Dr Tejas Digambar Ghude, Practicing Pulmonologist, Bronchosopist, Sleep Specialist in Thane from 2018.
Qualification- MBBS, DNB Respiratory Medicine .
Address:
Humanity Street, First Floor Delta Avenue Complex, Near Taloja Biryani Centre, Castle mill naka, Thane west.
OPD Timing :10.30 am to 11.30 am except Sunday.
Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.
For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.
Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust your treatment as needed.
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.
Asthma signs and symptoms include:
Seek emergency treatment
Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:
It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and inherited (genetic) factors.
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.
Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. These two conditions usually occur together and can vary in severity among individuals with COPD.
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production.
Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter.
Although COPD is a progressive disease that gets worse over time, COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.
COPD symptoms often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues.
Signs and symptoms of COPD may include:
The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes.
Only some chronic smokers develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They may be misdiagnosed as having COPD until a more thorough evaluation is performed.
Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide many times — like the branches of a tree — into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).
The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream. At the same time, carbon dioxide — a gas that is a waste product of metabolism — is exhaled.
Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and over-expand, which leaves some air trapped in your lungs when you exhale.
Causes of airway obstruction include:
In the vast majority of people with COPD, the lung damage that leads to COPD is caused by long-term cigarette smoking. But there are likely other factors at play in the development of COPD, such as a genetic susceptibility to the disease, because not all smokers develop COPD.
Other irritants can cause COPD, including cigar smoke, secondhand smoke, pipe smoke, air pollution, and workplace exposure to dust, smoke or fumes.
Risk factors for COPD include:
COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.
Seek immediate medical attention if you have serious symptoms. Always call before visiting your doctor or health facility.
People with mild symptoms who are otherwise healthy should manage their symptoms at home.
On average it takes 5–6 days from when someone is infected with the virus for symptoms to show, however it can take up to 14 days.
As you recover from COVID-19, the information in this leaflet about breathing techniques, general mobility and strengthening exercises will help to improve your day-to-day function.
We recommend that you complete these exercises daily after you leave hospital.
If your symptoms do not get better within six weeks, please speak to your GP about this and, if appropriate, please ask them to refer you to outpatient physiotherapy for further rehabilitation.
Breathing exercises to help clear your chest
Exercise programme to maintain strength and function
Monitor your exercise compliance to keep you motivated
Bacterial pneumonia is an infection of your lungs caused by certain bacteria. The most common one is Streptococcus (pneumococcus), but other bacteria can cause it too. If you’re young and basically healthy, these bacteria can live in your throat without causing any trouble. But if your body’s defenses (immune system) become weak for some reason, the bacteria can go down into your lungs. When this happens, the air sacs in your lungs get infected and inflamed. They fill up with fluid, and that causes pneumonia.
You have a higher risk of getting bacteria pneumonia if you:
The symptoms can come on fast and furious, or they can creep up on you over a few days. Common symptoms are:
There are two kinds of shots for bacterial pneumonia:
COVID-19 symptoms can sometimes persist for months. The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems.
Most people who have coronavirus disease 2019 (COVID-19) recover completely within a few weeks. But some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery.
These people sometimes describe themselves as "long haulers" and the conditions have been called post-COVID-19 syndrome or "long COVID-19." These health issues are sometimes called post-COVID-19 conditions. They're generally considered to be effects of COVID-19 that persist for more than four weeks after you've been diagnosed with the COVID-19 virus.
Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection. Common signs and symptoms that linger over time include:
Although COVID-19 is seen as a disease that primarily affects the lungs, it can also damage many other organs, including the heart, kidneys and the brain. Organ damage may lead to health complications that linger after COVID-19 illness. In some people, lasting health effects may include long-term breathing problems, heart complications, chronic kidney impairment, stroke and Guillain-Barre syndrome — a condition that causes temporary paralysis.
Some adults and children experience multisystem inflammatory syndrome after they have had COVID-19. In this condition, some organs and tissues become severely inflamed.
COVID-19 can make blood cells more likely to clump up and form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused by COVID-19 is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle.
