National Association of Tuberculosis and Respiratory Services
The National Tuberculosis and Respiratory Association is an IPSS, federation of the International Union against Tuberculosis and Respiratory Diseases, founded in 1989, which aims to encourage the Civil Society to promote the respiratory health of portuguese people, in these areas of the world. prevention, early diagnosis and acknowledgment of the patients, and all of them as they do, pulmões and cries.
Winter and Respiratory Diseases
- Bronchiectasis
- COPD (Chronic Bronchitis)
- Tuberculosis
- Tobacco and the Lungs
- The Flu
The respiratory system is exposed daily to the aggressions contained in the more than 12 m3 that pass through it daily. To defend itself, it has several defense mechanisms, starting with the nose.
The nose heats the air to 37 degrees Celsius and maintains humidity at 78%, which is essential for the proper functioning of the respiratory system. If the air is too cold, the capillaries in the nose dilate to warm it (congestion), producing more mucus (nasal discharge) which, at low temperatures, becomes thicker, making it difficult for the mechanisms to clean the particles, viruses and bacteria that accumulate there. Sudden changes in temperature also lead to nasal congestion, triggering these mechanisms.
If congestion increases, the passage of air becomes more difficult and there is a tendency to breathe through the mouth. Cold or dry air, chemical irritants and tobacco smoke then reach the bronchi directly, altering the composition of the mucus and hindering the effectiveness of the mechanisms for transporting deposited particles to the outside.
On the other hand, in winter, people tend to stay indoors, often in poorly ventilated rooms, keeping the windows closed and heating them with systems that dry the air. This creates environments in which the air is more aggressive to the lungs and where there are high concentrations of infectious agents. This risk increases if, due to previous exposure to the cold outside, there is nasal obstruction, leading the individual to breathe through the mouth.
Full Members
Anyone who proposes to collaborate in achieving the aims of the Association, is obliged to pay the membership fee and annual membership fee, as set at the General Assembly.
Individuals over 18 years of age and legal entities may become members, if they propose to join the Association and whose proposal is accepted by the Board of Directors.
Honorary Members
Effective Members who propose to support the Association economically by paying a higher annual fee, set at the General Assembly.
Honorary Members
People who the General Assembly considers worthy of the distinction for their work in favor of respiratory health.
What is bronchiectasis?
Bronchiectasis is the permanent dilation and distortion of one or more bronchi, usually secondary to an infectious process. They normally affect bronchi with a caliber equal to or greater than 2 mm and result from the destruction of the muscular and elastic components of the wall, with dilation of the bronchus and alteration of the mucociliary function.
Bronchiectasis can be congenital or secondary to various processes.The first result from an arrest in embryonic development. The bronchi divide dichotomously in their genesis. If there is an arrest in this division, the bronchus ends in a cul-de-sac.
Secondary bronchiectasis is often the result of a fixed obstruction (scarring stenosis, foreign body, tumour). This results in stasis of secretions, subsequent bacterial colonisation, chronic infection and irreversible damage to the bronchial wall, with dilation of the wall, rendering the bronchial drainage mechanisms ineffective. These wall lesions are due either to the action of the infectious agent or to the individual's response to the infection, with the release of cytokines, nitric oxide and neutrophil proteases.
Sometimes a generalized bronchial infection, especially in children, can damage the lining and lead to bronchiectasis. This is the case with measles pneumonia, which has been the cause of many cases of bronchiectasis. This chronic infection of the dilated bronchus extends to the adjacent parenchyma, extending the inflammatory process to it, further disturbing respiratory function. Extensive fibrosis processes can, by exerting retraction forces on the bronchial wall, lead to distortions of the bronchi, with failure of the drainage mechanisms, contributing to the appearance of so-called traction bronchiectasis (usually cylindrical bronchiectasis).
Types of bronchiectasis
According to Reid (1950), bronchiectasis can be classified into:
- Cylindrical – there is diffuse edematous involvement of the mucosa, with slight widening of the bronchus, which maintains its path and external limits and ends abruptly, in a broken branch (due to filling with mucus).
- Cystic or saccular – have a balloon-like appearance, with abundant neovascularization and may have fluid levels.
- Varicose – have a bullous appearance, interspersed with areas of relative constriction. May result from post-obstructive pneumonitis.
- Proximal – In invasive allergic aspergillosis there is destruction of the bronchial wall in the terminal portion and it dilates like a balloon, while the distal portion maintains a relatively normal caliber .
- Is this a disease that can appear at any age or can it appear at a younger age?
- It depends on the type and etiological causes. Congenital bronchitis and those resulting from measles appear in children. In relation to the others, it depends on the moment at which the localized bronchial obstruction is established. Traction bronchitis appears later, as it is a consequence of fibrosis processes that, as a rule, appear later.
Are there many cases of bronchiectasis every year?
Fortunately not, especially if we consider the saccular and varicose forms, which, among us, were very often caused by bronchial tuberculosis in times when treatments were not very effective. Nowadays, this “source” has been significantly reduced.
Traction bronchiectasis, on the other hand, continues to be very common and is the basis for many symptoms interpreted as asthma or bronchitis, which respond poorly to treatments.
