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Chronic airway diseases - Essay Example

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Name of the student Health Sciences and Medicine Name of the concerned Professor 19 May 2012 Chronic Airway Disease 1.0 Introduction and classification of Diseases that affect lung function Diseases of lung can be classified depending upon the part of the respiratory system affected as well as the duration of the disease…
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Chronic airway diseases

Asthma and chronic obstructive pulmonary disease (COPD) form the majority of lung diseases typified by airflow limitation. Asthma is a distinct clinical entity, differentiated from COPD on the basis of onset at an early age, largely reversible airway obstruction and an associated history of allergy (Celli & MacNee 2004). The term COPD has traditionally included two components: chronic bronchitis and emphysema. Chronic bronchitis is epidemiologically defined as presence of cough and mucous production in at least 3 consecutive months for at least 2 consecutive years (Global Initiative for Chronic Obstructive Lung Disease 2011). Emphysema is characterised by the destruction of lung parenchyma distal to terminal bronchioles and loss of elastic recoil (Global Initiative for Chronic Obstructive Lung Disease 2011). However, recently it has been suggested that emphysema is a pathological not clinical diagnosis and that chronic bronchitis can occur even in the absence of airway limitation (Global Initiative for Chronic Obstructive Lung Disease 2011). Thus, COPD has been defined as a preventable and treatable disease which has progressive and irreversible airflow limitation associated with chronic inflammatory response and FEV1/FVC < 0.7(NICE 2010). 1.1 Epidemiology and prevalence of Chronic Obstructive diseases COPD most commonly affects the elderly population with smoking as the most important risk factor. In Great Britain, it causes more than 25000 deaths each year and the prevalence is estimated to be more than 1.5 million (Health and Safety Executive 2011). In terms of economic burden, direct and indirect costs due to COPD amount to nearly 50 billion dollars in United States alone (Global Initiative for Chronic Obstructive Lung Disease 2011). This is brought about by hospitalisation, oxygen and treatment costs as well as because of loss of productivity during acute exacerbations of the disease. 2.0 Historical Background Description of chronic bronchitis was first given by Badham way back in 1814 and Laennec described features of emphysema from the lungs of the patients which he dissected (Petty 2006). Since then, the history of COPD has evolved amidst spirometer, invented in 1846 and FVC proposed by Gaensler in 1950 (Petty 2006). Various consensus definitions have been proposed over years and now evidence based guidelines have been established by NICE, Global Initiative for Chronic Obstructive Lung Disease (GOLD) and American Thoracic Society and European Respiratory Society. 3.0 Signs and Symptoms of Chronic Obstructive Pulmonary Disease A patient of chronic obstructive pulmonary disease presents with long standing cough, dyspnoea, phlegm formation and easy fatigability. COPD is a progressive disease and decline in lung function usually starts long before the symptoms manifest (NICE 2010). Onset of symptoms is heralded by an accelerated impairment of lung function. 3.1 Shortness of breath COPD patients complain of marked shortness of breath (air hunger), tightness in the chest and uncomfortable awareness of one’s own breathing (dyspnoea). Dyspnoea is typically progressive and is aggravated with physical activity. Dyspnoea is objectively assessed using either Medical Research Council (MRC) Scale (Table 1) questionnaire as recommended by GOLD (2011) as well as NICE (2010) guidelines. Table 1 MRC dyspnoea scale Grade Degree of breathlessness ... Read More
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