The consequent pain may lead to the cascade of quadriceps weakness, patellar tendon shortening and scarring in the tissues around the knee cap—with an end stage of permanent patella infera—where the knee cap is pulled down into an abnormal position where it becomes vulnerable to joint surface damage. Arthrofibrosis after knee injury, knee arthroscopy or other surgeries
The first step in treating arthrofibrosis is appropriately directed physical therapy with a focus on icing and elevating and passive stretching exercises such as continuous passive motion (CPM). Passive stretching can increase range of motion if conducted frequently and carefully so that tissues are not torn. There are a number of treatment options and treatment varies depending on the knowledge of the treating clinician and on the cause and duration of the fibrosis. Often physical therapy is used as an attempt at conservative management. Knowledge of the role of inflammation in arthrofibrosis has led a cautionary approach to exercise, because exercise increases inflammation. Advice to AF patients now typically consists of "listen to your knee" and stop, or reduce, activities that increase pain during and after exercise. Aggressive exercise of the affected limb may cause permanent damage. If physical therapy fails options include manipulation under anaesthesia (MUA), arthroscopic lysis of adhesions and open lysis of adhesions. Although MUA and surgery can be successful, the resulting increase in inflammation may cause scar tissue to rapidly return and symptoms can worsen.Pharmacological interventions such as anti-inflammatory medications and supplements are increasingly used to treat arthrofibrosis.
Additional prospective population-based data indicate that ACOS seems to represent a form of severe asthma, characterised by more frequent hospitalisations, and to be the result of early-onset asthma that has progressed to fixed airflow obstruction. Economics
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 rate of hospital stays for asthma in 2010 than those in the highest income communities. History
Asthma was recognized in ancient Egypt and was treated by drinking an incense mixture known as kyphi. It was officially named as a specific respiratory problem by Hippocrates circa 450 BC, with the Greek word for "panting" forming the basis of our modern name. In 200 BC it was believed to be at least partly related to the emotions.