIAGNOSTICS AND PREVENTION “for the degree of Doctor of Medical Sciences in the specialty 14.02.04 – Occupational Medicine.

The defense of the thesis will be held June 28, 2021 in the conference hall of the institute.

Chairman of the Dissertation Council D 001.012.01 Bukhtiyarov Igor Valentinovich.

10 February 2021

Kuzmina Svetlana Valerievna

RISKS OF IMPAIRMENT OF THE MENTAL HEALTH OF WORKERS OF PRODUCTION OF CHEMICALS. CLINICAL AND EPIDEMIOLOGICAL FEATURES OF EARLY DIAGNOSTICS AND PREVENTION

dissertation for the degree of Doctor of Medical Sciences in the specialty 14.02.04 – Occupational Medicine. Dissertation Council D.001.012.01. Federal State Budgetary Scientific Institution “Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerova “

105275, Moscow, Budenny prospect, 31, tel. +7 (495) 365-02-09; e-mail: [email protected]


Bronchial asthma: diagnosis and treatment

Bronchial asthma is a fairly common disease with a high mortality rate.The incidence does not depend on race, age or gender, is more than 5% of the total population and tends to increase. The course of bronchial asthma is chronic and progressive. At the same time, and despite the severity of the disease, subject to regular medical care and the steady fulfillment of medical prescriptions, bronchial asthma is quite confidently corrected. A well-designed treatment strategy allows patients not only to avoid death, but also to remain practically at the same high standard of living.

The main symptom of bronchial asthma is asthma attacks occurring with different frequency, expressed by shallow breathing, a feeling of squeezing the chest; short, difficult and sharp inhalation and long wheezing inhalation. Often accompanied by a cough with copious, viscous expectoration. The patient usually tends to assume a forced position of the body, in which it is easier to breathe. The attack is preceded by the so-called precursors, most often these are vasomotor phenomena – sneezing, profuse nasal discharge.

What signs should alarm you and become a reason to contact a specialist pulmonologist:

  • regularly occurring complications of acute respiratory infections, extending to the lower respiratory tract;
  • recurring attacks of shortness of breath, wheezing with a whistle;
  • increased cough at night;
  • exhalation, accompanied by wheezing;
  • dependence of well-being on the season;
  • Repetitive reactions to odors, drugs, food, physical or emotional stress.

The occurrence and progress of bronchial asthma is provoked by the presence of allergic diseases, smoking, and poor ecology. Diagnosis of bronchial asthma is carried out by pulmonologists. Usually, the diagnosis does not cause difficulties, it is much more difficult to choose a treatment regimen for a specific person, taking into account individual characteristics and general health.

Long-term treatment of bronchial asthma. Drug therapy has two goals – the first is to relieve symptoms – shortness of breath, shortness of breath, relieve bronchospasm and second – to reduce inflammation in the bronchi.In no case should you refuse basic drugs – without them it is impossible to stop the progression of the disease. If an allergen is detected, specific desensitizing therapy is performed.

Zvezda Medical Center offers diagnostics and treatment of bronchial asthma. The best specialists and modern equipment are at your service.

Make an appointment

An appointment with a pulmonologist can be made in any way convenient for you:

  • you can go through the registration via the Internet by clicking the button

  • you can also make an appointment by phone 8 (843) 291-00-19

HOW TO CONTROL BRONCHIAL ASTHMA – Planet of Health blog

Bronchial asthma (BA) is a well-studied disease. Science knows the causes, mechanisms of development, approaches to achieving control of bronchial asthma. However, as statistics show, only one patient out of four has the disease under control [1].

At the same time, the control of bronchial asthma is the main indicator when it comes to the effectiveness of therapy, and includes such characteristics as:

· Severity of symptoms;

· Frequency of exacerbations;

· Frequency of visits for emergency medical care;

· The need for drugs to relieve symptoms of the disease;

· Indicators of peak flowmetry [2].

Symptoms

Every patient with diagnosed bronchial asthma is familiar with its symptoms: wheezing; a feeling of congestion in the chest; suffocation; dry, with sputum difficult to separate, obsessive cough, including at night.

