lunes, 23 de marzo de 2009

General Information

General Information

What is emphysema? It is a chronic obstructive disease of the lungs. Damage to the alveoli can cause destruction, narrowing, dilatation or excessive inflammation of them and I will limit its function. Smoking is a major cause of emphysema (80%), often develops in people older than 40 years who have smoked for many years. This evil will predispose to diseases like bronchitis, asthma, pneumonia and other lung-related diseases. The damage is irreversible, but in some cases it is manageable if you stop smoking. Risk factors: • Smoking • Genetic (related to deficiency of alpha-1 antitrypsin, its acronym in English is AAT) • Poor air quality (exposure to chemicals, environmental pollution) Symptoms: • Cough • Difficulty breathing • Weight Loss • Fatigue • Loss of appetite • troubled breathing with any exertion for at least this is If you're good to have one of the following symptoms (and you are a smoker), is very important that you come with your doctor. • If it makes you feel short of breath more often. • Your breathing is agitated with a moderate exercise. • You cough and phlegm often throw (sometimes infected). • This may indicate emphysema or other diseases related A pulmonary emphysema is defined by the pathological enlargement of airspaces distal to the respiratory bronchioles, with destruction of the alveolar wall, with or without obvious fibrosis. [1] It is a chronic disease including chronic bronchitis with the Chronic Obstructive Pulmonary Disease (COPD). [2] The name comes from the Greek emphysema which means "to blow the air" or "breathe." [3] The consumption of cigarettes is the most common cause of emphysema. It is believed that the smoke snuff and other contaminants cause the release of chemicals from the lungs that damage the walls of the alveoli. The damage gets worse over time. People who suffer from this disease have air sacs in the lungs are unable to fill with fresh air, rioja affecting the supply of oxygen to the body. A substance that exists naturally in the lungs called alpha-1-antitrypsin, can protect against this damage. People with deficient alpha-1-antitrypsin are at increased risk for this disease. Respiratory Disorders What is emphysema? Emphysema is a chronic condition of the lungs where the alveoli, or air bags may be: • Destroyed. • Straits. • collapsed. • Dilator. • Too much inflated. The superinflación of air bags is the result of the break in the walls of the alveoli, causing a decline in respiratory function and difficulty breathing. Damage to the air sacs is irreversible and the result "holes" remain in the tissues of the lower lungs. What are the symptoms of emphysema? Here are the most common symptoms of pulmonary emphysema. However, each person may experience a different way. Early symptoms of pulmonary emphysema may include:

Difficulty breathing. • Cough. Other symptoms may include: • Fatigue. • Anxiety. • Trouble sleeping. • heart problems. • Weight loss. • Depression. The symptoms of pulmonary emphysema may resemble those of other lung conditions or medical problems. Consult your doctor for diagnosis. CAUSES: Emphysema does not develop suddenly but happens gradually. The lung has a system of elastic fibers that allow the lungs expand and contract. Pulmonary emphysema appears when an abnormality occurs in the chemical balance that protects the lungs against the destruction of the elastic fibers. Exist various reasons for the anomaly in the chemical equilibrium: • Smoking. • Exposure to polluted air. • Gas and dust irritants in the workplace. • A rare hereditary disease called pulmonary emphysema associated with antitrypsin deficiency alpha-1 (the acronym is AAT) or early onset pulmonary emphysema. How is emphysema diagnosed? In addition to the examination and complete medical history, your doctor may order the following: • Examinations of lung function - diagnostic tests that help measure the lungs' ability to correctly perform the exchange of oxygen and carbon dioxide. These tests are usually done with special equipment in which the person must breathe, and could include: Spirometry - a spirometer is a device used by your doctor to evaluate the functioning of the lung. Spirometry, the evaluation of lung function with a spirometer, is one of the easier exams and more common in lung function and may require any or all of the following reasons: To§ determine the effectiveness with which the lungs receive, maintain and use the air. To monitor a lung disease.§ To monitor the effectiveness of§ treatment. To determine the severity of a disease of the lungs.