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Common respiratory issues & their effects

Опубликовано: 25/04/2021 в 21:42

Автор:

Категории: Nekategorizirano

Respiratory system has an important role in humans. It major role is to supply the oxygen to the tissue cells and free the body from carbon dioxide that is toxic product of metabolism. Respiratory system is all the time in close contact with the surrounding atmosphere and exposed to various elements from the environment. Combining its crucial role for the normal function of the whole organism, it is designed with multiple systems that should filter inhaled air and control the humidity and temperature of it to prevent the possible damage to the sensitive inner parts of the system. Unfortunately, those mechanisms are designed for standard environmental exposures but nowadays the capacity of those protective systems is overwhelmed by different types of air pollution in modern world. Because of that, there is increase in the number of respiratory diseases worldwide and they are important health problem connected with substantial morbidity and mortality. Great efforts are involved in the prevention and treatment of those diseases.

Upper respiratory system (nose and connected passages) are exposed to the environmental factors and may be the first damaged in the case of pollution. That is called rhinitis and is defined as irritation and inflammation of the mucous membranes of the nose. Rhinitis represents a global health problem affecting 10 to 20% of the population. If the nose function of filtering, humidifying and cooling/heating the inhaled air is disturbed, the lungs are directly exposed to the same noxious factors and evidence clearly supports a link between diseases of the upper and lower airways and 10-40% of the patients with rhinitis will develop the lower respiratory system derangement.

Asthma and chronic obstructive pulmonary disease (COPD) are the main representatives. Both diseases are connected with the exposure to inhaled particles that cause allergic response in asthma or chronic inflammatory response in COPD and cause the chronic airflow limitation.

Asthma is a common, chronic respiratory disease affecting 1–18% of the population in different countries. Asthma is characterized by variable symptoms of wheeze, shortness of breath, chest tightness and/or cough, and by variable expiratory airflow limitation. Both symptoms and airflow limitation characteristically vary over time and in intensity. These variations are often triggered by factors such as allergen or irritant exposure, viral respiratory infections, change in weather or exercise. Data supporting the role of environmental risk factors for the development of asthma include a focus on: nutrition, allergens (both inhaled and ingested), pollutants (particularly environmental tobacco smoke) and microbes. Distribution of microorganisms over airborne particles of different sizes has significant implications on the human health. Exposure to outdoor pollutants, such as living near a main road, is associated with increased risk of asthma.

For sensitized patients it is advisable to avoid the direct contact to the air reach with pollen, mold or other respiratory irritants and dusts and to avoid contact with polluted environments during the seasons of viral infections.

Chronic obstructive lung disease (COPD) is another representative of major respiratory diseases. It is a leading cause of morbidity and mortality worldwide. Chronic cough and sputum production can be a first sign of the disease. The disease is characterized by the destruction of lung parenchyma, airways and pulmonary vasculature. Lungs are damaged by chronic inflammation caused by inhalation of the chronic irritants. Although the major cause of COPD is cigarette smoke, patients can develop COPD without smoking and the disease can be caused by inhalation of other noxious particles that provoke chronic inflammatory process, like outdoor, occupational and indoor air pollution and passive exposure to cigarette smoke. Asthma may also be a risk factor for the development of COPD and bronchial hyper reactivity even without a clinical diagnosis of asthma is a predictor of COPD and indicator of excess decline in lung function. The crucial step in the treatment of COPD is to stop the irritation of the respiratory system with the inhaled noxious factors.

The fact that air pollution can cause serious adverse health effects was observed in the early years of 20-th century when sudden large increase in sickness and death was connected with increase in air pollution. By the 1970s, a link between respiratory diseases and particulate air pollution was well established and there was enough evidence to support that link even at relatively low concentrations common in contemporary urban areas of the developed world. The increase was not noted only in mortality but also in the number of hospital admissions, hospital emergency room visits, and outpatient or doctor’s visits. Subjects with chronic lung diseases such as asthma or chronic bronchitis were mostly affected but increased symptoms, lower lung function, increased medication use, and higher use of hospital services were detected also among members of the general population. Air pollution from fossil fuel combustion, primarily from motor vehicle emissions in cities, is associated with decrements of respiratory function.

