Chronic obstructive pulmonary disease

Phonetic exercise: respiratory [ri’spirə tə ri; ri’spairə rə tə ri; ‘respirə tə ri], pulmonary [‘pΛ lmə nə ri; ‘pulmə nə ri], chronic [‘kr nik], obstructive [ [ə b’strΛ ktiv], pulmonary [‘pΛ lmə nə ri; ‘pulmə nə ri], disease [di’zi: z], disorder [dis’so: də; diz’o: də ], characterized [‘kæ ktə raizd], bronchus [‘br ŋ kə s], bronchi [‘br ŋ kai], passages [‘pæ sid3iz], airways [‘ε ə wiz], lungs [lΛ ŋ z], mucous [‘mju: kə s],  mucus [‘mju: kə s], respiration [, respə ’rei∫ n], bronchitis [, br ŋ k’aitis], approximately [ə ’pr ksimə tli],  diagnosis [, daiə ‘gn usis], diagnose [‘daiə gn uz], exposure [iks‘ə u3ə ], pollution [pə ‘lu: ∫ n], sputum [‘spju: tə m], pollution [pə ‘lu: ∫ n], dyspnea [disp’ni: ə ], emphysema [, empfi’si: mə ], lungs [lΛ ŋ z], cough [k : f], tightness [‘taitnis], rales [r lz], environmental [in, vaiə rə n’mə ntl], autoimmunity [, tə ui’mju: niti], autoimmune           [, tə ui’mju: n], spirometry [, spaiə ‘r mə tri], cessation [sə s’ei∫ n]  

Make a report on chronic obstructive pulmonary disease according to the plan below:

Definition: chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD); chronic bronchitis and emphysema, a pair of commonly co-existing diseases of the lungs in which the airways become narrowed.

Epidemiology: in the United States, the prevalence of COPD is approximately 1 in 20 or 5%, totaling approximately 13. 5 million people in USA, or possibly approximately 25 million people if undiagnosed cases are included.

Causes: smoking (80 to 90% of cases of COPD are due to smoking0; occupational exposures (occupational pollutants, intense and prolonged exposure to workplace dusts found in coal mining, gold mining, and the cotton textile industry and chemicals, intense silica dust exposure); air pollution, genetics (a genetic susceptibility); other risk factors: bronchial hyperresponsiveness, repeated lung infections, a diet high in cured meats, an autoimmune component to COPD, etc.

Symptoms, signs, clinical manifestations, clinical features: cough and sputum production (in chronic bronchitis), dyspnea (in emphysema); decreased intensity of breath sounds; prolonged expiration on physical examination; airflow limitation on pulmonary function testing that is not fully reversible and most often progressive; shortness of breath; dyspnea that tends to get gradually worse during milder, everyday activities such as housework, dyspnea that occurs during rest and is constantly present. Other symptoms of COPD: persistent cough; sputum or mucus production; wheezing; chest tightness, and tiredness; respiratory failure in advanced (very severe) COPD, cyanosis, a bluish discoloration of the lips caused by a lack of oxygen in the blood; headaches; drowsiness or twitching; peripheral edema, seen as swelling of the ankles; tachypnea, a rapid breathing rate; wheezing sounds or crackles in the lungs heard through a stethoscope; breathing out taking a longer time than breathing in; enlargement of the chest, particularly the front-to-back distance (hyperaeration); active use of muscles in the neck to help with breathing; breathing through pursed lips, etc.

Evaluation (diagnosis): History: a personal medical history, a medication history, a family history, a smoking history, a history of exposure to risk factors for the disease such as regular tobacco smoking. a social history, an occupational history, an environmental history, etc.

Physical examination: observation, percussion, palpation, and auscultation.

Instrumental evaluation: spirometry, X-ray of the chest, complete pulmonary function tests, a high-resolution computed tomography scan of the chest, blood samples taken from an artery, blood samples taken from a vein, etc.

Management: no cure for COPD; however, COPD is both a preventable and treatable disease.

The major current directions of COPD management: to assess and monitor the disease, to reduce the risk factors, to manage stable COPD, to prevent and treat acute exacerbations and manage comorbidity; smoking cessation and supplemental oxygen.

Risk factor reduction: smoking cessation, the role of anti-smoking health: education of workers and management about the risks, promoting smoking cessation, surveillance of workers for early signs of COPD, the use of personal dust monitors, the use of respirators and dust control, improving ventilation, using water sprays, using mining techniques that minimize dust generation; pollution reduction efforts which should lead to health gains for people with COPD; bronchodilators; β 2 agonists, anticholinergics that cause airway smooth muscles to relax; corticosteroids that act to reduce the inflammation in the airways; other medications: theophylline; supplemental oxygen; pulmonary rehabilitation: a program of exercise, disease management and counseling to benefit the individual; nutrition: weight control; surgery in selected cases: bullectomy, surgical removal of a bulla, lung volume reduction surgery, lung transplantation for severe COPD, particularly in younger individuals.