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Respiratory disease
Classification and external resources
Respiratory system
ICD-10 J00.-J99.
ICD-9 460-519
MeSH D012140

Respiratory Disease is the term for diseases of the respiratory system. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings J00-J99 - Diseases of the respiratory system (J00-J06 Acute upper respiratory infections ( Acute Nasopharyngitis ( Common cold) J00-J99 - Diseases of the respiratory system (J00-J06 Acute upper respiratory infections ( Acute Nasopharyngitis ( Common cold) The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly In living organisms a respiratory system functions to allow Gas exchange. These include diseases of the lung, pleural cavity, bronchial tubes, trachea, upper respiratory tract and of the nerves and muscles of breathing. lung is the essential Respiration organ in air-breathing Animals including most Tetrapods a few Fish and a few Snails The most primitive The bronchioles or bronchioli are the first Airway branches that no longer contain Cartilage. The Upper respiratory tract refers to the following parts of the Respiratory system: Nose and Oral cavity Throat Breathing takes Oxygen in and Carbon dioxide out of the body Aerobic Organisms require oxygen to create energy via respiration, in Respiratory disease ranges from mild and self-limiting such as the common cold to life-threatening such as bacterial pneumonia or pulmonary embolism. Acute viral nasopharyngitis or acute coryza, usually known as the common cold, is a highly contagious viral Infectious disease of the See Pneumonia for a general overview of pneumonia and its other causes Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein They are a common and important cause of illness and death. In the US, Adults average between 2 and 4 colds a year, children between 6 and 10[1]. One in seven people in the UK is affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease and asthma [2]. Chronic obstructive pulmonary disease ( COPD) is a Disease of the lungs in which the Airways become narrowed Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are Respiratory disease is responsible for over 10% of hospitalizations and over 16% of deaths in Canada[3]. The study of respiratory disease is known as pulmonology. In Medicine, pulmonology (aka pneumology) is the specialty that deals with Diseases of the Lungs and the Respiratory tract. A doctor who specializes in respiratory disease is known as a pulmonologist, a chest medicine specialist, a respiratory medicine specialist, a respirologist or a thoracic medicine specialist.

Contents

Symptoms

The symptoms of respiratory disease differ depending on the disease. Common symptoms are:

In some cases respiratory disease is diagnosed without symptoms in the investigation of another disease or through a routine check.

Diagnostic tests

Respiratory diseases may be investigated by perfoming one or more of the following tests

Treatment

Treatment of respiratory disease depends on the particular disease being treated, the severity of disease and the patient. A chest X-ray, commonly abbreviated CXR, is a projection radiograph ( X-ray) taken by a Radiographer, of the Thorax which is used Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs measuring Lung function specifically the measurement Computed tomography (CT is a Medical imaging method employing Tomography. A microbiological culture, AKA microbial culture, is a method of multiplying microbial organisms by letting them reproduce in predetermined culture media under controlled laboratory Sputum is matter that is Expectorated from the respiratory tract such as Mucus or Phlegm, mixed with Saliva, which can then be spat Bronchoscopy is a technique of visualising the inside of the Airways An instrument Bronchoscope is inserted into the Airways usually through A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues A ventilation/perfusion lung scan, also called a V/Q lung scan is a type of Medical imaging used to evaluate the circulation of air and blood within a patient's Lungs Lifestyle factors such as regular exercise and healthy nutrition are important in preventing and treating respiratory disease. Vaccination can prevent some respiratory diseases. In addition, the following treatments are often used for respiratory diseases:

Respiratory diseases

Respiratory diseases can be classified in many different ways; by the organ involved, by the pattern of symptoms or by the cause of the disease. Pleurodesis is the artificial obliteration of the pleural space. Lung transplantation is a surgical procedure in which a patient's diseased Lungs are partially or totally replaced by lungs which come from a donor

Obstructive lung diseases

These are diseases of the lung where the bronchial tubes become narrowed making it hard to move air in and especially out of the lung. The bronchioles or bronchioli are the first Airway branches that no longer contain Cartilage.