Depending on the frequency of symptoms, several levels of AD control are distinguished. So, with well-controlled asthma, attacks and the need to use drugs for their relief occur in the patient no more than 2 times a week, the patient, the patient does not wake up at night and his physical activity is not limited. With partially controlled asthma, daytime symptoms recur at intervals more often than 2 times a week, respectively, there is a need for an emergency inhaler, patients wake up at night due to seizures. Uncontrolled asthma can be talked about when the frequency of the onset of symptoms and the need for their relief is more than two per week, the patient experiences limited physical activity, and is also forced to wake up at night due to asthma symptoms. (see table) [1,7]

Table 1
Determination of the level of AD symptom control

Therefore, the minimum severity of symptoms, as well as rare exacerbations, indicates that the disease is controlled.

Need for emergency medications

Another marker of uncontrolled AD is the need for drugs to relieve symptoms (the so-called short-acting bronchodilators or emergency inhalers). The short-acting drug relieves symptoms by creating the illusion that everything is fine, although in reality the cause of the disease (inflammation) remains. As a result, the patient finds himself in a vicious circle: symptoms appear more and more often, and the need for bronchodilators is more and more.

Special questionnaires also help to control the disease. In 2020, AstraZeneca, with the support of the Russian Respiratory Society (RRO), launched a large-scale social non-branded program “Assess Addiction”. Patients with bronchial asthma are invited to undergo a specially developed Test * to assess the risk of dependence on excessive use of short-acting bronchodilators on the website of the campaign otseni-zavisimost.ru, as well as information on bronchial asthma, which helps patients to better assess their current state for timely access to a doctor.

Patients with bronchial asthma will be able, after passing the Test *, to save its results and show them to the doctor during the consultation, which will greatly simplify the diagnosis of the condition of the patient with asthma. Every day, patients all over Russia visit this program website and take a test *!

Take the test *

The test result * may indicate a high or moderate risk of over-dependence on an ambulance ** inhaler to relieve asthma attacks – this is a signal to your doctor that BA therapy should be reviewed. Also, the test results may show a low risk of over-dependence on an ambulance ** inhaler for relieving asthma attacks, which is a positive factor.

Revision of therapy may be required if:

You use your inhaler to relieve asthma attacks 3 times a week or more, or you use 12 inhalers (balloons) a year (if you have such a situation, do not wait for the next scheduled doctor’s consultation, make an appointment to evaluate the course of bronchial asthma) [7+ Russian wedge.rivers].

What to do next:

Keep track of how often you use an ambulance ** inhaler to relieve asthma attacks. The main purpose of prescribing a new drug for the regular therapy of bronchial asthma is to reduce the severity of asthma symptoms, and therefore to reduce the need for the use of an emergency inhaler. If you are taking a new medication for regular AD treatment but still need to use the inhaler for symptomatic therapy 3 or more times a week, you may need to make an appointment with your doctor again.

Control over future risks

Control of bronchial asthma is not only the absence or minimal severity of symptoms, but also “reducing the potential risk associated with deterioration of the condition, the development of exacerbations, the progression of the disease, the manifestation of side effects of drugs” [1]. Accordingly, the achievement of good clinical control over bronchial asthma can reduce the risk of exacerbations [2].

It must be remembered that provoking factors, or so-called triggers, play an important role in the development of exacerbation. Some of them are independent of the patient. For example, concomitant diseases. Others may well be controlled by the patient.

The patient must necessarily master the correct inhalation technique, since the effectiveness of therapy depends on this.

Another important condition for the control of bronchial asthma is the fulfillment of the doctor’s prescriptions. Bronchial asthma is a variable disease, that is, its symptoms are not always pronounced: a person may feel good, but this does not mean that there is no disease. That is why there should be no talk of any self-medication or self-withdrawal of drugs.

In addition, for the control of bronchial asthma, external influences are of great importance, which can cause its aggravation (allergens, stressful situations, etc.). Therefore, the patient’s task is to do everything possible to minimize their impact, and therefore reduce the risk of an attack.

Take the test *

** Emergency short-acting inhaler – an inhaler containing short-acting bronchodilators: salbutamol or fenoterol and / or ipratropium bromide or combinations thereof and not containing inhaled glucocorticosteroid (ICS).

