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Encyclopedia > COPD
Chronic obstructive pulmonary disease
Classification & external resources
ICD-10 J40. - J44., J47.
ICD-9 490 - 496
OMIM 606963
DiseasesDB 2672
MedlinePlus 000091
eMedicine med/373  emerg/99
MeSH C08.381.495.389

Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airway disease (COAD), is a group of diseases characterized by limitation of airflow in the airway that is not fully reversible. COPD is the umbrella term for chronic bronchitis, emphysema and a range of other disorders. It is most often due to tobacco smoking[1] but can be due to other airborne irritants such as coal dust, asbestos or solvents, as well as preserved meats containing nitrites [1]. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // J00-J99 - Diseases of the respiratory system (J00-J06) Acute upper respiratory infections (J00) Acute nasopharyngitis (common cold) (J01) Acute sinusitis (J02) Acute pharyngitis (J03) Acute tonsillitis (J04) Acute laryngitis and tracheitis (J05) Acute obstructive laryngitis (croup) and epiglottitis (J050) Acute obstructive laryngitis (croup) (J051) Acute epiglottitis (J06) Acute upper... // J00-J99 - Diseases of the respiratory system (J00-J06) Acute upper respiratory infections (J00) Acute nasopharyngitis (common cold) (J01) Acute sinusitis (J02) Acute pharyngitis (J03) Acute tonsillitis (J04) Acute laryngitis and tracheitis (J05) Acute obstructive laryngitis (croup) and epiglottitis (J050) Acute obstructive laryngitis (croup) (J051) Acute epiglottitis (J06) Acute upper... // J00-J99 - Diseases of the respiratory system (J00-J06) Acute upper respiratory infections (J00) Acute nasopharyngitis (common cold) (J01) Acute sinusitis (J02) Acute pharyngitis (J03) Acute tonsillitis (J04) Acute laryngitis and tracheitis (J05) Acute obstructive laryngitis (croup) and epiglottitis (J050) Acute obstructive laryngitis (croup) (J051) Acute epiglottitis (J06) Acute upper... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... The term disease refers to an abnormal condition of an organism that impairs function. ... The airways are those parts of the respiratory system through which air flows, to get from the external environment to the alveoli. ... An umbrella term is a word that provides a superset or grouping of related concepts, also called a hypernym. ... Bronchitis is inflammation of the bronchi (medium-size airways) in the lungs. ... The cigarette is the most common method of smoking tobacco. ... Coal dust is a fine powdered form of coal. ... Fibrous asbestos on muscovite Asbestos Asbestos Blue asbestos (crocidolite) from Wittenoom, Western Australia. ... A substance is soluble in a fluid if it dissolves in the fluid. ... In inorganic chemistry nitrites are salts of nitrous acid HNO2. ...

Contents

Signs and symptoms

The main symptoms of COPD include dyspnea (shortness of breath) lasting for months or perhaps years, possibly accompanied by wheezing, and a persistent cough with sputum production.[2] It is possible the sputum may contain blood (hemoptysis), usually due to damage of the blood vessels of the airways. Severe COPD could lead to cyanosis (bluish decolorization usually in the lips and fingers) caused by a lack of oxygen in the blood. In extreme cases it could lead to cor pulmonale due the extra work required by the heart to get blood to flow through the lungs.[3] The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: A symptom can be a physical condition which shows that one has a particular illness or disorder (see e. ... Dyspnea (R06. ... Wheezes are continuous, coarse, whistling sounds produced in the respiratory airways during breathing. ... Sputum is matter that is coughed up from the respiratory tract, such as mucus or phlegm, mixed with saliva and then expectorated from the mouth. ... Hemoptysis (US English) or haemoptysis (International English) is the expectoration (coughing up) of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs (e. ... Cyanosis refers to the bluish coloration of the skin due to the presence of deoxygenated hemoglobin in blood vessels near the skin surface. ... General Name, Symbol, Number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Standard atomic weight 15. ... Cor pulmonale is a medical term used to describe a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. ...


