Respiratory disease in practice - 2010


Co-morbidities associated with chronic obstructive pulmonary disease
Peter J Barnes
pp 1-4
Chronic obstructive pulmonary disease (COPD) is a major clinical problem in the UK, but is also a growing global epidemic that is increasing, particularly in developing countries. Morbidity and mortality from COPD will rise as populations age and mortality from cardiovascular and infectious diseases falls. While cigarette smoking is the most common cause of COPD in developed countries, COPD is also seen in nonsmokers, particularly in developing countries, yet very little is known about this form of COPD. Even in the UK, approximately 20–30% of COPD patients are non-smokers.
Comment: Looking again at lung cancer
Philip W Ind
pp 3-3
Lung cancer deaths exceed the mortality from colon, breast and prostate cancer combined. Lung cancer has a poor prognosis unless diagnosed early and removed by surgery. Survival has historically been bad in the UK, particularly compared with Norway and Sweden, countries with similar healthcare expenditure. Between 1996 and 2000, survival improved by 20–35% in Norway and Sweden, but by less than 10% in the UK.
The relation between obesity and asthma
Carel le Roux and Helen Ramsey
pp 5-6
Asthma and obesity are common clinical problems with the incidence of both rising in the UK. There are an estimated 5.4 million people in the UK with asthma (8% of the population) while 15 million people are obese – defined as having a body mass index (BMI) score >30 kg/m2 (a BMI of 18–25 is considered normal, with 25–30 being overweight).
Pulmonary rehabilitation – the challenge of delivery
Mike DL Morgan
pp 7-9
One of the big changes in respiratory practice over the past few years has resulted from the recognition that drug therapy alone may not be enough to limit the impact of chronic respiratory diseases. With chronic obstructive pulmonary disease (COPD) in particular, we have learnt that pulmonary rehabilitation, supported self-management programmes, and changes in the organisation of healthcare delivery can make a big difference.
Looking at the effects of the new White Paper on the commissioning of services
Ben Woodhouse
pp 10-11
With the installation of a new government and its White Paper on the commissioning and provision of medical services by GPs, we can expect a lot of changes in primary care. Respiratory disease in practice Editorial Board member Ben Woodhouse gives his take on the situation.

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