Other parts of the body affected by blood clots include the lungs, legs, liver and kidneys. COVID-19 can also weaken blood vessels and cause them to leak, which contributes to potentially long-lasting problems with the liver and kidneys.
People who have severe symptoms of COVID-19 often have to be treated in a hospital's intensive care unit, with mechanical assistance such as ventilators to breathe. Simply surviving this experience can make a person more likely to later develop post-traumatic stress syndrome, depression and anxiety.
Because it's difficult to predict long-term outcomes from the new COVID-19 virus, scientists are looking at the long-term effects seen in related viruses, such as the virus that causes severe acute respiratory syndrome (SARS).
Many people who have recovered from SARS have gone on to develop chronic fatigue syndrome, a complex disorder characterized by extreme fatigue that worsens with physical or mental activity, but doesn't improve with rest. The same may be true for people who have had COVID-19.
Much is still unknown about how COVID-19 will affect people over time, but research is ongoing. Researchers recommend that doctors closely monitor people who have had COVID-19 to see how their organs are functioning after recovery.
Many large medical centers are opening specialized clinics to provide care for people who have persistent symptoms or related illnesses after they recover from COVID-19. Support groups are available as well.
Lung diseases are some of the most common medical conditions in the world. Tens of millions of people have lung disease in the U.S. alone. Smoking, infections, and genes cause most lung diseases.
Your lungs are part of a complex system, expanding and relaxing thousands of times each day to bring in oxygen and send out carbon dioxide. Lung disease can happen when there are problems in any part of this system.
Your windpipe (trachea) branches into tubes called bronchi, which in turn become smaller tubes throughout your lungs. Diseases that can affect these airways include:
Your airways branch into tiny tubes (bronchioles) that end in clusters of air sacs called alveoli. These air sacs make up most of your lung tissue. Lung diseases affecting your alveoli include:
The interstitium is the thin, delicate lining between your alveoli. Tiny blood vessels run through the interstitium and let gas transfer between the alveoli and your blood. Various lung diseases affect the interstitium:
The right side of your heart gets low-oxygen blood from your veins. It pumps blood into your lungs through the pulmonary arteries. These blood vessels can have diseases, as well.
The pleura is the thin lining that surrounds your lung and lines the inside of your chest wall. A tiny layer of fluid lets the pleura on your lung's surface slide along the chest wall with each breath. Lung diseases of the pleura include:
Tuberculosis (TB) is a potentially serious infectious disease that mainly affects the lungs. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes.
Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS. HIV weakens a person's immune system, so it can't fight the TB germs. In the United States, because of stronger control programs, tuberculosis began to decrease again in 1993. But it remains a concern.
Many tuberculosis strains resist the drugs most used to treat the disease. People with active tuberculosis must take many types of medications for months to get rid of the infection and prevent antibiotic resistance.
Although your body can harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:
Tuberculous meningitis is an infection of the tissues covering the brain and spinal cord (meninges).
Tuberculous meningitis is caused by Mycobacterium tuberculosis. This is the bacterium that causes tuberculosis (TB). The bacteria spread to the brain and spine from another place in the body, usually the lung.
Tuberculous meningitis is very rare in the United States. Most cases are people who traveled to the United States from other countries where TB is common.
People who have the following have a higher chance of developing tuberculous meningitis:
Spinal Tuberculosis, also known as Pott's Disease, is a spinal infection caused by tuberculosis that can lead to osteomyelitis, kyphotic deformity, and spinal mechanical instability.
Diagnosis is made with a CT-guided biopsy sent for acid-fast bacilli.
Treatment is usually bracing and anti-tuberculosis antibiotics in the absence of neurological defects or mechanical instability. Surgical management is indicated in the presence of neurological deficits, progressive kyphosis, and/or mechanical instability.
Incidence
Demographics
Anatomic location
Onset of symptoms of tuberculous spondylitis is typically more insidious than pyogenic infection
Tuberculosis is a bacterial infection that kills approximately 1.5 million people a year. Most of these deaths occur in developing countries. The bacterium that usually causes tuberculosis in humans is Mycobacterium tuberculosis.
