Chronic Obstructive Pulmonary Disease (COPD) - It is defined as generally irreversible progressive chronic airflow obstruction. COPD is the 4th leading cause of death in the US. Some 14 million patients, 20% of adults, in the US have been diagnosed with one of the two sub-classifications of COPD, chronic bronchitis or emphysema.
Risk factors include smoking and exposure to smoke, occupational pollutants, family history, recurrent respiratory infections, and protease deficiencies. However, smoking is responsible for 80-90% of COPD cases.
Croup- Croup is a harsh, repetitive cough similar to the noise of a seal barking. The harsh, barking cough is the result of swelling around the vocal cords (larynx) and windpipe (trachea). When the cough reflex forces air through this narrowed passage, the vocal cords vibrate with a barking noise. Because children have small airways to begin with, those younger than age 5 are most susceptible to croup. Fluids, moist air and other self-care measures can speed recovery from croup. If you stay calm, you can quiet your child's cough so that everyone can get back to sleep.
Emphysema- When you have emphysema, some of the air sacs deep in your lungs have been damaged. When the bronchi become irritated, the normal elasticity of the air sacs and the walls of the airways are destroyed. People with emphysema need to forcefully blow the air out in order to empty the lungs. Forcing the air out in this way puts pressure on the airways from the outside, compresses them and causes them to collapse. The walls of the tiny air sacs may even tear. Excessive coughing may cause the airways to collapse as well.
Physical examination and history will suggest the possibility of COPD. Chest x-rays and pulmonary function tests help to confirm the diagnosis and exclude other possibilities such as tuberculosis or cancer. Treatments include lung reduction surgery, smoking cessation, and lung transplant. Symptomatic therapy is aimed as reducing bronchial-constriction and inflammation. Oxygen therapy and pulmonary rehabilitation are helpful in many patients. Influenza vaccine should be given yearly and the pneumococcal vaccine should be given once and again six years later. Preventative measures include smoking cessation, pulmonary rehabilitation, exercise, influenza vaccine, pneumococcal vaccine, nutritional supplementation.