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E-grāmata: Asthma, COPD, and Overlap: A Case-Based Overview of Similarities and Differences

Edited by , Edited by (National Jewish Health, Denver, Colorado, USA), Edited by (University of Cincinnati, Cincinnati, Ohio, USA)
  • Formāts: 304 pages
  • Izdošanas datums: 22-Mar-2018
  • Izdevniecība: CRC Press Inc
  • ISBN-13: 9781351649056
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Asthma, COPD, and Overlap: A Case-Based Overview of Similarities and DifferencesPalielināt
  • Formāts: 304 pages
  • Izdošanas datums: 22-Mar-2018
  • Izdevniecība: CRC Press Inc
  • ISBN-13: 9781351649056
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Using illustrative case examples, this book thoroughly reviews similarities and differences between asthma, chronic obstructive pulmonary disease (COPD) and the overlap syndrome. It is important to highlight the distinctions because these commonly encountered conditions in respiratory and primary care share many similarities but have important differences often mistaken for each other. This can have serious implications for treatment, particularly as new treatments are targeted at specific phenotypes of the diseases. This practical guide shows how to distinguish between the diseases on a pathological and clinical basis so that appropriate management and treatment may be pursued.

 

Preface ix
Contributors xi
1 Definitions of asthma and COPD and overlap 1(12)
Krystelle Godbout
Vanessa M. McDonald
Peter G. Gibson
1.1 Introduction
1(1)
1.2 Asthma and COPD
1(1)
1.2.1 Traditional method for definition and diagnosis
2(1)
1.2.2 Diagnostic criteria for asthma and COPD
2(1)
1.3 Overlap of asthma and COPD: A new entity?
2(3)
1.3.1 Relevance of identifying and defining ACO
3(1)
1.3.2 Definitions arising from studies
3(1)
1.3.3 Selecting characteristics for defining ACO
3(1)
1.3.4 Definitions and criteria arising from guidelines
4(1)
1.4 Clinical vignettes
5(1)
1.5 Applying definitions to clinical vignettes and related issues
6(2)
1.6 Asthma, COPD, or ACO, does it matter?
8(1)
1.7 Conclusions
9(1)
References
9(4)
2 Epidemiology of asthma, COPD, and asthma-COPD overlap 13(10)
Anne L. Fuhlbrigge
2.1 Introduction
13(1)
2.2 Asthma
14(1)
2.2.1 Risk factors
14(1)
2.2.2 Prevalence
14(1)
2.2.3 Morbidity and mortality
15(1)
2.3 COPD
15(2)
2.3.1 Risk factors
16(1)
2.3.2 Prevalence
16(1)
2.3.3 Morbidity and mortality
17(1)
2.4 ACO
17(2)
2.4.1 Risk factors
17(1)
2.4.2 Prevalence
17(1)
2.4.3 Morbidity and mortality
18(1)
2.5 Concluding remarks
19(1)
References
19(4)
3 The genetics of asthma, COPD, and the asthma-COPD overlap 23(18)
Robert Busch
Craig P. Hersh
3.1 Clinical vignette
23(1)
3.2 Clinical vignette: Management
24(1)
3.3 Background
24(1)
3.4 Genetic research methodology
24(3)
3.4.1 Human genetic variation
24(1)
3.4.2 Complex diseases: Genes and environment
25(1)
3.4.3 History of genetic studies
25(1)
3.4.4 GWAS methodology
25(1)
3.4.5 GWAS advantages and disadvantages
26(1)
3.4.6 GWAS in asthma, COPD, and ACO
27(1)
3.5 Genetic investigations of asthma
27(3)
3.5.1 Asthma phenotypes
27(1)
3.5.2 ZPBP2/ORMDL3/GSDMB/IKFZ3
28(1)
3.5.3 DENND1B
29(1)
3.5.4 IL33 and IL1RL1 regions
29(1)
3.5.5 TSLP
29(1)
3.5.6 Additional asthma loci: HLA-DQ, SMAD3, IL13, IL2RB, RTP2
30(1)
3.5.7 Candidate gene associations
30(1)
3.6 Genetic investigations of COPD
30(2)
3.6.1 COPD phenotypes
