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Asbestosis

It is a respiratory disease that is produced by inhalation of asbestos fibers. Asbestos is the name given to a group of naturally occurring minerals found in the environment, too, has long fibers that can be separated and are resistant to high temperatures.


Causes
Inhalation of asbestos fibers can cause lung fibrosis, the longer the exposure time to asbestos and the amount aspirated, the greater the risk of disease. In addition, it can cause cancer, the World Health Organization (WHO) says, "all forms of asbestos are carcinogenic to humans." Smoking along with asbestos fibers can increase your chances of getting lung cancer.

Asbestos we can find it in:

The highest levels of asbestos are found in cities or industrial areas.

Building materials such as tiles, tiles, cement products or tiles.

Mining.

Containers or coatings.

Textile materials.

Friction products such as brakes and clutch of automobiles.

Drinking water may contain asbestos from natural sources or cement pipes.

Demolitions, repair or renovation of buildings or houses.

Families of people working with asbestos may be exposed by the particles they carry in their clothing.
Symptoms usually do not appear until 20 years after exposure to asbestos. The manifestations that patients may have are:

Difficulty breathing and decreased ability to exercise.

Cough.

Chest pain.

Drum stick fingers: increase in fingertip size and loss of the angle that the nail forms at its exit.

Nail abnormalities: problems with color, shape, texture or nail thickness.
Prevention
To prevent asbestosis from occurring, people who have been exposed to asbestos should follow guidelines.

Taking a chest x-ray may help prevent asbestosis. In addition, reducing contact with asbestos as much as possible would also help reduce the risk of having the disease. Workers should wear appropriate protective gear, such as a suit or face masks, and it is preferable to avoid tobacco.

Types
According to the American Cancer Society, there are two main types of asbestos, both have been associated with cancer, especially pleural mesothelioma and lung:

Chrysotile: is the most common in industries. The chrysotile fibers are wrapped together in a spiral.

Amphibole: these fibers are shaped like a straight needle. Its types are amosite, crocidolite, tremolite, actinolite and anthophyllite.
Diagnosis
People with asbestosis often have abnormal sounds of pulmonary auscultation called rales or crackles.

These tests can help diagnose the disease:

Chest X-ray is used to evaluate the lungs, heart, and pleura.

Pulmonary Functional Tests: These are a group of tests that measure how well the lungs work. The simplest is spirometry.

Pulmonary high resolution computed tomography: uses x-rays to create images of cuts of the chest and lungs.

Lung scintigraphy with gallium: A radioactive gallium is used to identify inflammation in the lungs.

Pleural or pulmonary biopsy.
Treatments
There is no cure, so it is very important to avoid contact with asbestos. Most treatments for asbestosis usually relieve symptoms but are not curative:

Pulmonary Rehabilitation: Helps the affected person better manage pulmonary symptoms.

Receive oxygen, using masks or nasal goggles.

If the symptoms are severe, lung transplantation can be successful.

If there are tumors, surgery would be a first step, then chemotherapy.
Other data
Half of the deaths from work-related cancer are caused by asbestos, according to the World Health Organization.

Exposure to asbestos is a cause of lung cancer, larynx, ovary and mesothelioma, (mesothelium is a tissue that covers the lungs, stomach, heart and other organs, mesothelioma is a tumor of those tissues). In addition, it can cause other diseases such as plaques, thickening and pleural effusions.
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Asthma

Asthma is an increasingly common disease among children and young people. It is estimated that 5 percent of the adult population and 10 percent of children and adolescents in industrialized countries suffer from it, and in many cases the disease appears in response to certain allergy-producing stimuli: pollen, dust mites, Cat and dog skin, smoke, cold air, certain foods or food additives. It is characterized by episodes of respiratory distress (seizures), usually associated with other symptoms such as coughing, wheezing, and choking. Symptoms vary with age.

Thus, in children, cough predominates, especially during the night, while in adults the three main symptoms are chest stiffness, wheezing and fatigue at night. In recent years there has been a higher prevalence and a progressive increase of cases in children and adolescents, which highlights the need to take preventive measures. The cure of asthma can only be achieved in some cases of asthma allergic or related to the patient's workplace, as long as the causative agent can be avoided.

Causes
Pollens: Although pollination occurs during spring, there are variations depending on the climates and types of plants. Symptoms of pollen allergy are usually detected with concentrations greater than 50 pollen grains per cubic meter of air. The small size of the pollen favors it to remain suspended in the air for a long time and travel great distances until it penetrates the respiratory passages.

