**14. References**


**7** 

*USA* 

, Amisha Jain2,

**Current Overview of COPD with** 

Shantanu Rastogi1,

Sudeepta Kumar Basu1 and Deepa Rastogi3

**Special Reference to Emphysema** 

*1Department of Pediatrics, Maimonides Medical Center, Brooklyn NY 2Department of Pediatrics, Winthrop University Hospital, Mineola NY 3Division of Respiratory and Sleep Medicine, Childrens Hospital at Montefiore, Albert Einstein College of Medicine, Bronx NY* 

Pulmonary emphysema is a chronic disease defined pathologically as an abnormal permanent destruction and enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls without predominant fibrosis. Emphysema frequently occurs in overlapping association with chronic bronchitis which is clinically defined as chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough have been excluded. Previously, emphysema and chronic bronchitis was regarded as distinct entities and grouped under the

COPD is a collection of heterogeneous conditions characterized by persistent expiratory airflow limitation. There is significant overlap and co-existence of conditions like emphysema, chronic bronchitis and asthma(see Figure 1). COPD is heterogeneous clinically and at a pathophysiologic level and its recognition, has led to new initiatives to categorize and define COPD and its subsets.(American Thoracic Society[ATS],1995,2010;British

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) does not emphasise on the distinction between emphysema and chronic bronchitis (GOLD,2006). This report produced by the National Heart, Lung, and Blood Institute (NHLBI) and the World Health Organization(WHO) emphasised on the common feature of altered lung function recognizes both the systemic nature and the heterogeneity of COPD and defines it as

"Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation

umbrella term Chronic obstructive pulmonary disease(COPD).

**1. Introduction** 

Thoracic Society[BTS],1997)

Corresponding Author

follows:

 

