SlideShare a Scribd company logo
lobal Initiative for Chronic bstructive ung isease G   O L D
Description of Levels of Evidence  Evidence Category   Sources of Evidence   A Randomized controlled trials (RCTs).  Rich body of data B Randomized controlled trials (RCTs).  Limited body of data C Nonrandomized trials Observational studies.   D Panel consensus judgment
United States United Kingdom Argentina Australia Brazil Austria Canada Chile Belgium China Denmark Columbia Croatia Egypt Germany Greece Ireland Italy Syria Hong Kong ROC Japan Iceland India Korea Kyrgyzstan Uruguay Moldova Nepal Macedonia Malta Netherlands New Zealand Poland Norway Portugal Georgia Romania Russia Singapore Slovakia Slovenia Saudi Arabia South Africa Spain Sweden Thailand Switzerland Ukraine United Arab Emirates Taiwan ROC Venezuela Vietnam Peru Yugoslavia Albania Bangladesh France Mexico Turkey Czech Republic Pakistan Israel GOLD National Leaders Philippines
GOLD Objectives ,[object Object],[object Object],[object Object]
Global Strategy for Diagnosis, Management and Prevention of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition of COPD ,[object Object],[object Object],[object Object]
Classification of COPD Severity by Spirometry Stage I:  Mild   FEV 1 /FVC < 0.70    FEV 1   >  80% predicted Stage II:  Moderate   FEV 1 /FVC < 0.70 50%  <  FEV 1  < 80% predicted Stage III: Severe   FEV 1 /FVC < 0.70 30%  <  FEV 1  < 50% predicted Stage IV: Very Severe   FEV 1 /FVC < 0.70   FEV 1  < 30% predicted  or  FEV 1  < 50% predicted  plus   chronic respiratory failure
“ At Risk” for COPD ,[object Object],[object Object],[object Object]
Global Strategy for Diagnosis, Management and Prevention of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Burden of COPD:  Key Points   ,[object Object],[object Object],[object Object]
Burden of COPD:  Prevalence   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Burden of COPD:  Mortality   ,[object Object],[object Object],[object Object],[object Object]
Percent Change in Age-Adjusted Death Rates, U.S., 1965-1998 0 0.5 1.0 1.5 2.0 2.5 3.0 Proportion of 1965 Rate  1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 – 59% – 64% – 35% +163% – 7% Coronary Heart Disease Stroke Other CVD COPD All Other Causes Source :  NHLBI/NIH/DHHS
COPD Mortality by Gender, U.S., 1980-2000 Number Deaths x 1000 Source:  US Centers for Disease Control and Prevention, 2002
Global Strategy for Diagnosis, Management and Prevention of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors for COPD Lung growth and development  Oxidative stress Gender Age Respiratory infections Socioeconomic status Nutrition Comorbidities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors for COPD Nutrition Infections Socio-economic status Aging Populations
Global Strategy for Diagnosis, Management and Prevention of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
LUNG INFLAMMATION COPD PATHOLOGY Oxidative stress Proteinases Repair  mechanisms Anti-proteinases Anti-oxidants Host factors Amplifying mechanisms Cigarette smoke Biomass particles Particulates Source :  Peter J. Barnes, MD Pathogenesis of COPD
Alveolar wall destruction Loss of elasticity Destruction of pulmonary capillary bed ↑  Inflammatory cells macrophages, CD8 +  lymphocytes Source :  Peter J. Barnes, MD Changes in Lung Parenchyma in COPD
Chronic hypoxia Pulmonary vasoconstriction Muscularization Intimal  hyperplasia Fibrosis Obliteration Pulmonary hypertension Cor pulmonale Death Edema Pulmonary Hypertension in COPD Source :  Peter J. Barnes, MD
Mast cell CD4+ cell (Th2) Eosinophil Allergens Ep cells ASTHMA Bronchoconstriction AHR Reversible Irreversible Airflow Limitation Source :  Peter J. Barnes, MD Y Y Y Alv macrophage Ep cells CD8+ cell (Tc1) Neutrophil Cigarette smoke Small airway narrowing Alveolar destruction COPD
