Clinical explanation of Bronchiectasis

Permanent dilatation and distortion of the bronchi is called bronchiectasis. What is it’s effect to human health?

Etiology and Pathogenesis:

Most of the cases of bronchiectasis result from acquired causes.

• Obstruction to the bronchus due to any cause leads to distal collapse of the pulmonary segment. The pull on the bronchi by the collapsed alveoli leads to dilatation of the bronchi. In the initial stages this is reversible and the bronchi regain their normal size when the lung expands. If the obstruction persists, accumulation of mucus occurs distally, infection supervenes and the bronchial wall is destroyed permanently.

This results in permanent dilatation. The infective organisms are streptococci, pneumococci, Klebsiella, and anaerobes.

• Bronchiectasis may follow several viral infections without passing through the obstructive phase.

• Congenital defects in the bronchial wall lead to bronchiectasis. The classical example is Kartagener’s syndrome, which is characterized by dextrocardia, sinusitis, and defects of ciliary function in the bronchi and non-motile sperms.

• Middle lobe bronchiectasis is a sequel to pulmonary tuberculosis. This is caused by obstruction to the middle lobe bronchus by tuberculous glands. This is called “middle lobe syndrome” or “Block’s syndrome”.

Clinical features:

The clinical picture is very chronic, extending over several years.

The common site of lesion is the left lower lobe. Though children may be affected, usually symptoms manifest in early adulthood or middle age. Males are affected more than females. Digital clubbing is a prominent sign, sometimes being associated with hypertrophic pulmonary osteoarthropathy.

Postural cough with the production of large quantities of purulent and foul smelling sputum is the presenting complaint in most cases. On keeping for sometime, the sputum settles into 3 layers as described under lung abscess. Hemoptysis may occur frequently. This may be mild or severe. Recurrent infections such as pneumonia may develop. Repeated affection of the same lobe or segment should suggest the possibility of underlying bronchiectasis. Bronchiectasis sicca is the condition in which bronchiectasis presents with mild or severe hemoptysis without purulent sputum.

Physical examination may reveal impairment of the percussion note and diminution of respiratory sounds over the presence of coarse, persistent leathery rales. At times bronchiectasis may present with one of its complications. These include massive hemoptysis, recurrent pneumonia, emphysema, septicemia brain abscess, and cor pulmonale. Anemia develops in long standing cases due to chronic sepsis and recurrent hemoptysis. In untreated cases secondary amyloidosis may develop.

Diagnosis:

Bronchiectasis should be diagnosed by the long history, presence of clubbing, postural cough, coarse leathery rales over the affected part and reasonably normal general health. Once established, bronchiectasis is not curable by medical treatment.

Differential diagnosis

Bronchiectasis should be distinguished from chronic bronchitis and emphysema, lung abscess, tuberculosis, congenital cystic disease of the lung and malignancy. Lung abscess generally develops acutely. The right lower lobe is affected more often and the signs are localized. Tuberculosis is more common in the upper lobes and clubbing is not prominent in uncomplicated cases. Features like digital clubbing and copious sputum are seen in tuberculous bronchiectasis. Cystic disease is not uncommon. All age groups are affected. A long history or recurrent respiratory disease is present in the majority of cases. Clubbing is not prominent. The cysts may be localized or generalized. Clinical distinction from bronchiectasis is difficult. The presence of cysts in other organs like the kidneys, liver, etc, suggests the probability of congenital cystic disease of the lung. X-ray reveals the presence of soap bubble-like or ring shadows.

Diagnosis is confirmed by bronchography. This procedure is absolutely essential for determining the extent and type of bronchiectasis. Plain X-ray of the chest is not a reliable investigation to assess the site and extent of bronchiectasis.

