Endobronchial Valves in the Management of Broncho-Pleural and Alveolo-Pleural Fistulae
Lung
Sté Tunisienne des Maladies Respiratoires et d'Allergologie
Cercle des Bureaux - Appartement B 5-3 . 1082 Centre urbain Nord Tunis
Blog With Right Sidebar
Interstitial lung disease: the initial approach.
In the last decade, significant progress has been made toward a better understanding of interstitial lung disease (ILD). A valuable tool for the clinician is high-resolution computed tomography, which aids in narrowing the differential diagnosis in patients with ILD and obviates the need for surgical lung biopsy when a usual interstitial pneumonia pattern is present.
Clinicians evaluating and caring for patients with ILD need to recognize associated comorbidities.
Substantial evidence shows that implementation of a multidisciplinary approach provides a high standard of care for patients, leading to improvements in the accuracy of clinical diagnosis that can significantly affect patient outcome.
Eosinophilic lung diseases.
Accurate diagnosis of eosinophilic lung diseases is essential to optimizing patient outcomes, but remains challenging. Signs and symptoms frequently overlap among the disorders, and because these disorders are infrequent, expertise is difficult to acquire. Still, these disorders are not rare, and most clinicians periodically encounter patients with one or more of the eosinophilic lung diseases and need to understand how to recognize, diagnose, and manage these diseases.
This review focuses on the clinical features, general diagnostic workup, and management of the eosinophilic lung diseases.
Pulmonary microcirculation in interstitial lung disease.
Vascular abnormalities are a common feature of interstitial lung diseases (ILD). The development of pulmonary hypertension has been recognized as a condition that determines the overall prognosis, particularly for patients with idiopathic pulmonary fibrosis and scleroderma-associated lung disease.
The treatment of chronic ILD is challenging due to the lack of causal therapies, specifically of the fibroproliferative component of the disorders, but also due to the vascular abnormalities.
Recent studies suggest that the pathobiology underlying the remodeling and fibrosis of the parenchyma in ILD and the mechanisms leading to structural and functional alteration of the pulmonary vasculature are closely intertwined. This review summarizes the current understanding of the pathobiology of the microcirculation in ILD, with a specific focus on idiopathic pulmonary fibrosis and scleroderma-associated lung disease.
An improved understanding of the complex biological mechanisms that link alveolar interstitial and vascular remodeling in chronic ILD will be required to identify novel drug targets.
Sarcoidosis of the upper and lower airways.
Sarcoidosis is a systemic granulomatous disease of undetermined etiology characterized by a variable clinical presentation and disease course. Although clinical granulomatous inflammation may occur within any organ system, more than 90% of sarcoidosis patients have lung disease.
Sarcoidosis is considered an interstitial lung disease that is frequently characterized by restrictive physiologic dysfunction on pulmonary function tests. However, sarcoidosis also involves the airways (large and small), causing obstructive airways disease. It is one of a few interstitial lung diseases that affects the entire length of the respiratory tract - from the nose to the terminal bronchioles - and causes a broad spectrum of airways dysfunction. This article examines airway dysfunction in sarcoidosis. The anatomical structure of the airways is the organizational framework for our discussion. We discuss sarcoidosis involving the nose, sinuses, nasal passages, larynx, trachea, bronchi and small airways.
Common complications of airways disease, such as, atelectasis, fibrosis, bullous leions, bronchiectasis, cavitary lesions and mycetomas, are also reviewed.