Lung Diseases & Pulmonology

Severe acute respiratory syndrome (SARS) is a viral respiratory disease caused by a SARS-associated coronavirus. It was first identified at the end of February 2003 during an outbreak that emerged in China and spread to 4 other countries. WHO co-ordinated the international investigation with the assistance of the Global Outbreak Alert and Response Network (GOARN) and worked closely with health authorities in affected countries to provide epidemiological, clinical and logistical support and to bring the outbreak under control. SARS is an airborne virus and can spread through small droplets of saliva in a similar way to the cold and influenza.

Respiratory diseases encompass a variety of pathogenic conditions that affect respiration in living organisms. Respiration involves gas exchange in higher organisms. Respiratory disorders occur in the respiratory tract, which includes the alveoli, bronchi, bronchioles, pleura, pleural cavity, trachea and the nerves and muscles of breathing. Respiratory diseases or lung diseases include COPD, asthma, cystic fibrosis, emphysema, lung cancer, interstitial lung disease, mesothelioma, pulmonary hypertension, tuberculosis, alpha-1 antitrypsin deficiency, bronchiectasis, idiopathic pulmonary fibrosis, pneumonia, respiratory failure, respiratory distress syndrome, sarcoidosis, sleep apnea, sleep deprivation and deficiency, influenza and many more. If left untreated, they lead to health complications and life-threatening conditions.

COVID-19 is a respiratory disease which causes a range of breathing problems, from mild to critical. Older adults and people who have other health conditions like heart disease, cancer, and diabetes may have more serious symptoms when compared to others. Coronavirus can infect the upper or lower part of the respiratory tract and travels down the airways making the lining become irritated and inflamed. In some cases, the infection can reach all the way down into the alveoli. Respiratory inflammation can be observed on a chest X-ray or CT scan. Currently, convalescent plasma from a recovered patient is given by transfusion to a patient who is suffering from COVID-19. The donor antibodies may help the patient fight the illness, possibly shortening the reducing the severity of the disease.

Many individuals, including those who live with chronic lung disease, are at high risk for severe illness if they get sick with COVID-19. In this case, your doctor may recommend you receive an investigational treatment, monoclonal antibodies, which can help your immune system fight off the virus, so you are less likely to get severely ill. If you have stayed home due to illness from confirmed or suspected COVID-19 you should follow the guidance of your healthcare provider and local health department on when to end home isolation. Multiple factors are taken into account in determining when it is safe for you to return to work or emerge from self-quarantine.

Remdesivir, an antiviral which has been shown to shorten the recovery time needed in some hospitalized patients.

Dexamethasone, a corticosteroid used to prevent or reduce inflammation in hospitalized patients with severe illness who need supplemental oxygen.

Tocilizumab or baricitinib, biological therapy used to reduce inflammation in hospitalized patients with severe illness requiring oxygen delivery through a high-flow device, invasive mechanical ventilation or ECMO, if used in addition to dexamethasone.

A person with an acute respiratory infection, which may include history of fever or measured fever (≥ 38 °C, 100.4 °F) and cough; AND suspicion of pulmonary parenchymal disease (e.g. pneumonia or ARDS), based on clinical or radiological evidence of consolidation and not already explained by any other infection or aetiology, including all clinically indicated tests for community-acquired pneumonia according to local management guidelines. It is not necessary to wait for test results for other pathogens before testing for novel coronavirus. Adolescent or adult patient with fever or suspected infection, cough, respiratory rate > 30 breaths/min, severe respiratory distress, oxygen saturation (SpO₂ ) < 90% on room air.

As an expanded number of coronavirus vaccines enter human clinical trials, in addition to understanding their efficacy in preventing severe SARS-CoV-2-related disease, a key outcome that will be receiving outsized scrutiny will be whether these vaccines contribute to lung immunopathology upon natural viral infection. Since the emergence of life-threatening severe acute respiratory syndrome (SARS) almost 20 years ago and subsequently Middle East respiratory syndrome (MERS) in 2012, numerous vaccines have been developed and tested in experimental animals to combat these lethal coronavirus-associated respiratory syndromes. An unexpected and concerning feature of several of these is the appearance of lung immunopathology that is seen in animals receiving certain types of vaccines. This result is especially concerning given that vaccine associated enhanced respiratory disease (VAERD) was seen in human vaccine trials against the ubiquitous airway pathogen respiratory syncytial virus (RSV).

