Clinical explanation of Bronchiectasis

Permanent dilatation and distortion of the bronchi is called bronchiectasis. What is it’s effect to human health?

Etiology and Pathogenesis:

Most of the cases of bronchiectasis result from acquired causes.

• Obstruction to the bronchus due to any cause leads to distal collapse of the pulmonary segment. The pull on the bronchi by the collapsed alveoli leads to dilatation of the bronchi. In the initial stages this is reversible and the bronchi regain their normal size when the lung expands. If the obstruction persists, accumulation of mucus occurs distally, infection supervenes and the bronchial wall is destroyed permanently.

This results in permanent dilatation. The infective organisms are streptococci, pneumococci, Klebsiella, and anaerobes.

• Bronchiectasis may follow several viral infections without passing through the obstructive phase.

• Congenital defects in the bronchial wall lead to bronchiectasis. The classical example is Kartagener’s syndrome, which is characterized by dextrocardia, sinusitis, and defects of ciliary function in the bronchi and non-motile sperms.

• Middle lobe bronchiectasis is a sequel to pulmonary tuberculosis. This is caused by obstruction to the middle lobe bronchus by tuberculous glands. This is called “middle lobe syndrome” or “Block’s syndrome”.

Clinical features:

The clinical picture is very chronic, extending over several years.

The common site of lesion is the left lower lobe. Though children may be affected, usually symptoms manifest in early adulthood or middle age. Males are affected more than females. Digital clubbing is a prominent sign, sometimes being associated with hypertrophic pulmonary osteoarthropathy.

Postural cough with the production of large quantities of purulent and foul smelling sputum is the presenting complaint in most cases. On keeping for sometime, the sputum settles into 3 layers as described under lung abscess. Hemoptysis may occur frequently. This may be mild or severe. Recurrent infections such as pneumonia may develop. Repeated affection of the same lobe or segment should suggest the possibility of underlying bronchiectasis. Bronchiectasis sicca is the condition in which bronchiectasis presents with mild or severe hemoptysis without purulent sputum.

Physical examination may reveal impairment of the percussion note and diminution of respiratory sounds over the presence of coarse, persistent leathery rales. At times bronchiectasis may present with one of its complications. These include massive hemoptysis, recurrent pneumonia, emphysema, septicemia brain abscess, and cor pulmonale. Anemia develops in long standing cases due to chronic sepsis and recurrent hemoptysis. In untreated cases secondary amyloidosis may develop.

Diagnosis:

Bronchiectasis should be diagnosed by the long history, presence of clubbing, postural cough, coarse leathery rales over the affected part and reasonably normal general health. Once established, bronchiectasis is not curable by medical treatment.

Differential diagnosis

Bronchiectasis should be distinguished from chronic bronchitis and emphysema, lung abscess, tuberculosis, congenital cystic disease of the lung and malignancy. Lung abscess generally develops acutely. The right lower lobe is affected more often and the signs are localized. Tuberculosis is more common in the upper lobes and clubbing is not prominent in uncomplicated cases. Features like digital clubbing and copious sputum are seen in tuberculous bronchiectasis. Cystic disease is not uncommon. All age groups are affected. A long history or recurrent respiratory disease is present in the majority of cases. Clubbing is not prominent. The cysts may be localized or generalized. Clinical distinction from bronchiectasis is difficult. The presence of cysts in other organs like the kidneys, liver, etc, suggests the probability of congenital cystic disease of the lung. X-ray reveals the presence of soap bubble-like or ring shadows.

Diagnosis is confirmed by bronchography. This procedure is absolutely essential for determining the extent and type of bronchiectasis. Plain X-ray of the chest is not a reliable investigation to assess the site and extent of bronchiectasis.

