Volume 16, Number 3

Philip Ind, Editor

This issue of RDIP carries the first of three articles on lung transplantation – a procedure which has now come of age. Markedly understaffed and underfunded, transplantation can be seen as a microcosm of the NHS.

Rachel Garrod MSc MCSP Research Physiotherapist in Pulmonary Rehabilitation, The London Chest Hospital

Chronic obstructive pulmonary disease (COPD) is a chronic disabling disease characterised by ‘the presence of chronic bronchitis and/or emphysema associated with airflow obstruction which may be accompanied by airways hyper-reactivity and may be partially reversible’.1

Jo Congleton MA MRCP Consultant Respiratory Physician, Worthing General Hospital, West Sussex

We all recognise the cachexia associated with lung cancer, but marked wasting can also occur in non-malignant chronic lung diseases. The most common of these seen in hospital and general practice is chronic obstructive pulmonary disease (COPD).

Wei Shen Lim MRCP Clinical Research Fellow; John Macfarlane DM FRCP MRCGP Consultant Physician, Department of Respiratory Medicine, Nottingham City Hospital

It is estimated that a quarter of a million episodes of community-acquired pneumonia occur in the UK each year and Streptococcus pneumoniae is responsible for 30–50% of these. The overall incidence of pneumococcal pneumonia is estimated at one per 1,000 adults per year, and it carries a mortality of 10–20%.1 Bacteraemia occurs in 10–30% of cases. Patients of all age groups are affected but immunocompromised patients, those with depressed immune function, elderly people and those with chronic illnesses are at highest risk (Table 1).

Glenis Scadding MD FRCP Consultant Rhinologist, Royal National Throat, Nose and Ear Hospital, London

Rhinitis has many causes, but the major ones are allergy and infection. It is a common disorder and has noticeable effects on quality of life. Allergic rhinitis is an inflammatory disorder with a pathogenesis similar to that of asthma. It is present in about 80% of asthmatics, and is a risk factor for the development of asthma. Treatment of rhinitis can reduce bronchial hyperreactivity. Other comorbid associations include sinusitis and otitis media with effusion.

Robert Wilson MB ChB MA FRCP Consultant Physician, Respiratory Resource Centre, Royal Shrewsbury Hospital

Nebuliser therapy refers to the delivery of the chosen drug as an aerosol of respirable particles (therapeutic mist) over a short period of time, usually five to ten minutes.1

Anthony De Soyza MBChb MRCP BMSC Registrar in Respiratory Medicine and Pulmonary Transplant Medicine; Paul Corris FRCP Reader in Thoracic Medicine, Consultant in Respiratory Medicine and Pulmonary Transplant Medicine, The University of Newcastle, Freeman Hospital, Newcastle-upon-Tyne

In this issue we begin a major three-part series of articles on lung transplantation. Part 1 will focus on pre-transplantation matters, including donor and recipient selection and operation types. Parts 2 and 3 will deal with post-transplant complications, post-operative care, and the long-term outlook and outcomes.