Chronic Obstructive Pulmonary Disease: Open Access

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About Chronic Obstructive Pulmonary Disease: Open Access

Chronic Obstructive Pulmonary Disease Open Access Journal aim is to publish the work and reports on pulmonary related diseases and high unmet medical need are based on innovative research. Chronic Obstructive Pulmonary Disease Open Access Journal is an international journal for rapid dissemination of significant data related to pulmonary diseases and their other related research information.

The journal is an interdisciplinary medium serving several branches of medical sciences. COPD publishes original articles, short communications, notes, and mini reviews. Full length reviews are only published after invitation from the editorial board. Preliminary studies are inappropriate for publishing in Chronic Obstructive Pulmonary Disease Open Access Journal, unless the authors report the significance of their findings, in that case, the manuscript can be accepted. Average first decision of submitted manuscript is expected to be 14 days.

Submit manuscript at as an e-mail attachment to the Editorial Office at [email protected]

Pulmonary Hypertension

Pulmonary high blood pressure affects the arteries in the lungs and the right side of the heart. Pulmonary hypertension starts when pulmonary arteries and capillaries become narrowed, blocked or destroyed. This makes harder for blood to flow through lungs, and raises pressure within pulmonary arteries. Pulmonary hypertension is a serious illness that becomes progressively worse and is sometimes fatal. Pulmonary hypertension is not curable it is only treatable.

Pulmonary hypertension occurs in individuals of all ages, races, and ethnic backgrounds, although it is much more common in young adults and is approximately twice as common in women as in men.The first symptom of pulmonary hypertension is usually shortness of breath with everyday activities, such as climbing stairs. Fatigue, dizziness, and fainting spells also can be symptoms. Swelling in the ankles, abdomen or legs, bluish lips and skin, and chest pain may occur as strain on the heart increases.

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Lung Cancer

Cigarette smoking is the principal risk factor for development of lung cancer. Passive exposure to tobacco smoke can also cause pulmonary carcinoma. There are two types of lung cancer they are small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC).The stage of lung cancer is determined by the severity to which the cancer has spread in the body. Treatment of lung cancer is by a surgery, chemotherapy, and radiation therapy.

The general prognosis of lung cancer is poor because doctors tend not to find the disease until it is at an advanced stage. Five-year survival is 40%-50% for early stage lung cancer, but only 1%-5% in advanced, inoperable lung cancer. Smoking cessation is the most important measure that can prevent the development of lung cancer.

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Lung Transplantation

A lung transplant is an operation to get rid of and replace a diseased lung with a healthy human lung from someone who has died or donor. But in some cases a section of lung can be taken from a living donor. A lung transplant is used to treat patient with advanced lung disease who are failing to respond to other treatments and treat a patient whose life expectancy is less than 2 to a few years while not a transplant.

In most cases, the new lung or lungs are usually donated by a person who is under age 65 and brain-dead but is still on life-support. The donor tissue must be matched as closely as possible to your tissue type. This reduces the chances that the body will reject the transplant. Lungs can also be given by living donors. Two or more people are needed. Each person donates a segment (lobe) of their lung. This forms an entire lung for the person who is receiving it.

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Acute Exacerbation

Acute exacerbation of COPD or acute exacerbation of chronic bronchitis is shortness of breath and colour and measure of phlegm. It is the most vital outcome measure of COPD. It occurs by bacteria or viral infections caused by environmental pollutions.

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) describe the phenomenon of sudden worsening in airway function and respiratory symptoms in patients with COPD. These exacerbations can range from self-limited diseases to episodes of florid respiratory failure requiring mechanical ventilation. The average patient with COPD experiences two such episodes annually, and they account for significant consumption of health care resources. Although bacterial infections are the most common causes of AECOPD, viral infections and environmental stresses are also implicated.

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Forced Expiratory Volume

Forced expiratory volume is the volume of air that is forced out in a deep breath. It is used to diagnose asthma and chronic obstructive pulmonary disease is a measure of pulmonary function have lower FEV .

In asthma (an obstructive lung disorder) the forced expiratory volume in 1 second (FEV1) is usually decreased, the forced vital capacity (FVC) is usually normal and the ratio FEV1/FVC is decreased. In restrictive disorders the FEV1 and FVC are both decreased, leaving a normal FEV1/FVC.

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Lung Injury

Lung injury or pulmonary toxicity or pulmonary injury is due to medicinal drugs mostly, particulate matter, nanoparticles and chemical compounds. Lung injury score gives the extent of acute pulmonary damage. It represents side effects on the lungs.

Acute lung injury (ALI) is a common condition that is characterized by acute severe hypoxia that is not due to left atrial hypertension. The term ALI encompasses a continuum of clinical and radiographic changes that affect the lungs with the acute respiratory distress syndrome (ARDS) representing the more severe end of this continuum. Despite advances in our understanding of the pathophysiology and management of ALI, it is still associated with a high mortality.

