Stop Chronic Bronchitis Naturally

Relieve Your Bronchitis Cure

When you begin to take the specific natural ingredients outlined in the program you will be amazed at how you will really begin to feel the Phlegm and Mucus clear up nearly immediately! Within minutes of the first step you will feel the natural ingredients in action, targeting the specific root cause of the bronchitis. These ingredients will come in direct contact with the bacteria causing your infection, and get rid of them quickly. You will discover all the secrets I have come across while I was researching how to get rid of my own Bronchitis, and how you will not only get rid of your bronchitis, but actually prevent it from ever coming back again! Read more here...

Relieve Your Bronchitis Cure Summary

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Chronic Bronchitis Acute Exacerbation

Acute exacerbations of chronic bronchitis may be triggered by bacterial or viral infection or may be noninfectious. H. influenzae accounts for 50 of bacterial exacerbations with S. pneumoniae and M. catarrhalis causing an additional third (Moussaoui et al., 2008). For acute exacerbation of COPD associated with purulent sputum and increased shortness of breath, antibiotic therapy decreases mortality by 77 and treatment failure by 53 (Ram et al., 2009). This finding was true regardless of the antibiotic choice, although coverage for the organisms just noted seems rationale. Consideration of the frequency of beta-lactamase production within these organisms in a community is important. More recent meta-analysis shows that a shorter course, no longer than 5 days, is as effective as longer treatment with antibiotic (Moussaoui et al., 2008). Other features of the management of acute exacerbation of chronic bronchitis include systemic corticosteroids, inhaled beta agonists and...

Bronchitis Quit the Cough

Bronchitis is the inflammation or blockage of the bronchi, the breathing tubes that connect to your lungs. When they are blocked, mucus builds up and you may experience symptoms such as coughing, pain in the chest, difficulty breathing, fever, and a generally yucky, tired feeling. Acute bronchitis is caused by bacterial or viral infections, while chronic conditions result from frequent irritation of the lungs due to cigarette smoke, smog, allergies, or overexposure to cold, damp air. Mucus is not a bad thing. We need it to lubricate our lungs and filter out foreign substances like dust when they are not needed or wanted. In bronchitis, too much of a good thing causes the constant cough.

Acute Bronchitis

A frequently diagnosed infection in children and adults, acute bronchitis is typically a viral respiratory infection with lower tract symptoms, such as cough, phlegm, hoarseness, or wheezing. This syndrome should be distinguished from acute exacerbations in patients with chronic bronchitis, who are more vulnerable, who might be colonized with different bacterial flora in the respiratory tract, and who might require more aggressive treatment. In acute bronchitis in otherwise healthy patients, viral causes predominate. RSV and rhinovi-rus are common causative organisms even during influenza season. Treatment of acute bronchitis in otherwise healthy patients should be primarily supportive because the condition is largely self-limited. Patients with underlying pulmonary disease, or even smokers, may have a higher rate of pulmonary complications (e.g., secondary pneumonia) or exacerbation of COPD. Options for symptomatic treatment include air humidifiers, cough suppressants, and...

Infectious Diseases

BRONCHITIS Chronic Bronchitis Acute Exacerbation BRONCHITIS Acute bronchitis is part of the continuum of acute respiratory tract infection most often caused by viruses. Antibiotics are not routinely recommended for the treatment of bronchitis. The cough of bronchitis may last up to 4 weeks. Acute exacerbations of chronic bronchitis with increased sputum production should be treated with antibiotics to decrease mortality. Infections of the upper respiratory tract accounted for more than 36 million ambulatory medical visits in 2005, according to the National Ambulatory Medical Care Survey (Cherry et al., 2007). Although a large percentage of these infections are viral in origin, antibiotics are still prescribed for more than 50 of patients with acute respiratory tract infection (ARTI). Acute bronchitis, in the ARTI category, is defined as a respiratory infection in which cough is the predominant symptom and there is no evidence of pneumonia. Antibiotics are often prescribed despite...

Smoking and Other Risk Factors for Lung Disease

Than 400,000 deaths per year, or one in every five deaths. People who smoke suffer more than a 20-fold increase in risk of death from lung cancer and a 10-fold increase in risk of death resulting from bronchitis or emphysema (CDC, 1993). For women in the United States, there are more deaths caused by lung cancer than by breast cancer. Worldwide there were 5 million deaths attributable to smoking in 2000, almost 2 million of which were related to lung cancer and other lung diseases. WHO projects a doubling of smok-ing-related deaths by 2020 (Ezzati, 2003).

Obstructive Lung Disease

The most common chronic lung diseases that have a major global impact on disability and health care costs are three obstructive lung diseases asthma, chronic obstructive pulmonary disease, and chronic bronchitis. Some patients have features of more than one of these conditions, such as the patient with asthma (acute episodes of reversible obstruction) who also has chronic bronchitis (cough productive of phlegm at least 3 months of the year for at least 2 years in a row), or the adult patient with asthma who is developing some level of irreversible decline in pulmonary function. COPD alone can ultimately result in pathologic signs of emphysema, a diagnosis previously made only with tissue pathology or large blebs on x-ray film but increasingly visible with various multislice HRCT techniques.