30(1)
3.6.2 CHRNA3/CHRNA5/IREB2
30(1)
3.6.3 HHIP
30(1)
3.6.4 FAM13A
31(1)
3.6.5 RAB4B/EGLN2/CYP2A6
31(1)
3.6.6 MMP12, RIN3, and TGFB2
31(1)
3.6.7 AGER/PPT2 and emphysema-associated loci
31(1)
3.6.8 Alpha-1 antitrypsin deficiency and SERPINA1
31(1)
3.6.9 The United Kingdom Biobank
32(1)
3.6.10 Future studies
32(1)
3.7 Genetic investigations of asthma-COPD overlap
32(1)
3.8 Challenges for future genetic studies of ACO
33(1)
3.9 Opportunities for future ACO studies
34(1)
3.10 Conclusions
35(1)
3.11 Acknowledgments
35(1)
References
36(5)
4 Asthma-chronic obstructive pulmonary disease overlap: A distinct pathophysiological and clinical entity 41(12)
Rakhee K. Ramakrishnan
Bassam Mahboub
Qutayba Hamid
4.1 Introduction
41(1)
4.2 Asthma and COPD-Similarities and differences
42(1)
4.3 Pathophysiology of asthma
43(2)
4.3.1 Atopy
43(1)
4.3.2 Airway hyperresponsiveness
44(1)
4.3.3 Airway remodeling
44(1)
4.3.4 Airway inflammation
44(1)
4.4 Pathophysiology of COPD
45(1)
4.4.1 Airway hyperresponsiveness
45(1)
4.4.2 Airway obstruction
45(1)
4.4.3 Cigarette smoke-induced damage
45(1)
4.4.4 Inflammation and remodeling
46(1)
4.5 Pathophysiology of ACO
46(2)
4.5.1 Airway inflammation
46(1)
4.5.2 Airway obstruction
47(1)
4.5.3 Airway remodeling
48(1)
4.6 Conclusions
48(2)
References
50(3)
5 Pathophysiology of asthma, COPD, and the overlap 53(10)
Charles G. Irvin
David A. Kaminsky
5.1 Introduction
55(1)
5.2 Asthma
56(1)
5.3 Chronic obstructive pulmonary disease
57(1)
5.4 Physiological features of asthma-COPD overlap patients
58(1)
5.5 Other mechanisms of fixed airflow limitation
59(1)
5.6 Conclusions
59(1)
References
60(3)
6 Update on the clinical status, genomics, pathophysiology, and treatment of the asthma-COPD overlap 63(8)
Arthur F. Gelb
Jay A. Nadel
6.1 Introduction to ACO
63(1)
6.2 Historical overview of asthma-COPD overlap (ACO)
64(1)
6.3 Eosinophilic and type 2 inflammation in COPD
64(1)
6.4 Mechanism(s) for persistent expiratory airflow limitation in treated, never smoked, chronic asthmatics
65(1)
6.5 Mechanism(s) responsible for the inflammatory and proteolytic lung tissue breakdown in chronic nonsmoking asthmatics
66(1)
6.6 Severity and treatment response as a phenotypic characteristic of ACO
67(1)
6.7 Conclusion
67(1)
Acknowledgment
67(1)
References
68(3)
7 Tobacco: Active and passive smoke exposure 71(14)
Neil C. Thomson
7.1 Introduction
72(1)
7.2 Active smoking and asthma
72(4)
7.2.1 Development of asthma in active smokers
72(1)
7.2.2 Prevalence of cigarette smoking in asthma
72(1)
7.2.3 Clinical outcomes and inflammatory variables in current and former smokers with asthma
73(3)
7.2.3.1 Current symptom control and quality of life
73(1)
7.2.3.2 Chronic mucus hypersecretion
73(1)
7.2.3.3 Exacerbations and health care utilization
73(1)
7.2.3.4 Corticosteroid insensitivity
74(1)
7.2.3.5 Lung function
74(1)
7.2.3.6 Comorbidities
75(1)
7.2.3.7 Clinical outcomes in former smokers with asthma
75(1)
7.2.3.8 Phenotypes
75(1)
7.2.3.9 Inflammatory variables
75(1)
7.3 Active smoking and COPD
76(2)
7.3.1 Development of COPD
76(1)
7.3.2 Prevalence of cigarette smoking in COPD
77(1)
7.3.3 Clinical outcomes and inflammatory variables
77(1)
7.3.3.1 Current smokers and former smokers with COPD
77(1)
7.3.3.2 Former smokers with COPD
77(1)
7.4 Active smoking and the overlap syndrome
78(1)
7.4.1 Development of the overlap syndrome
78(1)