Management

General measures include high protein diet, treatment of intercurrent infections, and removal of focal sepsis from the upper respiratory tract. Principles of specific therapy include postural drainage, administration of antibodies, respiratory exercises and in selected cases surgical excision. Postural drainage helps in clearing the bronchi and brings about relief. The patient should be instructed to practice postural drainage regularly. This gives relief of cough and also the foul smell. The fetid odor of the breath can be controlled by administering steam inhalations containing tincture benzoin or eucalyptus oil. The choice of antibiotic is determined by microbiological studies. Intermittent antibiotic therapy is required to clear infection and prevent exacerbation. The site of lesion may have to be excised if medical treatment fails.

Indications for surgery:

The following are the indications for surgery.

• The disease is localized to one lung or one segment and is not amenable to medical therapy.
• Socio-economic factors such as non-compliance by the patient
• Uncontrollable hemoptysis in which the site of origin of blood may be detected by emergency bronchoscopy and surgical resection has to be planned;
• To reduce the area of infection-even in bilateral disease sometimes surgical resection may have to be done on the more affected side, with a view to reducing the surface area of infection; and
• To remove an obstructive lesion which tends to perpetuate the condition, eg, bronchial growth or bronchostenosis?

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What is also important in auto insurance rates is the driver’s gender…

Auto insurance quotes are affected by a number of things – your age, your gender, the place where your residence is located, etc. Statistics based on age and gender makes it possible for auto insurance companies to determine how cheap or how expensive your auto insurance quotes will be. This helps for them to see whether you are a high risk or a low risk client and of course, the “riskier” a client you are, the higher the rates.

Statistics show that males who are 16 to 25 years old are riskier clients compared to the female counterparts. Although some may say that this is gender bias, it is most definitely not because based on years of study on this subject, males in this age group have a tendency to drive recklessly as opposed to the females in the same age group. Do not worry though because rates even out between males and females as you grow older. However, there are still some insurance providers that still offer lower for women even if they are already over 25. This is where shopping around comes in handy because even if most carriers even out their rates at a certain point, there are those who follow a different formula.

Aside from your age and gender, other things are considered – your zip code for example will also help insurers make a right decision on how much you should be paying for your auto insurance policy . Based on gender, males drive more frequently than females and this makes them more susceptible to getting into accidents and as mentioned before, young males have a tendency to push their limits in terms of speed and are even more likely to drive when drunk, tired, or sleepy.

If you are a good driver i.e. one with a clean record with the DMV, you can get lower auto insurance quotes from reputable insurance companies. If you have already found the cheapest auto insurance quotes you can find, it is time to choose which policy is the right one for you.

Car rental companies do provide dinner for toddlers, but will you look for it?

Of course, those of us with a good credit score can rent an RV and cook whenever we need food for the toddlers. That way, we can always take the emerging food preferences into account without undue waste and expense. It’s the same if we decide to go the route of camping. We can either pick the sites with cooking facilities or carry our own gas rings. Remember starting real fires in the middle of our current hot summer is not likely to endear us to Park Rangers and others trying to prevent wildfires from starting. So this gives you a shopping list of possible makes and models to shop for at the car rental agencies if you propose carrying outdoor cooking equipment.

Otherwise you load the people into the vehicle and set off into the wild blue yonder, full of the joys of the road and hope in your hearts. Those of you with toddlers will know they are just learning about the world and beginning to take some control over how they relate to it. One of the first symptoms of toddler control comes in emerging taste preferences. This is not to say any child should have a say over what gets put on the plate, but practical reality may call for some negotiation over how much is eaten. Most children go through phases of being picky. Many never seem to emerge from this phase. If you’re lucky, the child will only eat something available at every diner or restaurant. This may be macaroni cheese which has the benefit of being relatively cheap and nutritious, or it may be junk food which will encourage faster growth around the waist. Either way, you need food storage in the vehicle you rented so that, if there’s a mutiny and all outside food is refused, you can fall back on snacks when the real hunger kicks in.

Hopefully, the car rental companies offered guidance on the diners and restaurants offering child-friendly portions at reasonable price. If not, spend time on the internet searching out the likely places to eat. Never assume all diners will cater for your toddlers.

