Disease Knowledge Centres

• Respiratory - Disease Topic Overview

  Respiratory medicine is the medical specialty that focuses on the study of the respiratory system, and on the diagnosis and the treatment of diseases of the lungs and bronchi.

  In Europe, and worldwide, respiratory diseases are a leading cause of morbidity and mortality.¹ Overall, in terms of incidence, prevalence, cost and mortality, they are placed second, behind cardiovascular disease.¹ In 2003, the total financial cost of lung disease in Europe was estimated at 102 billion Euros.¹ The most common respiratory diseases are; lung cancer, chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and tuberculosis.¹

  Asthma and COPD are the most common chronic respiratory diseases in adults in Europe.² COPD is a set of chronic respiratory diseases affecting bronchial tubes, characterised by persistent obstruction of the airways, and accompanied by emphysema and/or chronic bronchitis.³ The prevalence of COPD is steadily rising worldwide due to the increased consumption of tobacco and an aging population.⁴

  In 90% of cases, smoking is responsible for the development of respiratory diseases and thus represents the main risk factor.² However, other factors appear to be involved but are insufficiently evaluated. These include; domestic and atmospheric pollution⁵, dietary habits⁶ and the level of physical activity.⁷ Studies are needed to understand the mechanisms involved, identify risk factors and genetic predisposition, and to develop new strategies for prevention and treatment of respiratory diseases, as in the case of COPD.⁸

  1. European Respiratory Society. European lung white book. ERSJ Ltd, 2003 : 182 pages.
  2. World Health Organization. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. WHO Press. 2007 : available online.
  3. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003, 281-285.
  4. Halbert R. J. et al. Global burden of COPD: systematic review and meta-analysis. European Respiratory Journal. March 2006 ; 28 : 523-532.
  5. Schikowski T. et al. Long-term air pollution exposure and living close to busy roads are associated with COPD in women. Respiratory Research. December 2005 ; 6 : 152.
  6. Hu G. et al. Antioxidant nutrients and pulmonary function: The third national health and nutrition examination survey (NHANES III). American Journal of Epidemiology. 2000 ; 151 (10) : 975-981.
  7. Garcia-Aymerich J. et al. Physical activity and clinical and functional status in COPD. Chest. March 2009 ; 136 : 62-70.
  8. Calverley P.M. et al. Chronic obstructive pulmonary disease. Lancet. September 2003 ; 362 (9389) : 1053-61.

• COPD

  

  Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease of the respiratory system resulting in decreased lung function, which is a growing cause of morbidity and mortality worldwide. It has been estimated by The WHO Global Burden of Disease project that COPD was the fourth leading cause of death in 2004 and predicts that by 2030 it will be the third.¹ However it is thought that the current prevalence is an underestimate, due to a lack of awareness among primary care physicians.

  The three main symptoms of COPD are dyspnoea (breathlessness), cough and sputum production.² In addition to these symptoms, many patients also experience mild to moderate pulmonary hypertension, cor pulmonale, weight loss and a general deterioration in their feeling of well-being.^3-5

  Diagnosis of COPD can be made using a combination of different methods; patient history, physical examination, airflow measurements, chest X-ray, and electrocardiogram.²

  This progressive disease has no cure; however treatments for COPD are widely used to reduce the symptoms. Treatment guidelines outline the available treatments for specific stages of COPD.²

  Enter the COPD Knowledge Centre

  What's in the COPD Knowledge Centre?

  • Respiratory System Overview
  • Structure of the Respiratory System
  • Breathing
  • Respiratory Volumes
  • Understanding COPD
  • Definition of COPD
  • Epidemiology
  • Process and Pathophysiology
  • Risk Factors
  • Symptoms
  • Staging COPD
  • Course of Disease
  • Diagnosis of COPD
  • Medical History
  • Physical Examination
  • Airflow Measurement
  • Chest X-ray
  • Arterial Blood Gas Measurements
  • Electrocardiogram
  • Differentiating COPD from Asthma
  • Importance of Differential Diagnosis
  • Alpha-1 Antitrypsin Deficiency Screening
  • Treatment of COPD
  • Bronchodilators
  • Anti-Inflammatory Drugs
  • Combination of Bronchodilators
  • Inhalation Devices
  • Treatment Guidelines
  • Resources

  ---

  References:
  1. WHO The global burden of disease: 2004 update. Part 2 – Causes of death. Available at: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf (Accessed 11 November 2011).
  2. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2010). Available at: http://www.goldcopd.com/ - (accessed 11 November 2011).
  3. Rennard S, Decramer M, Caverley PMA et al. Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J 2002; 20: 799-805.
  4. Kumar P and Clark M (Eds.) Chapter 13 – Cardiovascular disease. In: Clinical Medicine 6th ed. Philadelphia, PA: Elsevier Saunders, 2005.
  5. Agustí A. Systemic effects of chronic obstructive pulmonary disease – what we know and what we don't know (but should). Proc Am Thorac Soc 2007; 4: 522-525.

