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1. Introduction Bronchial asthma is a disease caused by increased responsiveness of the tracheobronchial tree to various stimuli. The result is paroxysmal constriction of the bronchial airways. Bronchial asthma is the more correct name for the common form of asthma. The term 'bronchial' is used to differentiate it from 'cardiac' asthma, which is a separate condition that is caused by heart failure. Although the two types of asthma have similar symptoms, including wheezing (a whistling sound in the chest) and shortness of breath, they have quite different causes. Bronchial asthma is a disease of the lungs in which an obstructive ventilation disturbance of the respiratory passages evokes a feeling of shortness of breath. The cause is a sharply elevated resistance to airflow in the airways. Despite its most strenuous efforts, the respiratory musculature is unable to provide sufficient gas exchange. The result is a characteristic asthma attack, with spasms of the bronchial musculature, edematous swelling of the bronchial wall and increased mucus secretion. In the initial stage, the patient can be totally symptom-free for long periods of time in the intervals between the attacks. As the disease progresses, increased mucus is secreted between attacks as well, which in part builds up in the airways and can then lead to secondary bacterial infections. Bronchial asthma is usually intrinsic (no cause can be demonstrated), but is occasionally caused by a specific allergy (such as allergy to mold, dander, dust). Although most individuals with asthma will have some positive allergy tests, the allergy is not necessarily the cause of the asthma symptoms. Symptoms can occur spontaneously or can be triggered by respiratory infections, exercise, cold air, tobacco smoke or other pollutants, stress or anxiety, or by food allergies or drug allergies. The muscles of the bronchial tree become tight and the lining of the air passages become swollen, reducing airflow and producing the wheezing sound. Mucus production is increased. Typically, the individual usually breathes relatively normally, and will have periodic attacks of wheezing. Asthma attacks can last minutes to days, and can become dangerous if the airflow becomes severely restricted. Asthma affects 1 in 20

of the overall population, but the incidence is 1 in 10 in children. Asthma can develop at any age, but some children seem to outgrow the illness. Risk factors include self or family history of eczema, allergies or family history of asthma. Bronchial asthma causes cough, shortness of breath, and wheezing. Bronchial asthma is an allergic condition, in which the airways (bronchi) are hyper-reactive and constrict abnormally when exposed to allergens, cold or exercise. Treatment is aimed at avoiding known allergens and controlling symptoms through medication. A variety of medications for treatment of asthma are available. People with mild asthma (infrequent attacks) may use inhalers on an as-needed basis. Persons with significant asthma (symptoms occur at least every week) should be treated with anti-inflammatory medications, preferably inhaled corticosteroids, and then with bronchodilators such as inhaled Alupent or Vanceril. Acute severe asthma may require hospitalization, oxygen, and intravenous medications. Decrease or control exposure to known allergens by staying away from cigarette smoke, removing animals from bedrooms or entire houses, and avoiding foods that cause symptoms. Allergy desensitization is rarely successful in reducing symptoms.

Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials that enter the bronchial tree, usually oral or gastric contents (including food, saliva, or nasal secretions). Depending on the acidity of the aspirate, a chemical pneumonitis can develop, and bacterial pathogens (particularly anaerobic bacteria) may add to the inflammation.

3. What are the signs and symptoms of aspiration pneumonia? Sometimes it may take a few days for symptoms of aspiration pneumonia to begin. The signs and symptoms of aspiration pneumonia can get worse very quickly. The signs and symptoms that you have may depend on what you inhaled into your lungs, and how much was inhaled. Common signs and symptoms may include one or more of the following: Frequent coughing. Your cough may may bring up badsmelling mucus from your lungs. This phlegm (flem) may have pus or streaks of blood in it. You may also cough up frothy (bubbly) fluid from your lungs. Shortness of breath or noisy breathing. Your heartbeat or breathing (while resting) may seem much faster than normal. Fever or chills. You may sweat a lot. Chest pain when you cough or take a deep breath. Trouble swallowing, or you feel like something is stuck in your throat. Feeling dizzy, faint, or having new trouble thinking (confusion). You may feel upset or anxious. Feeling like you cannot get enough air. Your skin, lips, or fingernails may turn dusky or blue.

How is aspiration pneumonia diagnosed? Your caregiver will examine you and listen to your heart and lungs through a stethoscope (STETH-oh-skohp). You may need tests such as blood tests or a chest x-ray. You may need different tests to find out more about how well you swallow. These tests may include swallowing studies, or special tests of your throat or esophagus. Special x-ray pictures, such as a barium swallow, may be needed to see what happens when you swallow. You may need an endoscopy (en-DOS-koh-pee) to find or treat a swallowing problem. During an endoscopy, your caregiver uses a small tube with a light on the end (called a scope). The scope lets your caregiver see your throat, esophagus, and stomach.

How is aspiration pneumonia treated? You may need to stay in the hospital to get better from aspiration pneumonia. You may need oxygen and special medicines to help your lungs. You may need medicine to help reduce the acid in your stomach or to help food move through your stomach faster. You may need antibiotics (anti-bi-AH-tiks) to prevent or treat an infection caused by bacteria (bak-TEE-ree-ah). You may need a machine to help you breathe. If you inhaled something solid, you may need a bronchoscopy (brong-KOS-ke-pee) to remove it. This procedure uses a small, flexible scope that is passed through your mouth and into your lungs. You may need special caregivers to help decrease your chance of inhaling something into your lungs again. A speech and language pathologist (pah-THOL-oh-jist) or an occupational (ok-uPAY-shun-al) therapist may help find and treat swallowing problems. A dietitian (deye-e-TISH-an) can help you plan easy-to-swallow meals to decrease your risk of choking.

Risks: Aspiration pneumonia can be serious, even life threatening. You may get a lung infection that may spread to the bloodstream or other areas of your body. You may get other life threatening problems such as respiratory failure (when you cannot breathe without the help of a machine). Pneumonia is even more dangerous for people over the age of 50, and people with immune system or other health

problems. It may take a long time to get better after having aspiration pneumonia. The sooner your pneumonia is treated, the less chance you have of problems. What causes asthma? - Asthma is caused by inhaling an allergen that sets off the chain of biochemical and tissue changes leading to airway inflammation, bronchoconstriction, and wheezing