Clinical Management of Chronic Obstructive Pulmonary Disease, Second Edition,9780824706104

Clinical Management of Chronic Obstructive Pulmonary Disease, Second Edition

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ISBN13: 9780824706104
ISBN10: 0824706102
Format: Hardcover
Pub. Date: 2002-04-25
Publisher(s): CRC Press
List Price: $290.00

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Summary

This reference presents a comprehensive review of the most recent strategies used to assess, treat, and manage patients in each phase of chronic obstructive pulmonary disease (COPD)-offering the latest diagnostic modalities to identify and distinguish components of COPD in earlier, more reversible stages. Contains perspectives from the World Health Organization on the epidemiology and control of COPD in Africa, South America, and Eastern Europe!

Table of Contents

Introduction iii
Claude Lenfant
Preface v
Contributors ix
Foreword xxix
Gordon L. Snider
Part One DIAGNOSIS AND FOLLOW-UP
The Lung in Transition from Health to Disease
1(22)
Manuel G. Cosio
David H. Eidelman
James G. Martin
Introduction
1(1)
Age-Related Decline in Lung Function
2(2)
Detection Techniques for the Assessment of Early Altered Lung Function
4(3)
Structure-Function Correlations for Tests Based on Small Airways Dysfunction
7(1)
Airway Inflammatory Responses to Irritants
8(1)
Biochemical Markers of Early Lung Inflammation in Smokers
8(1)
Differences in Airway Inflammation Between Smokers with and Without COPD
9(3)
Heterogeneity in the Patterns of Lung Damage in Smokers
12(1)
Risk Factors for the Development of COPD
13(3)
The Tip of the Iceberg
16(1)
Conclusions
17(6)
References
17(6)
Clinical Examination in Clinical Obstructive Pulmonary Disease and Correlation with Functional Abnormalities
23(12)
Robert G. Badgett
David Tanaka
What Are the Best Findings to Diagnose COPD
23(4)
How Well Does History and Physical Examination Diagnose COPD?
27(2)
Summary
29(6)
References
32(3)
Technique and Interpretation of Blood Gases in Stable Chronic Obstructive Pulmonary Disease
35(18)
Alain Harf
Blood Gases: Techniques of Evaluation
35(8)
Blood Gases: Interpretation
43(10)
References
49(4)
Basic Spirometry in COPD
53(16)
Marc Zelter
Introduction
53(1)
Assessment of Flow Limitation in COPD
54(5)
Lung Volume Measurements
59(2)
Reference Values for Flows and Volumes
61(1)
Bronchial Hyperreactivity Testing
62(1)
How Often Should Lung Function Be Assessed?
63(1)
Conclusion
63(6)
References
63(6)
Imaging Techniques of the Thorax in Stable Chronic Obstructive Pulmonary Disease Patients
69(26)
Philippe Grenier
Catherine Beigelman
Introduction
69(1)
Radiographic Manifestations
70(5)
CT Manifestations
75(7)
CT Quantification of Emphysema
82(3)
Nuclear Medicine
85(1)
Magnetic Resonance Imaging
85(10)
References
88(7)
Diagnosis, Initial Assessment, and Follow-Up of COPD
95(18)
Paul A. Vermeire
Introduction
95(1)
Diagnosis
95(1)
Needs and Objectives of the Initial Assessment After First Diagnosis
96(1)
Components of Initial Assessment After Diagnosis of COPD
97(10)
Follow-Up
107(2)
Concluding Remarks
109(4)
References
109(4)
Assessment and Management of Dyspnea in Chronic Obstructive Pulmonary Disease
113(58)
Denis E. O'Donnell
Introduction
113(1)
Mechanisms of Dyspnea in COPD
114(8)
Assessment of Dyspnea
122(10)
Management of Dyspnea in Advanced COPD
132(20)
Experimental Approaches to Dyspnea Management
152(5)
Summary
157(14)
References
158(13)
The Assessment of Health-Related Quality of Life Among Patients with Chronic Obstructive Pulmonary Disease
171(16)
David H. Au
J. Randall Curtis
Leonard D. Hudson
Introduction
171(1)
Terms and Definitions
172(3)
Relevance and Use of Health-Related Quality of Life
175(1)
Generic Versus Disease Specific Instruments
176(1)
Generic Health-Related Quality-of-Life Instruments in COPD
176(3)
Disease-Specific Measurements in COPD
179(2)
Future Directions
181(1)
Summary
181(6)
References
182(5)
Disability in Chronic Obstructive Pulmonary Disease
187(14)
Abebaw M. Yohannes
Martin J. Connolly
Introduction
187(1)
Impairment, Disability and Handicap
188(1)
Severity of Disease
189(2)
Social Care Support and Disabling COPD
191(1)
Why Measure Physical Disability in the Elderly with COPD?
