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Chronic obstructive pulmonary disease 

Chronic obstructive pulmonary disease
Chapter:
Chronic obstructive pulmonary disease
Author(s):

William MacNee

DOI:
10.1093/med/9780199204854.003.1808_update_001

August 28, 2014: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

Update:

This chapter has been extensively revised.

Aetiology—expanded discussion of environmental (indoor air pollution) and genetic factors, and the role of ageing.

Epidemiology—worldwide prevalence described by Burden of Obstructive Lung Disease (BOLD) study; worldwide estimates of deaths and disability; mortality related to severity of airflow limitation.

Clinical features—expanded discussions of systemic features and comorbidities; use of the COPD assessment test (CAT); assessment of risk of exacerbations; differential diagnosis; combined assessments in COPD (BODE index, GOLD classification).

Management—updates on newer pharmacological treatments, including phosphodiesterase 4 inhibitors, and recommendations regarding combined treatments. Enhanced discussion of treatment of comorbidities and of surgical approaches, including resection of bullae and lung volume reduction surgery.

Relevant case histories from Oxford Case Histories in Respiratory Medicine have been added to this chapter.

Updated on 30 May 2013. The previous version of this content can be found here.
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date: 22 November 2017

Case History—A 37 yr old woman with slowly progressive breathlessness.

Case History—A 45 yr old man with increasing symptoms from his known COPD.

Chronic obstructive pulmonary disease (COPD) is a slowly progressive condition that produces considerable morbidity and mortality. It is characterized by airflow limitation that is not fully reversible and is associated with an enhanced inflammatory response in the airways and the lungs to noxious particles or gases. COPD is a group of lung conditions—chronic bronchitis (a chronic productive cough on most days for 3 months, in each of two consecutive years), small-airway disease (obstructive bronchiolitis), and emphysema (abnormal, permanent enlargement of the air spaces, distal to the terminal bronchioles, accompanied by destruction of their walls) that are present to a variable extent in different individuals resulting in heterogeneous presentations of the condition. Exacerbations and comorbidities contribute to the overall severity of the condition in individual patients....

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