Volume 17, Number 1

Philip Ind, Editor

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.

Abdullah Eid MB PhD Clinical Fellow, University of Wales College of Medicine; Alina Ionescu MD Clinical Fellow UWCM; Dennis Shale BSc MD FRCP Professor of Respiratory Medicine, UWCM, Cardiff

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.

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

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.1 Importantly, no case of human-to-human transmission has been reported.

Ian Johnston MD FRCP Consultant Physician, Dept Respiratory Medicine, Queen’s Medical Centre, Nottingham

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.1

Elizabeth Alexandra Barley BSc RGN Research Assistant, Division of Physiological Medicine, St George’s Hospital Medical School London

Asthma commonly impacts on the physical, emotional and social aspects of patients’ lives.1 Objective measures of disease, such as airway function, are not necessarily related to subjective well-being or quality of life.2 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.3,4

Michael Polkey MRCP PhD Consultant Physician, Royal Brompton Hospital, London

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.

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 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.