Reducing the risk from indoor and outdoor air pollution is feasible and requires a combination of public policy, local and national resources, cultural changes, and protective steps taken by individual patients. For all stated diseases, the essential step in the prevention and treatment is avoidance of the contact with noxious particles, allergens and infective particles in inhaled air.

Vehicle traffic and industry emit a variety of toxicants, including particulate matter, carbon monoxide, sulfur dioxide, and nitrogen dioxide. Urban atmospheres in modern cities carry characteristic mixtures of particulate pollution which are potentially aggravating for patients with chronic cardio-respiratory problems, and the presence of aerosolized bacteria in small size particles may have significant implications to human health. Traffic intensity, local and synoptic meteorological conditions, and degree of respiratory dysfunction correlate with the deposition of anthropogenic particles in the trachea and lungs.

Environmental interventions to reduce pollution would be ideal, but their implementation may be hampered in countries where emissions reductions are trumped by economic growth. Wearing a face masks is a simple and practical intervention for reducing individuals’ exposure to particulate air pollution. Developed as part of the biomedical response to the Spanish flu of 1919, this practice is nowadays accepted in some cultures as a best way of making a barrier against pollution. Face masks are well tolerated, and their use improves several health measures in susceptible people. Studies confirm that the use of face masks in extremely polluted cities can effectively reduce individuals’ air pollutant exposure and lower lower inflammatory and associated cardio-respiratory risks.

Salt

“There must be something sacred in salt. It is in our tears and in the ocean.” (Khalil Gibran)

Salt usually refers to sodium chloride, and the adjective for “salt” most often used in medicine is “saline”. Human life is not imaginable without a salt. Basic physiological functions depend on balance between the salts and liquids in the body.

Salt has been an essential, virtually omnipresent, part of medicine for thousands of years. It has been used as a remedy, a support treatment, and a preventive measure. It has been taken internally or applied topically and been administered in an exceedingly wide variety of forms. The ancient Egyptian papyrus recommends salt for the treatment of an infected chest wound. The healing methods of Hippocrates made frequent use of salt. Salt-based remedies were thought to have expectorant powers and Greek medicine had used salt inhalations for respiratory diseases.

In modern medicine, the precise roles of salt in the healthy and diseased human organism were scientifically investigated from the 1950s. Blood, sweat, and tears all contain salt, and both the skin and the eyes are protected from infectious germs by the anti-bacterial effect of salt. According to modern scientific research, salt does indeed have weak disinfectant properties when applied topically. Today, salt is a natural healing principle used in the form of inhalations, salt-water baths and in drinking-therapy.

Inhaling steam from salt water has become an established treatment for acute and chronic respiratory diseases. The antiseptic action of salt on the skin and mucous membranes has been known for a very long time and we know today that the anti-inflammatory effects of inhaled salt provide relief from respiratory symptoms.

Steam from salt water is inhaled in chronic diseases of the upper and lower respiratory track (pharynx, paranasal sinuses, and bronchial tree) or to ease the discomfort of a common cold. For the treatment recommended from Hippocrates now we know that salt can stimulate secretion, loosen and help eliminate viscous secretions, inhibit inflammation, reduce irritation causing cough, clean mucous membrane and clear the respiratory ducts.

Hypertonic saline solution has been shown to increase muco-ciliary clearance in normal subjects, in asthma, bronchiectasis, cystic fibrosis, and sino-nasal diseases Hypertonic saline breaks the ionic bonds within the mucus gel, thereby reducing the degree of cross-linking and entanglements and lowering the viscosity and elasticity of the mucus secretion. It can also induce an osmotic flow of water into the mucus layer, rehydrating secretions, improving mucus rheology and stimulates cilial beat via the release of prostaglandin E2. By absorbing water from the mucosa and submucosa, hypertonic saline solution can reduce edema of the airway wall in infants with acute bronchiolitis and is proven that nebulized 3% saline may significantly reduce the length of hospital stay and improve the clinical severity score in infants with acute viral bronchiolitis. Hypertonic saline inhalation can also cause sputum induction and cough, which can help to clear the sputum outside of the bronchi and thus improve airway obstruction.