Chronic obstructive pulmonary disease[4]

Main article: Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airways disease (COAD) or chronic airflow limitation (CAL), is a group of illnesses characterised by airflow limitation that is not fully reversible. Chronic obstructive pulmonary disease ( COPD) is a Disease of the lungs in which the Airways become narrowed Chronic obstructive pulmonary disease ( COPD) is a Disease of the lungs in which the Airways become narrowed The flow of air into and out of the lungs is impaired. This can be measured with breathing devices such as a peak flow meter or by spirometry. A peak flow meter is a small hand-held device used to manage Asthma by monitoring airflow through the bronchi and thus the degree of obstruction in the airways Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs measuring Lung function specifically the measurement The term COPD includes the conditions emphysema and chronic bronchitis although most patients with COPD have characteristics of both conditions to varying degrees. Emphysema is a chronic obstructive Pulmonary disease ( COPD) formerly termed a chronic obstructive Lung disease (COLD Bronchitis is an Inflammation of the bronchi (medium-size airways in the Lungs Acute bronchitis is usually caused by Viruses Asthma being a reversible obstruction of airways is often considered separately, but many COPD patients also have some degree of reversibility in their airways. Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are

In COPD, there is an increase in airway resistance, shown by a decrease in the forced expiratory volume in 1 second (FEV1) measured by spirometry. Airway resistance is a concept used in Respiratory physiology to describe mechanical factors which limit the access of inspired air to the Pulmonary alveoli, and thus Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs measuring Lung function specifically the measurement COPD is defined as a forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) that is less than 0. 7[5]. The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal. The increased total lung capacity (hyperinflation) can result in the clinical feature of a "barrel chest" - a chest with a large front-to-back diameter that occurs in some individuals with COPD. Hyperinflation can also be seen on a chest x-ray as a flattening of the diaphragm. A chest X-ray, commonly abbreviated CXR, is a projection radiograph ( X-ray) taken by a Radiographer, of the Thorax which is used

The most common cause of COPD is cigarette smoking. Smoking is a practice where a substance most commonly Tobacco, is burned and the Smoke tasted or inhaled COPD is a gradually progressive condition and usually only develops after about 20 pack-years of smoking. A pack year is a Quantification of Cigarette smoking. Definition A way to measure the amount a person has smoked over a long period of time COPD may also be caused by breathing in other particles and gasses.

The disagnosis of COPD is established through spirometry although other pulmonary function tests can be helpful. Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs measuring Lung function specifically the measurement A chest x-ray is often ordered to look for hyperinflation and rule out other lung conditions but the lung damage of COPD is not always visible on a chest x-ray. A chest X-ray, commonly abbreviated CXR, is a projection radiograph ( X-ray) taken by a Radiographer, of the Thorax which is used A chest X-ray, commonly abbreviated CXR, is a projection radiograph ( X-ray) taken by a Radiographer, of the Thorax which is used Emphysema, for example can only be seen on CT scan. Emphysema is a chronic obstructive Pulmonary disease ( COPD) formerly termed a chronic obstructive Lung disease (COLD Computed tomography (CT is a Medical imaging method employing Tomography.

The main form of long term management involves the use of inhaled bronchodilators (specifically beta agonists and anticholinergics) and inhaled corticosteroids. A bronchodilator is a substance that dilates the bronchi and Bronchioles decreasing airway resistance and thereby facilitating airflow Beta2-adrenergic agonists, also known as Beta2-adrenergic receptor agonists, are a class of drugs used to treat Asthma and other An anticholinergic agent is a substance that blocks the Neurotransmitter acetylcholine in the central and the Peripheral nervous system. Glucocorticoids (GC are a class of Steroid hormones characterised by an ability to bind with the glucocorticoid receptor ( GR) and trigger similar effects Many patients eventually require oxygen supplementation at home. Oxygen therapy is the administration of Oxygen as a therapeutic modality In severe cases that are difficult to control, chronic treatment with oral corticosteroids may be necessary, although this is fraught with significant side-effects. Glucocorticoids (GC are a class of Steroid hormones characterised by an ability to bind with the glucocorticoid receptor ( GR) and trigger similar effects

COPD is generally irreversible although lung function can partially recover if the patient stops smoking. Smoking cessation is an essential aspect of treatment[6]. Pulmonary rehabilitation programmes involve intensive exercise training combined with education and are effective in improving shortness of breath. Severe emphysema has been treated with lung volume reduction surgery with some success in carefully chosen cases. Emphysema is a chronic obstructive Pulmonary disease ( COPD) formerly termed a chronic obstructive Lung disease (COLD Lung transplantation is also performed for severe COPD in carefully chosen cases. Lung transplantation is a surgical procedure in which a patient's diseased Lungs are partially or totally replaced by lungs which come from a donor

