Tuberculosis, Lung Health and Respiratory Diseases

Early detection and treatment of cardiopulmonary disease is critical for correcting organ damage and avoiding further harm. The signs and symptoms of cardiopulmonary disease vary greatly and are frequently determined by the underlying condition(s) causing heart and/or lung failure. Understanding the disease's coursprecise diagnosis and best treatment strategy.Gastroesophageal reflux disease (GERD) is a disorder in which the oesophagus becomes irritated or inflamed as a result of acid backing up from the stomach. GERD is characterised by heartburn and regurgitation. GERD can result in esophageal and extra-esophageal disorders. One of the most common and difficult extra-esophageal disorders is GERD respiratory symptoms. It is linked to a variety of respiratory disorders, including asthma, pulmonary fibrosis, cystic fibrosis, and obstructive sleep apnea syndrome.

Early detection and treatment of cardiopulmonary disease is critical for correcting organ damage and avoiding further harm. The signs and symptoms of cardiopulmonary disease vary greatly and are frequently determined by the underlying condition(s) causing heart and/or lung failure. Understanding the disease's coursprecise diagnosis and best treatment strategy.Initial research suggests that HIV-positive people are more likely to develop chronic lung disorders such as chronic obstructive pulmonary disease, but most studies have relied on single-center designs, lacked HIV-negative controls, or tested lung function using solely spirometry. We looked at spirometry and single-breath diffusing capacity for carbon monoxide (DLCO) variations in people with and without HIV. DESIGN A cross-sectional, observational study was conducted. METHODS Participants were recruited from the Multicenter AIDS Cohort Study, a four-site longitudinal cohort study of MSM (both HIV-positive and HIV-negative). At normal study visits, all eligible, consenting individuals underwent standardised spirometry and DLCO testing. Using linear and logistic models, we looked for links between HIV status, spirometry, and DLCO findings.

Early Detection & Intervention

Early detection and treatment of cardiopulmonary disease is critical for correcting organ damage and avoiding further harm. The signs and symptoms of cardiopulmonary disease vary greatly and are frequently determined by the underlying condition(s) causing heart and/or lung failure. Understanding the disease's coursprecise diagnosis and best treatment strategy.Medical and technology advancements give more effective treatment options for patients at all stages of cardiopulmonary disease. For severe or advanced heart and/or lung failure, our multidisciplinary team of cardiologists, cardiac surgeons, pulmonologists, thoracic surgeons, intensivists, and other specialists excels in mechanical circulatory support (such as ventricular assist devices and extracorporeal membrane oxygenation) and transplantation. The team collaborates closely to determine the treatment or combination of treatments that will best meet the needs of each patient.

Treating Heart & Lung Failure

Early detection and treatment of cardiopulmonary disease is critical for correcting organ damage and avoiding further harm. The signs and symptoms of cardiopulmonary disease vary greatly and are frequently determined by the underlying condition(s) causing heart and/or lung failure. Understanding the disease's coursprecise diagnosis and best treatment strategy.Medical and technical improvements have resulted in more effective treatment options for patients suffering from cardiopulmonary illness at all stages. Our multidisciplinary team of cardiologists, cardiac surgeons, pulmonologists, thoracic surgeons, intensivists, and other specialists excels at mechanical circulatory support (such as ventricular assist devices and extracorporeal membrane oxygenation) and transplantation for severe or advanced heart and/or lung failure. The team collaborates closely to determine the optimum treatment or combination of treatments for each patient's needs.

Many people believe that palliative care can be harmful. Some oncologists are concerned that palliative care kills patients' hope. Previous study on the effects of palliative care on survival has yielded conflicting results. The Portland researchers, on the other hand, write that their new findings "help dispel the belief that early palliative care among patients with lung cancer is associated with shortened survival."

The study found that providing palliative care soon after a lung cancer diagnosis increased survival. According to the researchers, it is more beneficial when included in the early disease treatment rather than as part of the dying process. They conclude that palliative care, in addition to cancer treatment, should be regarded a complementary option in patients with advanced lung cancer.

Symptoms may start suddenly and get worse quickly. They include:

• Extreme shortness of breath and trouble breathing
• Tightness and pain in the chest
• Wheezing, coughing
• Paleness
• Sweating
• Bluish nails and lips
• Pink, frothy mucus coming from nose and mouth

If pulmonary edema is related to congestive heart failure, symptoms may come on more slowly. You may notice shortness of breath when you are lying down, quick weight gain from retaining fluid, and fatigue.