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Interstitial Lung Disease

Interstitial lung disease or diffuse parenchymal lung disease is a group of diseases thickens the tissues between air sacs of the lungs. It causes scarring leads to lung stiffness, effect breathe and oxygen into blood stream. It associates basement membrane, pulmonary capillary endothelium, alveolar epithelium, perivascular and perilymphatic tissues.

Interstitial lung disease may be broadly categorized into known and unknown causes. Common known causes include autoimmune or rheumatologic diseases, occupational and organic exposures, medications, and radiation. Interstitial lung disease of unknown cause is predominated by idiopathic pulmonary fibrosis, a specific and progressive fibrotic lung disease, followed by the idiopathic interstitial pneumonias, such as nonspecific interstitial pneumonia (NSIP), and sarcoidosis.

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Long Term Oxygen Therapy

Long term oxygen therapy( LTOT) is the administration of oxygen to increase survival and quality of life in hypoxemic patients with COPD as a medical intervention for both chronic and acute patient care. Patients having high blood carbon dioxide and emphysema may reduce respiratory drive in LTOT.

It also appears to reduce the number of hospitalizations, increase effort capacity, and improve health-related quality of life. Standard LTOT criteria are related to COPD patients who have PaO2 <60 mmHg, are in a clinical stable situation, and are receiving optimal pharmacological treatment. According to LTOT guidelines, oxygen should be prescribed for at least 18 hours per day.

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Respiratory Mechanics

Respiratory mechanics is to manage the patients under artificial ventilation because of respiratory failure. This is a condition outlined by a rapid deterioration in pulmonic gas exchange that may be due either to alterations within the mechanical properties of the respiratory system resulting in ventilation perfusion mismatching or shunt, or to neuromuscular depression causing alveolar hypoventilation.

Measurements of respiratory mechanics allow a clinician to monitor closely the course of pulmonary disease. At the bedside, changes in these mechanics can occur abruptly (and prompt immediate action) or they may reveal slow trends in respiratory condition (and prompt initiation or discontinuation of mechanical ventilation).

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Lung Volume Reduction

Lung volume is the volume of air associated with respiratory life cycle phrases. Lung volume can be measured directly. Lung volume surgery is used in treating emphysema a type of COPD to improve breathing. Surgery involves removal of damaged lung tissue for better functioning.

Lung volume reduction surgery is a surgical procedure performed to remove diseased, emphysematous lung tissue. This procedure reduces the size of an over-inflated lung and allows the expansion of the remaining, often more functional lung. Lung volume reduction surgery has been shown to help improve breathing ability, lung capacity and overall quality of life in selected patients.

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Patho Physiology

Pathophysiology or physiopathology is a convergence of pathology with physiology. Pathology is the medical discipline that describes conditions typically observed during a disease state, whereas physiology is the biological discipline that describes processes or mechanisms operating within an organism.

Patho physiology of COPD is the physical changes starts with damage to air sacs and airways in the lungs. COPD comprises of airway inflammation, dysfunction of mucociliations and structural changes of airway. Various factors of pathophysiology are inflammation, infection, airway limitation, pulmonary hypertension and weight loss.

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Pulmonary Embolism

Pulmonary embolism is a blockage of the pulmonary arteries caused by the blood clot. Patients with pulmonary embolism may present with various symptoms such as seizures, syncope, fever, abdominal pain, wheezing, etc. Diagnosis include D-dimer testing and CT. It is treated with anticoagulants such as warfarin and thrombolytic agents.

Causes of pulmonary embolism include prolonged immobilization, medications, smoking, genetic predisposition, an increased number of red blood cells (polycythemia), cancer, pregnancy, surgery, or damage to blood vessel walls. Symptoms of pulmonary embolism include chest pain, shortness of breath, and a cough that produces bloody sputum. If not treated promptly, pulmonary embolism may lead to sudden death.

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Pulmonary Gas Exchange

Pulmonary gas exchange or external respiration is the process of removing CO2 from blood and replenishing oxygen supply. It occurs between alveoli and the blood of lungs. Pulmonary gas exchange occurs by diffusion and depends on pressure gradient.

Pulmonary gas exchange takes place in the lungs between the alveoli and the blood. It is also referred to as ‘external respiration’ as it involves the respiratory processes that have contact with the external environment.The process of pulmonary gas exchange removes CO2 from the blood and replenishes the bloods O2 supply.

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Respiratory Failure

Respiratory failure is the syndrome of inadequate gas exchange i.e, not sufficient oxygen passes from lungs into the blood . It occurs with insufficient oxygenation and carbon dioxide elimination. It is classified into two types, they are hypoxemic and hypercapnic.

Respiratory failure may be further classified as either acute or chronic. Although acute respiratory failure is characterized by life-threatening derangements in arterial blood gases and acid-base status, the manifestations of chronic respiratory failure are less dramatic and may not be as readily apparent.

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Shortness of Breath

Shortness of breath or dyspnea is the episode of breathlessness and is the major symptom of COPD exacerbation. Shortness of breath also occurs with asthma , pneumonia, co poisoning, heart attack and pulmonary embolism etc. It can be associated with fainting, cough, chestpain, wheezing and bloody sputum etc.

