Chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide. Recognition that the burden of this disorder will continue to increase over the next 20 years despite medical intervention has stimulated new research into the underlying mechanisms, leading to a rationa...
| Published in: | Lancet Vol. 362; no. 9389; pp. 1053 - 1062 |
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| Main Authors: | , , , |
| Format: | review tables/charts Journal Article |
| Published: |
Lancet
9/27/2003
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106665666&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106665666 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 9/27/2003 vid: 362 iid: 9389 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 106665666 106665666 NLM14522537 2004188427 10.1016/s0140-6736(03)14416-9 NLM14522537 106665666 ppf: 1053 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Chronic obstructive pulmonary disease. aug: au: Calverley PMA Walker P Calverley, P M A Walker, Paul affil: Department of Medicine, University of Liverpool, Liverpool, UK sug: subj: Pulmonary Disease, Chronic Obstructive Disease Progression Prevention and Control Pulmonary Disease, Chronic Obstructive Complications Pulmonary Disease, Chronic Obstructive Diagnosis Pulmonary Disease, Chronic Obstructive Epidemiology Pulmonary Disease, Chronic Obstructive Physiopathology Pulmonary Disease, Chronic Obstructive Therapy ab: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide. Recognition that the burden of this disorder will continue to increase over the next 20 years despite medical intervention has stimulated new research into the underlying mechanisms, leading to a rational basis for evaluation of existing therapies, and has suggested novel treatment approaches. Tobacco exposure remains the main but not exclusive cause of COPD. Whether the lung is injured by changes in the balance of proteases and antiproteases, tissue damage by oxidative stress, or a combination of the two is still not known. The genetic basis of susceptibility to COPD is now being studied as is the role of computed tomography in the identification of structural damage in individuals with less symptomatic disease. Clinical diagnosis still relies heavily on an appropriate history confirmed by abnormal spirometry. Smoking cessation is possible in a substantial proportion of individuals with symptoms but is most effective if withdrawal is supported by pharmacological treatment. Treatment with long-acting inhaled bronchodilators and, in more severe disease, inhaled corticosteroids reduces symptoms and exacerbation frequency and improves health status. Rehabilitation can be even more effective, at least for a year after the treatment. Recent guidelines have made practical suggestions about how to optimise these treatments and when to consider addition of oxygen, surgery, and non-invasive ventilation. Regular review of this guidance is important if future management advances are to be implemented effectively. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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