* Not an approved diagnostic, treatment standard, or official guideline. The results of the questionnaire are not a diagnosis, the basis for prescribing treatment or self-medication, as this is the responsibility of the relevant specialists. A test for assessing dependence on overuse of a rapid-response inhaler for relieving symptoms of bronchial asthma was developed on the basis of the validated medical questionnaire 11 (BMQ) by the leading expert in behavioral medicine, Robert Horn, with the support of experts from the International Primary Care Respiratory Group (IPCRG) … 11.12 The Quality Asthma Care Initiative is an international movement led by the IPCRG with the support of AstraZeneca.ICS – inhaled glucocorticosteroids. # Hypothetical patient.

Sources:

1. Arkhipov V.V.Arkhipov 1, E.V. Grigorieva 2, E.V. Gavrishina 3 Control over bronchial asthma in Russia: results of a multicenter observational study NIKA https://journal.pulmonology.ru/pulm/article/viewFile / 423/423

2. Global strategy for the treatment and prevention of bronchial asthma (revision 2011.) / Ed. A.S. Belevsky. – M .: Russian Respiratory Society, 2012 .– 108 p., Ill. , P. 35-37

3. Medical reference book. Peak flowmetry. Registration of peak flowmetry results [Electronic resource], URL: https://academyexperts.ru/22-pikfloumetriya-registraciya-rezultatov-pikfloumetrii/, (date of treatment 03.23.2021).

4. Sobchenko S.A., Countechikova O.S., Leshenkova E.V., Pospelova S.N. Peak flowmetry in the treatment of bronchial asthma // To help a practitioner.2010. URL: https://cyberleninka.ru/article/n/pikfloumetriya-v-lechenii-bronhialnoy-astmy/viewer, (date of access 03/22/2021)

5. Trushenko N. What is peak flowmetry, who needs it and why // Asthma and Allergy. 2014. Issue. 3. URL: https://cyberleninka.ru/article/n/chto-takoe-pikfloumetriya-komu-i-zachem-ona-nuzhna/viewer (date of access 03/22/2021)

6. Federal clinical guidelines for the diagnosis and treatment of Bronchial Asthma 2019.Russian Respiratory Society. [Electronic resource], 22.06.2021 http://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/

7. From the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2021. [Electronic resource], 22.06.2021. Available from: http://www.ginasthma.org/

8. Juniper E.F., O’Byrne P.M., Guyatt G.H. et al. Development and validation of a questionnaire to measure asthma control // Eur.Respir. J. 1999. Vol. 14. P. 902–907.

9. Nathan R. A., Sorkness C. A., Kosinski M. et al. Development of the asthma control test: a survey forassessing asthma control // J. Allergy Clin. Immunol. 2004. Vol. 113 (1). P. 59–65.

10. Scales and algorithms in general medical practice. M .: Publishing group “GEOTAR-Media”, 2020. Pages 135-138

11. Price D, et al. NPJ Prim Care Resp Med.2014; 24: 14009. 4

12. Horne. R. et al. J Psychosom Res. 1999 Dec; 47 (6): 555-67.

The material is intended for a wide audience.

THE INFORMATION PROVIDED IN THIS SECTION DOES NOT REPRESENT OR REPLACE THE ADVICE OF A DOCTOR. IT IS NECESSARY TO RECEIVE A DOCTOR’S CONSULTATION.

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Address: 123112, Moscow, 1st Krasnogvardeisky proezd, d.21, building 1., Tower “OKO”, 30th floor

Tel .: +7 (495) 799-56-99 www.astrazeneca.ru, www.az-most.ru

Approval number: SYM_RU-11534. Date of approval: 10/12/2021. Expiration date: 11/10/2023

Bronchial Asthma

08.05.2019

Number of views: 15282

Bronchial asthma is a chronic non-infectious disease of the respiratory tract of an inflammatory nature.An attack of bronchial asthma often develops after the precursors and is characterized by a short, sharp breath and a noisy prolonged exhalation. It is usually accompanied by a cough with viscous phlegm and loud wheezing sounds. Diagnostic methods include the assessment of spirometry data, peak flowmetry, allergy tests, clinical and immunological blood tests. In the treatment, aerosol beta-adrenergic agonists, m-anticholinergics, ASIT are used; in severe forms of the disease, glucocorticosteroids are used.

