Asthma

qas: question: What two factors cause asthma?
answers: text: genetic and environmental factors
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question: What are two enviromental factors?
answers: text: exposure to air pollution and allergens
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question: What medications can also trigger asthma?
answers: text: aspirin and beta blockers
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question: What patterns are used to diagnose asthma?
answers: text: the pattern of symptoms, response to therapy over time, and spirometry
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question: How is asthma classified?
answers: text: according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate
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question: How does usng aspirin activate allergens in others?
is_impossible: yes

question: What are some triggers of spirometry?
is_impossible: yes

question: How do you know if you are affected by spirometry?
is_impossible: yes

question: How do you classify spirometry in people?
is_impossible: yes

question: What two categories can spirometry also be classified into?
is_impossible: yes

question: When do symptoms of Spirometry get worse?
is_impossible: yes

question: When did inhaled corticosteroids and short acting beta agonist start being used? 
is_impossible: yes

question: Exposure to what compounds can also trigger asthma?
is_impossible: yes
context: Asthma is thought to be caused by a combination of genetic and environmental factors. Environmental factors include exposure to air pollution and allergens. Other potential triggers include medications such as aspirin and beta blockers. Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry. Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. It may also be classified as atopic or non-atopic where atopy refers to a predisposition toward developing a type 1 hypersensitivity reaction.

qas: question: Is there a cure for asthma?
answers: text: There is no cure for asthma
is_impossible: no

question: How can symptoms be prevented?
answers: text: by avoiding triggers, such as allergens and irritants, and by the use of inhaled corticosteroids
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question: What is taken by mouth to treat rapidly worsening symptoms?
answers: text: an inhaled short-acting beta-2 agonist such as salbutamol and corticosteroids
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question: What happens in very severe cases of asthma?
answers: text: intravenous corticosteroids, magnesium sulfate, and hospitalization may be required
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question: Is there a cure for long acting beta agonists?
is_impossible: yes

question: How can symptoms of long acting beta agonists be prevented?
is_impossible: yes

question: How do you treat LABA if it gets worse?
is_impossible: yes

question: What is one thing you need to take if your LABA is severe?
is_impossible: yes

question: What may you need if your LABA is life threatening?
is_impossible: yes

question: What are some other causes of airway obstruction?
is_impossible: yes

question: What do some people have due to their eosinophils?
is_impossible: yes

question: When may prednisone also be helpful in spirometry?
is_impossible: yes
context: There is no cure for asthma. Symptoms can be prevented by avoiding triggers, such as allergens and irritants, and by the use of inhaled corticosteroids. Long-acting beta agonists (LABA) or antileukotriene agents may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled. Treatment of rapidly worsening symptoms is usually with an inhaled short-acting beta-2 agonist such as salbutamol and corticosteroids taken by mouth. In very severe cases, intravenous corticosteroids, magnesium sulfate, and hospitalization may be required.

qas: question: What are the characteristics of asthma?
answers: text: recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing
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question: When are symptoms of asthma normally worse?
answers: text: at night and in the early morning or in response to exercise or cold air
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question: What is produced in the lungs by coughing?
answers: text: Sputum
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question: Is asthma worst during the day or at night time?
answers: text: worse at night
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question: Does everyone have horrible episodes of asthma?
answers: text: Some people with asthma rarely experience symptoms, u
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question: What phisical symptoms does eosinophils cause?
is_impossible: yes

question: When do symptoms of eosinophils become worse?
is_impossible: yes

question: What is produced in the lungs by shortness of breath?
is_impossible: yes

question: When do people usually experience eosinophils symptoms in response to?
is_impossible: yes

question: What do some people have due to their eosinophils?
is_impossible: yes

question: What helps support the evidence of asthma?
is_impossible: yes

question: What can cause symptoms of COPD in children?
is_impossible: yes

question: What is taken by mouth to treat rapidly worsening symptoms?
is_impossible: yes
context: Asthma is characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. Sputum may be produced from the lung by coughing but is often hard to bring up. During recovery from an attack, it may appear pus-like due to high levels of white blood cells called eosinophils. Symptoms are usually worse at night and in the early morning or in response to exercise or cold air. Some people with asthma rarely experience symptoms, usually in response to triggers, whereas others may have marked and persistent symptoms.