COPD is particularly characterised by a ratio of forced expiratory volume over 1 second (FEV1) to forced vital capacity (FVC) being < 0.7 and the FEV1 < 70% of the predicted value [4] (see Spirometry). Other signs include a rapid breathing rate (tachypnea) and a wheezing sound heard through a stethoscope. Pulmonary emphysema is NOT the same as subcutaneous emphysema, which is a collection of air under the skin that may be detected by the crepitus sounds produced on palpation.[5] Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. ... Look up signs in Wiktionary, the free dictionary. ... Tachypnea is a medical term for breathing which is more rapid than normal. ... Stethoscope The stethoscope (Greek στηθοσκόπιο, of στήθος, stéthos - chest and σκοπή, skopé - examination) is an acoustic medical device for auscultation, or listening, to internal sounds in a human or animal body. ... Palpation is a method of examination in which the examiner feels the size or shape or firmness or location of something (of body parts when the examiner is a health professional). ...


Causes

Cigarette smoking

A primary factor of COPD is chronic tobacco smoking. In the United States, around 90% of cases of COPD are due to smoking.[6] Not all smokers will develop COPD, but continuous smokers have at least a 25% risk.[7]


Occupational pollutants

Some occupational pollutants, such as cadmium and silica, have shown to be a contributing risk factor for COPD. The people at highest risk for these pollutants include coal workers, construction workers, metal workers and cotton workers, amongst others. However, in most cases these pollutants are combined with cigarette smoking further increasing the chance of developing COPD.[6] These occupations are commonly associated with other respiratory diseases, particularly pneumoconiosis (black lung disease). General Name, Symbol, Number cadmium, Cd, 48 Chemical series transition metals Group, Period, Block 12, 5, d Appearance silvery gray metallic Standard atomic weight 112. ... The chemical compound silicon dioxide, also known as silica, is the oxide of silicon, chemical formula SiO2. ... These are a specific branch of Occupational Diseases concerned primarily with work related exposures to harmful substances, be they dusts or gases, and the subsequent pulmonary disorders that may occur as a result. ... Pneumoconiosis, also known as coal workers pneumoconiosis, miners asthma, or black lung disease, is a lung condition caused by the inhalation of dust, characterized by formation of nodular fibrotic changes in lungs. ...


Air pollution

Urban air pollution may be a contributing factor for COPD as it is thought to impair the development of the lung function. In developing countries indoor air pollution, usually due to biomass fuel, has been linked to COPD, especially in women.[1] Air pollution is a chemical, physical (e. ... A developing country is a country with low average income compared to the world average. ... Biofuel is any fuel that derives from biomass - recently living organisms or their metabolic byproducts, such as manure from cows. ...


Genetics

Very rarely, there may be a deficiency in an enzyme known as alpha 1-antitrypsin which causes a form of COPD.[8] Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Alpha 1-antitrypsin or &#945;1-antitrypsin (A1AT) is a serine protease inhibitor (serpin). ...


Other risk factors

Increasing age, male gender, allergy, repeated airway infection and general impaired lung function are also related to the development of COPD.


Pathophysiology

Chronic bronchitis

Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years.[9]


Chronic bronchitis is hallmarked by hyperplasia (increased number) and hypertrophy (increased size) of the goblet cells (mucous gland) of the airway, resulting in an increase in secretion of mucus which contributes to the airway obstruction. Microscopically there is infiltration of the airway walls with inflammatory cells, particularly neutrophils. Inflammation is followed by scarring and remodeling that thickens the walls resulting in narrowing of the small airway. Further progression leads to metaplasia (abnormal change in the tissue) and fibrosis (further thickening and scarring) of the lower airway. The consequence of these changes is a limitation of airflow.[10]. Hyperplasia (or hypergenesis) is a general term for an increase in the number of the cells of an organ or tissue causing it to increase in size. ... Bodybuilder Markus Rühl has marked hypertrophy of skeletal muscle. ... Goblet cells are glandular epithelial cells that are specifically designed to secrete mucus. ... Exocrine glands are glands that secrete their products into ducts. ... Robert Hookes microscope (1665) - an engineered device used to study living systems. ... Infiltration is the diffusion or accumulation (in a tissue or cells) of substances not normal to it or in amounts in excess of the normal. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Neutrophil granulocytes (commonly referred to as neutrophils) are a class of white blood cells and are part of the immune system. ... Metaplasia is the replacement of one differentiated cell type with another differentiated cell type. ... Fibrosis is the formation or development of excess fibrous connective tissue in an organ or tissue as a reparative or reactive process, as opposed to formation of fibrous tissue as a normal constituent of an organ or tissue. ...