General

Over the past two decades, the incidence of bronchial asthma (BA) has increased, and today there are about 300 million asthmatics in the world.This is one of the most common chronic diseases that affects all people, regardless of gender and age. Mortality among patients with bronchial asthma is quite high. The fact that over the past twenty years the incidence of bronchial asthma in children has been constantly growing, makes bronchial asthma not just a disease, but a social problem, against which maximum efforts are directed. Despite the complexity, bronchial asthma responds well to treatment, thanks to which you can achieve persistent and long-term remission.Constant control over their condition allows patients to completely prevent the onset of asthma attacks, reduce or eliminate the intake of drugs for stopping attacks, as well as lead an active lifestyle. This helps to maintain lung function and completely eliminate the risk of complications.

Reasons

The most dangerous provoking factors for the development of bronchial asthma are exogenous allergens, laboratory tests for which confirm a high level of sensitivity in BA patients and in those at risk.The most common allergens are household allergens – house and book dust, food for aquarium fish and animal dander, plant allergens and food allergens, which are also called nutritional allergens. In 20-40% of patients with bronchial asthma, a similar reaction to drugs is revealed, and in 2% the disease is obtained as a result of work in hazardous industries or, for example, in perfumery stores.

Infectious factors are also an important link in the etiopathogenesis of bronchial asthma, since microorganisms, their waste products can act as allergens, causing sensitization of the body.In addition, constant contact with the infection maintains the inflammatory process of the bronchial tree in the active phase, which increases the body’s sensitivity to exogenous allergens. The so-called haptenic allergens, that is, allergens of a non-protein structure, entering the human body and binding with its proteins also provoke allergic attacks and increase the likelihood of AD. Factors such as hypothermia, burdened heredity and stressful conditions also occupy one of the important places in the etiology of bronchial asthma.

Pathogenesis

Chronic inflammatory processes in the respiratory organs lead to their hyperactivity, as a result of which, upon contact with allergens or irritants, bronchial obstruction instantly develops, which limits the air flow rate and causes suffocation. Asthma attacks are observed with different frequency, but even in the remission stage, the inflammatory process in the airways persists. At the heart of the violation of the patency of the air flow in bronchial asthma are the following components: obstruction of the airways due to spasms of the smooth muscles of the bronchi or due to edema of their mucous membranes; blockage of the bronchi with secretion of the submucous glands of the respiratory tract due to their hyperfunction; replacement of muscle tissue of the bronchi with connective tissue during a long course of the disease, which causes sclerotic changes in the wall of the bronchi.

At the heart of the changes in the bronchi is sensitization of the body, when antibodies are produced during allergic reactions of an immediate type, proceeding in the form of anaphylaxis, and when an allergen is encountered again, an instant release of histamine occurs, which leads to edema of the bronchial mucosa and hypersecretion of the glands. Immunocomplex allergic reactions and delayed sensitivity reactions proceed similarly, but with less severe symptoms. An increased amount of calcium ions in human blood has recently also been considered a predisposing factor, since an excess of calcium can provoke spasms, including spasms of the muscles of the bronchi.

In the pathological examination of the dead during an attack of suffocation, there is a complete or partial blockage of the bronchi with viscous thick mucus and emphysematous expansion of the lungs due to difficulty exhaling. Tissue microscopy most often has a similar picture – it is a thickened muscle layer, hypertrophied bronchial glands, infiltrative bronchial walls with desquamation of the epithelium.

Classification

BA is subdivided according to etiology, severity of the course, level of control and other parameters.Allergic (including professional asthma), non-allergic (including aspirin asthma), unspecified, mixed bronchial asthma are distinguished by origin. According to the severity, the following forms of asthma are distinguished:

  1. Intermittent (episodic). Symptoms occur less than once a week, and exacerbations are rare and short.
  2. Persistent (constant flow). Divided into 3 degrees:
  • mild – symptoms occur from 1 time per week to 1 time per month
  • average – daily seizure frequency
  • severe – symptoms persist almost constantly.

During asthma, exacerbations and remission (unstable or stable) are isolated. Whenever possible, control over asthma seizures can be controlled, partially controlled and uncontrolled. A complete diagnosis of a patient with bronchial asthma includes all of the above characteristics. For example, “Bronchial asthma of non-allergic origin, intermittent, controlled, in the stage of stable remission.”

