Title: Navigating the Challenges of Crafting a PhD Thesis on the Prevalence of Asthma

Embarking on the journey of writing a Ph.D. thesis on the prevalence of asthma is a formidable task
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No further increase in asthma, hay fever and atopic sensitisation in adolescence living in Switzerland.
Validated questionnaires may be an option in settings where objective testing is unavailable. 12.
However, a mannitol testing kit using a dry powder inhaler has recently been developed that could
allow such testing to move outside the pulmonary function laboratory and into the office setting. The
use of microspirometry in detecting lowered FEV 1 values in current or former smokers. Guidelines
for methacholine and exercise challenge testing — 1999. Provocation testing may be necessary if the
spirometry results are normal. This pattern was reversed among children aged 0-17 years. The test
measures the fastest rate of expired airflow. Indirect stimuli include hyperpnea, hypertonic aerosols,
osmotic challenges and adenosine monophosphate. It is important to elicit the possible triggers of
asthma symptoms, especially those that can be modified. Obesity is also closely linked to lower
socioeconomic status and racial disparities, but obesity alone portends a worse prognosis among
those diagnosed with asthma even when race and income are controlled for. The choices include
direct challenges with histamine or methacholine 51 and indirect airway challenges with mannitol or
exercise. 52, 53. What is the prognosis for patients managed in the recommended ways. Depending
on the program, you might have to complete both to graduate. Inhalation of methacholine, a
cholinergic agonist, produces more bronchoconstriction in response to a given dose in asthmatics
than in individuals without asthma. And, some otherwise healthy individuals can establish asthma
signs just when working out. Therefore, if the diagnosis of asthma is confirmed, peak flow
monitoring will be initiated and she will be referred to a specialist with expertise in work-related
asthma. However, Th2 skewing is neither necessary nor sufficient for development of asthma, and
recent evidence suggests that Th1 may also have a role in asthma pathogenesis. Patients with COPD
may also have an allergic phenotype. If work-related asthma is a possibility, details of work
exposures and a pattern of improvement of asthma symptoms during holidays should be explored.
Add Links Send readers directly to specific items or pages with shopping and web links. However,
some patients with asthma may have negative pulmonary function tests. Summer Course on Research
Methodology in Medical Sciences July 10-21, 2017, Istanbul. This blog post will also be
simultaneously posted on the Core EM site here. He has also received consulting contracts and
speaker fees from this board. Exercise studies may be helpful in diagnosing and assessing this
condition. HL helped to acquire the data and write the article. However, heart failure most
commonly occurs in patients with a known history of cardiac problems and is often associated with
ankle edema and weight gain. The American Thoracic Society’s spirometric criteria alone is
inadequate in asthma diagnosis. Her mother has told her that she had eczema as a baby, and she
remembers having itchy, red rashes when she was younger.
In the same year, 1.1 million adults and 0.6 million children had asthma-related emergency room
visits, and asthma-related hospitalizations exceeded 299,000 for adults and 157,000 for children.
Good ones can positively take your company to another level by landing you that slew of clientele
you have been aiming to acquire. Arrows indicate use of reliever medication (salbutamol) for asthma
symptoms. Reproduced courtesy of Dr. Andre Cartier and Medical Resource Communications. 47.
Jugular venous distension suggests congestive heart failure or pericardial effusion. Females had a
20% higher outpatient visit rate compared to males. Monitoring asthma therapy using direct
bronchial provocation tests. The inflammation also causes an associated increase in the existing
bronchial hyperresponsiveness to a variety of stimuli. Harold Kim has received speakers fees and has
served on advisory boards for Merck, GlaxoSmithKline, AstraZeneca, Graceway and Nycomed.