qas: question: Do other health concerns happen less frequently or more frequently with asthma?
answers: text: more frequently
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question: What are three of the other health conditions that occur more frequently with asthma?
answers: text: gastro-esophageal reflux disease (GERD), rhinosinusitis, and obstructive sleep apnea
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question: What other type of disorders are frequent in asthma sufferers?
answers: text: Psychological disorders
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question: What are those with asthma that is poorly controll more susceptable to? 
answers: text: radiocontrast reactions
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question: If GERD is poorly controlled, what does it make you at risk for?
is_impossible: yes

question: What other conditions happen frequently with radiocontrast reactions?
is_impossible: yes

question: What percentage of people with GERD also have anxiety disorders?
is_impossible: yes

question: What percentage of people with radiocontrast reactions have mood disorders?
is_impossible: yes

question: Do we know if GERD causes psychological problems?
is_impossible: yes

question: What happenes if chronic bronchitis is untreated?
is_impossible: yes

question: What are two other ways allergen subgroups may be classified?
is_impossible: yes

question: What effect does bronchial thermoplasty have?
is_impossible: yes
context: A number of other health conditions occur more frequently in those with asthma, including gastro-esophageal reflux disease (GERD), rhinosinusitis, and obstructive sleep apnea. Psychological disorders are also more common, with anxiety disorders occurring in between 16–52% and mood disorders in 14–41%. However, it is not known if asthma causes psychological problems or if psychological problems lead to asthma. Those with asthma, especially if it is poorly controlled, are at high risk for radiocontrast reactions.

qas: question: What are some of the enviromental factors that have been linked to asthma?
answers: text: allergens, air pollution, and other environmental chemicals
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question: What two things are associated with a greater risk of asthma-like symptoms?
answers: text: Smoking during pregnancy and after delivery
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question: What can cause symptoms and asthma serverity to change?
answers: text: Low air quality from factors such as traffic pollution or high ozone levels
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question: Exposure to what compounds can also trigger asthma?
answers: text: indoor volatile organic compounds
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question: What envoronmental factors are associated with early delivery when pregnant?
is_impossible: yes

question: What two things are associated with a greater risk of symtoms from phtalates?
is_impossible: yes

question: What can change symptoms of formaldehyde exposure and severity?
is_impossible: yes

question: Exposure to what compounds can also trigger early delivery when pregnant?
is_impossible: yes

question: What other compound is associated with early delivery?
is_impossible: yes

question: Exercise-induced bronchoconstriction is common in what profession?
is_impossible: yes

question: Is there a test to diagnose Spirometry?
is_impossible: yes

question: How does the hygiene hypothesis explain the increase in asthma?
is_impossible: yes
context: Many environmental factors have been associated with asthma's development and exacerbation including allergens, air pollution, and other environmental chemicals. Smoking during pregnancy and after delivery is associated with a greater risk of asthma-like symptoms. Low air quality from factors such as traffic pollution or high ozone levels, has been associated with both asthma development and increased asthma severity. Exposure to indoor volatile organic compounds may be a trigger for asthma; formaldehyde exposure, for example, has a positive association. Also, phthalates in certain types of PVC are associated with asthma in children and adults.

qas: question: What hypothesis tries to explain the increased amount of asthma world wide?
answers: text: The hygiene hypothesis
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question: How does the hygiene hypothesis explain the increase in asthma?
answers: text: a direct and unintended result of reduced exposure, during childhood, to non-pathogenic bacteria and viruses
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question: What has caused the reduced exposure in childhood?
answers: text: increased cleanliness and decreased family size in modern societies
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question: What could prevent asthma?
answers: text: Exposure to bacterial endotoxin in early childhood
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question: What is some of the evidence backing the hygiene hypothesis?
answers: text: lower rates of asthma on farms and in households with pets.
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question: What hypothesis explains the increased rates of viruses worldwide?
is_impossible: yes

question: How does the hygene hypothesis explain the cause of bronchoconstriction?
is_impossible: yes

question: What can cause bacteria in pets?
is_impossible: yes

question: Why are people less likely to want to live on a farm?
is_impossible: yes

question: What is some evidence used to support the hypothesis on non-pathogenic bacteria?
is_impossible: yes

question: What is neutrophils the result of?
is_impossible: yes

question: What did law that limit smoking accomplish? 
is_impossible: yes

question: What percentage of people use inhaled beta2 agonists?
is_impossible: yes
context: The hygiene hypothesis attempts to explain the increased rates of asthma worldwide as a direct and unintended result of reduced exposure, during childhood, to non-pathogenic bacteria and viruses. It has been proposed that the reduced exposure to bacteria and viruses is due, in part, to increased cleanliness and decreased family size in modern societies. Exposure to bacterial endotoxin in early childhood may prevent the development of asthma, but exposure at an older age may provoke bronchoconstriction. Evidence supporting the hygiene hypothesis includes lower rates of asthma on farms and in households with pets.