Alpha 1-antitrypsin deficiency is a fairly rare genetic condition that results in COPD (particularly emphysema) due to a lack of the antitrypsin protein which protects the fragile alveolar walls from protease enzymes released by inflammatory processes. Alpha 1-antitrypsin deficiency ( α1-antitrypsin deficiency, A1AD or Alpha-1) is a Genetic disorder caused by defective production of Alpha Emphysema is a chronic obstructive Pulmonary disease ( COPD) formerly termed a chronic obstructive Lung disease (COLD Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens

Asthma

Main article: Asthma

Asthma is an obstructive lung disease where the bronchial tubes (airways) are extra sensitive (hyperresponsive). Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are The bronchioles or bronchioli are the first Airway branches that no longer contain Cartilage. The airways become inflamed and produce excess mucus and the muscles around the airways tighten making the airways narrower. Asthma is usually triggered by breathing in things in the air such as dust or pollen that produce an allergic reaction. It may be triggered by other things such as an upper respiratory tract infection, cold air, exercise or smoke. Upper respiratory tract infections, ( URTI or URI) are the illnesses caused by an acute Infection which involves the upper Respiratory tract: Asthma is a common condition and affects over 300 million people around the world[7]. Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

Asthma is diagnosed by the characteristic pattern of symptoms. A peak flow meter can record variations in the severity of asthma over time. A peak flow meter is a small hand-held device used to manage Asthma by monitoring airflow through the bronchi and thus the degree of obstruction in the airways Spirometry, a measurement of lung function, can provide an assessment of the severity, reversibility, and variability of airflow limitation, and help confirm the diagnosis of asthma[7]. Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs measuring Lung function specifically the measurement

Asthma is treated by identifying and removing the triggers that set it off, if possible. The main form of long term management involves the use of inhaled corticosteroids. Glucocorticoids (GC are a class of Steroid hormones characterised by an ability to bind with the glucocorticoid receptor ( GR) and trigger similar effects Inhaled bronchodilators, particularly beta agonists are used to relieve and control symptoms by reducing muscle spasm around the airways. A bronchodilator is a substance that dilates the bronchi and Bronchioles decreasing airway resistance and thereby facilitating airflow Beta2-adrenergic agonists, also known as Beta2-adrenergic receptor agonists, are a class of drugs used to treat Asthma and other An alternative way to control mild asthma is with a leukotriene antagonist tablet. A leukotriene antagonist is a Hormone antagonist acting upon Leukotrienes It has been demonstrated that leukotrienes are implicated in Bronchoconstriction

Other obstructive lung diseases

In many parts of the world, the most common cause of obstructive lung disease is lung scarring after tuberculosis infection. Bronchiectasis is a disease that causes localized irreversible dilatation of part of the Bronchial tree. Bronchiolitis is inflammation of the Bronchioles the smallest air passages of the lungs In Medicine, allergic bronchopulmonary aspergillosis ( ABPA) is a condition characterised by an exaggerated response of the Immune system (a hypersensitivity Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common

Restrictive lung diseases[8]

Restrictive lung diseases (also known as interstitial lung diseases) are characterised by a loss of lung compliance, causing incomplete lung expansion and increased lung stiffness. Compliance is the ability of the Lungs to stretch in a change in volume relative to an applied change in pressure The underlying process is usually pulmonary fibrosis (scarring of the lung). As the disease progresses, the normal lung tissue is gradually replaced by scar tissue interspersed with pockets of air. This can lead to parts of the lung having a honeycomb-like appearance.

The main symptoms are shortness of breath and cough.

In restrictive lung disease, both the FEV1 and FVC are reduced so the FEV1/FVC ratio is normal or even increased in contrast to obstructive lung disease where this ratio is reduced. The values for residual volume and total lung capacity are generally decreased in restrictive lung disease[9].

Restrictive lung diseases may be due to a specific cause such as:

Many cases of restrictive lung disease are idiopathic (have no known cause). Idiopathic is an Adjective used primarily in Medicine meaning arising spontaneously or from an obscure or unknown cause. Examples are:

Respiratory tract infections

Infections can affect any part of the respiratory system. Idiopathic pulmonary fibrosis (IPF, also known as cryptogenic fibrosing alveolitis, is a Chronic, progressive interstitial lung disease with an unknown Sarcoidosis, also called sarcoid (from the Greek sarx, meaning "flesh" or Besnier-Boeck disease, is an immune system disorder characterized Eosinophilic pneumonia ( EP) is a Disease in which a certain type of White blood cell called an Eosinophil accumulates in the Lung. Lymphangioleiomyomatosis (LAM is the result of disorderly smooth muscle proliferation throughout the Bronchioles, Alveolar septa, Perivascular spaces, They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections.

