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Perspectives and Perceptions on the Management of Acute Exacerbations of COPD

  • L. Allegra
  • F. Blasi

Abstract

Chronic obstructive pulmonary disease (COPD) is present in 20% of the population in the United States [1]. The development of the disease involves multiple risk factors including genetic predisposition, maternal smoking, nutrition, allergens, active and passive smoking, infection, air pollution, etc. In the past decades two major theories have been put forward to explain the pathogenesis of chronic bronchitis. The Dutch and the British hypotheses have generally been considered competing theories, the first underscoring the importance of hyperreactivity, the latter the role of infection [2, 3] . However, as suggested by Rennard, the underlying process is an upsetting of the tissue damage/tissue repair balance that initiates inflammatory derangement directly leading to airway remodelling and airflow obstruction [4].

Keywords

Chronic Obstructive Pulmonary Disease Acute Exacerbation Chronic Bronchitis Maternal Smoking Obstructive Lung Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    American Thoracic Society (1995) Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 152:S77–S120Google Scholar
  2. 2.
    Weiss ST, Speizer FE (1984) Increased level of airways responsiveness as a risk factor for development of chronic obstructive lung disease: what are the issues? Chest 86:3PubMedCrossRefGoogle Scholar
  3. 3.
    Fletcher C, Peto R, Tinker C, Speizer FE (1976) The natural history of chronic bronchitis and emphysema. Oxford University, OxfordGoogle Scholar
  4. 4.
    Rennard SI (1998) COPD: overview of definitions, epidemiology, and factors influencing its development. Chest 113:235S–241SPubMedCrossRefGoogle Scholar
  5. 5.
    Anthonisen NR, Manfreda J, Warren CPW, Hershfield ES, Harding GKM, Nelson NA (1987) Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 106:196–204PubMedGoogle Scholar
  6. 6.
    Ewig S, Soler N, Gonzalez J, El-Ebiary M, Celis R, Torres A (2000) Evaluation of antimicrobial treatment in mechanically ventilated patients with severe COPD exacerbations. Crit Care Med (in press)Google Scholar
  7. 7.
    Saint S, Bent S, Vittinghoff E, Grady D (1995) Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis. JAMA 273:957–960PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • L. Allegra
    • 1
  • F. Blasi
    • 1
  1. 1.Institute of Respiratory DiseasesUniversity of Milan, IRCCS Ospedale MaggioreMilanItaly

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