Commonly, the age of onset of bronchial asthma is childhood, but throughout my experience in Pneumology I have seen its onset at any age. In general, life expectancy, especially in the absence of smoking, does not differ from that of the normal population.
Approximately 3% of cases of chronic asthma associated with smoking, morbid obesity, coexistence of infections, vocal cord dysfunction or hypersensitivity to NSAIDs, is difficult to control and can be altered.
Late-onset asthma may be related to occupational exposures or drugs. Mortality under 30 years of age should be minimal in a country like ours, with health coverage and an abundance of centers.
Treatment of bronchial asthma
In general, treatment at present is very grateful and it is good for the patient to know the existing drugs and how they are managed. In difficult cases, it is useful for the patient to have self-monitoring systems such as Peak-Flow-Meter.
Some patients’ exaggerated fear of corticosteroids is an obstacle to treatment. For difficult cases different biologic drugs are being introduced. The “refinement” of vaccines is another advance in treatment. Both short-acting and long-acting beta-adrenergics combined with inhaled or non-inhaled corticosteroids control 95% of patients.
The diagnosis in general is simple: spirometry with bronchodilator test, Peak Flow before and after sport, or more continuous graphs, provocation test, IgE levels, specific IgE, exhaled nitric oxide, flow oscillometry in infants, imaging studies with CT or others, contribute to a more accurate affiliation.
In summary, this has been only a superficial review and remember: tobacco in parents favors asthma in children, although tobacco is not a direct cause of asthma, the mixture of asthma and tobacco is like gasoline and fire.
Don’t think of “The hand that rocks the cradle”, think of the number of Olympic medals in asthmatics.