In Spain prevails pollen of the grasses, the olive tree in the south zone and the parietaria in the Mediterranean zone.

Dust mites: They are microscopic parasites that live in the dust of houses and feed on dermal scales and other debris. They need precise conditions to develop: 25ºC temperature and 85 per cent humidity.

In Spain the most important are Dermatophagoides pteronyssinus and Dermatophagoides Farinae.

Foods: Food-related asthma episodes are common during childhood and are accompanied by other symptoms such as urticaria and vomiting, so they tend to be confused with food poisoning. The products that cause the most reactions are milk, eggs and fish. In adulthood this type of asthma is less frequent.

Fungi: Some fungi produce allergens that are deposited in their spores, and the release of these depends on the humidity, temperature and the existence of organic matter in their environment, such as garbage or shower curtains. The most favorable periods for its development are spring and autumn, and among the most common are the alternaria, cladosporium, penicillium, aspergillus and mucor.
During asthmatic seizures, the bronchial mucosa lining the respiratory tract becomes inflamed and a thick mucus is produced which obstructs the airway ducts. As a result, the muscles surrounding these ducts contract and narrow by decreasing their diameter, impede the passage of air and complicate breathing. The basic characteristics of the disease are as follows:

Inflammation: Increases bronchial sensitivity and obstruction. Sometimes its origin is allergic. It produces an increase of the secretions and the contraction of the bronchial musculature.

Increased bronchial sensitivity: After exposure to various stimuli (fumes, gases, odors, cold air or exercise), the bronchial tubes of the asthmatics contract producing the narrowing of the airway.

Bronchial obstruction: It is variable and reversible spontaneously or with treatment. During crises the air circulates with difficulty producing beeps and feeling of fatigue or drowning. At the time when the crisis resolves the air can move normally through the bronchi and symptoms disappear.
Prevention
Although asthma has no cure, a number of measures can be taken to prevent a crisis. Here are some tips:

When the cause of asthma is extrinsic such as an allergy, it is advisable to avoid exposure to the agents that cause it. The main ones in Spain are pollen (grasses, olive, cupresáceas, arizónicas, shade plantain and parietaria), environmental fungi, dust mites and epithelia of some animals (dogs, cats, horses and Rodents commonly). The most common symptoms of allergy to pollen are itchy eyes, sneezing and runny nose. In the event that a person is not diagnosed but has any of these symptoms, you should go to the allergist.

Another precaution that allergists should take into consideration is to avoid performing intense exercises during pollen season, as this can lead to respiratory difficulties leading to an asthma attack.

Patients with rhinitis should be especially careful as this disease often precedes asthma. It is recommended that the patient is observed for any indication of asthmatic principle.

Because of their limitations in detecting and explaining the symptoms they present, children are a vulnerable group (remember that asthma affects 10 percent of the child and adolescent population). Parents should monitor children especially when they go through a viral process or if they are obese, paying particular attention to the occurrence of beeping, fatigue and other signs of bronchial obstruction.

Asthmatics already diagnosed should follow the treatment closely, even when experiencing improvement phases. According to data provided by the Spanish Society of Pneumology and Thoracic Surgery on World Asthma Day (May 5), only 30% of patients have a correct adherence to treatment, which makes it difficult to control the disease and crisis.

People with asthma should completely abstain from smoking, since tobacco smoke is an irritant that causes inflammation of the bronchi.

In cases where asthma is caused by the exposure of meal, wood or other products present in the work environment (occupational asthma), it is necessary to avoid contact with an adequate ventilation system and the use of protective masks. If the picture is severe, it is advisable to change jobs.

It is always advisable for the asthmatic person to be alert to any signs of aggravation of symptoms. It is important that the specialist provide the patient with a written treatment plan with the precise instructions on the administration of the medications that he needs. These instructions can be modified according to the severity of the symptoms, so it is advisable that the patient is able to perceive any changes in the clinical picture, for example, a greater need to resort to a bronchodilator, unusual discomfort at night, beeping When exercising, etcetera.
There are different classifications of asthma. As for its origin can be divided into intrinsic asthma and extrinsic or allergic asthma. The origin of intrinsic asthma is unknown and is most commonly detected in adulthood. It has a worse prognosis than the one of allergic character and tends to be chronified. Extrinsic asthma, on the other hand, consists of an antigen-antibody reaction that triggers the process. It mainly affects children and young adults, is characterized by reversible and brief attacks of bronchospasm with whistles and respiratory distress, and is controlled with appropriate treatment.