7.4.2 Prevalence of cigarette smoking in the overlap syndrome
79(1)
7.5 Passive smoke exposure and asthma
79(1)
7.5.1 Development of asthma
79(1)
7.5.1.1 Children and adolescents
79(1)
7.5.1.2 Adults
79(1)
7.5.2 Prevalence of exposure to passive smoke
79(1)
7.5.3 Clinical outcomes and inflammatory variables
80(1)
7.5.3.1 Children
80(1)
7.5.3.2 Adults
80(1)
7.5.3.3 Inflammatory variables
80(1)
7.6 Passive smoke exposure and COPD
80(1)
7.6.1 Development of COPD
80(1)
7.6.2 Exposure to passive smoke
80(1)
7.6.3 Clinical outcomes and inflammatory variables
80(1)
7.7 Conclusions
81(1)
References
81(4)
8 Indoor and outdoor pollutants and allergens 85(10)
Charles S. Barnes
8.1 Introduction
85(1)
8.2 Air pollution background
86(1)
8.3 Common air pollutants
86(2)
8.4 Health effects
88(1)
8.5 Aeroallergens as pollutants
89(1)
8.6 Outdoor pollen, spores, and hay fever
89(1)
8.7 Climate change
90(1)
8.8 Indoor air pollutants and allergens
90(1)
8.9 Conclusion
91(1)
References
91(4)
9 The microbiome in asthma, COPD, and asthma-COPD overlap 95(12)
Stephanie Christenson
9.1 Introduction
95(1)
9.2 Contemporary microbiome analytical methods
96(1)
9.3 The gut microbiome and the development of airway disease
96(2)
9.4 The healthy lung microbiome
98(1)
9.5 The lung microbiome in chronic airway disease
98(2)
9.5.1 Asthma
98(1)
9.5.2 COPD
99(1)
9.6 The lung microbiome during acute exacerbations
100(1)
9.6.1 Asthma exacerbations
100(1)
9.6.2 COPD exacerbations
100(1)
9.7 The airway microbiome and asthma-COPD overlap
101(1)
9.8 The lung microbiome as a therapeutic target in chronic airway disease
101(2)
9.9 Antibiotic therapy in acute exacerbations
103(1)
9.10 Conclusions
103(1)
References
104(3)
10 Exercise in asthma, COPD, and asthma-COPD overlap 107(14)
Louis-Philippe Boulet
Francois Maltais
10.1 Introduction
109(1)
10.2 Asthma
109(4)
10.2.1 Introduction
109(1)
10.2.2 Prevalence and differential diagnosis
109(1)
10.2.3 Mechanisms of airway responses in asthma
109(1)
10.2.4 Evaluation of EIA/EIB
110(1)
10.2.5 Prevention and treatment
111(1)
10.2.6 Asthma in the high-level athlete: A specific phenotype
111(1)
10.2.7 Conclusion
112(1)
10.3 COPD
113(3)
10.3.1 Introduction
113(1)
10.3.2 Symptom perception during exercise
113(1)
10.3.3 Ventilatory limitation
113(1)
10.3.4 Physiological determinants of dyspnea
113(1)
10.3.5 Dynamic hyperinflation
113(1)
10.3.6 Limb muscle fatigue
114(1)
10.3.7 Interactions between limb muscles and the respiratory system
114(1)
10.3.8 Relative contribution of exercise-limiting factors
114(1)
10.3.9 Evaluation of exercise intolerance
115(1)
10.3.10 Prevention and treatments
115(1)
10.3.10.1 Pharmacotherapy
115(1)
10.3.10.2 Exercise training and pulmonary rehabilitation
115(1)
10.3.11 Conclusion
116(1)
10.4 Asthma-COPD overlap
116(1)
10.4.1 Introduction
116(1)
10.4.2 Mechanisms
116(1)
10.4.3 Management
116(1)
10.4.4 Conclusion
116(1)
10.5 General conclusion
117(1)
References
117(4)
11 Occupational-related asthma, COPD, and asthma-COPD overlap 121(14)
Karin A. Pacheco
Lisa A. Maier
11.1 Introduction
121(1)
11.2 Epidemiology
122(1)
11.3 Biological dusts
122(4)
11.3.1 Cotton and other textile workers
122(3)
11.3.2 Cotton textile worker with ACO
125(1)
11.3.2.1 Is it cotton dust or endotoxin?
126(1)
11.4 Swine confinement and dairy workers
126(1)
11.4.1 ACO in a cattle feedlot worker
126(1)
11.5 Grain workers
127(1)
11.5.1 Other organic dust exposures