qas: question: What else is a risk factor for asthma?
answers: text: Family history
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question: If one identical twin has asthma, what are the odds of the other twin having asthma?
answers: text: approximately 25%
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question: How many genes were associated with asthma by the end of 2005?
answers: text: 25 genes
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question: What else are these genes closely related to?
answers: text: the immune system or modulating inflammation
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question: How many genes were associated with asthma in 2006?
answers: text: over 100 genes
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question: What is a risk factor for modulating inflammation?
is_impossible: yes

question: What is thought to be the cause of modulating inflammation?
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question: In 2006 what percentage of genes were found to contribute to inflammation?
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question: How many genes were associated with the immune system in 2006?
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question: How many genes were associated with causing GSTM1 in 2005?
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question: What is used to support a COPD diagnosis?
is_impossible: yes

question: What treatment helps improve those with allergic rhinitis and asthma?
is_impossible: yes

question: What is neutrophils the result of?
is_impossible: yes
context: Family history is a risk factor for asthma, with many different genes being implicated. If one identical twin is affected, the probability of the other having the disease is approximately 25%. By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1, IL10, CTLA-4, SPINK5, LTC4S, IL4R and ADAM33, among others. Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested. In 2006 over 100 genes were associated with asthma in one genetic association study alone; more continue to be found.

qas: question: What is asthma the result of?
answers: text: chronic inflammation of the conducting zone of the airways
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question: What two airways are most effected by asthma?
answers: text: the bronchi and bronchioles
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question: In what ways do airways change?
answers: text: an increase in eosinophils and thickening of the lamina reticularis
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question: What other cell types are involced with the changing of airways?
answers: text: T lymphocytes, macrophages, and neutrophils
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question: What other components of the immune systems are included?
answers: text: cytokines, chemokines, histamine, and leukotrienes among others
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question: What is neutrophils the result of?
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question: What part of the airway is especially effected by neutrophils?
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question: How do macrophages change?
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question: What chronic changes happen to the macrophages?
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question: What other parts of the immune system are changed due to thickening of the neutrophils?
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question: What's weak and isn't helping prevent the development of the flu?
is_impossible: yes

question: Why are smoking bans in place?
is_impossible: yes

question: What age makes it harder to be diagnosed as having Spirometry?
is_impossible: yes
context: Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway and the classic symptoms of wheezing. The narrowing is typically reversible with or without treatment. Occasionally the airways themselves change. Typical changes in the airways include an increase in eosinophils and thickening of the lamina reticularis. Chronically the airways' smooth muscle may increase in size along with an increase in the numbers of mucous glands. Other cell types involved include: T lymphocytes, macrophages, and neutrophils. There may also be involvement of other components of the immune system including: cytokines, chemokines, histamine, and leukotrienes among others.

qas: question: Is there a universal definition of astham?
answers: text: there is not one universal agreed upon definition
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question: What main components play a role in asthma?
answers: text: many cells and cellular elements play a role
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question: What is the inflamation a result of?
answers: text: airway hyper-responsiveness
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question: What does hyper-responsiveness of the airways cause?
answers: text: episodes of wheezing, breathlessness, chest tightness and coughing
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question: What are two ways to reverse an asthma attack?
answers: text: spontaneously or with treatment
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question: How is cellular obstruction defined?
is_impossible: yes

question: Is there a universally agreed upon definition of cellular obstruction?
is_impossible: yes

question: What does cellular obstruction cause?
is_impossible: yes

question: How do you stop the symptoms of cellular obstruction?
is_impossible: yes

question: What does hyper-responsiveness at the cellular level cause?
is_impossible: yes

question: When do symptoms of Spirometry get worse?
is_impossible: yes

question: When do people usually experience eosinophils symptoms in response to?
is_impossible: yes

question: In 2006 what percentage of genes were found to contribute to inflammation?
is_impossible: yes
context: While asthma is a well recognized condition, there is not one universal agreed upon definition. It is defined by the Global Initiative for Asthma as "a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment".

qas: question: Is there a test to determine asthma in an individual?
answers: text: There is currently no precise test
is_impossible: no

question: What is diagnosis based on typically?
answers: text: pattern of symptoms and response to therapy over time
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question: When should you suspect asthma?
answers: text: if there is a history of: recurrent wheezing, coughing or difficulty breathing
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question: What is used to confirm the diagnosis of asthma?
answers: text: Spirometry
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question: What age is too young to use spirometry to determine asthma?
answers: text: children under the age of six
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question: Is there a test to diagnose Spirometry?
is_impossible: yes

question: How do you usually diagnose someone with Spirometry?
is_impossible: yes

question: With what symptoms should you suspect a person has Spirometry?
is_impossible: yes

question: When do symptoms of Spirometry get worse?
is_impossible: yes

question: What age makes it harder to be diagnosed as having Spirometry?
is_impossible: yes

question: What happenes if chronic bronchitis is untreated?
is_impossible: yes

question: What is used to treat airway remodeling?
is_impossible: yes

question: What is the prognosis for asthma? 
is_impossible: yes
context: There is currently no precise test with the diagnosis typically based on the pattern of symptoms and response to therapy over time. A diagnosis of asthma should be suspected if there is a history of: recurrent wheezing, coughing or difficulty breathing and these symptoms occur or worsen due to exercise, viral infections, allergens or air pollution. Spirometry is then used to confirm the diagnosis. In children under the age of six the diagnosis is more difficult as they are too young for spirometry.

