This document discusses restrictive lung diseases including interstitial lung fibrosis and asbestosis. It defines interstitial pulmonary fibrosis as a chronic, fibrosing interstitial pneumonia of unknown cause typically affecting adults over 50. Usual interstitial pneumonia is the most common form and has a median survival of 3 years. Asbestosis is an occupational lung disease caused by inhalation of asbestos fibers, which can lead to pleural thickening, effusions, rounded atelectasis or fibrosis. Prevention focuses on never disturbing asbestos materials and smoking cessation.
Small group presentation which was done during our physiology days under the guidance of Prof. Sampath Gunawardena senior lecturer in department of Physiology, Faculty of Medicine University of Ruhuna.
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
Small group presentation which was done during our physiology days under the guidance of Prof. Sampath Gunawardena senior lecturer in department of Physiology, Faculty of Medicine University of Ruhuna.
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
Gas exchange between the alveoli and the pulmonary capillary blood occurs by diffusion, as will be discussed in the next chapter. Diffusion of oxygen and carbon dioxide occurs passively, according to their concentration differences across the alveolar-capillary barrier. These concentration differences must be maintained by ventilation of the alveoli and perfusion of the pulmonary capillaries.
Alveolar ventilation brings oxygen into the lung and removes carbon dioxide from it. Similarly, the mixed venous blood brings carbon dioxide into the lung and takes up alveolar oxygen. The alveolar Image not available. and Image not available. are thus determined by the relationship between alveolar ventilation and pulmonary capillary perfusion. Alterations in the ratio of ventilation to perfusion, called the Image not available., will result in changes in the alveolar Image not available. and Image not available., as well as in gas delivery to or removal from the lung.
Alveolar ventilation is normally about 4 to 6 L/min and pulmonary blood flow (which is equal to cardiac output) has a similar range, and so the Image not available. for the whole lung is in the range of 0.8 to 1.2. Image not available. However, ventilation and perfusion must be matched on the alveolar-capillary level, and the Image not available. for the whole lung is really of interest only as an approximation of the situation in all the alveolar-capillary units of the lung. For instance, suppose that all 5 L/min of the cardiac output went to the left lung and all 5 L/min of alveolar ventilation went to the right lung. The whole lung Image not available. would be 1.0, but there would be no gas exchange because there could be no gas diffusion between the ventilated alveoli and the perfused pulmonary capillaries.
Oxygen is delivered to the alveolus by alveolar ventilation, is removed from the alveolus as it diffuses into the pulmonary capillary blood, and is carried away by blood flow. Similarly, carbon dioxide is delivered to the alveolus in the mixed venous blood and diffuses into the alveolus in the pulmonary capillary. The carbon dioxide is removed from the alveolus by alveolar ventilation. As will be discussed in Chapter 6, at resting cardiac outputs the diffusion of both oxygen and carbon dioxide is normally limited by pulmonary perfusion. Thus, the alveolar partial pressures of both oxygen and carbon dioxide are determined by the Image not available. If the Image not available. in an alveolar-capillary unit increases, the delivery of oxygen relative to its removal will increase, as will the removal ...
Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
Gas exchange between the alveoli and the pulmonary capillary blood occurs by diffusion, as will be discussed in the next chapter. Diffusion of oxygen and carbon dioxide occurs passively, according to their concentration differences across the alveolar-capillary barrier. These concentration differences must be maintained by ventilation of the alveoli and perfusion of the pulmonary capillaries.
Alveolar ventilation brings oxygen into the lung and removes carbon dioxide from it. Similarly, the mixed venous blood brings carbon dioxide into the lung and takes up alveolar oxygen. The alveolar Image not available. and Image not available. are thus determined by the relationship between alveolar ventilation and pulmonary capillary perfusion. Alterations in the ratio of ventilation to perfusion, called the Image not available., will result in changes in the alveolar Image not available. and Image not available., as well as in gas delivery to or removal from the lung.
Alveolar ventilation is normally about 4 to 6 L/min and pulmonary blood flow (which is equal to cardiac output) has a similar range, and so the Image not available. for the whole lung is in the range of 0.8 to 1.2. Image not available. However, ventilation and perfusion must be matched on the alveolar-capillary level, and the Image not available. for the whole lung is really of interest only as an approximation of the situation in all the alveolar-capillary units of the lung. For instance, suppose that all 5 L/min of the cardiac output went to the left lung and all 5 L/min of alveolar ventilation went to the right lung. The whole lung Image not available. would be 1.0, but there would be no gas exchange because there could be no gas diffusion between the ventilated alveoli and the perfused pulmonary capillaries.
Oxygen is delivered to the alveolus by alveolar ventilation, is removed from the alveolus as it diffuses into the pulmonary capillary blood, and is carried away by blood flow. Similarly, carbon dioxide is delivered to the alveolus in the mixed venous blood and diffuses into the alveolus in the pulmonary capillary. The carbon dioxide is removed from the alveolus by alveolar ventilation. As will be discussed in Chapter 6, at resting cardiac outputs the diffusion of both oxygen and carbon dioxide is normally limited by pulmonary perfusion. Thus, the alveolar partial pressures of both oxygen and carbon dioxide are determined by the Image not available. If the Image not available. in an alveolar-capillary unit increases, the delivery of oxygen relative to its removal will increase, as will the removal ...
Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. Parenchymal RLD Extraparenchymal RLD
FVC Decreased Decreased
MVV Normal Decreased
DLCO Decreased Normal
FVC: Forced Vital Capacity
MVV: Maximum Voluntary Ventilation
DLCO: Carbon Monoxide Diffusion
4. Primary IPFPrimary IPF
Diffuse Fibrosing AlveolitisDiffuse Fibrosing Alveolitis
Usual Interstitial Pneumonia (UIP)Usual Interstitial Pneumonia (UIP)
IPF is defined as a specific form of chronic,
fibrosing interstitial pneumonia of unknown
cause, typically affecting adults over 50 years,
limited to the lungs, and associated with the
histopathologic and/or radiologic pattern of
usual interstitial pneumonia (UIP)
It is the most frequent and devastating form of
IPF (median survival 3 years).
11. Disease Onset
Acute or Subacute
)Hamman Rich Syndrome(
Insidious
• Rare.
• Rapidly progressive,
severe
• Fatal within few months
• Most cases.
• Slowly progressive
dyspnoea
• Cyanosis may be only
exertional )short time for
gas exchange(.
12.
13. Acute Exacerbation of IPFAcute Exacerbation of IPF
Diagnostic Criteria
• Previous or concurrent diagnosis of idiopathic pulmonary fibrosis.
• Unexplained worsening or development of dyspnea within 30 days.
• HRCT with new bilateral ground-glass abnormality and/or
consolidation superimposed on background reticular or honeycomb
pattern consistent with UIP.
• Exclusion of alternative causes:
Infection
Left heart failure
Pulmonary embolism
15. Cause of Death in IPF
IPF
]N=543[
1-7year Follow up
60%Died
]N=326[
Respiratory
failure
39%
Lung
cancer
10%
Pulmonary
embolism
3%
Pulmonary
infection
3%
Cardiovascular
disease
27%
Other
18%
19. • A test of aerobic capacity and endurance.
• Tests the global and integrated responses of all systems
involved during exercise, including pulmonary,
cardiovascular and neuromuscular systems.
• Does not provide specific information on each
system/organ.
Advantages
• Easy, affordable )no need for expensive equipment or
advanced technician training(.
• Reflective of ADL )activities of daily living(: self-paced
and done at submaximal exercise capacity, like ADL.
• Safe.
• Strongly correlated with peak O2 uptake in many
pulmonary conditions.
20.
21. Indications
It is used in many chronic cardiac (coronary heart disease, heart
failure) and respiratory (COPD, IPF) conditions for:
• Assessment of Functional Status.
• Prediction of Morbidity, Mortality.
• Pre-Treatment, Post-Treatment Comparison.
Contraindications
• Absolute:
Unstable angina or myocardial infarction during last month.
• Relative:
- HR > 120 or < 50 bpm.
- BP > 180/100 mmHg.
Revise a recent ECG and revise the need for the test
- O2 Saturation < 88%>
22. Instructions
• Usual walking aids used.
• Usual drug regimen continued.
• Supplemental O2 continued.
• Warming up period not allowed.
• Sit at rest on a chair near the start line for > 10 mins before
the test starts.
• STOP in case of:
- Chest pain - Staggering
- Intolerable dyspnoea - Diaphoresis
- Leg cramps - Pallor
23. What to Record at End of Test
• 6MWD (absolute value and percent of predicted value).
• Pulse, BP, RPP (Rate Pulse Product, a measure of myocardial exertion).
• Perceived dyspnoea, perceived exertion (modified Borg scale).
• O2 saturation.
24. Treatment of IPF:Treatment of IPF:
Non-Pharmacologic TreatmentNon-Pharmacologic Treatment
• Home Oxygen Therapy
If there is hypoxaemia (O2 Saturation < 88%) at
rest or induced by 6MWT.
• Respiratory Rehabilitation
improves distance of 6MWT and improves health-
related quality of life.
• Lung Transplantation
The only treatment in advanced IPF that results
in a major functional improvement.
25. PPI + Anti-Reflux measures
IV Methyl Prednisolone 500-1000 mg/day for 3 days
then
Prednisone 0.5 mg/Kg/day, gradually tapered
Established role
26. Pirfenidone (Pirfenex)Pirfenidone (Pirfenex)
• The only drug with confirmed efficacy against IPF.
• The only drug that was specifically licensed for treatment of IPF.
• FDA approved for this indication in 2014.
• ↓ Fibroblast proliferation, ↓ TGF-β stimulated collagen production
→ Anti-Fibrotic effect
• Has also an anti-inflammatory effect.
• IPF is a fibroblast- activated process. Inflammation is a 2ry event.
• ↓ Disease progression, ↓ decline in FVC, ↑ exercise capacity.