Global Strategy for Diagnosis, Management and Prevention of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Four Components of COPD  Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOALS  of COPD MANAGEMENT VARYING EMPHASIS WITH DIFFERING SEVERITY
Four Components of COPD  Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Stable COPD Assess and Monitor COPD:  Key Points ,[object Object],[object Object],[object Object]
SYMPTOMS cough sputum shortness of breath EXPOSURE TO RISK FACTORS  tobacco occupation indoor/outdoor pollution SPIROMETRY Diagnosis of COPD   
Management of Stable COPD Assess and Monitor COPD:  Spirometry ,[object Object],[object Object],[object Object]
Spirometry:  Normal and Patients with COPD
Differential Diagnosis:  COPD and Asthma COPD ASTHMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COPD and Co-Morbidities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COPD and Co-Morbidities ,[object Object],[object Object],[object Object],[object Object],[object Object]
Four Components of COPD  Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Stable COPD Reduce Risk Factors:  Key Points ,[object Object],[object Object]
Brief Strategies to Help the  Patient Willing to Quit Smoking ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Stable COPD Reduce Risk Factors:  Smoking Cessation ,[object Object],[object Object],[object Object]
Management of Stable COPD Reduce Risk Factors:  Indoor/Outdoor Air Pollution ,[object Object],[object Object]
Four Components of COPD  Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Stable COPD Manage Stable COPD:  Key Points ,[object Object],[object Object],[object Object]
Management of Stable COPD Pharmacotherapy:  Bronchodilators ,[object Object],[object Object],[object Object]
Management of Stable COPD Pharmacotherapy:  Glucocorticosteroids ,[object Object],[object Object],[object Object]
Management of Stable COPD Pharmacotherapy:  Glucocorticosteroids ,[object Object],[object Object]
Management of Stable COPD Pharmacotherapy:  Vaccines ,[object Object],[object Object]
Management of Stable COPD All Stages of Disease Severity ,[object Object],[object Object],[object Object],[object Object],[object Object]
IV: Very Severe III: Severe II: Moderate I: Mild Add   regular treatment with one or more long-acting bronchodilators (when needed);  Add   rehabilitation Add   inhaled glucocorticosteroids if repeated exacerbations   Add   long term oxygen   if chronic  respiratory failure.  Consider   surgical treatments   Therapy at Each Stage of COPD   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Active reduction of risk factor(s); influenza vaccination Add   short-acting bronchodilator (when needed)
Management of Stable COPD Other Pharmacologic Treatments  ,[object Object],[object Object],[object Object]
Management of Stable COPD Non-Pharmacologic Treatments  ,[object Object],[object Object]
Four Components of COPD  Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Revised 2006
Management COPD Exacerbations Key Points ,[object Object],[object Object]
Management COPD Exacerbations Key Points ,[object Object],[object Object]
Manage COPD Exacerbations Key Points ,[object Object]
Management COPD Exacerbations Key Points ,[object Object],[object Object]
Global Strategy for Diagnosis, Management and Prevention of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Translating COPD Guidelines into Primary Care KEY POINTS ,[object Object],[object Object]
Translating COPD Guidelines into Primary Care KEY POINTS ,[object Object],[object Object]
WORLD COPD DAY November 14, 2007 Raising COPD Awareness Worldwide
THANK YOU