About one-third of the world's population is infected with tuberculosis. However, most do not show signs of the disease. In these people, the bacteria are inactive (latent) and cannot be transmitted to others. If the body's immune system weakens, tuberculosis can become active and cause disease.
Worldwide, tuberculosis is second only to the human immunodeficiency virus (HIV) in causes of death by infectious disease among adults. Many developing countries are suffering dual epidemics of tuberculosis and HIV. The interaction between these two diseases has been labeled "Toxic synergy." That's because each epidemic impacts people in the same impoverished regions of the world and because each worsens the other.
People with HIV have weakened immune systems, so they are more likely to acquire a new case of tuberculosis, or to develop reactivation of latent disease. Those with tuberculosis are more likely to die if they are co-infected with HIV.
Tuberculosis typically affects the lungs. But in up to one-third of infected people, particularly those with HIV/AIDS, the illness also involves other areas of the body. Common sites of infection include the lymph nodes, the membranes that cover the brain (meninges), the joints, the kidneys and the membrane covering the digestive organs (peritoneum).
Most people infected with tuberculosis have inactive disease that does not cause any symptoms. In these people, a skin test for tuberculosis (called a PPD skin test, for "protein purified derivative") will show positive results within three months of getting the infection. Once a PPD is positive, it usually will remain positive throughout life.
Among people with active tuberculosis, symptoms vary according to the type of disease:
Primary pulmonary tuberculosis – Some people, especially young children, with this type of tuberculosis have no symptoms other than fever and fatigue. Other symptoms can include:
Postprimary (reactivation) tuberculosis – Symptoms include:
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.
Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. These two conditions usually occur together and can vary in severity among individuals with COPD.
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production.
Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter.
Although COPD is a progressive disease that gets worse over time, COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.
COPD symptoms often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues.
Signs and symptoms of COPD may include:
The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes.
Only some chronic smokers develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They may be misdiagnosed as having COPD until a more thorough evaluation is performed.
Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide many times — like the branches of a tree — into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).
The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream. At the same time, carbon dioxide — a gas that is a waste product of metabolism — is exhaled.
Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and over-expand, which leaves some air trapped in your lungs when you exhale.
Causes of airway obstruction include:
Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during sleep.
Central sleep apnea occurs because your brain doesn't send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction. Central sleep apnea is less common than obstructive sleep apnea.
Central sleep apnea can result from other conditions, such as heart failure and stroke. Another possible cause is sleeping at a high altitude.
Treatments for central sleep apnea might involve treating existing conditions, using a device to assist breathing or using supplemental oxygen.
Common signs and symptoms of central sleep apnea include:
Seek immediate help if you experience severe chest pain or pressure, especially when combined with other signs and symptoms such as pain in the arm or jaw or difficulty breathing. Chest pain may be a symptom of a heart attack.
Make an appointment with your doctor if:
Consult a medical professional if you have — or if your partner notices — any signs or symptoms of central sleep apnea, particularly the following:
Central sleep apnea occurs when your brain fails to transmit signals to your breathing muscles.
Central sleep apnea can be caused by a number of conditions that affect the ability of your brainstem — which links your brain to your spinal cord and controls many functions such as heart rate and breathing — to control your breathing.
The cause varies with the type of central sleep apnea you have. Types include:
Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale.
Lung cancer is the leading cause of cancer deaths worldwide.
People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. The risk of lung cancer increases with the length of time and number of cigarettes you've smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer.
Lung cancer typically doesn't cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur when the disease is advanced.
Signs and symptoms of lung cancer may include:
Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer.
Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately.
At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.
Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have.
The two general types of lung cancer include:
A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can't be controlled, such as your family history.
Risk factors for lung cancer include:
Lung function tests (also called pulmonary function tests) include a variety of tests that check how well the lungs work. The most basic test is spirometry. This test measures the amount of air the lungs can hold. The test also measures how forcefully one can empty air from the lungs.
Spirometry is used to screen for diseases that affect lung volumes. It also is used to screen for diseases that affect the airways, such as COPD or asthma.
