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Previous Volume 359:1616-1618 October 9, 2008 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In 1976, Fletcher et al. published a monograph summarizing the results of an 8-year observational study of the relationship between cigarette smoking, chronic expectoration, and the development of irreversible airflow obstruction.¹ At that time, the nomenclature for chronic obstructive pulmonary disease (COPD) was confusing. COPD was understood to include chronic bronchitis and emphysema, but the definitions of these two entities contained no mention of airflow obstruction. The clinical paradigm described patients as either "blue bloaters," who had chronic airway inflammation and a propensity for resting hypercapnia, and "pink puffers," who had airspace destruction and preserved resting arterial oxygenation.

The study . . . [Full Text of this Article]

Source Information

This article (10.1056/NEJMe0807387) was published at www.nejm.org on October 5, 2008.

From the Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh.

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