Causes of shortness of breath include asthma, bronchitis, pneumonia, pneumothorax, anemia, lung cancer, inhalation injury, pulmonary embolism, high altitude with lower oxygen levels, congestive heart failure, allergic reaction, anaphylaxis, subglottic stenosis, interstitial lung disease, obesity, tuberculosis, emphysema, pulmonary artery hypertension, rib fracture, and aerobic exercise.

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Streptococcus Pneumonia

Patients with COPD are more prone to pneumonia caused by streptococcus pneumonia and are difficult to treat. Streptococcus pneumonia belongs to genus streptococcus is a facultative anaerobic, alpha haemolytic and gram positive bacteria. Pneumococcal diseases include meningitis, acute sinusitis , bronchitis and rhinitis etc

Streptococcus pneumoniae is a Gram-positive diplococcus with a well-formed capsule. This organism is one of the commonest seen in community-acquired pneumonias, accounting for up to 25% of these infections. In the preantibiotic era streptococcal pneumonia or pneumococcal pneumonia had a high fatality rate, being a frequent cause of death in the elderly.

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Corticosteroids are the anti-inflammatory agents that inhibit the inflammation or swelling in the airways of the lungs. They are used mostly as inhalers in chronic pulmonary disease.

Corticosteroids are a man-made version of hormones normally produced by the adrenal glands (two small glands that sit on top of the kidneys). Corticosteroids are available in different forms, including: tablets (oral steroids); injections – which can be into blood vessels, joints or muscles; inhalers – such as mouth or nasal sprays; lotions, gels or creams (topical steroids).

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Chronic obstructive Lung Disease

Chronic obstructive lung disease is a disorder that obstructs bronchial airflow. The main reason for chronic obstructive disease which is also called as chronic lung disease is smoking. The other associated diseases are chronic bronchitis and emphysema.

Approximately 12 million people in the United States have been diagnosed with COPD. Many more may be affected and not know they have it. According to the Centers for Disease Control and Prevention (CDC), Chronic obstructive lung disease is the fourth leading cause of death in the United States. Its prevalence increases with age. Men are more likely to have the disease, but the death rate for men and women is about the same.

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The diagnosis of chronic pulmonary disease is done through spirometry . It is one of the lung function test carried out to monitor the function of lungs. Spirometer is the device used for the test.

Normal readings vary, depending on your age, size, and sex. The range of normal readings is published on a chart, and doctors and nurses refer to this chart when they check your spirometry readings.Although spirometry shows the type, pattern and severity of lung disease, it does not give an indication of the long-term outlook (prognosis) or of your quality of life.

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Chronic Bronchitis

Chronic bronchitis is a pulmonary disorder causes inflammation of the bronchial tubes symptomized by cough, shortness of breath, chest pain. There are two types of bronchitis: acute bronchitis and chronic bronchitis. Patients suffering from this disease release a lot of mucus and has difficulty of breathing.

People often ignore the signs of chronic bronchitis until it is advanced, because they mistakenly believe that the disease is not life-threatening. But if you wait to seek treatment, your lungs may already have been seriously injured. This puts you in danger of developing serious respiratory problems or heart failure. The good news is that chronic bronchitis can be found early and there is much that can be done to treat and help manage the disease.

Cigarette smoking is by far the most common cause of chronic bronchitis. The airways of people with chronic bronchitis may also have been irritated initially by bacterial or viral infections.

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Mechanical Ventilation

Mechanical ventilation is also called positive pressure ventilation. Following an inspiratory trigger, a predetermined mixture of oxygen is forced into the central airways and then flows into the alveoli. As the intra alveolar pressure increases, termination signal eventually causes the ventilator to stop pumping air into the central airways and the central airway pressure decreases. Expiration follows passively, with air flowing from the higher pressure alveoli to the lower pressure central airways.

Mechanical ventilators are set to deliver a constant volume (volume cycled), a constant pressure (pressure cycled), or a combination of both with each breath. Modes of ventilation that maintain a minimum respiratory rate regardless of whether or not the patient initiates a spontaneous breath are referred to as assist-control (A/C). Because pressures and volumes are directly linked by the pressure-volume curve, any given volume will correspond to a specific pressure, and vice versa, regardless of whether the ventilator is pressure or volume cycled.

Adjustable ventilator settings differ with mode but include respiratory rate, tidal volume, trigger sensitivity, flow rate, waveform, and inspiratory/expiratory (I/E) ratio.

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Tumor Necrosis Factor

Tumor necrosis factor or cachectin or TNF alpha is a cytokine capable of inducing necrosis of tumor cells. TNF also effects insulin resistance, coagulation and lipid metabolism. Mechanism of TNF is causing fever a direct action or interleukin-1 secretion stimulation or cell proliferation .

Tumor necrosis factor: One of multiple proteins capable of inducing necrosis (death) of tumor cells that possess a wide range of proinflammatory actions. Drugs that block the action of TNF have been shown to be beneficial in reducing the inflammation in inflammatory diseases such as Crohns disease and rheumatoid arthritis.

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