Science, Technology and Medicine open access publisher.Publish, read and share novel research. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. The first ever friendship day was proposed in Paraguay in 1958 and is celebrated in numerous countries in southern part of South America.Digital communications like mobile phones and Internet have been an instrument in spread the fame of the World Friendship Day, as greeting your friends is much easier than ever before via text messages, tweet and Facebook. Bei der Verwendung von alteren Versionen des Internet Explorers kann es zu Fehlern bei der Anzeige von transparenten Bilddateien kommen. The idea was initially promoted by the greetings card industry.The Friendship Day is celebrated on different days in different parts of the world. Under these conditions, there is no flow rate of air since there is no pressure gradient from the alveolar space to the outside. The specific definition of the actual criterion for airflow limitation or airflow obstruction has been a point of discussion based upon different statements from professional groups. On April 27, 2011 The United Nations General Assembly declared July, 30 to be the official International Friendship Day.

Note in airflow obstruction the volume of air exhaled at any time point is reduced compared to the exhaled air for the normal individual. As a result, the red area would include younger individuals who would be considered to be normal if a value of 70% is used for the interpretation of airflow obstruction but actually by use of the LLN would be considered to have airflow obstruction (false negative).
The red line refers to the baseline measurement of spirometry testing and the blue line represents the results after a bronchodilator has been given to the individual. FEV1 refers to the forced expiratory volume in one second and FVC refers to the forced vital capacity. The parameter that best describes the presence of airflow obstruction is a reduction in the ratio of FEV1 to FVC as shown here: 27% for the ratio in the individual with airflow obstruction vs.
Other guidance documents are based on a statistical approach for the interpretation of airflow limitation using reference equations which in turn are based on population studies. The most recent revised GOLD guidance [5] does acknowledge that the LLN values are based on a normal distribution and that the use of a fixed ratio of 0.70 will result in more frequent diagnosis of COPD in the elderly.
The use of post-bronchodilator results is consistent with the aforementioned clinical guidance documents [4,5,6].Once airflow limitation is determined to be present, the severity of limitation is then assessed based on the FEV1 % of predicted value.

In those cases, it is recommended that the patient be referred to the pulmonary specialists for further evaluation.
It is known that there is not one physiological parameter that can completely describe all the changes that occur in the disease that is COPD.
Unfortunately, until we develop better means to characterize this disease, we are left with using spirometry to diagnose and characterize the severity of the disease.5.
It is critical that the test be done in an acceptable manner under the supervision of a trained technician.

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