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Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
Pulmonaryc /certified fixed orthodontic courses by Indian dental academy
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Pulmonaryc /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Lung Type I pneumocyte Type I pneumocyte Alveolar space Capillary lumen Type II pneumocyte Endothelium www.indiandentalacademy.com
  • 3. Pneumonia • Pathology: – Alveolar – • Bronchopneumonia (Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus) • Lobar (Streptococcus pneumoniae) Interstitial (Influenza virus, Mycoplasma pneumoniae) • Pathogenesis – Inhalation of air droplets – Aspiration of infected secretions or objects – Hematogenous spread www.indiandentalacademy.com
  • 4. Pulmonary infections Predisposing factors • Decreased cough reflex • Injury to cilia • Decreased function of alveolar macrophages • Edema or congestion • Retention of secretions www.indiandentalacademy.com
  • 5. Lung abscess • Localized suppurative necrosis • Organisms commonly cultured: – – – – – Staphylococci Streptococci Gram-negative Anaerobes Frequent mixed infections • Pathogenesis: – – – – – Aspiration Pneumonia Septic emboli Tumors Direct infection www.indiandentalacademy.com
  • 6. Pulmonary tuberculosis • Caused by Mycobacterium tuberculosis. • Transmitted through inhalation of infected droplets • Primary – Single granuloma within parenchyma and hilar lymph nodes (Ghon complex). • Infection does not progress (most common). • Progressive primary pneumonia • Miliary dissemination (blood stream). www.indiandentalacademy.com
  • 7. Pulmonary tuberculosis • Secondary – Infection (mostly through reactivation) in a previously sensitized individual. – Pathology • Cavitary fibrocaseous lesions • Bronchopneumonia • Miliary TB Fibrocaseous www.indiandentalacademy.com Miliary Granuloma Mycobacterium
  • 8. Opportunistic pneumonias • Infections that affect immunosuppressed patients • Associated disorders: – AIDS – Iatrogenic • Cancer patients • Transplant recipients Aspergillus Pneumocystis carinii www.indiandentalacademy.com Cytomegalovirus
  • 9. Chronic obstructive pulmonary disease (COPD) Chronic bronchitis • Definition – Persistent cough with sputum production for: – at least 3 months, – in at least 2 consecutive years. • Pathology – Inflammation of airways – Hyperplasia of mucous producing cells – Squamous metaplasia – Injury to cilia www.indiandentalacademy.com
  • 10. Chronic obstructive pulmonary disease (COPD) Emphysema • Destructive enlargement of airspaces distal to terminal bronchioles • Two main types Normal acinar unit Centriacinar emphysema – Centriacinar • Destruction of central portion with sparing of distal airways • Upper lobes > lower • Cause: smoking – Panacinar • Unform injury • Lower lobes > upper • Cause: alpha-1-antitrypsin deficiency Panacinar emphysema www.indiandentalacademy.com Neutrophils Alpha-1-AT
  • 11. Bronchiectasis • Dilatation of bronchi and bronchioles secondary to chronic inflammation • Associated conditions – – – – Obstruction Cystic fibrosis Immotile cilia syndromes Necrotizing pneumonia www.indiandentalacademy.com
  • 12. Bronchial Asthma • Chronic inflammatory disorder of the airways resulting in contraction of bronchial muscle • Types – Extrinsic (atopic, allergic). • Allergens: food, pollen, dust, etc. – Intrinsic (non-atopic) • Initiated by infections, drugs, pollutants, chemical irritants ATOPIC ASTHMA Allergen IgE Mucus secretion Mast cell Epithelial cell injury Muscle contraction Mucus secretion Muscle contraction Release of inflammatory mediators Recruitment of leukocytes Acute phase www.indiandentalacademy.com Late-phase
  • 13. Atelectasis • Collapse or incomplete expansion of part or all of the lung • Types: – Resorption (obstruction of airway). – Compressive (pleural effusion or pneumothorax) www.indiandentalacademy.com
  • 14. Pulmonary edema Oncotic pressure Hydrostatic pressure Normal Hydrostatic pressure Oncotic pressure Causes: - Heart failure - Mitral stenosis Hydrostatic pressure Causes: - Infections - Aspiration - Drugs - Radiation Oncotic pressure www.indiandentalacademy.com Microvascular injury Causes: - Nephrotic syndrome - Liver diseases
  • 15. Diffuse alveolar damage • Acute respiratory distress syndrome (respiratory failure and arterial hypoxemia refractory to O2 therapy). • Basic lesions: injury to pneumocytes and endothelial cells by: – Oxygen-derived free radicals – Activated neutrophils and macrophages – Loss of surfactant. • Etiology: – – – – Exudative stage Infections (viral) Gas inhalation or liquid aspiration Drugs, chemical, radiation Hypotension, sepsis, trauma • Pathology: – Acute (exudative) stage – Proliferative or organizing stage Proliferative stage www.indiandentalacademy.com
