Nihon rinsho. Japanese journal of clinical medicine
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Standard for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) was published from Japanese Respiratory Society in 1999. In this guideline the definition, epidemiology, risk factors, pathology, methods of diagnosis, methods of therapy and care were fully described. Especially, in this guideline, we used the thin slice CT for the diagnosis and classification of disease severity. After the publication, this guidelines were distributed to all of the JRS members(about 10,000 doctors).
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The identification of risk factors is an important step toward developing strategies for prevention and treatment of any disease. The risks of COPD are related to environmental exposures in combination with the genetic makeup of the individual. ⋯ Air pollution, occupational dusts and chemicals can also cause COPD when the exposures are sufficiently intense or prolonged. This is a summary of environmental risk factors for COPD.
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COPD is a name proposed by two American doctors, M. H. Williams and N. ⋯ Since the 1970s, COPD has been considered a smokers' disease brought on chiefly by the chronic stimulation of tobacco smoke. In 2001, the GOLD guideline indicated that COPD should not refer to a disease combining chronic bronchitis and pulmonary emphysema, but rather to a disease state characterized by an airflow limitation that is not fully reversible. Nonetheless, problems still remain in defining this disease entity.
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Substantial variation among countries has been reported regarding mortality data for COPD in industrialized countries. Differences in COPD death rates among countries have attracted considerable attention, with multiple suggested hypothesis, including smoking behaviors, air pollution, respiratory infections and genetic factors. ⋯ No comparable data regarding the COPD epidemiology such as Nippon COPD Epidemiology(NICE) study, has been available in other countries than Japan. NICE study indicated that most of COPD cases(90%) are undiagnosed, and a significant attention will be required to raise awareness of COPD.
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Chronic obstructive pulmonary disease(COPD) is a common cause of morbidity and mortality. It currently fourth leading cause of death in world wide and importance for end of life care for end-stage patients with COPD is increasing. Patients with COPD experience acute exacerbation once disease progressed. ⋯ However, these patients with COPD are more treated with life sustained interventions, palliation for these symptoms are not sufficients. In caring patients with severe COPD, consideration should be given to implementing palliative treatments more aggressively. In order to improve end of life care for patients with advanced COPD, it is also important to establish local support system for caring these patients.