More Related Content

What's hot

Antitubercular agents in TB patients with Chronic Liver disease (CLD)
Antitubercular agents in TB patients with Chronic Liver disease (CLD)Antitubercular agents in TB patients with Chronic Liver disease (CLD)
Antitubercular agents in TB patients with Chronic Liver disease (CLD)
Pratap Tiwari
 
Complications of pulmonary tb
Complications of pulmonary tbComplications of pulmonary tb
Complications of pulmonary tb
Ankur Gupta
 
evaluation of dyspnoea
evaluation of dyspnoeaevaluation of dyspnoea
evaluation of dyspnoea
prapulla chandra
 
Asthma
AsthmaAsthma
Asthma
Reynel Dan
 
Evaluation of preoperative pulmonary risk
Evaluation of preoperative pulmonary riskEvaluation of preoperative pulmonary risk
Evaluation of preoperative pulmonary riskNahid Sherbini
 
Hypersensitivity Pneumonitis
Hypersensitivity PneumonitisHypersensitivity Pneumonitis
Hypersensitivity Pneumonitis
Ashraf ElAdawy
 
Post covid pulmonary fibrosis , atypical covid19 sequele
Post covid pulmonary fibrosis , atypical covid19 sequelePost covid pulmonary fibrosis , atypical covid19 sequele
Post covid pulmonary fibrosis , atypical covid19 sequele
Dr-Ajay Tripathi
 
Respiratory failure
Respiratory failureRespiratory failure
Respiratory failure
Vijay Sal
 
Pulmonary thromboembolism
Pulmonary thromboembolismPulmonary thromboembolism
Pulmonary thromboembolism
Rikin Hasnani
 
PULMONARY EOSINOPHILIAS
PULMONARY EOSINOPHILIASPULMONARY EOSINOPHILIAS
PULMONARY EOSINOPHILIAS
Ashutosh Pakale
 
Interstitial lung diseases
Interstitial lung diseases Interstitial lung diseases
Interstitial lung diseases
Dr.Manish Kumar
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
Md Shahid Iqubal
 
Respiratory failure
Respiratory failureRespiratory failure
Respiratory failure
Chaithanya Malalur
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
Zulcaif Ahmad
 
Bronchial Challenge Testing
Bronchial Challenge TestingBronchial Challenge Testing
Nebulised Antibiotics
Nebulised AntibioticsNebulised Antibiotics
Nebulised Antibiotics
MohamedTrabelsi41
 
COPD Exacerbations: Significance, Assessment, and Current Management
COPD Exacerbations:Significance, Assessment, and Current ManagementCOPD Exacerbations:Significance, Assessment, and Current Management
COPD Exacerbations: Significance, Assessment, and Current Management
Dr.Mahmoud Abbas
 
Pulmonary function test
Pulmonary function testPulmonary function test
Pulmonary function test
velspharmd
 
Asthma vs COPD - A quick summary of the differences between them
Asthma vs COPD - A quick summary of the differences between themAsthma vs COPD - A quick summary of the differences between them
Asthma vs COPD - A quick summary of the differences between them
LGM Pharma
 

What's hot (20)

Antitubercular agents in TB patients with Chronic Liver disease (CLD)
Antitubercular agents in TB patients with Chronic Liver disease (CLD)Antitubercular agents in TB patients with Chronic Liver disease (CLD)
Antitubercular agents in TB patients with Chronic Liver disease (CLD)
 
Complications of pulmonary tb
Complications of pulmonary tbComplications of pulmonary tb
Complications of pulmonary tb
 
Viral pneumonia
Viral pneumoniaViral pneumonia
Viral pneumonia
 
evaluation of dyspnoea
evaluation of dyspnoeaevaluation of dyspnoea
evaluation of dyspnoea
 
Asthma
AsthmaAsthma
Asthma
 
Evaluation of preoperative pulmonary risk
Evaluation of preoperative pulmonary riskEvaluation of preoperative pulmonary risk
Evaluation of preoperative pulmonary risk
 
Hypersensitivity Pneumonitis
Hypersensitivity PneumonitisHypersensitivity Pneumonitis
Hypersensitivity Pneumonitis
 
Post covid pulmonary fibrosis , atypical covid19 sequele
Post covid pulmonary fibrosis , atypical covid19 sequelePost covid pulmonary fibrosis , atypical covid19 sequele
Post covid pulmonary fibrosis , atypical covid19 sequele
 
Respiratory failure
Respiratory failureRespiratory failure
Respiratory failure
 
Pulmonary thromboembolism
Pulmonary thromboembolismPulmonary thromboembolism
Pulmonary thromboembolism
 
PULMONARY EOSINOPHILIAS
PULMONARY EOSINOPHILIASPULMONARY EOSINOPHILIAS
PULMONARY EOSINOPHILIAS
 
Interstitial lung diseases
Interstitial lung diseases Interstitial lung diseases
Interstitial lung diseases
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
 
Respiratory failure
Respiratory failureRespiratory failure
Respiratory failure
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
 
Bronchial Challenge Testing
Bronchial Challenge TestingBronchial Challenge Testing
Bronchial Challenge Testing
 
Nebulised Antibiotics
Nebulised AntibioticsNebulised Antibiotics
Nebulised Antibiotics
 
