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ARDS (Adult Respiratory Distress Syndrome)

Adult respiratory distress syndrome is a life threatening condition of the respiratory system which, when it develops, is usually in response to another critical health problem. Normally, the lungs are filled with air and have an elastic quality to them. A person that develops ARDS experiences an overwhelming fluid buildup in both lungs that causes the lungs to become fluid-filled and stiff. Respiratory failure can occur very quickly after ARDS begins, and a breathing machine, called a ventilator and oxygen will likely be necessary to allow adequate breathing. Although ARDS develops very quickly, recovery from ARDS may take weeks or months. Forty percent of people that develop ARDS will die from it. Although many people make a full recovery, some will have lasting damage to their lungs.

For more information on ARDS, check the following web site: http://www.nhlbi.nih.gov

ALPHA-1-ANTITRYPSIN DEFICIENCY

Alpha-1-antitrypsin is a protein that is produced mostly by the liver. One of the functions of this protein is to inhibit a different enzyme, neutrophil elastase. This enzyme normally serves the useful purpose of digesting damaged or aging cells and bacteria in the lungs. Alpha-1-antitrypsin balances the activity of this enzyme by inactivating it, keeping it from destroying healthy, sensitive lung tissue. In people with low levels of alpha-1-antitrypsin, neutrophil elastase is not inactivated, and this enzyme damages healthy lung tissue. Alpha-1-antitrypsin deficiency is an inherited disorder.

Because of the damage caused by unchecked enzyme activity, people with alpha-1-antitrypsin deficiency develop lung disease very early. In a small amount of patients, the liver is affected also.

Symptoms of alpha-1-antitrypsin deficiency are the same as those for chronic obstructive pulmonary disease, however, they develop much earlier in life, and many times in people who have never smoked. If a person with alpha-1-antitrypsin deficiency does smoke, they will develop more severe lung disease at a much quicker rate.

Blood tests will confirm if alpha-1-antitrypsin deficiency is present. Pulmonary function testing and chest x-rays will be done to determine lung function.

Medication is available as an IV infusion given on a weekly basis to provide the deficient alpha-1-antitrypsin. Other medications may be prescribed to treat the symptoms of chronic obstructive pulmonary disease and emphysema. Oxygen may be necessary if the lungs have been damaged significantly. For severe lung disease, lung volume reduction surgery or lung transplant may be an option.

For more information, check the web sites:

http://www.alpha1.org , http://www.lungusa.org., or http://www.nhlbi.nih.gov

LUNG CANCER

Cancer of the lung is the most common cancer among both men and women. Most lung cancers originate from the lining of the tubes in the lung called bronchi, or from the air sacs, called alveoli. Almost 90% of all lung cancers occur in people who smoke or are former smokers. Other possible causes include asbestos exposure, radon and radiation exposure, and secondhand smoke. Some lung cancers can be cured, but only if detected very early, before any spread (metastasis) occurs.

Lung cancer can be divided into two general groups: non-small-cell lung cancer and small-cell lung cancer. Treatment is different for each type of cancer, so determining the specific type of cancer cells present is very important. This is done with a biopsy. A biopsy can be done in different ways, depending on the location of the suspected cancer. A bronchoscopy is the procedure of choice to obtain the biopsy. If this procedure is unsuccessful in providing a diagnosis, a needle aspiration or thoracentesis may be performed. If none of these procedures leads to a definite diagnosis, a surgical procedure called a mediastinoscopy or a thoracotomy may be needed to obtain an adequate specimen.

The signs and symptoms of lung cancer include a persistent cough, coughing up blood-tinged phlegm, wheezing, shortness of breath, recurrent pneumonia, loss of appetite, and weight loss. Sometimes the tumor can press on a large blood vessel and cause swelling of the face and neck, or it may press on a nerve near the lung and cause pain in the shoulder, arm, and hand. Lung cancer can also produce hormones that lead to a variety of syndromes.

When lung cancer has been diagnosed, it must be staged to determine if the tumor has spread to other parts of the body. This helps determine if surgery may be an option for non-small-cell lung cancer. Generally, a PET scan is ordered. This scan looks for areas of high metabolism, which is a characteristic of cancer cells. A mediastinoscopy may also be ordered to check the lymph nodes for spread of cancer cells. For small cell cancer, a CT of the head and a bone marrow biopsy may also be performed to check for spread of cancer to the brain or bone marrow.

Treatment of lung cancer is based on the type of cancer cells present, and the staging of the cancer. With non-small-cell cancer that has not spread to any other parts of the body, surgery to remove the tumor, along with part or all of the lung is the treatment of choice and provides the best hope for cure. For patients with more advanced disease or those whose health will not allow them to tolerate an operation, radiation along, or a combination of radiation and chemotherapy are recommended.

Small-cell lung cancer is treated with chemotherapy or a combination of chemotherapy and radiation, depending on how the tumor is staged.

For more information about lung cancer, check the following web sites:

http://www.nhlbi.nih.gov, http://pulmonarychannel.com, or http://lungusa.org

PNEUMONIA

Pneumonia is an infection and inflammation of the lungs. It occurs when the lungs are exposed to bacteria or viruses not usually present in the lungs. People that are chronically ill, have weakened immune systems, or who are currently sick with colds or the flu are more susceptible to developing pneumonia. Aspiration of gastric or esophageal contents is a common cause of pneumonia in the elderly.

Common symptoms of pneumonia include fever and chills, cough, shortness of breath, chest pain, especially when taking a deep breath, coughing up mucus, and muscle aches. However, these symptoms need not all be present when one has pneumonia. You should see your doctor immediately if you suspect you have pneumonia.

Treatment for pneumonia may involve in the hospitalization, depending on the severity of your symptoms. Pneumonia treated as an outpatient has often been referred to as “walking pneumonia”. Your physician will determine the best place for you to be treated. Your treatment may include antibiotics, rest, breathing treatments, oxygen, etc. Several chest x-rays may be done to monitor your recovery. Usually you will begin to feel better after 3-4 days of antibiotics, though it may take 2-3 weeks before you feel “normal” again.

It is important for you to take all the medication prescribed for you and follow the treatment plan your physician recommends for you. Rest until you no longer have a fever, chest pain, or shortness of breath. Drink plenty of fluids. Use cough medicine only if you have to; it is necessary to cough up secretions. If you are not improving in 2-3 days after taking antibiotics, contact your physician.

PNEUMONIA SHOT

The pneumonia shot protects against a kind of bacteria that commonly causes pneumonia. The pneumonia shot protects you from infection from a bacteria called Streptococcus pneumoniae. Pneumonia caused by this bacteria is called pneumococcal pneumonia, or streptococcal pneumonia. This bacteria can also cause infection in the blood stream, meningitis, (infection of the covering of the brain and spinal cord), and other infections. The vaccination is not 100% effective.

Pneumonia is a term used to describe inflammation or infection of the lungs. Pneumococcal pneumonia is the most common kind of pneumonia. The risk of developing pneumonia increases after age 40 and doubles after age 60. The pneumonia shot cannot protect you from all types of pneumonia, but it can help to prevent the most common form.

Your physician may recommend the shot if you are 65 years or older, have chronic health problems, or a compromised immune system. Generally you will need to have your pneumonia shot updated 5 years after the initial vaccination. You should not take the pneumonia shot if you are allergic to thimerosal or have had an allergic reaction to the vaccine in the past.