In the minds of family physicians, Streptococcus pyogenes has historically been associated primarily with strep throat and, secondarily, with the complications of rheumatic fever and glomerulonephritis. The latter complications have largely diminished in the antibiotic era. Despite such a reduction in complications, infection due to S. pyogenes has continued to attract considerable attention for various reasons. In the last 2 decades, for example, the entities of streptococcal toxic shock and invasive S. pyogenes infections have provided renewed interests.
Chronic obstructive pulmonary disease (COPD) is the only chronic disease with increasing mortality, which may mean that it will be the third leading cause of death worldwide by 2020.[1] A recent study showed that the prevalence of COPD in subjects over 40 years of age in Vancouver is 19.3%, and that in Canada the direct costs of treatment and management are estimated to be $2 billion a year.[2]
Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Today it is the fourth leading cause of death in the world[1] and in Canada.[2] The prevalence of COPD in Canada has been on the rise in both sexes, with a more significant rise in prevalence in men.[2]
