Acute Respiratory Diseases

malattie-respiratorie-acute_1The acute forms that hit the respiratory system derive their name from the affected tract and add the final –itis, which is present in all inflammatory forms (see chapter about inflammation), matching then the word with an adjective that specifies its characteristic. Usually the acute forms involve more organs (rhino-pharyngitis, tracheobronchitis, bronchopneumonia), probably as a consequence of the fact that, starting from the outside to the inside, each organ is a protective barrier for the next one. It is a sort of “front line” and, when it falls, the disease can continue its attack. The acute forms of respiratory diseases are mainly the consequence of a viral infection and, less frequently, of a bacterial infection that often occurs after the viral infection (bacterial superinfection), from which it is a complication. The most involved viruses, which we won’t list for brevity’s sake, are called “respiratory viruses.” It is sufficient to know that about one hundred micro-organisms are responsible for the common cold. The most dangerous respiratory virus is the influenza virus in its variants A and B and with its antigenic characteristics that differentiate the various families, giving them a combination of the letters “A” and “H” and some numbers. We all remember the A H1N1, the notorious pandemic virus that appeared in 2009-2010.

THE COLD

raffreddore_1It is the first pathology that hits the respiratory system since the inflammation takes place in the “access gateway” of air, which is the nose. It is an inflammation of the mucous membrane (rhinitis) that increases its thickness and causes a progressive obstruction and prevents proper respiration. This is often associated with hyper-secretion and emission of mucous (runny nose), lachrymation, sneezes (a strong emission of air and droplets of mucous through the nose), photophobia (trouble caused by exposure to light) and, sometimes, headaches. It is a benign pathology that usually disappears spontaneously in three-four days; there are no causal therapies (this means the virus responsible can be fought), but there are useful symptomatic therapies based on nose decongestants, paracetamol and anti-inflammatory drugs. An abundant administration of water and warm liquids is useful as well as a day of rest so that the person will not stay in closed environments (such as schools and workplaces) where colleagues or schoolmates could be contaminated.

PHARYNGITIS

faringite_1It is one of the inflammatory forms linked to the common cold of which it is a sort of a complication. In fact, because of a cold, the first defense, that of the nose and its mucosa, falls. The task of the nose and mucosa is to heat air that passes through the nose and stop the largest suspended particles in the inhaled air; the thermal shock caused by inhaled cold air can determine an inflammation of the pharynx and the development of pharyngitis, better known as a “sore throat.” Pharyngitis is associated with a difficulty swallowing (“doctor, I have the throat full of pins”) as well as a dry and often painful cough. Often, but not always, pharyingitis causes a moderate temperature, generally in the evenings. A particular type of pharyngitis is tonsillitis. This pathology affects two small organs in our throat, the tonsils, which are a sort of “gymnasium” for our immune system. In fact, the tonsils, due to their position, enter into contact with any type of microorganism (virus or bacteria) contained in the air and potentially dangerous to the body. This “close encounter” causes the development of an “immunological memory” that is able to immediately activate the defense system (anti-bodies and lymphocytes) that attack the microorganism as soon as it penetrates again. Because of this characteristic, the tonsils may mainly suffer from a bacterial inflammation that develops in pharyngitis and swell as a result; sometimes the air passage gets closed and the tonsils turn red with scattered white or white-grayish spots, named “patches.”If there are no casual therapies for simple acute viral pharyngitis, like for the cold sickness, and only symptomatic therapies, like bacterial pharyngotonsillitis, it is recommended to use antibiotics only after a doctor’s prescription. Obviously, symptomatic therapies can be associated to antibiotics to improve symptoms and, in a few cases, accelerate the healing process.

LARYNGITIS

laringite_1Even this pathology is caused by inflammation, but it is different from the above-described forms. This is due to the peculiarity of the organ that is affected, the larynx, which has the only function to modulate sound caused by air emitted from the lungs and transform it into words by means of the vibrations of the vocal cords. Because of this characteristic, the diseases that affect the larynx first cause an alteration of the voice (hoarseness) or its disappearance (aphonia) to which often a sore throat, difficulty swallowing and breathing, a dry cough and a “barking” cough are associated; sometimes there is also a temperature, even if not very high. There are no drugs able to remove the cause of the disease, which is mainly of a viral origin but, apart from symptomatic therapies already described (such as anti-fever, anti-inflammatory and decongestant drugs), the use of sprays and aerosols based on cortisone (see the section relevant to asthma and BPCO for further information) may be helpful. These drugs have an anti-inflammatory effect on the vocal cords so that voice is recovered faster

TRACHEITIS

tracheite_1It is the inflammatory form of “passage” among the pathologies of the “upper” airways that we have described up to now and the “lower” airways that we will see later. Tracheitis is often associated to laryngitis and pharyngitis (respectively laryngotracheitis and pharyngo-laryngo-tracheitis). Also, in this case, the origin is vital and the clinical onsets are similar to those of pharyngitis and laryngitis to which it is often associated. As a consequence, the treatment is almost the same and the recommendations relevant to hygiene and food are the same. But it is important to underline that the use of inhalations or sprays based on cortisone allow the faster elimination of the disease. In fact, we don’t have to forget that, as we have said, the trachea is the “middle land” between the upper and lower airways and its capitulation, using a “battle” word, opens the access way to viruses to the bronchi and lungs. To return to treatment in the tracheitis forms, it is recommended to use drugs with a fluidifying action, such as “syrup for the cough” with an emollient effect improving symptoms, but not shortening the course of the illness.

INFLUENZA

influenza_1It is a pathology included in respiratory diseases because its manifestations affect the respiratory system. The influenza virus is considered the most dangerous respiratory virus in its variants A and B and with its antigenic differences that differentiate the various families, adding to them a combination of the letters “A” and “H” and some numbers. The disease caused by these viruses is called “influenza,” a word dating back to ancient times and unchanged over centuries, the origin of which refers to the influence (from which the word influenza derives) that the astral or climatic conditions were supposed to have on the genesis of the disease that recognizes a typically seasonal trend, despite the virus being constantly and endemically present in every nation.Influenza, but also the other forms defined “as a cold” and not due to the influenza virus, shows itself with a series of symptoms that goes from a sudden high fever and chills, muscular aches (myalgia), often reported as a sensation “to have been beaten”, cold, cough, sore throat and headache sometimes associated to dysphonia or even aphonia. Even if the course of the disease is mainly benign, and a healthy adult heals in three-four days without complications or consequences, it can be more dangerous for a few types of people, such as those over 65 and the chronically ill, who may have respiratory complications, even fatal.That is why, nowadays, it is strongly recommended to get a flu shot, which is suggested for everybody and in particular for weaker categories of people. Vaccinations are charged with the National Sanitary System. The vaccination, whose preparation technique guarantees a very safe and reliable product, does not protect from influenza completely, but does shorten the duration of the disease while lowering its dangerousness and, as a consequence, the risk of respiratory complications.



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