Chronic Obstructive Pulmonary Disease, An Issue of Clinics in Chest Medicine

1st Edition, Volume 41-3 - August 25, 2020
Editors: Gerard Criner, Bartolome R. Celli
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 8 3 0 4 - 3
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 8 3 0 5 - 0

This issue of Clinics in Chest Medicine, guest-edited by Dr. Gerard Criner and Dr. Bartolome Celli, is focused on Chronic Obstructive Pulmonary Disease. Topics discussed in this… Read more

Chronic Obstructive Pulmonary Disease, An Issue of Clinics in Chest Medicine

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This issue of Clinics in Chest Medicine, guest-edited by Dr. Gerard Criner and Dr. Bartolome Celli, is focused on Chronic Obstructive Pulmonary Disease. Topics discussed in this issue include but are not limited to: COPD Pathogenesis; Epidemiology of COPD; Host, Gender, and Early Life Factors as Risks for COPD; Alpha One Antitrypsin Deficiency; Lung Function Testing; Assessing Symptom Burden; Chest Imaging in the Diagnosis and Assessment of the Patient with COPD; Biomarkers in the Diagnosis and Assessment of COPD; Asthma/COPD Overlap; Multimorbidity in the Patient with COPD; Definition Causes, Pathogenesis, and Consequences of Exacerbations; Treatment of Acute Exacerbations; Prevention of Exacerbations; Bronchodilators; Benefits and Risks of Inhaled Corticosteroids in COPD; Systemic Medications; Smoking Cessation/Vaccinations; Pulmonary Rehabilitation; Oxygen Therapy/Noninvasive Ventilation; and Interventional and Surgical Therapies for COPD.