Allergy is an alteration of the body's defense mechanism, which consists of an exaggerated reaction, by means of a special antibody (immunoglobulin E), against substances that are in principle not harmful (pollens, mites, epithelia, food or medicines) . When these antibodies, which are bound in certain cells, bind to allergens, certain substances are released that, directly or through other cells, cause inflammation of the organ where they settle (bronchi, nose, eyes or skin ). There is an inherited predisposition to allergy, but exposure to allergens is necessary to develop the disease.

Asthma can also be classified as mild, moderate or severe, depending on the frequency and intensity of symptoms, how it affects daily activity and the degree of bronchial obstruction. Mild asthma can be controlled by pharmacological treatment and does not usually alter the daily lives of patients; Moderate asthma requires more severe treatments and interferes with patients' daily activities; And severe asthma requires continued control and can endanger the lives of people who suffer from it.

Diagnosis
First, a clinical diagnosis must be made, based on the clinical history where the symptoms described above are revealed. In addition, it is necessary to investigate the characteristics of the crises, the form of presentation, the interval between the crises, the onset, the seasonal period, the evolution of the disease and a general pediatric history in order to make a differential diagnosis of other respiratory diseases that can The same symptoms as asthma. In order to be able to objectify obstruction to airflow, the functional diagnosis is made, which consists of a respiratory function test (spirometry). It has the drawback that requires the collaboration of the child and therefore is performed in children over 6 years.

In all children with suspected bronchial asthma, baseline and bronchodilator spirometry (giving the child a drug to inhale) should be performed to demonstrate that the airway obstruction is reversible (characteristic of asthma). Finally, an etiological diagnosis, aimed at finding the cause that triggers the symptoms; Identifying the cause is the most important step in controlling the disease.

Treatments
The treatment of asthma should cover several fronts: inflammation of the bronchial mucosa, bronchospasm and allergies:

1. Inflammation of the bronchial mucosa:
In recent years it has been proven that the treatment of inflammation is the most important part of asthma treatment. Until now, too much emphasis has been placed on bronchodilation, but if inflammation is not treated, the effects of bronchodilators are ephemeral. There are several drugs that have an anti-inflammatory effect on the bronchial mucosa, but the most potent and effective are inhaled corticosteroids (cortisone). Inhaled doses of corticosteroids are very low and produce a topical effect without the side effects of oral, intravenous or intramuscular administration. Inhaled corticosteroids have become the most important drug in the treatment of asthma. They begin to be prescribed in patients with persistent asthma, that is to say, those in which symptoms occur several days a week, and in those in which nocturnal symptoms occur. For those symptoms that occur sporadically, for example once or twice every 15 days, it is not necessary to start with corticosteroids and bronchodilators may suffice.
Bronchospasm:
Inhaled corticosteroids do not act immediately, but when they take effect after a few days of treatment, bronchospasm forwards. But for the immediate treatment of the same bronchodilators are used that normally are administered by inhalation. There are two basic types depending on the duration of their action: long-acting bronchodilators are taken in the morning and at night every day, whether or not they have symptoms, while short-acting bronchodilators are usually reserved to take if necessary (Choking, coughing, etc). The primary objective is for patients to resort to short-acting bronchodilators on very few occasions. If this is not the case, it is necessary to promote anti-inflammatory treatment. Obviously, there are patients with severe asthma who, despite receiving maximum anti-inflammatory therapy, frequently require bronchodilators.

. Allergies:
In patients in whom an allergic component is shown, treatment with antihistamines may be beneficial. On the other hand, with certain allergies there are effective immunological treatments (vaccines) that can help a lot in the control of asthma. However, the most effective treatment of allergies is to avoid or minimize exposure to allergens. For example, in the case of allergy to dust mites, simple household hygienic measures can significantly reduce the presence of dust mites.

Diseases associated with asthma:
Gastroesophageal reflux and chronic sinusitis may aggravate or cause asthma, so it is important to rule them out in cases of asthma that do not respond to the usual treatment.

