Chronic Obstructive Pulmonary Disease Exacerbations

Chronic Obstructive Pulmonary Disease Exacerbations covers the definition, diagnosis, epidemiology, mechanisms, and treatment associated with COPD exacerbations. This text also addresses imaging and how it plays a pivotal role in the diagnosis and study of exacerbations.Written by today's top experts, Chronic Obstructive Pulmonary Disease Exacerbat

This text aids practitioners who seek to diagnose, treat and manage patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) more effectively. It discusses pulmonary gas exchange, muscle function and breathing, water/electrolyte imbalances and end-stage disease.

A flood of data indicate the importance and the relevance in both respiratory and extrapulmonary disease of Chlamydia pneumoniae infection today. Antibody prevalence rates in Western countries reach 50% in the adult population and remain high in old age suggesting a high rate of reinfection. Chlamydia pneumoniae can cause upper respiratory tract infections, like pharyngitis and sinusitis as well as bronchitis and more than 10% of community-acquired pneumonia. Recent data suggest a possible association of Chlamydia pneumoniae infection with wheezing and adult-onset asthma. However, the most intriguing hypothesis pertains the possible association between Chlamydia pneumoniae infection and atherosclerosis.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive, largely irreversible lung condition characterised by airflow obstruction. Although cigarette smoking is the single most important risk factor in its development, other associations and risk factors are thought to have increasing relevance throughout the world. COPD is usually managed in primary care, although it is commonly under-diagnosed, and is one of the most common medical conditions necessitating admission to hospital. The second edition of the ABC of COPD provides the entire multidisciplinary team with a reliable, up-to-date and accessible account of COPD. Extensively updated by experienced clinicians - including new chapters on spirometry, inhalers, oxygen, death, dying and end of life issues - this ABC is an authoritative and practical guide for general practitioners, practice nurses, specialist nurses, medical students, paramedical staff, junior doctors, non-specialist doctors and all other health professionals working in both primary and secondary care.

In 2012 we received a grant from the Veterans Health Administration Office of Specialty Care entitled, “Patient-Centered Model for the Management of Chronic Obstructive Pulmonary Disease.” The grant’s goals were to enhance the recognition and diagnosis of COPD and implement a Patient-Centered Model for the Management of COPD. As the work on that proposal progressed, we realized that providers did not have an up-to-date, comprehensive, easily read, “how to” manual for the management of COPD despite all the advances in COPD care that have occurred over the past 5 years. Consensus documents such as the VA-DOD Guidelines were abbreviated summaries that were rarely used. From those discussions, the concept for this volume, a COPD Primer, developed. The goal was to develop a practical book that concisely presented COPD to providers with sufficient background and explanation of the physiologic and scientific rationale for various management strategies without becoming an esoteric academic work. We hope that this COPD Primer has achieved that goal and will be a useful, practical text for practitioners and medical trainees alike. The COPD Primer begins with an examination of what COPD is; it is really a syndrome, a constellation of historical features and clinical, physiologic, and radiographic findings. However, those elements come together in many different ways to create multiple different COPD phenotypes that are only now being recognized and used to define specific management strategies. COPD research has progressed beyond the simple classification of “blue bloaters” and “pink puffers.” Next, the epidemiology and economic consequences of COPD are reviewed. Bill Eschenbacher presents an approach to the patient with respiratory symptoms with detailed discussions of pulmonary function testing and how airflow limitation/obstruction is identified by spirometry and the use of lung imaging to identify individuals with COPD. Michael Borchers and Gregory Motz summarize current evidence implicating genetics, proteolytic imbalance, oxidative stress, inflammation, occupational and environmental exposures, and innate and adaptive immune function in the pathogenesis of COPD and the implication of these findings to future treatments. The single most important intervention in the prevention and treatment of COPD is smoking cessation. Shari Altum, Katherine Butler, and Rachel Juran present a practical approach to smoking cessation utilizing motivational interviewing in combination with pharmacologic interventions. Then, they expand upon these concepts to provide practitioners with convenient, realistic suggestions to encourage patient self-management in all aspects of COPD care and overall health. Ahsan Zafar reviews the natural history, recently described COPD phenotypes, and gender differences that clearly illustrate the broad spectrum of disease that comprises the term, COPD. The cover illustration highlights Dr. Zafar’s creative and artistic talents. The extensive nonpulmonary aspects of COPD are reviewed by Ralph Panos in an examination of COPD’s multi-organ manifestations. Next, the effect of COPD on sleep and the overlap syndrome, the concurrence of COPD and obstructive sleep apnea, and its consequences are presented. Jean Elwing examines the effect of COPD on the pulmonary vasculature with a detailed discussion of the evaluation and management of pulmonary hypertension associated with COPD. COPD’s effects on psychosocial functioning and familial interactions are presented by Mary Panos and Ralph Panos. The focus of the Primer then shifts from manifestations to treatment with a discussion of stable COPD management. With the current plethora of devices for delivering respiratory medications, it is difficult for both patients and providers to sustain knowledge of their proper use. Aaron Mulhall presents a practical guide to correct inhaler use that reviews all the current devices. Folarin Sogbetun then reviews the management of outpatient COPD exacerbations and Nishant Gupta discusses the approach to the patient hospitalized with COPD. Because patients with COPD often see multiple subspecialty physicians in addition to their primary care providers, interdisciplinary communication and coordination of care is essential for their management; Sara Krzywkowski-Mohn reviews the interactions between primary and specialty care for the patient with COPD with suggestions for improved communication and care coordination. Finally, advance care planning including palliative care and hospice is reviewed with a discussion of how end stage COPD affects not only the patient but also their family and social network. This COPD Primer incorporates the knowledge that we have learned over the past several years during the development and implementation of a patient-centered model for the management of COPD. It was written with the explicit goal of assisting both the practicing provider and medical trainee in the care of patients with COPD.

This text aids practitioners who seek to diagnose, treat and manage patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) more effectively. It discusses pulmonary gas exchange, muscle function and breathing, water/electrolyte imbalances and end-stage disease.

Significantly updated with the latest developments in diagnosis and treatment recommendations, Ferri’s Clinical Advisor 2020 features the popular "5 books in 1" format to organize vast amounts of information in a clinically relevant, user-friendly manner. This efficient, intuitive format provides quick access to answers on 1,000 common medical conditions, including diseases and disorders, differential diagnoses, and laboratory tests – all reviewed by experts in key clinical fields. Updated algorithms, along with hundreds of new figures, tables, and boxes, ensure that you stay current with today’s medical practice. Contains significant updates throughout, covering all aspects of current diagnosis and treatment. Features 27 all-new topics including chronic traumatic encephalopathy, medical marijuana, acute respiratory failure, gallbladder carcinoma, shift work disorder, radial tunnel syndrome, fertility preservation in women, fallopian tube cancer, primary chest wall cancer, large-bowel obstruction, inguinal hernia, and bundle branch block, among others. Includes a new appendix covering Physician Quality Reporting System (PQRS) Measures. Provides current ICD-10 insurance billing codes to help expedite insurance reimbursements. Patient Teaching Guides for many of the diseases and disorders are included, most available in both English and Spanish versions, which can be downloaded and printed for patients.

Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data--including population surveys, cohort studies, disease registries, administrative health data, and vital statistics--contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.