qas: question: What is recommended to help in the diagnosis of asthma?
answers: text: Spirometry
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question: Why is spirometry so commonly used to diagnose asthma?
answers: text: It is the single best test for asthma
is_impossible: no

question: What helps support the evidence of asthma?
answers: text: If the FEV1 measured by this technique improves more than 12% following administration of a bronchodilator
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question: What substance can skew the results of an asthma test?
answers: text: caffeine
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question: What test can tell the difference between asthma and COPD?
answers: text: Single-breath diffusing capacity
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question: What is recommended for the diagnosis of COPD?
is_impossible: yes

question: Why is spirometry used to diagnose COPD?
is_impossible: yes

question: What is used to support a COPD diagnosis?
is_impossible: yes

question: What can you take that will change the results of a COPD test?
is_impossible: yes

question: How often should you use a bronchodialator to track how well COPD is controlled?
is_impossible: yes

question: What type of condition is airway obstruction?
is_impossible: yes

question: Who was the primary payer for low income communities from 2000 to 2010?
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question: What percentage of people in developing countries are affluent?
is_impossible: yes
context: Spirometry is recommended to aid in diagnosis and management. It is the single best test for asthma. If the FEV1 measured by this technique improves more than 12% following administration of a bronchodilator such as salbutamol, this is supportive of the diagnosis. It however may be normal in those with a history of mild asthma, not currently acting up. As caffeine is a bronchodilator in people with asthma, the use of caffeine before a lung function test may interfere with the results. Single-breath diffusing capacity can help differentiate asthma from COPD. It is reasonable to perform spirometry every one or two years to follow how well a person's asthma is controlled.

qas: question: What is the rate that is used in most of the evidence?
answers: text: ≥20%
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question: What is more variable than spirometry but not recommended?
answers: text: . Testing peak expiratory flow
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question: What is not as stable as prednisone for a routine diagnosis?
is_impossible: yes

question: What is one instance when testing with prednisone is useful?
is_impossible: yes

question: When may prednisone also be helpful in spirometry?
is_impossible: yes

question: What percentage of a group think prednisone is helpful for treatment in acute cases?
is_impossible: yes

question: What percentage of people in acute cases use salbutamol?
is_impossible: yes

question: What treatment helps improve those with allergic rhinitis and asthma?
is_impossible: yes

question: What is produced in the lungs by shortness of breath?
is_impossible: yes

question: Do smoking bans prevent workplace allergies?
is_impossible: yes
context: Other supportive evidence includes: a ≥20% difference in peak expiratory flow rate on at least three days in a week for at least two weeks, a ≥20% improvement of peak flow following treatment with either salbutamol, inhaled corticosteroids or prednisone, or a ≥20% decrease in peak flow following exposure to a trigger. Testing peak expiratory flow is more variable than spirometry, however, and thus not recommended for routine diagnosis. It may be useful for daily self-monitoring in those with moderate to severe disease and for checking the effectiveness of new medications. It may also be helpful in guiding treatment in those with acute exacerbations.

qas: question: How is asthma clinically classified?
answers: text: according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate
is_impossible: no

question: How else is asthma classified?
answers: text: as atopic (extrinsic) or non-atopic (intrinsic)
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question: When asthma is caused by allergens that is called what? 
answers: text: atopic
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question: What  is asthma usually classified based on?
answers: text: severity
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question: What is a important goal of asthma research?
answers: text: Finding ways to identify subgroups that respond well to different types of treatments
is_impossible: no

question: How are allergen subgroups classified?
is_impossible: yes

question: What are two other ways allergen subgroups may be classified?
is_impossible: yes

question: What data is allergen subgroup classification based on?
is_impossible: yes

question: Is there a method for classifying allergen subgroups beyond the existing system?
is_impossible: yes

question: What is the main goal of allergen subgroup research?
is_impossible: yes

question: What two airways are most effected by asthma?
is_impossible: yes

question: What has caused the mortality rate to decrease?
is_impossible: yes

question: What can reduce the effectiveness of medications?
is_impossible: yes
context: Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic). While asthma is classified based on severity, at the moment there is no clear method for classifying different subgroups of asthma beyond this system. Finding ways to identify subgroups that respond well to different types of treatments is a current critical goal of asthma research.