191(1)
Disease-Specific Physical Disability Scale
192(3)
Statutory Support
195(1)
Conclusion
195(6)
References
196(5)
The General Practitioner and the Chronic Obstructive Pulmonary Disease Patient
201(20)
C. P. van Schayck
P. M. van Grunsven
C. van Weel
G. van den Boom
Introduction
201(1)
Pathophysiology
202(1)
Treatment of COPD with Inhaled Corticosteroids
203(3)
Treatment of COPD with N-Acetylcysteine
206(1)
Nondrug Treatment Options
207(1)
Management of COPD in Primary Care
207(2)
Aims of Treatment
209(1)
Treatment Strategy
210(5)
Summary
215(6)
References
215(6)
Part Two PATHOPHYSIOLOGICAL TREATMENTS
Genetics of Chronic Obstructive Pulmonary Disease and Emphysema: Diagnostic Applications and Therapeutic Perspectives
221(24)
Andrew J. Sandford
Peter D. Pare
Introduction
221(1)
Genetic Epidemiology of COPD
221(1)
Identification of Susceptibility Genes
222(2)
Genes Involved in the Pathogenesis of COPD
224(2)
Proteolysis-Antiproteolysis
226(3)
Inflammatory Mediators
229(1)
Xenobiotic Metabolizing Enzymes
230(2)
Cystic Fibrosis Transmembrane Regulator
232(1)
Diagnostic and Therapeutic Implications of COPD Genetics
233(1)
Conclusions
234(11)
References
235(10)
Is There a Place or a Future for Antioxidant Therapy in COPD?
245(10)
Bruno Housset
Bernard Maitre
Nature of Oxygen-Derived Metabolites
245(1)
Toxic Effects of Oxygen-Derived Metabolites
246(1)
Antioxidants
247(1)
COPD and Oxidant Burden
248(1)
Antioxidant Therapy in COPD
249(6)
References
251(4)
Part Three PHARMACOLOGICAL THERAPY
Methodology of Therapeutic Trials in COPD
255(32)
Yves Lacasse
Gordon H. Guyatt
Introduction
255(1)
Study Population: What is COPD?
256(3)
Intervention
259(1)
Outcomes
259(2)
Design
261(4)
Analysis and Interpretation
265(11)
Overviews and Meta-Analyses
276(2)
Conclusion
278(9)
References
278(9)
Beta2-Adrenergic Bronchodilators in the Treatment of Stable COPD
287(18)
Michael L. Ayers
Donald A. Mahler
Introduction
287(1)
Pharmacology and Pharmacokinetics
288(1)
Administration
289(1)
Goals of Therapy
289(1)
Is Testing for Acute Bronchodilator Responsiveness Useful?
290(1)
Short-Acting β2-Agonists
291(2)
Long-Acting β2-Agonists
293(6)
Side Effects
299(1)
For Which COPD Patients Should Long-Acting β2-Adrenergic Agonists Be Prescribed?
300(5)
References
301(4)
The Indications and Use of Inhaled Anticholinergic Agents in COPD Patients
305(24)
Stephen Corne
N. Anthonisen
Introduction
305(1)
Cholinergic Receptors in the Lung
306(1)
Pharmacology
307(1)
Safety and Side Effects
308(1)
Effects on Mucociliary Clearance
308(1)
Dose Response
309(1)
Comparison of Bronchodilator Response of Anticholinergics With β-Agonists in COPD
309(5)
Combination Therapy: Is There a Rationale for Its Use?
314(3)
Do Anticholinergics Improve Symptoms and Quality of Life in COPD?
317(3)
Method of Delivery: Nebulizer vs. MDI
320(9)
References
320(9)
Steroids in Stable COPD
329(30)
J. C. Yernault
Acute Exacerbations
329(3)
Short-Term (3 Month) Effects of Oral (Alone, or Compared to Inhaled) Steroids in Stable COPD
332(6)
Long-Term Effects of Oral Steroids in Stable COPD
338(1)
Short-Term (<3 Months) Effects of Inhaled Steroids in Stable COPD
339(4)
Long-Term Effects of Inhaled Steroids in Stable COPD
343(7)
Conclusion
350(9)
Addendum
350(1)
References
351(8)
Is There a Place for Vasodilators in Stable COPD?
