Pneumology


COPD

Chronic Obstructive Pulmonary Disease (COPD); airlines against harmful gases and particles and increased lung inflammatory responses associated with chronic and persistent airflow limitation is usually characterized by the progressive nature, is common, preventable and treatable. Exacerbations and comorbidities (cardiovascular disease, diabetes, chronic kidney or liver disease, kanser..vb.) Contributes to the severity of the disease (GOLD 2014).

Respiratory symptoms in non-COPD study aimed to detect the cases smokers spirometry (INHALED function tests) is the basic approach of making measurements. Objective detect early COPD patients, to prevent the progression of COPD, by stopping smoking.

 

• Disease is the most common symptoms include shortness of breath, chronic cough and chronic phlegm removal. Spirometry for diagnosis of the disease is mandatory. Chronic symptoms and risk factors in middle-elderly adults spirometric found a history of exposure (inhalation sonksiyo test) examination can confirm the diagnosis determining the contraction of the bronchi.

• According to the Global Burden of Disease Study data, COPD causes 2.9 million deaths a year. Today the whole world has become a cause of death in 3 COPD, is responsible for 5.5% of all deaths in

• Although not elucidated the role of genetic factors in the development of COPD, yet very good, smoking, particularly biomass fuel (dung burning, tandoor exposure to smoke emerging from cooked bread ..) air pollution secondary indoor use and most important environmental risks of working in the dusty-smoky workplaces it is known that factors. Good ventilation in the home heating and cooking in order wood, dung, biomass fuels, such as roots, especially plays a decisive role in the development of COPD in women.

 

• Recent studies have, in the womb, during infancy and early childhood encounter with risk factors, suggesting that there is a significant contribution to the emergence of COPD by preventing the maximum development of the lungs.

• harmful gases and particles that are inhaled (tobacco and biomass fuel smoke, occupational dusts and fumes, etc.) of Patients with COPD causes an exaggerated inflammatory response in the lungs. The resulting chronic inflammatory response in the lung tissue destruction (emphysema), and deterioration in normal tissue repair and defense mechanisms (in small airway fibrosis) can cause. These pathological changes also causes air trapping and progressive airflow limitation.

Exacerbation of respiratory symptoms in COPD are common. The main causes of exacerbation; bacterial or viral infections, environmental pollutants, or are unknown reasons. Pneumonia, thromboembolism, and conditions such as heart failure, as they can create a similar table exacerbations may aggravate an existing flare. Exacerbations during growth and a reduction in expiratory flow of air trapping in the lungs, which leads to an increase in shortness of breath.

PREVENTION AND KEPT of tobacco use

The most important risk factor for the development of COPD is cigarette smoking and use of tobacco products. Compared with those drinking, smoking or using other tobacco has been reported that the product was more of respiratory symptoms and lung function abnormalities and a higher mortality due to COPD. Other tobacco products (pipes, cigars, hookah) is also in use, has been reported to be higher than the death rate due to COPD than non-users. Similarly, passive smoking also increases the total gas load Sounan particles and contribute to the development of respiratory symptoms and COPD. Maternal smoking during pregnancy and / or childhood exposure to secondhand smoke increases the susceptibility to COPD development by affecting the growth and development of the lungs. In the US, 30% of the deaths from cancer of 90% of deaths from COPD and cardiovascular 30'un% of deaths from the disease has been reported to be related to tobacco use.

 

COPD TREATMENT:

In cases diagnosed at an early stage to prevent progression of the disease; reduction of exposure to risk factors / removal, particularly quitting smoking, regular physical activity daily, vaccination (once a year, influenza, pneumonia vaccine once every five years) and symptomatic treatment should be administered as needed. These patients are negative about the social determinants of health (living conditions, work, income, relationships, social support, access to quality health care, etc.) Work together with patients and relatives about the remedy to be displayed.

• cessation of smoking is the only intervention that interrupts the natural development and progression of the disease in COPD. Smoking cessation in patients with COPD, while slowing down the loss of lung function and reduces the symptoms of the disease

• regular daily physical activity recommendations should be made in every patient diagnosed with COPD. For this, firstly it is very important to determine the daily physical activity levels in patients.

• at least 5 days per week and the patient should be advised to walk daily for at least 30 minutes.

• Influenza vaccine in COPD patients requiring hospitalization can reduce lower respiratory tract infections and deaths.

• polysaccharide pneumococcal vaccine in patients over 65 years and, at the same time despite the fact that at a young age is recommended, especially in patients with concomitant diseases such as cardiac disease. In addition, age <65 and FEV1 in patients with less than 40% i has been shown to reduce the incidence of pneumonia in the community develop- merry.

The most important step in treatment of COPD is the reduction of risk factors;

1. The social determinants of health / health inequalities

improving

2. Removal of risk factors / improving

a) cessation of smoking

b) The improvement of the internal-external ambient air pollution

c) improve the business environment

3. The promotion of physical activity per day

4. Vaccination

5. bronchodilator (bronchi extender) drugs

6. continuous O2 therapy in patients with arterial hypoxemia in blood gas

7. Arterial blood gases in patients with hypercapnia BPAP of treatment