qas: question: What kind of condition is asthma?
answers: text: a chronic obstructive condition
is_impossible: no

question: What are examples of chronic obstructive pulmonary disease?
answers: text: bronchiectasis, chronic bronchitis, and emphysema
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question: Is the airway obstuction reversable in asthma?
answers: text: asthma is usually reversible
is_impossible: no

question: What part of the airway does emphysema affect?
answers: text: alveoli
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question: What part of the airway does asthma affect?
answers: text: the bronchi
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question: What type of condition is airway obstruction?
is_impossible: yes

question: What is airway remodeling considered a part of?
is_impossible: yes

question: What does brochiectasis affect instead of the alveoli?
is_impossible: yes

question: What happenes if chronic bronchitis is untreated?
is_impossible: yes

question: What diseases are examples of airway remodeling?
is_impossible: yes

question: Who was the primary payer for low income communities from 2000 to 2010?
is_impossible: yes

question: Who was more likely to seek hospital help in the US for asthma reasons?
is_impossible: yes

question: What profession is asthma most common in?
is_impossible: yes
context: Although asthma is a chronic obstructive condition, it is not considered as a part of chronic obstructive pulmonary disease as this term refers specifically to combinations of disease that are irreversible such as bronchiectasis, chronic bronchitis, and emphysema. Unlike these diseases, the airway obstruction in asthma is usually reversible; however, if left untreated, the chronic inflammation from asthma can lead the lungs to become irreversibly obstructed due to airway remodeling. In contrast to emphysema, asthma affects the bronchi, not the alveoli.

qas: question: Exercise-induced bronchoconstriction is common in what profession?
answers: text: professional athletes
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question: What professions has the highest rate of Exercise-induced bronchoconstriction?
answers: text: cyclists (up to 45%), swimmers, and cross-country skiers
is_impossible: no

question: What conditions are more likely to cause Exercise-induced bronchoconstriction?
answers: text: when it is dry and cold
is_impossible: no

question: What does not appear to help athletic performance that do not have asthma?
answers: text: Inhaled beta2-agonists
is_impossible: no

question: What does exercise trigger in people who use inhaled beta2 agonists?
is_impossible: yes

question: What percentage of people use inhaled beta2 agonists?
is_impossible: yes

question: What group has the highest rate of inhaled beta2 agonist use?
is_impossible: yes

question: What percentage of cyclists used inhaled beta 2 agonists?
is_impossible: yes

question: What profession is asthma most common in?
is_impossible: yes

question: Is there a cure for long acting beta agonists?
is_impossible: yes

question: Who recoomends immunizations?
is_impossible: yes

question: Do we know if GERD causes psychological problems?
is_impossible: yes
context: Exercise can trigger bronchoconstriction both in people with or without asthma. It occurs in most people with asthma and up to 20% of people without asthma. Exercise-induced bronchoconstriction is common in professional athletes. The highest rates are among cyclists (up to 45%), swimmers, and cross-country skiers. While it may occur with any weather conditions it is more common when it is dry and cold. Inhaled beta2-agonists do not appear to improve athletic performance among those without asthma however oral doses may improve endurance and strength.

qas: question: Asthma that is the result of or made worse by workplace exposure is reported as what?
answers: text: occupational disease
is_impossible: no

question: What percent of asthma cases in adults are work-related?
answers: text: It is estimated that 5–25%
is_impossible: no

question: What are some of the most common agents?
answers: text: isocyanates, grain and wood dust, colophony, soldering flux, latex, animals, and aldehydes
is_impossible: no

question: What professions normally have the highest risk of problems?
answers: text: those who spray paint, bakers and those who process food, nurses, chemical workers, those who work with animals, welders, hairdressers and timber workers
is_impossible: no

question: What is colophony commonly reported as when caused or made worse by workplace exposure?
is_impossible: yes

question: What happens to many cases of colophony?
is_impossible: yes

question: How many adult colophony cases are work-related?
is_impossible: yes

question: Name a few professions that have the highest risk of colophony?
is_impossible: yes

question: What are two agents that are commonly believed to cause colophony?
is_impossible: yes

question: What is one instance when testing with prednisone is useful?
is_impossible: yes

question: What helps support the evidence of asthma?
is_impossible: yes

question: In 2006 what percentage of genes were found to contribute to inflammation?
is_impossible: yes
context: Asthma as a result of (or worsened by) workplace exposures, is a commonly reported occupational disease. Many cases however are not reported or recognized as such. It is estimated that 5–25% of asthma cases in adults are work–related. A few hundred different agents have been implicated with the most common being: isocyanates, grain and wood dust, colophony, soldering flux, latex, animals, and aldehydes. The employment associated with the highest risk of problems include: those who spray paint, bakers and those who process food, nurses, chemical workers, those who work with animals, welders, hairdressers and timber workers.

qas: question: What is a condition that can cause symptoms of astham in children?
answers: text: allergic rhinitis and sinusitis
is_impossible: no

question: What are some other causes of airway obstruction?
answers: text: foreign body aspiration, tracheal stenosis or laryngotracheomalacia, vascular rings, enlarged lymph nodes or neck masses
is_impossible: no

question: What other conditions can cause wheezing?
answers: text: Bronchiolitis and other viral infections
is_impossible: no

question: In adults, what conditions can cause the symptoms of asthma?
answers: text: COPD, congestive heart failure, airway masses, as well as drug-induced coughing due to ACE inhibitors
is_impossible: no

question: What can cause symptoms of COPD in children?
is_impossible: yes

question: What are other causes of sinusitis?
is_impossible: yes

question: What do COPD and congestive heart failure also produce?
is_impossible: yes