There is increasing recent evidence that the mechanical stress from bronchoconstriction or ventilator-
induced lung strategy also result in smooth muscle hyperplasia over time. This material may not be
published, broadcast, rewritten or redistributed in any form without prior authorization. The project
caps off your educational experience, building off the foundation of your learning. Moreover,
osmotic challenge tests with mannitol have demonstrated higher specificity and greater safety for the
diagnosis of asthma than traditional measures of airway hyperresponsiveness, such as methacholine
challenge. 63. Although many clinicians diagnose asthma on the basis of a trial of therapy, objective
measurements are necessary to confirm the clinical diagnosis. More Features Connections Canva
Create professional content with Canva, including presentations, catalogs, and more. Furthermore,
we searched MEDLINE and PubMed for articles on newer issues related to the diagnosis of asthma.
A review of available data. July 2005. (2) ENHIS. Prevalence of asthma and allergies in children.
Cloudflare monitors for these errors and automatically investigates the cause. About 16% of all
adult-onset asthma is attributed to occupational asthma, and it should be considered in all cases of
adult-onset asthma. These differences are much smaller, however, than those observed among various
ethnic groups. Adequate treatment with an inhaled corticosteroid decreases hyper-responsiveness,
presumably by reducing cellular infiltration and resulting inflammation. Despite advances in
diagnosis and treatment, asthma remains a serious disease that is responsible for more than three
thousand deaths annually (1.1 per 100,000 total population). Most children have resolution of their
asthma as they grow. New grades for recommendations from the Canadian Task Force on Preventive
Health Care. Assessment of BHR in adults is much easier than it is in children, and BHR is often the
basis on which the diagnosis of asthma is made. Asthma-related mortality is higher among blacks
than among other ethnic groups. You will be able to get a quick price and instant permission to reuse
the content in many different ways. Trends from 1980-99 are presented in the CDC Asthma
Surveillance Survey. It is suggested that ACOS responds better to inhaled corticosteroids than COPD
alone, but current guidelines do not yet address management of ACOS. Asthma Programme in
Finland: the quality of primary care spirometry is good. International Vital and Health Statistics
Reports Series 6.
Asthma is associated with variable symptoms that often worsen after exposure to triggers and with
nocturnal symptoms (usually occurring between 2 am and 6 am). Many people with asthma who
have normal lung function are very responsive to indirect stimuli. However, several characteristics of
asthma are common to many phenotypes, including airway inflammation, airway hyper-
responsiveness, and reversible airflow obstruction. The decrease in forced expiratory volume in 1
second (FEV1) after a 30-minute exposure to toluene diisocyanate (TDI; day B, October 27;
rectangles) but not after a 30-minute control exposure to paint thinner (day A, October 21; triangles)
indicates a positive result on this specific challenge test, providing further confirmation of the
diagnosis of occupational asthma due to toluene diisocyanate. GIFs Highlight your latest work via
email or social media with custom GIFs. She wakes up a couple of times a week because of
coughing, but she can generally get back to sleep after she coughs up some phlegm. One of the
factors that could contribute to the mixup between dissertations and theses (the plural form of thesis
) is the phrase graduate thesis. In 2003, 195 children died from asthma, or 0.3 deaths per 100,000
children compared to 1.4 deaths per 100,000 adults. You may, for example, end up writing a
perfectly astute and well-accepted thesis that is fewer than 100 pages, and certain programs may not
require an oral presentation of your thesis. Moreover, the absence of heartburn makes a diagnosis of
reflux less likely, 69 and there is no clinical evidence of rhinitis. Th9 cells, which secrete IL-9, are
also upregulated in asthma and seem to be involved in allergic inflammation, While IL-9 and Th9
cells can propagate Th2-induced inflammation, IL-9 inhibition does not decrease airways
inflammation. We are here to direct you through the demanding environment of dissertation writing
throughout your medical research study. Meyer Balter serves on advisory boards for AstraZeneca,
Boehringer Ingelheim, GlaxoSmithKline, Merck, Nycomed and Pfizer and has received honoraria
from each of these companies for speaking engagements. He has also received consulting contracts
and speaker fees from this board. Developed through the APTR Initiative to Enhance Prevention
and Population. PMID 21355352. CS1 maint: Multiple names: authors list ( link ). Asthma may
