Bronchiolitis adults

Bronchitis and bronchiolitis are inflammatory conditions of the large and small elements, respectively, of the tracheobronchial tree. The inflammatory process does not extend to the alveoli. Bronchitis frequently is classified as acute or chronic. Acute bronchitis occurs in aU ages, whereas chronic bronchitis primarily affects adults. Bronchiolitis is a disease of infancy. 

RSV infection is highly contagious and infects mostly children, causing bronchiolitis and pneumonia. Infants younger than 6 months are the most severely affected. In adults, RSV causes colds and bronchitis, with fever, cough, and nasal congestion. When RSV affects immunocompromised patients, the consequences can be severe and sometimes fatal. 

For extrathoracic deposition of particles, the model uses measured airway diameters and experimental data, where deposition is related to particle size and airflow parameters, and scales deposition for women and children from adult male data. Similar to the extrathoracic region, experimental data served as the basis for lung (bronchi, bronchioles, and alveoli) aerosol transport and deposition. A theoretical model of gas transport and particle deposition was used to interpret data and to predict deposition for compartments and subpopulations other than adult males. Table 3-4 provides reference respiratory values for the general Caucasian population during various intensities of physical exertion. 

In the lungs, NO affects not only blood vessels but also the bronchi and bronchioles as well. In newborns with defective gas exchange, NO inhalation decreases pulmonary arterial blood pressure, enabling more blood to be oxygenated. In adults with obstructive lung diseases, NO inhalation seems to relax airway smooth muscle, thus acting as a bronchodilator. 

The commonest form of lung damage is an interstitial alveolitis, although pneumonitis and bronchiolitis obhter-ans have also been reported, as have sohtary localized fibrotic lesions, non-cardiac pulmonary edema, pleural effusions, acute respiratory failure, acute pleuritic chest pain, and adult respiratory distress syndrome (SEDA-17, 220) (SEDA-18, 201) (66-68). Amiodarone has also been reported to cause impairment of lung function, even in patients who do not develop pneumonitis (69), and preexisting impairment of lung function may constitute a contraindication to amiodarone. 

The overall density of the principal la" DC population in young adult animals varies from 500-800 mm tracheal epithelium to <100 mm in the small airways (Schon-Hegrad et ol., 1991 Gong et al., 1992) however, in older animals (> 1 year old) these differences narrow markedly, presumably reflecting net inflammatory history (unpublished). The density of DCs within the epithelium of small bronchioles in humans (sectioned as shown in Holt et al., 1990a) is in the order of 500-600 mm . In parenchymal lung tissue, DCs are typically found in interstitial tissues at the junction of adjoining alveoli ( interseptal junctional zones Holt et... 

Ascariasis is the infestation of humans with the round worm, Ascaris lumbricoides. The adult worms normally live in the lumen of the small bowel of an infected individual. The eggs of the worm are passed in the faeces of these individuals and can contaminate water or food. Humans become infected when they ingest contaminated water or food. Gastric juices cause the eggs to hatch in the small bowel. The larvae penetrate the intestinal wall to enter the blood stream and reach the lungs. They migrate, or are carried by the bronchioles to bronchi, ascend the trachea to the glottis and pass down the oesopha-... 

Follicular bronchiolitis is usually seen in adults, although it may also be seen in children (6,81). Patients typically have progressive dyspnea, cough and fever some may even present with recurrent pneumonia or weight loss (81). In cases where rheumatoid arthritis is the underlying cause, rheumatoid factor is often seen at very high titers (1 640 to 1 2560). 

Perez de Llano LA, Soilan JL, Garcia Pais MJ, et al. Idiopathic bronchiolitis obliterans with organizing pneumonia presenting with adult respiratory distress syndrome. Respir Med 1998 92 884-886. 

Respiratory effects occur in a dose-dependent manner from the nasal mucosa to the terminal bronchioles (WHO, 1970 Balali-Mood et al., 1986). Acute pulmonary effects commence with a tracheobronchitis, followed by bronchopneumonia, adult respiratory distress syndrome, and even pulmonary emboli in severely intoxicated patients, which may lead to death, mostly during the second week after SM exposure. Chest X-ray (CXR) of the Iranian SM-intoxicated patients revealed fewer abnormalities than the clinical manifestations. However, the severely intoxicated patients showed abnormal CXR results. CXRs of an Iranian patient with bronchopneumonia caused by acute SM poisoning before and after treatment in 1985 are shown in Figure 5.2. 

Fig. 4.1. Mixed thin-section computed tomography patterns in an adult smoker. There is generalised ground-glass opacification in both lungs (taken to represent a component of respiratory bronchiolitis). In addition, there are signs of fibrosis a fine superimposed reticular pattern is seen, and there is evidence of traction bronchiectasis thin arrows) in the right lung. There is also centrilobular emphysema, of limited extent, in the right lung thick arrow)...

Vassallo R, Ryu JH, Schroeder DR, Decker PA, Limper AH (2002) Clinical outcomes of pulmonary Langerhans -cell histiocytosis in adults. N Engl J Med 346 484-490 Vassallo R, Jensen EA, Colby TV, Ryu JH, Douglas WW, Hartman TE et al (2003) The overlap between respiratory bronchiolitis and desquamative interstitial pneumonia in pulmonary Langerhans cell histiocytosis high-reso-lution CT, histologic, and functional correlations. Chest 124 1199-1205... 

Turton CW, Williams G, Green M (1981) Cryptogenic obliterative bronchiolitis in adults. Thorax 36 805-810... 

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