Management

General measures include high protein diet, treatment of intercurrent infections, and removal of focal sepsis from the upper respiratory tract. Principles of specific therapy include postural drainage, administration of antibodies, respiratory exercises and in selected cases surgical excision. Postural drainage helps in clearing the bronchi and brings about relief. The patient should be instructed to practice postural drainage regularly. This gives relief of cough and also the foul smell. The fetid odor of the breath can be controlled by administering steam inhalations containing tincture benzoin or eucalyptus oil. The choice of antibiotic is determined by microbiological studies. Intermittent antibiotic therapy is required to clear infection and prevent exacerbation. The site of lesion may have to be excised if medical treatment fails.

Indications for surgery:

The following are the indications for surgery.

• The disease is localized to one lung or one segment and is not amenable to medical therapy.
• Socio-economic factors such as non-compliance by the patient
• Uncontrollable hemoptysis in which the site of origin of blood may be detected by emergency bronchoscopy and surgical resection has to be planned;
• To reduce the area of infection-even in bilateral disease sometimes surgical resection may have to be done on the more affected side, with a view to reducing the surface area of infection; and
• To remove an obstructive lesion which tends to perpetuate the condition, eg, bronchial growth or bronchostenosis?

I am Funom Theophilus Makama. I advertise through writing. As a platinum expert Author, I write lots of articles and hence promote interested websites, companies, groups, organizations, and communities through publishing and distributing my articles

Small Business Web Design And Development

The demand for Information Technology has driven many people to delve into its world. As software designs become more user-friendly, creating Web site designs is fast becoming a hobby for a number of people. But there are also many entrepreneurial individuals who make Web design and development a source of income. These sophisticated acts of programming and designing are not the exclusive domain of big IT companies anymore.

Small businesses with limited budgets earmarked for marketing and stakeholder management should take advantage of the growing number of Web designers and developers. This means more creative concepts and technological know-how to choose from and work with. A well-constructed site can draw in many potential customers and result to higher sales revenue. With a Web site, small businesses can develop structures that will build a stronger relationship with clients through company e-magazines, chat rooms and other feedback mechanisms. A Web site is also accessible by millions of people all around the world, 24 hours a day, seven days a week. This means that companies with Web sites have that much audience and room for growth. This is below-the-line marketing at its best.

Finding the right kind of Web developer is of course a big challenge. Most times you will meet them for the first time in the bidding process where they will outdo each other with impressive concept presentations. But a good small business Web designer and developer goes beyond producing the best Web site for the client. He or she gives a comprehensive after sales service program– like troubleshooting, Web management and maintenance, and hosting. This is important especially for small businesses that do not have their own IT departments or staff dedicated to the Web site. In the long run, companies that offer these kinds of services give more value and appeal to their products.

Career Employment Online – Find Professional Work at Home and Get Paid

Plenty of research goes into finding the best career employment online. Below is a list of professional working companies who are looking to hire now and you can work from home if this is something you are looking to do. Great paying jobs and you can get started right now once you apply. You will not have to pay a fee.

Sun Oasis

Many writing assignments to keep you busy. You can make some great money. Weekly newspapers, educational publishing companies, copy writing groups, and business web site building. This company is also looking for proof readers.

Solo Gig

Anything and everything when it comes to consulting work. Experience professionals are needed in IT, accounting, healthcare, sales and marketing, technical writers, account executive, etc. Some of the jobs here are paying $350.00 Per hour. Make sure you check out Solo Gig.

Writer Find

This is a site that is updated always with all the latest jobs pertaining to writing. You will also find a mailing list you can sign up with. The competition is fierce here so make sure you are one of the first to know about any new assignments. Make sure you sign up. This is a great site to be a part of. Look for Writer Find Freelance Jobs

Auto Club Renewals

Renewal specialist positions are available. You will call existing members of a fortune 500 company. You must have a friendly energetic voice, strong sales, and inbound and outbound calling experience. Hours are 3:00PM – 9:00PM Monday through Friday and working every other Saturday. They are still hiring. Go to the site for more information.

Call Desk

They are hiring in the state of Oregon. You will become an employee and not a independent contractor. You must have experience in customer service. They are looking forward to receiving your cover letter and resume. Look up Call Desk Agents.

