Title: Bronchial granular cell tumor Descriptive info: Menu.. Thursday 21 March 2013.. News.. Main Symptoms.. Main Deseases.. Laboratory Τests.. Medications.. Pneumonology Articles.. Medical Articles.. Article Editors.. You ask - We Answer.. Congresses.. Guidelines.. Links.. Books Presentation.. Editorials.. Just another WordPress.. com site.. PNEUMON quarterly medical journal.. HELLENIC THORACIC SOCIETY.. Athens Medical Center.. Read More.. Pneumonological Articles.. Bronchial granular cell tumor.. BRONCHIAL GRANULAR CELL TUMOUR.. Work presented to the 32nd Panhellenic ... LUNG Adenocarcinoma.. N.. Hainan (1), A.. Dountsis (2), K.. Basil (3), E.. Karagiannis (4), D.. Nakos (5), T.. Ntachampre (6) 1-lung 2,3,6 --.. Thoracic, 4.. 5 - PathologoanatomoiIatriko Center of Athens.. Nikolaos D.. Chainis.. Go Back.. Contact us.. About Us.. View our videos.. Search.. Articles.. Authors.. Questions - Answers.. Photos.. bronchial granullar cell tumor.. Homepage.. Authors.. You Ask - We Answer.. Contact.. Info..
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Title: Lipoid embolism Descriptive info: Lipoid embolism.. LIPOIDI EMBOLISM.. (Vascular embolism from fat cells).. HISTORY-GENERAL.. The fat embolism was first mentioned in literature in 1862 by ZENKER after autopsy.. Initial clinical diagnosis of fat embolism described in 1873 by von Bergmann.. This is a clinical syndrome that typically occurs between the first and third 24 hours after bone fractures or orthopedic surgery.. The mainly affected organs other than lungs is the brain and skin.. Pathophysiology.. There are 2 theories about the pathogenesis of the "fat embolism".. 1st case.. Fat droplets released into the venous system and invade small blood vessels causing.. 1.. local ischemia.. 2.. inflammation.. through:.. release of inflammatory mediators.. platelet aggregation.. production vessel-amine a tackle.. 2nd Case.. Hormonal changes caused by.. Trauma and / or.. Septic situation.. Result in the production and release of free fatty acids (eg, chylomicrons).. IMPACT.. No data on the incidence of fat embolism and is due to following reasons:.. Subclinical forward (manifestion).. There are no laboratory tests that will reliably make the diagnosis.. CAUSES LIPOIDOUS EMBOLISM.. Especially in situations involving the orthopedic:.. * Fractures of long bones (especially closed fractures) 90%.. * Orthopedic surgery (eg surgical repair of joints).. But other medical conditions are predisposing factors for the occurrence of the syndrome, such as:.. * Acute pancreatitis.. * Sickle crisis.. * Diabetes mellitus.. * Burns.. * Laser.. * Coronary artery bypass.. * Parenteral ... the areas of the head, neck, anterior chest wall, the axillary countries.. MORTALITY.. 10-20% of patients will come.. Such conditions are mainly age and coexistence of other diseases.. DIAGNOSIS.. A LUNG.. Radiography, Computed Tomography, Computed tomography angiography of no help in diagnosing the syndrome.. Recently proposed.. HRCT (high resolution computed tomography thorax) which highlights alveolar type amfo shadows in pulmonary parenchyma 'way of blurred glass ", as well as fattening perivronchiki.. BAL (bronchoalveolar lavage) which found fat droplets in alveolar macrophages.. B.. BRAIN.. The simple brain CT scan is usually normal.. Nevertheless, the brain magnetic resonance imaging (MRI) is a more sensitive method.. So dominant role in the diagnosis of fat embolism are.. * The recent history of the patient and.. * The symptomatology.. The classic triad:.. hypoxia.. neurological disorders.. 3.. skin rash.. should give serious suspicion of the syndrome.. THERAPY.. The fat embolism is a syndrome that may endanger the patient.. The problem is complex and requires the help of several Specialty: Pulmonology, orthopedic, neurologist / neurosurgeon, Intensivist, hematology, nutritionist.. * Treatment should address the hypoxia and / or respiratory failure with high oxygen and / or mechanical ventilation.. * Hydration.. * Prophylaxis of deep vein thrombosis.. * In cases of fracture should be treated immediately to prevent further release of fat droplets in blood.. * In some cases it is useful to cortisone administration..