128(1)
11.6 Biomass
128(1)
11.6.1 ACO in a biomass smoke-exposed worker
128(1)
11.7 Diesel exhaust
129(1)
11.7.1 ACO in a rail worker exposed to diesel exhaust and irritants
129(1)
11.8 Firefighters
130(1)
11.9 Welding fumes
130(1)
11.9.1 Mineral dusts
130(1)
11.10 Summary and conclusions
131(1)
Acknowledgments
132(1)
References
132(3)
12 Asthma, COPD, and asthma-COPD overlap in special populations 135(10)
Stephen Bujarski
Amit Parulekar
Nicola A. Hanania
12.1 Introduction
135(1)
12.2 Illustrative clinical vignettes
135(1)
12.3 Effect of age on asthma, COPD, and ACO
136(2)
12.3.1 Age and asthma
136(2)
12.3.2 Age and COPD
138(1)
12.3.3 Age and asthma-COPD overlap
138(1)
12.4 Effect of gender on asthma, COPD, and ACO
138(2)
12.4.1 Gender and asthma
138(1)
12.4.2 Gender and COPD
138(1)
12.4.3 Gender and ACO
139(1)
12.5 Effects of pregnancy
140(1)
12.6 Effects of race and ethnicity
140(1)
12.6.1 Race, ethnicity, and asthma
140(1)
12.6.2 Race and ethnicity and COPD
141(1)
12.6.3 Race, ethnicity, and asthma-COPD overlap
141(1)
12.7 Summary
141(1)
References
141(4)
13 History and physical examination of asthma, COPD, and asthma-COPD overlap 145(14)
Mark H. Almond
Kian Fan Chung
13.1 Introduction
146(11)
13.1.1 Medical history
147(1)
13.1.2 Physical examination
148(13)
13.1.2.1 Clinical assessment of individuals with confirmed asthma in the outpatient setting
149(2)
13.1.2.2 Asthma in the emergency room: Clinical assessment of an asthma exacerbation
151(1)
13.1.2.3 Initial consultation: Suspected COPD
152(1)
13.1.2.4 Clinical assessment of individuals with COPD in the outpatient clinic
153(2)
13.1.2.5 Clinical assessment of COPD in the emergency room
155(1)
13.1.2.6 Clinical assessment of an individual with suspected ACO
156(1)
13.2 Summary
157(1)
References
157(2)
14 Diagnostic testing for asthma, COPD, and asthma-COPD overlap 159(10)
Svien A. Senne
Kristina L. Bailey
14.1 Introduction
161(1)
14.2 Spirometry
161(1)
14.2.1 Forced expiratory volume in one second
161(1)
14.2.2 Forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio
162(1)
14.2.3 Postbronchodilator spirometry
162(1)
14.2.4 Forced expiratory flow at 25%-75% of FVC (FEF25-75)/Maximal Midexpiratory Flow
162(1)
14.3 Pulmonary function testing
162(1)
14.3.1 Lung volumes
162(1)
14.3.2 Diffusing capacity of the lungs for carbon monoxide
163(1)
14.3.3 Bronchoprovocation and airway hyperresponsiveness testing
163(1)
14.4 Radiographic studies
163(1)
14.5 Biomarkers
164(2)
14.5.1 Sputum
164(1)
14.5.1.1 Cytokines
165(1)
14.5.2 Serum and sputum biomarkers
165(7)
14.5.2.1 Peripheral eosinophilia
165(1)
14.5.2.2 IgE levels and allergy testing
165(1)
14.5.2.3 Inflammatory cytokines
166(1)
14.6 Exhaled nitric oxide testing
166(1)
14.7 Genetic testing
166(1)
References
167(2)
15 Environmental control of asthma, COPD, and asthma-COPD overlap 169(12)
Gennaro D&aposAmato
Carolina Vitale
Antonio Molino
Maria D&aposAmato
15.1 Introduction
170(1)
15.2 Components of outdoor air pollution in urban areas
171(1)
15.3 Pollutants of the indoor environment
172(2)
15.3.1 Indoor pollutants
172(1)
15.3.2 Indoor allergens
173(1)
15.3.2.1 Dust mites
173(1)
15.3.2.2 Furry pets
173(1)
15.3.2.3 Cockroaches
173(1)
15.3.2.4 Molds
174(1)
15.4 Effects of climate change on air pollution and allergenic pollen
174(1)
15.4.1 Thunderstorm asthma and reduction of the risk of asthma crises
175(1)
15.5 Measures to improve outdoor air quality
