Respiratory disease in practice - 2000

Comment: Medical scientific meetings
Philip Ind
pp 4-4
Hospital doctors, more so than GPs, attend medical scientific meetings. These are of course essential to present one’s own research work. Conference attendance is necessary in order to keep abreast of current work in rapidly moving areas of research. It may take a year or longer for data which are presented to be published and generally available. Young researchers gain from workshops that may involve practical demonstrations of new techniques. Many non-researchers benefit from review sessions which enable them to keep broadly up-to-date and fine-tune day-to-day clinical practice.
Quality of life in adult asthma
Elizabeth Alexandra Barley
pp 5-7
Asthma commonly impacts on the physical, emotional and social aspects of patients’ lives. Objective measures of disease, such as airway function, are not necessarily related to subjective well-being or quality of life. Asthma is chronic and incurable, so consideration of quality of life is particularly important. Proxy ratings of health, such as those used by physicians and carers, do not relate well to patients’ own ratings. Quality of life must be measured directly. Several standardised measures exist. Most have been developed for research use, but there are many potential applications in clinical practice.
Body composition in COPD
Abdullah Eid, Alina Ionescu and Dennis Shale
pp 7-10
The term chronic obstructive pulmonary disease (COPD) encompasses a group of disorders with the common features of airways obstruction and probable chronic airways inflammation. The major mechanisms leading to airways obstruction are loss of elastic recoil, with injury to gas exchange units, and obstruction or obliteration of small conducting airways. There is no absolute relationship between changes in pulmonary architecture and function, but there are aspects of pulmonary function and clinical features which allow subgroups to be identified.
Respiratory muscle disease: when to suspect it and how to rule it out
Michael Polkey
pp 11-14
The respiratory muscles may be considered, after the heart, the most important biological pump. Although disease of the respiratory muscle pump is unusual, it can occur and, when it does, it is commonly unrecognised. Recognition of respiratory muscle weakness is important, both because making the diagnosis can spare the patient other investigations, and also because, for selected patients, treatment in the form of domiciliary non-invasive positive pressure ventilation is now available.
Lung transplantation – long-term complications
Anthony de Soyza and Paul Corris
pp 15-18
In the first two parts of our review series on pulmonary transplantation we focused on the different lung transplant operations, immediate post-transplant complications and drug regimens. In this final part, we review the long-term outlook and complications in survivors. The International Society for Heart and Lung Transplantation has recorded over 8,000 lung transplant operations worldwide. There is a trend towards improving survival within the last ten years, with a major improvement in the reduction of early deaths. Overall survival is around 50% at five years post-transplant and 38% at eight years.
Community-acquired legionnaires’ disease
Wei Shen Lim and John Macfarlane
pp 19-20
Outbreaks of Legionella pneumonia in hotels and on cruise ships, linked to contaminated aerosol generating systems such as cooling towers, showers and whirlpool baths, continue to capture the attention of the press. However, the majority of cases of Legionella pneumonia (LP) are sporadic (non-outbreak) and a clear source of infection is not often identified. Importantly, no case of human-to-human transmission has been reported.
Diffuse parenchymal lung disease – British Thoracic Society recommendations
Ian Johnston
pp 21-23
Diffuse parenchymal lung disease (DPLD) is a complex area in respiratory medicine, partly because the differential diagnosis requires knowledge of inflammatory, allergic and occupational processes and partly because there is a paucity of evidence on management. Nevertheless DPLDs are important, accounting for up to 15% of specialist respiratory practice with an incidence of at least 30/100,000 population.