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Chronic obstructive pulmonary disease COPD is a type of obstructive lung disease characterized by long-term breathing problems and poor airflow. Tobacco smoking is the most common cause of COPD, with factors such as air pollution and genetics playing a smaller role. Most cases of COPD can be prevented by reducing exposure to risk factors. As of , COPD affected about
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease COPD is a type of obstructive lung disease characterized by long-term breathing problems and poor airflow. Tobacco smoking is the most common cause of COPD, with factors such as air pollution and genetics playing a smaller role. Most cases of COPD can be prevented by reducing exposure to risk factors.
As of , COPD affected about The most common symptoms of COPD are sputum production, shortness of breath , and a productive cough. A chronic cough is often the first symptom to develop. When it persists for more than three months each year for at least two years, in combination with sputum production and without another explanation, it is by definition chronic bronchitis. This condition can occur before COPD fully develops. The amount of sputum produced can change over hours to days. In some cases, the cough may not be present or may only occur occasionally and may not be productive.
Some people with COPD attribute the symptoms to a "smoker's cough". Sputum may be swallowed or spat out, depending often on social and cultural factors. Vigorous coughing may lead to rib fractures or a brief loss of consciousness. Those with COPD often have a history of " common colds " that last a long time. Shortness of breath is often the symptom that most bothers people. In COPD, breathing out may take longer than breathing in.
Advanced COPD leads to high pressure on the lung arteries , which strains the right ventricle of the heart. COPD often occurs along with a number of other conditions, due in part to shared risk factors. An acute exacerbation of COPD is defined as increased shortness of breath, increased sputum production, a change in the color of the sputum from clear to green or yellow, or an increase in cough in someone with COPD.
The primary cause of COPD is tobacco smoke, with occupational exposure and pollution from indoor fires being significant causes in some countries. The primary risk factor for COPD globally is tobacco smoking. Poorly ventilated cooking fires, often fueled by coal or biomass fuels such as wood and dung, lead to indoor air pollution and are one of the most common causes of COPD in developing countries.
People who live in large cities have a higher rate of COPD compared to people who live in rural areas. Intense and prolonged exposure to workplace dusts, chemicals, and fumes increases the risk of COPD in both smokers and nonsmokers. A number of industries and sources have been implicated, including  high levels of dust in coal mining , gold mining , and the cotton textile industry , occupations involving cadmium and isocyanates , and fumes from welding.
Genetics play a role in the development of COPD. A number of other factors are less closely linked to COPD. The risk is greater in those who are poor, although if this is due to poverty itself or other risk factors associated with poverty, such as air pollution and malnutrition, is not clear. An acute exacerbation a sudden worsening of symptoms  is commonly triggered by infection or environmental pollutants, or sometimes by other factors such as improper use of medications.
COPD is a type of obstructive lung disease in which chronic, incompletely reversible poor airflow airflow limitation and inability to breathe out fully air trapping exist. The relative contributions of these two factors vary between people. This form of disease is called bullous emphysema. COPD develops as a significant and chronic inflammatory response to inhaled irritants.
Those who smoke additionally have Tc1 lymphocyte involvement and some people with COPD have eosinophil involvement similar to that in asthma. Part of this cell response is brought on by inflammatory mediators such as chemotactic factors. Other processes involved with lung damage include oxidative stress produced by high concentrations of free radicals in tobacco smoke and released by inflammatory cells, and breakdown of the connective tissue of the lungs by proteases that are insufficiently inhibited by protease inhibitors.
The destruction of the connective tissue of the lungs leads to emphysema, which then contributes to the poor airflow, and finally, poor absorption and release of respiratory gases. Narrowing of the airways occurs due to inflammation and scarring within them. This contributes to the inability to breathe out fully. The greatest reduction in air flow occurs when breathing out, as the pressure in the chest is compressing the airways at this time.
Some also have a degree of airway hyperresponsiveness to irritants similar to those found in asthma. Low oxygen levels , and eventually, high carbon dioxide levels in the blood , can occur from poor gas exchange due to decreased ventilation from airway obstruction, hyperinflation, and a reduced desire to breathe. This can also lead to insufficient ventilation , and eventually, low blood oxygen levels.
Both of these changes result in increased blood pressure in the pulmonary arteries , which may cause cor pulmonale. The diagnosis of COPD should be considered in anyone over the age of 35 to 40 who has shortness of breath , a chronic cough, sputum production, or frequent winter colds and a history of exposure to risk factors for the disease. Spirometry measures the amount of airflow obstruction present and is generally carried out after the use of a bronchodilator , a medication to open up the airways.
Evidence for using spirometry among those without symptoms in an effort to diagnose the condition earlier is of uncertain effect, so currently is not recommended. A number of methods can determine how much COPD is affecting a given individual. A chest X-ray and complete blood count may be useful to exclude other conditions at the time of diagnosis. COPD may need to be differentiated from other causes of shortness of breath such as congestive heart failure , pulmonary embolism , pneumonia , or pneumothorax.
Many people with COPD mistakenly think they have asthma. Most cases of COPD are potentially preventable through decreasing exposure to smoke and improving air quality. Keeping people from starting smoking is a key aspect of preventing COPD. In those who smoke, stopping smoking is the only measure shown to slow down the worsening of COPD. Some smokers can achieve long-term smoking cessation through willpower alone.