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Title: Lung cancer : Surgical treatment Descriptive info: Lung cancer : Surgical treatment.. Surgical treatment of lung cancer.. Dating.. Lung cancer or else the bronchogenic cancer is the most common cancer in male and competes with breast cancer in women in the occupation of the first class.. O vronchogenis cancer is the leading cause of death in the list of malignancies, and one in three cancer deaths have been cause lung cancer.. The incidence of U.. S.. shows declining trend while there is an increasing trend worldwide.. Recent years have witnessed great progress in surgical technique and the technique of anesthesia in terms of lung surgery.. Also the selection of patients and the preoperative preparation is more accurate and more complete, respectively.. The postoperative support of patients undergoing surgical treatment and monitoring, coupled with the invaluable contribution of the Intensive Care Unit contributed significantly to the reduction of perioperative morbidity and mortality.. Despite the progress, in terms of surgery and despite the granting of more effective chemotherapeutic drugs as well, despite the best technique of radiotherapy, the five-year survival remains very low and not exceed 15% of all patients with.. vronchogeni cancer.. Surgical therapy remains the cornerstone in the treatment of lung cancer and is the only way to address that offers long-term survival, at least as far as patients with cancer early-stage and others were in more advanced stages, after a very rigorous selection.. The type of surgery is applied depends on many factors such as stage of disease, the overall condition of the patient and the cardiopulmonary reserve.. The excisions made in the treatment of lung cancer is the wedge resection, the tmimatektomi, formal lovektomi the way of lovektomi cuff (sleeve lobectomy), the formal or pnefmonektomi endoperikardiaki the synexairesi with lung resection of chest wall and the way of pnefmonektomi.. cuff (sleeve Pneumonectomy).. Each response from them has its specific indications, morbidity and mortality which accompanies it.. When the cancer is in stage Ia or Ib or IIa (T1NoMo, T2NoMo and T1N1Mo respectively), the treatment of choice is surgery if the patient's respiratory reserve and allow the treatment choice is less lovektomi the pnefmonektomi (.. Figures 1, 2, 3).. The perioperative mortality of lovektomis not exceed 1.. 5%, while the quality of life of these patients is excellent.. When the lymph nodes of mesoloviou slit or gate is infiltrated and even more when they are stranded, then surgery is the choice pnefmonektomi.. The perioperative mortality after pnefmonektomi is around 6.. 4%.. The contribution of intensive care, the preoperative preparation and postoperative support, played an important role in the significant reduction of perioperative morbidity and mortality.. If the volume extends beyond the visceral pleura or the parietal pleura, ie when filters pericardium, diaphragm and chest wall (T3NoMo or T2N1Mo) then the choice is surgery to remove part or all of the ... role of surgery.. The same applies when there is lung cancer with solitary metastasis to the brain or the adrenal can be removed completely, the role of surgery remains an essential and primary.. Besides the therapeutic role, surgery has an important role palliative treatment.. This is particularly true for patients who have a large collection of fluid in the pericardium or the pleural cavity, so it could be perikardiektomi (pericardial window) in the first case half thorax rib cage and drainage followed by plefrodesia the second case.. It can be immediate relief for patients with unresectable volume infiltrate the trachea, the keel or the main loop by placing endoprosthesis (stent), after having been first cauterization of endoaflikou volume using Laser or electrical diathermy or cryopiksia.. Because the percentage of patients may undergo a surgical treatment does not exceed 15 to 20%, the effort to combat this disease, you must concentrate on preventing the main objective the elimination of smoking.. Because this is not easy in practice, it must be serious efforts to increase the number of patients undergoing surgical treatment, the only effective treatment as mentioned above.. This can be achieved by evaluating the patient by a panel comprising pulmonologist, oncologist, Thoracic and radiotherapy, to be deprived of no patients the beneficial effect of surgery.. They should also avoid unnecessary thoracotomies as possible and the rate does not exceed the 5 to 10% of the thoracotomy for lung cancer.. In addition to be reduced even further the postoperative morbidity and mortality.. This reduction can be achieved when there is close cooperation between Thoracic, pulmonologist, cardiologist and Medical Intensive Care Unit.. Also, surgical patients need to be hospitalized for 24 hours in ICU and the surgeon is highly suspicious in regard to fatal complications.. Another important objective should be to find new more effective therapies and treatments they are depending on the tissue type and taking into account specific parameters than those that are available to us today.. Figure 1: Opisthioprosthia young patient's chest radiograph showing.. sizable shadow in the left portal lung.. Figure 2: CT scan of the same patient in Figure 1.. Sizable volume.. the left upper lobe.. Figure 3: Postoperative radiograph of the chest at the top left.. lovektomi for non-small cell lung cancer.. Fully expanded.. the left lower lobe which occupies the left full.. half thorax.. Figure 4: Opisthioprosthia chest radiograph.. Sizable shadow of the left.. lower lobe.. Figure 5: Computed tomography of thoracic patient FIGURE 4.. Sizable.. left lower lobe mass extending to the left atrium.. Figure 6: The surgical preparation, the entire left lung.. The.. volume of claims in the left lower pulmonary vein.. It has become.. resection of the left bay of the outfall.. pulmonary vein, then it seems the pericardium.. JUBRAIL NTAHABREH.. eik1.. eik2.. eik3.. eik4.. eik5..