Uses of Solar Power

Conversion of solar power into electricity is one of the most popular political agenda in many countries, which can be used to resolve the issue of demand and supply gap of petroleum products in an eco-friendly way. Solar Power for home and industrial development is getting famous day by day due to its immense number of benefits. It can be used in many ways, and according to a recent researches, it is found that some scientists have developed a virtual houseplant, which has organic thin-film solar cells as leaves. Here are some of the utilizations of solar power, which can benefit the users: Air-conditioning though Solar Power: Solar power is one of the most efficient ways to reduce your electricity bills, and that saving can be utilised on other useful purposes. Solar power can also be used to run air-conditions as well, which can be used for homes and industries.

You can also get other home solar power equipments in the market, which can fulfil some of your requirements. Water Heating Systems: Solar energy can also be used for the purpose of heating water for household and industries, and can save more than thirty percent of your average electricity bills. It can also be used to provide electricity for home users. Solar Trash Cans: Solar trashcans are the latest invention of scientists, which can be used to reduce the impact of trash and various biological wastes in your area. These devices use the energy of sun to destroy the waste without even polluting the environment, and can also store more trash. They are more efficient than other devices and low in operating costs. Electricity through Solar Power: In order to make a solar powered home , users can install PV panels on the roofs of their houses, which can provide the electricity to the most of home appliances. In addition, with the help of appropriate solar management techniques, one can easily make a full use of solar energy, and excess energy can also be sent back to the grid for further use. Solar Intersections: Users can also find various equipments and devices, which are used to maximize the visual and lighting impact at any place through solar energy. They are operated on the principal of collecting energy from solar cells. The above-mentioned measures can educate people about the unlimited powerful capabilities of solar energy, which can be utilized in many useful and productive ways.

Cutting Corners – How to Build a Healthy Family

Do we all sometimes forget to floss? Brushing your teeth alone will leave your mouth only about 60% clean. Although it is something awkward to do, flossing is imperative in your teeth cleaning process as it breaks up and removes the plaque from the gum line and teeth where your toothbrush cannot reach. Within just two short days of not flossing, plaque can turn into hard calculus, which is composed of salt, food, and other debris. This causes bad breath, gingivitis and ultimately periodontal disease, which occurs when the body’s immune system cannot clear the bacterial and toxins in the mouth. There is also a proven connection between sever gum disease and an atherosclerosis, which is a condition where arteries get clogged up. But it is bad enough having to walk around with a terrible smelly breath.

Therefore ultimately try to floss every day, but is you just cannot, then swish water around and through your teeth after brushing your teeth as it has been shown to reduce bacteria, but this is only for a once in a while solution to not flossing.

Even slept with your make-up on? Although leaving your make-up on when you go to bed seems like a great idea at the time, especially after a late night out or you are just lazy, you are not doing your skin any good at all. Wearing foundation to bed can cause your pores to clog up, which leads your skin to break out and have blackheads. And not only is sleeping with foundation not good, your mascara fragments will dislodge into your eyes while you sleep and could cause painful corneal abrasions. Just keep some pre-moistened make-up removal pads at hand for these occasions when you have little time for makeup removal, or are just not in the mood for doing it right now, your skin and eyes will thank you for it.

Do we award ourselves fewer hours to sleep? We compromise our health by sleeping less. Men who sleep fewer than five hours a night are at risk of becoming obese and also have high levels of blood sugar, which could lead to diabetes. It has also been concluded that a lack of sleep triggers off a hormone in the blood, and this hormone stimulates your appetite. Sleep disorders are very common and also under-diagnosed especially in woman. Therefore it is really important, for both men and woman, to have seven to eight hours of sleep to prevent poor concentration, irritability, depression, fatigue and even obesity which can often times lead to other health problems as well. To curve this problem, start by limiting your food intake before bed time, stick to regular bed times, and give yourself fifteen minutes to fall asleep, if you don’t just get up and do something until you are sleepy, like reading. Do not watch television or work on your computer. Also use herbal sleeping tables or teas to get you sleepy. If you feel these tips do not work to help you sleep better, visit your doctor for some further help and advice.