Cover image
Title page
Table of Contents
Copyright
Contributors
Clinics in Chest Medicine
Preface
Section I: COPD pathogenesis and risk factors
Chronic Obstructive Pulmonary Disease Pathogenesis
Key points
Introduction
The traditional understanding of chronic obstructive pulmonary disease: a self-inflicted disease caused by tobacco smoking (in males)
Some observations do not fit this traditional pathogenic paradigm
A new pathogenic understanding of chronic obstructive pulmonary disease: a balanced lung development and aging process determines lifelong lung function trajectories
Implications
Summary
Epidemiology of Chronic Obstructive Pulmonary Disease
Key points
Introduction
Spirometric definition of chronic obstructive pulmonary disease
Global epidemiology of chronic obstructive pulmonary disease
Risk factors for chronic obstructive pulmonary disease
Rural-urban disparities
Racial/ethnic disparities
Useful interventions to address chronic obstructive pulmonary disease disparities
Summary
Host, Gender, and Early-Life Factors as Risks for Chronic Obstructive Pulmonary Disease
Key points
Introduction
Host factors
Environmental and occupational exposures
Early-life factors
Summary
Alpha-1 Antitrypsin Deficiency Associated COPD
Key points
Introduction
Summary
Section II: Diagnosis and Assessment of COPD
Lung Function Testing in Chronic Obstructive Pulmonary Disease
Key points
Introduction
Structural and physiologic Basis of respiratory dysfunction in chronic obstructive pulmonary disease
Lung function tests in the diagnostic assessment of chronic obstructive pulmonary disease
Lung function tests in the assessment of disease severity
Lung function tests in the indication for and responses to interventions
Balanced recommendations
Summary
Assessing Symptom Burden
Key points
Introduction
Assessment of symptoms
Assessment of dyspnea
Assessment of health status
Chronic obstructive pulmonary disease assessment test
Multidimensional scoring systems
Thresholds for symptom assessment
Conflict of interest statement
Computerized Chest Imaging in the Diagnosis and Assessment of the Patient with Chronic Obstructive Pulmonary Disease
Key points
Introduction
Background
Airways
Beyond lung parenchyma and airways
Clinical utilization of imaging in chronic obstructive pulmonary disease
The path forward
Summary
Biomarkers in Chronic Obstructive Pulmonary Disease: The Gateway to Precision Medicine
Key points
Introduction
The move toward precision medicine
What is (and what is not) a biomarker?
The current (and future) landscape of biomarkers in chronic obstructive lung disease
Summary
What Is Asthma Chronic Obstructive Pulmonary Disease Overlap?
Key points
Diseases and diagnoses
Asthma and chronic obstructive pulmonary disease
The importance of definitions
Asthma chronic obstructive pulmonary disease overlap
Multimorbidity in Patients with Chronic Obstructive Pulmonary Disease
Key points
Introduction
Dying from or with chronic obstructive pulmonary disease
Epidemiology of chronic obstructive pulmonary disease–related comorbidities
Comorbidities of clinical relevance in chronic obstructive pulmonary disease patients
A novel approach to chronic obstructive pulmonary disease comorbidities
Addressing the complexity of multimorbidity
The use of novel tools to analyze complex interactions
Summary
Section III: Exacerbations
Definition, Causes, Pathogenesis, and Consequences of Chronic Obstructive Pulmonary Disease Exacerbations
Key points
Introduction
Summary
Treatment of Acute Exacerbations in Chronic Obstructive Pulmonary Disease
Key points
Introduction
Diagnosis
Determination of etiology
Determination of the severity of an exacerbation
Site of treatment
Outpatient management of chronic obstructive pulmonary disease exacerbation
Hospital management of chronic obstructive pulmonary disease exacerbation
Care on the general medical floor
Care in the intensive care unit
Summary
Prevention of Chronic Obstructive Pulmonary Disease
Key points
Introduction
Primal and primary prevention
Secondary prevention
Tertiary prevention
Summary
Section IV: Pharmacologic Therapy in COPD
Long-Acting Bronchodilators for Chronic Obstructive Pulmonary Disease: Which One(S), How, and When?
Key points
Introduction
Safety and clinical effectiveness of long-acting bronchodilators
Long-acting beta-2 adrenoreceptor agonist versus placebo
Long-acting muscarinic antagonist versus placebo
Long-acting beta-2 agonist versus long-acting muscarinic antagonist
Long-acting beta-2 agonist/long-acting muscarinic antagonist versus monocomponents
Long-acting muscarinic antagonist versus long-acting beta-2 agonist/inhaled corticosteroid
Long-acting beta-2 agonist/long-acting muscarinic antagonist versus long-acting beta-2 agonist/inhaled corticosteroid
Impact of bronchodilators on dynamic hyperinflation and exercise performance
Bronchodilators and comorbidities
Factors to be considered when choosing molecules and devices
Place of long-acting bronchodilators in guidelines and the clinical practice
Summary
Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease: Benefits and Risks
Key points
Introduction
Inhaled corticosteroid monotherapy
Inhaled corticosteroid/long-acting beta-agonist therapy
Trials of triple therapy with inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist
Risks/safety
Risk-benefit considerations
Discussion
Systemic Medications in Chronic Obstructive Pulmonary Disease: Use and Outcomes
Key points
Introduction
Oral beta2-adrenergic agonists
Xanthines, theophylline
Phosphodiesterase 4 inhibitors
Macrolides and other antibiotics
Mucomodifiers
Oral corticosteroids
Antileukotrienes
Cardiovascular/metabolic treatments
Biologics
Alpha1-antitrypsin augmentation therapy
Systemic treatments for dyspnea
Summary
Section V: Non-pharmacological therapy in COPD
Smoking Cessation/Vaccinations
Key points
Smoking cessation in chronic obstructive pulmonary disease
Smoking prevalence in chronic obstructive pulmonary disease
Characteristics of smokers with chronic obstructive pulmonary disease
Smoking diagnosis in chronic obstructive pulmonary disease
Smoking cessation treatments
Smoking reduction
E-cigarettes
Vaccination in patients with chronic obstructive pulmonary disease
Vaccination rates
Influenza disease
Pneumococcal diseases in patients with chronic obstructive pulmonary disease
Summary
Pulmonary Rehabilitation
Key points
Introduction
Definition, concept and source documentations
Exercise training, testing and prescription in pulmonary rehabilitation
Pulmonary rehabilitation patient selection, setting, and delivery
Behavior modification, exercise maintenance, and increased physical activity
Pulmonary rehabilitation, acute exacerbations, and advanced disease
Summary
Oxygen Therapy and Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease
Key points
Introduction
Supplemental oxygen therapy in chronic obstructive pulmonary disease
Noninvasive ventilation in chronic obstructive pulmonary disease
Summary
Interventional Bronchoscopic Therapies for Chronic Obstructive Pulmonary Disease
Key points
Introduction
Bronchoscopic approaches to lung volume reduction
Targeted lung denervation
Summary
Surgical Therapies for Chronic Obstructive Pulmonary Disease
Key points
Introduction
Rationale for lung volume reduction
History of lung volume reduction surgery
The National Emphysema Treatment Trial
Lung volume reduction surgery: current state
Bullectomy
Lung transplantation in chronic obstructive pulmonary disease
Summary

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Bartolome R. Celli