Emphysema

Main article: Emphysema

Emphysema is defined histologically as the enlargement of the air spaces distal to the terminal bronchioles, with destruction of their walls.[9] A thin section of lung tissue stained with hematoxylin and eosin. ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... A terminal bronchiole is a bronchiole at the end of the respiratory zone. ...


The enlarged air sacs (alveoli) of the lungs reduces the surface area available for the movement of gases during respiration. This ultimately leads to dyspnea in severe cases. The exact mechanism for the development of emphysema is not understood, although it is known to be linked with smoking and age. The alveoli (singular:alveolus), tiny hollow sacs which are continuous with the airways, are the sites of gas exchange with the blood. ... Area is the measure of how much exposed area any two dimensional object has. ... The Respiratory System Among four-legged animals, the respiratory system generally includes tubes, such as the bronchi, used to carry air to the lungs, where gas exchange takes place. ...


Diagnosis

The diagnosis of COPD is usually suggested by symptoms; it is a clinical diagnosis and no single test is definitive. A comprehensive history from the patient is very important with regard to smoking and occupation. Physical examination with a plethysmograph can reveal the true extent of COPD. A plethysmograph is an instrument for measuring changes in volume within an organ or whole body (usually resulting from fluctuations in the amount of blood or air it contains). ...


The severity of COPD can be classified as follows using spirometry (see above):

Severity Post-bronchodilator FEV1/FVC FEV1 % predicted
At risk >0.7 ≥80
Mild COPD ≤0.7 ≥80
Moderate COPD ≤0.7 50-80
Severe COPD ≤0.7 30-50
Very Severe COPD ≤0.7 <30 or 30-50 with Chronic Respiratory Failure symptoms

Management

Although COPD is not curable, it can be controlled in a variety of ways.


Smoking cessation

Main article: Smoking cessation

Smoking cessation is one of the most important factors in slowing down the progression of COPD. Even at a late stage of the disease it can reduce the rate of deterioration and prolong the time taken for disability and death.[10] A No Smoking sign Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. ... A No Smoking sign Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. ...


Occupational change

Workers may be able to transfer to a significantly less contaminated area of the company depending on circumstances. Often however, workers may need complete occupational change.


Pharmacotherapy

Bronchodilators

There are several types of bronchodilators used clinically with varying efficacy: β2 agonists, M3 antimuscarinics, leukotriene antagonists, cromones and xanthines.[11] These drugs relax the smooth muscles of the airway allowing for improved airflow. The change in FEV1 may not be substantial, but changes in the vital capacity are significant. Many patients feel less breathless after taking bronchodilators. Wikipedia does not yet have an article with this exact name. ... Smooth muscle is a type of non-striated muscle, found within the walls of hollow organs; such as blood vessels, bladders, uteri. ... Vital capacity is the maximum volume of air that a person can exhale after maximum inhalation. ...


β2 agonists

There are several highly specific β2 agonists available. Salbutamol (Ventolin) is the most widely used short acting β2 agonist to provide rapid relief and should be prescribed as a front line therapy for all classes of patients. Other β2 agonists are Bambuterol, Clenbuterol, Fenoterol, and Formoterol. Longer acting β2 agonists such as Salmeterol act too slowly to be used as relief for dypsnea so these drugs should be used as a secondary therapy. An increased risk is associated with long acting β2 agonists due to decreased sensitivity to inflammation so generally the use of a concomitant corticosteroid is indicated[2][3][4]. Salbutamol (INN) or albuterol (USAN) is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and COPD. Salbutamol sulphate is usually given by the inhaled route for direct effect on bronchial smooth muscle. ... Bambuterol (INN, marketed by AstraZeneca under the trade names Bambec® and Oxeol®) is a long acting beta-adrenoceptor agonist used in the treatment of asthma. ... Clenbuterol is a drug prescribed to sufferers of breathing disorders as a decongestant and bronchodilator. ... Formoterol belongs to the family of prescription-only medicines known as beta 2-agonists. ... Salmeterol is a long-acting beta2-adrenergic receptor agonist drug that is currently prescribed for the treatment of asthma and chronic obstructive pulmonary disease COPD. It is currently available in both dry-powder inhalers (DPIs) and pressurised metered dose inhalers (pMDIs). ... Dyspnea (R06. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ...