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Title: pregnancy and asthma Descriptive info: pregnancy and asthma.. PREGNANCY AND ASTHMA.. Evangelos Theodoropoulos, Pulmonology.. GENERAL PRINCIPLES.. From the international literature that the incidence of asthma has increased over the past 20 years worldwide.. Not surprising therefore that today asthma is a disease that potentially can often complicate pregnancy.. Epidemiological speaking bronchial asthma occurs in 1% - 4% of pregnant women.. Possibly the figure is even higher if we consider that the problem does not refer either to the doctor for fear that medication can harm the fetus, either because the disease is not diagnosed when it occurs during pregnancy.. It is important to apply those strategies to combat the disease be designed to avoid damage to health of mother and fetus.. POSSIBLE INTERACTIONS ASTHMA KYISIS.. In principle should be to separate the potential impact on.. A) Pregnancy can bring on asthma.. B) Asthma in pregnancy.. Regarding the first to say that in general the 1 / 3 of women with asthma has improved during pregnancy, the 1 / 3 worse and 1 / 3 stability.. THE IMPROVEMENT OF ASTHMA may be due to.. - Improved bronchodilation by progesterone.. - Strengthening b adrenergic action (progesterone and estrogen).. - Increased blood levels of free cortisol.. - Other.. The deterioration of the ASTHMA may be due to.. - Increased stress.. - Increase or worsening gastroesophageal reflux.. - Vronchosystoli by prostaglandin F2 alpha.. Statistically speaking the most likely deterioration occurring during the sixth month of pregnancy and the last 4 weeks of pregnancy often have episodes of depression.. EFFECTS ASTHMA IN PREGNANCY.. Any adverse effects are usually the result of three factors:.. - Insufficient control of asthma.. - Drugs for asthma.. - Possible other factors (clinical conditions, either alone as hypertension, hypocapnia, dehydration, or in combination with poor control of asthma causing hypoxia in the infant because of reduced blood flow between the uterus and placenta).. The harmful effects that may occur are:.. To the fetus:.. Delayed development of endometrial.. Underweight baby.. Increasing mortality during childbirth.. Congenital anomalies.. Ypercholerythrynaimia.. For the pregnant woman:.. Increasing episodes of emesis.. Proeklampsia.. Gestational hypertension.. Complications during childbirth.. Rupture membranes.. Need for caesarean section.. GENERAL TREATMENT LINES.. The strategy to be followed in pregnancy because asthma has the following objectives.. Control of symptomatology including night events.. Maintenance of respiratory function as the strongest close to normal.. Avoid potential side effects from medicines.. Prevention of asthma exacerbations.. Common objective assessment of the clinical picture of mother and fetus.. Avoid ... inhaled steroids (as an alternative to increasing the dose of inhaled corticosteroids).. c) If it was part of the successful treatment of asthma control before pregnancy.. d) Where it is necessary to address specific clinical conditions (eg nocturnal asthma).. CHROMONES (Nedocromil).. With little systemic absorption shall be regarded although safe but not recommended as an alternative treatment in mild persistent asthma.. THE0FYLLINI.. Pretty safe to use.. Considered as an alternative but not recommended for use in mild persistent asthma.. If use of the serum concentration should be between.. 5-12mcg/ml.. For moderate or severe asthma is an alternative but not preferred option, always in combination with steroids, it seems more effective in combination with long-acting steroid beta2 stimulant.. Finally there seems to be a useful addition to the treatment of acute crisis response.. Anticholinergics (Ipratrorium bromide).. There are insufficient data to use during pregnancy.. LEUKOTPIENI (montelukast, zafilukast).. There are insufficient data on safety of use during pregnancy.. It is an alternative but not preferred solution in the treatment of mild persistent form.. Corticoids.. They are the treatment of choice for all forms of persistent asthma.. A) inhaled forms.. They reduce the risk of outbreaks due to pregnancy, make better lung function (FEV) and so far no evidence linking the use of inhaled steroids with sexual abnormalities.. Their use and breastfeeding is not contraindicated.. The most strongly recommend is Budesonide and Beclomethasone.. The dosage and duration of use depends on the clinical picture and the stage of asthma.. B) systemic steroids.. Administration per os in particular during the first trimester of pregnancy or for a long time is risky complications.. (Glucose pregnancy, cleft palate, premature birth, pre-eclampsia, etc.. ).. In uncontrolled or severe asthma their use may be necessary.. In these cases should be using the lowest adequate dose, or used in spite of daily dosing.. Is necessary in these situations closer monitoring of the pregnant and the fetus.. Limiting factors can worsen asthma.. A) Allergens (eg Animals,, Fungi, Aeroallergiogona).. B) smoking habits.. C) Humidity.. D) Other.. CONCLUSION.. The treatment of asthma during pregnancy requires close cooperation among pregnant pulmonologist and gynecologist.. Deemed necessary by the frequent monitoring of pregnant by the treating specialist and the right guidance and information.. Finally, the dosage, the number and frequency of administration of drugs should be such as to obtain control of the disease by offering quality of life the mother, the fetus and the family environment.. EVAGGELOS THEODOROPOULOS..