Symptoms of bronchial asthma

The asthma attack in bronchial asthma is divided into three periods: the precursor period, the peak period and the period of reverse development.The period of precursors is most pronounced in patients with an infectious-allergic nature of asthma, it is manifested by vasomotor reactions from the nasopharynx organs (abundant watery discharge, incessant sneezing). The second period (it can start suddenly) is characterized by a feeling of tightness in the chest, which does not allow breathing freely. The inhalation becomes sharp and short, and the exhalation, on the contrary, becomes long and noisy. Breathing is accompanied by loud wheezing, a cough with viscous, difficult to expectorate sputum appears, which makes breathing arrhythmic.

During an attack, the patient’s position is forced, usually he tries to take a sitting position with the body tilted forward, and find a fulcrum or rests with his elbows on his knees. The face becomes puffy, and during exhalation, the cervical veins swell. Depending on the severity of the attack, the involvement of muscles can be observed, which helps to overcome the resistance on exhalation. In the period of reverse development, a gradual discharge of sputum begins, the number of wheezing decreases, and the attack of suffocation gradually fades away.

Manifestations in which the presence of bronchial asthma can be suspected.

  • high-pitched wheezing wheezing on exhalation, especially in children.
  • Repetitive episodes of wheezing, shortness of breath, tightness in the chest and cough, worse at night.
  • seasonality of deterioration of health from the respiratory system
  • a history of eczema, allergic diseases.
  • worsening or onset of symptoms upon contact with allergens, taking medications, upon contact with smoke, with sudden changes in ambient temperature, acute respiratory infections, physical exertion and emotional stress.
  • Frequent colds “descending” into the lower respiratory tract.
  • improvement after taking antihistamines and anti-asthma drugs.

Complications

Depending on the severity and intensity of asthma attacks, bronchial asthma can be complicated by emphysema of the lungs and the subsequent addition of secondary cardiopulmonary insufficiency. An overdose of beta-adrenostimulants or a rapid decrease in the dosage of glucocorticosteroids, as well as contact with a massive dose of an allergen, can lead to status asthmaticus, when asthma attacks follow one after another and are almost impossible to stop.Status asthmaticus can be fatal.

Diagnostics

The diagnosis is usually made by a pulmonary clinician based on complaints and symptoms. All other research methods are aimed at establishing the severity and etiology of the disease. With percussion, the sound is clear boxy due to the hyper-airiness of the lungs, the mobility of the lungs is sharply limited, and their boundaries are shifted downward. On auscultation over the lungs, vesicular breathing is heard, weakened with a prolonged expiration and with a large number of dry wheezing.Due to the increase in lung volume, the point of absolute dullness of the heart decreases, the heart sounds are muffled with an accent of the second tone over the pulmonary artery. From instrumental research is carried out:

  • Spirometry. Spirography helps to assess the degree of bronchial obstruction, to find out the variability and reversibility of the obstruction, as well as to confirm the diagnosis. In BA, forced expiration after inhalation with a bronchodilator increases by 12% (200 ml) and more in 1 second. But to obtain more accurate information, spirometry should be performed several times.
  • Peak flowmetry. Measurement of peak expiratory activity (PSV) allows monitoring the patient’s condition by comparing the indicators with those obtained earlier. An increase in PSV after inhalation of a bronchodilator by 20% or more from PSV to inhalation clearly indicates the presence of bronchial asthma.

Additional diagnostics include allergen tests, ECGs, bronchoscopy, and chest x-rays. Laboratory blood tests are of great importance in confirming the allergic nature of bronchial asthma, as well as for monitoring the effectiveness of treatment.

  • Blood test. Changes in the KLA – eosinophilia and a slight increase in ESR – are determined only during an exacerbation. A blood gas assessment is needed during an attack to assess the severity of DN. A biochemical blood test is not the main diagnostic method, since the changes are general in nature and such studies are prescribed to monitor the patient’s condition during an exacerbation.
  • General sputum analysis. Microscopy in sputum can detect a large number of eosinophils, Charcot-Leiden crystals (shiny transparent crystals that form after the destruction of eosinophils and have the shape of rhombuses or octahedrons), Kurshman spirals (formed due to small spastic contractions of the bronchi and look like casts of transparent mucus in the form spirals). Neutral leukocytes can be found in patients with infectious-dependent bronchial asthma in the stage of an active inflammatory process. The release of Creole bodies during an attack is also noted – these are rounded formations consisting of epithelial cells.
  • Study of the immune status. In bronchial asthma, the number and activity of T-suppressors decreases sharply, and the amount of immunoglobulins in the blood increases. The use of tests to determine the amount of immunoglobulins E is important if allergy tests are not possible.