M3 muscarinic antagonists (anticholinergics)

Derived from the deadly agaric Amanita muscaria, specific antimuscarinics were found to provide effective relief to COPD. Inhaled antimuscarinics have the advantage of avoiding endocrine and exocrine M3 receptors. The quaternary M3 muscarinic antagonist Ipratropium is widely prescribed with the β2 agonist salbutamol. [5]. Ipratropium is offered combined with salbutamol (Combivent) and with fenoterol (Duovent). Tiotropium provides improved specificity for M3 muscarinic receptors. Binomial name Amanita muscaria (Linnaeus) Hook. ... ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... Exocrine gland refers to glands that secrete their products via a duct. ... Sources Brenner, G. M. (2000). ... Salbutamol (INN) or albuterol (USAN) is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and COPD. Salbutamol sulphate is usually given by the inhaled route for direct effect on bronchial smooth muscle. ... Tiotropium (IPA: ) is a long-acting anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD). ...


Cromones

Cromones are mast cell stabilizers that are thought to act on a chloride channel found on mast cells that help reduce the production of histamine and other inflammatory factors. Chromones are also thought to act on IgE-regulated calcium channels on mast cells. Cromoglicate and Nedocromil, which has a longer half-life, are two chromones available.[12] The structural formula of chromone Chromone (or 1,4-benzopyrone) is a derivative of benzopyran with a substituted keto group on the pyran ring. ... Mast cell stabilizers are medications used to prevent or control certain allergic disorders. ... Ion channels are present in the membranes that surround all biological cells. ... A mast cell (or mastocyte) is a resident cell of connective tissue that contains many granules rich in histamine and heparin. ... This article or section does not cite any references or sources. ... Another, unrelated ion channeling process is part of ion implantation. ... Cromoglicate (INN) (also referred to as cromolyn (USAN) or cromoglycate (former BAN)) is traditionally described as a mast cell stabilizer, and is commonly marketed as the sodium salt sodium cromoglicate. ... The introduction to this article provides insufficient context for those unfamiliar with the subject matter. ...


Leukotriene antagonists

More recently leukotriene antagonists block the signalling molecules used by the immune system. Montelukast, Pranlukast, Zafirlukast are some of the leukotrienes antagonists.[13] Leukotrienes are autocrine and paracrine eicosanoid lipid mediators derived from arachidonic acid by 5-lipoxygenase. ... Montelukast is an oral leukotriene receptor antagonist (LTRA) for the maintenance treatment of asthma and to relieve symptoms of seasonal allergies. ... Pranlukast is a cysteinyl leukotriene receptor-1 antagonist. ... Zafirlukast is an oral leukotriene receptor antagonist (LTRA) for the maintenance treatment of asthma. ...


Xanthines

Theophylline is the prototype of the xanthine[14] class of drug. Teas are natural sources of methylxanthines, xanthines and caffeine while chocolate is a source of theobromine. Caffeine is approximately 16% metabolized into theophylline. Nebulized theophylline is used in the EMR for treatment of dyspnea (Difficulty in breathing). Patients need continual monitoring as theophylline has a narrow therapeutic range. More aggressive EMR interventions include IV H1 antihistamines and IV dexamethasone. Theophylline is a methylxanthine drug used in therapy for respiratory diseases such as COPD or asthma under a variety of brand names. ... Xanthines are a group of alkaloids that are commonly used for their effects as mild stimulants and as bronchodilators, notably in treating the symptoms of asthma. ... Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ... Chocolate most commonly comes in dark, milk, and white varieties, with cocoa solids contributing to the brown coloration. ... Theobromine, also known as xantheose,[1] is a bitter alkaloid of the cacao plant. ... Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ... Dyspnea (R06. ... The therapeutic index (also known as therapeutic ratio or margin of safety), is a comparison of the amount of a therapeutic agent that causes the therapeutic effect to the amount that causes toxic effects. ... An antihistamine is a drug which serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions, through action at the histamine receptor. ... Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid hormones. ...


Corticosteroids

Inhaled corticosteriods (specifically glucocorticoids) act in the inflammatory cascade and may improve airway function considerably,[10] however the long term value has not been proven. Corticosteroids are often combined with bronchodilators in a single inhaler. Some of the more common inhaled steroids in use are beclomethasone, mometasone, and fluticasone. Corticosterone Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... The name glucocorticoid derives from early observations that these hormones were involved in glucose metabolism. ... Beclometasone dipropionate is a corticosteroid drug. ... Mometasone furoate (also referred to as Mometasone) is a moderately potent glucocorticoid steroid used in the treatment of inflammatory skin disorders (such as eczema and psoriasis), allergic rhinitis (such as hayfever), and asthma for patients unresponsive to less potent corticosteroids. ... Fluticasone proprionate is a glucocorticoid often prescribed as treatment for asthma and allergic rhinitis. ...


