Massachusetts Medical Society's Physician Focus

October 2011

Common Respiratory Conditions

PROGRAM HIGHLIGHTS:

  • Respiratory conditions include such illnesses as chronic obstructive pulmonary disorder (COPD), pneumonia, tuberculosis, and asthma.

  • COPD, which includes chronic bronchitis and emphysema, is the third leading cause of death in America.

  • Tuberculosis, while on the decline in the U.S. with less than 12,000 cases annually, affects nine million people around the world each year.

  • Asthma is widespread in the U.S. and increasing every year; it affects about 1 in 12 adults and 1 in 10 children.

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Respiratory conditions such as chronic pulmonary obstructive disorder, pneumonia and asthma affect millions of people around the world and present major challenges to public health as well as personal health. COPD, for example, is a life-threatening lung disease which affects men and women equally and claims close to 125,000 lives each year in the U.S.

The details of these illnesses were the topics of discussion in the October edition of Physician Focus with the Massachusetts Medical Society, with host and primary care physician Mavis Jaworski, M.D., interviewing Ronald Sen, M.D., a primary care physician, specialist in pulmonary and critical care medicine, and Chief of the Division of Pulmonary Disease at Melrose-Wakefield Hospital in Melrose, Massachusetts.

The discussion began with a description of how the respiratory system works, followed by capsule presentations of individual conditions.

“COPD is very common condition,” said Dr. Sen, “and a lot of people have the idea that everyone who smokes ultimately gets COPD or lung cancer, and that’s fortunately not true. Although a small percentage of people who actually smoke get chronic lung disease, it’s certainly devastating for many of them.” Smoking is the primary risk factor for COPD, which include emphysema and chronic bronchitis, with approximately 80-95 percent of COPD deaths caused by smoking.

With regard to asthma, that condition is dramatically increasing, said Dr. Sen, “to the point where in some parts of the country over 10 percent of Americans have asthma and it’s increasing in children. No one really understands why that is, although there have been many theories. I try to consider asthma not as a monolith, but asthma comes in many different flavors – allergy or sinus related, acid reflux or job related – so there’s a lot to identify what the individual trigger is for patients so they might have fewer episodes.”

Tuberculosis is an historically important disease, said Dr. Sen, and remains one of the most common conditions throughout the world (causing two million deaths and sickening nine million every year), and it’s not likely to be eradicated. While it’s not widespread in the U.S., it tends to occur more in inner cities and with prison and immigrant populations.

The doctors were quick to point out that patients should recognize the signs and symptoms of respiratory conditions. According to Dr. Sen, there are six hallmark signs: cough, shortness of breath, wheezing, coughing up blood, sputum production, and chest pain. Patients who experience any of these should see their primary care physician promptly.

And one of the most important preventive measures to avoid respiratory conditions? Don’t smoke.

Watch the accompanying video for the full discussion, including more conversation on asthma and identification of its triggers, COPD, how reflux disease can affect the lungs, and the use of antibiotics in treating these conditions.

Text:
MMS/Richard Gulla

ADDITIONAL RESOURCES

American Lung Association

American College of Chest Physicians

Pulmonary Hypertension Association

National Institutes of Health

Global Initiative for Chronic Obstructive Lung Disease

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Common Respiratory Conditions
PSA - 60 sec.


From left, Mavis Jaworski, M.D., and
Ronald Sen, M.D.
hi-res photo
promo slide