359(24)
George Cremona
Tim Higenbottam
Introduction
359(1)
Anatomical Changes in the Pulmonary Vascular Bed Associated with Chronic Obstructive Airways Disease
360(1)
Pulmonary Hemodynamics in Stable COPD Patients
361(1)
Gas Exchange in Stable COPD Patients
361(3)
Pathophysiology of Chronic Hypoxic Pulmonary Hypertension
364(4)
Rationale for Vasodilator Therapy in Stable COPD Patients
368(6)
Conclusion
374(9)
References
374(9)
Is There a Place for Respiratory Analeptics or Related Drugs in Stable COPD Patients?
383(22)
Roberto Duranti
Giorgio Scano
Nicolino Ambrosino
Introduction
383(2)
Almintrine Bismesylate
385(4)
Analeptics
389(1)
Narcotic Antagonists
390(1)
Progestational Hormones
390(2)
Carbonic Anhydrase Inhibitors
392(1)
Tricyclic Antidepressants
393(2)
Theophyllines
395(1)
Conclusion
395(10)
References
396(9)
Should Drugs Affecting Mucus Properties Be Used in COPD? Clinical Evidence
405(22)
Julia A. Nightingale
Duncan F. Rogers
Introduction
405(4)
Mucolytics
409(2)
Mucoregulators (``Blocked'' Sulfhydryl Group)
411(2)
Expectorants
413(2)
Muscarinic Receptor Antagonists (Anticholinergics)
415(1)
Recombinant Human DNase
415(1)
Corticosteroids
416(1)
Erythromycin
417(1)
Summary and Conclusions
417(10)
References
417(10)
Part Four TREATMENT AND PREVENTION OF INFECTION
Indications for and Choice of Antibiotics in COPD
427(24)
S. Ewig
R. Rodriguez-Roisin
A. Torres
Introduction
427(1)
Colonization of Stable COPD Patients
428(4)
Role of Bacteria and Viruses in COPD Exacerbations
432(4)
Predictors of Particular Microorganisms
436(1)
Antibiotics in COPD
437(7)
Conclusions
444(7)
References
444(7)
Part Five ASSOCIATED DISEASES AND THEIR THERAPY
The Diagnosis and Management of Lung Cancer in COPD
451(24)
V. Ninane
T. Berghmans
J.-P. Sculier
Epidemiological Data
451(3)
Early Detection
454(1)
Treatment
455(5)
Elective Chest Irradiation of Limited Non-Small Cell Lung Cancer
460(5)
Endoscopic Palliation of Central Airway Obstruction
465(1)
Chemotherapy for Advanced Non-Small Cell Lung Cancer
465(1)
Treatment of Small Cell Lung Cancer
466(9)
References
466(9)
The Heart in the Stable COPD Patient
475(58)
Teofilo L. Lee-Chiong, Jr.
Richard A. Matthay
Introduction
475(1)
Incidence
475(1)
The Pulmonary Circulation in COPD
476(2)
The Right Ventricle in COPD
478(3)
The Left Ventricle in COPD
481(1)
Etiology of Pulmonary Artery Hypertension in COPD
482(3)
Natural History of Untreated Cor Pulmonale
485(1)
Prognosis of Patients with Cor Pulmonale
486(1)
Cardiac Arrhythmia in Patients with COPD
487(3)
Edema Formation in COPD
490(3)
Evaluating Cardiac Function in Patients with COPD
493(7)
Therapy for Cor Pulmonale Secondary to COPD
500(14)
Conclusion
514(19)
Acknowledgments
515(1)
References
515(18)
COPD and the Left Heart
533(16)
Teofilo L. Lee-Chiong, Jr.