COPD Exacerbations: Significance, Assessment, and Current Management
COPD Exacerbations:Significance, Assessment, and Current ManagementCOPD Exacerbations:Significance, Assessment, and Current Management
COPD Exacerbations: Significance, Assessment, and Current Management
 
Pulmonary function test
Pulmonary function testPulmonary function test
Pulmonary function test
 
Asthma vs COPD - A quick summary of the differences between them
Asthma vs COPD - A quick summary of the differences between themAsthma vs COPD - A quick summary of the differences between them
Asthma vs COPD - A quick summary of the differences between them
 

Viewers also liked

COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam
COPD  (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslamCOPD  (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam
COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam
Dr.Aslam calicut
 
Chronic obstructive pulmonary disease (copd) power point
Chronic obstructive pulmonary disease (copd) power pointChronic obstructive pulmonary disease (copd) power point
Chronic obstructive pulmonary disease (copd) power point
wandatardy
 
Copd update 2015
Copd update 2015Copd update 2015
Copd update 2015
Veerendra Singh
 
Pathology of COPD
Pathology of COPDPathology of COPD
Pathology of COPD
Shashidhar Venkatesh Murthy
 
COPD (Chronic Obstructive Pulmonary Disease)
COPD (Chronic Obstructive Pulmonary Disease)COPD (Chronic Obstructive Pulmonary Disease)
COPD (Chronic Obstructive Pulmonary Disease)
HoneymoonSwami.com
 
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
CHRONIC OBSTRUCTIVE PULMONARY DISEASECHRONIC OBSTRUCTIVE PULMONARY DISEASE
CHRONIC OBSTRUCTIVE PULMONARY DISEASETomcy Thankachan
 
Chronic Obstructive Pulmonary Disease (Copd)
Chronic Obstructive Pulmonary Disease (Copd)Chronic Obstructive Pulmonary Disease (Copd)
Chronic Obstructive Pulmonary Disease (Copd)Nida Fatima
 
COPD GOLD 2014
COPD GOLD 2014COPD GOLD 2014
COPD GOLD 2014
Sai Krishna
 
Basics of computational assessment for COPD: IWPFI 2017
Basics of computational assessment for COPD: IWPFI 2017Basics of computational assessment for COPD: IWPFI 2017
Basics of computational assessment for COPD: IWPFI 2017
Namkug Kim
 
Presentation1.pptx, radiological imaging of copd.
Presentation1.pptx, radiological imaging of copd.Presentation1.pptx, radiological imaging of copd.
Presentation1.pptx, radiological imaging of copd.Abdellah Nazeer
 
COPD
COPDCOPD
COPD case presentation
COPD case presentation COPD case presentation
COPD case presentation
sara_abudahab
 
Recent advances in Asthma & COPD by Dr.Tinku Joseph
Recent advances in Asthma & COPD by  Dr.Tinku JosephRecent advances in Asthma & COPD by  Dr.Tinku Joseph
Recent advances in Asthma & COPD by Dr.Tinku Joseph
Dr.Tinku Joseph
 
Heart failure / cardiac failure
Heart failure / cardiac failureHeart failure / cardiac failure
Heart failure / cardiac failureFuad Farooq
 
Chrnonic Obstructive Pulomonary Disease - Pathophysiology
Chrnonic Obstructive Pulomonary Disease - PathophysiologyChrnonic Obstructive Pulomonary Disease - Pathophysiology
Chrnonic Obstructive Pulomonary Disease - Pathophysiology
Omair Riaz
 

Viewers also liked (20)

COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam
COPD  (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslamCOPD  (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam
COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam
 
Chronic obstructive pulmonary disease (copd) power point
Chronic obstructive pulmonary disease (copd) power pointChronic obstructive pulmonary disease (copd) power point
Chronic obstructive pulmonary disease (copd) power point
 
Copd update 2015
Copd update 2015Copd update 2015
Copd update 2015
 
Copd 2017
Copd 2017  Copd 2017
Copd 2017
 
Pathology of COPD
Pathology of COPDPathology of COPD
Pathology of COPD
 
COPD (Chronic Obstructive Pulmonary Disease)
COPD (Chronic Obstructive Pulmonary Disease)COPD (Chronic Obstructive Pulmonary Disease)
COPD (Chronic Obstructive Pulmonary Disease)
 
