> Chronic bronchitis: 4 types of patients, for each one his care

in order To answer more comprehensive have been approved for the new guidelines prepared by the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The work will beà presented in Modena on the 28th of February on the occasion of the International Meeting on asthma, COPD and concomitant diseases.

The news è important becauseé the chronic obstructive pulmonary disease (COPD) is a pathology quite frequent. According to data released by the Who, is in fact the fourth leading cause of death in the world.

it Is a disease lurking that is often ignored becauseé be convinced that they can live with the symptoms, maybe you dà blame età or some cigarettes too. Such neglect, however, could lead to major problems such as severe respiratory insufficiency that makes the daily life more and moreù sure.

Therefore, the new guidelines change substantially the approach to the pathology. Include three important steps to identify the disease, one the patient, the other doctors.

the path to The diagnosis port così to the identification of four types of sick, four different categories, which allow you to fine-tune the care più appropriate.

In the first step should be the patient to move. The cough, the phlegm and wheezing can easily become symptoms which is suitable perché “unfortunately, the awareness of COPD is very poor: if it were made all of a spirometry, you will find a good 10-20 percent of people do not suspect at all of being so”, said Leonardo Fabbri, co-author of the guidelines and chairman of the Congress.

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Then the first move of the patient is the one to go to the doctor and fill in the questionnaires, CAT and mMRC. If the responses are identified risk factors is performed in a spirometry test, the second step.

an examination is simple and non-invasive that allows to the doctor (even the basic one would do) to measure the abilityà of the respiratory of the patient to arrive at a diagnosis.

For patients with a capacità respiratory compromised c’è the third step. Rebuild cioè the history of the disease in order to understand the frequency of crises and exacerbations that often lead the hospital to be resolved.

Giorgio Walter Canonica, vice president of Project LIBRA and the director of the Clinic of Respiratory Diseases and Allergology of the università of Genoa, has explained that  “studies have shown that some patients tend to have more relapses, regardless of the severityà of the symptoms: are subject to greater risk, recognize them serves to intervene in a più incisive”

regarding the treatment, the objective of the guidelines is that not to proceed with the più to attempts, as in the past, but to know in advance the type of patient who respond toà to a specific treatment.

Thanks to the diagnostic path elaborated in the guidelines emerge così the four subtypes of patients. For each one of them have been shown the drugs of first choice and all the possible therapeutic associations.

In this way, it is possible to avoid “overdoing it” when it is not necessary “and to use all the weapons available in the cases più serious, by changing the therapy,” explained Fabbri.

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February 2012