175(2)
15.5.1 The farm environment is able to reduce the risk of asthma
176(1)
15.6 Measures to improve indoor air quality
177(1)
Conclusions and key points
177(1)
References
178(3)
16 Medications for asthma, COPD, and asthma-COPD overlap 181(20)
Robert Ledford
Max Feldman
Thomas Casale
16.1 Introduction
182(3)
16.1.1 Clinical vignettes
182(3)
16.2 Medication classes
185(7)
16.2.1 Short-acting beta2-agonists
185(1)
16.2.1.1 Mechanism
185(1)
16.2.1.2 Medications
185(1)
16.2.1.3 Side effects
185(1)
16.2.1.4 Use in asthma
185(1)
16.2.1.5 Use in COPD
185(1)
16.2.2 Long-acting beta2-agonists
186(1)
16.2.2.1 Mechanism
186(1)
16.2.2.2 Medications
186(1)
16.2.2.3 Side effects
186(1)
16.2.2.4 Use in asthma
186(1)
16.2.2.5 Use in COPD
186(1)
16.2.3 Inhaled corticosteroids
186(1)
16.2.3.1 Mechanism
186(1)
16.2.3.2 Medications
186(1)
16.2.3.3 Side effects
186(1)
16.2.3.4 Use in asthma
187(1)
16.2.3.5 Use in COPD
187(1)
16.2.4 Leukotriene receptor modifying agents
187(1)
16.2.4.1 Mechanism
187(1)
16.2.4.2 Medications
188(1)
16.2.4.3 Side effects
188(1)
16.2.4.4 Use in asthma
188(1)
16.2.4.5 Use in COPD
188(1)
16.2.5 Anti-IgE
188(1)
16.2.5.1 Mechanism
188(1)
16.2.5.2 Medications
188(1)
16.2.5.3 Side effects
188(1)
16.2.5.4 Use in asthma
188(1)
16.2.5.5 Use in COPD
188(1)
16.2.6 Anti-IL-5
188(1)
16.2.6.1 Mechanism
188(1)
16.2.6.2 Medications
189(1)
16.2.6.3 Side effects
189(1)
16.2.6.4 Use in asthma
189(1)
16.2.6.5 Use in COPD
189(1)
16.2.7 Allergy immunotherapy
189(1)
16.2.7.1 Mechanism
189(1)
16.2.7.2 Side effects
189(1)
16.2.7.3 Use in asthma
189(1)
16.2.7.4 Use in COPD
190(1)
16.2.8 Long-acting muscarinic antagonist
190(1)
16.2.8.1 Mechanism
190(1)
16.2.8.2 Medications
190(1)
16.2.8.3 Side effects
190(1)
16.2.8.4 Use in asthma
190(1)
16.2.8.5 Use in COPD
190(1)
16.2.9 Short-acting muscarinic antagonist
190(1)
16.2.9.1 Mechanism
190(1)
16.2.9.2 Medications
190(1)
16.2.9.3 Side effects
190(1)
16.2.9.4 Use in asthma
190(1)
16.2.9.5 Use in COPD
190(1)
16.2.10 Oral corticosteroids
191(1)
16.2.10.1 Mechanism
191(1)
16.2.10.2 Side effects
191(1)
16.2.10.3 Use in asthma
191(1)
16.2.10.4 Use in COPD
191(1)
16.2.11 Theophylline
191(1)
16.2.11.1 Mechanism
191(1)
16.2.11.2 Side effects
191(1)
16.2.11.3 Use in asthma
191(1)
16.2.11.4 Use in COPD
192(1)
16.2.12 Roflumilast
192(1)
16.2.12.1 Mechanism
192(1)
16.2.12.2 Side effects
192(1)
16.2.12.3 Use in asthma
192(1)
16.2.12.4 Use in COPD
192(1)
16.3 Discussion
192(5)
16.3.1 Asthma management
192(1)
16.3.2 COPD management
192(1)
16.3.3 ACO management
193(4)
16.4 Conclusion
197(1)
References
197(4)
17 Biologics and emerging therapies for asthma, COPD, and asthma-COPD overlap 201(8)
Angira Dasgupta
Amber J. Oberle
Parameswaran Nair
17.1 Introduction
201(4)
17.1.1 Discussion of clinical vignette 1
202(2)
17.1.2 Discussion of clinical vignette 2
204(1)
17.2 Conclusion
205(1)
Acknowledgment
205(1)
References
205(4)
18 Endoscopic and surgical treatment for asthma, COPD, and asthma-COPD overlap 209(10)
Diane Tissier-Ducamp
A. Bourdin
Alain Palot
Celine Tummino
Laurie Pahus
Pascal Chanez
18.1 COPD
209(2)
18.1.1 Introduction
209(1)
18.1.2 Discussion
210(1)
18.2 Asthma
211(3)
18.2.1 Introduction
211(2)
18.2.2 Discussion
213(1)
18.3 Asthma-COPD overlap (ACO)
214(2)
18.3.1 Introduction
214(1)
18.3.2 Discussion
215(1)
18.4 Conclusion
216(1)
References
216(3)