mimic other common conditions and may be either overdiagnosed 1 or underdiagnosed. 2 After an
appropriate history has been obtained and a physical examination performed, the recommended
diagnostic testing methods include spirometry (preferred), serial peak flow measurements and
provocational challenges. The asthma attack prevalence rate for boys (5.9%) was 30% higher than the
rate among girls (4.5%) (data not shown). These triggers are typically allergic but may be
occupational in nature and are commonly overlooked unless specifically considered. Reversibility of
airflow limitation may be incomplete in some patients with asthma.”. Unfortunately, many clinicians
diagnose asthma without confirming the diagnosis with objective testing, and misdiagnosis and
mistreatment, particularly overtreatment, are therefore common. 27, 30. As well, airway changes
during periods at work compared with periods off work should be determined, by serial monitoring
of peak expiratory flow at least 4 times a day for 2 weeks while the patient is working, then for a
similar period when the patient is away from work ( Figure 2 ). 47 This monitoring is combined with
a self-recorded diary of symptoms and use of reliever bronchodilator. 43, 44. The choices include
direct challenges with histamine or methacholine 51 and indirect airway challenges with mannitol or
exercise. 52, 53. What imaging studies will be helpful in making or excluding the diagnosis of
asthma. An evaluation of standardizing target ventilation for eucapnic voluntary hyperventilation
using FEV 1. After completion the lecture the students enable to. These episodes are usually
associated with widespread but variable airflow obstruction that is often reversible either
spontaneously or with treatment. Compilations of Advance Data From Vital and Health Statistics
Series 20. Chronic cough as the sole presenting manifestation of bronchial asthma. People meeting
this definition may or may not have had asthma at the time of the survey.
Among all race and ethnicity groups, Puerto Ricans have the highest rate of lifetime asthma and
Mexicans have the lowest. Among children with asthma, black children have over twice the
likelihood of hospital readmission than white counterparts. Among those who currently have asthma,
about 55% had at least one asthma attack in the previous year. However, heart failure most
commonly occurs in patients with a known history of cardiac problems and is often associated with
ankle edema and weight gain. These respiratory tracts, or bronchial tubes, enable air to come in and
out of the lungs. The optimal type of challenge test to use depends on local availability and physician
preference, and hence the choice is best left to an asthma specialist. He has received travel
reimbursement to meetings of the European Respiratory Society from Merck and AstraZeneca. The
current review encompasses records published in or added to the register between 2005 and June
2008. Additionally black children have increased exposure to allergens, less use of long-acting
bronchodilators, and increased reliance on rescue inhalers. As previously discussed, asthma is a
disease with many phenotypes and is characterized by variability in severity and triggers. Overall
Prevalence of Asthma Asthma Prevalence by Age and Gender Asthma Prevalence by Racial and
Ethnic Group, Geography, and Income Obesity and Asthma Maternal Factors What laboratory
studies should you order to help make the diagnosis, and how should you interpret the results.
Asthma-related mortality is higher among blacks than among other ethnic groups. Measurement of
sputum eosinophilia has been proposed for clinical use in the diagnosis of asthma. Alternatively, she
may be experiencing recurrence of childhood asthma, unrelated to her work but exacerbated by
exposures at work, such as to fumes and dust. Severe acute “occupational asthma” caused by
accidental allergen exposure in an allergen challenge laboratory. In the same year, 1.1 million adults
and 0.6 million children had asthma-related emergency room visits, and asthma-related
hospitalizations exceeded 299,000 for adults and 157,000 for children. Although people with asthma
may display many physical signs, normal results on physical examination, such as were found in
Sara’s case, are typical. Other diseases may mimic or co-exist with asthma: Allergic
Bronchopulmonary Aspergillosis (ABPA), aspirin-exacerbated respiratory disease (AERD), and
vocal cord dysfunction (VCD), among others, must be considered. For more details, see chapter,
Asthma: Clinical Manifestations and Management. Variable airflow obstruction means that the
obstruction is not necessarily present at all times, varying with time, exposure to asthma triggers and
treatment. Pathological examination of the lungs may identify cellular and other components of
airway inflammation. Dissertations are common for Doctor of Philosophy degrees ( PhDs ). Lifetime
asthma diagnosis is defined as having ever been diagnosed with asthma by a doctor. Where? When?.