Content Current

Contract writers are needed for article writing, forum posting and custom writing tasks. You can get paid every week and you can pick your own writing tasks from thousands of offers. If you are a good writer, you will be paid nicely. You can pick the hours you want too. Make sure your register to become a writer.

Alpine Access

This company is hiring home based agents. The goal of this company is to to provide world class customer service to their clients. You will work from the comfort of your home as a employee not a contractor. The Alpine advantage. Become a part of it. Hiring English speaking, Spanish, Cantonese and Mandarin customer service reps. They are hiring now.

Lung Cancer Symptoms – Disease and Treatment Options

The picture of lung disease is that of no hope. Lung cancer affects millions of Americans and others around the world. Understanding the symptoms, treatments, causes such as smoking, and signs will help to increase awareness of this debilitating lung disease. This section of the website is devoted to helping to promote awareness of this disease.

Just what is Lung cancer? It’s a condition in which cancerous cells grow uncontrollably and reproduce cause devastating effects on the lungs. Healthy cells are replaced by abnormal cells that turn into tumors that destroy the lungs.

There are tow main types of lung disease. They are non-small cell which current accounts for 80% of diagnosed cases, and small cell making up the remaining 20%. Lung cancer usually always starts in just one lung. If left untreated, it can spread to other vital organs of the body as well such as the lymph nodes, the brain, bones, and liver just to name a few.

Although over eighty percent of patients develop lung disease due to smoking, this is not the all-inclusive cause. Studies have shown that many environmental factors influence the probability of contracting lung cancer. Such factors include environmental pollution, toxic gas emissions, and exposure to carcinogens such as in asbestos and other toxic inhalants.

Small cell is most often caused by smoking tobacco. The early symptoms and signs of this form of lung disease may show up as persistent coughing that gradually increases over time, sputum changes in color and quantity, excessive wheezing, loss of appetite and chronic fatigue. Other related symptoms could include rapid weight loss, unexplained back pain, and swelling in the face and neck.

Like all cancers, early detection is the key to increasing the survival rate. Doctors may use a variety of tests to diagnose cancer cells in the lungs. These include a physical examination accompanied with advanced image scanning of the chest and lungs.

The following tests may be used to diagnose lung cancer: CT scans (takes 2 dimensional x-ray pictures of the lungs), chest x-rays of the lung cavity, MRI or magnetic Resonance Imaging, PET scan or Positron Emission Tomography which uses cellular reactivity to sugar, and a biopsy which is removing part of the tissue for further microscopic examination.

Other no so intrusive tests may incorporate the use of a bronchoscop where the physician is able see the lungs and surrounding areas through a small hollow tube that magnifies the images, and sputum cytology – where a sample phlegm is taken and analyzed with a high powered microscope for abnormal cell growth and tissue.

Doctors have a variety of methods in lung caner treatment. They include the use of various conventional medical practices such as surgery, chemotherapy, and radiological therapy. Once a diagnosis of confirmed, only then will your doctor design a treatment plan that will be most effective. This all depends on your current health, how advanced the cancer is, and on whether the cancer has mastasized.

The way to protect yourself is to increase your awareness by visiting information sites that contain pictures, photos, and new articles about this disease. Prevention is the key, and if you are beyond that, then early detection holds the greatest chance of your survival rate. Your may want to look into alternative treatments as well which will be available from this site with promising results.

Small Business Web Design – Enhance Online Presence

With an efficiently designed website, small business dealers can create a good impression and attract more people to their business. Small business web design services are now provided by leading companies in the field which aim at enhancing the online presence of their clients, thereby bringing more visitors to these websites.

Small business web design companies utilize the services of web developers and talented SEO professionals. Depending on the business owners’ needs, they carry out any sort of web design including data driven, custom, multimedia, flash, and E commerce. These providers can also redesign your existing website for a better look.

With creatively designed websites, proper communication with the website visitors can be attained. An ideal designer highlights the company products and information, appropriately blending graphics and advertising tools. Web designers take care of all aspects involved such as planning, designing, page layout and final finishing touches.