question: How many conditions can cause symptoms of congestive heart failure?
is_impossible: yes

question: What kind of dysfunction can be seen only in adults with COPD?
is_impossible: yes

question: What type of condition is airway obstruction?
is_impossible: yes

question: What is used to treat airway remodeling?
is_impossible: yes

question: What age makes it harder to be diagnosed as having Spirometry?
is_impossible: yes
context: Many other conditions can cause symptoms similar to those of asthma. In children, other upper airway diseases such as allergic rhinitis and sinusitis should be considered as well as other causes of airway obstruction including: foreign body aspiration, tracheal stenosis or laryngotracheomalacia, vascular rings, enlarged lymph nodes or neck masses. Bronchiolitis and other viral infections may also produce wheezing. In adults, COPD, congestive heart failure, airway masses, as well as drug-induced coughing due to ACE inhibitors should be considered. In both populations vocal cord dysfunction may present similarly.

qas: question: What is a complication of chronic asthma?
answers: text: Chronic obstructive pulmonary disease
is_impossible: no

question: If you are 65 years old and have an obstructive airway disesase, you are more likely to have what other conditions?
answers: text: asthma and COPD
is_impossible: no

question: How is COPD differentiated?
answers: text: by increased airway neutrophils, abnormally increased wall thickness, and increased smooth muscle in the bronchi
is_impossible: no

question: Why is this not determined in a patient with COPD?
answers: text: due to COPD and asthma sharing similar principles of management
is_impossible: no

question: What are the principles of management for asthma and COPD?
answers: text: corticosteroids, long acting beta agonists, and smoking cessation
is_impossible: no

question: What is a complication of family history of chronic atopy?
is_impossible: yes

question: If you smoke after 65, what two conditions will you also have?
is_impossible: yes

question: How can you tell who has stopped smoking and who hasn't?
is_impossible: yes

question: What principles of management are used for increased airway neutrophils and smoking cessation?
is_impossible: yes

question: What are two things that make a doctor want to investigate family history of atopy?
is_impossible: yes

question: What two medications were widely used to treat asthma in 1905?
is_impossible: yes

question: What percentage of people use inhaled beta2 agonists?
is_impossible: yes

question: Do smoking bans prevent workplace allergies?
is_impossible: yes
context: Chronic obstructive pulmonary disease can coexist with asthma and can occur as a complication of chronic asthma. After the age of 65 most people with obstructive airway disease will have asthma and COPD. In this setting, COPD can be differentiated by increased airway neutrophils, abnormally increased wall thickness, and increased smooth muscle in the bronchi. However, this level of investigation is not performed due to COPD and asthma sharing similar principles of management: corticosteroids, long acting beta agonists, and smoking cessation. It closely resembles asthma in symptoms, is correlated with more exposure to cigarette smoke, an older age, less symptom reversibility after bronchodilator administration, and decreased likelihood of family history of atopy.

qas: question: What is weak that is not helping prevent the development of asthma?
answers: text: The evidence for the effectiveness of measures to prevent
is_impossible: no

question: What preventative measures always work to prevent asthma?
answers: text: none are well supported enough to be recommended for this indication
is_impossible: no

question: What has been determined about dietry restrictions during pregnancy and when breast feeding?
answers: text: have not been found to be effective and thus are not recommended
is_impossible: no

question: Why are smoking bans in place?
answers: text: effective in decreasing exacerbations of asthma
is_impossible: no

question: Who recoomends immunizations?
answers: text: World Health Organization
is_impossible: no

question: What's weak and isn't helping prevent the development of the flu?
is_impossible: yes

question: What are some methods that seem promising to prevent workplace allergies?
is_impossible: yes

question: What methods are foolproof to prevent the flu?
is_impossible: yes

question: What group recommends having a smoking ban?
is_impossible: yes

question: Do smoking bans prevent workplace allergies?
is_impossible: yes

question: Is it known why developing countries are economically disadvantaged?
is_impossible: yes

question: How much was the average cost of hospital stays for asthma-related issues for adults?
is_impossible: yes

question: Exercise-induced bronchoconstriction is common in what profession?
is_impossible: yes
context: The evidence for the effectiveness of measures to prevent the development of asthma is weak. Some show promise including: limiting smoke exposure both in utero and after delivery, breastfeeding, and increased exposure to daycare or large families but none are well supported enough to be recommended for this indication. Early pet exposure may be useful. Results from exposure to pets at other times are inconclusive and it is only recommended that pets be removed from the home if a person has allergic symptoms to said pet. Dietary restrictions during pregnancy or when breast feeding have not been found to be effective and thus are not recommended. Reducing or eliminating compounds known to sensitive people from the work place may be effective. It is not clear if annual influenza vaccinations effects the risk of exacerbations. Immunization; however, is recommended by the World Health Organization. Smoking bans are effective in decreasing exacerbations of asthma.

