Dear all, as my first blog of this month of April, I will bring you into a respiratory disease: COPD

COPD is a chronic respiratory disease with airflow limitation and impaired gas exchange; usually it is the result of a combination of two conditions, emphysema and chronic obstructive bronchitis.

For more information, emphysema is due to destruction of lung tissue that causes a reduced expiratory flow rate and overinflated alveoli (also called air sac). It is an irreversible disease. Chronic bronchitis is inflammation of the mucous membrane of the bronchus with excessive mucous secretion in the bronchial tree.

In China, Usually diagnose in elderly people, it is mainly caused by cigarettes, smokes... 90% of smokers will develop COPD one day in their life.

Chronic bronchitis is defined clinically as the presence of a chronic productive cough for 3 months during each of 2 consecutive years.

Emphysema, on the other hand, is defined pathologically as an abnormal, permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.

COPD is manifested by:

O Cough with sputum, and dispnea

O exacerbation triggers

Physical exam will show increase of chest's diameter, diaphragmatic excursion and breath sounds...

Confirmation of the diagnosis is made by nuclear exam (CT or MRI) and lung function test.

According to the Journal of American Medical Association (Jama) 2003, the principal treatment of COPD is Corticosteroids, a supply in oxygen, dilators (anticholinergic...), but surgery can be done: it concerns a reduction of the lung or lung transplantation (in severe cases). But let us specify that in terms of therapy we have: Oxygen therapy, Chest physiotherapy, Ultrasonic or mechanical nebulizer treatments, physical therapy program etc.

Asthma and COPD cause similar symptoms. However, they are different diseases; COPD is a permanent damage of the airways. The narrowed airways are 'fixed', and the open up of airways is limited; when in asthma it is an airway's inflammation which causes muscles in the airways to constrict. This causes the airways to narrow. The symptoms tend to ' << come and go >>, and vary in severity from time to time. But it is still possible to find individuals with both Asthma and COPD.

Reference:

[a]. Lu Zai Ying, Zhong Nan Shan et al. Internal Medicine Seventh Edition Nov 2008. Respiratory System p62

[b]. Mary M. Canobbio. Mosby's Handbook of Patient Teaching Third Edition 2006 p259

[c]. http://www.med126.com/yingyu/2008/21609.shtml

[d]. http://emedicine.medscape.com/article/297664-overview

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