19 Supplemental oxygen and pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD), asthma, and asthma-COPD overlap 219(16)
Ralph J. Panos
19.1 Introduction
219(5)
19.2 Supplemental oxygen and COPD
224(1)
19.3 Resting hypoxemia
224(1)
19.4 Mild resting or nocturnal hypoxemia
225(1)
19.5 Exertional desaturation
225(1)
19.6 Short-burst oxygen
226(1)
19.7 Adverse effect of supplemental oxygen
226(1)
19.8 Oxygen and asthma
226(1)
19.9 Pulmonary rehabilitation
227(1)
19.10 Pulmonary rehabilitation and COPD
228(1)
19.11 Pulmonary rehabilitation and asthma
229(1)
19.12 Conclusion
230(1)
References
230(5)
20 Smoking cessation for asthma, COPD, and asthma-COPD overlap 235(8)
Adrienne L. Johnson
Alison C. McLeish
Talya Alsaid-Habia
20.1 Overview
235(1)
20.2 Current smoking cessation guidelines
235(5)
20.2.1 For patients willing to quit
236(3)
20.2.1.1 Counseling
236(2)
20.2.1.2 Pharmacotherapy
238(1)
20.2.1.3 Summary
239(1)
20.2.2 For patients unwilling to quit
239(1)
20.2.2.1 Non-MI approach
239(1)
20.2.2.2 MI approach
240(1)
20.3 Special considerations for smoking cessation for patients with asthma and COPD
240(1)
20.3.1 Managing withdrawal symptoms
240(1)
20.3.2 Comorbid psychopathology
241(1)
20.3.3 Symptom management
241(1)
20.3.4 Smoking cessation medications
241(1)
20.4 Summary
241(1)
References
241(2)
21 Management of acute asthma, COPD, and asthma-COPD overlap 243(14)
Cristina Villa-Roel
Brian H. Rowe
21.1 Definition and economic burden
243(1)
21.2 Diagnosis
243(1)
21.3 Management
244(9)
21.3.1 Role of patients and primary care providers in the management of asthma, COPD, and ACO exacerbations
244(1)
21.3.2 Role of acute-care facilities in the management of asthma, COPD, and ACO exacerbations
245(12)
21.3.2.1 Asthma
248(2)
21.3.2.2 Chronic obstructive pulmonary disease
250(2)
21.3.2.3 Asthma-chronic obstructive pulmonary disease overlap
252(1)
21.4 Gaps in acute care and research opportunities
253(1)
References
253(4)
22 Quality of life and health outcomes in asthma, COPD, and asthma-COPD overlap 257(12)
Christine F. McDonald
Don D. Sin
22.1 Introduction
257(1)
22.1.1 Discussion of clinical vignette
258(1)
22.2 Quality of life in asthma and COPD
258(1)
22.3 Clinical presentation of ACO
259(1)
22.4 Symptom burden and health status of ACO patients (versus those with COPD and those with asthma)
259(2)
22.5 Exacerbations in ACO patients
261(1)
22.6 Prognosis of asthma, COPD, and ACO patients: Trajectory of lung function decline for patients with asthma, COPD, and ACO
261(3)
22.7 Proposed management of ACO
264(1)
22.8 Morbidity and mortality in ACO
264(1)
References
265(4)
23 Asthma, COPD, and asthma-COPD overlap from the primary care physician perspective 269(12)
Mark L. Levy
23.1 Nature of primary care (general practice)
270(1)
23.2 Accurate diagnosis is important
270(2)
23.3 The asthma-COPD overlap (ACO)
272(1)
23.3.1 Definitions
272(1)
23.3.2 Differentiating asthma, COPD, and ACO in primary care
272(1)
23.4 Chronic management in primary care
272(2)
23.4.1 Education
273(1)
23.5 Monitoring and follow-up
274(1)
23.6 Lung function tests
275(1)
23.7 Routine review
276(2)
23.7.1 Recognizing risk
276(1)
23.7.2 Non pharmacological treatment
277(1)
23.7.3 Drug treatment
277(1)
23.7.4 Comorbidities
278(1)
23.8 Conclusions
278(1)
References
279(2)
Index 281
Dr. Jonathan A. Bernstein is professor of clinical medicine in the Department of Internal Medicine, Division of Immunology/Allergy