What Causes It?

The most common cause of pulmonary edema is heart failure. But not every case is due to heart problems. Other risk factors for pulmonary edema include:

• Acute, severe asthma
• High blood pressure, including preeclampsia
• Diabetes
• Coronary or valvular heart disease
• Obesity
• Being at a high altitude, especially exercising
• Central nervous system injury
• Infection, including pneumonia
• Hanta virus
• Breathing in toxins
• Having a blood transfusion
• Tonsilectomy

Climate change is a reality that, according to recent forecasts, will worsen in the next years. Climate change poses a significant threat to respiratory health: 1) by directly causing or exacerbating respiratory disorders; or 2) by increasing exposure to respiratory disease risk factors. Climate change increases the amount of pollen and allergens produced by each plant, mould proliferation, and outdoor ozone and particulate matter concentrations at ground level. Asthma, rhinosinusitis, chronic obstructive pulmonary disease (COPD), and respiratory tract infections are the main causes of concern. Individuals with pre-existing cardiac disorders or those from underprivileged backgrounds are more vulnerable to the consequences of climate change. Adaptation and mitigation strategies are urgently required.

Common endocrine diseases can have a variety of effects on the respiratory system, ranging from an increased risk of certain infections in diabetics to upper airway constriction in goitres. Many studies of pulmonary physiology in people with endocrine problems have been conducted, with some revealing clinically significant functional abnormalities. However, physiologic anomalies in other investigations did not transfer into clinical dysfunction, but they did contribute to our understanding of lung parenchymal growth and development, responsiveness to extrathoracic stimuli, and possibly even ageing. The effects of various endocrine disorders on the pulmonary system are discussed in this chapter.

• Diabetes Mellitus
• Thyroid Disorders
• Hyperthyroidism
• Hypothyroidism
• Parathyroid Diseases

Atelectasis and pneumothorax are conditions in which one or more lungs collapse, resulting in chest pain and trouble breathing.

When one or more lobes (parts) of the lung collapse due to a blockage or pressure inside or outside the bronchial tubes in the lungs, this is referred to as atelectasis. Because of the blockage, air becomes trapped, causing a sensation of shortness of breath. Blocked drains can be caused by:

• Mucus plug
• Tumor
• Inhaled foreign object

The accumulation of air or gas in the pleural space (the area between the lung and the chest wall) causes the lung to collapse. This could be caused by physical lung trauma, such as a wound. The condition is known as spontaneous pneumothorax when there is no apparent reason.

Asthma is a chronic disease that makes lungs harder and affects the airways that carry air to and from the lung which leads to swelling or inflammation of the airway wall. This swelling or inflammation makes the airways extremely sensitive to irritations and increases your susceptibility to an allergic reaction. As inflammation causes the airways to become narrower, less air can pass through them, both to and from the lungs which makes difficult to breathe. Thus the patience suffers from symptoms like wheezing (a hissing sound while breathing), chest tightness, breathing problems, and coughing.

• Asthma
• COPD
• Cystic Fibrosis
• Lung Cancer
• Tuberculosis
• Bronchitis
• Pneumonia
• Emphysema

COPD is a disease involving airway inflammation and thickening.  It also involves the destruction of oxygen-exchanged lung tissue. The Global Initiative for Chronic Obstructive Pulmonary Disease is described as "preventable and treatable disease, characterized by an incompletely reversible airflow limitation, which is usually progressive and is associated with an abnormal inflammatory response to harmful particles or gases. This gradual and relentless loss of lung disease is caused by emphysema caused by the destruction of the lung parenchyma. Smoking (long term smokers), chronic bronchitis, genetic factors (genes) and due to chronic inflammation and fibrosis as well as elasticity The resulting loss of small airway narrows, which leads to gradual airflow limitation, air capture, and further shortages of breathing in motion.

