title: Recent advances in diagnosis and management of chronic bronchitis and emphysema.
abstract: Chronic obstructive pulmonary disease is a progressive inflammatory disease of the airways and lung parenchyma. Expiratory airflow limitation is the hallmark of chronic obstructive pulmonary disease. It is a significant cause of morbidity and mortality in the United States and worldwide and results in a large consumption of health care resources. Unfortunately, despite efforts to curb this disease, its prevalence is increasing. The diagnosis is usually made when the patient complains of dyspnea on exertion; by this time, irreversible structural damage to the lung has already occurred. Given the nonspecific symptoms of the disease and the inability to effectively treat and reverse the damage, it is essential to diagnose the disease in its early stages and take the necessary preventive measures, thus avoiding disability or death. This review summarizes the latest developments in the diagnosis and management of chronic obstructive pulmonary disease. The first half of the review discusses functional, radiographic, biochemical, and cellular/histopathologic issues in the diagnosis of chronic obstructive pulmonary disease. The second half focuses on the current pharmacologic and nonpharmacologic advances in chronic obstructive pulmonary disease, including the role of respiratory support and surgical treatment. Based on the research on the cellular mechanisms of chronic obstructive pulmonary disease, the review also makes a reference to novel and experimental therapies for chronic obstructive pulmonary disease.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Veterans Administration Palo Alto Health Care System, and Stanford University School of Medicine, Palo Alto, California 94304, USA. rkc@stanford.edu
authors.forename: Rajinder K
authors.initials: RK
authors.lastname: Chitkara
authors.forename: Priscilla S A
authors.initials: PS
authors.lastname: Sarinas
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001991:Bronchitis / Q000175:diagnosis* / Q000628:therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis; D011656:Pulmonary Emphysema / Q000175:diagnosis* / Q000628:therapy*; D012138:Respiratory Therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D010100:Oxygen