Natural salt caves have been used to help relieve symptoms of chest conditions. This therapy is known as speleotherapy, where a natural salt cave climate is used as a therapy for ill health. The basis for the treatment is presence of fine aerosol elements as well as a lack of airborne pollutants and pollens. This treatment has been associated with relief of respiratory conditions such as asthma, cystic fibrosis, and COPD.

Inhalation of the dry salt particles improves many lung function parameters including forced vital capacity, forced expiratory volume in 1 second (FEV1), oxygen saturation, partial pressure of oxygen in arterial blood, and partial pressure of carbon dioxide in arterial blood.  The assessment of results achieved in the investigated patients with bronchial asthma and chronic bronchitis indicates the triggering of an anti-inflammatory (including anti-allergic) mechanism. As a consequence the inflammatory process was reduced, particularly during exacerbations. These positive shifts in immunological status resulted in improved clinical symptoms, decreased need for medications, and improved their quality of life by decreasing exacerbations, reducing hospitalization, improving physical tolerance, and reducing fatigue.

What face mask should you pick?

Опубликовано: 22/04/2021 в 14:59

Автор:

Категории: Nekategorizirano

COVID-19 is a disease caused by the SARS-CoV-2 virus. The course of the disease itself is unpredictable and varies from asymptomatic disease to a life-threatening condition that predominantly affects the respiratory system but can significantly affect other organs. As there is no specific therapy or effective vaccine yet, the basis of the fight against COVID-19 to prevent the spread of the infection – are non-pharmacological measures.

Particles in the form of droplets in the exhaled air formed while the virus carrier is coughs, sneezes or talks are the main way of spreading the SARS-CoV-2 virus. These droplets spread through the air and fall on surfaces near the source of the disease.

Inhalation of those particles in the air or transmission from the contaminated surfaces to mucous membranes causes transmission of infection.

At a time while the virus is circulating freely among the population, and considering the relatively large number of asymptomatic carriers (up to 55%) and the high degree of the virus contagiousness (i.e. up to 80% of those infected received it from asymptomatic contact); from the epidemiological side, each individual should be, from an epidemiologists’ perspective – approached as a potential source of infection.

Basic non-pharmacological interventions are public health measures that aim to prevent transmission of the virus.

They include avoiding gathering more people indoors, maintaining physical distance, regular hand hygiene, avoiding touching the face, lips and eyes and wearing protective masks that prevent both – virus entering the respiratory system and dropping virus droplets from an infected person.

Wearing protective masks when staying indoors or outdoors when not being able to avoid contact with other people, for the last twenty years has become a common behavior of East Asian countries due to outbreaks of diseases such as SARS, MERS and bird flu.

The current pandemic of SARS-CoV-2 requires the acceptance of such behavior in our country with strict adherence to the recommendations for the prevention of the spread of the virus. Knowing the ways of SARS-CoV-2 spread, wearing a face mask is crucial in preventing virus spread caused by droplets and aerosols.

Protective mask’s choice depends on the intended effect. Available masks can be divided into home-made or factory-made textile masks, “surgical masks” and occlusive masks (“respirators”). Each one of these has a different protective role, as well as the advantages and disadvantages in certain situations, and that should be considered when choosing the best form of protection.

Textile, non standardized masks mostly provide the lowest degree of protection, depending on the chosen material and the number of layers. In general, they provide the least resistance to breathing and can be used repeatedly after washing and ironing. They are recommended for active, younger people without risk factors for the development of severe COVID-19 case and also, when staying in rooms / areas of low risk for disease transmission such as outdoor gatherings, smaller groups indoors with a suitable distance over 2 m.

“Surgical” masks are primarily designed to protect patients from the spread of infections that could be transmitted from a healthcare professional.

