Respiratory disease in practice - 2011

Inhaled corticosteroids and fracture: disease or drugs?
Frank de Vries
pp 1-4
In the UK, approximately 8% of the total population receives treatment for asthma, while the prevalence of chronic obstructive pulmonary disease (COPD) has been estimated to range from 3–10%. Current pharmacological therapies for asthma and COPD include bronchodilators, inhaled corticosteroids (ICSs), oral glucocorticoids (OGCs), leukotriene receptor antagonists and acetylcysteine.
Comment: ECMO – its time has come
Philip W Ind
pp 3-3
Extracorporeal membrane oxygenation (ECMO) is a relatively new method of improving gas exchange to support patients with severe respiratory failure from potentially reversible causes. Although used in neonates and infants for some time, ECMO has recently shown benefit in adults and it gained prominence in the treatment of severe respiratory failure related to swine flu last winter. In April 2011, NICE published guidance.
The role of the occupational therapist in managing respiratory disease
Jessica Callaghan
pp 5-7
Occupational therapists (OTs) are recognised as ‘essential members of the multi-disciplinary team managing patients with COPD [chronic obstructive pulmonary disease]’ and work within a range of services – inpatient and community, specialist and generalist. The Department of Health (DH) emphasis on healthcare provision being more accessible to the patient has led to a growth in community respiratory multidisciplinary teams (MDTs). Some include OTs and, although the role varies, most of these OTs see patients in their homes and as part of pulmonary rehabilitation (PR).
How to approach a patient with breathlessness
Dilys Lai
pp 7-9
Breathlessness (or dyspnoea) is the sensation of difficult, laboured or uncomfortable breathing. While it is a normal sensation during heavy exercise, it becomes pathological when it occurs with little or no exertion. The sensation of breathlessness arises from receptors in the upper airway, lungs and chest wall and from autonomic centres in the brain and motor cortex.
Achieving the best possible asthma control in primary care
Jane Scullion and Steve Holmes
pp 10-11
Asthma UK estimates that there are over 5.4 million people in the UK diagnosed with asthma across all age ranges – asthma is a common chronic problem. Defined as a variable disease, although it is not ‘curable’, asthma can be effectively treated and its symptoms minimised. Despite this, patients have varying levels of asthma control and differing expectations as to what constitutes control and what can actually be achieved.