Ugeskrift for laeger
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Ugeskrift for laeger · Apr 2013
Review[New guidelines for diagnosis and staging of chronic obstructive pulmonary disease].
A clinical diagnosis of chronic obstructive pulmonary disease (COPD) should be considered in any individual who has dyspnoea, chronic cough or sputum production and/or a history of exposure to risk factors for the disease. Spirometry is essential for the definite diagnosis of the disease. Differential diagnosis and co-morbidities such as osteoporosis, heart failure and lung cancer are important to consider and treat. The combined results of symptoms (few/many), lung function and the amount of exacerbations make up the risk of future exacerbations and risk of death of any given patient.
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Ugeskrift for laeger · Apr 2013
Review[Occupational exposure for dust and gases is an important risk factor for developing COPD].
Some patients with chronic obstructive pulmonary disease (COPD) are never-smokers, which suggests that there must be other important risk factors. This paper describes the evidence for an association between occupational exposure and COPD. In several studies a consistent and predominantly significant association between occupational exposures and COPD is found, even though the studies vary in design, enrolled populations and in measures of exposure and outcome. Strong evidence supports a causal association between multiple categories of occupational exposure and COPD, both within and across industry groups.
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Chronic obstructive pulmonary disease (COPD) is treated with bronchodilator and antiinflammatory drugs along with smoking cessation and pulmonary rehabilitation. The pharmacological treatment of COPD is based on the assessment of current symptoms and future risk as first proposed in the GOLD 2011 strategy document. ⋯ Inhaled corticosteroids can be added for reducing exacerbations where also roflumilast has proven efficacy. This review covers recommendations for treating COPD according to the latest recommendations from the Danish Respiratory Society.
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Chronic obstructive pulmonary disease (COPD) is substantially underdiagnosed and under treated. The present review paper discusses the possibilities of early diagnosis by means of spirometry in the setting of Danish general practice. It is concluded that case finding of undiagnosed COPD is feasible by applying opportunistic spirometry in patients with relevant exposures and relevant respiratory symptoms. The potential barriers of this approach and possible solutions are discussed.
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Ugeskrift for laeger · Apr 2013
Review[Diagnosis and treatment of acute colonic pseudo-obstruction].
Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a clinical condition with acute dilatation of the colon without a provable mechanical cause. Early recognition and treatment of the condition is important in order to improve the outcome. ⋯ If no improvement occurs after 24 hours, medical treatment with neostigmine administered i.v. is instituted and repeated if necessary. Colonoscopic decompression is the next step, but if ischaemia or perforation appear surgery should be performed.