• Dose: One capsule (200 mg) / 8 h for 1 week
2 capsules / 8 h for 1 week
3 capsules / 8 h thereafter, for at least 12 months.
• Continued longer if there is some disease improvement or stabilization.
27. Adverse Effects, CautionsAdverse Effects, Cautions
Adverse EffectAdverse Effect CautionCaution
GI Upset (N, V,
dyspepsia)
Taken after food to ↓ these
upsets (though food
significantly ↓ its absorption)
Anorexia and Weight
Loss
Monitor weight, ↑ caloric
intake if needed.
Photosensitivity Avoid exposure to sunlight,
use sunscreen.
↑ Transaminases Check at baseline,
monthly for 6 M,
then every 3 M
Dizziness Avoid before driving vehicles
28. InteractionsInteractions
It is metabolized through CYP1A2 enzyme pathway:
Inducers ↓ Effect
• Smoking: quit.
• Omeprazole: Use pantoprazol
Inhibitors ↑ Toxicity
• Fluvoxamine (Faverine): Contraindicated.
• Ciprofloxacin, Amiodarone: Caution
31. Progression can occur
after exposure has
ceased, due to the
retention of fibers in the
lung and persistent
inflammatory/fibrotic
response.
AsbestosisAsbestosis
32. Asbestosis Containing MaterialsAsbestosis Containing Materials
• Asbestos is a broad term that includes a group of naturally
occurring fibrous mineral silicates of magnesium and iron.
• Asbestos content varies in different materials (1%-100%).
• Asbestos rich materials include:
• Wall and ceiling insulators
• Floor and Ceiling tiles
• Cement pipes
• Brake and clutch pads.
33. • Asbestos fibers are remarkably insulator to heat,
electricity and sound, so they were widely used in industry.
• Asbestos tends to break into very tiny fibers which remain
suspended in air for hours or days.
•Asbestos fibers are resistant to acid, alkali, water, heat and
flame. So, they are environmentally persistent, not
biodegradable and virtually indestructible.
34. Routes of ExposureRoutes of Exposure
• Asbestos containing material is not generally
considered harmful unless it is releasing dust or fibers
into the air where they can be inhaled or (less frequently)
ingested.
• Many of the fibers will become trapped in the mucous
membranes of the nose and throat where they can then
be removed, but some may pass deep into the lungs, or,
if swallowed, into the digestive tract.
• People at risk:
o Construction workers.
o Car mechanics.
o Those exposed at home.
35. Pleuro-Pulmonary Disease due to AsbestosisPleuro-Pulmonary Disease due to Asbestosis
Benign
• Pleural Disease
– Pleural Thickening
(localized or diffuse):
commonest health
consequence of
asbestos exposure.
– Pleural Effusion
– Rounded Atelectasis
• Lung Disease (Asbestosis):
IPF (Latency 15 - 20 Y)
Malignant
• Pleural mesothelioma
• Peritoneal mesothelioma
• Lung Cancer
Cause of Death:
• Cancer: - Bronchial Carcinoma: most common cause of death
- Mesothelioma less common but more characteristic.
• Respiratory Failure.
36. Determining Factors for Development ofDetermining Factors for Development of
Asbestos- Related DiseaseAsbestos- Related Disease
– Level, frequency, and duration of exposure.
There is no “safe” level; any exposure is risky.
– Time elapsed since exposure
– Age at time of exposure
Younger persons more likely to develop disease.
– Smoking history (significantly ↑ risk of lung cancer).
– Individual susceptibility factors (?)
37. • Considered a “signal neoplasm” because of its rarity in
absence of exposure to asbestos.
• Latency: ≥ 20 years.
• Presenting symptoms often are chest pain and dyspnea,
due to pleural effusions.
• Rapidly invasive.
• At high concentrations: cancer of GIT, kidney, pancreas.
Mesothelioma of Pleura / Peritoneum
Restrictive lung diseases are broadly classified into parenchymal and extra-parenchymal groups
Parenchymal restriction results from diseases involving the lung itself.
Interstitial pulmonary fibrosis (IPF) is the most common and most serious among these parenchymal disorders.
Collagenic diseases: like rheumatoid arthritis, scleroderma, systemic lupus erythematosus
Granulomatous: as sarcoidosis
Irradiation: eg, for cancer breast
Resection of part of lung tissue leads to actual loss of functioning parenchyma.
Ankylosing spondylitis: chronic inflammatory condition of the spine (vertebral column: spondylitis) with partial fusion of the vertebrae and limitation of their movement (ankylosis).
The mobility of the joints between ribs and vertebral column (costovertebral joints) is encroached upon.
Reminder about respiratory functions
In obstructive disease, air trapping leads to marked increase of RV. Consequently, FRC and TLC (which include RV) are also increased.
Vital capacity as a whole may be slightly decreased, but limitation of expiratory airflow leads to marked diminution of the earliest (and normally greatest) part of expiratory FVC (FEV1). So, we get marked decrease of FEV1/FVC.
In restrictive disease, all lung volumes and capacities are decreased.
Smoking index: number of packs consumed daily, multiplied by number of years of smoking