Besides having search engine optimized content, websites have to be effectively designed if you want to attract the right people to your business. To draw more customers, web designers normally utilize effective web design tools. Java, Flash, Video, Audio, CSS based and fast loadable websites are designed by the professionals. Incorporating innovative technology programs such as XML, MySQL, XHTML, PHP, and Javascript, they provide attractive website designs.

Professional website designing is available for all kinds of websites such as those dealing with real estate, finance, E-commerce, education, medicine, family, teens and more. Nowadays these services are available at economical rates to meet the needs of small businesses and home based businesses.

A perfectly designed website will be search engine friendly, meta tag optimized and properly linked with the other pages. So, if you wish to redesign your existing website or are planning to design a new one for your small business, ensure that you associate with a reliable and experienced web design service provider.

Comparing Online Travel Services To Your Local Travel Agent

Sites such as Expedia, Orbitz, and Travelocity claim to offer the best price – sometimes even guaranteed. They may even claim to offer the best rates on a luxury world cruise, a trip that travel wholesalers publicly prefer to be sold by agents. The emergence of online travel sites have put many agencies out of business, and claim to have conquered the consumer base by offering quality product at a lower cost. When you call your local travel agency and ask for a price quote on an air and hotel luxury travel vacation package, most consumers will check against one of the more popular travel websites to see what prices better. True, two thirds of the time, you will find that the Internet will beat the travel agent price by about $150. The travel website will assure you that it is the same package. The resorts and hotels are aware that you are going to be in the most unfavorable rooms, in fact, that is why they sold them to the Internet travel site at a discounted rate in the first place.

Travel service sites proudly proclaim that they are able to further save customers money by selling large volumes of travel and collecting a smaller fee. Orbitz and Travelocity do have a large volume of travel reservations made, but what little they make in commission they make back in changed or canceled reservations. Most travel agencies offer a travel insurance that covers you and your travel companions if you should have to cancel for a medical or personal emergency.

American Express Travel offers a cancel for any reason insurance that even covers your airline tickets. These Internet booking engines are now beginning to offer “insurance,” but it rarely covers cancellations in full. Your local travel agent is there to offer the customer care you need back at home while you’re traveling abroad. When it comes to planning luxury travel vacation, you are truly better off using a travel agent. If you don’t like your room, your travel agent can have it fixed in a matter of moments. Travel agents are not focused on quantity, but quality. So travel safe, not sorry, and call a travel agent to hear more benefits that each agency offers their clients

Healthy Family Lifestyle

This article discusses the influence of the family on a healthy lifestyle.

Diseases: A healthy family lifestyle always begins with a disease free lifestyle. A hundred years ago, people succumbed to communicable diseases like small pox, cholera, malaria, dysentery, tuberculosis etc. To a large extent, these diseases are well under control today if not totally eliminated from the face of the earth, thanks to advances in scientific research. Nowadays, we are plagued with different diseases. The world is plagued with modern diseases like AIDS, obesity, cancer, diabetes, cardiovascular diseases etc. Here are some alarming statistics:

o Cardiovascular diseases and stroke claim almost 18 million lives a year worldwide
o 750 million people worldwide are overweight of which 300 million are obese. Obesity is a more serious form of overweight and has been classified as a chronic disease
o This year about 547,000 Americans will die of cancer. Globally, approximately 7.6 million people die from cancer each year
o According to the American Diabetes Association, Type 2 diabetes grows annually at a rate of 5% since 1990

Prevention is better than cure. Healthy family lifestyle will mitigate many health risks only if you are aware of what is at stake. Educate your family about the diseases, and what they must do to prevent them.

Role of parents as role models: Children often look up to their parents as role models. Parents can influence children to a large extent to make a good start in life by inculcating in them good values. A healthy family lifestyle is a good starting point. It will instill in them the right values that they can pass on to their own families in future.

