The history of development of pulmonology

Pulmonology - a section of internal medicine who studies diseases of the respiratory system, as well as developing methods of diagnosis, treatment and prevention of these diseases. Pulmonary separated from the internal medicine as an independent branch of medicine in the second half of the last century. This was due to the growing number of diseases of the lungs and bronchi, which required the creation of specialized pulmonary centers, departments in hospitals, clinics and classrooms in the training of doctors, pulmonologists.

Modern pulmonology includes:

• the doctrine of non-specific lung diseases - inflammatory diseases of nontuberculous nature allergoses (eg, asthma), fibrosis (growths in the lung connective tissue replacement lung tissue) and so on.
• doctrine of pulmonary tuberculosis - the science called tuberculosis and is separate from the pulmonology; Today there is a tendency for the reunification of Pulmonology and Tuberculosis, which is caused by a change in the flow of tuberculosis, the appearance of signs of it, brings him to the other (allergic, neoplastic, professional, parasitic) lung diseases;
• the doctrine of occupational lung diseases;
• doctrine of lung tumors.

Pulmonary always developed mainly by improving diagnostic methods. At the beginning, in the middle of the 18th century, the method was implemented tapping (percussion) light at the beginning of the 19th century - the method of listening (auscultation) lung using a special tube - stethoscope. These methods enable to recognize the various processes in the lungs, making it possible to describe the symptoms of diseases such as bronchitis, pneumonia Pneumonia - Symptoms and Causes , Lung abscess, pleurisy, tuberculosis Tuberculosis - a full recovery is not guaranteed   lungs and others.

Further advances in pulmonology were associated with advances in microbiology. At the end of the 19th century were discovered, many infectious agents, it is possible to begin to study the causes of lung diseases inflammatory nature. At this time R.Kohom was isolated the causative agent of tuberculosis, L. Pasteur - Streptococcus pneumoniae, set its role in causing inflammation of the lungs.

The discovery in the late 19th century, X-rays significantly expand understanding of the diseases of the lungs and bronchi. Modern methods of X-ray examination of the lungs, such as computed tomography, magnetic resonance imaging, allow very accurately determine the nature and location of changes in lung tissue.

The next stage of the diagnosis in pulmonology practice was the introduction of endoscopic methods of investigation and treatment. With the help of special equipment, bronchoscopes could thoroughly investigate the condition of the bronchial mucosa, if necessary, remove foreign body or enter the drug directly into the bronchial tubes.

A great influence on the development of pulmonology was the discovery of methods of lung function as spirography (definition of lung capacity under different conditions), pneumotachograph (check volume and speed of inhaled and exhaled air at rest and during exercise), the study of blood circulation in the lungs and others.

Today in pulmonology are different diagnostic techniques that allow diseases to identify the lungs and bronchi at an early stage and to treat them in strict accordance with the diagnosis. This variety of radiographic techniques, radiological investigations, bronchoscopy Bronchoscopy - unpleasant but necessary , A large number of laboratory tests (blood tests, sputum, bronchial wash water, biological material obtained from a biopsy, and so forth).

Pneumotherapy

Treatment of diseases of the lungs evolved throughout the history of medicine. Emptying the collection of pus in the lungs and in the pleural cavity was described by Hippocrates. For the conservative treatment was used, as a rule, thermal treatments (wraps, banks), cough suppressant and facilitates expectoration, climatic factors, diet and other methods that increase the body's defenses. Modern pulmonology and took into account the experience continued.

A new stage in the development of treatments for lung disease was the discovery of drugs that affect the infectious process. At the end of the 30s of the last century it was discovered sulfa drugs, and ten years later - antibiotics, which ensured the successful treatment of pulmonary diseases. Antibiotics are the latest generation, which are used today are appointed only after the laboratory tests for susceptibility to pathogens him.

In chronic lung diseases have an excellent effect of such treatments as hemosorbtion and plasmapheresis (blood purification methods of toxic substances), HBO-treatment (treatment in hyperbaric chambers with increased atmospheric pressure), therapeutic massage Massage Therapy - when it is needed? , Gymnastics, physiotherapy, inhalation therapy, spa treatment.

Pulmonology - a young science, which is now under intensive development.

Galina Romanenko

How does pneumothorax

Know the signs of a serious condition that can occur suddenly after an injury or in the background of a disease, it is necessary for everyone. Such knowledge, as well as the ability to provide first aid may save the life of the affected people. Pneumothorax - it is a condition that at the time that may require immediate first aid.