qas: question: What is a key component of control and preventing asthma attacks?
answers: text: Avoidance of triggers
is_impossible: no

question: What are some of the more common triggers?
answers: text: allergens, smoke (tobacco and other), air pollution, non selective beta-blockers, and sulfite-containing foods
is_impossible: no

question: What can reduce the effectiveness of medications?
answers: text: Cigarette smoking and second-hand smoke
is_impossible: no

question: What did law that limit smoking accomplish? 
answers: text: decrease the number of people hospitalized for asthma
is_impossible: no

question: What type of exercise can provide small improvements?
answers: text: Yoga
is_impossible: no

question: What is a main way people can prevent reactions to dust mites?
is_impossible: yes

question: The two most common things used with corticosteroids?
is_impossible: yes

question: What do sulfite-containing foods reduce the effectiveness of?
is_impossible: yes

question: What decreases the number of people who are hospitalized for passive smoke exposure?
is_impossible: yes

question: What methods have no effect on smokers quality of life?
is_impossible: yes

question: What are some of the most common agents?
is_impossible: yes

question: What type of condition is airway obstruction?
is_impossible: yes

question: When was the first paper written about asthma?
is_impossible: yes
context: Avoidance of triggers is a key component of improving control and preventing attacks. The most common triggers include allergens, smoke (tobacco and other), air pollution, non selective beta-blockers, and sulfite-containing foods. Cigarette smoking and second-hand smoke (passive smoke) may reduce the effectiveness of medications such as corticosteroids. Laws that limit smoking decrease the number of people hospitalized for asthma. Dust mite control measures, including air filtration, chemicals to kill mites, vacuuming, mattress covers and others methods had no effect on asthma symptoms. Overall, exercise is beneficial in people with stable asthma. Yoga could provide small improvements in quality of life and symptoms in people with asthma.

qas: question: What type of person would use bronchial thermoplasty as an option?
answers: text: For those with severe persistent asthma not controlled by inhaled corticosteroids and LABAs
is_impossible: no

question: What does bronchial thermoplasty consist of?
answers: text: It involves the delivery of controlled thermal energy to the airway wall during a series of bronchoscopies
is_impossible: no

question: What effect does bronchial thermoplasty have?
answers: text: it appears to decrease the subsequent rate.
is_impossible: no

question: What treatment helps improve those with allergic rhinitis and asthma?
answers: text: sublingual immunotherapy
is_impossible: no

question: What is an option for someone with LABAs not controlled by corticosteroids?
is_impossible: yes

question: What does inhaling corticosteroids deliver?
is_impossible: yes

question: What does taking corticosteroids increase in the first few months of use?
is_impossible: yes

question: What is decreased when you use sublingual immunotherapy for LABAs?
is_impossible: yes

question: What treatment has evidence that shows an outcome improvement for people with LABAs?
is_impossible: yes

question: What is neutrophils the result of?
is_impossible: yes

question: What can cause symptoms and asthma serverity to change?
is_impossible: yes

question: Who was the most frequent primary payer amount children and adults?
is_impossible: yes
context: For those with severe persistent asthma not controlled by inhaled corticosteroids and LABAs, bronchial thermoplasty may be an option. It involves the delivery of controlled thermal energy to the airway wall during a series of bronchoscopies. While it may increase exacerbation frequency in the first few months it appears to decrease the subsequent rate. Effects beyond one year are unknown. Evidence suggests that sublingual immunotherapy in those with both allergic rhinitis and asthma improve outcomes.

qas: question: What is the prognosis for asthma? 
answers: text: generally good
is_impossible: no

question: What has caused the mortality rate to decrease?
answers: text: due to better recognition and improvement in care
is_impossible: no

question: Worldwide, how many people suffer from asthma?
answers: text: 19.4 million people as of 2004
is_impossible: no

question: How many cases that are diagnosed in childhood make it past 10 years with asthma?
answers: text: half of cases will no longer carry the diagnosis after a decade
is_impossible: no

question: What is the prognosis after treating airway remodeling?
is_impossible: yes

question: Why has airway remodeling decreased in children over the last few decades?
is_impossible: yes

question: How many people will no longer be diagnosed with decline in lung function after 2004?
is_impossible: yes

question: Is treatment with corticosteroids harmful or beneficial?
is_impossible: yes

question: What is used to treat airway remodeling?
is_impossible: yes

question: What is a main way people can prevent reactions to dust mites?
is_impossible: yes

question: What is one thing you need to take if your LABA is severe?
is_impossible: yes

question: If GERD is poorly controlled, what does it make you at risk for?
is_impossible: yes
context: The prognosis for asthma is generally good, especially for children with mild disease. Mortality has decreased over the last few decades due to better recognition and improvement in care. Globally it causes moderate or severe disability in 19.4 million people as of 2004 (16 million of which are in low and middle income countries). Of asthma diagnosed during childhood, half of cases will no longer carry the diagnosis after a decade. Airway remodeling is observed, but it is unknown whether these represent harmful or beneficial changes. Early treatment with corticosteroids seems to prevent or ameliorates a decline in lung function.