Upper respiratory tract infection

The most common upper respiratory tract infection is the common cold however infections of specific organs of the upper respiratory tract such as sinusitis, tonsillitis, otitis media, pharyngitis and laryngitis are also considered upper respiratory tract infections. Upper respiratory tract infections, ( URTI or URI) are the illnesses caused by an acute Infection which involves the upper Respiratory tract: Acute viral nasopharyngitis or acute coryza, usually known as the common cold, is a highly contagious viral Infectious disease of the Sinusitis is an Inflammation of the Paranasal sinuses which may or may not be as a result of infection from Bacterial fungal, viral Tonsillitis is an Infection of the Tonsils and will often but not necessarily cause a Sore throat and Fever. Otitis media is Inflammation of the Middle ear, or middle ear infection (the word otitis is Greek and it means “inflammation of the ear” and media See also Strep throat. Pharyngitis (ˌfarɪnˈdʒʌɪtɪs is in most cases a Painful inflammation of the Pharynx, and is Laryngitis is an Inflammation of the Larynx. It causes hoarse voice or the complete loss of the voice because of irritation to the Vocal folds

Lower respiratory tract infection

The most common lower respiratory tract infection in is pneumonia, a lung infection. Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal Pneumonia is usually caused by bacteria, particularly [[Streptococcus pneumoniae]] in Western countries. Worldwide, tuberculosis is an important cause of pneumonia. Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common Other pathogens such as viruses and fungi can cause pneumonia for example severe acute respiratory syndrome and pneumocystis pneumonia. Pneumocystis pneumonia ( PCP) is a form of Pneumonia caused by the yeast-like Fungus, Pneumocystis jirovecii (Jirovecii is pronounced A pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection or an empyema, the spread of the infection to the pleural cavity.

Respiratory tumours

Tumours of the respiratory system are either malignant or benign.

Malignant tumours

Malignant tumours, or cancers of the respiratory system, particularly lung cancers, are a major health problem responsible for 15% of all cancer diagnoses and 29% of all cancer deaths[10]. The majority of respiratory system cancers are attributable to smoking tobacco.

The major types of respiratory system cancer are:

In addition, since many cancers spread via the bloodstream and the entire cardiac output passes through the lungs, it common for cancer metastases to occur the lung. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, Breast cancer may invade directly through local spread, and through lymph node metastases. Breast cancer is a Cancer that starts in the cells of the Breast in women and men After metastasis to the liver, colon cancer frequently metastasizes to the lung. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and Prostate cancer, germ cell cancer and renal cell carcinoma may also metastasize to the lung. "Kidney Cancer" redirects here For Wilms' Tumor/Nephroblastoma see Wilms' tumor.

Treatment of respiratory system cancer depends on the type of cancer. Surgery (usually removal of part of the lung, a lobectomy or an entire lung, a pneumonectomy), chemotherapy and radiotherapy are all used. Lobectomy means surgical excision of a lobe. This may refer to a lobe of the Lung, a lobe o the Thyroid or a lobe of the Brain (as in Anterior A pneumonectomy (or pneumectomy) is a surgical procedure to remove a Lung. Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. Radiation therapy (or radiotherapy) is the medical use of Ionizing radiation as part of Cancer treatment to control Malignant The chance of surviving lung cancer depends on the cancer stage at the time the cancer is diagnosed and is only about 14-17% overall[11]. In the case of metastases to the lung, treatment can occasionally be curative but only in certain, rare circumstances.

Benign tumours

Benign tumours are relatively rare causes of respiratory disease. Examples of benign tumours are:

Pleural cavity diseases

Pleural cavity diseases include empyema and mesothelioma which are mentioned above. An empyema is a collection of Pus within a naturally existing anatomical cavity Mesothelioma is a form of Cancer that is almost always caused by previous exposure to Asbestos.