  • 16. Pulmonary embolism • Most emboli arise in veins from the legs • Large emboli (10%) are a cause of sudden death • Small emboli (70%) may be: – Clinically silent – Cause infarctions (in patients with heart failure). – Cause hemoptysis • Medium sized emboli (20%) generally cause infarctions. www.indiandentalacademy.com Infarct
  • 17. Pulmonary hypertension • Secondary (most common): – Chronic obstructive pulmonary disease – Chronic interstitial pulmonary disorders – Chronic heart failure – Recurrent pulmonary emboli Expected luminal opening in normal individual Plexiform changes • Primary (idiopathic) www.indiandentalacademy.com
  • 18. Hypersensitivity pneumonitis • Immunologically mediated disorder affecting airways and interstitium. Farmer’s lung Thermophilic actinomycetes in hay Pigeon Air-condition lung breeder’s Thermophilic bacteria www.indiandentalacademy.com
  • 19. Usual interstitial pneumonia / idiopathic pulmonary fibrosis • Progressive fibrosing disorder of of unknown cause • Adults 30 to 50 y/o • Respiratory and heart failure (cor pulmonale) ~ 5 y www.indiandentalacademy.com
  • 20. Pneumoconioses • Disorders caused by inhalation of inorganic elements, primarily metals. • Injury is determined by: – Length of exposure – Physicochemical characteristics – Host factors • Carbon dust - Coal worker’s pneumoconiosis: – Anthracosis – Simple coal worker’s pneumoconiosis – Progressive massive fibrosis • Silicosis – Silicotic nodules • Asbestos – Asbestosis (pulmonary fibrosis) – Pleural disease (fibrous plaques, mesothelioma). www.indiandentalacademy.com
  • 21. Carcinoma of the Lung • 6.5 % of all deaths • #1 cause of cancer deaths in males & females – 31% of male cancer deaths in 2001 • 90,367 deaths – 25% of female cancer deaths • 65,506 deaths www.indiandentalacademy.com
  • 22. Lung cancer Lung cancer in males www.indiandentalacademy.com Lung cancer in females
  • 23. Cancer Deaths estimated for 2004 Sites New Cases Deaths ALL 1,368,300 563,700 Lung 173,770 160,440 Colon-Rectum 146,940 56,808 Breast 217,440 40,580 Prostate 230,110 29,900 www.indiandentalacademy.com
  • 24. Smoking-related diseases www.indiandentalacademy.com
  • 25. Annual death rate for lung cancer www.indiandentalacademy.com
  • 26. Causes of Lung Cancer • 85-95% smoking • 1%asbestos + smoking (estimate) • Rare arsenic, chromium, mustard gas, nickel, vinyl chloride, bis (chloromethyl) ether • Speculation – 0.3-3% passive smoking – 3-14% radon www.indiandentalacademy.com
  • 27. www.indiandentalacademy.com
  • 28. Classification of Lung Carcinoma (Major Types) • Squamous cell carcinoma 35% • Adenocarcinoma 30% • Small cell carcinoma 25% www.indiandentalacademy.com
  • 29. Squamous cell carcinoma • • • • • • • Frequency: 35% Smoking: X 25 (increased risk) Males > females Survival (5 years): 15 - 20% Arises in bronchial squamous metaplasia Centrally located May cavitate www.indiandentalacademy.com
  • 30. www.indiandentalacademy.com
  • 31. Adenocarcinoma • • • • • Frequency: 30% Smoking: X 3 (increased risk) Males < females Survival (5 years): 15 - 20% Peripheral www.indiandentalacademy.com
  • 32. Bronchioloalveolar carcinoma • • • • • Frequency: 2 % Smoking: yes Males = females Survival (5 years): 25 a 40 %. Presentation: – Single or multiple tumor nodules – Miliary tumor – “Pneumonic form” www.indiandentalacademy.com
  • 33. Small cell carcinoma • • • • Frequency: 25 % Smoking: 95% of patients Males >> females Survival (5 years): 1 - 5 %. www.indiandentalacademy.com
  • 34. www.indiandentalacademy.com
  • 35. Large Cell Carcinoma • Frequency: 10 % • Gross – Peripheral lesion • Microscopic – Wastebasket group of tumors that do not fit the criteria of a squamous cell carcinoma, adenocarcinoma, or small cell carcinoma • Prognosis – Similar to adenocarcinoma www.indiandentalacademy.com
  • 36. www.indiandentalacademy.com
  • 37. www.indiandentalacademy.com
  • 38. www.indiandentalacademy.com
  • 39. 100 pa tie nts 35 ope ra ble 25-30 re se cte d for cure 8-12 survive for 5 ye a rs ( 3 0 % of those re se cte d for cure ) www.indiandentalacademy.com
  • 40. Mesothelioma • Mesothelioma: – Malignant tumor of mesothelial cells – Highly malignant neoplasm with short survival – Most patients (70%) have an asbestos exposure history • Asbestos exposure also increases the risk of pulmonary cancer • Smoking is not related to mesothelioma www.indiandentalacademy.com
  • 41. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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