Healthy family lifestyle will require attention to the following areas:

1. Foods: Fundamentally important to healthy family lifestyle are foods and diets we ingest daily. It is a well known medical fact that foods have a very large role to play in the state of our health. Educate your family about good and bad food habits, but what better education there is than providing wholesome and nutritious foods for the family as a starting point. For example:

o Eating a balanced diet is important for the heart as well as making sure your family gets all the nutrients they need to grow.
o Avoid or reduce the intake of certain foods for example fast foods; these are often loaded with fats, salt and sugar and low in complex carbohydrates.
o Eating more plant based foods like fruits, vegetables, beans and legumes.
o Reducing sugar intake and avoid sugary drinks, salt and salt related food products like preserved meats (bacon, ham)

2. Maintaining right body weight: This is the single most important factor in maintaining a healthy family lifestyle. Many dreaded diseases owe their origins to overweight and obesity. Foremost among them are Type 2 diabetes, thyroid problem, cardiovascular disease, hypertension and many types of cancer. The importance of maintaining a healthy body weight can never be over-emphasized enough.

3. Exercise: Impress upon the importance of exercise. It is highly recommended for all of us to have half an hour of vigorous exercise or one hour of less vigorous exercise a day. Set a good example by doing it yourself. Lead a more physically active lifestyle and get the whole family involved. Get the children to play less computer games and more outdoor sports. Lead by example; don’t be a couch potato yourself! Do everything together the healthy family lifestyle way.

4. Smoking: Quit smoking. Cigarettes are known to be a leading cause for lung cancer and a host of other serious ailments. Besides, you don’t want your family exposed to second hand smoke, do you? Educate your children about the dangers of tobacco.

Healthy family lifestyle requires serious effort and commitment from you chiefly as the head of the family and co-operation from the whole family. The benefits far outweigh the effort.

The Travel Career in nursing and it is Advantages

There are quite a bit of profession prospects accessible to nurses today. Nurses can be found in various medical areas a variety of medical establishments for instance hospitals, schools, government, medical clinics, nursing homes, administration, plus more. One sort of nursing job that may be now being chosen by more nurses because several positive aspects will be the travel career in nursing.

A travel nurse is usually a nurse who goes toward areas everywhere over the nation and works for a medical facility for any set specific time. These nurses are replacement workers for nurses who’re away for reasons like if they’re on the holiday to have an extended period of time. Since the nursing positions are temporary, the employer will be expecting a nurse who does not have for being trained or supervised.

As a travel nurse, you require some important qualifications. You will need to be considered a licensed nurse that completed the nursing program from a certified school for nursing. It’s also advisable to been employed by being a nurse for the year or higher. Employers rely on travel nurses to be prepared to leap into work can be with the necessity for supervision or much training. To obtain a job as a travel nurse, most nurses will join a nurse recruiting agency.

A nurse recruiting company assists employers in the healthcare industry hire travel nurses to temporarily replace nurse on leave. Upon joining a staffing company, every one of the specifics of the nurse such as qualifications is set up a database. When an employer requests a nurse for the short term job vacancy, the agency will quickly realize the proper nurse to complete the job. The agency will help make a phone interview between the employer and nurse, assist the nurse with pay for it for travel, get the right nursing licenses, and help with finding suitable housing. A nursing staffing company could also offer courses to help keep nursing skills and knowledge on issues within the medical industry.

You can find nurse staffing agencies that provide nurses to employers needing temporary workers. As effectively, a travel nurse in most cases obtain compensation for travel relates expenses. There can also be a housing compensation and medical insurance benefits. Using a travel nursing career, flexibility is really a benefit as a nurse can choose the type of work assignment that meets the requirements and preferences. They even have a holiday between work assignments. As nicely, this can be a fun and lucrative way to see the country. If a nurse isn’t ready for any full-time career available as one place, travel nursing is a superb choice.

Nursing travel jobs tends to make a lucrative income because these nurses need to be experienced and ready to travel and begin work competently the first day. For nurses trying to travel as well as a great living, the travel nursing profession may be the solution. They also receive the good thing about working in different medical environments and experience new places. When nurses attempt this kind of career, they soon discover travel nursing is often a rewarding and lucrative career.

