There is an association between treating emphysema, and osteoporosis; the use of systemic corticosteroids for treating exacerbations is a significant risk factor for osteoporosis, and their repeated use is not recommended. Other terms
Compensatory emphysema, is overinflation of part of a lung in response to either removal by surgery of another part of the lung or decreased size of another part of the lung.Pulmonary interstitial emphysema (PIE) is a collection of air outside of the normal air space of the alveoli, found as pneumatoses inside the connective tissue of the peribronchovascular sheaths, interlobular septa, and visceral pleura. Lung volume reduction
Lung volume reduction may be offered to those with advanced emphysema. When other treatments fail, and the emphysema is located in the upper lobes a surgical option may be possible. A number of minimally invasive bronchoscopic procedures are increasingly used to reduce lung volume. Surgical
Where there is severe emphysema with significant hyperinflation that has proved unresponsive to other therapies lung volume reduction surgery (LVRS) may be an option. LVRS involves the removal of tissue from the lobe most damaged by emphysema, which allows the other lobes to expand and give improved function. The procedure appears to be particularly effective if the emphysema primarily involves the upper lobes; however, the procedure increases the risk of adverse events and early death in people who have diffuse emphysema. Bronchoscopic
Minimally invasive bronchoscopic procedures may be carried out to reduce lung volume. These include the use of valves, coils, or thermal ablation.
Pyromania moved from the DSM-4 chapter "Impulse-Control Disorders Not Otherwise Specified," to the chapter "Disruptive, impulse-control, and conduct disorders" in DSM-5. Signs and symptoms
According to DSM-5, there are six signs of pyromania. Pyromania is mainly categorized by the purposeful setting of fire, tension or arousal before a fire is set, interest in or attraction to fire, and pleasure or relief after setting a fire. These fires not set for personal gain, are not meant to express anger or conceal illegal activity, are not in support of sociopolitical ideologies, are not in response to delusions, and are not signs of intellectual disability. For diagnosis, the setting of fire should not be better explained by a conduct disorder, manic episode, or a personality disorder (antisocial personality disorder). ICD-11 also adds substance abuse to this list. According to ICD-11, signs of fire setting may occur "in response to feelings of depressed mood, anxiety, boredom, loneliness, or other negative affective states." Those with pyromania exhibit problems in social environments and learning disabilities. Women pyromaniacs "often report histories of exposure to trauma, including sexual abuse, and self-harm." Episodic fire setting may become more intense and violent over time, becoming potentially chronic if untreated. Causes
Most studied cases of pyromania occur in children and teenagers. There is a range of causes, but an understanding of the different motives and actions of fire setters can provide a platform for prevention. Common causes of pyromania can be broken down into two main groups: individual and environmental.