Chronic Bronchitis and Emphysema Pathophysiology Research Paper

Chronic Bronchitis and Emphysema Pathophysiology - Research Paper Example The exact prevalence of these lung diseases across the globe is not well known. In this article, both the diseases with be discussed by comparing and contrasting with each other. Definitions Chronic bronchitis is defined clinically as a condition in which the patient suffers from expectorant cough for a minimum of 3 months for 2 consecutive years (Celli, 2008). The diagnosis is mainly through clinical presentation. On the other hand, emphysema is defined as a condition in which the patient has permanent and abnormal enlargement of the air spaces distal to the terminal bronchioles and associated with destruction of the walls without any obvious fibrosis (Celli, 2008). Chest radiography and pulmonary function tests are needed to arrive at the diagnosis. Pathophysiology In chronic bronchitis, there is typical inflammation of the bronchi. The endothelium is damaged because of which the mucociliary response is impaired. This leads to improper clearance of bacteria and mucus. Thus, inflamm ation, along with inadequate clearance of mucus contributes to obstruction in the disease. There is histopathological evidence of goblet cell hyperplasia, mucus plugging, smooth muscle hyperplasia and fibrosis. Alveolar attachments that are supportive are lost, the airways are deformed and the air lumens are narrowed. The capillary pulmonary bed is undamaged. In emphysema, the airspaces distal to the terminal bronchioles are enlarged permanently, because of which alveolar surface area necessary for gas exchange is decreased. Loss of alveolar walls leads to decreased elastic recoil property of the alveoli, causing limitations to airflow. Decrease in the alveolar limiting structure causes narrowing of the airway, causing further limitation of airflow. There are 3 characteristic patterns of morphology in emphysema and they are centriacinar, panacinar and distal acinar. In centriacinar type, destruction is mainly in the central portions of the acini. In panacinar type, entire alveolus i s involved. In distal acinar type, only those acini in the distal portion of the airways in involved. (Maclay et al, 2009). Etiology and pathogenesis The most common etiological agent in both chronic bronchitis and emphysema is cigarette smoking. Smoking over a long duration of time triggers the macrophages to release chemotactic factors like elastases which destroy the tissues of the lung. Passive smoking and other environmental factors also can contribute to chronic obstructive pulmonary disease. Airway hyperresponsiveness is a risk factor for chronic bronchitis. Alpha-1 antitrypsin deficiency, a genetic disorder, is an important risk factor for chronic pulmonary obstructive disease, especially emphysema. Intravenous drug abuse is another important risk factor for emphysema. The disease occurs because of the pulmonary vascular damage that occurs due to insoluble fillers present in the drugs. Immunodeficiency syndromes like HIV infection, vasculitis disorders, connective tissue dis orders and Salla disease are risk factors for both chronic bronchitis and emphysema (Celli, 2008). Prognosis As far as prognosis is concerned, both the conditions are associated with significant mortality and morbidity. The prognosis is worse in emphysema because of damage to pulmonary vascular bed. Chronic obstructive pulmonary disease is infact, the fourth leading cause of mortality in the United States. Both chronic bronch

Health Reform Research Paper Example | Topics and Well Written Essays - 750 words

Health Reform - Research Paper Example Preskitt (2008) indicates that Clinton’s health reform plan is one that not only affected patients but also other service providers and physicians.. First, studies indicate that about 36 million Americans were uninsured at that time (Preskitt, 2008). This percentage of Americans comprises of the poor and majority depended on aid from other sources. On a realistic point of analysis, it would be extremely tasking for Clinton’s policy to apply among such population brackets. This can be discussed on a cost constraint point of view, since the available resources were not well reorganized. Universal recognition not being the centre of the focus of Clinton’s reform plan, failure of the plan was indeed in the pipeline. Brady & Kessler (2009) indicate that Clinton’s Health Care Reform failed for the reason that this plan was more inclined towards promoting a market for insurance on a long term basis. The administration was of the opinion that expanding then public health sector would be very expensive for the government. Long term insurance care was on a great extent left for the private sector. Investors were at an advantage that was geared towards coming up with a market for private employers, in terms of provision of long term care. The costs of health care rose tremendously, provision of long term care was then laid on the line. Preskitt (2008) indicates that Clinton’s health plan did not receive public support both from the liberals and conservatives. Democrats were opposed to the fact that none of the constituencies was fully for the program. For instance, the aged feared the cutting down of Medicare and nothing would do good to them in return (Starr, 1995). The high costs of health plans were also expected to be expensive; thus, taxing to the common citizens. Generally, Clinton had no back up to support the policies. It is in line to this argument that Oberlander (2002) argues that Clinton’s health plan would have been planned and