Destacan la importancia de los síntomas y los episodios de tos para el diagnóstico de la EPOC
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The clinical practice guidelines have represented a radical change for the detection and treatment of Chronic Obstructive Pulmonary Disease (COPD), a condition that increases and whose level of underdiagnosis is high even until advanced stages of the disease. Additionally, as a disease of ‘progressive’ type, the box usually worsen over time if proper treatment is not received.
In Dr. Alvar Agusti , Director, Institute of Chest Barcelona Review » in 2011 came the latest version of the so-called Gold Guide prepared by the Committee of the Global Initiative for Chronic Obstructive Lung Disease (GOLD for short English ) , which involved a major change in the treatment of the disease so far as patients are evaluated and treated based only on spirometry . The new guidelines stated that this is not the only parameter to consider because not all patients have the same symptoms or perceived illness in the same way . »
Symptoms and episodes of afudización
» Thus insisted Pulmonary specialist during his recent visit to Buenos Aires – the new guidelines not only consider spirometry but contemplate symptoms and exacerbations , as there are few patients with exacerbations and other many , which is now known that the disease must be approached from the three dimensions. »
The expert also noted that Spanish should not lose sight that COPD is an inflammatory disease basically , so although currently no markers to guide therapy are used , yes they are successfully used anti-inflammatory drugs .
However , the professional said that while medical practice guidelines are important because homogenized quality health care , «not a dogma but recommendations. Then will be the responsibility of each physician to take them as reference and not as imposing in the care of each individual patient . »
One of the main causes of underdiagnosis of COPD is the lack of an appropriate examination for detection. In that sense , the correct use of spirometry plus symptom assessment and crisis episodes the patient are an essential tool when diagnosing the disease . Keep in mind that late diagnosis is responsible for which patients often have lost up to 50 percent more lung function . »
Experts recommend to consider COPD and spirometry in people over age 40 who have:
a) Dyspnea (difficulty breathing ) : persistent , progressive and worsens with exercise
b ) Chronic cough : can be non-productive and intermittent
c ) Chronic Coughing
d ) History of exposure to risk factors: Snuff , occupational dusts and chemicals and smoke cooking
e) Family history of COPD.
Generally , COPD is diagnosed in people 40 or older, but no longer seen as a disease in the elderly.
Since there is no cure for COPD , treatment requires long-term and systematic approach to delay disease progression , control symptoms and reduce complications. COPD is a complex condition , and the treatment strategy is customized in order to work on the symptoms and improve quality of life . To diagnose the disease and assessing its severity , doctors commonly use spirometry.
Options for prevention and treatment of COPD include:
Reduction of risk factors, including smoking cessation ( the only intervention that can slow the progression of the disease) .
Vaccination against seasonal flu.
Medications such as bronchodilators , which include short-acting agents «on demand » and acting agents such as long-term maintenance therapy. This helps open the airways by relaxing the bronchial muscles improving airflow . The guidelines and recommendations stress that bronchodilation is the cornerstone in the treatment of COPD , because it treats symptoms.
The use of long-acting bronchodilators is recommended at all stages of the disease, primary treatment .
Corticosteroids are often used to help reduce and prevent inflammation within the airways. Indicated from severe stages of the disease .
Pulmonary rehabilitation , including exercise training programs , leading to improved exercise tolerance and symptoms of dyspnea and fatigue.
Oxygen, when its levels in the body are low.
Surgery , including bullectomy and lung transplantation may be considered in carefully selected patients with Stage IV COPD , severe.
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