Wednesday, 27 November 2013

Bronchiectasis (Respiratory Disease) – The Risk factors

Respiratory Disease is defined as medical conditions, affecting the breathing organ and tissues including Inflammatory lung disease, Obstructive lung diseases, Restrictive lung diseases, Respiratory tract infections, trachea, bronchi, bronchioles, alveoli, the nerves and  muscles breathing , etc,.
Bronchiectasis  is defined as a condition chracterized by the damage of the localized, irreversible dilation of part of the bronchial tree and the walls of the large airways of the lung as a result of the destruction of the lung muscles and elastic tissues. Bronchiectasis can be present alone, but in most cases, it is a disease coexisted with patient of chronic obstructive pulmonary disease (COPD).
B.2. Risk factors
1. Tuberculosis, tobacco smoking and exposure to indoor air pollution
Tuberculosis, tobacco smoking and exposure to indoor air pollution are associated to increased risk of bronchiectasis. In the study to describe the clinical spectrum of the patients presenting with bronchiectasis at the referral clinic for the respiratory diseases in eastern Nepal, conducted by Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, indicated that in Nepal bronchiectasis remains one of the important chronic respiratory diseases, post tubercular variety being the commonest type. Tuberculosis, tobacco smoking and exposure to indoor air pollution contributes towards higher morbidity of this diseases(14). Other suggested that  increased smokers, urbanization and air pollution are associated to the prevalence of the Morbidity and mortality of respiratory diseases(14a).
2. Gender
If you are women, you are at increased risk of Bronchiectasis. According to the study by
University of California-Davis School of Medicine, bronchiectasis in women may act more virulently. Identified gender and sex differences range from increased exposure risks to altered inflammatory responses. There is sufficient evidence to suggest that chronic airway infection, most notably non-CF bronchiectasis, is a more common and more virulent disease in women(15).
3. Systemic inflammation and accelerated aging
Systemic inflammation, the consequences of systemic inflammation, the possibility of accelerated aging, and of how these concepts could relate to shared genetic risk factors for both comorbidity and pulmonary aspects of COPD, including small airways diseases, chronic bronchitis and bronchiectasis, as well as pulmonary emphysema(16).
4. Family history and other diseases
There is a report of a 68 year old woman with a lifelong history of chronic bronchitis diagnosed as having cystic fibrosis. The diagnosis was based on a suggestive family history, steatorrhoea, bronchiectasis with respiratory insufficiency, and very high sweat sodium content. The patient was found to be heterozygous for the delta F 508 gene defect(17).
5. Delay diagnosis
In the study to provide advice regarding when to suspect bronchiectasis, how to proceed with confirming or refuting a diagnosis, and the principles of management to minimise disease progression and manage the acute exacerbations, symptoms and associated disability and impaired quality of life, found that delay in the diagnosis, investigation and management of bronchiectasis in both children and adults is common, and this delay has been shown to be associated with more rapid progression of disease(18).
6. Etc.
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