The immune system protects the body from disease. Over the past decade, however, researchers have come to understand that the innate immune system — the part of the immune system that serves as the body’s first line of defense — is implicated in an enormous number of disease processes that affect many millions of people around the world. Pulmonary fibrosis is a group of serious lung diseases that affect the respiratory system. Pulmonary fibrosis scars and thickens lung tissue. It impacts the connecting tissue in the lung and the alveoli (air sacs inside the lungs). The lung damage gradually gets worse over time.

Coronavirus disease 2019 (COVID-19) is defined as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China. It was initially reported to the World Health Organization (WHO) on December 31, 2019. On January 30, 2020, the WHO declared the COVID-19 outbreak a global health emergency. On March 11, 2020, the WHO declared COVID-19 a global pandemic, its first such designation since declaring H1N1 influenza a pandemic in 2009. Utilization of programs established by the FDA to allow clinicians to gain access to investigational therapies during the pandemic has been essential. The expanded access (EA) and emergency use authorization (EUA) programs allowed for rapid deployment of potential therapies for investigation and investigational therapies with emerging evidence

The term "Cardiopulmonary Disease" describes a range of conditions affecting the heart and lungs. These organs are closely related, and the problem in one can spill over to another. Exposure to tobacco smoke has long been recognized as an important component of cardiovascular risk. Likewise, minimizing your exposure to tobacco smoke is the most effective way to save you from COPD

Type and signs of conditions that affect the heart and lungs.

The term cardiopulmonary disease describes a spread of conditions that affect the guts and lungs. These organs are closely connected, and drag in one can spill over to the opposite. For example, when the center isn't able to pump blood efficiently, normal oxygen movement within the lungs is reduced, causing shortness of breath. On the opposite hand, drag with the lungs can cause the guts to possess to figure harder to purge oxygen from the lungs into the blood.

Common types of this disease include:

Chronic bronchitis

 Heart failure

Emphysema

Signs of the cardiopulmonary disease can vary widely reckoning on the particular condition. Some common symptoms include sweating.

• Wheezing Bluish skin on the hands or feet
• Chest pain will radiate to the arms or jaw, especially during or after physical activity
• Dizziness or lightheadedness
• High blood pressure
• Nausea and vomiting
• Shortness of breath
• Sudden
• Treatments
• Cardiopulmonary treatment options depend upon your specific condition and should include lifestyle modifications, medication, or more advanced treatments.

Tuberculosis (TB) is a serious infectious disease that mainly affects the lungs and it is caused by bacteria (Mycobacterium tuberculosis). The bacteria responsible for tuberculosis are spread from one person to another through tiny droplets released into the air via cough and sneeze. Tuberculosis can be fatal when it is untreated. Untreated active disease typically affects the lungs, and it can spread to other parts of the body through the blood stream. Complications of tuberculosis include spinal pain, joint damage, swelling of the membranes that cover the brain, liver or kidney problems and heart disorders. People diagnosed with active TB disease generally have to take a combination of medications for six to nine months. A significant number of TB patients develop post tubercular airway disease or TB-associated COPD.

 Lung cancer (Thoracic) illness is that the tumor of the chest and lungs area. The Lowe Center for Thoracic Oncology treats lung tumor non-little cell lung development, little cell lung danger, and mesothelioma, and various illnesses of organs inside the chest. Fragile tissue chest divider tumors often show as a limited mass without various indications. Various chest divider tumors are recognized suddenly on imaging looks at improved the circumstance other clinical explanation. A couple of patients have fevers. Patients generally haven't got torture until the purpose that the tumor is advanced. On the alternative hand, fundamental cartilaginous and bone tumors are routinely anguishing. Patients with chest divider tumors require chest x-bar, CT, MRI, and now and again PET–CT to decide on the first site and level of the tumor and whether it's a fundamental chest divider tumor or a metastasis. Biopsy and histologic appraisal insist on the end. Most chest divider tumors are treated with cautious resection and propagation. Diversion as often as possible uses a combination of my cutaneous folds and prosthetic materials. The proximity of undermining pleural radiation is a contraindication to cautious resection. Other Treatments joins; Chest divider resections incorporate clearing a vicinity of the ribs and also the muscles of the chest lung danger form into the chest divider. The method could need the support of a plastic expert for extra redoing.

