Percy Harvin Jersey
Posted: Tue Feb 23, 2016 1:22 am
The number and range of occupational respiratory concerns are rapidly increasing Seantrel Henderson Jersey , and include the following: ? Asbestos ? Mesothelioma ? Silicosis ? Interstitial Pulmonary Fibrosis ? Popcorn Workers? Lung ? Wood Dust ? Benzene?Related Diseases These cases are medical record intensive with many critical details that can be used as ammunition for litigation. Understanding the various medical and diagnostic aspects of each disease etiology is important in knowing what to look for and how to strategize. All organ systems in the body can be targets of toxic exposure. The respiratory system is both a target organ and a portal of entry for toxicants. As a foundational starting point, let us recall our basic anatomy and physiology. As air is inhaled through the nose and mouth, it collects in the throat and passes through the trachea into the lungs. The windpipe divides into right and left bronchiole tubes. The right lung is divided into 3 lobes, the left into 2. The lungs are surrounded by a membrane, pleura, which separate it from the chest wall. The pleura are mesothelium. The bronchiole tubes are lined with Cilia, hairs that move and combine with mucous, which is the mechanism for carrying unwanted dust, germs and matter up and out of the trachea, which is then coughed up. The smallest subdivisions of the bronchial tubes are called bronchioles, at the end of which, are the air sacs or alveoli. The alveoli are the final destination of the air we breathe and it is here that the exchange of oxygen and carbon dioxide occur in the capillaries. Picture 1 ? Normal bronchioles As a system of narrowing passageways, any disease or reaction that affects the diameter of the bronchioles impacts breathing, respiration, cardiovascular function, and tissue perfusion. If Cilia and mucus production are impacted Richie Incognito Jersey , particles are not carried out of the airways. So, any person with pre existing diseases that restrict airways, such as asthma, COPD (chronic obstructive pulmonary disease), or bronchitis may progress more rapidly with asbestos related disease. Picture 2 ? Asthmatic bronchioles Most occupational respiratory diseases either manifest as common medical problems or have non specific symptoms. Etiology distinguishes a disorder as an occupational illness. Unless an exposure history is pursued by the doctor, the etiological diagnosis might be missed, treatment may be inappropriate, and the exposure can continue. Most people with an illness brought on by exposure to a toxin obtain their medical care from doctors who are not specialists in occupational medicine. Very few providers get information about home, workplace, or community environment as a part of the demographic and social history. There was a recent study of 1000 medical charts in a primary care setting and only 24 percent of charts had any mention of the patients? occupation, and only 2 percent had exposure history. Although most doctors recognize the importance of taking a work and exposure history to evaluate certain problems, most have little practice in doing so. Asbestos Picture 3 ? Asbestosis Inflammation This is a microscopic view of an Asbestos fiber coated by protein surrounded by macrophages. There is conflicting evidence regarding the relative importance of the different physical properties of the asbestos fiber types in causing disease. Certainly, fine fibers are more pathogenic than thick fibers. Larger diameter fibers that are longer tend to become deposited in larger airways, in which they are effectively cleared. In comparison, fibers that are more slender and shorter tend to be deposited in the smaller airways, from which only a portion of them are cleared. Despite differences in their physical properties Percy Harvin Jersey , all types of asbestos fibers are fibrogenic. The most recent data from the CDC in 2005 show us that deaths from asbestosis have been on the rise since the late 70?s with a peak in 2000. Asbestosis is reported to develop in 49 percent of adults with industrial asbestos exposure, after a latency period of 20 45 years. These patients present clinically with chest pain, pain with breathing, fatigue and clubbing of the fingers. Asbestosis is diagnosed on the basis of certain clinical, functional, and x ray findings, as outlined by the American Thoracic Society. These criteria include: ? A Reliable history of non trivial exposure ? Appropriate interval between exposure and detection ? Abnormal chest x ray ? Abnormal pulmonary function test ? Abnormal diffusing capacity ? Bilateral crackles at the base of the lungs not cleared with coughing Picture 4 ? Diagnostic X Ray This x ray is virtually diagnostic of asbestos exposure with bilateral scattered pleural plaques. Note that there are limitations with x rays; studies have shown a high rate of both false negative and false positive rates. Extrapleural fat mimics pleural thickening and is a significant cause of false positive readings. 20 percent of asbestos patients have normal chest x rays. That being said, x ray is still the preferred modality for initial detection and characterization of pleural disease. High Resolution Cat Scans are more sensitive and specific than chest x rays and are playing an increasingly important role in the diagnosis of all asbestos related pleural disease. Other modalities that are being utilized include ultrasound and nuclear medicine, ultrasound to define pleural effusions and guide aspirations, and biopsy. Nuclear medicine is being used to differentiate benign from malignant asbestos related pleural disease and to give a quantitative index of inflammatory activity. In looking at the medical records, these studies will all be documented by radiology reports in the diagnostic test section, and will be referenced by physicians in the history and physical, progress notes, consultation notes, and the hospital admission and discharge records. Mesothelioma The mesothelium is a membrane that line.