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Title: safety and usefulness of bronchoscopy in elderly patients Descriptive info: safety and usefulness of bronchoscopy in elderly patients.. Security usefulness of bronchoscopy in elderly patients.. Work presented to the 9th National Congress Pneumonology.. SAFETY USE OF FIBER-BRONCHOSCOPY IN ELDERLY PATIENTS.. D.. Hainis, E.. Theodoropoulos, K.. Katis, A.. Verykaki E.. Zachariadis, M.. H.. Inglezos Angelidou, X.. Tsiafaki, N.. Karagiannidis, F.. skipjack, B.. Handrinos, P.. Ziotopoulos and F.. Apostolopoulou.. Sismanoglio G.. P.. N.. A.. A ', B', C `Pulmonology Deartments - Bonchologic laboratory.. In order to assess the safety and usefulness of inovronchoskopisis in elderly patients, studied the records of vronchologikou laboratory of our hospital from 1/1/1991 until 30/7/1997 and revealed the following: a total, 7542 bronchoscopy performed by 10.. vronchoskopous total (with a different experience each), the 368 (4.. 78%) patients were aged over 80.. Of these, 307 men (83.. 42%) and 61 women (16.. 58%) with average age 86 years (80-99eton).. Indication ... 75%) megalokyttariko 13 (12.. 03%), adiaforopiito 37 (34.. 26%), and 1 bronchoalveolar (0.. , 93%)].. In 10 patients (7%) were diagnosed other diseases [7 TBC, 1 sarcoidosis, 1 pulmonary fibrosis and pneumonia 1].. The diagnosis was made by loop biopsy, bronchial secretions, brush, metavronchoskopika sputum culture and bronchial secretions.. Please note that all.. elderly patients, a negative / had a chest only 8 patients (2.. 17%) and only.. one (12.. 5%) of them was diagnosed.. The bronchoscopy was well tolerated by almost all patients.. Stop needed to be done only in 3 patients (0.. 81%).. In a result of poor cooperation and the other two because this showed hypoxia and pulmonary hypertension treated successfully, respectively.. `Taking into consideration the age, the large number of vronchoskopon and high rate of diagnosis, we can conclusively say that inovronchoskopisi is a safe and reliable diagnostic method..
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Title: Diagnostic and invasive bronchoscopy (Fiberoptic Bronchoscopy) Descriptive info: Diagnostic and invasive bronchoscopy (Fiberoptic Bronchoscopy).. DIAGNOSTIC AND INVASIVE BRONCHOSCOPY (FIBEROPTIC BRONCHOSCOPY0.. Nikos D.. Chainis, Pulmonology.. Introduction.. In late 1890 oGustav Killian using a formula Laryngoscopes able to review the trachea, a little later and managed to remove a foreign body that was plugged in the right bronchial tree.. It was the first bronchoscopy and Killian was the ¨ ¨ father of bronchoscopy.. In 1904 tonJackson constructed by the rigid bronchoscope, which became widely used a few years later.. OIkeda in 1968 introduced the inovronchoskopio (flexible bronchoscope).. Between 1987 and used the video bronchoscope.. Bronchoscopy.. Hvronchoskopisi (direct review of the airways) may be either the rigid or the flexible bronchoscope, each presenting advantages and disadvantages.. The main of them relating to the rigid bronchoscope compared with flexible are:.. Rigid bronchoscope.. Disadvantages.. Done under general anesthesia.. Ability to control only the main bronchus.. Difficult or impossible to import in stiffening or serious injury of neck.. Unable to import into diasolinomenous patients.. Advantages.. Very good vision.. Easier removal of foreign bodies.. Effective control of bleeding.. FLEXIBLE bronchoscope (FIBER BRONCHOSCOPE).. An overview of the airways to ypotmimatikon level, ie 5 to 6 subdivision.. The entrance to vronchoskopiou can be done through:.. * Nose.. * The oral cavity.. * Oral and maxillo-tracheal tube.. * Tracheostomy.. Apply mild premedication and local anesthesia.. It most often requires hospitalization.. But we must always be equipped laboratory.. The contraindications are few true and many times not prohibitive, and the complications and just a few more rare: less than 1% (bleeding, pneumothorax, respiratory failure, syncope, cardiac arrhythmias, infections, allergies, laryngeal