Tuberculosis is a chronic inflammatory infectious disease which is caused by the bacteria, Mycobacterium tuberculosis. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections are asymptomatic, known as latent tuberculosis. About 10% of latent infections progress to active disease, if left untreated, mostly kills about half of those infected. Symptoms of active TB are chronic cough with blood-containing sputum, night sweats, one weight loss and fever. Infection of other organs can cause a wide range of symptoms including bones and joint pains, chest pain, neurological disorders and chronic pulmonary or respiratory distress etc

Mycobacterium bovis is the main causative agent of bovine tuberculosis (BTB) that causes zoonotic tuberculosis (TB) in humans. Bovine TB is mostly acquired from domestic animals and their products, in which cattle’s are the major reservoir. The disease results in huge economic loss, particularly in urban and per-urban cross breed dairy cattle due to mortality, low productivity and carcass condemnation as well as trade restrictions of live animals, products and by products of animals. To prevent and control zoonotic TB, veterinary sectors must be cross sectored in controlling the disease in its animal reservoir, developing diagnostic tools for diagnosingM. bovis, strengthening surveillance systems and assessing economic impact.

TB diagnosis includes microbiological studies such as sputum, alternative sampling, PCR.  Immunological test involves ALS assay, transdermal patch, tuberculin skin test, mantoux skin test, heaf test, CDC classification of tuberculin reaction, BCG vaccine and tuberculin skin test, Adenosine deaminase, Nucleic acid amplification tests (NAAT), Full blood count & Interferon-? release assays.

TB prevention and control efforts depend primarily on the vaccination of infants and the detection & treatment of active cases. The World Health Organization (WHO) has achieved some success with rapid diagnostics and improved treatment regimens. US Preventive Services Task Force (USPSTF) endorses screening those who are at high risk for latent tuberculosis with either mantoux tuberculin skin tests or interferon- release assays. Prevention of TB consists of two main parts. The first part of preventing TB is to cease the transmission of tuberculosis from one person to another. This can be done firstly, by identifying people with active TB infection, and then curing them by providing the drug treatment. With the provision of proper TB therapy someone with TB will not be infectious very quickly, and so cannot spread the disease to others. The second main part of preventing TB is to prevent people with latent TB infection from developing active infectious TB disease.

TB and HIV co-infection is that where people have both, either latent or active TB disease and also HIV infection. In addition to HIV infection is speeding up the progress from latent TB infection to active TB disease, in accordance TB bacteria also enhance the progression of HIV infection. Than many other opportunistic infections, TB occurs earlier in the course of HIV infection. In co-infected individuals, the risk of death is also twice that of HIV infected individuals without TB, even when antiretroviral therapy and CD4 cell count are taken into account. The provision of anti TB drug therapy and HIV antiretroviral treatment at the same time involves a number of potential difficulties including: A high pill burden, Drug – drug interactions, Cumulative drug toxicities.

TB and Diabetes co-infection: Poorly controlled diabetes can lead to numerous complications, including neuropathy, vascular disease, and increased susceptibility to infection. Diabetes may also lead to increased susceptibility to the disease via multiple mechanisms that are caused by M. tuberculosis.

There are even other co-infections with Tuberculosis such as malaria, Typhoid fever, Dengue, hepatitis.

Multidrug-resistant TB (MDR-TB) begins when an antibiotic fails to eradicate all the bacteria that it targets, with the surviving bacteria producing resistance to that antibiotic and usually others at the same time. Primary Multidrug resistant, MDR-TB occurs in patients who was not earlier been infected with TB but who became infected with a strain which is resistant to the treatment. Acquired multidrug resistance for TB occurs in patients during treatment with a drug regimen that is not competent of killing the particular strain of TB with which they have been infected. MDR-TB requires treatment with second-line drugs, often four or more anti-TB drugs for a minimum of 6 months and a maximum for 18–24 months, if rifampin resistance has been identified in the specific strain of TB with which the patient has been infected. Under ideal program conditions, MDR-TB cure rates can approach 70%. In general, second-line drugs are less effective, more toxic and much more expensive than first-line drugs.

Clinical trials are concerned with diagnosis and treatment of the disease. The development of drug-resistant TB (XDR-TB) and multidrug-resistant TB (MDR-TB) are extensively a rising global health problem. A recent advance in the progress of new drugs & regimens provides hope that may be well effective, tolerated and shorter-duration treatment for tuberculosis will become available. During clinical trials they promote research within local TB control programs through association on clinical research of importance to public health settings, and to provide a platform for internatiseases and Tuberculosis.onal collective research of consequence to both domestic and universal TB control.