Asthma is a clinical syndrome of chronic airway inflammation characterized by recurrent and reversible airway obstruction. Most people with asthma will not develop COPD; however, it’s possible to have both. Asthma-COPD overlap syndrome (ACOS) occurs when someone has these two diseases at a time. Signs of ACOS include difficulty in breathing, wheezing, frequent coughing, excess phlegm, feeling tired, low physical tolerance for exercise, shortness of breath during routine activities. Common triggers for asthmatic symptoms include exposure to allergens (dust mites, cockroach, molds and pollens), exercise and viral infections. Most people who have asthma are treated with daily medicine, called long-term control medicines, along with inhalers containing medicine for short-term relief.

Pneumonia is an infection that inflames the air sacs in the lungs and people with COPD are more likely to develop pneumonia. It is most serious for infants, young children and older people whose age is above 65, and people with weakened immune systems. Bacterial pneumonia, is the most common form, tends to be more serious than other types of pneumonia. The symptoms of bacterial pneumonia can develop gradually. In few cases pneumonia can be difficult to diagnose because the symptoms are so variable and are often very similar to those seen in a cold or influenza. Complications of pneumonia are as follows: pleural effusion, empyema, lung abscess, bacteremia, septicemia, meningitis, septic arthritis, endocarditis, or pericarditis.

Sleep apnea is a sleep disorder that occurs when a person's breathing is interrupted during sleep. If left untreated, sleep apnea can increase the risk of health problems, such as high blood pressure, stroke, heart failure, irregular heartbeats, and heart attacks, diabetes, depression, worsening of ADHD, headaches. Depending on the cause and the level of apnea, there are different methods of treatment and the goal of treatment is to normalize breathing during sleep. Treatment options for obstructive sleep apnea include: Continuous Positive Airflow Pressure (CPAP), other breathing devices, oral appliances, implants and surgery

Cystic fibrosis is a progressive, genetic disease that causes persistent lung infections and limits the ability to breathe over time and it affects the cells that produce mucus, sweat and digestive juices. It is caused by a change, or mutation, in a gene called CFTR (cystic fibrosis transmembrane conductance regulator). This gene controls the flow of salt and fluids in and out of the cells. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of the lungs. This can cause signs and symptoms such as persistent cough that produces thick mucus, wheezing, breathlessness, exercise intolerance, repeated lung infections, inflamed nasal passages or a stuffy nose. Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways and this makes it harder to move air in and out of the lungs and clear mucus from the airways.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease isolated to the lung. IPF is a type of interstitial lung disease, which is a group of 200 diseases with similar symptoms but different causes. Symptoms of Idiopathic pulmonary fibrosis develop gradually and may not be noticed until the disease is well-established. IPF affects each person differently and the disease progresses at varying rates and it primarily involves the interstitium (the tissue and space around the air sacs of the lungs) and does not affect the airways or blood vessels directly.

Alpha-1 antitrypsin deficiency is a genetic disorder that is passed on in families and affects the lungs, liver and skin. When this condition affects the lungs, it causes COPD. There is no cure, but treatment can help people with Alpha-1 antitrypsin deficiency manage their symptoms and live a better life. The preliminary symptoms are shortness of breath following mild activity, reduced ability to exercise, and wheezing. Other signs and symptoms include unintentional weight loss, recurring respiratory infections, fatigue, and rapid heartbeat upon standing. Affected individuals often develop emphysema, which is a lung disease caused by damage to the small air sacs in the lungs. Alpha-1 antitrypsin deficiency accounts for 1 to 2% of all cases of chronic obstructive pulmonary disease.

The predominant pathologic changes of COPD are found within the airways; however, changes are seen within the lung parenchyma and pneumonic vasculature. In an individual, the pattern of pathologic changes depends on the underlying illness (e.g., bronchitis, emphysema, alpha-1 antitrypsin deficiency), presumably individual susceptibility, and illness severity. High resolution computerized axial tomography can assess lung parenchyma, airways, and pneumonic vasculature. About 62 % of patients with moderate to severe COPD report variability in symptoms (e.g., dyspnea, cough, sputum, wheezing, or chest tightness) over the course of the day or week-to-week; morning is usually the worst time of day. An effective COPD management objective includes four components: assess and monitor the disease; reduce the risk factors; manage and stabilize COPD; manage the exacerbations. The most important factor for the COPD is cigarette smoking. The clinical management techniques involved to reduce the exacerbation of these factors that affect COPD must be developed in an efficient way.

