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Thoracic Medicine

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Sleep Medicine

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New research confirms that sleep disturbances are linked to pain and depression, but not disability, among patients with osteoarthritis (OA).  Results from a new study found that poor sleep increases depression and disability, but does not worsen pain over time.

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Older women with disordered breathing during sleep were found to be at greater risk of decline in the ability to perform daily activities, such as grocery shopping and meal preparation, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of California, San Francisco.

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People with moderate to severe obstructive sleep apnoea may have an intrinsic inability to burn high amounts of oxygen during strenuous aerobic exercise, according to a new study led by researchers at University of California, San Diego School of Medicine.

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This webinar will be a clinical presentation in assessing a child who presents with snoring. Snoring is a very common presentation in childhood with some studies suggesting that up to 30% of children will snore at some point in their life. Within those that snore, there will be some who have obstructive sleep apnoea.

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Sleep apnoea may make it hard for you to remember simple things, such as where you parked your car or left your house keys, a small study suggests.

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Researchers believe that disrupted circadian clocks are the reason that shift workers experience higher incidences of type 2 diabetes, obesity and cancer. The body's primary circadian clock, which regulates sleep and eating, is in the brain. But other body tissues also have circadian clocks, including the liver, which regulates blood glucose levels.

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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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