Pulmonology is a medical specialty associated with ailments involving the respiratory tract. This term is derived from the Latin word pulm ?, pulm? Nis ("lung") and the Greek suffix - ??? ?? , -logia ("study of"). Pulmonology is identical to pneumology (from the Greek ??????? ("lung") and - respiratory and respiratory medicine .
Pulmonology is known as chest medicine and respiratory medicine in several countries and regions. Pulmonology is considered a branch of internal medicine, and is associated with intensive care. Pulmonology often involves managing patients who need live support and mechanical ventilation. Pulmonologists are specially trained in diseases and chest conditions, especially pneumonia, asthma, tuberculosis, emphysema, and complicated chest infections.
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Variasi dalam nomenklatur
In the UK, Ireland, South Africa, and Australia the term "respiratory physician" is used (not a pulmonologist) to distinguish physicians who practice pulmonology. In Canada, respirology and respirologist is used [1]. Respiratory tract surgery is generally performed by specialists in cardiothoracic surgery (or thoracic surgery), although small procedures can be performed by pulmonologists. As mentioned above, pulmonology is closely related to critical care drugs when dealing with patients who require mechanical ventilation. As a result, many lung experts are certified to practice critical care drugs in addition to pulmonary medicine. There is a fellowship program that allows physicians to become certified boards in lung care and critical care simultaneously. Interventional pulmonology is a relatively new field in lung treatment that is associated with the use of procedures such as bronchoscopy and pleuroscopy to treat some lung diseases. Interventional pulmonology is increasingly recognized as a specialized medical specialty.
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Diagnosis
Pulmonolog started a diagnostic process with an overview focusing on:
- hereditary disease affects the lungs (cystic fibrosis, alpha 1-antitrypsin deficiency)
- exposure to toxins (tobacco smoke, asbestos, exhaust fumes, coal mining smoke)
- exposure to infectious agents (specific bird species, malt processing)
- autoimmune diathesis which may affect certain conditions (pulmonary fibrosis, pulmonary hypertension)
Physical diagnostic is as important as in other medical fields.
- Hand checks for signs of cyanosis or dugem, chest wall, and respiratory rate.
- Palpate the cervical lymph nodes, trachea and chest wall movements.
- Percussion of lung fields for dull or hyper-resonance.
- Auscultation (with stethoscope) of the lung for a decreased or unusual breath sound.
- Rales or rhonchi are heard above the lungs with a stethoscope.
Since many heart diseases can provide signs of lung, thorough cardiac investigations are usually included.
Procedures
- Laboratory investigation of blood (blood test). Sometimes arterial blood gas measurements are also needed.
- Spirometry determines the maximum airflow on lung volume as measured by breathing into a special machine; this is a key test for diagnosing airflow obstruction.
- Spirometry Lung Function Tests, as above, plus response to bronchodilators, lung volumes, and diffusion capacity, the latter being the size of the extent of pulmonary oxygen uptake
- Bronchoscopy with bronchoalveolar lavage (BAL), endobronchial and transbronchial biopsy and epithelial brushing
- Chest X-ray
- CT scanning
- Skintigraphy and other nuclear treatment methods
- positron emission tomography (especially in lung cancer)
- Polysomnography (sleep study) is commonly used for the diagnosis of Sleep apnea
Surgical procedure
The main surgical procedure of the heart and lungs is performed by a thoracic surgeon. Pulmonologists often perform special procedures to obtain samples from the inside of the chest or inside the lungs. They use radiographic techniques to look at the blood vessels of the lungs and heart to help diagnose.
Treatment and therapy
Drugs are the most important treatment for most pulmonological diseases, either through inhalation (bronchodilators and steroids) or in oral form (antibiotics, leukotriene antagonists). A common example is the use of inhalers in the treatment of conditions of lung inflammation such as asthma or chronic obstructive pulmonary disease. Oxygen therapy is often required in severe respiratory diseases (emphysema and pulmonary fibrosis). When this is not sufficient, the patient may require mechanical ventilation.
Pulmonary rehabilitation has been defined as a multidimensional service continuum aimed at people with pulmonary disease and their families, usually by an interdisciplinary specialist team, with the goal of achieving and maintaining a degree of individual independence and functioning in the community. Lung rehabilitation is intended to educate patients, families, and improve overall quality of life and prognosis for patients. Interventions may include exercise, education, emotional support, oxygen, noninvasive mechanical ventilation, optimization of airway clearance, improved adherence with medical care to reduce exacerbations and hospitalization, and return to work and/or a more active and emotionally rewarding life. This goal is appropriate for any patient with reduced respiratory reserve either due to obstructive or intrinsic (oxygenated) lung disease or neuromuscular weakness (ventilation disorder). Pulmonary rehabilitation teams may include rehabilitation physicians, pulmonary therapists, and allied health professionals including rehabilitation nurses, respiratory therapists, physical therapists, occupational therapists, psychologists, and social workers. In addition breathing games are used to motivate children to perform lung rehabilitation.
Education and training
In the United States, lung experts are doctors who, after receiving a medical degree (MD or DO), complete residence training in internal medicine, followed by at least two additional years of subspecialty fellowship training in pulmonology. After successfully completing the fellowship in pulmonary medicine, doctors are allowed to take the board certification exam in lung treatment. After passing this exam, the doctor then up certified as a pulmonologist. Most pulmonologists complete three years of subspecialty joint training in lung treatment and critical care.
Pediatric pulmonologist
In the United States, pediatric pulmonologists are doctors who, after receiving a medical degree (MD or DO), complete residency training in pediatrics, followed by at least three additional years of subspecialty fellowship training in pulmonology.
Scientific research
The lungs are involved in clinical and basic research of the respiratory system, ranging from the anatomy of the respiratory epithelium to the most effective treatment of pulmonary hypertension. Scientific research is also conducted to look for causes and possible treatment of diseases such as pulmonary tuberculosis and lung cancer.
Pulmonology journal
- American Association for Respiratory Care
- American College of Chest Physicians
- The American Lung Association
- American Thoracic Society
- British Thoracic Society
- European Respiratory Society
History of pulmonology
One of the first major findings relevant to the field of pulmonology is the invention of pulmonary circulation. Initially, it is thought that the blood reaching the right side of the heart passes through the tiny 'pores' in the septum to the left side to be oxygenated, as Galen is theorized; However, the discovery of pulmonary circulation disputes this theory, which had previously been accepted since the 2nd century. The 13th century anatomist and physiologist, Ibn Al-Nafis, accurately theorizes that there is no 'direct' part between the two sides (ventricle) of the heart. He believes that blood must pass through the pulmonary artery, through the lungs, and return to the heart to be pumped throughout the body. It is believed by many to be the first scientific description of the pulmonary circulation.
Although pulmonary medicine only began to evolve as a medical specialty in the 1950s, William Welch and William Osler founded the 'parent' organization of the American Thoracic Society, National Association for Tuberculosis Study and Prevention. Treatment, treatment, and studies of pulmonary tuberculosis are recognized as self-discipline, phthisiology. As specializations begin to evolve, several inventions are made linking the respiratory system and arterial blood gas measurements, attracting more and more doctors and researchers into emerging fields.
References
Source of the article : Wikipedia
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