Other data
This disease is a public health problem affecting 10 percent of children and young people, and 5 percent of the adult population in industrialized countries. In Spain two million individuals suffer from asthma, and in the world they exceed 150 million. As for the mortality rate due to this pathology, in our country 2 x 100,000 h / a die, and in the world there are 100,000 deaths per year. Deaths are caused by acute attacks that can not be controlled, although there are other factors that prevent the approach of fatal crises.

A multicenter study sponsored by the Spanish Society of Respiratory Pathologies (Separ) has shown that there is a relationship between dying or suffering a near-fatal asthma crisis and alexithymia, a psychological disorder that affects 10 percent of the healthy population and prevents Perceive and express well the emotions and physical sensations. The study finds that asthmatics with alexithymia, about 38 percent of the patients who took part in the research, suffer more often almost fatal crises, since not correctly perceiving the symptoms of asthma are not able to act accordingly.

"Alexithymia could also be one of the causes of the low compliance of the treatment that is registered among asthmatic patients," said Vicente Plaza, of the Pneumology Service of Hospital San Pablo, Barcelona. Asthma is the most frequent cause of emergency visits in pediatric age and the fifth cause of primary care consultation. Sixty percent of the urgencies treated in the pulmonology services are asthma exacerbations, most of the time due to lack of compliance with the prescribed treatment.

This confirms that the disease is not well controlled, since more than half of diagnosed asthmatics, despite being under treatment, have to use rescue medication to relieve the exacerbation of their symptoms. Lack of compliance could be resolved with more convenient drugs, improved communication between doctor and patient, and patient education. "The patient should be informed about everything related to his illness and trained for the correct use of the medication, creating an active and continuous relationship between the practitioner, the patient and their environment.

Thus, through the acceptance and understanding of the disease, the patient is responsible for his treatment, and does not need to lie to the doctor or feel guilty for not following the treatment, "says Santiago Nevot, head of the Pediatric Service of Manresa General Hospital So far it has been proven that compliance is better with oral drugs than inhaled and increases if it is a single daily dose.
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Astigmatism

Astigmatism is a defect in the curvature of the cornea, which prevents the clear focus of objects near and far. This is because the cornea, instead of being round, is flattened by the poles and different radii of curvature appear in each one of the main axes.

Therefore, when light strikes through the cornea, distorted images are obtained that affect vision from near and far.

Causes
The underlying cause of this anomaly is hereditary, although in some cases it may occur after a corneal transplant or cataract surgery. The most frequent symptomatology is the perception of distorted images. However, it can often cause headaches or eye discomfort.

In addition, depending on the age, amount and type of astigmatism the symptoms can be different, and even, do not affect the vision.

Prevention
Given the causes that cause it to appear, astigmatism can not be prevented.

Types
This vision defect can be classified into:

Simple astigmatism: Appears on a single axis.

Astigmatism compound: In addition to affecting an axis is associated with myopia or farsightedness.

Mixed astigmatism: When one axis focuses in front of the retina (myopia) and another behind the retina (hypermetropic).
Diagnosis
Astigmatism can be detected from an ophthalmological examination that includes a refraction test.

If the patient, whether child or adult, can not perform the standard refraction test the specialist can request an ophthalmoscopy, a test that measures refraction through reflected light.
Like other ocular defects, the treatment of astigmatism admits a multiple approach:

It can be corrected using glasses, even if it is a solution aesthetically not accepted by some people.

The second alternative is the use of contact lenses, although these cause a dependence on use, in addition to requiring hygiene and maintenance that some patients find impractical.

However, the most permanent option is laser surgery that corrects the defect and allows the patient not to rely on glasses or contact lenses. However, the economic cost is higher and, like all surgical operations, carries risks.

Other data
As with other eye conditions, if the patient begins to detect that they have difficulty seeing or to visualize the details of their environment, they should consult the specialist. In addition, if after wearing glasses and / or contact lenses the problems continue or worsen it is advisable to visit the doctor again to check if the diagnosis is correct or if corrective lenses are well graded.

Forecast
Depending on each person, the astigmatism can increase with time causing the patient to have to renew the glasses and the lenses to adapt to the new graduation.

The alternative of the laser usually finishes with this affection or to reduce it to a great extent.

On the other hand, if in children, astigmatism can only be corrected in one eye, it can lead to the development of an amblyopia.

Contact your doctor for more information. The information provided on (what the health) is of a general nature and for purely disclosure purposes can in no way replace the advice of a physician (or a legally qualified person) or, in specific cases, of other operators health.


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