A collection of fluid in the pleural cavity is known as a pleural effusion. Pleural effusion is excess fluid that accumulates in the Pleural cavity, the fluid-filled space that surrounds the Lungs Excessive amounts of such fluid can impair This may be due to fluid shifting from the bloodstream into the pleural cavity due to conditions such as congestive heart failure and cirrhosis. It may also be due to inflammation of the pleura itself as can occur with infection, pulmonary embolus, tuberculosis, mesothelioma and other conditions. Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common Mesothelioma is a form of Cancer that is almost always caused by previous exposure to Asbestos.

A pneumothorax is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung “collapses” like a deflated baloon. A tension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life threatening situation. A tension pneumothorax is a life-threatening condition that results from a progressive deterioration and worsening of a simple Pneumothorax, associated with the formation

Pulmonary vascular diseases

Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Pulmonary circulation is the portion of the Cardiovascular system which carries Oxygen -depleted Blood away from the heart to the Lungs, and Examples of these conditions are:

Disorders of breathing mechanics

The brain co-ordinates breathing and sends messages via nerves to the muscles of respiration. The muscles produce the movements of breathing. Disorders of the brain’s control of breathing, the nerves or the muscles of respiration can affect the respiratory system. Common disorders of breathing mechanics are:


Obesity is often associated with sleep apnea and can cause either an obstructive or a restrictive pattern on spirometry. Sleep apnea is a sleep disorder characterized by pauses in Breathing during Sleep. Sleep apnea is a sleep disorder characterized by pauses in Breathing during Sleep. Amyotrophic Lateral Sclerosis ( ALS, sometimes called Maladie de Charcot, or in the United States Lou Gehrig's Disease) is a progressive Guillain-Barré syndrome ( GBS) (in French ɡilɛ̃ baˈʁe in English ˈɡiːlæn ˈbɑreɪ /ɡiːˈæn bəˈreɪ/ etc Myasthenia gravis (literally "serious muscle-weakness" from Greek μύς "muscle" "weakness" and Latin gravis Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected Sleep apnea is a sleep disorder characterized by pauses in Breathing during Sleep. Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs measuring Lung function specifically the measurement Obesity reduces the movement of the chest wall which can, in extreme cases, result in the obesity-hypoventilation syndrome, a cause of respiratory failure.

References

  1. ^ National Institutes of Health – common cold. Retrieved on 2008-05-07. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 558 - In Constantinople, the dome of the Hagia Sophia collapses
  2. ^ British Lung Foundation - Facts about respiratory disease. Retrieved on 2008-04-19. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1012 - Martyrdom of Alphege in Greenwich London. 1529 - At the Second Diet of Speyer
  3. ^ [http://www.phac-aspc.gc.ca/ccdpc-cpcmc/crd-mrc/facts_gen_e.html Public Health Agency of Canada - Centre for Chronic Disease Prevention and Control Chronic Respiratory Diseases]. Retrieved on 2008-05-06. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1527 - Spanish and German troops sack Rome; some consider this the end of the Renaissance.
  4. ^ Kleinschmidt, Paul. Chronic Obstructive Pulmonary Disease and Emphysema. Retrieved on 2008-04-19. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1012 - Martyrdom of Alphege in Greenwich London. 1529 - At the Second Diet of Speyer
  5. ^ GOLD – the Global initiative for chronic Obstructive Lung Disease disease. Retrieved on 2008-05-06. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1527 - Spanish and German troops sack Rome; some consider this the end of the Renaissance.
  6. ^ What is chronic obstructive pulmonary disease (COPD)?. Retrieved on 2008-04-19. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1012 - Martyrdom of Alphege in Greenwich London. 1529 - At the Second Diet of Speyer
  7. ^ a b GINA – the Global INitiative for Asthma. Retrieved on 2008-05-06. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1527 - Spanish and German troops sack Rome; some consider this the end of the Renaissance.
  8. ^ Sharma, Sat. Restrictive Lung Disease. Retrieved on 2008-04-19. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1012 - Martyrdom of Alphege in Greenwich London. 1529 - At the Second Diet of Speyer
  9. ^ www.spirXpert.com.
  10. ^ LungCancer.org. Retrieved on 2008-05-07. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 558 - In Constantinople, the dome of the Hagia Sophia collapses
  11. ^ Canadian Lung Association – Lung Cancer. Retrieved on 2008-05-07. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 558 - In Constantinople, the dome of the Hagia Sophia collapses
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