GOLD and COPD: Definition, stages, and more - Medical News Today
GOLD and COPD: Definition, stages, and more - Medical News Today |
| GOLD and COPD: Definition, stages, and more - Medical News Today Posted: 28 Apr 2021 12:00 AM PDT  The Global Initiative for Chronic Obstructive Lung Disease (GOLD) is an organization that produces reports and guidelines on lung disease. Chronic obstructive pulmonary disease (COPD) is the term for a group of lung diseases that can result from smoking. People with COPD can experience a wide range of symptoms due to the condition. GOLD provides grades and categories to classify the severity and type of COPD symptoms. This information helps doctors determine the best treatment options for people with COPD. This article discusses what GOLD is, how its categorization systems work, and how it can guide treatment. GOLD is an acronym for the Global Initiative for Chronic Obstructive Lung Disease. It is an international organization that works with public health workers and healthcare professionals to raise awareness around COPD. The Centers for Disease Control and Prevention (CDC) say that COPD refers to a group of related lung diseases that cause blocked airflow on expiration and breathing-related problems. The organization notes that at least 16 million people in the United States have a COPD diagnosis, with more likely to have the condition without being aware of it. COPD is the fourth leading cause of death in the U.S. The National Heart, Lung, and Blood Institute (NHLBI) describes COPD as a progressive disease, which means that the condition will worsen over time. However, treatment can improve a person's quality of life and slow the disease progression. GOLD creates an annual "GOLD Report" for healthcare workers, officials, and any other interested parties. The 2021 GOLD Report is available for download here. GOLD uses research findings and committees of experts to inform its reports. It aims to improve understanding of COPD, providing guidance on the latest treatment options and diagnostic criteria for the condition. A 2012 paper by GOLD recommends that doctors use spirometry for the diagnosis of COPD. Spirometry is useful for avoiding misdiagnosis and determining the severity or stage of COPD. When diagnosing COPD, a doctor should assess the:
An updated 2019 paper compared the differences between the 2011 and 2017 GOLD standards of COPD staging. These stages can guide healthcare professionals' treatment decisions. The GOLD Report breaks down the classifications and stages of COPD into two categories. The first category consists of four COPD grades and bases the classification on forced expiratory volume (FEV). A doctor determines a person's FEV score by testing how much air volume they can breathe out in a set number of seconds. They typically opt for FEV1 scores, which use just 1 second for this test. The grades in this category look at the FEV1 score as a percentage of the predicted score. They are:
The GOLD Report also uses another classification system, which involves lettered groups. The letter indicates the person's medical history and scores on other tests of symptom severity. These include COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) scores, both of which show the impact of COPD on daily living. The letter categories include:
People with Grade 1 and Category A COPD typically have the fewest symptoms and the best outlook. In a 2014 study, researchers found that the lettered categories were a better predictor of quality of life and COPD costs than the numbered grades. For example, someone with Grade 1 and Category D COPD may have a lower quality of life and higher treatment costs than someone with Grade 2 and Category A COPD. The GOLD categories can guide treatment by outlining symptom severity and the impact of COPD on quality of life. According to the American Lung Association, treatment approaches will vary greatly among individuals. Some common treatments for COPD include:
According to the NHLBI, the most important step for avoiding COPD is to avoid or quit smoking. The institute also recommends avoiding irritants, such as:
In those who have received a COPD diagnosis, taking medications as a doctor has prescribed them can help control the symptoms and minimize the chance of exacerbations. A person should always talk with a doctor if they experience new or worsening COPD symptoms. The doctor can assess the person's condition and determine the best treatment options. People without a diagnosis should be aware of the early signs of COPD. These include some of the common symptoms of the condition, such as:
GOLD is an organization that raises awareness of the treatment, prevention, and management of COPD. It provides grades and categories to help doctors diagnose and treat people with COPD. There may be many people with COPD who have not received a diagnosis. Anyone with signs of COPD should speak with a doctor. Those with a diagnosis should seek medical advice if their treatment plan is proving ineffective. |