UK. Adult. Children. Europe. Global. What is asthma?. Sources. You need to keep in mind all of the
points essential for your company. Posted on April 25, 2017 in Medical Dissertation Help. If it was
easy, everyone would have a graduate degree, but to really prove that you learned something in your
graduate studies, schools will require you to write a dissertation or thesis to move on to the next
phase of your life. Objective measurement of airflow obstruction and reversibility is required to
confirm the diagnosis, and spirometry before and after administration of bronchodilator is ordered.
As such, ILC2s are implicated in allergic asthma as well. Testing was performed in a single-blind
manner, with multiple spirometry measurements over time before and after exposure.
Doctoral programs require dissertations, while master’s programs require theses. Alternative causes
of symptoms suggestive of asthma ( Box 2 ) should also be considered in the differential diagnosis
of asthma. In addition, macrophages and dendritic cells are potent antigen-presenting cells that
activate adaptive immune responses and direct the nature of that response by secreting TH1- or TH2-
promoting cytokines. Mechanisms of asthma in Olympic athletes — practical implications. Diagnosis
is consequently less accurate if it is based on peak flow monitoring or a trial of therapy. Role of
Eosinophils Role of Neutrophils Role of Macrophages Role of Mast Cells Role of Lymphocytes Role
of Epithelial Cells What is Airway Hyper-responsiveness. Accurate determination of the prevalence
of asthma is difficult, however, because clinicians and researchers use many definitions of the
disorder. In some rare cases, an undergraduate program might require a dissertation or thesis. History
of the Minority Affairs Committee and possible future directions. Victor J. Schoenbach, Ph.D.
Department of Epidemiology and Minority Health Project UNC Gillings School of Global Public
Health. Data From the National Health Examination Survey, the National Health and Nutrition
Examination Surveys, and the Hispanic Health and Nutrition Examination Survey Series 12.
Moreover, although nocturnal symptoms are often prominent in heart failure, they tend to occur 1 or
2 hours after the patient reclines, rather than in the early morning hours. Genetics Versus
Environmental Influences in Asthma Gene Associations in Asthma If you decide the patient has
asthma, how should the patient be managed. Prevalence of asthma is high among children and
females in industrialized nations. However, Th2 skewing is neither necessary nor sufficient for
development of asthma, and recent evidence suggests that Th1 may also have a role in asthma
pathogenesis. During 1966-2003 almost 1.4 million men were examined. There are no diagnostic
genetic tests that can be performed, but it is prudent to understand gene associations, which relate to
pathogenesis and clinical course of the disease. Most children have resolution of their asthma as they
grow. Females had a hospitalization rate about 35% higher than males. These patients made 17
million visits to doctors’ offices and emergency rooms and accounted for over 456,000
hospitalizations. In response to stimulation, macrophages may enhance inflammation both directly
and by recruiting other immune cells. Distinguishing asthma from chronic obstructive pulmonary
disease (COPD) is a common clinical challenge. Digital Sales Sell your publications commission-free
as single issues or ongoing subscriptions. Chronic inflammatory disease of the lungs Airways are
constricted from inflammation and hyper-responsiveness to asthma “triggers”. Work-related asthma
is suspected because her adult symptoms began while she was working and because she may be
exposed to occupational sensitizers (such as diisocyanates or amines from autobody spray paints)
and irritants in her workplace. Once a patient is sensitized to the trigger, very low dose exposures can
trigger symptoms, which are often accompanied by allergic rhinitis and conjunctivitis. As such,
ACOS is becoming an accepted clinical entity and is thought to make up 15-45% of obstructive
airways disease. Clubbing, which is not associated with asthma, suggests an alternative diagnosis
such as bronchiectasis, interstitial lung disease or malignant disease. 26. Females had a 40% higher
prevalence rate than males. Positive results may occur with allergic rhinitis, 56 cystic fibrosis, 57
bronchiectasis and COPD. 56 As such, the challenge test, when negative, may be most useful in
ruling out asthma. Current asthma is defined as having been diagnosed with asthma and currently
having asthma.