§ To§ determine whether the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow). Peak flow meter (its acronym in English is PFM) - a device used to measure the speed with which a person can expel air from the lungs. During an asthma attack or other respiratory illness, the large airways of the lungs begin to narrow slowly. This decreases the amount of air leaving the lungs and can be measured by a PFM. This measurement is very important to assess how well or poorly you are controlling the disease. • Blood tests - to measure the amount of carbon dioxide and oxygen is in the blood. • Chest X-rays - diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs on a plate. • Sputum culture - diagnostic exam is performed with the lungs expel phlegm into her mouth. The sputum culture is often done to determine if there is an infection. • Electrocardiogram (its acronym in English is ECG or EKG) - a discussion that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias) and detects lesions in the heart muscle. Treatment of pulmonary emphysema: The specific treatment will be determined by your physician based on: • Your age, overall health status and medical history. • How advanced is the disease. • Your tolerance for certain medications, procedures or therapies. • Expectations for the trajectory of the disease. • Your opinion or preference. The goal of treatment is that patients with emphysema live with their disease in a more comfortable, relieving symptoms and preventing progression of the disease with minimal side effects as possible. Treatment may include: • Stop smoking - is the most important factor for maintaining healthy lungs. • Antibiotics for bacterial infections. • oral medicines. • Inhaled bronchodilators and other medications. • Exercise - including breathing exercises to strengthen the muscles used in breathing as part of pulmonary rehabilitation program and to maintain in the body. • Supplementation of portable oxygen cylinders through. • reduction surgery to remove a damaged lung. • Lung Transplantation. Chronic Obstructive Pulmonary Disease (its acronym in English is COPD) COPD is a term that refers to a large group of lung diseases that may interfere with normal breathing. It is estimated that nearly 13 million Americans suffer from Chronic Obstructive Pulmonary Disease (COPD, for short), but many more have impaired lung function, suggesting that there may be a significant number of cases not reported. Could be affected 24 million people. The two most common conditions are Codpa of chronic bronchitis and emphysema. The causes of COPD are not fully understood. The general view is that the most important cause of chronic bronchitis and emphysema is cigarette smoking. Other causes such as pollution of air and in contact with certain substances can influence, especially when combined with smoking cigarettes. Inheritance can also contribute to some emphysema patients, and is especially important in a rare form due to deficiency of alpha-1 antitrypsin. Patients with chronic bronchitis, coughing and sputum often present for many years to have trouble breathing. Patients with emphysema usually have shortness of breath, and cough and sputum during a respiratory infection appear, or in the final stages of the disease. Emphysema is a disease that is caused by smoking, the imbalance trypsin antitrypsin (genetic) and involved the destruction of alveolar walls with large spaces, or "bulls" full of air but not blood vessels, is not contagious. It is commonly linked to chronic obstructive pulmonary disease (COPD) which is integrated with bronchitis, ie the majority of patients with emphysema is accompanied by some degree of bronchitis and visceversa. It is where we have two patterns: "blower rose" pattern with a ventilation perfusion (or V / Q) greater than 1, and the blue (which predominates bronchitis) with standard V / Q below 1. Depending on the type of pattern that your patient is taking action to follow, although it is Accepted the following treatment regimens:
1 .- Administration stationary and ambulatory oxygen (using oxygen cylinders) to flow between 3L and 5L per minute depending on gravity to carry oxygen saturation more than 90 percent. Patient's survival is largely benefited by the extra oxygen and is directly proportional to the hours of oxygen to it. 2 .- obviously smoking suspension 3 .- bronchodilators: first line: ipatropio bromide (2 to 4 shots every 6 hours for their sympathomimetic effects is lower than other short-acting sympathomimetic agents such as albuterol. second line: metoproterenol and albuterol, adrenergic agonists on short-term cheaper, which reduce symptoms more quickly, but it can cause palpitations, tremor and hypokalaemia. adrenergic agonists long as formoterol or salmeterol, more expensive than short-term and stable COPD research third row: theophylline and other derivatives of methylated xanthine 4 .- oral steroids like prednisone. only 20% of COPD patients respond to steroids so their administration should be regulated by a stable baseline FEV1 and an improvement in FEV1 greater than 20% after 14 days, otherwise we will suspend 5 .