Lung volume testing is another commonly performed lung function test. It is more precise than spirometry and measures the volume of air in the lungs, including the air that remains at the end of a normal breath. In addition, a diffusing capacity test measures how easily oxygen enters the bloodstream. Exercise testing helps evaluate causes of shortness of breath. There are also tests to find out if asthma is present when the usual breathing test results are normal.
These tests are not painful. They are performed by a pulmonary function technician, who will require you to use maximal effort to blow out and breathe in air. The tests are repeated several times to make sure the results are accurate. When performing the test, keep the following in mind:
You need to understand and follow directions to perform a lung function test. Exercise testing should not be done in those who have had:
An allergy test is an exam performed by a trained allergy specialist to determine if your body has an allergic reaction to a known substance. The exam can be in the form of a blood test, a skin test, or an elimination diet.
Allergies occur when your immune system, which isyour body’s natural defense, overreacts to something in your environment. For example, pollen, which is normally harmless, can cause your body to overreact. This overreaction can lead to:
Allergens are substances that can cause an allergic reaction. There are three primary types of allergens:
Before your allergy test, your doctor will ask you about your lifestyle, family history, and more.
They’ll most likely tell you to stop taking the following medications before your allergy test because they can affect the test results:
An allergy test may involve either a skin test or a blood test. You may have to go on an elimination diet if your doctor thinks you might have a food allergy.
Skin tests are used to identify numerous potential allergens. This includes airborne, food-related, and contact allergens. The three types of skin tests are scratch, intradermal, and patch tests.
Your doctor will typically try a scratch test first. During this test, an allergen is placed in liquid, then that liquid is placed on a section of your skin with a special tool that lightly punctures the allergen into the skin’s surface. You’ll be closely monitored to see how your skin reacts to the foreign substance. If there’s localized redness, swelling, elevation, or itchiness of the skin over the test site, you’re allergic to that specific allergen.
If the scratch test is inconclusive, your doctor may order an intradermal skin test. This test requires injecting a tiny amount of allergen into the dermis layer of your skin. Again, your doctor will monitor your reaction.
Polysomnography, also called a sleep study, is a comprehensive test used to diagnose sleep disorders. Polysomnography records your brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements during the study.
Polysomnography may be done at a sleep disorders unit within a hospital or at a sleep center. While it's typically performed at night, polysomnography is occasionally done during the day to accommodate shift workers who habitually sleep during the day.
In addition to helping diagnose sleep disorders, polysomnography may be used to help initiate or adjust your treatment plan if you've already been diagnosed with a sleep disorder.
Polysomnography monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted and why.
There are different types of home sleep apnea test devices using different combinations of sensors. They generally record your breathing rate and airflow, as well as oxygen levels and heart rate. One style also incorporates information on blood vessel tone.
The normal process of falling asleep begins with a sleep stage called non-rapid eye movement (NREM) sleep. During this stage, your brain waves, as recorded by electroencephalography (EEG), slow down considerably.
Your eyes don't move back and forth rapidly during NREM, in contrast to later stages of sleep. After an hour or two of NREM sleep, your brain activity picks up again, and rapid eye movement (REM) sleep begins. Most dreaming occurs during REM sleep.
You normally go through multiple sleep cycles a night, cycling between NREM and REM sleep in about 90 minutes. Sleep disorders can disturb this sleep process.
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest.
During a VATS procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through one or more small incisions in your chest wall. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.
Surgeons use the video-assisted thoracoscopic surgery technique to perform a variety of procedures, such as:
Possible complications of video-assisted thoracoscopic surgery include:
You may need to have some tests to determine whether video-assisted thoracoscopic surgery is a good option for you. These may include imaging tests, laboratory tests, pulmonary function tests and cardiac evaluation.
Usually people undergoing video-assisted thoracoscopic surgery are given a general anesthetic, which means they're asleep during surgery. You'll have a breathing tube put down your throat into your trachea to provide oxygen to your lungs. Then a surgeon makes small incisions in your chest and inserts specially designed surgical instruments to perform the procedure.