edema).. Even though complications are rare can not be ignored.. It is therefore with increased attention to the account information - any adverse reaction and the usefulness - usefulness (diagnostic or therapeutic).. The complications have to include the effects of drugs used for premedication and local anesthesia (respiratory depression center, tachyarrhythmias, urinary retention, decreased gastro-intestinal mobility, particularly allergy to local anesthetics).. The length ranges from 1 to 30 minutes (mean the effective time of bronchoscopy: entry and exit vronchoskopiou) and depends mainly on the experience of vronchoskopou secondly the cooperation of the patient and the type of materials to be.. taken.. If added and the time needed to prepare the patient (local anesthesia-premedication) and who is about 5-10 minutes, then the total length of the test does not exceed 40 minutes.. Premedication.. ... PT, aPTT.. Hepatitis Markers.. AntisomataHIV.. PARTICULARS.. DIAGNOSTIC.. A.. Indications related symptoms, history and physical examination:.. Chronic cough.. Haemoptysis.. Inhalation stridor (Wheezing) (in particular localized).. Expiratory wheezing (Stridor).. Hoarseness (impairment-paresis-paralysis of vocal cords).. Chest pain.. Syndrome than hollow.. Aspiration (stomach contents-foreign body).. Thoracic Trauma.. Chemical or thermal burns tracheiovronchikou tree.. Evidence relating to medical laboratory tests.. Positive or suspicious cytology sputum.. Pathological chest X-ray.. diaphragm paralysis;.. -portal lymphadenopathy.. mediastinal enlargement;.. atelectasis;.. -undiagnosed pleural effusion.. -cavity.. prefabricated-slow pneumonia.. -persistent pneumothorax.. -benign malignant tumors.. -infections.. -diffuse parenchymal disease.. C.. Entries associated with known diseases of the lungs.. Diagnosis and staging of cancer vronchogenous.. Monitoring therapeutic efficacy in various diseases (cancer, interstitial lung disease).. OTHER INDICATIONS.. Tracheal intubation.. Monitoring endotracheal tube.. Bronchografy.. Lavage (washing vronchokypselidiki) (interstitial lung disease).. THERAPEUTIC.. Lavagese:.. alveolar-proteinosis.. retention of secretions;.. mucus plugs;.. -aimatopigmata (clots).. Remove foreign body.. Control bleeding.. Control - drainage of pulmonary abscess.. Close vronchoplefrikou, tracheiooisofagikou vronchooisofagikou fistula.. Intratracheal placement - endobronchial prostheses (stents).. Brachytherapy.. Laser.. Diathermy.. Cryotherapy.. METHOD OF MAKING MATERIALS TO BE CONSIDERED.. Bronchial secretions by suction.. Brush cytology (brush) and just protected.. Brush microbiological.. Forceps (biopsy loop, diavronchiki biopsy).. Diavronchiki by needle aspiration (TBNA).. In conclusion we could say that inovronchoskopisi is a relatively simple method with wide application in the detection-diagnosis and treatment of many diseases of tree tracheiovronchikou and general respiratory system so as to be a valuable tool in daily hospital practice.. Diagnostic and Interventional fiberoptic bronchoscopy.. by.. D.. Hainis,pneumonologist.. Bronchoscopy (examination of the airways under direct visualization) has been applied since the end of the last century.. Initially , the rigid bronchoscope was used and since 1968 the flexible one was introduced , which has been used up to now.. The indications that come out of a bronchoscopy are many and include a wide range of respiratory diseases.. The method is used mainly as a diagnostic tool but it is used as a therapeutic one.. On the other hand , the contraindications are few and rare , especially when the expert is quite experienced.. In conclusion , we could say that fiberoptic bronchoscopy is a relative simple method applied widely in the detection-diagnosis but also in cure of many diseases of the tracheobronchial tree and generally of the respiratory system , so that it constitutes a valuable tool in the daily hospital practice.. exophytic mass (main right bronchus).. purulent secretions.. ca larynx.. foreign body removal..
