Emphysema is a disorder in which the alveolar walls are destroyed. This is a result from a breakdown in the lung’s normal defense mechanisms, which is the alpha-antitrypsin, against enzymes protease and elastase, which attacks and destroys the connective tissue of the lungs. Difficult expiration is the result of the destruction of the walls between the alveoli, partial airway collapse and loss of elastic recoil which be caused by smoking. As the alveoli collapse, pockets of the air form the alveolar spaces and within the lung parenchyma. This process leads to increased ventilator dead space from areas that do not participate in gas or blood exchange. The work of breathing is increased because there is less function at lung tissue to exchange oxygen and carbon dioxide. Individual with emphysema shows productive cough, decreased exercise tolerance, wheezing, shortness of breath, prolonged expiration and barrel chest presentation. To diagnose this condition, doctors will arrange for the person to have lung function test. Spirometry is used to measure the volume of air that the individual can inhale and exhale over a period of time. The result will show whether the airways are narrowed as a result of lung disorder, this test can also tell if the bronchodilator drugs prescribed, to widen the airways, are effective. Individual may have X-ray and CT scanning to assess the extent of damage to the lung and to exclude other disorders and look for evidence of lung tissue damage. Doctor will prescribe an inhaler containing a bronchodilator drug to open up the airways of the lungs by relaxing muscles of the bronchial walls, some will have oxygen therapy to relieve shortness of breath and antibiotics may be prescribed if a chest infection develops. Smoking and air pollution causes inflammation in the airways leading to the destruction of lung tissue. Smoking also weakens the immune system, which causes the lungs to be susceptible to infections resulting to decreased elasticity leading to gradual destruction of lung function.
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This is also known as the “dust disease”, result from inhalation of minerals, notably silica, coal dust or asbestos. This disease is commonly seen in miners, construction workers, sandblasters, potters and foundry and quarry workers. Pneumoconiosis usually develop gradually over a period of years, eventually leading to diffuse pulmonary fibrosis or progressive fibrosis of lung tissues that diminishes lung capacity and produces restrictive lung disease. Disease is caused by very small particles that are inhaled going through the bronchioles and alveoli that cannot be removed that eventually accumulate causing scarring and thickening of the lining of the lungs until it loses its ability to supply oxygen through out the body, while larger particles are trapped by mucus on upper respiratory tract and expelled by coughing. Early clinical manifestations are cough and dyspnea on exertion. Chest pain, productive cough and dyspnea at rest, loss of appetite, respiratory failure develops as the condition progresses and may lead to death. Pneumoconiosis can be diagnosed by using chest x-ray and pulmonary function test. Doctor will prescribe medication called bronchodilators that open airways. Other treatments would be avoiding all dust exposures, use of oxygen and stop smoking.
Cystic fibrosis (CF) is a hereditary, chronic disease characterized by abnormal secretions of the exocrine glands that causes body secretions to be thick and abnormal. Cystic fibrosis is present at birth and the abnormal genes are inherited from both parents. This order affects the sweat glands, respiratory system, digestive tract and reproductive tract. Cystic used to be considered a pediatric problem because it was fatal in childhood. However, advances in early diagnosis and treatment, including antibiotics, chest physiotherapy and nutrition programmes have extended the median life expectancy into mid 30s. A newborn baby with CF may have swollen abdomen and may not pass thick, sticky faeces passed by newborn infants for the first few days following birth. Other symptoms usually develop later in infancy and may include recurrent chest infection; constant cough develops, producing large amounts of sticky mucus. As CF progresses, the lung disorder bronchiectasis may occur, where the main airways are abnormally widened. An early diagnosis improves the long-term outlook by helping to prevent damage to the lungs in infancy. If the doctor suspects that a child has the condition at birth or later in infancy, a sweat test may be carried out to look for abnormally high levels of salt in the baby’s sweat. A sample of blood may also be tested to look for the abnormal gene. If the test result is found to be positive, siblings of the affected child can also be tested. Treatment for the cystic fibrosis is aimed at slowing the progression of lung disease and maintaining adequate nutrition. Chest physiotherapy is usually performed to remove secretions from the lungs; they sometimes require intravenous antibiotics to eliminate bacteria that become established in the lung secretions. Inhaled drugs can also help to reduce the stickiness of the secretions in the lungs. If the lungs are severely damaged, it may be possible to carry out a heart-lung transplant. Gender and lifestyle are not significant factors for this disease.
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