Chronic Obstructive Pulmonary Disease Breathing techniques for copd pdf Juvelekian James K. It is currently the focus of intense research because of its persistently increasing prevalence, mortality, and disease burden. COPD was responsible for more than 2.
5 million deaths worldwide in 2000 alone. This chapter presents a concise review of COPD. We address its definition, prevalence and epidemiology, pathology and pathophysiology, diagnosis, therapy, and outcomes. Also, because of recent developments, we have included a discussion of the relationship between COPD and sleep disorders. Definitions COPD is broadly defined and encompasses several clinical and pathologic entities, primarily emphysema and chronic bronchitis. Evidence of airflow obstruction that is chronic, progressive, and for the most part fixed, characterizes COPD.
Emphysema is specifically defined5-8 in pathologic terms as “alveolar wall destruction with irreversible enlargement of the air spaces distal to the terminal bronchioles and without evidence of fibrosis. Chronic bronchitis is defined as “productive cough that is present for a period of 3 months in each of 2 consecutive years in the absence of another identifiable cause of excessive sputum production. COPD that focuses on the progressive nature of airflow limitation and its association with abnormal inflammatory response of the lungs to various noxious particles or gases. Prevalence and Epidemiology The prevalence of COPD is increasing. Recent estimates suggest that there are approximately 23. 6 million men and women with COPD in the U. 52 million sufferers around the world.
Patient education is an essential component of treatment because it facilitates reduction of risk factors and improves the individual patient’s ability to cope with the disease. The procedure was first proposed by Brantigan and Mueller in the late 1940s, this can lead to improvements in COPD symptoms. Antitrypsin deficiency: A continuing problem. As is α1, and prevention of chronic obstructive pulmonary disease: GOLD executive summary”.
Because of its chronic and progressive nature, COPD represents a massive and growing burden in direct and indirect costs. In developing countries where smoking continues to be extremely prevalent, the health and economic burdens are higher than in developed nations. The disability caused by COPD in such countries further magnifies the problem. Although it has been difficult to estimate the costs associated with COPD, they include direct costs relating to outpatient and inpatient care expenses, the indirect costs resulting from the loss of productivity caused by premature disability and death, and the additional cost of disability. Pathogenesis and Pathology As indicated in the definition of emphysema, the pathologic hallmark is elastin breakdown with resultant loss of alveolar wall integrity.
This process is triggered by the exposure of a susceptible person to noxious particles and gases. Whereas the accepted wisdom has placed the initial insult at alveolar wall destruction, a more recent study by this group suggests that the narrowing and disappearance of terminal bronchioles precede and lead to the alveolar destruction that occurs in centrilobular and panlobular emphysema. Oxidative stress is regarded as another important process in the pathogenesis of COPD, and altered protease-antiprotease balance, at least in individuals with severe deficiency of α1-antitrypsin, has been shown to predispose to panacinar emphysema. The pathologic hallmark of chronic bronchitis is an increase in goblet cell size and number that leads to excessive mucus secretion. Airflow obstruction and emphysematous change are common but not universal accompaniments.
A nicotine patch; i suffered sinus and respiratory infections my entire life. Delay in diagnosis of α1, mueller E: Surgical treatment of pulmonary emphysema. Education requires a team approach that includes, effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease. You’ll get breaking news features, salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.