Diseases as well as Their Causes, Symptoms, and Treatment
The problem of health has become paramount today. People begin to lose confidence in medicine. They refuse from vaccination and do not always follow orders of the doctor. Therefore, one should pay attention to the most widespread diseases, their symptoms, mechanism of their development and treatment. This paper will discuss pulmonary embolism, negative pressure pulmonary edema, measles, mumps, pertussis, and tuberculosis, as well as their causes, symptoms and treatment.
Pulmonary embolism is a blockage of the main artery of the lung (Ouellette, 2015). The cause of the blockage is usually a thrombus that goes through the blood system from the lower extremities. When the thrombus appears in the venous system, it can break away from endothelium. In this case, it is called a trombo embolus. The venous system returns blood back to the heart. Thus, a thrombus goes up. If it goes through the lumen of blood vessels, it moves with the blood stream to the right atrium, tricuspid valve, right ventricle, and then sticks in the pulmonary artery. The embolus can cause disturbances in the blood supply of the pulmonary tissue (National Heart, Lung, and Blood Institute, 2011a). Therefore, it is not only the exchange of oxygen and carbon dioxide, but also the blood flow that affects lungs. The major signs and symptoms include the following ones:
Shortness of breath (dyspnea). The appearance of this symptom often occurs without a certain reason. It has a tendency to get worse after physical activity (Thompson & Hales, 2014).
Chest pain. People may feel as if they have a heart attack. The pain goes worse during physical exercises. However, it does not stop when a person takes rest (National Heart, Lung, and Blood Institute, 2011b).
Cough. As a rule, one suffers from a bloody cough.
Other symptoms of pulmonary embolism are pain in the calf, cyanosis, sweating, dizziness and irregular heartbeat.
It is important to know clinical criteria of pulmonary embolism to differentiate its common signs and symptoms from other diseases. The major method to diagnose pulmonary embolism is the Wells score. When a certain symptom is present, a doctor gives a score. At the end, one counts all scores up and makes a prognosis.
The Wells score looks like this:
- suspected deep vein thrombosis — 3.0 points
- another diagnosis is less likely than pulmonary embolism — 3.0 points
- tachycardia — 1.5 points
- immobilization in previous four weeks — 1.5 points
- probability of deep vein thrombosis or pulmonary embolism is as much as 1.5 points (Wedro, 2015)
- hemoptysis — 1.0 points
- malignancy— 1.0 points
Then the doctor makes an interpretation of the scores:
Score more than six — it is a high probability - 59%
Score from two to six — it is a moderate probability - 29%
Score less than two — it is a low probability - 15% (Bauer & Lip, 2015)
Nevertheless, there is an alternative interpretation:
Score is more than four — the patient is likely to get pulmonary thrombosis. It is recommended to make a diagnostic imaging to confirm the diagnosis.
Score is 4 or less — the patient is unlikely to get pulmonary thrombosis. One should take measures to exclude the diagnosis.
Negative Pressure Pulmonary Edema
Negative pressure pulmonary edema (NPPE) is a complication of anesthesia. It occurs as a result of laryngospasm during extubation. The frequency of its occurrence is very low. However, the condition has a difficult mechanism. The cause of negative pressure pulmonary edema is associated with the upper airway obstruction. Then negative intrapleural and alveolar pressures lead to the fact that fluid leaves pulmonary blood vessels and goes to the interstitial space. It gives four mechanisms of negative pressure pulmonary edema (Life in the Fastlane, 2014). The first mechanism leads to the increased hydrostatic pressure in the pulmonary capillaries. The second mechanism results in the low osmotic pressure of plasma. The third mechanism causes increased permeability of the membrane. The fourth one leads to irregularities in lymphatic vessels, when fluid returns back less and less. Intrathoracic negative pressure results in an increased return of deoxygenated blood to the heart, which leads to volume overload of the left heart. It causes increased diastolic and end systolic ventricular volumes. Low intrapulmonary pressure leads to an increase of pulmonary microvascular pressure (Waheed & Khan, 2011). This is the mechanism of development of pulmonary edema (Bhaskar & Fraser, 2011).
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An increased return of the deoxygenated blood also causes a low cardiac output. It occurs as a result of the reduction of the deoxygenated blood drainage to the left atrium. At the same time the pulmonary blood pressure increases while cell junctions become destructed. Then fluid moves to the interstitium (Hannania, Barak, & Katz, 2004). One should notice that even after the resumption of breathing fluid remains at the same place.
Another complication of the upper airway obstruction is hypoxemia. It can increase pulmonary vascular resistance, resulting in increased pulmonary pressure (Saqib, Ahmad, & Khan, 2011). This mechanism stimulates high content of catecholamine, which creates an imitation of neurogenic pulmonary edema. Hypoxemia also increases blood distribution in pulmonary blood vessels. It may result in high pulmonary capillary resistance.
Problems with heart also increase the probability of catching NPPE. Scientists believe that beside laryngospasm after extubation, possible causes of pulmonary edema may include croup and obstruction with foreign bodies. Negative pressure pulmonary edema II has a different mechanism than NPPE I. The obstruction leads to increased end-expiratory lung volume. When the obstruction is removed, lungs return to normal. When one removes positive end-expiratory pressure abruptly, transudation occurs in interstitium (Omar et al., 2009). Signs and symptoms of NPPE may develop at once or delay. As a matter of fact, after the relief of the obstruction, deoxygenated blood return brings blood redistribution to central blood vessels and hydrostatic transudation.
