Volume 17, Number 4

Caroline J Bateman FRCA Senior Clinical Fellow in Cardiothoracic Anaesthesia; Brian F Keogh FRCA Consultant in Anaesthesia and Intensive Care, Royal Brompton Hospital, London

Acute respiratory distress syndrome (ARDS) represents an ongoing challenge to the critical care physician. Mortality from the syndrome remains high and survivors commonly suffer a stormy course – the management of which is often prolonged, labour-intensive and expensive. Recently, there has been an increasing recognition of post-ARDS morbidity in survivors, which may impact substantially on their quality of life and ongoing healthcare requirements.

Stephen J Connellan FRCP Consultant Physician, Dept of Respiratory Medicine, New Cross Hospital, Wolverhampton and Honorary Senior Lecturer, Wolverhampton University

Several studies carried out over the last 50 years have identified cigarette smoking as the most important factor predisposing to chronic bronchitis in Western Europe and North America.1,2 However, the early descriptions of chronic bronchitis and emphysema from Badham3 and Laennec4 were made before cigarette smoking was common. Some of the studies documenting the importance of smoking have also shown that chronic cough and expectoration occurs in a significant percentage of lifelong non-smokers.5

Mark A Chilvers MRCP BSc Specialist Registrar; Christopher O’Callaghan BmedSci FRCPCH FRCP DM PhD Senior Lecturer, Department of Child Health, University of Leicester

The association of situs inversus and bronchiectasis was first described in 1904.1 However, it was the Swiss physician, Manes Kartagener, who described the association of sinusitis, situs inversus and bronchiectasis as a clinical syndrome.1 The relationship between abnormal ciliary function and respiratory problems was first reported in the 1970s.

Lorcan PA McGarvey MD MRCP Specialist Registrar in Respiratory Medicine; Joe MacMahon MB FRCP Consultant Physician, Department of Respiratory Medicine, Belfast City Hospital, N Ireland

The successful treatment of persistent cough remains a difficult challenge for the practising physician. Chronic cough, defined as one lasting more than three weeks, may present as an isolated problem, and has been estimated to account for over one-third of new patient referrals to respiratory clinics.1

Daniel Peckham MRCP DM Consultant Respiratory Physician; Christine Etherington, Staff Grade, Adult Cystic Fibrosis Unit, Seacroft and St James’s University Hospitals, Leeds

The identification of the cystic fibrosis (CF) gene sequence in 1989 resulted in an explosion of molecular and cellular research. This has led to a dramatic improvement in our understanding of the pathophysiology of CF and the development of exciting new therapeutic options to combat this disease. Although significant improvements in early diagnosis and conventional therapy have increased life expectancy to a median of 30 years, most patients still die from respiratory failure in early adulthood.1

Philip Ind, Editor

The intimate involvement of the lung and respiratory disease in conditions affecting other organs is reflected in this current issue of the journal.

Jon Miles MD MRCP Consultant Physician, North Manchester General Hospital

Asthma is a common chronic condition in the West, with an estimated prevalence of about 5% in the adult population. Gastro-oesophageal reflux (GOR) is also common, with an equivalent prevalence in adults.1 Symptoms of GOR occur frequently in patients with asthma, with an estimated prevalence between 30 and 89%.2–5 This has inevitably led to the suggestion of a causal association between the two conditions.