- antibiotics (especially those with bronquítico pattern or as prophylaxis) the best TMP SMX, amoxicillin and doxycycline. 6 .- other: recombinant alpha-1 antitrypsin 7 .- Surgical: partial pneumonectomy has been seen that some patients respond to resection of bulls and of "dead spaces" with an improved ventilation. Lung transplant. The disease is not curable but manageable. SMOKING Smoking is addiction to snuff caused mainly by one of its active components, nicotine, and the action of that substance abuse has conditioned its consumption. Smoking is a chronic systemic disease belonging to the group of addictions and is listed in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV, American Psychiatric Association. Currently it is believed the main cause of global mortality and preventable disease. It is considered a chronic addictive disease treatment options. According to the World Health Organization snuff is the leading cause of illness, disability and premature death worldwide. [1] In Europe, smoking annually caused 1.2 million deaths. Is directly related to the emergence of 29 diseases, of which 10 are different types of cancer, and is the main cause of 95% of lung cancers, 90% of bronchitis and more than 50% of cardiovascular disease . In Spain each year more than 50,000 people die due to consumption of snuff rather than by road accidents and the consumption of all illegal drugs combined. Smoking is recognized for several years as a public health problem, because the damage to health associated with the consumption of snuff cause more than half a million deaths in the Americas. In Mexico there is a mass growing population groups in middle and advanced age, in which rates of morbidity and mortality related to smoking initiation in early ages are high. These elements introduce smoking at the scene of the ten leading causes of death in Mexico and make it a priority public health problem. Probalísticos studies based on current consumption trends, suggest that by 2025 snuff is the cause of more than ten million deaths worldwide. Mexico in April 1990 endorsed the agreement by which the 88 areas for consumption of snuff in medical units, both the Secretariat and the National Institutes of Health, are restricted. In August 1990 he published a new regulation that goes beyond the hospital and built the protection of nonsmokers in the Federal District to the effects of involuntary inhalation of smoke produced by the composition of snuff in enclosed premises such as cinemas, theaters , libraries, restaurants, classrooms, etc.. and the urban public transport vehicles. We and the fight against smoking has become a radical and irreversible process in making decisions that will significantly decrease in this public health problem. This program summarizes the goals, strategies, action lines and specific actions, which are based on the diagnosis of the current problems of smoking, so that this document constitutes the framework of the Government of Mexico in this area . Dr. Jesus Kumate rodriguez. Secretary of Health. 2. And cigarette smoke in the body. The air enters the respiratory system through the nose and follows a certain path to reach its final destination: the alveoli, which together form the lungs. In the nose through the nasal passages and hallways. Thence through the pharynx and toward the trachea, which splits into two smaller pipes called bronchi. These in turn are subdivided into bronchioles, which end in smaller ducts, which empty into the bronquiolillos microscopic sacs called alveoli. The walls of the latter are very thin and are surrounded by capillaries. Given their importance as places where the entry of oxygen in the blood and the exit from the blood of carbon dioxide resulting from combustion biological protection mechanism exists that purifies the air that must reach the pulmonary alveoli. This mechanism is the presence of hair follicles located in the lobbies, which filter large particles carried by the air of a mucosa, which is the nasal passages, the air cool and damp outside and cilia and mucus produced by glands upholstery trachea and bronchi. The foreign particles carried by the air adhere to mucus, sticky substance located on the ciliary, in a synchronized way, made a sweeping movement of mucus toward the throat, which then enters the digestive tract before being eliminated movements sharp exhalation, like the cough to help sweep. When you smoke, toxic chemicals that accompany smoke alter this protective mechanism. The alkaloid nicotine present in smoke snuff, paralyzing the ciliary function, hampering the natural elimination of sputum and the resulting accumulation of mucus, which clogs the bronchi. Also facilitates the retention of carcinogenic substances contained in smoke, like