Reading in dim light, although reading in bad lighting increases tension, concentration and strain, causing headaches and sore eyes these symptoms are not permanent. Suboptimal lighting can create a sensation of having difficulty in focusing. It also decreases the rate of blinking and leads to discomfort from drying eyes. The important counterpoint is that these effects do not persist. But avoid unwanted headaches by switching on more lights or invest in a reading light for where you are most likely to sit down and read your book.

Not wearing sunglasses is a very good habit we all seem to brake from time to time. Whatever the reason for this may be, your skin is not the only part of your body that will be damaged from over exposure to the sun. Your eyes are also at risk of UV rays, and reflections from shiny objects. Like white buildings and water and metal. These subject the eyes to more than 12 times more light than what is needed. UV rays are invisible to the naked eye, but are high energy rays of light, and it is through this light that a reaction is caused in your eye tissue. And one this has occurred it cannot be reversed. When spending a lot of time where there is a lot of glare and not enough adequate protection, you can develop a short term condition known as photokeratitis; this is reversible sunburn on the cornea of the eye. This damage causes eye pain, sensitivity to light and the sensation of having sand in your eye constantly. Cataracts, which is a cloudy formation on the lens inside the eye, or the yellow areas on the whiles of the eye may appear after too much sun exposure as well. Then there is also Pteryguim, this is where tissue growth happens on the whiles of the eye, and can result in blocked vision and exposure to UV rays will also bring about eye cancer as well. It is better to have a pair of UV ray large wraparound sunglasses kept away in your car, bag and at home so you have them with you and ready to use whenever the need arise. Also get your whole family to do the same, especially the younger family members too, protecting everyone’s eyes will help build a healthy happy family.

Something not too many of us do, but still too many do, and that is biting nails. Your nail splits, so you just take it upon yourself to just bite of what has been broken off. You think this is a good idea at the time, but in fact it is a bad idea! And besides your nails just looks terrible, your fingernails are actually dead cells made of the same stuff as your hair, which is a protein called Karatin. So when you bite your nails, you risk transferring infectious organisms between your mouth and your fingers, and this could result in a bacterial or yeast infection of the nail bed. Therefore it is better to pack clippers and an emery board in your bag, or in a place where you will be the most times during the day. Then make sure you wash your hands properly, thoroughly and regularly throughout the day.

And now that you know what the risks are that you are really putting your health at, next time it may be better to just rethink taking those convenient shortcuts, but rather take these tips to heart and put them to good use. These can be really beneficial to you but also to your family, and if you are anything like me, these ideas can be put to good use on how to build a healthy family.

Is Leisure Associated With Travel Agency?

Travel agencies are the travel specialists which have revolutionized the world of traveling, add the flavor of leisure and comfort to it. They join hands with airlines, tour companies, hotels along with cruise lines so as to give door step services to the customers like hotel stays, transportation, tours, car rentals making traveling a more enjoyable, convenient and affordable event on passengers part.

All the facilities like food, destination management, insurance, trade fair, air travel tickets etc are arranged in different packages catering to the needs of different kinds of customers.
They also inform their customers regarding tourist attractions, weather conditions, restaurants and other necessary details. Good Travel agents access all types of information and knowledge about the places that can be traveled and are in demand giving a wider choice to customers to choose from.
They prove to be the best insiders who give worthy travel tips of every sort ranging from family travels to business travels, air travels to packing and these tips immensely help to visit the city or country with great pleasure and convenience. Pay less with a travel agent!

Quiet Air Purifiers

If you reside in an area where there is a great deal of air pollution, you will want to consider shopping for quiet air purifiers. These devices not only provide you with clean air in your home, but can do so without making too much noise. It is not a good idea to live in a busy city where you are inhaling smog and other harmful substances everywhere you go. At least you can control the quality of the air in your home.