  Read Less

  View Knowledge Centre

  Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease of the respiratory system resulting in decreased lung function, which is a growing cause of morbidity and mortality worldwide. It has been estimated by The WHO Global Burden of Disease project that COPD was the fourth leading cause of death in 2004 and predicts that by 2030 it will be the third.

  Read More

  View Knowledge Centre

• Cystic Fibrosis

  

  Patients with Cystic Fibrosis (CF) develop a wide range of clinical consequences and experience varying degrees of disease severity. Regardless of its clinical presentation, the basic problem of the disease is the same - an abnormality in the glands that produce or secrete sweat and mucus.

  Read More

  View Knowledge Centre

  Cystic Fibrosis (CF) is caused by a defect in a gene known as the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This gene makes a protein that controls the movement of ions, such as chloride, and water, across cell membranes.^1,2

  CF is caused by hundreds of different gene mutations. The most common mutation is delta F508, usually written as ΔF508.³

  Thick, sticky mucus causes most of the symptoms of CF. The most common symptoms of CF include:⁴

  • Persistent cough, often with phlegm
  • Frequent lung infections
  • Wheezing or shortness of breath
  • Very salty-tasting skin
  • Poor growth or weight gain despite a good appetite
  • Greasy, bulky, foul-smelling stools Stomach pain and discomfort caused by too much gas in the intestines
  • Dehydration

  Because CF is a multisystem disease, treatment must be multidisciplinary, with a team of healthcare professionals providing comprehensive management of the patient.

  Current therapy for CF is targeted at prevention and treatment of exacerbations. Care at the CF center includes inpatient as well as outpatient clinical care.⁵

  Enter the Cystic Fibrosis Knowledge Centre

  What's in the Cystic Fibrosis Knowledge Centre?

  • Definition
  • Causes of Cystic Fibrosis (CF)
  • Physiologic Consequences
  • Incidence and Prevalence
  • Clinical Consequences
  • Effects on the Respiratory System
  • Effects on the Digestive system
  • CF- related Diabetes Mellitus
  • Effects on the Heart
  • Other Effects of Cystic Fibrosis
  • Early screening and Diagnosis
  • Clinical Manifestation
  • Multiple Organ Involvement
  • Progression of Respiratory Clinical Features
  • Complications of Lung Disease
  • Other Symptoms Affected by CF
  • Diagnostic Approach
  • Lung Function Tests
  • Spirometry Testing
  • Pulmonary Function Tests
  • Management of Cystic Fibrosis
  • Nutritional Support
  • Lung Management
  • Management of the Digestive System
  • Management of the Gallbladder and Liver
  • Management of the Pancreas
  • Prognosis
  • Antibiotic Therapy
  • Emerging Pathogens
  • Anti-inflammatory Therapy
  • Severe Disease
  • Resources - FAQ

  ---

  References

  1. Boucher RC. Cystic Fibrosis. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL et al., editors. Harrison's Internal Medicine. 16th ed. New York: McGraw-Hill; 2005. p. 1-9.
  2. Aitken M, Fiel SB, Stern RC. Cystic Fibrosis: Respiratory Manifestations. In: Taussig LM, Landau LI, editors. Pediatric Respiratory Medicine. 1st ed. St. Louis: Mosby, Inc.; 1999. p. 1-47.
  3. Farrell PM, Kosorok MR, Rock MJ, et al. Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. PEDIATRICS 2001;107:1-13.
  4. National Heart Lung and Blood Institute. What Is Cystic Fibrosis. US Department of Health and Human Services National institute of Health 2005;1.
  5. Smyth RL. Diagnosis and management of cystic fibrosis. Arch Dis Child Ed Pract 2005;90:1-6.

  Read Less

  View Knowledge Centre

• NSCLC

  

  The World Health Organisation estimates that globally there were 7.6 million deaths caused by cancer worldwide in 2008, and expects this figure to exceed 11 million by 2030 if the current trends continue. Lung cancer was the most common; accounting for 1.4 million deaths annually¹.

  Lung cancer can be divided into two forms; Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer. NSCLC is the most common form accounting for 80% of all cases². It is not one single type of cancer; instead it is a group of cancers that have been grouped together because approaches to diagnosis, staging, prognosis and treatment are similar. This group is composed of squamous cell carcinomas, adenocarcinomas and large cell carcinomas².

  During 2011, four symposia have been hosted by AstraZeneca to discuss the role of EGF Receptor Tyrosine Kinase Inhibitors on the treatment of EGFR+ tumours in people with advanced stage lung cancer. These symposia were held during four conferences; The 7th Asia Pacific International Academy of Pathology Congress (APIAP 2011), the 14th World Conference on Lung Cancer (WCLC 2011), the 23rd European Congress of Pathology of the European Society of Pathology (ECP 2011), and the 2011 European Multidisciplinary Cancer Congress (ECCO-ESMO 2011).