Smoking, however, is highly addictive,  and many smokers need further support. The chance of quitting is improved with social support, engagement in a smoking cessation program, and the use of medications such as nicotine replacement therapy , bupropion , or varenicline. A number of measures have been taken to reduce the likelihood that workers in at-risk industries—such as coal mining, construction, and stonemasonry—will develop COPD.
Both indoor and outdoor air quality can be improved, which may prevent COPD or slow the worsening of existing disease. A number of developed countries have successfully improved outdoor air quality through regulations. This has resulted in improvements in the lung function of their populations. One key effort is to reduce exposure to smoke from cooking and heating fuels through improved ventilation of homes and better stoves and chimneys.
Using alternative energy sources such as solar cooking and electrical heating is also effective. Using fuels such as kerosene or coal might be less bad than traditional biomass such as wood or dung. No cure for COPD is known, but the symptoms are treatable and its progression can be delayed. Pulmonary rehabilitation is a program of exercise, disease management, and counseling, coordinated to benefit the individual.
The optimal exercise routine, use of noninvasive ventilation during exercise, and intensity of exercise suggested for people with COPD, is unknown. Being either underweight or overweight can affect the symptoms, degree of disability, and prognosis of COPD. People with COPD who are underweight can improve their breathing muscle strength by increasing their calorie intake. Supplemental nutrition may be useful in those who are malnourished. Inhaled bronchodilators are the primary medications used,  and result in a small overall benefit.
In those with mild disease, short-acting agents are recommended on an as needed basis. Some feel the evidence of benefits is limited,  while others view the evidence of benefit as established. Two main anticholinergics are used in COPD, ipratropium and tiotropium. Ipratropium is a short-acting agent, while tiotropium is long-acting. Tiotropium is associated with a decrease in exacerbations and improved quality of life,  and tiotropium provides those benefits better than ipratropium.
Corticosteroids are usually used in inhaled form, but may also be used as tablets to treat and prevent acute exacerbations. While inhaled corticosteroids ICSs have not shown benefit for people with mild COPD, they decrease acute exacerbations in those with either moderate or severe disease. Long-term antibiotics , specifically those from the macrolide class such as erythromycin , reduce the frequency of exacerbations in those who have two or more a year.
For people with COPD, the use of cardioselective heart-specific beta-blocker therapy does not appear to impair respiratory function. For those with very severe disease, surgery is sometimes helpful and may include lung transplantation or lung volume-reduction surgery ,  which involves removing the parts of the lung most damaged by emphysema, allowing the remaining, relatively good lung to expand and work better.
Acute exacerbations are typically treated by increasing the use of short-acting bronchodilators. Excessive oxygen; however, can result in increased CO 2 levels and a decreased level of consciousness. Corticosteroids by mouth improve the chance of recovery and decrease the overall duration of symptoms. For people with type 2 respiratory failure acutely raised CO 2 levels non-invasive positive pressure ventilation decreases the probability of death or the need of intensive care admission.
COPD usually gets gradually worse over time and can ultimately result in death. The rate at which COPD worsens varies with the presence of factors that predict a poor outcome, including severe airflow obstruction, little ability to exercise, shortness of breath, significant underweight or overweight, congestive heart failure , continued smoking, and frequent exacerbations. Between and the number of deaths from COPD decreased slightly from 3. In England, an estimated 0. In the most socioeconomically deprived parts of the country, one in 32 people were diagnosed with COPD, compared with one in 98 in the most affluent areas.
The terms chronic bronchitis and emphysema were formally defined in at the CIBA guest symposium and in at the American Thoracic Society Committee meeting on Diagnostic Standards. Early descriptions of probable emphysema include: Bonet of a condition of "voluminous lungs" and in by Giovanni Morgagni of lungs which were "turgid particularly from air".
In Charles Badham used "catarrh" to describe the cough and excess mucus in chronic bronchitis. He noted that they did not collapse as usual because they were full of air and the airways were filled with mucus. In , John Hutchinson invented the spirometer , which allowed the measurement of vital capacity of the lungs. However, his spirometer could measure only volume, not airflow. Tiffeneau and Pinelli in described the principles of measuring airflow. In , Dr.
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Antonyms for carbon dating at Synonyms. Synonyms for carbon dating at Thesaurus. Dictionary and Word of the Day. Synonyms for radio carbon-dating at Thesaurus. Radiocarbon dating definition, the determination of the age of objects of organic origin by measurement of the radioactivity of their carbon content.
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Scientists from Oxford University in England have discovered that the written use of the zero is years older than previously thought. The scientists used carbon dating to trace the symbol's origins to a famous ancient Indian scroll called the Bakhshali Manuscript.
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Absolute Dating Determining age on a specific time scale, such as a years B.
A process for determining the age of an object by measuring the amount of a given radioactive material it contains. If one knows how much of this radioactive material was present initially in the object by determining how much of the material has decayed , and one knows the half-life of the material, one can deduce the age of the object. The simple days of immediately understanding what SWF means are far behind us. Online dating has made acronyms more inscrutable—and more fun—than ever.
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A right-facing swastika may be described as "clockwise" The arms are of varying width and are often rectilinear but need not be. Only in modern use are the exact proportions considered important: The ubiquity of the swastika has been explained by three main theories: Buddhism in particular enjoyed great success, spreading eastward and taking hold in southeast Asia, China, Korea and Japan by the end of the first millennium. The use of the swastika by the indigenous Bn faith of Tibet, as well as syncretic religions, such as Cao Dai of Vietnam and Falun Gong of China, is thought to be borrowed from Buddhism as well.
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