COPD
COPDCOPD
COPD
 
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
CHRONIC OBSTRUCTIVE PULMONARY DISEASECHRONIC OBSTRUCTIVE PULMONARY DISEASE
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
 
Chronic Obstructive Pulmonary Disease (Copd)
Chronic Obstructive Pulmonary Disease (Copd)Chronic Obstructive Pulmonary Disease (Copd)
Chronic Obstructive Pulmonary Disease (Copd)
 
Copd imp د. جيهان
Copd imp د. جيهانCopd imp د. جيهان
Copd imp د. جيهان
 
COPD GOLD 2014
COPD GOLD 2014COPD GOLD 2014
COPD GOLD 2014
 
Basics of computational assessment for COPD: IWPFI 2017
Basics of computational assessment for COPD: IWPFI 2017Basics of computational assessment for COPD: IWPFI 2017
Basics of computational assessment for COPD: IWPFI 2017
 
Asthma copd
Asthma copdAsthma copd
Asthma copd
 
Presentation1.pptx, radiological imaging of copd.
Presentation1.pptx, radiological imaging of copd.Presentation1.pptx, radiological imaging of copd.
Presentation1.pptx, radiological imaging of copd.
 
COPD
COPDCOPD
COPD
 
Emphysema
EmphysemaEmphysema
Emphysema
 
COPD case presentation
COPD case presentation COPD case presentation
COPD case presentation
 
Recent advances in Asthma & COPD by Dr.Tinku Joseph
Recent advances in Asthma & COPD by  Dr.Tinku JosephRecent advances in Asthma & COPD by  Dr.Tinku Joseph
Recent advances in Asthma & COPD by Dr.Tinku Joseph
 
Heart failure / cardiac failure
Heart failure / cardiac failureHeart failure / cardiac failure
Heart failure / cardiac failure
 
Chrnonic Obstructive Pulomonary Disease - Pathophysiology
Chrnonic Obstructive Pulomonary Disease - PathophysiologyChrnonic Obstructive Pulomonary Disease - Pathophysiology
Chrnonic Obstructive Pulomonary Disease - Pathophysiology
 

Similar to Gold - global initiative against COPD

COPD 2014
COPD 2014COPD 2014
COPD 2014
Ankur Kaushik
 
Chronic obstructive airway disease (coad)
Chronic obstructive airway disease (coad)Chronic obstructive airway disease (coad)
Chronic obstructive airway disease (coad)Nandinii Ramasenderan
 
COPD.pptx
COPD.pptxCOPD.pptx
COPD.pptx
BijayaSaha5
 
C O P D By Dr Sarma
C O P D By  Dr  SarmaC O P D By  Dr  Sarma
C O P D By Dr Sarmagoolappa
 
Ers ats copd guidelines
Ers ats copd guidelinesErs ats copd guidelines
Ers ats copd guidelines
Bệnh Hô Hấp Mãn Tính
 
Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...
Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...
Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...
Raghunath Ramanarasimhaiah MS, MD
 
COPD back to basis
COPD back to basisCOPD back to basis
COPD back to basis
Ashraf ElAdawy
 
Gold pocket 2015_feb18
Gold pocket 2015_feb18Gold pocket 2015_feb18
Gold pocket 2015_feb18
Vũ Nhân
 
Gold pocket 2015_feb18
Gold pocket 2015_feb18Gold pocket 2015_feb18
Gold pocket 2015_feb18
FJ QB
 
COPD: Management of Acute Exacerbation
COPD: Management of Acute ExacerbationCOPD: Management of Acute Exacerbation
COPD: Management of Acute Exacerbation
mustaqadnan1
 
copd.pptx
copd.pptxcopd.pptx
copd.pptx
AbdirisaqJacda1
 
COPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATION
COPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATIONCOPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATION
COPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATION
Dr.RMLIMS lucknow
 
Non Communicable Diseases: COPD
Non Communicable Diseases: COPDNon Communicable Diseases: COPD
Non Communicable Diseases: COPDRalph Bawalan
 