People with chronic pulmonary disease find the specialized care and support they need at the Mayo Clinic Pulmonary Rehabilitation Program. The experts in this program will work with you to improve your health and reduce your risk of future pulmonary disease and medical complications. Most people go through the comprehensive evaluation, educational and exercise components on an outpatient basis.
You'll get exactly the care you need from a multispecialty group of people with special training, including pulmonologists, respiratory therapists, physical therapists, occupational therapists, social workers and dietitians.
Participation in the program may help you:
The Pulmonary Rehabilitation Program at Mayo Clinic's campus in Arizona provides care by doctors in a clinical setting, as well as patient education and support for people with qualifying lung (pulmonary) disease. The typical program length in Arizona is 6 to 10 weeks.
The Pulmonary Rehabilitation Program at Mayo Clinic's campus in Florida is a combined rehabilitation program for people with lung disease or heart disease (cardiovascular disease).
The Pulmonary Rehabilitation Program at Mayo Clinic's campus in Minnesota offers a program that lasts 6 to 10 weeks. For people who aren't able to commit to that length of stay, the program offers individual appointments or helps you identify a health care facility near your home where you can complete a comprehensive pulmonary rehabilitation program. Your Mayo care team may provide you with specific guidelines to take to your local facility.
The Pulmonary Rehabilitation Program is open to people who have a chronic pulmonary disease that affects their ability to breathe and their quality of life.
You may be eligible for the program in the following situations:
Pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing. Normally, a small amount of fluid is present in the pleura.
Some patients with pleural effusion have no symptoms, with the condition discovered on a chest x-ray that is performed for another reason. The patient may have unrelated symptoms due to the disease or condition that has caused the effusion.Symptoms of pleural effusion include:
Pleural effusions are very common, with approximately 100,000 cases diagnosed in the United States each year, according to the National Cancer Institute. Depending on the cause, the excess fluid may be either protein-poor (transudative) or protein-rich (exudative). These two categories help physicians determine the cause of the pleural effusion.
A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. A pneumothorax can be a complete lung collapse or a collapse of only a portion of the lung. A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Or it may occur for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event. Treatment for a pneumothorax usually involves inserting a needle or chest tube between the ribs to remove the excess air. However, a small pneumothorax may heal on its own.
The main symptoms of a pneumothorax are sudden chest pain and shortness of breath. Severity of symptoms may depend on how much of the lung is collapsed.
A pneumothorax can be caused by:
In general, men are far more likely to have a pneumothorax than women are. The type of pneumothorax caused by ruptured air blisters is most likely to occur in people between 20 and 40 years old, especially if the person is very tall and underweight. Underlying lung disease or mechanical ventilation can be a cause or a risk factor for a pneumothorax. Other risk factors include:
During an initial physical exam, your doctor will want to specifically listen to your chest through a stethoscope. As you breathe, they may tap your chest and listen for hollow sounds. Since higher than normal levels of carbon dioxide and low levels of oxygen can be indicators, your doctor may suggest an arterial blood gas test to test these levels. To get a definite diagnosis, your doctor will most likely need to order an imaging test such as a chest X-ray, an ultrasound or CT scan.
Symptoms normally come on almost immediately and commonly begin with chest pain. Other signals that the problem may be a collapsed lung are:
Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity).
The most common cause of hemothorax is chest trauma. Hemothorax can also occur in people who have:
Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine. Sometimes, narcolepsy can be accompanied by a sudden loss of muscle tone (cataplexy), which can be triggered by strong emotion. Narcolepsy that occurs with cataplexy is called type 1 narcolepsy. Narcolepsy that occurs without cataplexy is known as type 2 narcolepsy. Narcolepsy is a chronic condition for which there's no cure. However, medications and lifestyle changes can help you manage the symptoms. Support from others — family, friends, employers, teachers — can help you cope with narcolepsy.