Global strategy for asthma management and prevention: GINA executive summary. Both diseases
can show airways hyperreactivity, and patients with COPD can also have eosinophilic airways
inflammation and atopy. Asymptomatic bronchial hyperresponsiveness in rhinitis. Diagnosis and
management of cough executive summary: ACCP evidence-based clinical practice guidelines. The
test measures the fastest rate of expired airflow. Exercise studies may be helpful in diagnosing and
assessing this condition. Available tests can help the clinician to make a firm diagnosis of asthma in
most patients. Capstone is also sometimes synonymous with keystone, which is the structurally
integral stone placed at the apex of an arch. The classic trigger for mast cell activation is cross-
linking of IgE on the cell surface; however, other non-specific triggers also induce mast cell
activation. The first page of the PDF of this article appears above. The decrease in forced expiratory
volume in 1 second (FEV1) after a 30-minute exposure to toluene diisocyanate (TDI; day B, October
27; rectangles) but not after a 30-minute control exposure to paint thinner (day A, October 21;
triangles) indicates a positive result on this specific challenge test, providing further confirmation of
the diagnosis of occupational asthma due to toluene diisocyanate. Positive results may occur with
allergic rhinitis, 56 cystic fibrosis, 57 bronchiectasis and COPD. 56 As such, the challenge test, when
negative, may be most useful in ruling out asthma. The optimal type of challenge test to use depends
on local availability and physician preference, and hence the choice is best left to an asthma
specialist. Despite advances in diagnosis and treatment, asthma remains a serious disease that is
responsible for more than three thousand deaths annually (1.1 per 100,000 total population).
Exercise-induced bronchospasm is confirmed by a 15% or greater decrease in peak flow rate or FEV
1. Asthma Programme in Finland: the quality of primary care spirometry is good. The safety and
efficacy of inhaled dry powered mannitol as a bronchial provocation test for airway
hyperresponsiveness: a phase 3 comparison study with hypertonic (4.5%) saline. Respir Res 2005; 6:
144. Given this definition, asthma may present in a variety of ways that vary by age, severity, co-
morbidities, triggering stimuli, and ability to detect BHR. Obese children and adolescents also tend
to be less bronchodilator responsive and have larger symptom burden compared to non-obese
asthmatic controls. If it was easy, everyone would have a graduate degree, but to really prove that
you learned something in your graduate studies, schools will require you to write a dissertation or
thesis to move on to the next phase of your life. Unfortunately, many clinicians diagnose asthma
without confirming the diagnosis with objective testing, and misdiagnosis and mistreatment,
particularly overtreatment, are therefore common. 27, 30. An effective strategy for diagnosing
occupational asthma: use of induced sputum. However a positive test result does not always mean
that asthma is present. Consequences of Asthma Natural History of Asthma What other
considerations exist for patients with asthma. Females were about 20% more likely than males to
ever have been diagnosed with asthma, but among children ages 0-17 years, males (14.6%) were
more likely to have an asthma diagnosis than females (10.6%) (data not shown). You have to
produce a proposal with all the elements to lead you towards success. Clinical presentations tend to
vary by age (asthma tends on occur earlier in life) and clinical risk factors (e.g., allergens trigger
asthma vs. By using our services, you agree to our use of cookies. OK. The word comes from Latin
dissertationem, meaning “a discourse, discussion, or disquisition.” That can include an essay,
treatise, or even a sermon. However, some patients with asthma may have negative pulmonary
function tests.