Lower Respiratory Infections

Lower Respiratory Infections

Acute lower respiratory infections include pneumonia (infection of the lung alveoli), as well as infections affecting the airways such as acute bronchitis and bronchiolitis, influenza and whooping cough. They are a leading cause of illness and death in children and adults across the world. The importance of lower respiratory infections may be underestimated

SYMPTOMS

ACUTE BRONCHITIS AND BRONCHIOLITIS

The main symptom of acute bronchitis is a cough that cannot be explained by an existing long-term lung condition.

Bronchiolitis causes babies and infants to have prolonged symptoms of wheeze and cough, lasting for weeks and months after the first symptoms.

INFLUENZA

The usual form of influenza can result in symptoms of fever, muscle pain, headache, cough, sore throat and a blocked nose. If the infection is more severe it can lead to pneumonia.

PNEUMONIA

People with pneumonia experience a cough along with other symptoms such as fever or breathlessness without an obvious cause. 

CAUSES

Infections are caused by tiny organisms, known as bacteria or viruses. There are millions of organisms that surround us.

Viruses are carried in tiny droplets and are passed between people when someone with the virus coughs or sneezes. People who are infected produce antibodies to fight the virus. Once they have fought of this strain, they will be able to fight it if infected again. However, over time, the virus can change into different forms, which means the body may not have the right antibodies to fight it again.

ACUTE BRONCHITIS AND BRONCHIOLITIS

Almost 90% of cases of acute bronchitis are related to viruses such as influenza and the rhinovirus. Less than 10% are linked with bacteria.

Bronchiolitis is most often caused by respiratory syncytial virus (RSV) in infants and babies.

INFLUENZA

There are three influenza viruses A, B and C. A has the biggest impact, B causes less severe illness and C does not cause any illness in humans.

When a new strain develops that people have no resistance to, it can spread across the world. This was the case during the ‘swine flu’ outbreak in 2009.

PNEUMONIA

The most common cause of pneumonia in adults is a bacterium called Streptococcus pneumonia. Viruses can also cause pneumonia, most commonly the respiratory syncytial virus (RSV) in small children, and sometimes influenza. Hospital-acquired pneumonia is caused by germs in a hospital, whereas community-acquired pneumonia is caused by different germs in the community.

TREATMENT

One way to treat in an infection is through drugs known as antibiotics. Antibiotics should only be prescribed when necessary or antibiotic resistance can develop.

Antibiotic resistance is when bacteria is regularly exposed to the same drug over time and will eventually mutate and develop resistance to this drug. Using antibiotics to treat mild illnesses unnecessarily speeds up the problem of antibiotic resistance, than if the drugs were only used in severe cases.

ACUTE BRONCHITIS AND BRONCHIOLITIS

People who suspect they have bronchitis do not need to visit a doctor for a diagnosis, unless they have severe or persistent symptoms. Most cases of acute bronchitis do not require drugs to treat the condition and the symptoms can be managed at home by getting rest and drinking fluids. Antibiotics have no effect on viruses so are not prescribed to treat acute bronchitis.

Bronchiolitis is diagnosed by monitoring the symptoms and analysing a child’s breathing. Babies infected with the respiratory syncytial virus (RSV) usually require supportive care but no medication. In extremely severe cases, they are given antiviral drugs.

INFLUENZA

People who are fit and healthy do not need to visit a doctor to diagnose flu. It is usually possible to treat the symptoms of influenza at home with rest and drinking plenty of water. Antiviral drugs are also used to treat influenza in people who are at risk of other complications. A doctor will diagnose flu based on symptoms and medical history if a person is at risk.

PNEUMONIA

 An x-ray can be used to check for pneumonia and is likely to show shadowing on the lungs if the infection is present. Antibiotics are used to treat pneumonia and different approaches should be used according to the risk of the person and severity of the illness.

WHAT IS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)?

WHAT IS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)?

Chronic obstructive lung disease (COPD) describes a group of lung conditions (diseases) that make it difficult to empty the air out of the lungs. This difficulty can lead to shortness of breath (also called breathlessness) or the feeling of being tired. COPD is a word that can be used to describe a person with chronic bronchitis, emphysema or a combination of these. COPD is a different condition from asthma, but it can be difficult to distinguish between COPD and chronic asthma.