Structure and function of the pleura

Pleura - a thin dense connective tissue sheath, which has two pieces: an outer (parietal), lining the chest cavity and the mediastinum and internal (visceral) covering the lungs. Between the outer and inner layer of the pleura is the pleural cavity within which is contained a few milliliters of pleural fluid that helps pleura slip relative to each other during inhalation and exhalation. The pleural cavity of right and left lungs are sealed and do not communicate with each other, that supports them in a constant pressure and pleural fluid surface tension which hold the light in the expanded state. Thus, the pleura is directly involved in the act of breathing.

Types of pneumothorax

Pneumothorax - a condition in which the pleural cavity in the air gets. It occurs when the violation of the integrity of the chest, lung damage, or at any of the hollow internal organ (esophagus, stomach, intestines). Pneumothorax is unilateral or bilateral, partial or complete (depending on the volume of the gas bubble), the light partially or completely collapses (kollabiruetsya).

Pneumothorax can be open (free air enters the pleural cavity and out of it), closed (after receipt of air in the pleural cavity of the hole was closed) and the valve (air enters the pleural cavity, but can not get out of it).

By origin pneumothorax is divided into:

• traumatic - in case of damage of the chest or lung tissue;
• operating - during operations on the organs of the chest cavity, where the ingress of air into the pleural cavity is inevitable;
• Spontaneous - in various lung diseases (e.g., tuberculosis); this appears externally as spontaneous pneumothorax, but examination revealed that various changes in the lung which result in damage to the chest wall or lung tissue as a result of minor trauma or therapeutic manipulation;
• artificial - is a method of treatment comprising administering to the air in the pleural cavity in order to create conditions for wears off (collapse) of the affected lung; It is used to treat some forms of pulmonary tuberculosis.

Violations that occur during pneumothorax

Violations occur when pneumothorax depends on the amount released to the pleural cavity of air, the speed of its income and other factors. In a closed pneumothorax with a small amount of supplied air, these violations are small, with an open pneumothorax are more pronounced. This results in atelectasis and mediastinal fluctuation during inspiration and expiration, leading to kink and compression of the vena cava and decrease blood flow to the heart. When valve pneumothorax increasing the amount of air in the pleural cavity may lead to that air will penetrate into the subcutaneous tissue or mediastinum. The developing pulmonary heart disease Heart failure - when the heart is unable to cope with the work   It can lead to death of the patient.

Signs of spontaneous pneumothorax

The degree of severity of symptoms of pneumothorax depends on its type and its causes.

Spontaneous pneumothorax can sometimes begin unnoticed and be a random finding during routine inspections. But more often it is the beginning of an acute among full health, sometimes amid insignificant physical stress or after coughing. The rapid flow of air into the pleural cavity is accompanied by a sharp stabbing pain in the chest Chest pain is one symptom - a lot of diseases And the appearance of shortness of breath, dry cough Dry cough - whether to worry about it? , Feeling short of breath, palpitation, cyanosis of the skin.

It is possible to notice the expansion of intercostal spaces and reducing the volume of inhalation on the affected side. Respiratory and circulatory disorders the fastest growing in the valve spontaneously or with bilateral spontaneous pneumothorax.

When uncomplicated pneumothorax closed defect in the visceral pleura with time it closes fibrin film and heals. Air resolves within one to three months. But spontaneous pneumothorax often produces complications. The most serious of them - acute progressive tension pneumothorax with progressive deterioration of the patient's condition, intrapleural bleeding and infection accession.

Sometimes acute spontaneous pneumothorax becomes chronic, it is not uncommon for tuberculosis Tuberculosis - a full recovery is not guaranteed .

Diagnosis and measures

The diagnosis of pneumothorax doctor may have to put on the basis of examination of the patient. The diagnosis is confirmed and refined by means of X-ray studies, including computed tomography.

First aid when pneumothorax is that an open pneumothorax need to be translated into a closed, putting a bandage on the wound sealed, for example, several layers of gauze or polyethylene. After that, you should immediately call an ambulance.

Treatment pneumothorax is to remove air from the pleural cavity by suction and restoration of negative pressure therein. If a closed pneumothorax, it is enough to remove the air. When open pneumothorax first converted into its closed, ushivaya wound, and then deaerated. The valve pneumothorax is first converted into the open, then closed.

Galina Romanenko