  Read More

  View Knowledge Centre

  The World Health Organisation estimates that globally there were 7.6 million deaths caused by cancer worldwide in 2008, and expects this figure to exceed 11 million by 2030 if the current trends continue. Lung cancer was the most common; accounting for 1.4 million deaths annually¹.

  Lung cancer can be divided into two forms; Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer. NSCLC is the most common form accounting for 80% of all cases². It is not one single type of cancer; instead it is a group of cancers that have been grouped together because approaches to diagnosis, staging, prognosis and treatment are similar. This group is composed of squamous cell carcinomas, adenocarcinomas and large cell carcinomas².

  During 2011, four symposia have been hosted by AstraZeneca to discuss the role of EGF Receptor Tyrosine Kinase Inhibitors on the treatment of EGFR+ tumours in people with advanced stage lung cancer. These symposia were held during four conferences; The 7th Asia Pacific International Academy of Pathology Congress (APIAP 2011), the 14th World Conference on Lung Cancer (WCLC 2011), the 23rd European Congress of Pathology of the European Society of Pathology (ECP 2011), and the 2011 European Multidisciplinary Cancer Congress (ECCO-ESMO 2011).

  Click here to view webinars from these symposia on our NSCLC symposia resource.

  EGFR mutation testing: guiding treatment for advanced non-small-cell lung cancer (NSCLC) was an AstraZeneca sponsored symposium held during APIAP 2011 in Taipei, Taiwan on 20th-24th May 2011. Webinars of the symposium presentations from two key speakers; Dr Kaoru Kubota and Dr Manuel Salto-Tellez can be viewed here.

  The symposia entitled “EGFR mutation-positive advanced NSCLC: optimising treatment sequences based on molecular biology” was held during WCLC 2011 in Amsterdam, The Netherlands on 3rd-7th July. Five presentations from the major speakers (Professor Egbert Smit, Professor Tony Mok, Dr Pasi Jänne, and Professor Jean-Yves Douillard) at this CME symposium are available to watch here.

  EGFR mutation testing in advanced NSCLC: best practice and future perspectives was held during ECP 2011 on 29th August 2011 in Helsinki, Finland. Webinars from this symposium were presented by Dr Nicola Normanno, Professor Keith Kerr, and Dr Marc Denis and can be viewed here.

  The symposium entitled ‘Advanced NSCLC: current concepts and future development of targeted treatment’ was held during ECCO-ESMO 2011 on 25th September 2011 in Stockholm, Sweden. Presentations from four key speakers; Dr Martin Reck, Professor Fabrice Barlesi, Dr James Yang and Dr Bruce Johnson, are available to view here.

  ---

  References:

  1. WHO. Cancer Fact Sheet [http://www.who.int/en/]. Geneva: WHO; updated 2011 February; cited 2011 September 22]. Available from: http://www.who.int/mediacentre/factsheets/fs297/en/

  2. NICE. Clinical Guidelines 24. National Institute of Clinical Excellence. February 2005; All Pages

  Read Less

  View Knowledge Centre

• Third Party Website - Asthma and COPD

  

  Asthma is a disorder defined by its clinical, physiological, and pathological characteristics. The main physiological feature of asthma is episodic airway obstruction characterized by expiratory airflow limitation. The dominant pathological feature is airway inflammation, sometimes associated with airway structural changes.

  Read More

  View Website

  Understanding Asthma

  Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role.

  The chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

  Learn more about Asthma…by visiting our website

  
  

  Understanding Chronic Obstructive Pulmonary Disease (COPD)

  COPD’s pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.

  Learn more about COPD…

  
  

  Asthma Care

  Asthma is a chronic disorder with significant impacts on patients, their family and society. Although there is no cure for asthma, appropriate management often leads to control of the disease.

  Learn more about Asthma Care…

  
  

  COPD Care

  COPD is a progressive disease: lung function is expected to worsen over time. Therefore, adherence to therapy and a continuous assessment of the pathology progression are important.

  Learn more about COPD Care…

  
  

  Asthma Therapy

  Asthma is a chronic disorder with significant impacts on patients, their family and society. Although there is no cure for asthma, appropriate management often leads to control of the disease.

  Learn more about Asthma Therapy…

  
  

  COPD Therapy

  COPD is a progressive disease: lung function is expected to worsen over time. Therefore, adherence to therapy and a continuous assessment of the pathology progression are important.

  Learn more about COPD Care…

  
  

  Resources

  A wealth of useful resources including a slide sharing portal, device area, expert’s tips, conference and events calendar and more.

  Read Less

  View Website

Latest Multi Media

Respiratory Drug Data - A-Z English

Drug Updates

Latest Drug News

Latest Social Media

Latest Clinical Trials

Latest Journal Publications

Latest Apps