Two people may have COPD, but one may have more symptoms of chronic bronchitis while another may have more symptoms of emphysema. It is helpful to understand the difference between the two conditions, as COPD means a person may have some chronic bronchitis as well as emphysema.

How do I know I have COPD?

Cough, sputum production or shortness of breath that will not go away are all common signs of COPD. These signs and a history of smoking will usually indicate the need for a test called spirometry, which measures if you have airway obstruction or not.

How does my healthcare provider know I have COPD?

Your healthcare provider will decide if you have COPD based on both your reports of symptoms and test results. The single most important test to determine if you have COPD is spirometry. The most important things you can do to help your healthcare provider in determining if you have COPD is to: 1) be honest about your smoking history; 2) share your exposures to pollutants and chemicals; and 3) remember, as best you can, when your symptoms first started.

How is COPD treated?

The first most important treatment if you are a smoker is to stop smoking. As well as helping you quit smoking, your healthcare provider may prescribe medicines that widen the breathing tubes (bronchodilators), reduce swelling in the breathing tubes (anti-inflammatory drugs) or treat infection (antibiotics). Medications have been shown to help stabilize the breathing passages and decrease swelling. In order to provide control of your COPD, these medications must be taken every day, probably for the rest of your life.

Currently, there is no treatment available to restore damaged bronchi from bronchitis or alveoli affected by a large amount of emphysema. Unfortunately, the damage that has been done to the alveoli is permanent. In some parts of the world, surgery (lung volume reduction) can be performed as a way of removing some (but not all) areas of the lungs with large amounts of emphysema.

With COPD you can learn to use the lung power you have more efficiently. You should learn as much as you can about your condition. Attending groups or enrolling in a Pulmonary Rehabilitation Program can be helpful. Pulmonary rehabilitation may also be recommended so that you can learn to be in control of your breathing, instead of your breathing controlling you.

What causes COPD?

COPD can be caused by many factors, although the most common cause is cigarette smoke. Inhaling irritating particles, such as smoke or air pollutants, can cause the mucus glands that line the bronchial tubes (bronchi) to produce more mucus than normal, and can cause the walls of the bronchi to thicken and swell (inflame). This increase in mucus causes you to cough, frequently resulting in raising mucus (or phlegm). COPD can develop if small amounts of these irritants are inhaled over a long period of time or if large amounts are inhaled over a short period of time.

Environmental factors and genetics may also cause COPD. For example, heavy exposure to certain dusts at work, chemicals and indoor or outdoor air pollution can contribute to COPD. The reason why some smokers never develop COPD and why some never-smokers get COPD is not fully understood. Family genes or heredity probably play a major role in who develops COPD.

What is asthma?

Asthma is a condition of chronic swelling of the airways. These airways are sensitive to stimulation by a number of things, such as infection, cold air, exercise, pollens, etc. The swelling may produce an obstruction of the airways, similar to COPD. Some people with COPD also have asthma.

What is bronchiectasis?

Bronchiectasis is a permanent enlargement of the bronchi and bronchioles. The enlarged airways produce abnormal amounts of mucus, which can block (obstruct) the breathing passages. Bronchiectasis may occur after severe pneumonia. While bronchiectasis may at first appear to be COPD, the evaluation and treatment are different.

What is bronchiolitis?

Bronchiolitis is characterized by swelling of the small airways (bronchioles), usually resulting from inflammation or infection. This condition is more commonly seen in children after severe lung problems and in adults after lung transplantation. The narrowing of the breathing passages can be confused with COPD.

What is chronic bronchitis?

Chronic bronchitis is a constant swelling and irritability of the breathing tubes (bronchi or bronchioles) and results in increased mucus (phlegm) production. Chronic bronchitis is diagnosed when a person reports cough and mucus on most days for 3 months during 2 consecutive years when other lung conditions have been eliminated as a cause. This means that other conditions (and there are many) that may cause sputum production or cough are not the cause. Airway obstruction occurs in chronic bronchitis because the swelling and excessive mucus production cause the inside of the breathing tubes to be narrower than normal. The narrowing of the airways prevents the normal amount of air from reaching the lungs. The amount of narrowing is measured with a breathing test called spirometry.