Clinical Presentation

Chronic obstructive pulmonary disease includes the two overlapping clinical conditions of chronic bronchitis and emphysema, which can coexist in the same patient. A practical clinical approach is to diagnose COPD by documenting obstruction that is not completely reversible on clinical examination and pulmonary function testing, then assessing whether the patient also has a component of chronic bronchitis, that is, cough productive of phlegm at least 3 months of each year for at least 2 years. Some patients meet this criterion for chronic bronchitis before developing clinical or spirometric evidence of obstructive lung disease. The international GOLD guidelines no longer categorize this as stage 0 COPD, because of insufficient evidence that patients will inevitably progress to obstructive lung disease.

Clinical Manifestations

Pulmonary vein stenosis causes dyspnea' orthopnea' cough' hemoptysis' and lower respiratory infections.9'20'26'56'76'82 Lifespan occasionally extends into the middle or late teens' but only a minority of patients survive childhood.20 Precordial palpation detects a right ventricular and pulmonary trunk impulse and a loud pulmonary component of the second heart sound.26 Murmurs are absent except for high-pressure pulmonary regurgitation or tricuspid regurgi-tation.56'76 The electrocardiogram reflects pulmonary hypertension with right atrial P wave abnormalities' right axis deviation' and right ventricular hypertrophy.26'59'76 Left atrial P wave abnormalities are uniformly absent. Pulmonary vascular patterns in the x-rays are determined by which of the four pulmonary veins are stenosed and by the degree of stenosis.2'8'43'59'82 Regional differences are characterized by asymmetry between the right and left lungs and by nonuniform distribution within each lung.2'8'43'59'82 Left atrial size...

Impact of Lung Disease on the Patient

Chronic obstructive pulmonary disease can be divided into two types emphysema and chronic bronchitis. Both are characterized by a slowly progressive course, obstruction of airflow, and destruction of the lung parenchyma. Classically, patients with emphysema are the ''pink puffers.'' They are thin and weak from severe dyspnea associated with little cough or sputum production. The classic ''blue bloaters'' suffer primarily from bronchitis. They are cyanotic and have a productive cough but are less troubled by dyspnea they are usually short and stocky. These classic descriptions are interesting, but most patients with chronic obstructive pulmonary disease have characteristics of both types.

Respiration A Breath of Fresh

V Break up bronchitis In this chapter, we give you hope of treating your awful allergies and asthma. Oriental Medicine once more comes to the rescue in the case of bronchitis. We'll take a look at the issues of allergies, their treatment, and prevention. Asthma and bronchitis sufferers will get tips on self-care techniques using acu-points and medical massage. Life can be challenging enough without struggling for each breath. Now it's time to begin your journey to better breathing.

Bronchial asthma Definition

Result of studies of bronchoalveolar lavage fluid, endobronchial biopsies and induced sputum over the past four decades that our appreciation and understanding of the inflammatory nature of the disease has increased 2,3 . This has resulted in a shift of emphasis away from airway smooth muscle dysfunction to a T-lymphocyte-modulated chronic desquamative eosinophilic bronchitis as the primary abnormality in asthma 4-6 . In the 1992 international consensus statement, asthma is now defined as 'a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils, and T-lymphocytes. In susceptible individuals, this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough particularly at night and or in the early morning. These symptoms are usually associated with widespread but variable airflow limitation that is at least partly reversible either spontaneously or with treatment. The inflammation also...

Past Clinical Studies

A further study included trials with no replicates, and contained six studies. It showed that in five out of six cases the main outcomes were positive however, these were limited to very specific criteria, such as small airways resistance for common colds (Cohen and Dressler, 1982), prophylaxis of bronchi for bronchitis (Ferley et al., 1989), lessening smoking withdrawal symptoms (Rose and Behm, 1993, 1994), relief of anxiety (Morris et al., 1995), and treatment of alopecia areata (Hay et al., 1998). The alleviation of perineal discomfort (Dale and Cornwell, 1994) was not significant.

Autosomal Recessive Disease

Patients with AT also demonstrate progeric changes of the hair and skin, including early graying of the hair and atrophic, hidebound facial skin. Pigmentary changes are also frequent and consist of hyperpigmentation and hypopigmentation with cutaneous atrophy. A few patients may demonstrate partial albinism, vitiligo, and cafe au lait spots. Seborrheic dermatitis occurs in nearly all patients, and senile keratoses, atopic dermatitis, and eczema are also reported. Another prominent feature of AT is frequent sinopulmonary infections. These may range from infection of the ears, nose, and sinuses to chronic bronchitis and recurrent pneumonia. The latter two may result in bronchiectasis and pulmonary fibrosis. Chronic infections are typically due to common bacteria however, they are sometimes poorly responsive to antibiotic therapy. The predisposition to infection is associated with the presence of an abnormal thymus and a marked deficiency of IgA, which is the predominant immunoglobulin...

