Bronchiectasis: Difference between revisions
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It is underestimated in prevalence, incidence and morbidity because symptoms are often ascribed to smoking. A study by Hill <ref name="4">Hill AT, Welham S, Reid K, Bucknall CE. British Thoracic Society national bronchiectasis audit 2010 and 2011. Thorax 2012; 1:1-3.</ref>found that one in 1000 Britons have bronchiectasis, with associated deaths increasing at a rate of approximately 3% per year in England and Wales <ref name="5">Roberts HJ, Hubbard R. Trends in bronchiectasis mortality in England and Wales. Respiratory Medicine 2010; 104: 981-5.</ref>. Though the overall mortality rate is increasing in these countries, rates in older groups are rising whereas rates in younger groups are falling <ref name="5">Roberts HJ, Hubbard R. Trends in bronchiectasis mortality in England and Wales. Respiratory Medicine 2010; 104: 981-5.</ref>. A disproportionate amount of cases found in developing countries and in Aboriginal populations in affluent communities <ref name="6">Chang AB, Marsh RL, Vaughan-Smith HC, Hoffman LR. Emerging drugs for bronchiectasis. Informa healthcare 2012; 17: 361-378.</ref>. In some populations, an improvement in socio-economic status, housing and education can improve overall health and reduce the incidence of respiratory infection and development of bronchiectasis <ref name="6">Chang AB, Marsh RL, Vaughan-Smith HC, Hoffman LR. Emerging drugs for bronchiectasis. Informa healthcare 2012; 17: 361-378.</ref>. <br> | It is underestimated in prevalence, incidence and morbidity because symptoms are often ascribed to smoking. A study by Hill <ref name="4">Hill AT, Welham S, Reid K, Bucknall CE. British Thoracic Society national bronchiectasis audit 2010 and 2011. Thorax 2012; 1:1-3.</ref>found that one in 1000 Britons have bronchiectasis, with associated deaths increasing at a rate of approximately 3% per year in England and Wales <ref name="5">Roberts HJ, Hubbard R. Trends in bronchiectasis mortality in England and Wales. Respiratory Medicine 2010; 104: 981-5.</ref>. Though the overall mortality rate is increasing in these countries, rates in older groups are rising whereas rates in younger groups are falling <ref name="5">Roberts HJ, Hubbard R. Trends in bronchiectasis mortality in England and Wales. Respiratory Medicine 2010; 104: 981-5.</ref>. A disproportionate amount of cases found in developing countries and in Aboriginal populations in affluent communities <ref name="6">Chang AB, Marsh RL, Vaughan-Smith HC, Hoffman LR. Emerging drugs for bronchiectasis. Informa healthcare 2012; 17: 361-378.</ref>. In some populations, an improvement in socio-economic status, housing and education can improve overall health and reduce the incidence of respiratory infection and development of bronchiectasis <ref name="6">Chang AB, Marsh RL, Vaughan-Smith HC, Hoffman LR. Emerging drugs for bronchiectasis. Informa healthcare 2012; 17: 361-378.</ref>. <br> | ||
== | == Aetiology == | ||
The cause is unknown for 50% of cases, but it has been linked to inflammatory bowel disease, rheumatoid arthritis, and in 29-50% of patients, COPD <ref name="7">Goeminne P, Dupont L. Non-cystic fibrosis bronchiectasis: Diagnosis and management in the 21st century. Postgrad Med J 2010; 86: 493-501.</ref>. There are several associated conditions with bronchiectasis including; cystic fibrosis, primary ciliary dyskinesia, lung tuberculosis, allergic bronchopulmonary aspergilosis, rheumatoid diseases, symptomatic lupus erythematosus, immune deficiency, severe childhood respiratory infection and exposure to foreign body or corrosive substance <ref name="2">Hough A. Physiotherapy in Respiratory and Cardiac Care: an evidence-based approach. 4th ed. Hampshire: Cengage Learning EMEA, 2014.</ref>. It has also been linked to an x1-antitrypsin deficiency <ref name="2">Hough A. Physiotherapy in Respiratory and Cardiac Care: an evidence-based approach. 4th ed. Hampshire: Cengage Learning EMEA, 2014.</ref>. Bronchiectasis tends to predispose patients to acquired and congenital lung infections <ref name="2">Hough A. Physiotherapy in Respiratory and Cardiac Care: an evidence-based approach. 4th ed. Hampshire: Cengage Learning EMEA, 2014.</ref>.<br> | |||
== Management / Interventions<br> == | == Management / Interventions<br> == | ||
Revision as of 12:36, 1 May 2015
Original Editors - Students from Glasgow Caledonian University's Cardiorespiratory Therapeutics Project.
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Definition
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Bronchiectasis is an obstructive lung disease that results from the presence of chronic inflammatory secretions and microbes leading to the permanent dilation and distortion of airway walls, as well as recurrent infection Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Mechanism of Injury / Pathological Process
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Bronchiectasis is chronic irreversible dilation of the bronchi on the lungs. It follows a severe lung infection or aspiration. It is more common in conditions such as Cystic Fibrosis, Rheumatoid Arthritits, Immunodeficiency, Young's syndrome and Allergic Bronchopulmonary Aspergillosis, and after chilhoos diseases such as whooping cough, TB and measles.
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Clinically Relevant Anatomy [edit | edit source]
Bronchiectasis involves inflammation of the airway walls, specifically the bronchial walls Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The airway walls are the ‘tubes’ that run from the mouth and nose and travel to the lung. The main area that is affected in bronchiectasis is the bronchi Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The trachea bifurcates into the right and left main bronchi, which then further divide into secondary bronchi; one for each lobe of the lung Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. They then divide into tertiary bronchi; one for each bronchopulmonary segment Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
The cilia are also damaged in bronchiectasis. Cilia line the airway and are attached to the epithelium. They are hair-like with tiny hooks on the tip to grab the mucous and help move the mucous up to the throat Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Epidemiology
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It is underestimated in prevalence, incidence and morbidity because symptoms are often ascribed to smoking. A study by Hill Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titlefound that one in 1000 Britons have bronchiectasis, with associated deaths increasing at a rate of approximately 3% per year in England and Wales Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. Though the overall mortality rate is increasing in these countries, rates in older groups are rising whereas rates in younger groups are falling Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. A disproportionate amount of cases found in developing countries and in Aboriginal populations in affluent communities Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. In some populations, an improvement in socio-economic status, housing and education can improve overall health and reduce the incidence of respiratory infection and development of bronchiectasis Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Aetiology[edit | edit source]
The cause is unknown for 50% of cases, but it has been linked to inflammatory bowel disease, rheumatoid arthritis, and in 29-50% of patients, COPD Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. There are several associated conditions with bronchiectasis including; cystic fibrosis, primary ciliary dyskinesia, lung tuberculosis, allergic bronchopulmonary aspergilosis, rheumatoid diseases, symptomatic lupus erythematosus, immune deficiency, severe childhood respiratory infection and exposure to foreign body or corrosive substance Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It has also been linked to an x1-antitrypsin deficiency Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. Bronchiectasis tends to predispose patients to acquired and congenital lung infections Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Management / Interventions
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add text here relating to management approaches to the condition
Differential Diagnosis
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add text here relating to the differential diagnosis of this condition
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
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add appropriate resources here
Case Studies[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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