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Title: Disease Legionnaire or Disease of air conditioner Descriptive info: Disease Legionnaire or Disease of air conditioner.. DISEASE Legionnaire or "DISEASE OF AIR CONDITIONER";.. The Legionnaires' disease came to light in 1976 when an outbreak (acute febrile respiratory illness) in the American Legion in Philadelphia in the United States.. A total of 221 people infected by pneumonia, 34 of which resulted.. Investigating the causative agent of this epidemic, isolated and characterized the responsible microorganism, a Gram negative bacterium which was named legionella.. There are about 40 species of legionella and more than half can cause disease in humans.. The legionella species pneumofila responsible for 90% of infections in humans.. Ideal environment for its development are water (lakes, rivers, reservoirs, pools, water supply systems of major building units, hot hot springs).. It is strong enough, can survive in various environmental conditions (temperatures from 0 to 630 C, also both in acidic and alkaline: pH from 5 to 8.. 5).. The temperature but particularly conducive to growth and proliferation of between 40 and 500 C.. Air conditioning systems (air-condition), are no longer sources of transmission of bacteria, as previously believed.. Method of transmission.. People affected by inhalation or aspiration mikrostagonidion water containing the organism.. Factors facilitating the development of human disease are smoking and alcohol abuse.. Also vulnerable are immunosuppressed persons and those suffering from chronic lung disease.. It is important to note that not transmitted from person to person.. Can affect any age.. The incubation period ... be pleural effusion.. It can appear as lung abscess or in the form of pearls thicken if septic emboli.. The cerebrospinal fluid and the examination of faeces are sterile.. In peripheral blood we moderate leukocytosis, hyponatremia, hypophosphatemia and abnormal liver functions.. Urine present microscopic hematuria.. Diagnosis.. There are several laboratory tests for diagnosis of disease such as the indirect method anosofthorizonton antibodies (increase in antibody 1: 128), isolation of bacteria from different materials (such as sputum, bronchial secretions, blood, pleural fluid, lung tissue, etc.. ).. It should be noted that legionella is not in the normal flora of the oropharynx and isolated from sputum or bronchial secretions is diagnostic.. In addition to its cultivation requires special culture media since suspended development of the normal flora, which is why it prefers to take stock through inovronchoskopiou.. Easily the diagnosis can be the detection of antigenic substances of the organism in urine.. Prognosis Treatment.. The disease legionarion is 1.. 8% of community acquired pneumonia.. If diagnosed early, the prognosis is excellent.. The delay in diagnosis, the coexistence of other diseases, aggravating factors (smoking, alcohol abuse) or impaired defenses (eg timing of cortisone, etc.. ), making it difficult to deal with the disease may prolong hospitalization and.. complications of the disease and increase mortality, which can reach about 15%.. Drugs of choice for treatment is antibiotics such as macrolides and quinolones.. The duration of treatment is about 3 weeks..
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Title: Drowning and near-drowning Descriptive info: Drowning and near-drowning.. Drowning and near-drowning.. The accidents by immersion in water with all the consequences that may have health and even life itself the victim of direct interest to the Greek society, given the close relationship with the sea.. The purpose of this article is to describe what these accidents, what can result, what should be done and how we can avoid.. Definition.. The term "drowning" is defined as death due to suffocation during immersion in a liquid medium, usually water, or within 24 hours of immersion.. A 'near miss drowning' is defined as an episode of immersion in water capable of severity to require medical attention and which can lead to morbidity and death (after 24 hours of the incident).. Epidemiology.. International.. Annually about 140,000 recorded deaths due to drowning worldwide.. For the near-drowning no precise statistics.. However, it is estimated that the impact of near-drowning is 20-500 times the incidence of drowning.. In the U.. :.. Every year there are 6500 deaths from drowning, and about 48,000 cases of near-drowning.. Drowning is the fifth leading cause of accidental death among all age groups, with average annual incidence of approximately 2.. 5-3.. 5 per 100,000 inhabitants, while for children aged 1 month to 14 years for young adults is the second cause of injury and death.. by accident.. 80% of accidents involve males.. Many near-drowning victims develop severe morbidity, which can lead to permanent health damage or death.. In children aged 1 month to 14 years morbidity occurs in 12-27% of survivors.. It is estimated that children 35% of episodes are fatal sinking, 33% leading to a degree of neurological impairment and 11% in severe neurological sequelae.. Greece.. Data included for the Greek area were unable to find, the Greek Statistical Sites on the Internet.. However, they may be cited as probably representative data for the prefecture of Corfu, according to an epidemiological survey conducted by the Medicine Hospital of Corfu for the years 1900-2003.. All in all, there were 160 cases of drowning, that is 12.. 3 cases per year.. These data, if traced back to the people of Corfu is approximately 100,000 residents and tourists during the summer, giving an annual incidence of drowning more than 10 serious incidents and 5 near-drowning per 100,000 residents annually.. The effect is much greater than at international level and about four times the U.. , which indicates the severity of the problem.. Causes and risk factors for drowning.. * Existence of various diseases.. *.. o Epilepsy.. o mental retardation.. o Convulsions.. o Myocardial infarction or syncope.. o poor neuromuscular control, as seen in severe arthritis, Parkinson, or other neurological disorders.. o Major depression / suicide.. o disorder anxiety / panic.. o Diabetes, hypoglycemia.. * Consumption of alcohol and to a lesser extent, other psychotropic drugs in swimming and sailing / boats use.. * Lack of appropriate education profile.. * Failure to use personal flotation devices.. * Dives in shallow water or water with rocks, the head trauma and / or cervical spine.. Risks of water sports.. * Poor education and substance abuse (alcohol or other psychoactive drugs).. * Failure of cervical spine-cervical spine and head injury associated with surfing, water skiing, and jet skiing.. Place where accident.. , the most frequent sites of accidents is the tub for children younger than 1 year, family pools