Richard A. Matthay
Introduction
533(1)
Left Ventricular Dysfunction in COPD
534(2)
Normal Left Ventricular Performance in COPD
536(1)
Mechanisms of Left Ventricular Dysfunction in COPD
537(3)
Effects of Medications on Left Ventricular Performance and Lung Function in COPD
540(3)
Summary
543(6)
Acknowledgment
543(1)
References
544(5)
Anxiety and Depression in COPD
549(34)
Noemi Eiser
Introduction
549(1)
Depression
550(4)
Anxiety and Panic
554(4)
Chronic Obstructive Pulmonary Disease
558(4)
Prevalence of Anxiety and Depression in Patients with COPD
562(2)
Effects of Treatment of Mood Disorders in COPD Patient
564(6)
Incorporation of Psychological Therapy into Pulmonary Rehabilitation
570(1)
Summary and Conclusions
571(12)
References
573(10)
Sleep-Related Respiratory Disorders in COPD: When and How to Make the Diagnosis
583(20)
Isabelle Arnulf
Jean-Philippe Derenne
William A. Whitelaw
Introduction
583(1)
Methods of Investigations of Sleep-Related Respiratory Disorders in COPD
584(1)
Night Sleep-Related Respiratory Phenomena
585(3)
Pathophysiology
588(2)
Consequences
590(4)
When and How to Evaluate Sleep In COPD
594(9)
References
596(7)
Sleep-Related Respiratory Disorders in COPD: Who and How to Treat
603(18)
Ana C. Krieger
David M. Rapoport
Patrick Levy
Introduction
603(1)
Mechanisms
604(2)
Who to Study
606(3)
How to Treat
609(5)
Final Remarks
614(1)
Conclusions
614(7)
References
614(7)
Part Six RESPIRATORY MUSCLES, NUTRITION AND PHYSIOTHERAPY
The Relevance of Respiratory Muscles in COPD Patients and How to Assess Their Function
621(18)
G. Czaika
A. Grassino
P. Begin
Introduction
621(1)
Factors Leading to Respiratory Muscle Dysfunction
622(7)
Methods for Evaluating Respiratory Muscle Function
629(10)
References
632(7)
Corticosteroids and Muscle Function in Stable COPD
639(20)
Ghislaine Gayan-Ramirez
Marc Decramer
Introduction
639(1)
Studies In Experimental Animals
640(3)
Studies In Patients
643(7)
Potential Mechanisms of Steroid-Induced Myopathy
650(2)
Diagnosis and Therapy of Steroid-Induced Myopathy
652(2)
Conclusions
654(5)
Acknowledgments
654(1)
References
654(5)
Pharmacotherapy and Hormone Therapy of the Respiratory Muscles in Stable COPD
659(22)
Michael I. Polkey
John Moxham
General Rationale for Pharmacotherapy and Hormone Therapy
659(7)
Discussion of Specific Agents
666(8)
Conclusion
674(7)
References
674(7)
Nutritional Assessment and Support of the Stable COPD Patient
681(22)
A. M. W. J. Schols
E. F. M. Wouters
Rationale for Nutritional Support
682(2)
Body Composition
684(2)
Causes of Weight Loss and Muscle Wasting
686(3)
Assessment of Energy Balance
689(1)
Outcome of Nutritional Intervention
690(1)
Timing of Nutritional Support
691(1)
Macronutrient Composition of Nutritional Supplement
692(4)
Practical Implementation of Nutritional Support
696(7)
References
696(7)
Respiratory Physiotherapy in Stable COPD
703(28)
Gail Dechman
Introduction
703(1)
Secretion-Removal Techniques
704(2)
Secretion-Mobilization Techniques
706(3)
Physiological Effects of Enhanced Secretion Clearance
709(2)
Breathing Exercise
711(2)
Exercise
713(10)
Conclusion
723(8)
References
724(7)
Exercise in Stable COPD
731(28)
Claudio Ferdinando Donner
Antanio Patessio
Introduction
731(1)
Factors Limiting Exercise Tolerance
732(4)
Therapeutic Strategies
736(11)
Conclusion
747(1)
References
748(11)
Respiratory Muscle Training in Chronic Obstructive Pulmonary Disease
759(22)
Thomas L. Clanton
Philip T. Diaz
Introduction
759(1)
Rationale for Respiratory Muscle Training in COPD
760(6)
Unresolved Issues Related to Training Methods: A Review of the Literature
766(9)
Conclusions and Speculations
775(6)
References
776(5)
Part Seven INSTRUMENTAL TREATMENTS
Long-Term Oxygen Therapy in Stable COPD
781(32)
Emmanuel Weitzenblum
Ari Chaouat
Romain Kessler
Roland Schott
Monique Oswald
Arguments for LTOT in Hypoxemic COPD: The Beneficial Effects of LTOT
781(11)
Indications of LTOT in COPD
792(6)
Home Oxygen
798(15)
References
807(6)
Domiciliary Noninvasive Ventilatory Support
813(36)
Stefano Nava
Paolo Navalesi
Introduction
813(1)
What Determines the Prognosis in Advanced COPD?
814(1)
What Causes CO2 Retention in COPD Patients?
815(2)
Rationale for Using Long-Term Noninvasive Ventilation
817(5)
Clinical Studies
822(9)
When Should NIMV Be Started?
831(3)
How to Set Domiciliary Ventilation
834(5)
How to Follow the Patients at Home
839(1)
Conclusions
840(9)
Acknowledgments
840(1)
References
840(9)
The Indications for and Management of Tracheostomy in COPD
849(22)
Jean-Francois Muir
Antoine Cuvelier
Physiological Basis for Chronic Mechanical Ventilation
851(2)
Results of HMVT in COPD
853(6)
Indications for HMVT in COPD
859(3)
Methods
862(2)
From the Hospital to Home
864(7)
References
865(6)
Part Eight SURGERY
Management of the COPD Patient Undergoing Surgery
871(24)
B. Dureuil
Introduction
871(1)
Pathophysiology of Postoperative Respiratory Complications
872(2)
COPD as a Patient-Related Risk Factor
874(1)
Preoperative Evaluation and Preparation
875(4)
Preoperative Preparation of Stable COPD Patients
879(2)
Intraoperative Management
881(3)
Postoperative Care and Risk-Reduction Strategies
884(3)
Conclusion
887(8)
References
888(7)
Lung Volume Reduction Surgery and Chronic Obstructive Pulmonary Disease
895(26)
P. M. A. Calverley
M. Fournier
Introduction
895(1)
Theoretical Considerations
896(2)
Physiological and Clinical Effects of LVRS
898(7)
Surgical Aspects of LVRS
905(4)
Assessing the Cost of LVRS
909(3)
The Future of LVRS
912(9)
References
914(7)
Lung Transplantation and COPD
921(22)
E. P. Trulock
Background
921(2)
Recipient Selection
923(2)
Timing Transplantation
925(2)
Bridging to Transplantation
927(2)
Choice of Procedure
929(1)
Outcomes
930(5)
Summary
935(8)
References
935(8)
Part Nine PERSPECTIVES
New Treatments for COPD
943(22)
Peter J. Barnes
Introduction
943(1)
New Bronchodilators
944(1)
Smoking Cessation
945(1)
Mediator Antagonists
946(2)
New Anti-Inflammatory Treatments
948(4)
Protease Inhibitors
952(3)
Mucoregulators
955(2)
Alveolar Repair
957(1)
Route of Delivery
957(1)
Future Directions
957(8)
References
959(6)
Part Ten MANAGEMENT OF COPD THROUGH THE WORLD
Critical Comparison of Guidelines
965(22)
Nicolas Roche
Gerard J. Huchon
Introduction
965(1)
Areas of Concordance and Discrepancies between Guidelines
966(9)
What is a ``Good'' Clinical Practice Guideline?
975(3)
Are Recommendations on COPD ``Good'' Guidelines? Lessons from Experiences in Asthma
978(1)
How Could COPD Guidelines be Improved?
979(1)
What are the Main Unanswered Questions?
980(7)
References
981(6)
Epidemiology and Management of COPD in Russia
987(20)
A. G. Chuchalin
S. N. Avdeev
History
987(2)
Morbidity and Mortality
989(2)
Smoking
991(1)
Occupational Factors
991(1)
Air Pollution
992(1)
Genetics
993(1)
Consequences of the Catastrophe at Chernobyl
994(3)
Climatic Conditions
997(2)
Management
999(8)
References
1003(4)
Epidemiology and Management of Stable COPD in Africa
1007(24)
N. Ait-Khaled
P. Chaulet
D. Enarson
K. Slama
Epidemiology
1007(11)
Management of Stable COPD in Africa
1018(8)
Conclusion
1026(5)
Acknowledgment
1026(1)
References
1026(5)
Chronic Obstructive Pulmonary Disease in Latin America
1031(14)
Alvaro Undurraga
Patricio Gonzalez
Bartolome Celli
Introduction
1031(1)
Latin America: The Facts
1031(2)
COPD in Latin America
1033(2)
Some Etiopathogenic Factors of COPD
1035(5)
Latin American COPD Consensus
1040(1)
Final Comments
1040(5)
References
1041(4)
The Point of View of the WHO on Chronic Obstructive Pulmonary Disease
1045(14)
Nikolai Khaltaev
Introduction
1045(1)
Definition and Classification
1046(1)
Epidemiology
1047(6)
Risk Factors
1053(1)
Conclusion
1054(5)
References
1055(4)
Index 1059

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