Depression as a Disabling Disease Shifting Paradigms

The Global Burden of Disease Study conducted by WHO in 1990 (Murray et al., 1997) investigated the worldwide prevalence and disability due to mental disorders, including unipolar major depression and panic disorder. This study developed a measurement index, the Disability-Adjusted Life Years (DALYs) to be used to compare the burden of disease from premature mortality and years lived with disability across various types of disease and injury in global populations. The DALYs consists of two classes, the YLL (years of life lost to premature mortality) and the YLD (years lived with disability, adjusted for severity of disability). Using these two measures, depression was found to be one of the most disabling diseases in the world and ranked as the fourth most disabling disease after lower respiratory infections, diarrheal diseases, and perinatal diseases (Murray et al., 1997)

Constraints on Metaphorical Creativity

The physical environment also shapes people's differential experience of their bodies and the world around them, and this too influences the creation of metaphors in talking about abstract ideas. For example, consider some metaphoric expressions used in talk about the economy like healthy economy, economic recovery, sickly firm, a financial injection, arthritic economy, and so on. These expressions may arise from people's experiences of their bodies in particular environments in the form of the economy is health metaphor. One possibility is that people use more health metaphors in talking about the economy during times of the year when they were more likely to be ill, such as when experiencing common ailments of colds, the flue, pneumonia, and bronchitis. In fact, one 10-year analysis of 'The Economist' showed that the use of health metaphors in talking about the economy was far more evident during the winter months of December to March, which is when people most often experience...

Nanoparticles in air pollution

Although the term 'nanotoxicology' did not really exist prior to 2004, research into the hazards of particles within the nanoscale did exist. Much of this research was focused on the potential risks associated with inhalation of particulate air pollution known as PM10. PM stands for particulate matter, while the 10 refers to 10 m, the largest particle size that can be inhaled past the larynx and enter the small terminal airways of the lung. PM10 is the mass of particles generally less than 10 m in diameter per cubic metre of air. Elevated PM10 is associated with a number of adverse health effects, including increased asthma symptoms and asthma medication usage, increased hospital admissions and an increase in the death rate (Pope 2000). The increases in hospital admissions and deaths include respiratory causes such as asthma, smoking-related lung disease (chronic obstructive pulmonary disease, COPD), and bronchitis. The respiratory system is an obvious target for an inhaled pollutant,...

Multiple Transforming Illnesses

While Frida Kahlo, Henry Ossawa Tanner, Nell Blaine, Itchiku Kubota, Chuck Close, Lawrence Alma-Tadema, and Odilon Redon all had more than transforming illness, few individuals have had their lives and art as affected by incidents of poor health as Henri Matisse (French, 1869-1954). He had five transforming illnesses. Matisse's first transforming illness came at age 20 when intestinal problems he had since childhood flared into an acute attack. Forced to recuperate for months, and hoping that creativity might help his boredom, Matisse asked for art supplies. Upon receiving them from his mother he said, The moment I had this box of colors in my hands, I had the feeling that my life was there. When Matisse was in his late forties, bronchitis, his second transforming illness, forced him to move to the south of France. The beautiful colors of the Mediterranean brightened his palette and he became a great colorist (see Figure 3).

Secondhand Smoke Effects on Children

Over 50 of children younger than 5 years of age live in homes with at least one adult smoker. Children of smoking parents have more bronchitis and pneumonia during their first year of life and more otitis media when older. They have increased incidence of cough, bronchitis, and pneumonia proportional to the number of cigarettes smoked by the parents, particularly the mother. In fact, children of parents who smoke at least a half-pack a day have almost twice the risk of hospitalization for a respiratory illness. Secondhand smoke causes new-onset asthma in exposed children, and young persons with asthma have more asthma episodes (Charlton, 1994 Rantakallio, 1978 USHHS Report of the Surgeon General , 2006).

Intermediatestage complications

A patient's risk of undergoing a respiratory complication depends on the underlying condition of his or her lungs and the circumstances they are exposed to. Smoking has a significant impact because smokers are predisposed to bronchitis and emphysema, ischaemic heart disease and heart failure. The normal action of the mucociliary apparatus in the tracheobronchial tree is to clear secretions and this is significantly affected in smokers. Lower respiratory tract infections Aspiration Lower respiratory tract infection (LRTI)

Internal Usage Of Essential Oils By Aromatherapists

Oral intake of essential oils is not true aromatherapy as the odor has virtually no effect past the mouth and the effect of the chemical components takes over as odors cannot influence the internal organs (Lis-Balchin, 1998a). Therapy with essential oils is dealt with in another chapter. Most aro-matherapists consider that essential oils should only be prescribed by primary care practitioners such as medical doctors or medical herbalists who have intimate knowledge of essential oil toxicology (Tisserand and Balacs, 1995). In the United Kingdom, such clinical aromatherapy is rare, unlike on the continent. Maladies treated include arthritis, bronchitis, rheumatism, chilblains, eczema, high blood pressure, and venereal diseases. In clinical aromatherapy, there is a real risk of overdosage due to variable droppers on bottles, which can differ by as much as 200 (Lis-Balchin, 2006) this may be the cause of asphyxiation of a baby, as already shown by peppermint oil (Bunyan, 1998). It is...