The signs and symptoms of narcolepsy may worsen for the first few years and then continue for life. They include:
The exact cause of narcolepsy is unknown. People with type 1 narcolepsy have low levels of the chemical hypocretin (hi-poe-KREE-tin). Hypocretin is an important neurochemical in your brain that helps regulate wakefulness and REM sleep. Hypocretin levels are particularly low in those who experience cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn't known, but experts suspect it's due to an autoimmune reaction. It's also likely that genetics play a role in the development of narcolepsy. But the risk of a parent passing this disorder to a child is very low — only about 1%. Research also indicates a possible association with exposure to the swine flu (H1N1 flu) virus and a certain form of H1N1 vaccine that's currently administered in Europe, though it's not yet clear why.
Obesity hypoventilation syndrome (OHS) is a condition in some obese people in which poor breathing leads to lower oxygen and higher carbon dioxide levels in the blood.
The exact cause of OHS is not known. Researchers believe OHS results from a defect in the brain's control over breathing. Excess weight against the chest wall also makes it harder for the muscles to draw in a deep breath and to breathe quickly enough. This worsens the brain's breathing control. As a result, the blood contains too much carbon dioxide and not enough oxygen.
The exact cause of narcolepsy is unknown. People with type 1 narcolepsy have low levels of the chemical hypocretin (hi-poe-KREE-tin). Hypocretin is an important neurochemical in your brain that helps regulate wakefulness and REM sleep. Hypocretin levels are particularly low in those who experience cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn't known, but experts suspect it's due to an autoimmune reaction. It's also likely that genetics play a role in the development of narcolepsy. But the risk of a parent passing this disorder to a child is very low — only about 1%. Research also indicates a possible association with exposure to the swine flu (H1N1 flu) virus and a certain form of H1N1 vaccine that's currently administered in Europe, though it's not yet clear why.
Spinal Tuberculosis, also known as Pott's Disease, is a spinal infection caused by tuberculosis that can lead to osteomyelitis, kyphotic deformity, and spinal mechanical instability.
Diagnosis is made with a CT-guided biopsy sent for acid-fast bacilli.
Treatment is usually bracing and anti-tuberculosis antibiotics in the absence of neurological defects or mechanical instability. Surgical management is indicated in the presence of neurological deficits, progressive kyphosis, and/or mechanical instability.
Incidence
Demographics
Anatomic location
Onset of symptoms of tuberculous spondylitis is typically more insidious than pyogenic infection
Tuberculosis is a bacterial infection that kills approximately 1.5 million people a year. Most of these deaths occur in developing countries. The bacterium that usually causes tuberculosis in humans is Mycobacterium tuberculosis.
About one-third of the world's population is infected with tuberculosis. However, most do not show signs of the disease. In these people, the bacteria are inactive (latent) and cannot be transmitted to others. If the body's immune system weakens, tuberculosis can become active and cause disease.
Worldwide, tuberculosis is second only to the human immunodeficiency virus (HIV) in causes of death by infectious disease among adults. Many developing countries are suffering dual epidemics of tuberculosis and HIV. The interaction between these two diseases has been labeled "Toxic synergy." That's because each epidemic impacts people in the same impoverished regions of the world and because each worsens the other.
People with HIV have weakened immune systems, so they are more likely to acquire a new case of tuberculosis, or to develop reactivation of latent disease. Those with tuberculosis are more likely to die if they are co-infected with HIV.
Tuberculosis typically affects the lungs. But in up to one-third of infected people, particularly those with HIV/AIDS, the illness also involves other areas of the body. Common sites of infection include the lymph nodes, the membranes that cover the brain (meninges), the joints, the kidneys and the membrane covering the digestive organs (peritoneum).
Most people infected with tuberculosis have inactive disease that does not cause any symptoms. In these people, a skin test for tuberculosis (called a PPD skin test, for "protein purified derivative") will show positive results within three months of getting the infection. Once a PPD is positive, it usually will remain positive throughout life.
Among people with active tuberculosis, symptoms vary according to the type of disease:
Primary pulmonary tuberculosis – Some people, especially young children, with this type of tuberculosis have no symptoms other than fever and fatigue. Other symptoms can include:
Postprimary (reactivation) tuberculosis – Symptoms include: