This document defines COPD and discusses its epidemiology. It begins by defining COPD as a disease characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response. It is caused by a mixture of small airway disease and parenchymal destruction. The document then discusses the global prevalence of COPD, noting that it is a leading cause of mortality and results in a substantial economic burden. According to epidemiological studies cited, the prevalence of COPD increases with age for both men and women. Cigarette smoking is identified as the primary risk factor. The document concludes by noting COPD is underdiagnosed in many population studies.
Chronic Obstructive Pulmonary Disease (COPD) by Dr Kemi DeleKemi Dele-Ijagbulu
Presentation on definition and general overview of COPD, how to differentiate COPD from Asthma, how to make diagnosis of COPD, simple tools for assessment of COPD; available therapeutic options; as well as management of stable COPD, COPD exacerbations and comorbidities
COPD exacerbation case presentation and disease overview farah al souheil
management of a simulated case scenario: patient presenting with COPD exacerbation: what's the best next step? summary of the guideline is then described
Chronic Obstructive Pulmonary Disease (COPD) by Dr Kemi DeleKemi Dele-Ijagbulu
Presentation on definition and general overview of COPD, how to differentiate COPD from Asthma, how to make diagnosis of COPD, simple tools for assessment of COPD; available therapeutic options; as well as management of stable COPD, COPD exacerbations and comorbidities
COPD exacerbation case presentation and disease overview farah al souheil
management of a simulated case scenario: patient presenting with COPD exacerbation: what's the best next step? summary of the guideline is then described
The latest guidelines on the management of a COPD patient ( Stable COPD, patient with an exacerbation of COPD), latest modalities of treatment of a COPD patient
Acute respiratory infection in children, etiology, clinical features, diagnosis, treatment. Common infections in children including common cold, tonsillitis, LTB, Croup, Epiglottitis etc.
COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.
The main symptoms are:
• A long-lasting (chronic) cough.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you exercise.
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Sexual activity after myocardial infarctionTarek Anis
This presentation describes cardiovascular risk of sexual activity as well as recommendation to manage erectile dysfunction in men with coronary artery disease
Comorbidities and Other Predictors for Severity of Colonic Diverticulitis?semualkaira
Predicting severity of acute colonic diverticulitis (ACD) is important for management, morbidity and mortality. The aim of this study is evaluating the Charlson’s Comorbidity Index (CCI) as severity predictor of ACD.
Interstitial lung disease (ILD) is a common complication of scleroderma that leads to inflammation and scarring of the lungs. In this session, we will review the prevalence of scleroderma-associated ILD (SSc-ILD), classic symptoms, and the approach to evaluating patients with suspected disease. In addition, we will cover various treatments available for patients with SSc-ILD.
This talk was presented at the Scleroderma Patient Education Conference on May 4, 2024, hosted by the Scleroderma Foundation of Greater Chicago.
For more info about scleroderma and the foundation, head to www.stopscleroderma.org
The Changing Role of the Coronary Care Cardiologist & The Emerging Role of Ca...Dr.Mahmoud Abbas
The Changing Role of the Coronary Care Cardiologist
&
The Emerging Role of Cardiac Intensive Care Specialists lecture presented by Dr Sherif Mokhtar, President ECCCP at the Egyptian Spanish Critical care Symposium held at Cairo, Egypt on 11 May 2023
Drug induced Kidney Injury in the ICU. Presentation by Dr Sandra Kane Gill , President Society of Critical Care Medicine (SCCM) , USA at the Egyptian Critical care Summit 2022 conference , organized by the Egyptian College of Critical care Physicians (ECCCP) , Egypt
Using Novel Kidney Biomarkers to Guide Drug Therapy.pdfDr.Mahmoud Abbas
Using Novel Kidney Biomarkers to Guide Drug Therapy: Presentation by Dr Sandra Gill , President SCCM at the Egyptian Critical Care Summit 2022 held at Cairo, Egypt and organized by the Egyptian College of Critical care Physicians (ECCCP)
Presentation by Dr Marwa Atef , National Research Center, Cairo, Egypt . Presented at Cairo Textile Week 2021 , the leading textiles conference in Egypt
Cairo Textile Week 2021 Conference -Egypt Textiles & Home Textiles Export Cou...Dr.Mahmoud Abbas
Egyptian Textiles Export
Opportunities & Requirements
Presentation by Engineer Hany Salam, CEO Salam Textiles, Board member Egypt Textiles & Home Textiles
Export Council (THTEC)
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
2. GOLD Definition
COPD, a common preventable and treatable disease, is
characterized by persistent airflow limitation that is
usually progressive and associated with an enhanced
chronic inflammatory response in the airways and the
lung to noxious particles or gases.
Exacerbations and comorbidities contribute to the
overall severity in individual patients.
GOLD 2013
3. ATS/ ERS Definition
Chronic obstructive pulmonary disease (COPD) is a
slowly progressive disease involving the airways or
pulmonary parenchyma (or both) that results in airflow
obstruction.
Manifestations of COPD range from dyspnea, poor
exercise tolerance, chronic cough with or without
sputum production, and wheezing to respiratory failure
or cor-pulmonale.
Exacerbations of symptoms and concomitant chronic
diseases may contribute to the severity of COPD in
individual patients.
Ann Intern Med. 2011;155:179-191.
4. Definition : Airflow Limitation
The chronic airflow limitation characteristic of COPD is
caused by a mixture of small airway disease (obstructive
bronchiolitis) and parenchymal destruction (emphysema),
the relative contributions of which vary from person to
person
Global initiative for chronic obstructive pulmonary disease updated 2013
5. Definitions
Emphysema pathological term which is destruction of
the gas exchanging surfaces of the lung (alveoli).
Chronic bronchitis is the presence of cough and
sputum production for at least 3 months in each of two
consecutive years.
GOLD 2013
6. Epidemiology
COPD is a leading cause of morbidity and mortality
worldwide and results in an economic and social burden
that is both substantial and increasing.
COPD is the result of cumulative exposures over decades
GOLD 2013
7. Epidemiology
Studies to improve the global understanding of COPD
prevalence and prognosis include:
▫ Burden of Obstructive Lung Disease (BOLD) Initiative 1 (now complete
in China, Turkey, Austria, South Africa, Iceland, Poland, Germany,
Norway, Canada, Philippines, USA and Australia) 2
▫ Latin-American Project for the Investigation of Pulmonary
Obstruction (PLATINO) (in Brazil, Chile, Mexico and
Uruguay) 3
1-Buist et al COPD 2005; 2-BOLD 2007; 3-Menezes et al LANCET 2005
8. Epidemiology
The BOLD Study: a population-based prevalence
study
9425 Participants from 12 sites , aged 40 years and
older.
The prevalence of stage II or higher COPD was 10・1%
(SE 4・8) overall, 11・8% (7・9) for men, and 8・5% (5
・8) for women.
Generally, the prevalence of COPD that is GOLD stage II
or higher increased steadily with age for men and women
in every site.
The prevalence increased with increasing pack-years.
Lancet 2007; 370: 741–50
9. Epidemiology
The Global Burden of Disease Study projected
that COPD, which ranked sixth as the cause of
death in 1990, will become the third leading
cause of death worldwide by 2020; a newer
projection estimated COPD will be the fourth
leading cause of death in 2030
And the seventh leading cause of DALYs
lost worldwide in 2030.
GOLD 2013
10. Epidemiology
COPD prevalence by gender and age groups
60
50
40
Prevalence %
30 Male
Female
20
10
0
40-49 50-59 60-69 70+
Prevalence of COPD According to GOLD Stage I and Higher COPD
Chest 2007;131;29-36
11. Epidemiology
Factors Influence disease development and progression
Genes
Age and Gender
Lung Growth and Development
Exposure to particles
▫ Tobacco smoke
▫ Occupational dusts, organic and inorganic
▫ Indoor air pollution from heating and cooking with biomass
in poorly ventilated dwellings
▫ Outdoor air pollution
Socioeconomic status
Respiratory Infections
Chronic Bronchitis
Asthma / Bronchial Hyperreactivity
GOLD 2013
12. Epidemiology
Factors Influence disease development and progression
Cigarette smoking is the most commonly encountered
risk factor for COPD
100 Never smoked or not
susceptible to smoke
FEV1 (% of value at age 25)
80
Smoked regularly
60 and susceptible
to its effects
Stopped at 45
40 Disability
20
Death Stopped at 65
0
25 50 75
Adapted from Fletcher C, et al. Br Med J 1977 Age (years)
13. Epidemiology
Genes
The genetic risk factor that is best documented is a
severe hereditary deficiency of alpha-1
antitrypsin, a major circulating inhibitor of serine
proteases.
Genetic factors with environmental factors could
influence susceptibility to develop airflow limitation
Gender
In the past most studies showed that COPD were
greater among men
But now studies shows prevalence is almost equal
which reflects changing patterns of tobacco
smoking
15. COPD has the third highest overall
lifetime risk after diabetes and asthma
Gershon AS et al. Lancet 2011; 378: 991–96
16. COPD: Prevalence Rates
Country/region Extrapolated Population estimated
Prevalence use
Egypt 3,777,886 76,117,421
Gaza strip 65,762 1,324,991
Jordan 278,497 5,611,202
Kuwait 112,047 2,257,549
Lebanon 187,472 3,777,218
Saudi Arabia 1,280,313 25,795,938
United Arab Emirates 125,267 2,523,915
West Bank 114,710 2,311,204
Yemen 993,881 20,024,867
http://www.rightdiagnosis.com/c/copd/stats-country.htm last accessed 20/3/2013
17. 17
COPD in Egypt
Statistical analysis of COPD prevalence in Egypt showed
that 3 millions from the egyptian population have
COPD.1
In different studies prevalence were from 3.3% up to
10%. 1,2
Prevalence rate in men was ~6.7 % while it was ~1.5% in
woman1
1-BREATHE Study, Prevalence of COPD in middle east and north Africa. E-poster, ERS Sep 2011
2- E-poster Burden of COPD in some African and Asian countries V.Kiri et al, Sep 2007
18. Air pollution is a major problem in Asia
SO2 : Sulfur Dioxide NO2 : Nitrogen dioxide.
PM 10 :particulate matter 10 microns and less TSP :Total suspended particulates
Thorax 2007;62:748-749
19. Biomass smoke exposure and the
risk of COPD
Am J Respir Crit Care Med Vol 182. pp 693–718, 2010
20.
21. TORCH : Overall, 27% of the deaths were adjudicated as
due to cardiovascular causes, 35% to pulmonary causes,
and 21% to cancer
Unknown
Other 7% Respiratory
10%
35%
Respiratory
Cancer Cardiac
21%
Cancer
Other
Unknown
Cardiac
27%
N Engl J Med 2007;356:775-89.
22. COPD Uncovered
75% stated they had ≥1 comorbid condition
The most commonly reported conditions were
hypertension, asthma, arthritis, anxiety,
depression and diabetes.
Fletcher et al. BMC Public Health 2011, 11:612
24. Prevalence of CVD in COPD
BCMJ, Vol. 50, No. 5, June 2008, page(s) 246-251
25. Clinical consequences of
Osteoporosis
• Acute and chronic pain • Bulging abdomen, reflux and other Gl symptoms
• Kyphosis • Breathing difficulties
• Loss of height • Depression
• Loss of mobility • Loss of Independence
REDUCED QUALITY OF LIFE
27. GOLD staging and osteoporosis
The prevalence of osteoporosis was greater than
50% regardless of GOLD stage
COPD 2008, 5:291–297
28. Reported prevalence of chronic obstructive
pulmonary disease and relative Underdiagnosis
in selected population studies
Lancet 2009; 374: 721–32
29. COPD prevalence and GOLD
severity stages by gender and age
M: men
W:women;
T:total
Thorax 2009;64:863-868
30. Recent trends in COPD prevalence in
Spain: a repeated cross-sectional survey
1997-2007
Eur Respir J.2010 Oct;36(4):758-65
31.
32. International COPD network
(ICON) study
Twelve territories across the Asia-Pacific region, Africa, eastern
Europe, and Latin America
Total of 600 GPs (50 from each territory)
Survey demonstrated that the GPs’ understanding of COPD was
variable across the territories, with large numbers of GPs having
very limited knowledge of COPD and its management.
A consistent finding across all territories was the underutilization of
spirometry (median 26%; range 10%–48%) and reliance on X-rays
(median 14%; range 5%–22%) for COPD diagnosis
International Journal of COPD 2012:7 271–282
33. Perceived prevalence of chronic obstructive
pulmonary disease (COPD) in each territory
International Journal of COPD 2012:7 271–282
34. Parameters considered by GPs for ongoing
treatment of COPD in different territories
International Journal of COPD 2012:7 271–282
35. Gender Bias Can Impede
Diagnosis
Survey of 192 primary care physicians
▫ Provided a case of male patient and female patient
with same history and physical exam
▫ Asked about provisional diagnosis
Physicians Provisional diagnosis (%)
Male Patient Female Patient
COPD 65 49
Asthma 32 44
36. The Changing Face of COPD
Younger More women
70% of patients with COPD In 2004 women
are <65 years old, accounting accounted for 63% of
for: all self reported COPD
▫ 67% of COPD office visits cases
▫ 43% of hospitalizations
37. Conclusions
The Prevalence de COPD is between 10 - 15 %.
Most patients have not been diagnosed.
Cigarette smoking and biomass are major risk factors for
the disease.
Co-morbid conditions prevalence are increasing.
COPD is a disease of younger patie nts, and increased
number of women.
Different therapies including smoking cessation, and
pharmacotherapy impact the disease.
38. Pathophysiology
Inhaled cigarette smoke and other noxious particles such
as smoke from biomass fuels cause lung inflammation, a
normal response that appears to be modified in patients
who develop COPD.
This chronic inflammatory response may induce
parenchymal tissue destruction (resulting in
Emphysema) and disrupt normal repair and defense
mechanisms (resulting in small airway fibrosis)
39. Pathophysiology
Inflammatory Cells
COPD is characterized by a specific pattern of inflammation involving
Neutrophils ,Macrophages, Cytotoxic Lymphocytes
Oxidative stress
A number of studies have indicated that oxidative stress has a
significant role in the pathogenesis of COPD.
Biomarkers of oxidative stress are increased in the breath and sputum
of COPD patients.
Protease-antiprotease imbalance
This imbalance is at least partly due to the secretion of proteases by
macrophages and neutrophils associated with the chronic
inflammatory response
40. Pathophysiology
Although both COPD and asthma are associated with
chronic inflammation of the respiratory tract, there are
differences in the inflammatory cells and mediators
involved In the two diseases, which in turn account lor
differences in physiological effects, symptoms, and
response to therapy.
Some patients with COPD have features consistent with
asthma and may have mixed inflammatory pattern with
increased eosinophils.
41. Distribution of Direct Costs of
COPD by Severity
100%
90%
80%
70%
Equipment aids
60%
50% Oxygen therapy
40% Outpatient care
30%
Medicines
20%
10% Hospitalizations
0%
<40% 40-59% 60-79% >80% Mean