What is emphysema? Emphysema is a degenerative disease that usually develops after years of attack by light
tissues from cigarette smoke or other toxins that pollute the air. These toxins destroy the small >> << air sacs in the lungs, called alveoli, that stretch as they carry oxygen from the air >> << in the blood and then shrink as they displace carbon dioxide . As a result, the lungs lose their elasticity
, and exhaling becomes difficult as the damaged lungs trap air and can not effectively
exchange it for fresh air. As the damage progresses, the effort needed to increase breathe
and, ultimately, each breath becomes difficult. Emphysema is a group of lung diseases called chronic obstructive pulmonary disease (COPD), which may interfere with normal breathing. Other diseases that come under COPD include asthma and chronic bronchitis. According to the American Lung Association (ALA), nearly 16 million Americans are estimated to suffer from some form of COPD and COPD is the fourth ranking cause of death just for heart disease, cancer and stroke. ALA believes that 2 million Americans have emphysema in 1998, and smoking is the main cause. Impact of air pollution and irritating fumes and dusts in the workplace, also consider the factors of emphysema. The preferred symptom of emphysema is shortness of breath or feeling unable to get enough air. A person may initially visit the doctor because he or she began to feel shortness of breath during physical activity, but as the progression of the disease, this symptom may be present at all times, as if Gooden, even while sitting quietly. Cough, shortness of breath and chronic mucus production are other common symptoms. Diagnosis, however, can not be based on these symptoms only Saia says. Careful history taking, he says, focusing on the number and duration of these symptoms, as well as smoking and occupational history is essential for diagnosis of this disease. The doctor carefully examine the chest, breathing watch designs, and control how hard people work to breathe. Careful examination will also include noting the degree of inflation of the lungs, listening to the chest by stethoscope to hear the air and light, and listening to heart sounds to determine its rate and rhythm, and no signs of heart strain that may accompany advanced stages of emphysema. In addition, routine tests of lung function can be defined several characteristics and capabilities of the lungs. The following tests may determine the different stages of emphysema:
spirometry: with tubes connected to the vehicle, records and airflow capacity, the patient makes a deep breath and blows it as soon as possible. Measuring the amount of air that can be pushed in one second, and the total amount of air that can be exhaled is the best way to determine the amount of airway obstruction. Arterial blood gas (SAC): ABG analyzes of blood from the arteries of carbon dioxide and oxygen. This test is often used to assess the later stages of emphysema and to determine whether this or that person needs supplemental oxygen. Pulsoksymetriyi: a special world, which is fixed on the finger or ear lobe, may indirectly determine the amount of oxygen in the blood. X-rays: X-rays are not often helpful in early diagnosis of emphysema, but in moderate and severe cases, quite accurate diagnosis can be done with a simple chest X-ray and computed tomography (CAT) scanning. Some of the most common presentation on chest x-ray include the flat membrane, the loss of labeling of blood vessels, and appearance of reduced size of the heart. These and other test results, in comparison to values considered healthy for various age groups, height, weight, sex and race. There are a number of treatments that may help patients with emphysema, but the most important step to quit smoking. Quitting smoking with airway obstruction is mild or moderate slows the development of disabling shortness of breath. However, "to quit at any time during the illness", Saia insists, "gives some advantage." People with emphysema should also try to avoid contact with other air irritants. Broncholytic medicine: This class of drugs works by relaxing muscles around the airways. They are usually prescribed for relief of bronchospasm in patients with reversible obstructive airway disease. Often used to treat asthma, they can be set for emphysema patients if there is a tendency to airway narrowing or tightening. Some of the most common bronchodilator medicines include: albuterol, terbutalin, ipratropiyu bromide and theophylline. Inhaled medications that go directly into the lungs and have less impact on other parts of the body, often tried first because they usually start to work less than five minutes with a low incidence of side effects. "Valuable addition broncholytic treatment of blood used for monitoring pharmacological agents such as theophylline," adds Steven Gutman, MD, director of clinical laboratory devices in the Center for Food and Drug Administration for devices and radiological status. "Although the tests for measuring theophylline have been available for decades," he says, "is still a refinement of this test that make them more accurate and accessible."
Anti-inflammatory drugs (corticosteroids): Since emphysema may be associated with inflammation, doctors may prescribe corticosteroids to soothe and ultimately heal a thin layer of mucous membrane of the air passages, making them more resistant to obstruction. Inhaled steroids are not FDA approved indication for COPD but not used for its intended purpose by many clinicians. The type of steroids contained in these preparations are not the type that builds muscle. Prolonged use of oral corticosteroids is usually associated with different dose-dependent side effects such as osteoporosis (men and women), weight gain and fat redistribution, hypertension, loss of muscle mass and elevated blood sugar. Commonly used corticosteroids include oral drug prednisone and several inhaled corticosteroids. Oxygen therapy: Supplemental oxygen can benefit the patient who has severe lung function disorders and can not absorb enough oxygen from the air. Long-term oxygen therapy prolongs life in patients like Gooden, who have low levels of oxygen in the blood (hypoxemia). This therapy reduces the excess red blood cells, which improves mental activity and heart failure. It can also relieve shortness of breath on exertion. Lung reduction surgery: Emphysema sufferers can find relief from the symptoms of this surgical procedure. It often eliminates the need for oxygen and improves respiratory function. This technique, which is a minimally invasive procedure that requires two or three small incisions made in the chest and a tiny camera inserted through one of the incisions to view the lungs. In another section, a special device is inserted to reduce the binding of the lungs, so that healthy tissue lung has more room for expansion. Prospective patients must undergo rigorous testing to review the operation. Transplantation surgery: Lung transplantation is a highly invasive, complex procedure that carries significant risks. Because of the known complications of any operation to transplant, this option is only viable in a small, selected group of patients. Exercise programs can be done to improve independence lasix 150 mg and quality of human life and reduce the frequency and duration of hospital stay, although lung function does not improve. Gains in air conditioning systems, however, warns Saia, quickly lost if the person stops training. The key to managing emphysema, Saia insists, is to identify the disease early. Methods continue to be developed to help doctors find the first signs so that preventive and therapeutic measures can be instituted. But modern methods of treatment, even those who are seriously suffering from emphysema and out of the house, like Gooden, can be more comfortable and may experience a higher quality of life. Carol Lewis, staff writer for Consumer FDA. For more information on emphysema, contact the following organizations:
Timonium, MD 21093-5156
1719 East Nineteenth Street. Denver, CO 80218
For information on how to quit smoking, contact:
4770 Buford Highway, N. E
Chamblee, GA 30341
WWW. CDC. GOV / NCCDPHP / Osh / resource. HTM 2101
East Jefferson St. Rockville, MD 20852
see the November-December 1997 FDA Consumer There are rare inherited forms of the disease called alpha-1-antitrypsin (A1AD), related emphysema. People with A1AD absence of protective protein alpha-1-antitrypsin (AAT) or alpha-1-proteinase inhibitor. Without AAT, a natural enzyme called neutrophilic elastase that initially fights bacteria and purified the body of the dead tissues of the lungs may rage and eventually damage lung tissue. For people with A1AD, missing or defective protein, alpha-1 may be replaced or supplemented. In December 1987, the FDA approved the first specific treatment for A1AD related emphysema, called Prolastin, which raises the level of AAT in the blood and can protect lung tissue from the destructive enzyme. Replacement therapy derived from human plasma that had been checked and tested for viruses and it is usually taken in weekly intravenous infusion. - C. LD.
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