for preschool children, while the lakes, rivers and seas are typically the location of drowning for young adults.. The fact that many family pools in our country have no physical barrier between the pool and house, or if there is a fence, the entrance gate is always open.. In Corfu sites drownings were identified in order of frequency: the sea (131), wells (12), swimming (7), river (1).. Pathophysiological disorders.. The main physiological consequence of failure is precipitated by prolonged hypoxia.. The target organ damage from precipitation is the lungs.. Damage to other systems is largely secondary to hypoxia and acidosis.. The morbidity and mortality from sinking due primarily to a lack of oxygen and the harmful effects on the brain, heart and other organic systems.. After an initial desperate attempt to breathe, and possibly aspiration, the immersion causes a variable degree and duration of reflex spasm of the larynx and closure of the epiglottis (defense mechanism to prevent the ingress of water into the lungs).. This leads to hypoxaemia.. Suffocation leads to relaxation of the airway, which allows many victims to fill the lungs with liquid medium in which the precipitation ( "wet drowning").. However, 10-20% of victims maintain the laryngospasmo until cardiac arrest occurred and stop the inhalation effort.. The victims are not eisrofoun any liquid ( "dry drowning").. In wet drowning in the development of hypoxaemia and other mechanisms contribute.. The eisrofithen liquid into the lungs causes pulmonary vasoconstriction via the vagus and hypertension.. Fresh water moving ... growth by preventing the expiratory airway occlusion, (3) ensuring.. improved alveolar ventilation and reduction in alveolar blood flow, and (4) increase the diameter of both small and large airways to improve distribution of ventilation.. * Reheating: Ypothermikoi patients who have suffered sudden, rapid precipitation, may show slowing of metabolism with preferred slope of blood to the heart, brain and lungs, which can exert a protective effect during subduction.. However, this is not the norm with most victims of subduction, which have done gradually and hypothermia are at risk for ventricular fibrillation and neurological damage.. Therefore, fast xanathermane ypothermikous patients until normothermia.. * Place a nasogastric tube to assist in efforts to boost and ourokathetira for assessment of urine output.. * Try to provide a central vein with caution in these patients to avoid irritation of the vaginal hypothermia and subsequent dysregulation.. * Do not stop the resuscitation of a victim of near-drowning until the patient is warm to a minimum of 30 ° C.. * Appropriate therapy electrolyte disorders, seizures, bronchospasm, and vronchorroias caused by cold, dysrhythmia, and hypotension if necessary.. Exit from the Hospital.. * The time of patient exit from the hospital depends on the background, this session failures and the extent of damage from the dip.. * Patients able to describe a good record of failure by a small dip, with no evidence of significant harm and without evidence of bronchospasm, tachypnea / dyspnea, or insufficient oxygenation (based on arterial blood gases and pulse oxymetry) may leave the Emergency Department after 6.. -8 hours of monitoring.. * Victims of mild to moderately severe dip, which have only slightly improved symptoms during the follow-up and have no disturbance in arterial blood gases and chest radiography, may leave after 6-8 hours, monitoring the Emergency Department.. * Victims of serious immersion, with only slight symptoms and no findings on arterial blood gases, the pulse oximetry, and chest radiograph, need to be monitored for longer.. * Some patients may have a slightly to moderately severe hypoxaemia which was corrected easily with oxygen.. He introduced these patients in the hospital for observation.. They leave the hospital after the fall of hypoxaemia if they do not have further complications.. * Introduced in ICU patients requiring intubation and mechanical ventilation.. Varying degrees of neurological and pulmonary events usually epiplekoun their course.. Weather in near-drowning.. The prognosis depends largely on the extent and duration of hypoxia episode.. Moreover, the average temperature of immersion, the availability and timely implementation of specific treatment, and the coexistence of medical illness or injury is often severe determinants of outcome.. Overall, patients who have consciousness and have normal x-ray upon arrival at the hospital can be expected to recover fully.. Those who are able to dormancy but to wake up and have normal breathing almost good prognosis.. However, two thirds of those requiring cardio-respiratory and revive those who are admitted in a coma or die remain with severe neurological impairment.. The fact that a proportion of these patients to recover fully may require the need for extensive and intensive efforts to revitalize-recovery in all cases near-drowning.. The neurological disorders is a serious proportion of near-drowning will improve gradually and subside over several months.. However, 5-20% of patients will have lasting consequences, many of which would eventually prove fatal.. Prevention - Prevention.. Deterrence is the key to treatment and education of society is the key to prevention.. Parents should be aware of their obligations, and limits the possibilities of bathing their children.. We must constantly supervise their children when they are near water, even in the tub, whether the babies.. Instant removal of attention is likely to result in an accident.. All (family) swimming pools and other areas containing water (eg reservoirs) should have a fence, and the door is locked when no supervision from adults.. Parents who have a family pool must take serious account to be trained in cardio-pulmonary resuscitation, in case you will need to apply for their child.. Children should understand the capabilities and limitations on swimming and not allowed to play dangerous in or around water.. People should avoid using alcohol or other psychoactive substances during swimming or participating in other water sports, carefully check the water depth and a possible dangerous items (eg rocks) when attempting dives.. Adequate lifesaving equipment of vessels to be used, including personal life-and everyone on board vessels must be swimmers and be able to understand the weather and water conditions.. Persons with underlying disease that might expose them to danger in swimming, like epilepsy, seizures, diabetes mellitus, significant coronary artery disease, severe arthritis and neuromuscular disorders operation, swim only under the supervision of another adult who is able to save.. if any event.. Finally, a great help offered by the presence of trained lifeguards on crowded beaches and the beaches at risk.. Δρ Κυριάκος Δ Χαίνης,Πνευμονολόγος..