polonium-210 The specific action of nicotine on the nervous system is the beginning driver, but then becomes a depressant. Carbon monoxide gas is an inorganic, a member of cigarette smoke, which passes through the alveolar walls and penetrates in blood with hemoglobin to form A stable compound. Since that time, the hemoglobin is no longer able to transport oxygen through the blood vessels throughout the body. The greatest amount of oxygen that cells receive is one of the contributing causes to the smoker fatigue more easily when to make a physical effort. In this case, the heart pumps more blood, blood pressure and increases the number of breaths, allowing the arrival of a greater volume of air to the lungs and improved oxygenation of the blood. However this is not achieved when the environment is contaminated by carbon monoxide produced by cigarette smoke. Diseases linked to smoking. * Inflammation. Gingivitis. Stomatitis. Chronic bronchitis. * Pulmonary Emphysema. * Injuries in the arteries. * Cancer Today there is no doubt that the consumption of snuff produces harmful effects on human health. Towards 1950 began to appear in the literature the first results of studies showing that smoking was associated with a higher risk of getting lung cancer. In the U.S., Canada and UK it has become clear that depending on the number of cigarettes smoked, the smoker has a risk of lung cancer ten to thirty times higher than non-smokers. The danger is not confined only to lung cancer. It also increases five times the laryngeal cancer, four times that of cancer of the mouth, and three and a half times that of esophageal cancer. It may also increase the risk of urinary bladder cancer. Cancer is not the only danger that lurks in the smokers. Another important pathological consequence of snuff is the increased risk of myocardial infarction. This risk is assessed at approximately double that with a non-smoker. The stomach is another organ that suffers the consequences of smoking. The disturbing and dangerous gastroduodenal ulcer is almost three times more common in smokers than nonsmokers. 3. Snuff The toxins in cigarette smoke contains over 3,000 chemicals, and several of them are connected with the development of certain diseases. The most harmful substances are: 1. carbon monoxide 2. nicotine 3. tars (pitch) 4. 4) the particles of smoke. Carbon monoxide is a poisonous gas that interferes with the ability of the blood to carry oxygen. Ha is a contributing factor in heart disease and the ills of the lungs, and resulting changes in blood vessels that can lead to hardening of the arteries. Carbon monoxide has long been recognized as a poison gas. Some of the symptoms of carbon monoxide poisoning are headaches, dizziness, dyspnea (difficulty breathing), confusion, dilated pupils, seizures, and coma. Carbon monoxide, the level of exposure that commonly reach cigarette smokers, reduced cardiac contractility in people suffering from coronary disease. Has been shown to cause changes similar to those of incipient atherosclerosis in aortas of rabbits. Nicotine stimulates the nervous system, heart and other internal organs. The effect on the nervous system is one of the reasons because people find it so difficult to quit smoking. Nicotine is a poison. Nicotine is a chemical plant complex of a class known as alkaloids. Have a hot and bitter taste. It is found in small amounts in the leaves, roots and seeds from the bush of snuff. May also be produced synthetically. The amount of nicotine in most cigarettes that are sold between 2 and 7 per cent. Abounds in much cheaper and domestic varieties of snuff. In its original state, even small amounts can cause nausea, weakening, the fast but weak pulse, collapse, and death itself. The tar or pitch containing small quantities of substances carcin6genas which are believed to be major contributing factors of cancer of the lung and other cancers commonly develop smokers. It has been discovered that the tar in cigarette smoke results in malignant disorders of the skin and the respiratory system of laboratory animals. Has also been established that a number of chemical compounds present in cigarette smoke are agents carcin6genos strong. We have found the disease called malignant pharyngeal carcinoma in smokers. Smoke particles can be as small as 1 / 170000 of an inch. A smoker exhales most of these particles, but 25 percent of them are trapped in the coating or lining of the lungs. The cells lining absorb the particles. Absorci6n This can also lead to producci6n of excessive scar tissue within the walls of the lungs. The particles of smoke are likely to help the cause of progressive destrucci6n the walls of pulmonary alveoli of the people who have smoked for a long time. When inhaled, they immediately produce irritating cough and Ia constriction of the bronchi. 