Treatment of bronchial asthma

Since bronchial asthma is a chronic disease, regardless of the frequency of attacks, the fundamental point in therapy is the exclusion of contact with possible allergens, adherence to elimination diets and rational employment. If it is possible to identify an allergen, then specific hyposensitizing therapy helps to reduce the body’s response to it.

For the relief of asthma attacks, beta-adrenomimetics in the form of an aerosol are used in order to quickly increase the lumen of the bronchi and improve the outflow of sputum. These are fenoterol hydrobromide, salbutamol, orciprenaline. The dose in each case is selected individually. Preparations of the m-anticholinergic group – aerosols of ipratropium bromide and its combination with fenoterol – also relieve attacks well.

Xanthine derivatives are very popular among patients with bronchial asthma. They are prescribed to prevent asthma attacks in the form of prolonged-release tablets. In the past few years, drugs that inhibit the degranulation of mast cells have had a positive effect in the treatment of bronchial asthma.These are ketotifen, sodium cromoglycate and calcium ion antagonists.

In the treatment of severe forms of asthma, hormonal therapy is used, almost a quarter of patients need glucocorticosteroids, 15-20 mg of Prednisolone is taken in the morning along with antacids that protect the gastric mucosa. In a hospital setting, hormonal drugs can be administered in the form of injections. The peculiarity of the treatment of bronchial asthma is that it is necessary to use drugs in the minimum effective dose and to achieve an even greater reduction in dosages. For better sputum discharge, expectorant and mucolytic drugs are indicated.

Forecast and prevention

The course of bronchial asthma consists of a series of exacerbations and remissions, with timely detection, a stable and long-term remission can be achieved, the prognosis depends to a greater extent on how carefully the patient treats his health and complies with the doctor’s prescriptions. The prevention of bronchial asthma is of great importance, which consists in the rehabilitation of foci of chronic infection, the fight against smoking, as well as in minimizing contact with allergens.This is especially important for people who are at risk or have a history of family history.
Source: https://www.krasotaimedicina.ru/diseases/zabolevanija_pulmonology/asthma

90,000 (PDF) Asthma. Free yourself and forget. Forever and ever.

Such negative emotions as fear, congestive anxiety, resentment, anger, guilt,

also criticism of oneself and others, can cause an increase in blood pressure,

provoke an attack of peptic ulcer disease, dyskinesia of the biliary tract. They also

contribute to the development of vegetative-vascular dystonia, headache and heartache,

bronchospasm, shortness of breath, weakness, decreased immunity, etc.

ways.

The physiological consequences of the same emotion are different for different people.

For example, aggression in different people causes a different set of shifts in the

functioning of the body, and these shifts are individually constant.Emotion can become

pathogenic for the body if it is repeated,

of the emotional state becomes chronic. An emotion that does not find expression in open

action, behavior (suppressed emotion) is also pathogenic.

If a person constantly experiences the emotions of the sthenic circle (anger, aggression),

which are realized through the sympathetic nervous system, and these emotions are suppressed, chronic excitement occurs in the

sympathetic nervous system, the so-called

sympathetic-adrenaline complex, which leads to to arterial hypertension,

neurodermatitis, nonspecific polyarthritis (joint diseases).

If asthenic emotion is suppressed (resentment, anxiety, fearfulness, timidity,

shyness), which is realized through the parasympathetic nervous system, then

its chronic excitation in these cases increases the risk of ulcerative lesions

of the gastrointestinal tract, bronchial asthma, diabetes mellitus.

Both the depth and the strength (intensity) of the experienced emotion matter. The more intense it is

, the more pronounced the physiological changes, and the chronization of such an emotion –

, the more pathogenic.Thus, the focus is on the physiological

component of emotion.