qas: question: By 2011, how many people were affected by asthma?
answers: text: 235–330 million people worldwide are affected by asthma
is_impossible: no

question: How many people die per year from asthma?
answers: text: 250,000–345,000 people
is_impossible: no

question: What countries is asthma more commonly seen?
answers: text: It is more common in developed than developing countries
is_impossible: no

question: Why are different countries effected differently?
answers: text: The reason for these differences is not well known
is_impossible: no

question: How many people were affected by asthma in Asia as of 2011?
is_impossible: yes

question: How many people died in 2011 in Europe from asthma?
is_impossible: yes

question: What percentage of people in developing countries are affluent?
is_impossible: yes

question: What percentage of people in Eastern Europe are affluent?
is_impossible: yes

question: Is it known why developing countries are economically disadvantaged?
is_impossible: yes

question: How can symptoms of long acting beta agonists be prevented?
is_impossible: yes

question: Why are people less likely to want to live on a farm?
is_impossible: yes

question: What do sulfite-containing foods reduce the effectiveness of?
is_impossible: yes
context: As of 2011, 235–330 million people worldwide are affected by asthma, and approximately 250,000–345,000 people die per year from the disease. Rates vary between countries with prevalences between 1 and 18%. It is more common in developed than developing countries. One thus sees lower rates in Asia, Eastern Europe and Africa. Within developed countries it is more common in those who are economically disadvantaged while in contrast in developing countries it is more common in the affluent. The reason for these differences is not well known. Low and middle income countries make up more than 80% of the mortality.

qas: question: How much was the average cost of hospital stays for asthma-related issues for children??
answers: text: about $3,600
is_impossible: no

question: How much was the average cost of hospital stays for asthma-related issues for adults?
answers: text: from $5,200 to $6,600
is_impossible: no

question: Who was the most frequent primary payer amount children and adults?
answers: text: Medicaid
is_impossible: no

question: Who was more likely to seek hospital help in the US for asthma reasons?
answers: text: the lowest income communities
is_impossible: no

question: What was the average cost per hospital stay for high income communites in 2010?
is_impossible: yes

question: How much did the cost increase for a child to be hospitalized for asthma in 2000?
is_impossible: yes

question: Who was the primary payer for low income communities from 2000 to 2010?
is_impossible: yes

question: What group with adults 18-44 had higher stays in the hospital in 2000 instead of higher income communities?
is_impossible: yes

question: What group was covered by private insurance  in 2000?
is_impossible: yes

question: How many people die per year from asthma?
is_impossible: yes

question: What are two other ways allergen subgroups may be classified?
is_impossible: yes

question: What effect does bronchial thermoplasty have?
is_impossible: yes
context: From 2000 to 2010, the average cost per asthma-related hospital stay in the United States for children remained relatively stable at about $3,600, whereas the average cost per asthma-related hospital stay for adults increased from $5,200 to $6,600. In 2010, Medicaid was the most frequent primary payer among children and adults aged 18–44 years in the United States; private insurance was the second most frequent payer. Among both children and adults in the lowest income communities in the United States there is a higher rates of hospital stays for asthma in 2010 than those in the highest income communities.

qas: question: When was the first paper written about asthma?
answers: text: In 1873
is_impossible: no

question: What was first used as a cure for asthma?
answers: text: by rubbing the chest with chloroform liniment
is_impossible: no

question: In 1880 what was used intraveniously for asthma?
answers: text: pilocarpin
is_impossible: no

question: When did inhaled corticosteroids and short acting beta agonist start being used? 
answers: text: in the 1960s
is_impossible: no

question: What did the paper written in 1886 mention about an asthma cure?
is_impossible: yes

question: What treatment was used for asthma in 1873?
is_impossible: yes

question: In 1950 what connection was theorized by F.H. Bosworth?
is_impossible: yes

question: What two medications were widely used to treat asthma in 1905?
is_impossible: yes

question: What condition was epinephrine connected to the treatment of in 1873?
is_impossible: yes

question: What other parts of the immune system are changed due to thickening of the neutrophils?
is_impossible: yes

question: What part of the airway does emphysema affect?
is_impossible: yes

question: What are two enviromental factors?
is_impossible: yes
context: In 1873, one of the first papers in modern medicine on the subject tried to explain the pathophysiology of the disease while one in 1872, concluded that asthma can be cured by rubbing the chest with chloroform liniment. Medical treatment in 1880, included the use of intravenous doses of a drug called pilocarpin. In 1886, F.H. Bosworth theorized a connection between asthma and hay fever. Epinephrine was first referred to in the treatment of asthma in 1905. Oral corticosteroids began to be used for this condition in the 1950s while inhaled corticosteroids and selective short acting beta agonist came into wide use in the 1960s.