| Toddler Chest Congestion: Causes and Treatment - Verywell Health Posted: 13 Apr 2021 12:00 AM PDT /GettyImages-96465256-5b979adc7b7848508b7c7a08d82ddd27.jpg) Chest congestion is a common symptom of a number of conditions that affect toddlers, from a virus such as a common cold to a genetic condition such as cystic fibrosis. The additional symptoms that come with chest congestion and the course of treatment depend on the cause of the congestion and the characteristics of the child. Your child's healthcare provider can help find a diagnosis and suggest treatment options. StephanieFrey / Getty Images Symptoms and CausesChest congestion is a symptom of a condition, not a condition unto itself. It can have several different causes and is usually accompanied by other symptoms like a cough. ColdAs the name states, the common cold is common. Colds are caused by respiratory viruses and are the number one reason for doctor calls and visits. Healthy children experience about six colds per year, and colds are rarely serious. In the 5 to 10% of children who develop a secondary health problem due to a cold, the condition is usually an ear or sinus infection. Normal symptoms of colds include:
Symptoms of a secondary problem that prompt a visit to a healthcare provider include:
What Kind of Cough Is It?Coughs are a common symptom of many illnesses, but the type of cough makes a difference. Your toddler's healthcare provider is likely to ask you to describe the cough. Does it sound:
Acute BronchitisOften called a "chest cold", acute bronchitis is an inflammation of the bronchi (large breathing tubes in the lungs). In contrast to chronic bronchitis, acute bronchitis is short-lasting. Symptoms usually develop and go away quickly, and most cases are mild. In children, acute bronchitis is usually caused by a viral infection, sometimes after a cold or other viral upper respiratory infection. It can also be caused by bacteria or as a result of exposure to irritants such as dust, allergens, strong fumes, or tobacco smoke. Symptoms of acute bronchitis usually last one to two weeks and include:
Take your toddler to a healthcare provider right away if:
BronchiolitisBronchiolitis is an infection in which swelling occurs in the bronchioles (smaller airways) of the lungs, blocking airflow in and out of the lungs. Bronchiolitis is usually caused by an infection in the upper respiratory tract which spreads down into the windpipe and lungs. This infection is often a viral infection, most frequently respiratory syncytial virus (RSV). It occurs most often in winter and early spring, and usually affects children under two years old. Bronchiolitis often looks like a common cold at first, but then the cough (and often other symptoms) get worse over time. It is important to see a healthcare provider for a diagnosis as the symptoms are similar to other conditions, especially in babies and young toddlers. Symptoms of bronchiolitis include:
Call your child's healthcare provider right away, or seek emergency care if your child:
RSVRespiratory syncytial virus (RSV) is a virus that is a leading cause of childhood respiratory infection. It is very common, with nearly all children contracting an RSV infection by the age of 2 years old. Most often, RSV infection is mild but it can be serious, especially for premature infants, infants under six months, children who are immunocompromised, and children with certain disorders that put them at risk for serious RSV infections. RSV usually causes mild, cold-like symptoms, but it can cause more severe illnesses such as bronchiolitis or pneumonia. Approximately 58,000 children younger than 5 years old in the United States are treated in hospital for RSV infections each year. Symptoms of RSV include:
An important note: Infants often show no symptoms with RSV infection beyond irritability, decreased appetite, decreased activity, and/or apnea (pauses in breathing). What Does "Trouble Breathing" Look Like?With a cough and/or congestion, it can be hard to tell if a child is having trouble breathing. If you notice any of these signs, your child may be experiencing breathing difficulties and you should seek immediate or emergency medical care: AllergiesAllergies are more common in children from families that have a history of allergies, but any child can have allergies. Children can have allergies to environmental triggers such as pollen, insect bites, or animals, to certain medications, or to foods such as peanuts or milk. Common symptoms of allergies in children include:
In severe cases, allergies can cause a serious and potentially life-threatening reaction called anaphylaxis which causes breathing impairment, a sudden drop in blood pressure, and possibly shock. This is a medical emergency requiring an immediate 911 call and injection of epinephrine (adrenaline), if available. CroupCroup is an infection in children that causes swelling in the upper part of the airway in the neck, usually seen in the winter. Croup is usually caused by a virus, but can also be caused by bacteria, allergies, or reflux from the stomach. Symptoms of croup are not universal, can change over time, and do not always occur at the same time. They usually last three to seven days and are often worse at night. Symptoms of croup include:
Croup can become an emergency situation if breathing difficulties become severe. Call 911 if your child is experiencing any of the following:
AsthmaAsthma is a chronic inflammatory respiratory condition that causes airways to narrow, swell, and sometimes produce extra mucus. The most common symptom of asthma in children is a chronic cough. Other symptoms can include:
A sudden worsening of symptoms caused by the constriction of muscles surrounding the bronchial tubes, narrowing the airway, and making breathing very difficult is called an asthma attack. Asthma attacks are serious and potentially life-threatening. If your child has asthma, discuss with their healthcare provider what to do to prevent and manage asthma attacks, and call 911 during an attack if necessary. PneumoniaPneumonia is a lung infection usually caused by a virus, but is sometimes caused by bacteria. It often follows an upper respiratory infection. Symptoms include:
If you suspect your child may have pneumonia, call their healthcare provider as pneumonia can become serious. The FluThe flu is a serious respiratory infection caused by influenza A and influenza B viruses. It is highly contagious and can be especially dangerous for young children. Flu symptoms are more severe than cold symptoms. They include:
If you suspect your child has the flu, call their healthcare provider right away as some treatments such as antivirals work best or are only effective if given early. Cystic FibrosisCystic fibrosis is a progressive, genetic disease that causes the mucus in various organs to become thick and sticky, resulting in infections, inflammation, and problems with organ function. Cystic fibrosis is present at birth and usually diagnosed by age two. Symptoms of cystic fibrosis include:
Babies Require Different CareChest congestion, cough, and fever can look different in infants than in toddlers and older children, and often require more urgent medical care, particularly for babies under six months. If your baby is ill, make sure you follow advice and information specifically for infants, not for toddlers or older children. When to See a DoctorWhether a cough and/or chest congestion needs medical attention depends largely on the cause of the illness, the accompanying symptoms, the age of the child, the severity of the symptoms, and the duration of the symptoms. Generally speaking, call your child's healthcare provider if there's:
Seek medical care immediately if your child:
What Symptoms Indicate You Should Call 911?Call 911 if your child:
DiagnosisTo determine if a child has chest congestion, and what is causing their symptoms, a medical health provider may use a number of diagnostic tools. Physical ExamDuring an office or hospital visit, a healthcare provider is likely to do a physical examination. This might include:
ImagingImaging tests such as a chest x-ray or CT scan may be ordered to look at the lungs and check for congestion, foreign objects, or other areas of concern. Lab WorkA healthcare provider may requisition various lab work including:
A bronchoscopy is a rarely used procedure used to look inside the airways of the lungs. Other Tests and ProceduresA pulse oximeter (a small, painless sensor on the finger or toe) may be used to check blood oxygen levels. Allergy tests may be run to determine if symptoms are caused by an allergy. These sometimes involve:
Tests to measure lung capacity and airflow may be ordered, particularly if asthma is suspected. Diagnosing Cystic FibrosisThis diagnosis requires more than a physical exam or blood test. It is a multi-step process that should include:
TreatmentTreatment depends on the symptoms and what is causing them. For more specific treatment plans for each condition, consult a healthcare provider who can tailor treatment to your child's needs. In general, treatment for chest congestion and some of the conditions that cause it falls into two categories: Medical treatment and treatment that can be given to your child on your own at home. Medical TreatmentMedical treatments include:
At-Home TreatmentIf the illness and symptoms are mild, or it is advised by a healthcare provider, at-home measures can help your child feel more comfortable while they get better. Some home treatments to try include:
Can Children Take Cough Medicine?Children under the age of 4 years should not be given cough or cold medicine, and children aged 4 to 6 years should only do so if advised by a healthcare provider. Children over age 6 years can take cough and cold medicine according to the dosage guidelines, but it still isn't recommended because they aren't very effective and they may cause side effects. A Word From VerywellIt's never easy when little ones don't feel well. Coughs and colds are a common part of the childhood experience, but they are no fun for kids or parents, especially when they come with chest congestion. Chest congestion in toddlers can be caused by a lot of different illnesses, some minor and some serious-but fortunately, most of the time it clears up with the help of medical treatment, or on its own with some home treatments and lots of TLC. |
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