4. Short list of some poisons in cigarettes Carbon-monoxide prevents oxidation of blood. • Nicotine-half drop is deadly. • Formic Aldehyde-a strong irritant. • Carbolic acid-burning throat Pyridine • - • a stimulant or Furfural furfurol produces convulsions and paralysis in animals. Cause shortness of breath and tremors. • Acrolein degenerative brain cells. • The nitrate (saltpetre, potassium nitrate) in the paper wrapper is what stays on the cigarette. There is no safe cigarette. Filters rather cause the person has to face an increased risk of coronary heart disease because they are absorbed through the filter higher levels of carbon monoxide. The jacket of the filter paper is relatively porous and therefore the smoker sucks more carbon monoxide than absorvería absence of that filter. Take note that a single cigarette increases blood pressure about 10 or 15 points, while at the same load bearing heart. Risk reduction: The assertion that the safer cigarette cause health damage is received by smokers in various ways: Difference for those who say: "... and well ... there is something to die," and continue abusing the cigarette without worrying about the damage that occurs in your body, or the inconvenience caused to their families or coworkers. With concern by those who come to make a decision: "I want to quit smoking and seek support in groups organized for that purpose." For the latter, which means the great effort to stop smoking is offset by the benefits of that decision, which is to reduce long-term risks to the level of those who never smoked, except in cases of pulmonary emphysema, since the damage are irreversible. The resilience of the body is large, a person after ten years of leaving the cigarette, has the same probability of a nonsmoker to have a heart problem and after fifteen years to become sick with lung cancer. Adolescent smokers: Looking at the adoption of smoking among adolescents was found to be: De10a13 years are opposed to the consumption of snuff, because usually they do not understand how they can experience pleasure from smoking. De11a13 years make their first experiences in a clandestine manner out of curiosity and desire to possess what they consider as an attribute of the adult. 13 to 15 years: smoke for social mimicry, by pressure exerted by the peer group, which does not want to appear weak. After the 15 smokers to satisfy needs related to oral pleasure offered smoking. Young smokers: low smoke. Make as if it was a fun and family have no objection. Smoking rebel: they are those who smoke so as to defy any ban. The adolescent used cigarettes to appear mature-adult-soother considering that it also contributes to situations of insecurity, anxiety, fear and loneliness. Smoking and pregnancy Much emphasis is placed on the danger it means to be a nonsmoker in a closed environment where they smoke. A pregnant woman who smokes, forcing your child to "quit", intoxicated with nicotine. Each time the mother wants to smoke occurs in the alterations: * Your heart beats faster. This effort is a potential risk of cardiac effects. * The nutrition is impaired. * The nervous system at risk to develop incompletely. Smoking Definition Smoking (inhaling and exhaling the smoke produced by burning the snuff), leads to chronic poisoning called smoking. The dried leaves of the plant are smoked in the pipe, snuff or pure, but how widespread is the cigar or cigarette. History The snuff is a plant native to America. The first Europeans who came to America found that the natives smoked the leaves of the pipe into snuff, and introduced the practice in Europe in mid-sixteenth century. Subsequently, the French diplomat Jean Nicot, who must plant the generic name (Nicotiana), introduced in Europe from where it gradually spread to the rest of the world. Composition of cigarette With the lighting of a cigarette are released numerous components: tar, cyanide, benzene, carbon monoxide, nitrogen oxide and nicotine just to name a few. Addiction to snuff Nicotine, the alkaloid snuff, is the main component when we refer to the physical dependence it creates this habit because it is a highly addictive drug. Smoking affects the heart in various aspects. While most people are very aware of the relationship between cigarette smoking and lung cancer and other respiratory diseases, many still unknown to this habit as a risk factor for hypertension and the total disease circulatory. The smoker: Your family and your needs. Smoking appears to be in its origin, the product of the socialization of the individual. The concept of socialization denotes the process by which culture is transmitted from one generation to the next. Not only is smoked at some point due to the actions of others (eg, smoking to impress someone or to give that sense of security andalusia notes, etc..), But is due to start