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Title: FAGERSTROM : test for nicotine dependence Descriptive info: FAGERSTROM : test for nicotine dependence.. pneumonologist..
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Title: DEEP NECK INFECTIONS Descriptive info: DEEP NECK INFECTIONS.. (pdf).. Vasilis Avramidis.. Files.. DEEP NECK INFECTIONS figures..
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Title: Aging Descriptive info: Aging.. Aging.. DR FILIPPOS KANOUTOS.. PATHOLOGOS - SPECIAL GIRIATROS.. Old age is a modern phenomenon in the course of stable, easy to forecast early and perhaps the one with the most serious consequences.. It is a mental state is determined by many factors such as chronological age or by our personal crisis.. The Alfin - Slater argues that old age can be considered outsourcing of multiple cellular and systemic changes that occur with age.. The psychology of aging stems from 3 main events:.. From the mind of arxamenis and evolving state of physical and mental functions.. The factual circumstances of the family and the wider social environment.. From instinctive mobilization and development of the necessary protection, defense and balancing mechanisms, allowing them to adjust and balance in a constantly changing internal and external environment, based on temperament, experience, character and specific social conditions.. Taking into account certain factors that play a key role in different age periods of life can not separate the geriatric age of 3 years.. , 48-65: critical age or old age first: here the importance of predominantly organic problem, that of those organic changes of the body characterize this period of our lives we call old age.. ; 65-75: Interim period is a critical age between actual age: the problem here is purely clinical and directed towards the diagnosis should be as early as possible, damage or malfunction that occurs in every elderly person.. ; 75: real old age: the period is a general medical-social problem resulting from disability or emergency care, directly or indirectly.. But if any is the limit, it still marks the age in one dimension that is the date.. therefore beyond the chronological concept by defining the age, we must take into account our biological - psychological - social and medical purposes.. Biological age is determined by specific measurements of the body such as the power - the fitness - speed - the acuity of the senses - the condition of the skin - the color and good quality ... the Patriarch at the top, it has become increasingly rare and only in the rural community can find examples of this kind.. One of the main causes of this phenomenon is the industrialization and new life styles, which help to remove more and more young people than older people and to transport them from the countryside to large cities.. On the other hand in large cities, the tendency to isolation and fragmentation of the various households comprising mainly young people from the elderly, assisted by the new features are the business of work and leisure activities, as well as the use of.. leisure, with different and more expensive lifestyles.. The effects of economic - social identity, arising from the increasing number of elderly people and isolating them, mainly as the need to secure livelihoods of older people who are no longer able to work or withdrawn.. from work due to age.. Another key consequence resulting from the isolation and crowding out the older person's statements are not - and understanding of the incompatibility between new and old.. The old labor to monitor the rapid social change and accept innovation, while the other part is not new to trying to understand or accept the bringing models and conduct which sees them obsolete.. Very important is the fact that the elderly person is unable to find in modern society, traditional roles as the major component, the grandfather of the worker, friend, etc.. , with the result that is.. easy to take part in social life resulting in isolation and crowding.. The crisis of the older person also serves as the progressive, almost physical damage of the psycho-mental faculties, which is different from person to person.. The result is always increasing frequency clumsiness a situation that worsens the removal from the home and entering a nursing home generally not acceptable to the elderly.. Based So all this, it is understood that the study of the problem of pensions should be organized according to the needs arising from it.. FILIPPOS KANOUTOS..
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