Science and Profession (Magill’s Medical Guide, Sixth Edition)
Pulmonary medicine is a major specialty requiring years of training in its unique disciplines. The specialist in pulmonary diseases studies the wide variety of pathogens that can infect the human lungs. These include many families of bacteria, viruses, and fungi. Also, the pulmonary specialist learns to treat noninfectious lung diseases, such as asthma, chronic bronchitis, emphysema, and cystic fibrosis, as well as lung diseases that are caused by lifestyle (smoking), the natural environment (pollution, smog, or allergens), and the workplace (toxic chemicals, paints, or airborne dusts). Lung cancer, a major killer in Western societies, is often related to cigarette smoking, although other factors may be involved.
An increasingly visible respiratory problem in modern society is found in premature babies: These infants are often born before their lungs are fully developed. The problem for the caregiver in treating a newborn with respiratory distress is to maintain a steady supply of oxygen for as long as the infant needs it. The services of the pulmonary specialist may be required in the care of these babies.
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Diagnostic and Treatment Techniques (Magill’s Medical Guide, Sixth Edition)
The specialist in pulmonary diseases becomes an expert in rapid diagnosis. Often, a patient comes into the emergency room or the physician’s office in an acute state of discomfort. He or she may require immediate lifesaving measures. The physician must be able to decide quickly what is causing the problem and how to give the patient fast relief. How this is done varies considerably according to the disease.
Some respiratory tract infections progress so rapidly that the patient may require immediate surgical intervention to maintain an airway. Most respiratory infections, however, are considerably more manageable. Many require little more than palliative care.
By far the most common lung infections are attributable to the same organisms that cause the common cold. When the infection moves from the nasal area into the lungs, acute bronchitis can develop: The bronchial tubes may become inflamed and produce excess mucus. The patient coughs to relieve the congestion and may need to take medications and/or breathe in steam in order to break up the mucus deposits. Most common colds are caused by viruses for which there are no drugs that are analogous to the antibiotics taken to treat bacterial infections. Instead, the patient is given medications to relieve symptoms such as fever, hacking cough, and congestion.
Similarly, for more serious lung infections caused by viruses—such as viral pneumonia...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
Until the discovery of antibiotics, infectious diseases of the lungs were among the major killers of humankind. Diphtheria epidemics were common, and tuberculosis was rampant throughout the world. Today, most children in the industrialized world are vaccinated against diphtheria early in life. Tuberculosis has resurfaced as a major problem, however, because strains resistant to ordinary antibiotics have developed. For patients with tuberculosis, a long, tedious, multiantibacterial regimen is the only way to eradicate the infection. At least two antibiotics are recommended, often three, and the course of therapy may take years.
Pneumonia has become a major infection in hospitals, where outbreaks among patients are common. Hospital infection control teams are active in reducing the incidence of outbreaks, and extensive immunization programs are in operation in many hospitals to vaccinate against pneumococcal pneumonia. Most other bacterial lung diseases respond to antibiotic therapy.
A major area of research today is in antiviral medications. Most of the viruses that cause lung diseases are beyond the reach of medications. Nevertheless, inroads have been made with amantadine, ribavirin, and some others.
The treatment of asthma continues to improve. The main course of therapy for many patients is corticosteroids to reduce bronchial inflammation. Oral cortico- steroids often have undesirable side effects,...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Hansel, Trevor, and Peter J. Barnes. An Atlas of Chronic Obstructive Pulmonary Disease. Boca Raton, Fla.: Pantheon, 2004. Provides seventy detailed schematic diagrams describing disease progression, diagnosis, and treatment protocols, as well as figures, flow diagrams, and extensive references that review epidemiology, diagnosis, and management.
Weinberger, Steven. Principles of Pulmonary Medicine. 5th ed. Philadelphia: Saunders/Elsevier, 2008. Details all aspects of the practice of pulmonary medicine.
West, John B. Pulmonary Pathophysiology: The Essentials. 7th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2008. Examines lungs afflicted with obstructive, restrictive, vascular, and environmental diseases.
(The entire section is 90 words.)