Section at the University of Cincinnati Medical Center and director of clinical research for the Division of Immunology. He is the



director of clinical research at the University of Cincinnati and is a Drug Information Association (DIA)-certified investigator. He has



extensive experience conducting multicenter and physician-initiated clinical therapeutic trials related to asthma, chronic obstructive



pulmonary disease, rhinitis, urticaria, hereditary, and angiotensin-converting enzymeinduced angioedema. He has published over 165



peer-reviewed articles and clinical reviews, and 35 chapters on a variety of relevant topics in allergy and clinical immunology. Dr.



Bernstein is actively involved in the University of Cincinnati Allergy Fellowship Training Program and in the education of residents and



medical students. He is a member of the board of directors for the American Academy of Asthma, Allergy, and Immunology. He is the



editor-in-chief of the Journal of Asthma and on the editorial board of the Journal of Allergy and Clinical Immunology, Annals of Allergy,



Asthma and Immunology, Allergy Asthma Proceedings, and Journal of Angioedema. Dr. Bernstein has been voted best doctor in



Cincinnati from 1999 to 2013 and ranked by U.S. News and World Report as being in the top 1% of doctors in his specialty. He is a



member of the University of Cincinnati Alpha Omega Alpha chapter.



Dr. Michael E. Wechsler is Director of the Asthma Program in the Division of Pulmonary, Critical Care & Sleep Medicine and Professor



of Medicine for National Jewish Health in Denver, CO. He also serves as Faculty Member for the Program in Placebo Studies at



Harvard Medical School in Boston, MA, and is on the Steering Committee of the (National Institutes of Health) NIH's Asthma Clinical



Research Network. He earned an AB in Biochemical Sciences magna cum laude from Harvard College, his medical degree from



McGill University in Montreal, and Masters in Medical Science from Harvard Medical School.
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