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Previous Volume 360:2749-2757 June 25, 2009 Number 26 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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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 60-year-old white man presents for evaluation of progressive dyspnea. He is a former smoker with a 20-pack-year smoking history and a 10-year history of diagnosed chronic obstructive pulmonary disease (COPD). There is no family history of COPD. Severe airflow obstruction is seen on spirometry, with a forced expiratory volume in 1 second (FEV₁) that is 40% of the predicted value. . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnosis

Evaluation and Follow-up

Treatment

            Lung Disease

            Liver Disease

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Channing Laboratory and Pulmonary and Critical Care Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (E.K.S.); and the Pulmonary Division, National Jewish Health, Denver (R.A.S.).

An audio version of this article is available at NEJM.org.

Address reprint requests to Dr. Silverman at Channing Laboratory and Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, MA 02115, or at ed.silverman@channing.harvard.edu.

Related Letters:

Alpha₁-Antitrypsin Deficiency
Gøtzsche P. C., Johansen H. K., Taylor N. J., Shawcross D. L., Silverman E. K., Sandhaus R. A.
Extract | Full Text | PDF  
N Engl J Med 2009; 361:2101-2102, Nov 19, 2009. Correspondence

This article has been cited by other articles:

• Gotzsche, P. C., Johansen, H. K., Taylor, N. J., Shawcross, D. L., Silverman, E. K., Sandhaus, R. A. (2009). Alpha1-Antitrypsin Deficiency. NEJM 361: 2101-2102 [Full Text]