Air purifiers are necessary for your health if you live where the air is not the cleanest around. Respiratory problems can come about if you allow your lungs to take in this dirty air every day. You will save a lot of time and money in the long run if you invest in a purifier for your home today. Medical bills that could be incurred from taking in unclean air could be cost you a great deal more than even the most expensive air purifier.

If nothing else, these tools can help to cut down on allergies from pollen and other substances.

Quiet air purifiers not only help you live in a healthy manner, but they can also provide you with a more comfortable home. Many purifiers filter out odors, so you will have clean and fresh air that you breathe in. This is very effective for a home that is smoked in. Even if someone smokes just outside the door, the cigarette smell can travel into the home. The purifier will help to remove this scent from the air so no one will have to deal with it. Getting a silent purifier will give you fresh air without all the noise of other purifiers. This really comes in handy when you are trying to sleep or concentrate on working or reading.

Look for air purifiers that offer a HEPA filter.

These filters have passed specific standards set by the Department of Energy. With such a filter, you can remove 99.9% of all allergens and other substances from the air in your home. This will allow you to decrease the amount of dirt, toxins, and other particles that you breathe in on a daily basis.

As you can see, quiet air purifiers are a great investment, especially if you live in a busy, smog-filled city. Even if you live away from pollution, you may benefit from these devices if you are prone to allergies. It can help to filter out pollen, cigarette smoke, and other elements that could irritate your lungs and airways. Be sure to get one with a HEPA filter so you can be sure that you are making a wise investment into a device that will work effectively to remove harmful particles in the air.

Sonography Websites and Blogs

There are numerous great sonography Websites and blogs for professionals in this field who want to stay on top of the latest news and information for their careers. You could easily compile a list of 50 sonography Websites and blogs, and they would all be very useful. These five Websites and five blogs are a great place to start, though. They all have plenty of visitors, lots of recently updated information and credibility in the industry.

Websites

1. Aunt Minnie: This Website, found online at AuntMinnie.com, is an excellent forum for industry professionals such as business managers, members of organized medicine, radiologists and technologists. If you want to meet others in the profession to network and collaborate with, this is a great site for you.

2. Diagnostic Imaging: Go to DiagnosticImaging.com to find out about the latest developments across all segments of the field of diagnostic radiology.

3. Health Imaging: This site, HealthImaging.com, boasts “Images, information and knowledge across the enterprise.”

4. Image Radiology Magazine: RT-Image.com is “the source for radiology professionals,” with everything from job listings to CEO directories to data sheets to informative articles and much, much more.

5. Learning Radiology: This is a great resource if you are a student or new to the field. Regular features at Learningradiology.com include a case of the week, an image DDX, quizzes and more.

Blogs

1. American Journal of Neuroradiology: Find everything neuroradiology-related at this blog site, including editorials, cases, book reviews and more.

2. Americans for Responsible Imaging: The ARI blog site features doctors and patients from the world of medical imaging who are focused on preserving the healthcare system in the United States.

3.Free Ultrasound Machine Reviews and Tips: If you are looking for evaluations of diagnostic ultrasound equipment with details about 3D and 4D ultrasound techniques, image quality and user friendliness, visit GPS Medical President Brian Gill’s blog.

4. Imaging Informatics News: Everything related to medical imaging informatics is discussed in this blog, including news on CAD, PACS, RIS, image acquisition, processing enhancement and more.

5. Sonography News: All the diagnostic medical ultrasound imaging news that you need to know now is right here in this blog.

Find best sonography schools or sonography college programs on SonographySchoolsU.com and start your path to a rewarding career. SonographySchoolsU.com is an online education resource offering information about top sonography schools/ Ultrasound Technician Schools that offers best sonography programs in various disciplines.

The Automotive Industry Marketing Plan

The auto industry is one of the largest industries in the world. It includes dealers, service shops for repair and body work, parts suppliers, insurance companies and even towing companies just to name a few. All areas of the auto industry share a common interest and that is cars. The interest in the auto industry has done nothing but increase over the years and all areas of the industry are learning to implement new marketing techniques in order to gain their customers attention.

