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Thoracic Medicine

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Sleep Medicine

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The Wall Street Journal reported recently on the topic of sleep deprivation as to which cities around the World are the most and least sleep deprived. Brisbane leads the way with the earliest bed time and earliest wake up time.

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According to new research, risk of being obese by age 21 was 20 percent higher among 16-year-olds who got less than six hours of sleep a night, compared with their peers who slumbered more than eight hours.

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As we get older there is a strong relationship between reduced amount and quality of sleep. Recent research has found specific cluster of neurons that have linked insomnia and more sleep fragmentation. The reduction of these neurons can be from normal aging but has also been seen in Alzheimers disease.

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A bedtime routine might sound like something that's only necessary for the grade-school set, but following a nightly schedule can greatly improve the sleep of adults, too. Sleep experts recommend establishing a bedtime routine, both to calm and relax you as you get ready to sleep and so you aren't inadvertently giving yourself jet lag.

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Researchers at NYU Langone Medical Center and elsewhere, using a mouse model, have recorded the activity of individual nerve cells in a small part of the brain that works as a "switchboard," directing signals coming from the outside world or internal memories. Because human brain disorders such as schizophrenia, autism and post-traumatic stress disorder typically show disturbances in that switchboard, the investigators say the work suggests new strategies in understanding and treating them.

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The death rate from asthma in Australia has fallen by almost 70 per cent since the 1980s, according to a new report released by the Australian Institute of Health and Welfare

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Interstitial Lung Disease

What is INterstitial lung disease?

Interstitial lung disease is a name that covers a group of lung conditions that cause chronic breathlessness.  The most common type of ILD is idiopathic pulmonary fibrosis (IPF).  The major problem with ILD is inflammation of the lung tissue leading to scarring (fibrosis) of the air sacs (alveoli) which interferes with the ability of the lungs to deliver oxygen to the body.

Interstitial lung disease is a name that covers a group of lung conditions that cause chronic breathlessness.  The most common type of ILD is idiopathic pulmonary fibrosis (IPF).The major problem with ILD is inflammation of the lung tissue leading to scarring (fibrosis) of the air sacs (alveoli) which interferes with the ability of the lungs to deliver oxygen to the body.

What are the symptoms of interstitial lung disease?

Breathlessness on exertion and occasionally a dry cough are the most common symptoms of interstitial lung disease.  It is uncommon for people to develop breathlessness at rest, chest pain or to have a productive cough.

causes of INTERSTITIAL LUNG DISEASE

Most interstitial lung diseases are caused by the body’s own inflammation and repair system.  Some ILD’s are caused by widespread disease in the body such as Sarcoidosis, rheumatoid arthritis and scleroderma.  ILD can be caused by viral infection, drugs, radiation and occupational hazards. 

Viral infections can sometimes cause interstitial lung disease.  Bacterial infections include pneumonia and fungal infections.

Occupations hazards include – asbestos, coal dust, cotton dust, sand (silica) dust.

Quite a few drugs taken for other diseases have side-effects that can damage the lung.  Some of these drugs include bleomycin, methotrexate and amiodarone. 

Radiation – some people who received radiation for breast or lung cancer can show signs of lung damage long after they receive the radiation treatment.  The severity of the lung disease may include how much or how long your lung was exposed to radiation, and whether there was any underlying lung disease.

how does the doctor diagnose Interstitial lung disease?

There are many different types of ILD and they are often difficult to distinguish between.  Usually the doctor will initially order at least some if not all of the following tests:

  1. Chest x-ray 
  2. Lung function testing
  3. Blood tests
  4. Computed Tomography (CT scan).
  5. Bronchoscopy

treatment of interstitial lung disease 

Treatment can involve a range of drugs depending on your type of interstitial lung disease. 

Medication

Drugs such as corticosteroids can help to reduce inflammation, azathioprine is a cytotoxic normally used to prevent organ rejection after transplantation and acetylcisteine which is a type of antioxidant. 

Oxygen Therapy

Oxygen therapy may be prescribed by your doctor to increase the amount of oxygen circulating through your blood. 

Pulmonary Rehabilitation

Pulmonary rehabilitation may also be of some help to people to improve daily function.  This type of program focuses on teaching you how to breath more efficiently, how to exercise for your disease, education and nutritional information to improve quality of life. 

 complications OF INTERSTITIAL LUNG DISEASE 

Scar tissue formation in your lungs can lead to a series of life-threatening complications, including:


Low blood oxygen levels (hypoxemia)

Because interstitial lung disease reduces the amount of oxygen you take in and the amount that enters your bloodstream, you're likely to develop lower than normal blood oxygen levels. Lack of oxygen can severely disrupt your body's basic functioning.

High blood pressure in your lungs (pulmonary hypertension)

Unlike systemic high blood pressure, this condition affects only the arteries in your lungs. It begins when scar tissue restricts the smallest blood vessels, limiting blood flow in your lungs. This in turn raises pressure within the pulmonary arteries. Pulmonary hypertension is a serious illness that becomes progressively worse.

Right-sided heart failure (cor pulmonale)

 This serious condition occurs when your heart's lower right chamber (right ventricle) — which is less muscular than the left — has to pump harder than usual to move blood through obstructed pulmonary arteries. Eventually the right ventricle fails from the extra strain.

Respiratory failure
In the end stage of chronic interstitial lung disease, respiratory failure occurs when severely low blood oxygen levels along with rising pressures in the pulmonary arteries cause heart failure.

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