Pulmonology 585383 223644726 2008-07-05T01:35:25Z Thijs!bot 1392310 robot Adding: [[cs:Pneumologie]] {{Unreferenced|date=December 2007}} In [[medicine]], '''pulmonology''' (aka '''pneumology''') is the specialty that deals with [[disease]]s of the [[lung]]s and the [[respiratory tract]]. It is called '''chest medicine''' and '''respiratory medicine''' in some countries and areas. ''Pulmonology'' is generally considered a branch of [[internal medicine]], although it is closely related to [[intensive care medicine]] when dealing with patients requiring [[mechanical ventilation]]. [[Surgery]] of the respiratory tract is generally performed by specialists in [[cardiothoracic surgery]] (or [[thoracic surgery]]). '''Chest medicine''' is not a specialty in itself but is an inclusive term which pertains to the treatment of diseases of the chest and contains the fields of pulmonology, thoracic surgery, and [[intensive care medicine]]. Pulmonology is concerned with the diagnosis and treatment of [[lung]] diseases, as well as secondary prevention ([[tuberculosis]]). Physicians specializing in this area are called pulmonologists. In the United Kingdom, Ireland, South Africa and Australasia the term "respiratory physician" is used rather than pulmonologist. == Diagnosis == In [[medicine]], 50% of all diagnoses can be made by a thorough medical history {{Fact|date=June 2008}}, and lung diseases are no different. The pulmonologist will conduct a general review and focus on: * hereditary diseases affecting the lungs ([[cystic fibrosis]], [[alpha 1-antitrypsin deficiency]]) * exposure to [[toxin]]s ([[tobacco smoking|tobacco smoke]], [[asbestos]], [[exhaust fume]]s, [[coal mining]] fumes) * exposure to [[infectious disease|infectious agents]] (certain types of [[bird]]s, malt processing) * an [[autoimmunity|autoimmune diathesis]] that might predispose to certain conditions ([[pulmonary fibrosis]], [[pulmonary hypertension]]) Physical diagnostics are as important as in the other fields of [[medicine]]. *Inspection of the hands for signs of [[cyanosis]] or [[clubbing]], chest wall, and respiratory rate. *Palpation of the [[cervical lymph nodes]], [[Vertebrate trachea|trachea]] and chest wall movement. *Percussion of the lung fields for dullness or [[hyperresonance]]. *[[Auscultation]] (with a [[stethoscope]]) of the lung fields for diminished or unusual [[breath sounds]]. As many [[cardiology|heart diseases]] can give pulmonary signs, a thorough cardiac investigation is usually included. Other tools include: * [[Laboratory]] investigation of [[blood]] ([[blood test]]s). Sometimes [[arterial blood gas]] measurements are also required. * [[Spirometry]] (the determination of [[lung volumes]] in time by breathing into a dedicated machine; response to [[bronchodilatator]]s and [[diffusion]] of [[carbon monoxide]]) * [[Bronchoscopy]] with [[bronchoalveolar lavage]] (BAL), endobronchial and transbronchial [[biopsy]] and [[epithelium|epithelial]] brushing * [[X-rays|Chest X-rays]] * [[Computed tomography|CT scanning]] ([[Magnetic resonance imaging|MRI scanning]] is rarely used) * [[Scintigraphy]] and other methods of [[nuclear medicine]] * [[Positron emission tomography]] (especially in [[lung cancer]]) == Treatment == [[Surgery|Surgical]] treatment in generally performed by the ([[cardiothoracic surgery|cardio]])[[thoracic surgery|thoracic surgeon]], generally after primary evaluation by a pulmonologist. [[Medication]] is the most important treatment of most diseases of pulmonology, either by inhalation ([[bronchodilator]]s and [[steroid]]s) or in oral form ([[antibiotic]]s, [[leukotriene antagonist]]s). [[Oxygen therapy]] is often necessary in severe respiratory disease ([[emphysema]] and [[pulmonary fibrosis]]). When this is insufficient, the patient might require [[mechanical ventilation]]. == Training == In the [[United States]], pulmonologists are physicians who, after receiving a medical degree [[Doctor of Medicine|MD]] or [[DO]], complete residency training in internal medicine (3 years), followed by at least 2 additional years of subspeciality fellowship training in pulmonology. <!-- I CAN ONLY SAY THAT FOR US, DON'T KNOW HOW IT WORKS IN OTHER COUNTRIES!!-->Most pulmonologists complete 3 years of combined subspecialty fellowship training in pulmonary medicine and critical care medicine. In the [[United States]], pediatric pulmonologists are physicians who, after receiving a medical degree [[Doctor of Medicine|MD]] or [[DO]], complete residency training in pediatrics (3 years), followed by at least 3 additional years of subspeciality fellowship training in pulmonology. == Diseases managed by the pulmonologist == *[[Allergic bronchopulmonary aspergillosis]] * [[Asthma]] * [[Chronic obstructive pulmonary disease]]: - ** [[Chronic bronchitis]] ** [[Emphysema]] * [[Cystic fibrosis]] (in adults; [[Pediatrics|pediatricians]] may be involved in the care of children with the disease) * [[Lung cancer]] diagnosis * [[Pneumoconiosis]] * [[Pneumonia]] * [[Pneumothorax]] * [[Psittacosis]] * [[Pulmonary embolism]] * [[Pulmonary fibrosis]] * [[Pulmonary hypertension]] * [[Pulmonary sequestration]] * [[Sarcoidosis]] * [[Sleep apnea]] * [[Tuberculosis]] == Scientific research == Pulmonologists are involved in both clinical and basic research of the [[respiratory system]], ranging from the anatomy of the bronchial epithelium to the most effective treatment of [[pulmonary hypertension]] (a disease notoriously resistant to therapy). {{medicine}} [[Category:Pulmonology|*]] [[Category:Respiratory system|*]] [[Category:Subjects taught in medical school]] [[ar:طب الأمراض الصدرية]] [[bn:ফুসফুসবিদ্যা]] [[bg:Пулмология]] [[ca:Pneumologia]] [[cs:Pneumologie]] [[de:Pneumologie]] [[es:Neumología]] [[eu:Pneumologia]] [[fr:Pneumologie]] [[it:Pneumologia]] [[he:פולמונולוגיה]] [[la:Pulmonologia]] [[nl:Pneumologie]] [[ne:फोक्सोशास्त्र]] [[ja:呼吸器学]] [[nn:Pulmonologi]] [[pl:Pulmonologia]] [[pt:Pneumologia]] [[ru:Пульмонология]] [[sq:Pneumologjia]] [[sk:Pneumológia]] [[sl:Pulmologija]] [[tr:Göğüs hastalıkları]] [[zh:胸腔醫學]]