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Sunday, January 17, 2016

Most Common Diseases of elder: Bronchiectasis (Respiratory Disease) – The Symptoms

Kyle J. Norton(Scholar and Master of Nutrients, all right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Respiratory Disease is defined as medical conditions which affect the breathing organ and tissues including Inflammatory lung disease, Obstructive lung diseases, Restrictive lung diseases, Respiratory tract infections, trachea, bronchi, bronchioles, alveoli, the nerves and muscles breathing , etc,.

                                              Bronchiectasis

Bronchiectasis is defined as a condition chracterized by the damage of the localized, irreversible dilation of part of the bronchial tree and the walls of the large airways of the lung as a result of the destruction of the lung muscles and elastic tissues. Bronchiectasis can be present alone, but in most cases, it is a disease coexisted with patient of chronic obstructive pulmonary disease (COPD).


                                                   The  Symptoms


1. Chronic cough and Increased amount of sputum production
Substantial similarities in composition between normal human and canine mucus and in mucus isolated from dogs with chronic airway inflammation induced by repeated irritant exposure and from human patients with chronic bronchitis, according to the study by Department of Pathology, Children’s Hospital, Boston(1).

2. Night-time symptoms and hypoxemia
The study of Fifty-four patients with bronchiectasis and age-matched controls included to the study by Pittsburgh Sleep Quality Index (PSQI) and Pediatric Sleep Questionnaire (PSQ) to evaluate sleep quality and presence of sleep disordered breathing, found that patients with bronchiectasis have disturbed sleep associated with severity of disease. Night symptoms increase the risk of poor sleep quality. Sleep disordered breathing and sleep quality should be assessed in these patients(2).

3. Abnormal tiredness and difficulty in concentrating
Patients with bronchiectasis often complain of abnormal tiredness, difficulty in concentrating or low spirits, according to the study by Department of Physiological Medicine, St George’s Hospital Medical School(3).

4. Depression and anxiety and effects of quality of life
Anxiety and depression are quite common symptoms in bronchiectasis with 34% of patients had elevated scores for anxiety depression or both. In the study to measure symptoms of depression and anxiety in a sample of patients with bronchiectasis and evaluate their relationship to health outcomes and health-related quality of life, found that symptoms of depression and anxiety were significant predictors of health-related quality of life in patients with bronchiectasis, independently of respiratory involvement, gender, age or other variables(4).

5. Dyspnea on exertion
There is a report of a 54-year old woman referred to our service with an unusual presentation of an under-diagnosed condition. A life-long non-smoker, she was referred to respiratory services by our emergency department with a left sided pneumothorax, progressive dyspnoea on exertion, and recurrent chest infections. Subsequent investigation yielded findings consistent with Mounier-Kuhn syndrome (Tracheobronchomegaly), a condition characterised by marked dilatation of the proximal airways, recurrent chest infection, and consequent emphysema and bronchiectasis(5).
6. Wheezing and chronic cough
According to the University of Louisville, Bronchiectasis can be challenging to diagnose as its symptoms can mimic many more common diseases. The most common symptoms are wheezing, chronic cough, and dyspnea(6).

7. Other symptoms
In the study to compare peripheral muscle function, exercise capacity, fatigue, and health status between patients with bronchiectasis and healthy subjects in order to provide documented differences in these characteristics for individuals with and without bronchiectasis, researcher at the Hacettepe University, showed that Peripheral muscle endurance, exercise capacity, fatigue and health status were adversely affected by the presence of bronchiectasis(7).
And according to study of “Broncholithiasis: Not Just a Middle Lob Disorder” Journal of the KMA, in the MAY 2011/VOL 109/NO 5, the commonly reported symptoms of broncholithiasisinclude persistent cough, recurrenthemoptysis, fever and chills, and purulentsputum (Table 1).2,4 Some patientsexperience pleuritic chest pain. Lithoptysisis pathognomonic and has been reported tooccur in 3% to16% of documented broncholithiasiscases. Fever with purulent sputumsuggestive of respiratory infection is estimatedto occur in 11% to 61% of cases. Wheezing is a less common symptom, butmay lead to a misdiagnosis of asthma.2 Anisolated wheeze or wheezing that does notrespond to bronchodilator treatment shouldraise suspicion for symptomatic broncholithiasis, particularly if a calcified lymph nodeis present on plain radiographs. Hemoptysisoccurs in 37% to 85 % of cases and may be the sole presenting symptom. The hemoptysismay occasionally be massive. 

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/3342778
(2) http://www.ncbi.nlm.nih.gov/pubmed/21462360
(3) http://www.ncbi.nlm.nih.gov/pubmed/12243314
(4) http://www.ncbi.nlm.nih.gov/pubmed/22544417
(5) http://www.ncbi.nlm.nih.gov/pubmed/21736094
(6) http://www.ncbi.nlm.nih.gov/pubmed/23207272
(7) http://www.ncbi.nlm.nih.gov/pubmed/22958327

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