GOLD16 – MANAGEMENT AND TREATMENT OF COPD
GOLD16 – MANAGEMENT AND TREATMENT OF COPDGOLD16 – MANAGEMENT AND TREATMENT OF COPD
GOLD16 – MANAGEMENT AND TREATMENT OF COPD
evidenciaterapeutica.com
 
Pharmacological Management of COPD
Pharmacological Management of COPD  Pharmacological Management of COPD
Pharmacological Management of COPD
Ashraf ElAdawy
 
Copd seminar
Copd seminarCopd seminar
Copd seminar
hemin sab
 
COPD 1.pptx
COPD 1.pptxCOPD 1.pptx
COPD 1.pptx
RichardArce18
 
Copd And The Gold Guidelines 02 21 2005[2]
Copd And The Gold Guidelines 02 21 2005[2]Copd And The Gold Guidelines 02 21 2005[2]
Copd And The Gold Guidelines 02 21 2005[2]MedicineAndDermatology
 

Similar to Gold - global initiative against COPD (20)

COPD 2014
COPD 2014COPD 2014
COPD 2014
 
Chronic obstructive airway disease (coad)
Chronic obstructive airway disease (coad)Chronic obstructive airway disease (coad)
Chronic obstructive airway disease (coad)
 
Copd 2006
Copd 2006Copd 2006
Copd 2006
 
COPD.pptx
COPD.pptxCOPD.pptx
COPD.pptx
 
C O P D By Dr Sarma
C O P D By  Dr  SarmaC O P D By  Dr  Sarma
C O P D By Dr Sarma
 
Ers ats copd guidelines
Ers ats copd guidelinesErs ats copd guidelines
Ers ats copd guidelines
 
Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...
Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...
Chronic obstructive pulmonary diseases presentation at Hackensack Meridian he...
 
COPD back to basis
COPD back to basisCOPD back to basis
COPD back to basis
 
The Gold 2003 Update
The Gold 2003 UpdateThe Gold 2003 Update
The Gold 2003 Update
 
Gold pocket 2015_feb18
Gold pocket 2015_feb18Gold pocket 2015_feb18
Gold pocket 2015_feb18
 
Gold pocket 2015_feb18
Gold pocket 2015_feb18Gold pocket 2015_feb18
Gold pocket 2015_feb18
 
COPD: Management of Acute Exacerbation
COPD: Management of Acute ExacerbationCOPD: Management of Acute Exacerbation
COPD: Management of Acute Exacerbation
 
copd.pptx
copd.pptxcopd.pptx
copd.pptx
 
COPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATION
COPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATIONCOPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATION
COPD:CLINICAL REVIEW AND ANESTHESIA CONSIDERATION
 
Non Communicable Diseases: COPD
Non Communicable Diseases: COPDNon Communicable Diseases: COPD
Non Communicable Diseases: COPD
 
GOLD16 – MANAGEMENT AND TREATMENT OF COPD
GOLD16 – MANAGEMENT AND TREATMENT OF COPDGOLD16 – MANAGEMENT AND TREATMENT OF COPD
GOLD16 – MANAGEMENT AND TREATMENT OF COPD
 
Pharmacological Management of COPD
Pharmacological Management of COPD  Pharmacological Management of COPD
Pharmacological Management of COPD
 
Copd seminar
Copd seminarCopd seminar
Copd seminar
 
COPD 1.pptx
COPD 1.pptxCOPD 1.pptx
COPD 1.pptx
 
Copd And The Gold Guidelines 02 21 2005[2]
Copd And The Gold Guidelines 02 21 2005[2]Copd And The Gold Guidelines 02 21 2005[2]
Copd And The Gold Guidelines 02 21 2005[2]
 

Recently uploaded

Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
Shweta
 
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
Catherine Liao
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
GL Anaacs
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
Dr. Rabia Inam Gandapore
 
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTSARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
Dr. Vinay Pareek
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
VarunMahajani
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
Swetaba Besh
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Savita Shen $i11
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
i3 Health
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
Levi Shapiro
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Saeid Safari
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
DR SETH JOTHAM
 
Antiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptxAntiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptx
Rohit chaurpagar
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
MedicoseAcademics
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
The hemodynamic and autonomic determinants of elevated blood pressure in obes...The hemodynamic and autonomic determinants of elevated blood pressure in obes...
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
Catherine Liao
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
MedicoseAcademics
 