When it comes to molecular mechanisms, one can say that increased permeability of the endothelium occurs. After that an increase in transmural pressure of the linear cellular stretch takes place. Thus, oxidative stress is followed by the increased cyclic linear. One connects it with an increase of nitric oxide synthase and xanthine oxidoreductase.
Measles, Mumps, and Pertussis
Measles is a childhood illness. The virus that causes measles multiplies in upper respiratory tract (a nose and a throat). The transmission can be airborne and by contact with infected items. When a child with measles has a cough, sneezes or talks to another person, the latter is likely to become infected, too. Infected particles can also settle on different surfaces. They remain dangerous within three hours. The incubation period lasts for ten days from the time of infection of the organism by the virus (Longo et al., 2012). In the second period, the major signs and symptoms of the disease include an increased temperature, dry cough, rheum, and inflamed eyes (Higuera, n.d.). The period of acute illness includes such signs as red spots. They can cover a big area of skin. The nest period is communicable. It lasts for eight days. Virus can be transmitted to the others. Common complications include ear pain, diarrhea, pneumonia and encephalitis (Mayo Clinic Staff, 2014).
Mumps is transmitted is by droplets of saliva or mucus from the mouth or nose of an ill person. It may take place when one coughs, blows his or her nose or sneezes. A person may also catch this infection when he or she touches items that are infected by an ill person. The transmission can be present before the beginning of the inflammation of salivary glands and five days after it. Thus, the incubation period is about 12-15 days. Signs and symptoms of the disease include swelling of the neck, a high temperature, headache, and dry mouth (Mayo Clinic Staff, 2012). Patients may have a pain in the ear that gets worse when the person chews. In most cases, mumps includes inflammation that can arise in different parts of the body. When inflammation appears in testicles, it is called orchitis. It is inherent to men who have reached puberty. Despite the fact that it is very painful, sterility takes place not very often. When the inflammation occurs in the pancreas, it is called pancreatitis. Characteristic symptoms are qualmishness and pain in the epigastrium. The inflammation may also cause oophoritis, mastitis, encephalitis and meningitis by hitting the nervous system.
Pertussis. The mode of transmission of the disease is airborne. It is spread when people infected with pertussis cough or sneeze in the immediate vicinity to other people. Signs and symptoms appear within 5-11 days after the pathogen enters in organism. They include running nose, a high temperature, cough, red eyes, vomiting, blue face and extreme fatigue (CDC, 2014). Complications may vary from adults to infants. Thus, an adult may have bruised ribs, abdominal hernias and internal bleeding. Infants suffer from pneumonia, respiratory insufficiency, dehydration, encephalitis and meningitis (Harding, 2014).
Tuberculosis is caused by Mycobacterium tuberculosis (Schiffman, 2014). In most cases, this disease strikes lungs, but it can also affect different organs. Thus, there are two types of tuberculosis: latent and active. During latent form mycobacterium is inactive (Centers for Disease Control and Prevention, 2014). Thus, it causes no symptoms. Nevertheless, it can become active later. When a person has active form of tuberculosis, he or she complains of having pain. People who have active form are infectious. The mode of transmission is airborne. When a person has a talk with an ill man or woman, he or she is likely to get the illness, too. If a person with active form of tuberculosis has a proper treatment, he or she is not infectious for at least two weeks (Mayo Clinic Staff, 2014a).
When it comes to signs and symptoms, one should notice that latent form is not clinically manifested. Therefore, the following symptoms are present in active form. Thus, people may suffer from cough (as a rule, it is with blood), a high temperature, loss of weight (people lose weight without any reason), loss of appetite (people refuse to eat anything even if they do not have food for a long time), and sweating at night (Carey, n.d.). As a rule, tuberculosis affects lungs. However, if one does not treat the illness, it can spread to other parts of the body through blood vessels. When tuberculosis affects other organs, its signs and symptoms will be different. If the infection is localized in bones, a person will suffer from pain in the spine and joint destruction. When it is localized in the brain, it will cause the inflammation of the meninges – meningitis. By affecting kidneys, tuberculosis breaks filtration processes. The clinical manifestation of the disease is the presence of blood in urine. When the infection strikes the heart, it causes pumping dysfunction of the heart.
Tuberculosis has significantly spread in Australia. The major factor is that many people constantly migrate. In these conditions, the probability of getting tuberculosis increases. Risk groups include people who may become ill upon the first contact and people with comorbidities. People who have the greatest risk of infection are travellers from counties with a high rate of tuberculosis, workers in the field of medicine, and those in close contact with people who might be ill. Tuberculosis may also develop on the basis of concomitant diseases that, as a rule, suppress the immune system (Mayo Clinic Staff, 2014c). They include HIV infection, diabetes, chronic renal failure, gastrectomy, cancer, immunosuppressive treatment (it unites the therapy of medicaments that suppress the immune system, for instance, corticosteroids), poor nutrition, and old age (Schiffman, 2014).
Doctors use antibiotics in the treatment of tuberculosis. However, this infection demands a long period of their use. It can take almost nine months. Researchers have found out that combined therapy of antibiotics for five month is effective towards remaining tuberculosis in latent form. The major advantage of this method is the decrease of side effects that can occur after a long-term treatment. When one has latent form, on needs only one type of antibiotics. Active form demands using different medicaments. One can explain it with resistance to certain drugs. Doctors use isoniazid, rifampin, ethambutol, and pyrazinamide (Mayo Clinic Staff, 2014b). When resistant bacteria are present, it is important to undergo combined therapy, including the use fluoroquinolones, amikacin or kanamycin.
In conclusion, it is obvious that timely treatment gives more chances to recovery. Early visit to a doctor may help to prevent side effects.