Salmeterol and fluticasone are combined (Advair), however the reduction in death from all causes among patients with COPD in the combination therapy group did not reach the predetermined level of statistical significance.[15][16]


TNF antagonists

Tumor necrosis factor antagonists (TNF) are the most recent class of medications designed to deal with refractory cases. Tumor necrosis factor-alpha is a cachexin or cachectin and is considered a so-called biological drug. They are considerered immunosopressive with attendant risks. These rather expensive drugs include infliximab, adalimumab and etanercept.[17] In medicine, tumor necrosis factor alpha (TNF&#945;, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... Infliximab (brand name Remicade®) is a drug used to treat auto-immune disorders. ... Adalimumab (Humira®) is the third TNF antagonist (after infliximab and etanercept) to be approved in the US. Like infliximab and etanercept, adalimumab binds to TNFα, preventing it from activating TNF receptors; adalimumab was constructed from a fully human monoclonal antibody, while infliximab is a mouse-human chimeric antibody and etanercept... Etanercept (Enbrel®, co-marketed by Amgen and Wyeth) is a human recombinant, soluble tumor necrosis factor-alpha (TNFα) receptor. ...


Vaccination

Patients with COPD should be routinely vaccinated against influenza, pneumococcus and other diseases to prevent illness and the possibility of death.[11] Vaccination is the process of administering pathogens that cant reproduce (due to being weakened or dead) to a healthy person or animal, with the intent of conferring immunity against a targeted form of a related disease agent. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses). ... Binomial name Streptococcus pneumoniae Streptococcus pneumoniae is a species of Streptococcus that is a major human pathogen. ...


Pulmonary rehabilitation

Pulmonary rehabilitation is a program of disease management, counseling and exercise coordinated to benefit the individual.[18] Pulmonary rehabilitation has been shown to relieve difficulties breathing and fatigue. It has also been shown to improve the sense of control a patient has over their disease as well as their emotions.[19]


Diet

A recent French study conducted over 12 years with almost 43,000 men concluded that eating a Mediterranean diet "halves the risk of serious lung disease like emphysema and bronchitis". [6] The Mediterranean diet is a modern[1] nutritional model inspired by the traditional dietary patterns of some of the countries of the Mediterranean basin, particularly Greece and Southern Italy. ...


Prognosis

A good prognosis of COPD relies on an early diagnosis and prompt treatment. Most patients will have improvement in lung function once treatment is started, however eventually signs and symptoms will worsen as COPD progresses. The median survival is about 10 years if two-thirds of expected lung function was lost by diagnosis.


Bronchitis

Acute bronchitis usually resolves in 7-10 days with no underlying lung disease. Chronic bronchitis however is dependent on early recognition and smoking cessation which improves the outcome significantly.


Emphysema

The outcome is better for patients with less damage to the lung who stop smoking immediately. Still, patients with extensive lung damage may live for many years so predicting prognosis is difficult. Death may occur from respiratory failure, pneumonia, or other complications. Pneumonia is an illness of the lungs and respiratory system in which the alveoli (microscopic air-filled sacs of the lung responsible for absorbing oxygen from the atmosphere) become inflamed and flooded with fluid. ...


Asbestosis

The outcome is clouded by the many complications associated with asbestosis. Malignant mesothelioma is refractory to management affording patients with 6-12 months of life expectancy upon clinical presentation. In medicine, malignant is a clinical term that means to be severe and become progressively worse, as in malignant hypertension. ...


Pneumoconiosis

The outcome is good for patients with minimal damage to the lung. However, patients with extensive lung damage may live for many years so predicting prognosis is difficult. Death may occur from respiratory failure, pneumonia, cor pulmonale or other complications. Respiratory failure is a medical term for inadequate gas exchange by the respiratory system. ... Pneumonia is an illness of the lungs and respiratory system in which the alveoli (microscopic air-filled sacs of the lung responsible for absorbing oxygen from the atmosphere) become inflamed and flooded with fluid. ... Cor pulmonale is a medical term used to describe a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. ...