The Travel Career in nursing and it is Advantages

There are quite a bit of profession prospects accessible to nurses today. Nurses can be found in various medical areas a variety of medical establishments for instance hospitals, schools, government, medical clinics, nursing homes, administration, plus more. One sort of nursing job that may be now being chosen by more nurses because several positive aspects will be the travel career in nursing.

A travel nurse is usually a nurse who goes toward areas everywhere over the nation and works for a medical facility for any set specific time. These nurses are replacement workers for nurses who’re away for reasons like if they’re on the holiday to have an extended period of time. Since the nursing positions are temporary, the employer will be expecting a nurse who does not have for being trained or supervised.

As a travel nurse, you require some important qualifications. You will need to be considered a licensed nurse that completed the nursing program from a certified school for nursing. It’s also advisable to been employed by being a nurse for the year or higher. Employers rely on travel nurses to be prepared to leap into work can be with the necessity for supervision or much training. To obtain a job as a travel nurse, most nurses will join a nurse recruiting agency.

A nurse recruiting company assists employers in the healthcare industry hire travel nurses to temporarily replace nurse on leave. Upon joining a staffing company, every one of the specifics of the nurse such as qualifications is set up a database. When an employer requests a nurse for the short term job vacancy, the agency will quickly realize the proper nurse to complete the job. The agency will help make a phone interview between the employer and nurse, assist the nurse with pay for it for travel, get the right nursing licenses, and help with finding suitable housing. A nursing staffing company could also offer courses to help keep nursing skills and knowledge on issues within the medical industry.

You can find nurse staffing agencies that provide nurses to employers needing temporary workers. As effectively, a travel nurse in most cases obtain compensation for travel relates expenses. There can also be a housing compensation and medical insurance benefits. Using a travel nursing career, flexibility is really a benefit as a nurse can choose the type of work assignment that meets the requirements and preferences. They even have a holiday between work assignments. As nicely, this can be a fun and lucrative way to see the country. If a nurse isn’t ready for any full-time career available as one place, travel nursing is a superb choice.

Nursing travel jobs tends to make a lucrative income because these nurses need to be experienced and ready to travel and begin work competently the first day. For nurses trying to travel as well as a great living, the travel nursing profession may be the solution. They also receive the good thing about working in different medical environments and experience new places. When nurses attempt this kind of career, they soon discover travel nursing is often a rewarding and lucrative career.

Small Business Web Design – Enhance Online Presence

With an efficiently designed website, small business dealers can create a good impression and attract more people to their business. Small business web design services are now provided by leading companies in the field which aim at enhancing the online presence of their clients, thereby bringing more visitors to these websites.

Small business web design companies utilize the services of web developers and talented SEO professionals. Depending on the business owners’ needs, they carry out any sort of web design including data driven, custom, multimedia, flash, and E commerce. These providers can also redesign your existing website for a better look.

With creatively designed websites, proper communication with the website visitors can be attained. An ideal designer highlights the company products and information, appropriately blending graphics and advertising tools. Web designers take care of all aspects involved such as planning, designing, page layout and final finishing touches.

Besides having search engine optimized content, websites have to be effectively designed if you want to attract the right people to your business. To draw more customers, web designers normally utilize effective web design tools. Java, Flash, Video, Audio, CSS based and fast loadable websites are designed by the professionals. Incorporating innovative technology programs such as XML, MySQL, XHTML, PHP, and Javascript, they provide attractive website designs.

Professional website designing is available for all kinds of websites such as those dealing with real estate, finance, E-commerce, education, medicine, family, teens and more. Nowadays these services are available at economical rates to meet the needs of small businesses and home based businesses.

A perfectly designed website will be search engine friendly, meta tag optimized and properly linked with the other pages. So, if you wish to redesign your existing website or are planning to design a new one for your small business, ensure that you associate with a reliable and experienced web design service provider.