At the same time, patients with emotionally conditioned (psychosomatic) diseases

most often first go to a general practitioner. Each of us

has experience when at a doctor’s appointment (and every doctor is also a potential patient) we

treat only that part of the body at the level of which the symptom exists, without taking into account our personal

history.

According to the combined WHO data, from 38 to 42% of all patients attending

somatic doctors’ offices belong to the group of psychosomatics.

Strictly speaking, the psychosomatic direction is not an independent medical discipline

– it is an approach that takes into account the variety of causes that led to the

illness. Hence the variety of methods and techniques that allow you to work with a person

holistically, integratively. After all, it was precisely the disunity of medical specialties and views of

on a person that led to the loss of the idea of ​​integrity in work. This problem has its

reasons, and above all the predominance of analysis as a method in medical science.In

, about 10,000 symptoms and nosological forms are currently described, and more than three hundred

medical specialties exist in order to cope with diseases of

people. Symptoms and syndromes reflecting changes manifested themselves and numerically

increased in the course of human evolution, which means that the

universal mechanism of adaptation was gradually disrupted. Ancient programs that protect humans,

helped to resist hunger, cold, attack by animals and enemies.Thanks to them,

people acquired flexibility, mobility, thermoregulation, hearing, smell, etc.

As human history developed, the loads for which were not created

genetic protection programs, and therefore adaptation depends on the mental

of a person in many times more than from his muscles, fascia, tendons and

running speed. It was not the enemy’s weapon that became dangerous, but the word. Emotions of a person, originally

designed to mobilize for protection, are now more often suppressed, embedded in a special context

, over time they are perverted, cease to be recognized by their master and

Breathe deeply.7 facts you should know about bronchial asthma

Difficulty breathing, wheezing, coughing, chest discomfort – in today’s reality, such symptoms are associated with COVID-19. But in reality, such signs are characteristic of another serious diagnosis, bronchial asthma. May can be called the month of counteraction to this disease, because May 4 is World Asthma Day, and May 17 is the Day of the Pulmonologist. What and why is it worth knowing about bronchial asthma? Experts from UNIQA medical assistance report.

According to the WHO, about 340 million patients worldwide suffer from bronchial asthma. In Ukraine, according to the Ministry of Health, more than 200 thousand people are registered with this diagnosis. The problem is quite common and quite complex, because asthma is a chronic disease with which one must learn to live a full life.

What is bronchial asthma and how does it manifest itself?

This is a disease that can be considered a chronic inflammation of the airways.Due to the constant inflammatory reaction over time, the contractility of the surrounding smooth muscles increases – which means that a sharp narrowing, spasm of the respiratory muscles and breathing problems can occur.

Bronchial asthma is characterized by a whole “bouquet” of symptoms: a feeling of compression in the chest, wheezing, shortness of breath, cough of variable frequency and intensity. From time to time, a person with asthma may have so-called asthmatic attacks, when the airways become narrowed and swollen, and the air flow through them passes with considerable difficulty.

This condition can be very pronounced, does not go away on its own, and without the help of drugs, it can be life threatening. Asthma symptoms are more likely to worsen at night and in the morning, or as a reaction to exercise or cold air.

What Causes Asthma?

In fact, modern medicine still does not have an exact answer to this question. Doctors agree only that the disease can appear due to a complex combination of circumstances: genetic factors and the adverse effects of the external environment.

Poor air quality from traffic pollution, the effects of formaldehyde and certain volatiles emitted by PVC have been shown to be associated with the development of asthma in both adults and children. The risks of asthmatic manifestations in children increase if the expectant mother does not quit smoking during pregnancy.

However, other factors also matter. Some studies show that people with asthma are more likely to have comorbid conditions such as anxiety disorders or mood disorders.But one cannot say for sure whether psychological problems are capable of provoking the onset of asthma, or, on the contrary, because of asthma, people are more often faced with such diagnoses.

Probably not the main risk factor for the development of asthma, modern medicine considers the presence of atopic dermatitis, eczema or allergic rhinitis in a person. Overweight people and those who have relatives with diagnosed asthma are also at risk. Moreover, modern researchers have even proven a link between asthma and a person’s level of financial well-being.

At what age can you get asthma for the first time?

