The Pleural Diseases is a thin, delicate membrane that surrounds the lungs and lines the inside of the chest cavity. It forms a protective barrier and also allows the lungs to easily expand and contract during breathing. The pleura is made up of two layers - the parietal pleura which lines the chest cavity and the visceral pleura which surrounds each lung. Between these two layers is a thin space that contains a small amount of fluid that acts as a lubricant and allows the lungs to glide smoothly within the chest cavity during breathing.

Types of Pleural Diseases
There are several types of pleural diseases that can affect the protective membranes surrounding the lungs. Some of the most common types include:

Pleural Effusion
A pleural effusion occurs when there is an abnormal accumulation of fluid in the pleural space between the two layers of the pleura. This excess fluid puts pressure on the lungs and makes it difficult to breathe. Pleural effusions are usually caused by congestive heart failure, infections like pneumonia or tuberculosis, cancers that have spread to the pleural space or circulatory disorders.

Pneumothorax
A pneumothorax involves air or gas leaking into the pleural space, causing the lung to collapse. This happens when there is a tear or hole in the pleura. It can be spontaneous without any obvious cause or occur due to an underlying lung condition or trauma to the chest. A tension pneumothorax is a medical emergency that requires immediate treatment as air builds up rapidly in the pleural space.

Pleural Plaques
Pleural plaques are flat, irregular thickened areas on the pleura that contain calcification or scar tissue. They usually appear as a result of prior asbestos exposure but do not impair lung function. Plaques may be incidental findings on chest x-rays or CT scans done for other reasons.

Mesothelioma
Mesothelioma is a type of cancer that develops from the mesothelial cells of the pleura or peritoneum. Exposure to asbestos is the main risk factor for pleural mesothelioma, which accounts for about 70% of all mesothelioma cases. It often takes a long time between exposure and the onset of the disease. Pleural mesothelioma is an aggressive form of cancer with poor survival rates.

Symptoms of Pleural Disease
The symptoms of pleural disease will depend on the specific underlying condition but may include:
- Chest pain or pain with breathing or coughing
- Shortness of breath or difficulty breathing
- Dry cough
- Fatigue
- Fever
- Weight loss
- Coughing up bloody or abnormally coloured mucus (in case of infection or cancer)

Diagnosis and Treatment
When pleural disease is suspected based on symptoms and risk factors, tests are required to confirm the diagnosis and determine the cause. These include chest x-rays, CT scans, ultrasound of the chest, thoracentesis (sampling pleural fluid), biopsies and blood tests.

Treatment depends on the underlying etiology but may involve antibiotics for infections, diuretics to remove excess fluid, drainage of fluid or air in the pleural space via a chest tube, chemotherapy for cancers, radiation and surgery in some situations. Oxygen therapy can help with breathing difficulties. The prognosis varies according to the specific pleural condition.

Prevention of Pleural Diseases
While some pleural diseases have no known causes, others can be prevented:

- Avoid exposure to asbestos as much as possible through proper safety gear and ventilation in construction or insulation work. Asbestos is the main risk factor for pleural plaques and mesothelioma.

- Get vaccinated against pneumonia which is a common cause of pleural effusion and empyema.

- Maintain good lung health through a balanced diet, exercise, stress management and avoiding smoking or secondhand smoke. This reduces susceptibility to infections and other lung problems.

- Wear protective equipment while working with machinery or in environments with dust or fumes to prevent chest trauma or inhalation of harmful materials.

In conclusion, the pleura is an important membrane that protects the lungs. Various inflammation and infections can cause pleural diseases with breathing difficulties. Timely medical evaluation and management is vital. Awareness about risk factors empowers us to take necessary precautions.