Archive for the ‘Pulmonology’ Category

TB risk factors and Treatment

Monday, November 8th, 2010

Known since antiquity, tuberculosis has markedly decreased since the discovery of BCG vaccine in 1921 by Calmette-Guerin, and the marketing of anti-TB antibiotics. However, current data are being modified with the HIV pandemic, with recrudescence cases, especially in Africa and the USA.

A – Physiopathology:
TB originates in the tubercle bacillus (Mycobacterium tuberculosis or bovis africanum), discovered in the late nineteenth century. It is a bacillus, alcoholics, and acid resistant. It is conveyed by saliva droplets, especially during coughing, its mode of transmission is air, and the first inoculation is an inoculation chancre in paremchyme lung.

This primary infection is either overt or latent.
Primo latent infection: Totally asymptomatic, she rose with a TST in the IDR (Intra Dermo reaction) in a non-vaccinated.
Primary patent infection: There is a weakening of the condition, with weight loss and fatigue, accompanied by a cough and a fever, and chest X-ray shows the inoculation chancre.

TB disease is then said during a lung infection to BK, following the primary infection or exogenous reinfection, or, more commonly, endogenous reactivation of existing organization infected.

Risk Factors:

  1. extreme ages of life
  2. Immunosuppression, faisaint following a pathology (HIV) or consequence of treatment (chemotherapy, high dose corticosteroids.

(more…)

The physical laws of gas

Tuesday, March 23rd, 2010

To properly absorb and understand the physiological processes involved in breathing, incorporating a simple, different physical laws governing the gas. This is a reminder level terminal S.

I – Ideal Gas Law
Gases are compressible, and expand at an elevated temperature. This law, called the ideal gas law, relates the pressure P, volume V and temperature T of a gas in the following formula:

PV = nRT where

  • n represents the number of molecules per gram of gas,
  • R is the gas constant
  • T is expressed in absolute temperature (T c 273 °)

Note that under physiological conditions “normal” correspond to 1 atmosphere is 760mmHg at 0 ° c (more…)

Cystic fibrosis

Friday, February 26th, 2010

This is one of the most common genetic diseases.

Genetic Aspect
Cystic fibrosis gene located on chromosome 7, encodes the first membrane protein called CFTR conditioning the quality of ion exchange between the glands and the lumen of the bronchus, but also upper respiratory tract, pancreas, digestive tract, the bile ducts.

Respiratory Events
Especially during the first year of life.
Then shift to attacks (super infection) characterized. Worsening respiratory symptoms with impaired general condition.
The bacterial colonization of the trachea bronchial tree is most often initially with Staphylococcus aureus or Haemophilus influenzae.
Then move to the pyocyaneus (very virulent, almost inaccessible to ATB and defense mechanisms).

Extra Respiratory Events

  • Pancreatic disease (90% of cases)
  • Intestinal
  • Hepatobiliary
  • Nutritional disorders:
    • maldigestion of fat
    • increased energy needs related respiratory disability.
  • Genital Event:
  • delayed puberty
  • infertile men (95% of cases)
  • decreased fertility in women (but may have children with a risk of having a child with ¼: genetic counseling mandatory).

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The broncho-pulmonary

Friday, February 5th, 2010

A) The viral bronchitis
Appear during seasonal changes, often epidemic.
Beginning as nasopharyngitis, headache, fever, muscle aches.
dry cough after 2 or 3 days.
an asthmatic attack may accompany the extreme ages of life.
No further consideration, outside the context of epidemiological and clinical examination.
Evolution
Healing spontaneously favorable, or as a result of treatment:

  • antipyretic
  • broncho-dilators if necessary.

Complications

  • Bacterial bronchitis (infection).
  • Cough with muco purulent sputum associated with relatively abundant dyspnea.
  • Bronchial, snoring, which may be accompanied by signs of respiratory control.
  • sometimes vital prognosis.

Signs of severity of bronchitis

  • Dimensions major
  • Sweating important
  • Cyanosis
  • Confusion
  • Pics hypertensive

(in this case, since resuscitation on respiratory decompensation in response to hypercapnia by hypoventilation.)
Investigations

  • Radio Lung etiology.
  • NFS VS if needed (hyper leukocytosis).
  • ECBC in cases of bronchitis repeatedly resistant to antibiotic treatments.

(more…)

Apnea Sleep

Friday, August 8th, 2008

Syndrome of Sleep Apnea

Definitions
At apnea: is the cessation of breathing greater than 10 seconds.
In obstructive apnea: is a cessation of breathing by pharyngeal obstruction related to hypotonia of pharyngeal muscles with persistence of respiratory movements.
A central apnea: is the cessation of respiratory drive with stop motion and respiratory flow.
A hypopnea: it decreased ventilation of about 50%.
A syndrome of sleep apnea: it is from 10 apneas + hypopneas per hour of sleep.
A syndrome of severe sleep apnea: is when the apnea-hypopnea index greater than 30%.

Epidemiology
9 Apnea Syndrome Sleep button:
4 3 to 5% of the male population,
4 1 to 2% of the female population.
9 Risk factor: hypertension, stroke, myocardial infarction, car accidents, social gene.

Screening

  • Polygraphie respiratory recording of nocturnal SaO 2, respiratory movements, respiratory flow, snoring.
  • Polysomnography: respiratory polygraphy + + EEG + EMG electro-occulogramme.

(more…)

Anatomophysiological

Monday, July 28th, 2008

I-Anatomy
A-The lung parenchyma:
The alveoli secrete a film of fluid, including the surfactant, which has a large mechanical function: Indeed, by capillary action, they prevent the cells collapses at the end. At the epithelium, there are several types of cells pneumocytaires and macrocytic. The interstitium it is made up of cells and fibers with role structure.
The parenchyma has many functions: This is where we place the gas exchange, the destruction of certain molecules, their conversion (eg, angiotensin in angiotensinogen by the enzyme conversion) and a role Immune presence in number of alveolar macrophages.

B-vascularization:
There are two blood circulation in the lungs: the first is provided by the bronchial vessels (arteries and veins, bronchial) and provide the organ of oxygen and substances necessary for its operation. The second, consisting of veins and pulmonary arteries serves the function of gas exchange. (more…)

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