Accreditation Commission for Acupuncture and Oriental Medicine AGAOM

Acu-points, 5-8, 10, 15, 18-20, 38-39, 238-241 anxiety, 205-206, 211 arthritis, 78-79 asthma, 138-139 back pain, 82-85 balance, 252 Bell's palsy, 104 bladder infections, 182-184 breathing, 126 bronchitis, 121 Bronze Man, 25 bursitis, shoulders, 70-71 cancer, 151-153 anxiety, 211 arthritis, 78-79 asthma, 118-120 back pain, 82-85 Bell's palsy, 104 bronchitis, 120-121 cancer, 149 acupressure, 4, 9-10, 19, 21-24, 27-29, 74, 86, 128-131, 239-241 acu-points, 5-7, 63-64, 238 allergies, 116-117 anxiety 210-211 arthritis, 78-79 asthma, 118-120 back pain, 82-85 bladder infections, 182-184 bronchitis, 121 bursitis, shoulders, 70-71 cancer, 151-153 carpal tunnel syndrome, 76-77 colds, 124-125 constipation, 188-189 dental pain, 62-64 diarrhea, 190 dysmenorrhea, 169-170 eczema, 196-197 elbow pressure, 30-31 electrical currents, 8 endometriosis, 177-179 facelifts, 199-200 feet, reflexology, 24-25 finger pressure, 30 foot pressure, 31-32 headaches, 61 hypertension, 220-221 IBS, 186-187 indigestion,...

Colds Nosing Around for Better Health

While there is no proven cure for the common cold, the time-tested techniques of Oriental Medicine can definitely shorten the course of your condition. Also, these methods are designed to strengthen your body's immunity to avoid secondary infections, such as bronchitis or strep, or the same cold over and over again. Because there are more than 100 viruses that cause our colds and no form of western medicine that can tame them, it makes sense to choose oriental medicine to individually diagnose and treat your cold symptoms. Rest is a common prescription and one that's frequently ignored. Acupuncture, herbs, and cupping are also frequent fliers on this kind of trip.

Aptamers to Natural Products

Caffeine Aptamer Interaction With Target

Jenison et al. (1994) selected an RNA aptamer that binds to the alkaloid theophyl-line with high sensitivity and high specificity. Theophylline is used as bronchodi-lator in the treatment of asthma, bronchitis, and emphysema, but because of its narrow therapeutic index, serum levels must be monitored carefully to avoid serious poisoning. Theophylline is also chemically similar to theobromine and caffeine (Fig. 4.5), which may be present in serum samples due to consumption of coffee or chocolate. Thus, diagnostic methods must discriminate efficiently among these compounds. A counterselection with caffeine was performed during the SELEX process. The dissociation constant of the selected aptamer was 100nmol L and its affinity to theophylline was remarkably 10 000 times higher than to caffeine, which differs only from theophylline by a single methyl group at nitrogen atom N7. Antibodies against theophylline show a discrimination factor of only 1000. This demonstrates that RNA molecules...

Patient Encounter Part 2 The Medical History Physical Exam and Diagnostic Tests

PMH Allergic rhinitis for 6 years (allergic to dust mites per skin testing no other allergies positive on the skin testing panel). Bronchitis 3 times in the last 6 years (all treated with azithromycin and Robitussin DM) last episode 6 months ago. Hospitalized with viral lower respiratory tract infections twice at ages 1 and 2.

Levocarnitinein Libido

Physical characteristics of, 177t Low-density lipoprotein cholesterol, 120, 230 goals for, 120, 151, 236, 755-756 optimal level for, 230 oxidation of, 125 Lower esophageal sphincter pressure, in GERD, 316, 317t Lower respiratory tract, normal flora of, 1157 Lower respiratory tract infection, 1189-1201 Lower urinary tract symptoms, 809

Common Pulmonary Symptoms Shortness of Breath

Else The most common pulmonary causes of chronic or repeated episodes of shortness of breath include asthma, smoking-related COPD, chronic lung infections (TB and HIV-related infections), and occupational pneumoconio-sis. Acute-onset shortness of breath can be caused by acute exacerbations of any of these chronic conditions, by acute infections such as pneumonia or acute bronchitis, or by spontaneous pneumothorax. Among otherwise healthy children, shortness of breath can be related to asthma, bronchiolitis, pneumonia, or upper-airway problems such as croup or epiglottitis. Chronic shortness of breath in children can be related to poorly controlled asthma, broncho-pulmonary dysplasia from infancy, or chronic diseases (e.g., cystic fibrosis).

Fun and Laughter Remember Us

Moxibustion The treatment of diseases by applying heat to acupuncture points. Acupuncture and moxibustion are considered complementary forms of treatment, and are commonly used together. Moxibustion is used for ailments such as bronchial asthma, bronchitis, certain types of paralysis, and arthritic disorders.

Diseases of the Premodern Period in Japan

In addition to the plentiful information on diseases supplied by court histories, literature, and other records, medical texts and an encyclopedia called the Wamyo ruiju sho also list medical terminology (Hattori 1945). Among the infections included are idiopathic cholera (shiri yori kuchi yori koku yamai, kakuran), leprosy (raibyd), elephantiasis igeju), bronchitis (shiwabuki yami), hepatitis (kibamu yamai), dropsy (harafukuru yamai), asca-rids (kaichu), threadworms (gyochu), meningitis (fubyo), infantile dysentery (shoji kakuran), diphtheria (bahi), bronchial asthma (zensoku), epilepsy (tenkari), chronic nephritis (shokatsu), tonsilitis (kdhi), osteomyelitis (fukotsuso), thyroiditis (ei), erysipelas (tandokuso), ringworm (senso), gastritis (iso), palsy (kuchi yugamu), and scabies (kaiso). Records from the era 700-1050 also have led scholars to infer the existence of cancer, pneumonia, tapeworms, rheumatoid arthritis, and hookworms.

Early Mortality Data Sources and Difficulties of Interpretation

Thus, there are further compositional advantages, in addition to the enhanced validity of the underlying-cause mortality model, to dealing with low-life-expectancy historical populations. Calculations indicate that in a population with a life expectancy of 30, of the men 52.9 percent eventually die from causes falling into fairly robust categories respiratory tuberculosis, other infectious and parasitic diseases, diarrheal disease, the influenza-pneumonia-bronchitis complex, and violence. In a population with a life expectancy of 70, by contrast, the corresponding figure is only 14.6 percent (Preston et al. 1972 Preston 1976). Partially vitiating this compositional advantage of low-life-expectancy populations is the relatively large proportion of deaths from diseases of infancy and early childhood that are difficult to diagnose. Nevertheless, it appears that nineteenth- and early-twentieth-century mortality statistics give a fairly accurate picture (excluding problems related to...

Points to Cut Off the Cough

The key in relieving bronchitis is to clean away the extra mucus and open the lungs. Acu-points include Ding Chuan (Stop Wheezing), B-12 (Wind's Door), LU-1 (Central Residence), and CV-17 (Penetrating Odor). (I'm just relaying the names, folks I didn't make them up myself ) Your acupuncturist will use these points plus others that correspond to helping your general health. Moxabustion or heat treatment may be used on your back and neck to melt the mucus, or cupping jars placed on BL-12 to dislodge mucus and open the lungs. Then, open sesame you enjoy better breathing. Acupressure self-care requires the right touch (see the following figures). The same percussion techniques that were used for asthma can be used on BL-12 to fight bronchitis. Moving two fingers down from Ding Chuan and two-finger width beside your spine (see the preceding figure), put a slight curve in your hands, reach behind the top of your shoulders, and pretend you are playing the bongos. Remember to play a soothing...

Seals of Excavated Tombs

The Yiieh Ling text has other interesting features It says, for example, that if cool spring weather comes in what would normally be a very hot summer, there will be much feng kho (i.e., tonsillitis, bronchitis, pneumonia, etc.). It also says that if hot summer weather comes in autumn, there will be many cases of fever (nio chi). This is the word later appropriated to malarial fevers, but in the ancient times of which we are now speaking, it was simply associated with rapid alterations of shivering cold and hot fever. The text also says that if the hot rainy season continues into the autumn, there will be many cases of chhou chih (i.e., diseases involving sneezing, such as colds and catarrhs with some fever). The last part of the text says that if spring weather occurs in the last month of winter, there will be many problems of pregnancy, especially miscarriages and stillbirths (thai yao to shang). A possible explanation for this association might be shocks to the body caused by going...

Preoperative Preparation

Children who are systemically unwell should not have elective surgery. It is not unusual for a child to present with coryzal symptoms alone. There is an increased incidence of airway problems during anaesthesia these children are more at risk of laryngeal spasm, breath-holding and bronchospasm, and in the postoperative period the chance of post-intubation croup is increased. The decision to proceed should be made only by a senior anaesthetist. Occasionally these symptoms precede a more serious upper or lower respiratory tract infection. In very rare cases, the viraemic phase of the illness may be associated with a myocarditis. Each case should be dealt with on its merits. Children who have active viral illnesses such as chickenpox should not have elective surgery, nor should children who have recently been immunized using live vaccines, for two reasons first, there is an associated myocarditis or pneumonitis and, second, to protect others on the ward who may be immunocompromised.

Chronic Obstructive Pulmonary Disease

Chronic bronchitis is characterized by the presence of productive cough for at least 3 months in two successive years. Airways obstruction is caused by bronchoconstriction, bronchial oedema and hypersecretion of mucus. In the postoperative period, pulmonary atelectasis and pneumonia result if sputum is not cleared. COPD may be classified into two groups - the bronchitis group (blue bloaters) and the emphysematous group (pink puffers) -although in practice most patients have mixed pathologies. The former group is characterized by hypoxaemia, hypercapnia and right ventricular failure, while patients in the latter group are usually markedly dyspnoeic.

Carbon dioxide tension

Normal or low PaCC> 2 before IPPV, minute volume should be adjusted to produce a PaCO2 of 4.5-5 kPa, a value at which spontaneous ventilatory efforts should be minimal. If the initial PaCC> 2 is high, its value should not be reduced by more than 1 kPa h l and, if raised chronically (e.g. in chronic bronchitis), it should not be reduced below the patient's own 'normal' level when well. If the PaCC> 2 is below 4 kPa, minute volume should be reduced by decreasing the respiratory rate. Because PaCO2 increases relatively slowly, at least 1 h should elapse before contemplating further changes in minute volume.

Epidemiology and etiology Etiology and Mortality Rates

The etiology of bacterial pneumonia varies in accordance with the type of pneumonia. Table 71-1 lists the common pathogens associated with the various types or classifications of pneumonia. S. pneumoniae colonizes the nasopharyngeal flora in up to 50 of healthy adults and may colonize the lower airways in individuals with chronic bronchitis.67 It possesses many virulence factors enhancing its ability

Etiology and Epidemiology

Mechanical defenses are hampered by immobility due to altered consciousness, paralysis or pain, endotracheal intubation, and prior viral infection of the upper airway, such as bronchitis or a cold. Controversy surrounds the ancient etiologic theory about cold temperatures. August Hirsch (1886) found a high incidence of pneumonia in months having wide variability in temperature. Two factors do tend to support an indirect correlation between cold and pneumonia Predisposing viral infections are more common in winter, and some evidence suggests that the mechanical action of cilia is slowed on prolonged exposure to cold.

Early Urban Environments

This is not to say, however, that in-migrating rural peasants were greeted as saviors of civilization. On the contrary, they were fodder to be wasted in the interests of civilization's continuance. As Lawrence Stone (1977), among others, has vividly shown, as late as the seventeenth, eighteenth, and nineteenth centuries, the centers of Western civilization were cesspools of disease, exploitation, starvation, and death. In Manchester, England, for example, for much of the nineteenth century, the mortality rate for children under 5 was around 50 percent (Forbes 1986). All during this time urban dwellers in Europe were dying of bubonic plague, smallpox, syphilis, typhus, typhoid fever, measles, bronchitis, whooping cough, tuberculosis, and other diseases (e.g., Matos-sian 1985), which still had not spread to what - to Europeans, at least - were the most remote portions of the globe.

Occupational and Environmental History

Many occupational diseases have been well described over the years malignant meso-thelioma in workers exposed to asbestos cancer of the bladder in workers exposed to aniline dye malignant neoplasms of the nasal cavities in woodworkers pneumoconiosis in coal miners silicosis in sandblasters and quarry workers leukemia in those exposed to benzene hepatic angiosarcoma in workers exposed to vinyl chloride byssinosis in cotton industry workers skin cancer in those chronically exposed to the sun, such as sailors ornithosis in bird breeders toxic hepatitis in solvent users and workers in the plastics industry and chronic bronchitis in individuals exposed to industrial dusts. It has been shown that there is an association between sterility in men and women and exposure to certain pesticides and an association between dementia and exposure to certain solvents.

Epidemiology and Risk Factors

Secondary causes of pulmonary hypertension include chronic lung disease (COPD and chronic bronchitis), cardiac disease (congenital defects, mitral stenosis, left atrial myxoma), autoimmune or inflammatory conditions such as scleroderma and SLE (Paolini et al., 2004), and granulomatous disease such as sarcoidosis. Certain drugs (fenfluramine) can also cause the condition, as can chronic liver disease with portal hypertension. Some patients experience pulmonary hypertension as a complication of arterial clotting or chronic damage from single or multiple episodes of PE.

Bronchoscopy

Fiberoptic bronchoscopy allows direct visualization of the bronchial tree. It is useful for diagnosing conditions that require culture of a lower respiratory tract infection by bronchoalveolar lavage (BAL), or conditions such as bronchogenic carcinoma, that require tissue diagnosis by transbronchial biopsy. Sometimes these techniques are combined, as in the diagnosis of Pneumocystis jiroveci (carinii) pneumonia (PCP), for which the sensitivity of bronchoscopy with BAL is approximately 86 and with transbronchial biopsy is 87 (Broaddus et al., 1985). A comparative assessment of different bronchoscopic techniques in obtaining culture specimens in cases of ventilator-associated pneumonia found no significant difference between blind bronchial brushings and bronchoscope-assisted lavage, bronchoscope-directed brushings, or even blind endotracheal aspirates (Wood et al., 2003). Rates of complications (including hemoptysis and pneumothorax) with traditional bronchoscopy are in the range of...

Hemoptysis

Bronchiectasis, chronic bronchitis Any suppurative (associated with the production of pus) process of the airways or lungs can produce hemoptysis. Bronchitis is probably the most common cause of hemoptysis. Bronchiectasis and bronchogenic carcinoma are also major causes. Hemoptysis results from mucosal invasion, tumor necrosis, and pneumonia distal to bronchial obstruction by tumor. Pneumococcal pneumonia characteristically produces rust-colored sputum. Pink and frothy sputum can result from pulmonary edema.

Influenza

There is at present no specific cure effective against this viral disease. In mild cases, symptoms disappear in 7-10 days, although physical or mental depression may occasionally persist. Influenzal pneumonia is rare but often fatal. Bronchitis, sinusitis, and bacterial pneumonia are among the more common complications, and the last can be fatal if untreated. Influenza is generally benign, and even in pandemic years, mortality is usually low - 1 percent or less - the disease being truly life-threatening for only the very young, the immunosuppressed, and the elderly. However, this infection is so contagious that in most years multitudes contract it, and thus the number of deaths in absolute terms is usually quite high. The sequelae of influenza are often difficult to define, but evidence indicates that the 1920s global pandemic of

Toxicity of mercury

Following an acute exposure to elemental mercury vapour via inhalation, respiratory effects such as cough, dyspnoea (shortness of breath), chest tightness, bronchitis, and decreased pulmonary (lung) function may occur. Cognitive, personality, sensory, or motor disturbances may also arise, including tremor, irritability, hallucinations, muscle weakness, and headaches. Because of the accumulation of mercury in the kidneys, acute renal failure indicated by proteinuria (passage of proteins in the urine), haematuria (passage of blood in the urine), and oliguria (passage of reduced amounts or volumes of urine) is commonly reported. Acute inhalation of elemental mercury may also cause gastrointestinal effects such as stomatitis (inflammation of the mouth), abdominal pain, vomiting, diarrhoea, and ulceration of the oral mucosa, as well as cardiovascular effects such as hypertension (high blood pressure) and tachycardia (increase in heart or pulse rate).

Nicotine

Cancers include oral, esophageal, stomach, pancreatic, tracheal, cervical, urinary, and leukemia. Heart diseases include ischemia, atherosclerosis, aneurysm, and others. Lung diseases include pneumonia, influenza, bronchitis, emphysema, and chronic airway obstruction. Birth problems include short pregnancy, low birth weight, respiratory distress syndrome, and sudden infant death syndrome. Secondhand smoke deaths include those from lung cancer and ischemic heart disease. The total number of deaths exceed 435,000. Aside from these deaths, chronic illnesses cause much misery and expense. (Adapted from Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses, United States, 1997-2001, found at mm5425a1.htm, accessed February 7, 2011.) Cancers include oral, esophageal, stomach, pancreatic, tracheal, cervical, urinary, and leukemia. Heart diseases include ischemia, atherosclerosis, aneurysm, and others. Lung diseases include pneumonia, influenza,...

Marijuana Cannabis

Impaired learning and memory, sedation, panic reactions, and paranoia. The physiological effects are the well known reddening of the eyes, dry mouth and throat, the munchies (increased appetite), vasodilation, increased heart rate, urinary retention, constipation, and loss of coordination. Withdrawal symptoms have been reported and include craving, mood changes, headache, weight gain, and sleep dis-turbances.2 It is interesting that the quantity of tar inhaled and the amount of carbon monoxide absorbed is three to five times greater than what occurs with tobacco smokers National surveys from 2005-2007 indicate positive associations between duration of marijuana use and bronchitis and lung cancer, as well as anxiety, depression, and sexually transmitted diseases.3

Respiratory disease

Long-standing or severe obstructive pulmonary disease poses general anaesthetic problems not only because of the compromised gaseous exchange but also because of the possible related right-sided heart failure problems. The conditions most likely to cause chronic obstructive pulmonary disease are bronchitis, bronchiectasis and asthma.

Airways Diseases

Chronic bronchitis, whose clinical definition is productive cough (from bronchial secretion) on most days for 3 months year for two consecutive years. The mucus hypersecretion comes from hypertrophied bronchial glands and increases the risk of bacterial lung infections. The disease entities asthma, chronic bronchitis and emphysema are in no way mutually exclusive a given patient can have symptoms from more than one. The definitions of the last two does not imply that the patient has airway obstruction, so not everyone with these diseases has COPD. Pathologically COPD is a disease with per-iferal inflammation (thus rather a bronchioli-tis than bronchitis) with progressive lung tissue The typical COPD patient has been smoking 20 or more cigarettes a day for more than 20 years and presents with a chronic cough, shortness of breath (dyspnea) and frequent respiratory infections. If the underlying disease is mainly emphysema, shortness of breath may be the only symptom. Initially the...

High Altitude Illness

The high-altitude environment can pose other potential medical concerns. High-altitude retinopathy is a generally benign, asymptomatic condition that is relatively common, especially above 5000m (16,000 feet). Blindness or scotomas may be present when the macula is involved, but these usually resolve with descent and cause no permanent sequelae.35,40 Peripheral edema in the absence of any of the acute altitude illness is also common, especially in women, and can be treated with low-dose diuretics. It too will resolve on descent.35,36 High-altitude pharyngitis and bronchitis can cause significant morbidity due to persistent coughing spasms. It is thought to be more related to the inspiration of large volumes of cold, dry air leading to a

Breathing Problems

Breathing difficulties that predate the cancer, such as from smoking, include diseases such as chronic obstructive pulmonary disease (COPD), emphysema, bronchitis, and asthma. Even when made worse by cancer, they can still be treated with some success using standard measures.

Metereddose inhalers

Holding Chamber

The pressurized metered-dose inhaler (pMDI or MDI) is the most commonly used inhaler, and is an inexpensive, quick and convenient way to take asthma medicine, and the device may also be used in conjunction with a spacer. The MDI, often simply called an inhaler, is a small device incorporating a pressurized canister that contains aerosol medicine to be inhaled. Many asthma medications are taken with an inhaler. Every day more than 500 million patents in the world carry easy-to-use MDI devices to deliver medicines to their pulmonary airways (Colthorpe, 2003). MDIs are also used by people who suffer from other respiratory ailments such as emphysema, chronic lung disease, and bronchitis. Each time a patient uses an MDI, a precisely measured, or ''metered,'' amount of medicine is delivered. Inhalers can be used by all asthma patients aged 5 and older, according to the American Medical Association. Through inhalation, it takes only 5 15 minutes for short-acting bronchodilators (quick-relief...

Shih Ching

A police chief who seems to have had bladder cancer accompanied by intestinal obstruction due to heavy ascaris infestation (chia). The Chief Eunuch of the Palace of Chhi fell into a river and got very cold and wet, so his je ping due to han was surely bronchitis or pneumonia Shunyii I gave antipyretic drugs and pulled him through. Then the Queen Mother of Chhi had feng tan, which is clearly interpretable as acute cystitis, probably connected with nephritis. She had hematuria, but she got better under Shunyu's treatment. An old nurse of the princely family had je chiieh, with hot and swollen feet this may have been gout accompanied by chronic alcoholism, or possibly simply a traumatic infection of the extremities. Chhiu chih was clearly dental caries, and one of the grand prefects of Chhi had it. One of the concubines of the Prince of Tzu-chhuan had a difficult childbirth Shunyu I gave nitrate and obtained the rejection of postpartum blood clots. A young courtier had shen pi -...

The History

Situs Psychosis

In 1933, Kartagener called attention to the association of sinusitis, bronchiectasis and situs inversus,72 a combination subsequently called Kartagener syndrome or triad.16'51'73'80'92'132 In the first English language publication of the syndrome (1937), as many as one fifth of patients with situs inversus had bronchiectasis, underscoring that the association was not fortuitous.5 In 1986, a blinded controlled study of cilia ultrastructure in Kartagener syndrome found a widespread inherited ciliary disorder40,95,98,133 that included the upper and lower respiratory tracts54,73,133 (bronchitis, bronchiectasis, sinusitis) and the testis4,6,7,49,103 (immobile sperm, male infertility). Situs inversus is common in infertile men, an observation that contributed to the identification of a generalized disorder of ciliary motil-ity6,49 Respiratory symptoms are a significant part of the history and may lead to the discovery of situs inversus. The connection between abnormal cilia and laterality...

Smoking

Long-term deleterious effects of smoking include vascular disease of the peripheral, coronary and cerebral circulations, carcinoma of the lung and chronic bronchitis. It has been suggested that there are good theoretical reasons for advising all patients to cease cigarette smoking for at least 12 h prior to surgery, although there is little evidence to suggest that this influences patients' behaviour in this period.

Bronchial Carcinoma

Patients with bronchial carcinoma frequently suffer from coexisting chronic bronchitis. In addition, there may be infection and collapse of the lung distal to the tumour. Patients with bronchial carcinoma may have myasthenic syndrome (see p. 452), while oat-cell tumours may secrete a number of hormones, among the commonest being adrenocortico trophic hormone (ACTH), producing Cushing's syndrome, and antidiuretic hormone (ADH), producing dilutional hyponatraemia (syndrome of inappropriate ADH secrction).

Vni73 Influenza

There is at present no specific cure that is effective against this viral disease. In mild cases the acute symptoms disappear in 7 to 10 days, although general physical and mental depression may occasionally persist. Influenzal pneumonia is rare, but often fatal. Bronchitis, sinusitis, and bacterial pneumonia are among the more common complications, and the last can be fatal, but seldom is if properly treated. Influenza is generally benign, and even in pandemic years, the mortality rate is usually low 1 percent or less-the disease being a real threat to life for only the very young, the immunosuppressed, and the elderly. However, this infection is so contagious that in most years multitudes contract it, and thus the number of deaths in absolute terms is usually quite high. Influenza, combined with pneumonia, is one of the 10 leading causes of death in the United States in the 1980s. The sequelae of influenza are often hard to discern and define - prolonged mental depression, for...

Sputum Production

Sputum is the substance expelled by coughing. Approximately 75 to 100 mL of sputum is secreted daily by the bronchi. By ciliary action, it is brought up to the throat and then swallowed unconsciously with the saliva. An increase in the quantity of sputum production is the earliest manifestation of bronchitis. Sputum may contain cellular debris, mucus, blood, pus, or microorganisms.

Subject Index

Borrelia burgdorferi, 201-3 Borrelia recurrentis, 275 botulism, 57-58, 115, 308 Bouchard's nodes, 235 boutonneuse fever, 285 bovine rabies, 270 bovine tuberculosis, 193, 337 bradycardia, 27, 86, 196 bradykinesia, 240-41 brain damage, 185, 210, 264 brain tumors, epilepsy and, 117 brandy liver, 80 breakbone fever, 87 breast cancer, 63-65 Bright's disease, 144-46 Brill's disease, 353 Brill-Zinsser disease, 353 broad fish tapeworm, 320 bronchiectasis, 360 bronchitis, 113, 178, 276 bronchocele, 146

Dealing With Bronchitis

Dealing With Bronchitis

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