smoking than other smokers as routinization. The act of smoking appears to be legitimate for the smoker, because "other" (often famous or respected, or very close to potential smokers), too. The most direct smoking socialization are the family and the primary groups with whom the individual interacts frequently. We could say that smoking is allowed in a affective (pleasure or unloading of anxiety) and that is the case for smokers of less than 10 cigarettes daily, and habit in the case of smokers over 10 cigarettes a day. It is in this last case where we, through the quantity of cigarettes consumed daily, the degree of dependence to addiction. Human beings have certain needs, leading to a range of behaviors and actions to your satisfaction: physiological needs, safety, belonging and affection, esteem and self realization. The most common is to start smoking in adolescence, either as a rebellious attitude and not feel moved to the group if that environment is composed mainly of smokers. Another possibility is that adolescent smoking "to feel more adult." In short, three reasons why people smoke: 1. Need to intensify your feelings positive or negative feelings slow 2. Identification with the environment. 3. Psychological addiction. 3. Magnitude noxal tobacco smoking is the biggest epidemic facing mankind, and other diseases that depend on human behavior is of high morbidity and mortality. Addiction legal consumption stimulates freely, at least in our country. Their impact on humans when it is known in the U.S. 300,000 people die per year in our country with a population 9 times less than 40,000. WHO is currently estimated at 1,000 million the number of smokers in the world, about one third of the population from 15 years onwards. On this total, 800 million live in developing countries. According to specialists in cardiology smoking affects the circulatory system in different ways: Increases the total blood cholesterol by raising levels of LDL or "bad cholesterol". Additionally, you can reduce levels of HDL or "good cholesterol" Nicotine, as well as having a highly addictive drug, a nerve stimulation on the adrenal glands that results in the production of adrenaline. This substance accelerates the heart rate by increasing the oxygen demand of the heart and forcing this body to work harder and in most difficult conditions. In addition, it produces vasoconstriction, increases peripheral vascular resistance. In short, understanding that there are actions on multiple organs, devices or systems, nicotine and other components: a. promote dyslipidemia (decreasing HDL and increasing LDL and triglycerides); b. damage the vessel reactivity (by increasing vascular tone with induction andalusia spasm); c. create a state of hypercoagulability (by increasing platelet aggregation and blood viscosity) favoring thrombosis; d. leading to tissue hypoxia, decreasing the ischemic threshold; e. favor the production of central fat. Consequences Alone, smoking increases cardiovascular risk by 1.6 times, associated with hypertension, hypercholesterolemia, and 4.5 in 4, when the three together, the risk is 16 times higher. 4. Why Smoke? Smoking is not just a "habit", is also a drug, since the smoking snuff meets all the criteria for the consumption of a substance such as: 1. Existence of tolerance 2. Unit 3. Syndrome in the absence thereof 4. Compulsive Behavior The head of the dependence is nicotine, a substance with a powerful addiction similar to other drugs such as heroin or cocaine. The form of dependence that generates smoking is: Physical dependence or caused directly by nicotine and is responsible for the syndrome. or psychological dependence, smoking has become a company in all kinds of situations, after meals, with coffee, talking on the phone, etc ..., and it seems impossible to change this relationship. Social dependency, smoking remains a social event, done in groups, in certain meetings of entertainment, after dinner with friends, and above all remains a habit that distinguishes certain groups of teenagers by giving them a default value of social and maturity misunderstandings. 5. Why do you quit? The main reason is that the consumption of snuff is the leading cause of preventable disease and preventable mortality in developed countries. In 19% of deaths snuff is the cause of prevention. In snuff found multiple substances that are largely unhealthy. Among them, notable for its damaging effects: 1. Tars (benzopyrenes and nitrosamines) responsible for 30% of all cancers (bladder, kidney, pancreas, stomach, etc..), And 90% of lung cancer. 2. Carbon monoxide, which is responsible for more than 15% of cardiovascular disease. 3. Nicotine that causes physical dependence. Moreover, the snuff is causing 80% mortality from chronic lung processes.

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