What message would you like to convey to General Practitioners about this pathology?
- The first is to think about this disease, which is multifactorial, has multiple origins, causing enormous suffering to patients and significantly disrupting respiratory function. They may not be very common, but they do exist and can be diagnosed and treated, with notable relief of symptoms. Persistent cough and constant bronchorrhea have a considerable impact on patients' quality of life and their socialization.
- The second is that it is always necessary to look for the cause of a localized obstruction of a bronchus, which may hide a tumor, a foreign body or active tuberculosis. The slightest suspicion requires recourse to bronchofibroscopy.
OPD – Chronic Obstructive Pulmonary Disease
Chronic bronchitis has been known for hundreds of years , and is defined as a condition characterized by the presence of chronic coughing and expectoration, with the threshold of the disease being considered the presence of these complaints for a number of days exceeding three months, for two consecutive years. Gradually, we became aware of the presence of another factor of even greater importance: as the disease progresses, a chronic obstruction of the bronchi sets in, leading to a limitation of the passage of airflow from the outside to the alveoli and from there to the outside. Furthermore, this limitation is not fully reversible, even with the correct medication, and tends to be progressive. This difficulty in the passage of airflow is due to the reduction in the calibre of the bronchi ( bronchoconstriction ) due to contraction of the muscles surrounding the bronchi and the obstruction caused by the secretions accumulated due to the chronic inflammation caused by the disease in the lungs as a result of the attacks by the causative agents of the disease. This leads to the concept of Chronic Obstructive Pulmonary Disease . As the disease progresses, bronchoconstriction, inflammation and the release of mediators lead to air retention, distension of the alveolar spaces and subsequently the destruction of the walls – this is Emphysema .
What causes COPD
The predominant factors that cause the disease are damage to the surface of the bronchi (mucosa) by particles, smoke and toxic gases. The main cause of the disease is tobacco smoke , inhaled when smoking a cigarette. In fact, it has been shown that 90% of COPD cases are caused by this. When a smoker inhales the smoke from a single cigarette, they paralyze the vibrating cilia, which are essential elements in the lungs' defense. Therefore, every cigarette counts and should be avoided. Smoke in a room will also be inhaled by everyone present, even non-smokers, causing them harm. This is known as passive smoking . Air pollution also plays a role in the onset and worsening of COPD (chronic bronchitis and emphysema). Suspended particles and combustion gases from engines are particularly aggressive. For COPD, pollution originating from vehicle exhausts is particularly aggressive, as the concentrations of particles and toxic gases are particularly high. Industrial pollution , whose fumes are rich in particles, sulphur dioxide and carbon monoxide, is also harmful. In a more discreet way, there are genetic factors that can contribute to the onset of the disease, but it is pollution caused by man that is largely responsible
Tuberculosis
- Tuberculosis Symptoms
- Tuberculosis Prevention
- Tuberculosis Treatment
- Consequences of Tuberculosis
- Tuberculosis Documentation
What is Tuberculosis?
It is an infectious, serious and potentially fatal disease, if left untreated, caused by a bacterium, MYCOBACTERIUM TUBERCULOSIS and, more rarely, by other bacteria of the same group such as Mycobacterium bovis. Myobacterium tuberculosis is also known as Koch's bacillus , because it was identified by Robert Koch.
It is an airborne disease that can affect all organs of the body, but especially the lungs, which are the entry point for the microorganism into the individual and the starting point of the disease.
About a third of the world's population is infected with Koch's bacillus. Fortunately, only 10% of those infected develop the disease.
If the disease appears and is not treated and left to its natural course, it kills around half of the patients.
In Portugal, the incidence of tuberculosis is still very high, higher than in most countries with our economic development. More than 3,000 new cases of the disease appear in Portugal each year, but since treatment is easily accessible and free, the vast majority are cured and mortality is very low.
Background :
In 1899 it was created at the National Assistance for Tuberculosis, by the initiative and initiative of Rainha D. Amélia, impressed by the very serious problem that tuberculosis represented, in the number of patients and deaths. To try to reduce the situation if funds were necessary, they are not only stated as obtained through contributions from the Civil Society. As this fim was então imagined or Selo Antituberculoso.
It was first lithographed at the Casa da Moeda, with the design and engraving of Domingos Alves, and 90,000 specimens were issued in the brown and green cores, intended for correspondence, and 90,000 in the brown and pink cores for the prints. Its dissemination and circulation throughout the national space began on August 6, 1904. Thus, the first anti-tuberculosis seal issued throughout the world, whose purpose was to help fight against tuberculosis.
From 2001 onwards, aware that the fight against respiratory diseases should not be limited to tuberculosis and that the most important thing is to prevent respiratory diseases from emerging, the seal became known as Respiratory Disease Prevention Seal.
In 2005 – 2006 we once again published the label and, this time, we chose to publish two series, each consisting of 125,000 sheets of 6 vignettes each with the idea of making them attractive to a wider audience, given their graphic diversity. We will seek to ensure that, from this year onwards, the vignettes carry a message of promoting respiratory health to wider sections of the population.