Hello. I'm Omar Usmani.
I'm a Reader in Respiratory Medicine at
Imperial College London and a Consultant Physician at the Royal Brompton Hospital.
I'm going to be talking about updates in Chronic Obstructive Pulmonary Disease, COPD,
particularly those in the last two years that have had an influence on
our clinical practice and may also help us guide research in the future years.
And this is my faculty disclosure and I wanted to emphasize that I have
no shares in any of the company and I have
no relationship of any kind with the tobacco industry.
So, I will review the anatomy and the pathology,
and how that relates to the physiology and importantly,
how that determines our management and treatment and
pharmacological approach of patients with COPD in the clinic.
So, I will review five key areas: clinical characteristics,
the Pathophysiology of patients with COPD,
how we're assessing the lungs and novel methods of assessing
the lungs that have appeared over the last few years,
the new disease classifications we have seen particularly this year, and also,
how that reflects on our new approach to
the therapeutic management of patients with COPD.
So, this year, we have seen the Global Initiative of
Obstructive Lung Disease or GOLD update their document.
And there are five key points related to COPD.
The first that we are aware of is that COPD is
a preventable and treatable disease that is
characterized by persistent respiratory symptoms.
Importantly, is point two,
and that the symptoms of dyspnea, cough,
and sputum production may actually be under-reported,
and a key point for us to reflect on this is our ability
to assess patients with COPD and find these patients,
not just in secondary care, but also primary care and using
Spirometry in an effective manner to find these patients.
The third point we see is that certainly
tobacco smoking is an important risk factor for COPD,
but a lot of research over the last few years has shown that biomass fuel exposure
and air pollution certainly may contribute to the manifestation of patients with COPD.
We also need to realize that COPD can be punctuated by periods of
acute worsening of respiratory symptoms called
exacerbations and we will pick up on this a little bit later.