Emphysema

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EMPHYSEMA
(CHRONIC OBSTRUCTIVE
PULMONARY DISEASE)

EMPHYSEMA
-is a condition of the lung characterized by abnormal, permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls. This over-inflation results from a breakdown of the walls of the alveoli, which causes a decrease in respiratory function and breathlessness. In emphysema, the lungs loose elasticity and are unable to fully expand and contract. This occurs because the air sacs cannot completely deflate, thus unable to fill with fresh air for adequate ventilation. Emphysema in children is usually caused by congenital abnormalities of the lung and alpha-1 antitrypsin deficiency.In emphysema, the patient can breathe in but breathing out is difficult and inefficient. The seriousness of emphysema varies greatly. Some persons with emphysema never reach a stage of incapacity and go through life with relatively little inconvenience, while in others, emphysema worsens until final degeneration of the ability to breath occurs.

PREVALENCE OF EMPHYSEMA
-prevalence generally refers to the number of patients suffering with a condition at any particular time, while incidence rate refers to newly diagnosed cases or annual rates. In the US, around 2 million persons are managing emphysema or about 17 per 1000 population or 1 in 136, with a lifetime incidence risk of 1.4%. Around the world, China and India lead in emphysema prevalence with nearly 10 million and 8 million cases respectively; nations with approximately 1 million emphysema patients include Pakistan, Indonesia, Brazil, Russia, Japan, and Bangladesh; nations with emphysema prevalence rates of approximately 1/2 million include Germany, Italy, UK, Iran, Thailand, Egypt, Vietnam, and the Philippines.

ECONOMIC BURDEN OF EMPHYSEMA
Emphysema affect approximately 1.9 million Americans and is one of the fastest growing causes of morbidity and mortality in the USA. Worldwide, the social burden of chronic obstructive pulmonary disease (COPD), in terms of days lost to disability, is expected to increase from twelfth to fifth among all chronic diseases from 1990–2020. Given the prevalence of this disease and the duration of illness for those affected, medical expenditures for treating COPD and the indirect costs of morbidity can represent a substantial economic and social burden for societies and for public and private payers. More importantly, because emphysema is highly prevalent, new treatments that are widely adopted for this condition, even if inexpensive at the individual patient level, can have a tremendous impact on the overall economic burden of the disease. In today’s cost-conscious environment, evaluating the economic impact of new therapies has become nearly as important as understanding their clinical impact. As healthcare costs continue to escalate, more emphasis is being placed on understanding the economic implications associated with disease processes and their treatments. Unfortunately, very little economic information concerning COPD is available, particularly outside of a few developed Western nations. Given the rising prevalence of COPD worldwide, it is urgently necessary to understand its economic burden and to provide more robust evaluations of healthcare interventions designed to reduce its incidence and impact. Studies designed for making decisions and policy must apply robust methods and report results in a standardized fashion.

FACTORS THAT INFLUENCE DISEASE DEVELOPMENT AND PROGRESSION

Smoking. The primary risk factor for the development of emphysema is tobacco abuse. Cigarette smoke contributes to this disease process in 2 ways. It destroys lung tissue, which is the cause of the obstruction, and it causes inflammation and irritation of airways that can cause the disease to get worse. It is not possible to predict in any individual smoker who will develop emphysema, how long it will take, or...
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