Rapid urine-based screening for Tuberculosis in hospitalised patients in Africa to reduce AIDS-related mortality. Thibela TB is the mass screening and treatment plan in mining communities, The ZAMSTAR trial is the community TB testing and counselling, Diabetes correlated with increased risk of TB in the United Kingdom are some of the latest clinical trials or the projects going-on to reduce the risk of Tuberculosis.

As of 2011, the only available vaccine is Bacillus Calmette-Guérin , is a vaccine for  tuberculosis disease. Many people have been BCG-vaccinated. BCG is primarily used as a vaccine in many countries which is a high aid for preventing TB as childhood tuberculous meningitis and miliary disease. Tuberculosis can be treated by taking several drugs for 6 to 9 months.  There are 10 drugs which are presently approved by FDA  for treating TB. Out of the approved drugs, the first-line anti-TB agents that form the basis of treatment regimens include: isoniazid, pyrazinamide rifampin, ethambutol, streptomycin. Once the TB patient is known to be fully susceptible to ethambutol or streptomycin, it can be discontinued.

Directly observed therapy (DOT) is mainly recommended for all the patients. With DOT treatment, patients with the above regimens can shift to 2 to 3 times per week dosage after an initial 2 weeks of daily dosing. Patients on twice-weekly dosing should not miss any doses. Require daily therapy for patients on self-administered medication.

A Lung infection affects lungs, either in the larger airways or in the smaller air sacs. There is a build-up of pus and fluid, and the airways become swollen, making it difficult  to breathe. Chest infections can affect the people of all ages. Young children and the elderly are most at risk, as well as people who are ill and smokers. A chest infection can be serious for these people.

Advanced  diagnostic techniques such as X-ray and echocardiography is used to diagnose lung diseases and lung function tests is another test to determine lung cancer disease. This is a medical process involving the pleural cavity and other thoracic internal examination, biopsy and resection of the disease or mass. Thoracoscopy may be sedation under general anesthesia or local anesthesia. Surgical biopsy is a better way to diagnose lung cancer standards. Must wear appropriate masks & monitor exposure and in some working environments it is important to take precautions. Chronic obstructive pulmonary disease is a gradual process that causes difficulties in the death of respiratory failure or its associated lung disease and is the process of stopping smoking.

Persons with latent TB infection do not feel sick and do not have any symptoms. They are infected with M. tuberculosis, but do not have TB disease. The only sign of TB infection is a positive reaction to the tuberculin skin test or TB blood test. Persons with latent TB infection are not infectious and cannot spread TB infection to others

The TB bacteria overcome the defenses of the immune system and begin to multiply, resulting in the progression from latent TB infection to Active TB disease. Some people develop TB disease soon after infection, while others develop TB disease later when their immune system becomes weak.

Tuberculosis epidemiology is the field of science that is concerned with the study of health and disease within populations and the various circumstances that lead to these conditions, with a goal of preventing the spread of disease. One-third of the world's population has been infected with M. tuberculosis. 13.7 million Chronic active cases, were reported by 2007 and 8.8 million new cases were roughly calculated in 2010 and 1.45 million deaths, are frequently noted in developing countries.  Out of these, 0.35 million deaths occur in those co-infected with HIV. In 2012, around 450,000 people developed MDR-TB. TB incidence varies with age. In Africa, TB chiefly affects adolescents and young adults. However, in United States, TB has gone from high to low incidence, where TB is mainly a disease of older people, or of the immunosuppressed.

Since 1985, Lung cancer has been the most quotidian cancer in the globe. Worldwide, lung cancer, new cancer diagnosis and cancer fatalities. COPD is the fourth leading cause of death in the United States and is related to age. Lung cancer intensifies with age, especially after age 60. The average age of patients diagnosed with lung cancer is 70 years.

The effect of psychological strain on lung function, illness aggravation, mortality, and health-care resource utilisation has been widely documented.

Because of the significant prevalence of psychological distress in COPD patients (Chetta et al 2005; van Manen et al 2002). How will this be adequately evaluated, assessed, and treated as needed?

There is mounting evidence that people with COPD have higher levels of depression and anxiety than people with other chronic health problems.

According to this study, psychological distress has a negative impact on an individual's physical symptoms of COPD. The quality of life suffers as well. Anxiety and sadness levels are more strongly associated to quality of life than physical COPD symptoms.