Therefore, they are more efficient in preventing the spread of disease from already ill/infested person (up to 80% risk reduction) than in protecting healthy individuals (about 50% risk reduction).

When roper applied, their impact on daily activities is minimal. They have the best balance of the ability to apply masks in everyday use and provided protection. They are highly recommended for people who are at increased risk of developing severe COVID-19 (age, associated diseases), and these that are in areas of low to moderate risk of spreading infections (greater outdoor gatherings, stay indoors without the possibility of spacing> 2m)).

Occlusive masks (“respirators”) are designed to protect healthy individuals in contact with highly contagious patients and are, therefore, most commonly used, among other protective equipment, in health facilities to protect staff caring for COVID-19 patients.

They represent a significant resistance to breathing and significantly reduce the endurance of effort and limit daily activities, due to their significantly higher degree of filtration.  Applied incorrectly (incomplete fit that allows circulating air between the masks and the face), their effect is even worse than the protective effect of “surgical” masks; in that case all the air enters unfiltered through the crack, canceling the filtration effect of the mask.

Regarding this, they are recommended only for health professionals and for the protection of persons that are the most at risk (persons with reduced immunity, patients with cancer, patients suffering from severe chronic diseases) while staying in high risk areas (health facilities, vehicles, enclosed spaces with more people).

It should be noted that models of occlusive masks with non-return valves, if the person that wears them is infected, do not protect those in their surrounding from the spread of the disease. Exhaled air is released directly into the environment without filtration, while only the inhaled air is filtrated, therefore, they should not be used in public places where, one of the main goals of wearing a mask is to prevent the spread of the virus from a potential asymptomatic carrier.

Masks with additional effects intend to solve some of the shortcomings of standard masks while preserving their existing, positive characteristics.

“Surgical” masks are most suitable for wide use, so usually, these improvements are performed on them by adding various chemical compounds to the original filter mask in order to improve the filtration effect or to increase their effect against bacteria, viruses and fungi while reducing the risk of secondary spread of infection due to the accumulation of pathogens in the mask filter during prolonged wear.

A number of different chemical compounds, such as polyvinyl alcohol, polyethylene oxide, polyamic acid, hydroxypropyl cellulose and nanoparticles (titanium oxide, zinc oxide, copper, gold, magnesium and silver) have been tested and, so far – have given the best results.

All of the additives mentioned above have improved the filtration effect and have shown an antimicrobial effect but, their use is limited/questionable regarding the potential toxic effect of inhalation of these particles. Therefore, the use of substances of the natural origin, with proven antimicrobial effects has become much more common recently.

Natural sea salt is one of the most popular natural antiseptics. From the first known civilizations, it has been used, due to its antimicrobial properties – for food preservation, as a corrective to fermentation, as an addition to toothpastes and as an antiseptic.

Salt crystals can inactivate microorganisms in a number of ways. The most significant are: their direct effects on growth and mechanical damage of microorganism, its dehydration, osmotic imbalance and changes in pH. Adding salt to microbiological filters can increase their antimicrobial effect.

Unlike previously mentioned substances, inhalation of sea salt micro-particles can only give positive effects on respiratory function. Due to the numerous positive effects of sea salt on the mucous membrane of the respiratory system function, inhalation of sea aerosol, since the ancient times, has been used as one of the treatments of respiratory diseases and a way of protection against respiratory infections.

SALT AND CHECKER MASK WITH ADDITION OF ADRIATIC SALT combines safety and applicability of the classic protective mask with the improvement of the protective antibacterial and protective effect of sea salt on the respiratory system.

By proper application of this protective mask in compliance with other epidemiological measures (physical distance, regular hand hygiene, avoidance of face-touching) can significantly reduce the risk (up to 80%) of SARS-CoV-2 transmission; and, in case of transmission – it can reduce viral load and risk of COVID-19 complications.

Furthermore, this mask protects against harmful chemical and physical factors (air pollution) that could lead to respiratory damage, reduces exposure to allergens and, by inhalation of sea salt micro-particles – it produces a beneficial effect on users’ respiratory system.

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