What is emphysema?

Emphysema is a disease that involves the alveoli (air sacs) of the lung. Normally there are over 300 million alveoli in the lung. These alveoli are stretchy and springy, like little balloons. Like a balloon, it takes effort to blow-up a normal alveoli, however, it takes no energy to empty the air sac because the alveoli spring back to their original size. In emphysema, the walls of some of the alveoli have been ruined. When this happens the alveoli become stretchy and act more like paper bags. A paper bag is easy to blow-up, but you need to squeeze the bag to get the air out. So, instead of just needing effort to get air into the lungs, it also takes energy to squeeze the air out. As it is difficult to push all of the air out of the lungs, they do not empty efficiently and therefore contain more air than normal. This is called hyperinflation or air trapping. The combination of constantly having extra air in the lungs and the extra effort needed to breathe, results in the feeling of shortness of breath.

The "obstruction" in emphysema is because the breathing tubes tend to collapse on exhalation, preventing you from getting the normal amount of air out of your lungs. This is a result of the loss of stable alveolar walls, which normally hold the breathing tubes open as your exhale. Airway obstruction is measured with spirometry (a breathing test). Several other tests can be performed that can tell your provider if it is likely that you have a lot of emphysema causing your COPD.

Will COPD ever go away?

The term chronic in chronic obstructive respiratory disease means all of the time, therefore, you will have COPD for life. While the symptoms sometimes are less after you stop smoking, they may never go away entirely. Improvements in symptoms depend on how much damage has occurred to your lungs.

What is Stroke Disease?

What is Stroke Disease?

Stroke (Brain Attack, TIA)

General information

Stroke or Brain Attack is an infection that includes the veins that supply blood to the mind. 

A stroke happens when a vein that brings oxygen and supplements to the mind breaks or is stoped up by a blood coagulation or some different mass. 

Without sufficient supply of oxygen, nerve cells of the mind can't work and pass on inside minutes. At the point when nerve cells can't work, the zone of the body they control can't work either. 

TIA are transient ischemic assaults or smaller than usual strokes that happen when the lacking blood supply to the mind is recuperated after few minutes of an impediment of a vessel. They speak to cautioning indications of more genuine or lasting strokes. 

Reasons for stroke and TIA incorporate meandering clumps (an embolus) from the heart, greasy developments (atherosclerotic sores) on the aortic curve or the vessels of the neck or mind, stenosis or narrowing of the corridors of the neck and the cerebrum or essential maladies influencing the courses of the focal sensory system known as vasculitis. 

Infections connected with strokes incorporate diabetes, hypertension, elevated cholesterol, carotid malady, atrial fibrillation or other coronary illness, history of TIAs (scaled down strokes), sickle cell weakness, heftiness, fibromuscular dysplasia, connective tissue issue, other relatives with history of strokes. 


Roughly 700,000 strokes happen in the United States yearly.

Symptoms

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, difficulties speaking or understanding.
• Sudden loss of vision in one or both eyes.
• Sudden gait troubles, dizziness or loss of balance and or coordination.

Diagnosis

• MRI and CT scans can recognize the presence of strokes.
• MR-angiograms, CT-angiograms and Cerebral angiography provide complementary, important information regarding the location of the vessel occlusion, the degree of brain tissue affected, and the collateral circulation to the affected part of the brain.

Treatment

• The treatment of strokes requires rapid interventions including use of medications for dissolving clots or endovascular mechanical removal of the clot, and use of neuroprotectants and close critical care monitoring.
• Patients at risk of stroke or with TIA’s can be treated with medications to thin their blood, reduction of risk factors, and correction of the cause of the clots or vascular occlusion.
• Carotid stenosis can be treated with surgery to remove the fatty buildups or with applications of angioplasty and stents.
• Intracranial narrowing of the vessels can be treated with angioplasty and stenting or extracranial to intracranial bypass surgery
• Inadequate blood supply, due to diseases like moyamoya, is treated with revascularization techniques including bypass surgery and EDAS.