Defınıtıon and Management of Asthma in Children

Yıl 2018, Cilt: 10 Sayı: 2, 27 - 32, 06.03.2018

Prof. Dr. Cevdet Özdemir

Öz

Abstract

Asthma, is the most common chronic childhood disorder, characterized by airwayinflammation and airflow limitation triggered by various stimuli, marked by recurrentcough, wheezing, shortness of breath and chest tightness. Allergen sensitization is the most important factor responsible in development of asthma. Besides, genetic and on going epigenetic influences, respiratory infections, air pollution and smoking affect the development and course and exacerbations of asthma. Despite difficulties in childhood, it is possible to establish asthma diagnosis with a detailed disease history and physical examination, with clinical follow-up, evaluation of treatment responsiveness and by relevant diagnostic methods. Identification of asthma phenotypes facilitates asthma follow-up and treatment plans. The main goal of treatment is to maintain symptomcontrol, to prevent exacerbations and avoid deterioration of quality of life. In addition to the treatment steps recommended in guidelines, it is possible to improve disease control by increasing patient education, by creating written action plans, by avoiding modifiable risk factors andcomorbidities, as well as by promoting physical activity,weight restriction and by overviewing inhaler techniques.

Anahtar Kelimeler

Asthma, Atopy, Epigenetic, Personal Medicine, Risk Factors

Çocuklarda Astım’ın Tanımı ve Yönetimi

Öz

Öz

Astım, tekrarlayan öksürük, hışıltı, nefes darlığı ve göğüste sıkışma hissi ataklarıyla seyreden alt hava yollarında çeşitli uyaranların etkisiyle gelişen havayolu inflamasyonuyla ve hava akımı kısıtlanmasıyla karakterize çocukluk çağının en sık görülen kronik rahatsızlığıdır. Alerjen duyarlılığı astım gelişiminde en önemli etkendir. Alerjenlerin yanı sıra genetik ve süregelen epigenetik etki, solunum yolu enfeksiyonları, çevresel hava kirliliği, sigara dumanı gibi faktörler astımın gelişimini ve seyrini etkilemekte, atakları alevlendirmektedir. Çocukluk çağında astım tanısı, zorluklarıyla beraber, özellikle iyi bir anamnez ve fizik muayeneyle, klinik takip, tedavi yanıtı ve tanısal testlerinin değerlendirilmesiyle konulur. Astım fenotiplerinin tanımlanması, astımın takip ve tedavi planlamalarının şekillendirilmesinde yol göstericidir. Semptomların kontrolü ve kontrolün devamının sağlanması, atakların önüne geçilmesi, yaşam kalitesinin bozulmasının engellenmesi çocukluk çağı astımında tedavinin ana hedefidir. Günümüzde tedavi kılavuzlarında önerilen tedavi basamaklarına ek olarak hasta eğitimi, yazılı eylemplanlarının oluşturulması, değiştirilebilir risk faktörlerinin ve komorbiditelerin önüne geçilmesi, fiziksel aktivite, kilo kısıtlanması ve ilaç kullanım tekniklerinin kontrol edilmesi ayrıca önem taşımaktadır.

Anahtar Kelimeler

Astım, Atopi, Epigenetik, Kişiselleştirilmiş Tıp, Risk Faktörleri

Kaynakça

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