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CARA (chronic aspecific respiratory ailments) Combination of disorders of the air

passages and lungs, sometimes grouped together for diagnostic convenience. The group includes chronic bronchitis, asthma and emphysema. None of these has a specific cause, but some patients are highly susceptible to them. They often run in families and are associated with allergies and hypersensitivity of the mucous membrane of the air passages. CARA occurs more in men than women, and although the signs do not usually appear clearly until after the age of forty, the disorder probably originates from the patient’s youth, and is encouraged by cigarette smoking and to a lesser extent atmospheric pollution. A characteristic pattern is that the patient has chronic bronchitis when he is young, with coughing and bringing up mucus. This and the recurrence of acute bronchitis with every cold cause gradually increasing shortness of breath (dyspnoea), which can take the form of asthma attacks. In later life the alveoli are stretched (emphysema), and ultimately blood pressure rises in the lungs, causing excess strain on the right-hand side of the heart. There is no cure for CARA, although complete incapacity can be avoided by correct treatment. The patient must not smoke, and if possible should live in an area free from atmospheric pollution. It is also important to prevent colds by avoiding crowds in the winter, and by staying indoors if it is foggy or cold. Infection should be rapidly and conclusively treated with antibiotics. Cough medicine may also be necessary, and also drugs to widen the air passages in patients inclined to asthma.

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