Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Hood Alsagaff
Heart Disease
Cancer
Cerebrovascular disease (stroke)
Respiratory Diseases (COPD)
Accidents
Pneumonia and influenza
Diabetes
Suicide
Nephritis
Chronic liver disease
All other causes of death
Number
724,269
538,947
158,060
114,381
94,828
93,207
64,574
29,264
26,295
24,936
469,314
Coronary
Heart
Disease
Stroke
Other CVD
COPD
All Other
Causes
59%
64%
35%
+163%
7%
2.0
1.5
1.0
0.5
0
1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998
1965
1970
1975
1980
1985
1990
1995
2000
10
1980
1985
1990
Year
1995
1998
6.98
7.35
4.38
26.20
2.89
4.41
3.36
2.69
9.34
Female/1000
3.79
3.45
3.44
23.70
1.79
2.49
2.72
2.83
7.33
Year
rank
1986
3.8
10
1992
5.6
1995
15.7
1986
1992
Diarrhoea
12.0
Cardiovascular
Cardiovascular
9.7
Tuberculosis
11
Tuberculosis
8.6
Not known
9.8
Measles
6.7
Resp.infection
9.5
Low Resp.Dis
6.2
Diarrhoea
8.0
Tetanus
6.0
Other inf.dis
7.8
Mental disorders
5.3
CB, Asthma,emphy
5.6
Injuries
4.7
Injuries
5.3
Neoplasms
4.3
Gastro intestinal
5.1
10
CB,Asthma,
3.8
Neoplasms
4.0
Emphysema
16.0
% with symptoms
Burden of COPD
Key Points
Burden of COPD
Key Points
The global burden of COPD will
increase enormously over the
foreseeable future as the toll
from tobacco use in developing
countries becomes apparent.
Burden of COPD
Key Points
$18.0
Total Cost
$ 14.1
7.3
6.8
$32.1
Exposure
Tobacco smoke
Occupational dusts and
chemicals
Infections
Socioeconomic status
Pathogenesis of COPD
NOXIOUS AGENT
COPD
Noxious particles
and gases
Host factors
Anti-oxidants
Lung inflammation
Oxidative stress
Anti-proteinases
Proteinases
Repair mechanisms
COPD pathology
INFLAMMATION
Parenchymal destruction
Loss of alveolar attachments
Decrease of elastic recoil
AIRFLOW LIMITATION
ASTHMA
Sensitizing agent
Completely
reversible
COPD
Noxious agent
Airflow limitation
Completely
irreversible
Irreversible
Fibrosis and narrowing of the
airways
Loss of elastic recoil due to
alveolar destruction
Destruction of alveolar support
that maintains patency of small
airways
Reversible
Accumulation of inflammatory cells,
mucus, and plasma exudate in
bronchi
Smooth muscle contraction in
peripheral and central airways
Dynamic hyperinflation during
exercise
Education
Pharmacologic
Non-pharmacologic
4. Manage exacerbations
Objectives of COPD
Management
Diagnosis of COPD
EXPOSURE TO RISK
FACTORS
tobacco
occupation
indoor/outdoor pollution
SYMPTOMS
cough
sputum
dyspnea
SPIROMETRY
FEV1
Normal
COPD
Liter
FVC
FEV1/ FVC
4.150
5.200
80 %
2.350
3.900
60 %
FEV1
COPD
4
FEV1
Normal
5
1
FVC
FVC
4
6 Seconds
Severity of symptoms
Severity of airflow limitation
Frequency and severity of exacerbations
Presence of complications of COPD
Presence of respiratory insufficiency
Comorbidity
General health status
Number of medications needed to manage the
disease
Stage
0: At risk
Classification by
Severity
Characteristics
Normal spirometry
Chronic symptoms (cough, sputum)
I: Mild
II: Moderate
III: Severe
Could it be COPD?
Do you know what COPD is? This chronic lung disease is a major cause of illness,
yet many people have it and dont know it.
If you answer these questions, it will help you find out if you could have COPD.
1. Do you cough several times most days?
3. Do you get out of breath more easily than others your age? Yes ___ No ___
4. Are you older than 40 years?
If you answered yes to three or more of these questions, ask your doctor if you
might have COPD and should have a simple breathing test. If COPD is found
early, there are steps you can take to prevent further lung damage and make you
feel better.
Take time to think about your lungsLearn about COPD!