Promotional products have been proven to be very effective marketing tools for businesses within the auto industry. Repair tools, key chains, safety tools, road side kits and many other promotional products that boast the company’s name or logo can not only be useful to the consumer but can be very effective in gaining more business for the company.

Tow companies often use roadside kits as a promotional part of their marketing campaign and it works. Think about the times of accidents, emergencies or break downs and that feeling of desperation while wondering who you should call. When you reach for the bag in your trunk that supplies your road side safety and emergency supplies and the logo of a towing company is clearly printed with a number for assistance, who else would you call? Many companies offer elaborate kits while others offer simple ones, the effectiveness of the advertising in those situations are not easily compared so there is no real proof that creating a kit complete with jumper cables and hazard signals works any better than one with road flares and a few simple tools.

Insurance companies and parts suppliers can also benefit from this promotional method of advertising. Any event that requires assistance will cause the driver to look for items they already possess in their vehicle to rectify the situation at hand and with those items and the contact information that is the number that will 9 times out of 10 be used.

Branding is another great way to use promotional advertising within the auto industry. When people take great lengths to accessorize or customize their vehicles they often want to show off the brands that they used. By incorporating engraved key chains, branded licensed plates and other accessories that sport the company brand or logo will be a great way to grab the attention of admirers. When consumers see the vehicle looking great and your company brand is located on it you will get the majority of the credit and they of course will come to you for all of their customization needs.

Parts suppliers and service garages often use tools as part of their promotional advertising campaign. This is due to the fact that when a vehicle breaks down or is in need of service or maintenance those tools that are on standby with the company logo on it will often be the reminder for the consumer to contact that company for their parts or service needs. You can use anything from flashlights, tire gauges to multi set tool kits to offer the advertising that you need to get that customer in your door.

Career Employment Online – Find Professional Work at Home and Get Paid

Plenty of research goes into finding the best career employment online. Below is a list of professional working companies who are looking to hire now and you can work from home if this is something you are looking to do. Great paying jobs and you can get started right now once you apply. You will not have to pay a fee.

Sun Oasis

Many writing assignments to keep you busy. You can make some great money. Weekly newspapers, educational publishing companies, copy writing groups, and business web site building. This company is also looking for proof readers.

Solo Gig

Anything and everything when it comes to consulting work. Experience professionals are needed in IT, accounting, healthcare, sales and marketing, technical writers, account executive, etc. Some of the jobs here are paying $350.00 Per hour. Make sure you check out Solo Gig.

Writer Find

This is a site that is updated always with all the latest jobs pertaining to writing. You will also find a mailing list you can sign up with. The competition is fierce here so make sure you are one of the first to know about any new assignments. Make sure you sign up. This is a great site to be a part of. Look for Writer Find Freelance Jobs

Auto Club Renewals

Renewal specialist positions are available. You will call existing members of a fortune 500 company. You must have a friendly energetic voice, strong sales, and inbound and outbound calling experience. Hours are 3:00PM – 9:00PM Monday through Friday and working every other Saturday. They are still hiring. Go to the site for more information.

Call Desk

They are hiring in the state of Oregon. You will become an employee and not a independent contractor. You must have experience in customer service. They are looking forward to receiving your cover letter and resume. Look up Call Desk Agents.

Content Current

Contract writers are needed for article writing, forum posting and custom writing tasks. You can get paid every week and you can pick your own writing tasks from thousands of offers. If you are a good writer, you will be paid nicely. You can pick the hours you want too. Make sure your register to become a writer.

Alpine Access

This company is hiring home based agents. The goal of this company is to to provide world class customer service to their clients. You will work from the comfort of your home as a employee not a contractor. The Alpine advantage. Become a part of it. Hiring English speaking, Spanish, Cantonese and Mandarin customer service reps. They are hiring now.