Pulmonary neoplasms

The stage of the tumor(s) has a major impact on neoplasm prognosis. Staging is the process of determining tumor size, growth rate, potential metastasis, lymph node involvement, treatment options and prognosis. Two-year prognosis for limited small cell pulmonary neoplasms is twenty percent and for extensive disease five percent. The average life expectancy for someone with recurrent small cell pulmonary neoplasms is two to three months.[7] Tumor or tumour literally means swelling, and is sometimes still used with that meaning. ... Neoplasia (literally: new growth) is sudden and abnormal growth in a tissue or organ. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...


The 5-year overall survival rate for pulmonary neoplasms is 14%.[20]


Epidemiology

According to the World Health Organization (WHO), 80 million people suffer from moderate to severe COPD and 3 million died due to it in 2005. The WHO predicts that by 2030, it will be the 4th largest cause of mortality worldwide.[21] The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ...


Since COPD is not diagnosed until it becomes clinically apparent, prevalence and mortality data greatly underestimate the socioeconomic burden of COPD.[11] In the UK, COPD accounts for about 7% of all days of sickness related absence from work.[10] Socioeconomics or Socio-economics is the study of the relationship between economic activity and social life. ...


Smoking rates in the industrialized world have continued to fall, causing rates of emphysema and pulmonary neoplasms to slowly decline.


References

  1. ^ a b Devereux G. ABC of chronic obstructive pulmonary disease. Definition, epidemiology, and risk factors. BMJ 2006;332:1142-1144. PMID 16690673
  2. ^ U.S. National Heart Lung and Blood Institute - Signs and Symptoms
  3. ^ MedicineNet.com - COPD signs & symptoms
  4. ^ PatientPlus - Spirometry
  5. ^ eMedicine - Barotrauma
  6. ^ a b MedicineNet.com - COPD causes
  7. ^ Lokke A, Lange P, Scharling H, Fabricius P, Vestbo J. Developing COPD: a 25 year follow up study of the general population. Thorax. 2006 Nov;61(11):935-9. PMID 17071833
  8. ^ MedlinePlus Medical Encyclopedia
  9. ^ a b Longmore M, Wilkinson I, Rajagopalan S (2005). Oxford Handbook of Clinical Medicine, 6ed. Oxford University Press. pp 188-189. ISBN 0-19-852558-3.
  10. ^ a b c d Kumar P, Clark M (2005). Clinical Medicine, 6ed. Elsevier Saunders. pp 900-901. ISBN 0702027634.
  11. ^ a b c American Thoracic Society / European Respiratory Society Task Force (2005). Standards for the Diagnosis and Management of Patients with COPD. Version 1.2. New York: American Thoracic Society. http://www.thoracic.org/go/copd
  12. ^ http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=4166895&dopt=Abstract
  13. ^ available.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=13804592&dopt=Citation
  14. ^ http://www.chemistry.org/portal/a/c/s/1/acsdisplay.html?DOC=HomeMoleculearchivemotw_xanthine_arch.html
  15. ^ http://content.nejm.org/cgi/content/short/356/8/775
  16. ^ http://clinicaltrials.gov/show/NCT00268216
  17. ^ http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/C/CellSignaling.html
  18. ^ U.S. National Heart Lung and Blood Institute - Treatment
  19. ^ Lacasse Y, Goldstein R, Lasserson T J, Martin, S. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. (4):CD003793, 2006. PMID 12137716
  20. ^ John D. Minna, "Neoplasms of the Lung," in Harrison's Principles of Internal Medicine, 16th ed. (2005), p. 506
  21. ^ WHO - COPD

The British Medical Journal (BMJ) is a medical journal published weekly in the United Kingdom by the British Medical Association (BMA)which published its first issue in 1845. ... Oxford University Press (OUP) is a highly-respected publishing house and a department of the University of Oxford in England. ...

External links


  Results from FactBites:
 
What Is COPD? (349 words)
COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath.
COPD is a major cause of death and illness, and it is the fourth leading cause of death in the United States and throughout the world.
COPD is not contagious—you cannot catch it from someone else.
COPD - Wikipedia, the free encyclopedia (1056 words)
Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of respiratory tract diseases that are characterized by airflow obstruction or limitation.
COPD can also be caused by prolonged exposure to certain dusty environments.
COPD is also characterized by exacerbations which typically present with a rapid progression of the chronic symptoms.
  More results at FactBites »

 
 

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