Pulmonary rehabilitation, also known as respiratory rehabilitation, is an important part of creating and maintaining the health of people with chronic respiratory conditions who persist in symptoms or continue to decline in function despite standard treatment. This is a broad therapeutic concept. The American Thoracic Society and the European Respiratory Society describe it as an evidence-based, interdisciplinary, and comprehensive intervention for patients with chronic respiratory conditions who have symptoms and regularly reduce daily activity. In general, pulmonary rehabilitation refers to the sequence of services that are provided to patients with respiratory disease and their families, usually with the aim of improving the patient's quality of life. Pulmonary rehabilitation can be completed in a variety of settings, depending on the patient's wishes, and may or may not include pharmacological intervention. Pulmonary rehabilitation is usually tailored to the patient's personality to meet his or her desires. It is an extensive program that can benefit people with lung conditions such as chronic obstructive pulmonary disease (COPD), sarcoidosis, idiopathic pulmonary fibrosis (IPF), and cystic fibrosis, among others.  Although the technique is aimed at rehabilitating the victim himself, the family is also involved. The system usually does not start until a scientific examination of the victim has been performed by an authorized physician.

Even if an individual has never smoked or been unprotected to pollutants for an extended period, they can still develop COPD. Alpha-1 Antitrypsin Deficiency (AATD) is the most commonly known genetic risk factor of COPD in emphysema. Alpha-1 Antitrypsin related COPD is caused by a deficiency of the Alpha-1 in the bloodstream. Without the Alpha-1 Antitrypsin protein, white blood cells begin to harm the lungs and lung deterioration occurs. The World Health Organization and the American Thoracic Society suggests that everyone determined to have COPD be tested for Alpha-1. 

The main test for diagnosing COPD is a lung function test called spirometry which involves the use of a machine called a spirometer that measures how much air you are able to move by taking a deep breath in and out, and how quickly you are able to do so. Arterial blood gas analysis is second important test in diagnosing COPD. This test measures how much oxygen and carbon dioxide are present in the blood. A high percentage of carbon dioxide in the blood can be a sign of poorly functioning lungs. The important methods of treatment are pharmacotherapy and smoking cessation, while pulmonary rehabilitation, long-term oxygen therapy, and surgery may be considered in selected patients. Steroids, inhalers and antibiotics may be prescribed to treat various symptoms of COPD. Smoking cessation is the most effective intervention in stopping the progression of COPD, as well as increasing survival rate of persons suffering with COPD. Hence, smoking cessation should be the top priority in the treatment of COPD.

Everyday life is increasingly influenced by digitization. Digital health technology promises to facilitate a patient-centered care model for the management of COPD by empowering patients to self-manage effectively and presently, it is not widely used in medicine. For pulmonology, digitization offers opportunities and risks in different areas like obstructive lung diseases, thoracic oncology, pulmonary rehabilitation, sleep medicine, home mechanical ventilation, and in intensive care medicine. One of the opportunities is that the use of new technologies such as medical apps and the analysis of this new support make it possible to better understand and manage diseases. One of the key advantages is the use of "big data" for displaying dynamic behavior to better understand disease processes, and to optimize patient management by using analytic techniques such as machine learning. Risks to be considered are data privacy and security as well as the use of artificial intelligence. Strategies used to date include approaches to monitoring and improving adherence, such as electronic inhalers, text messaging and reminders, and self-management tools.

Lung cancer is a condition that causes cells to divide in the lungs uncontrollably which leads to the growth of tumors that reduce a person's ability to breathe. Symptoms of lung cancer include appetite loss, changes to a person's voice, such as hoarseness, frequent chest infections, such as bronchitis or pneumonia, lingering cough that may start to get worse, shortness of breath, unexplained headaches, weight loss and wheezing. Early diagnosis of lung cancer can be lifesaving because lung cancer cells can travel to other areas of the body before a doctor detects them in the lungs. If metastasis has taken place, it makes treating the disease much more difficult. Treatment for lung cancer depends on its location and stage, as well as the overall health of the individual. Possible treatments include surgery, chemotherapy, radiation therapy and targeted therapy.

Depression and anxiety in COPD are regular in patients with chronic obstructive pulmonary disease (COPD), assessments of their pervasiveness differ significantly. These likely reflect the assortment of scales and strategies used to measure such symptoms. Patients with COPD with three or more comorbidities are more likely to be frequently hospitalized and may die prematurely compared to COPD patients without comorbidities.  An uplifted experience of dyspnoea is probably contributing component to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders. The cause of depression and anxiety symptoms are multifactorial and include behavioural, social and biological factors. Lung Conferences exhibits randomized controlled trials show that activity exercise training and precisely chose pharmacological treatment are regularly effective in ameliorating anxiety and depression.