Nihon rinsho. Japanese journal of clinical medicine
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COPD(Chronic Obstructive Pulmonary Disease) is a cause of chronic respiratory failure which leads to pulmonary hypertension and cor pulmonale. Not only chronic hypoxia but also low QOL(quality of life) due to dyspnea are shown to affect survival of COPD patients. ⋯ The induction of HOT needs a consideration of risk of narcosis and evaluations of oxygen desaturation during exercise and sleep as well as hypoxia at rest. Higher QOL of HOT patients might require an alteration of prescription guidelines of HOT.
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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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We have to consider the exacerbation of chronic obstructive pulmonary disease(COPD) may be caused not only by infection, but also by acute exacerbation of chronic heart failure, pulmonary embolism, pneumothorax, or other cardiopulmonary complications. Because it is characteristic that the exacerbation of COPD is often recurensive, the most important thing is the administration during stable status. ⋯ Also, approximately 15% is exacerbated by atypical pathogens such as Chlamydia pneumoniae and approximately 30% is by viral infection. We should contemplate the possibility of pathogens according to the statistics, when we choose antibiotics empirically.
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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.