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdfARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
Anujkumaranit
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 

Recently uploaded (20)

Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
 
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
 
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTSARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
 
Antiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptxAntiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptx
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
The hemodynamic and autonomic determinants of elevated blood pressure in obes...The hemodynamic and autonomic determinants of elevated blood pressure in obes...
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
 
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdfARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 

Gold - global initiative against COPD

  • 1. lobal Initiative for Chronic bstructive ung isease G O L D
  • 2. Description of Levels of Evidence Evidence Category Sources of Evidence A Randomized controlled trials (RCTs). Rich body of data B Randomized controlled trials (RCTs). Limited body of data C Nonrandomized trials Observational studies. D Panel consensus judgment
  • 3. United States United Kingdom Argentina Australia Brazil Austria Canada Chile Belgium China Denmark Columbia Croatia Egypt Germany Greece Ireland Italy Syria Hong Kong ROC Japan Iceland India Korea Kyrgyzstan Uruguay Moldova Nepal Macedonia Malta Netherlands New Zealand Poland Norway Portugal Georgia Romania Russia Singapore Slovakia Slovenia Saudi Arabia South Africa Spain Sweden Thailand Switzerland Ukraine United Arab Emirates Taiwan ROC Venezuela Vietnam Peru Yugoslavia Albania Bangladesh France Mexico Turkey Czech Republic Pakistan Israel GOLD National Leaders Philippines
  • 4.
  • 5.
  • 6.
  • 7. Classification of COPD Severity by Spirometry Stage I: Mild FEV 1 /FVC < 0.70 FEV 1 > 80% predicted Stage II: Moderate FEV 1 /FVC < 0.70 50% < FEV 1 < 80% predicted Stage III: Severe FEV 1 /FVC < 0.70 30% < FEV 1 < 50% predicted Stage IV: Very Severe FEV 1 /FVC < 0.70 FEV 1 < 30% predicted or FEV 1 < 50% predicted plus chronic respiratory failure
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13. Percent Change in Age-Adjusted Death Rates, U.S., 1965-1998 0 0.5 1.0 1.5 2.0 2.5 3.0 Proportion of 1965 Rate 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 – 59% – 64% – 35% +163% – 7% Coronary Heart Disease Stroke Other CVD COPD All Other Causes Source : NHLBI/NIH/DHHS
  • 14. COPD Mortality by Gender, U.S., 1980-2000 Number Deaths x 1000 Source: US Centers for Disease Control and Prevention, 2002
  • 15.
  • 16.
  • 17. Risk Factors for COPD Nutrition Infections Socio-economic status Aging Populations
  • 18.
  • 19.  
  • 20. LUNG INFLAMMATION COPD PATHOLOGY Oxidative stress Proteinases Repair mechanisms Anti-proteinases Anti-oxidants Host factors Amplifying mechanisms Cigarette smoke Biomass particles Particulates Source : Peter J. Barnes, MD Pathogenesis of COPD
  • 21. Alveolar wall destruction Loss of elasticity Destruction of pulmonary capillary bed ↑ Inflammatory cells macrophages, CD8 + lymphocytes Source : Peter J. Barnes, MD Changes in Lung Parenchyma in COPD
  • 22. Chronic hypoxia Pulmonary vasoconstriction Muscularization Intimal hyperplasia Fibrosis Obliteration Pulmonary hypertension Cor pulmonale Death Edema Pulmonary Hypertension in COPD Source : Peter J. Barnes, MD
  • 23. Mast cell CD4+ cell (Th2) Eosinophil Allergens Ep cells ASTHMA Bronchoconstriction AHR Reversible Irreversible Airflow Limitation Source : Peter J. Barnes, MD Y Y Y Alv macrophage Ep cells CD8+ cell (Tc1) Neutrophil Cigarette smoke Small airway narrowing Alveolar destruction COPD
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29. SYMPTOMS cough sputum shortness of breath EXPOSURE TO RISK FACTORS tobacco occupation indoor/outdoor pollution SPIROMETRY Diagnosis of COPD   
  • 30.
  • 31. Spirometry: Normal and Patients with COPD
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58. WORLD COPD DAY November 14, 2007 Raising COPD Awareness Worldwide