(COPD, chronic obstructive airways disease) a disease of adults, especially those over the age of 45 with a history of smoking or inhalation of airborne pollution, characterized by airflow obstruction that is not fully reversible. The disease has features of *emphysema, chronic *bronchitis, and asthmatic bronchitis. It is now diagnosed, according to the *GOLD guidelines, at different stages:
Stage 0: the presence of risk factors and symptoms (e.g. cough and wheeze) with normal *forced expiratory volume in 1 second (FEV1).
Stage 1: FEV1 is normal, but the ratio of FEV1 to forced *vital capacity (FVC) is less than 70%.
Stage 2: FEV1 is less than 80% but more than 50% of the predicted value for the patient’s age and height.
Stage 3: FEV1 less than 50% but more than 30%.
Stage 4: FEV1 less than 30% or the presence of chronic respiratory failure.
The guidelines for COPD recommend different treatment regimens for different stages. Although the response to inhaled corticosteriods is less for COPD than for asthma, these drugs, especially combined with inhaled long-acting beta agonists (e.g. *salmeterol), can improve quality of life and survival in stages 3 and 4. There is also a decrease in the number of acute exacerbations of COPD (AECOPD): increased sputum volume or purulence and/or breathlessness, with or without symptoms (e.g. cough, wheeze, chest pain, malaise, fever).... chronic obstructive pulmonary disease
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