Asthma can affect anyone and at any age, although most often the onset of this disease is recorded in childhood, mainly at school age. Up to 10 years of age, boys are more likely to suffer from asthma, and in adolescence, girls. This diagnosis in different countries can be established in 10% – 15% of children, but very often mild forms of asthma are not diagnosed.

Asthma in adults sometimes begins, disguising itself as “commonplace” diseases that do not pay much attention to – ARI or ARVI.It also happens that a bacterial or viral infection becomes the impetus for the development of asthmatic complications. Asthma of an allergic nature can also occur after the next seasonal exacerbation of perennial allergies.

How to recognize bronchial asthma?

A fairly typical symptom is a cough and wheezing sounds when breathing, a feeling of lack of oxygen. Moreover, the condition can occur suddenly, often at night, but sometimes during the day after contact with allergens.A person who has an asthmatic attack breathes shallowly, shallowly, faster, and may complain that they cannot breathe in deeply. A pulse oximeter may indicate a decrease in oxygen saturation (oxygen level in the blood).

Important: all these symptoms are non-specific, that is, characteristic of many diseases and conditions: allergic Quincke’s edema, chronic obstructive pulmonary disease, acute heart failure and others. Therefore, the final diagnosis can be made only after a multilevel examination.In particular, this is X-ray of the lungs, spirometry (assessment of the composition of the inhaled air and exhaled air), blood tests.

We hope that you have not and will never face any symptoms of asthma. But if any of the described symptoms or situations are familiar to you, make an appointment with your doctor. For those who have UNIQA insurance, it is easy to do this through the myUNIQA mobile application. You can get an online consultation at any time convenient for you, as well as a visit to a specialized specialist.

Systemic and long-term treatment of bronchial asthma is usually not provided by the insurance program, because this disease is chronic. But we will definitely compensate the costs of diagnostics if the problem arose for the first time, and we also organize medical care in case of an acute condition.

A person has an asthma attack, how can I help?

An attack of bronchial asthma can find a person anywhere: at home, at work and even on public transport.It is important to remember that the first aid for a patient with bronchial asthma is to use an inhaler recommended by a doctor. Most often, a person has it with him. Therefore, first aid is to get the inhaler, shake it, turn the aerosol can up, give it to the patient, or make 1-2 clicks on your own so that the drug hits the back of the throat. At this time, the patient must take several breaths so that the active substance enters the respiratory tract. After that, it is necessary to arrange the person comfortably: it is uncomfortable for such a patient to lie, therefore, he must be seated comfortably so that his legs are on the floor, his hands are resting on the railing, and the elbows are spread apart.

What else can be done?

  • Open shirt collar, remove tie, provide fresh air, open windows,
  • Warm drink and hot baths for hands up to the elbow can also alleviate the patient’s condition.

If the attack occurred for the first time, you need to reassure the person – the feeling of lack of air can be very frightening. Here special breathing exercises can distract: a very deep breath and a sharp deep exhalation.

Is it true that asthmatics are more at risk of contracting COVID-19?

Lack of oxygen is characteristic of the severe course of COVID-19. And while the causes of this condition are not the same as the causes of asthma choking, many people are concerned: could asthma increase the risk of complications from Coronavirus disease?

The results of several studies in the United States provide reassuring results. In particular, two studies supported by the National Institute of Allergy and Infectious Diseases (USA) show that people with allergic asthma do not have a higher risk of contracting coronavirus.In patients with bronchial asthma, the expression of the gene on the receptor cells of the respiratory tract, which SARS-CoV-2 uses to penetrate and infect humans, is reduced. Therefore, the risk of getting sick may be even less.

There is one more very positive news. The steroid budesonide, which is used in inhalers for patients with bronchial asthma, may be effective in treating COVID-19 at an early stage. At the end of April 2021, a study by the University of Oxford was published in the authoritative medical journal The Lancet: according to scientists, patients with COVID-19 who started taking budesonide at the first symptoms of the disease are less likely to need hospitalization and recover faster.

Can asthma be cured?

Unfortunately, there is usually no question of complete recovery. However, now there are effective medical protocols that allow people with asthma to lead almost the same lifestyle as people without this diagnosis, to reduce the frequency of attacks, their duration, or even achieve a stable long-term remission.

About such diseases, doctors usually say that they are well controlled and have a positive prognosis, if the recommendations of specialists are strictly followed.