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Volume 18, Number 3 |
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| Chronic irritant exposures and asthma |
Samuel C Stenton BSc MFOM FRCP Senior Lecturer, University of Newcastle-upon-Tyne, Consultant Physician, Royal Victoria Infirmary, Newcastle-upon-Tyne |
In 1985, Brooks and colleagues described ten subjects who developed persisting asthma following a single, brief, high-level exposure to an inhaled ‘irritant’.1 The wheezing began within 24 hours of the exposure, and often immediately. The authors coined the term Reactive Airway Dysfunction Syndrome (RADS) and devised diagnostic criteria (Table 1). |
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| Life and death decisions in respiratory failure |
Philip Ind, Editor |
Good practice and, increasingly, trust guidelines, dictate that firm decisions about mechanical ventilation and attempted resuscitation should be made as early as possible. Ideally, discussion of the issues should take place on admission. |
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| The role of exercise testing in patients with lung disease |
Stanley B Pearson MA DPhil DM FRCP Consultant Physician, Department of Respiratory Medicine, Leeds General Infirmary |
Cardiopulmonary exercise testing has an important role to play in the patient with lung disease, and the aim of this short article is to provide an introduction to the physiological principles underlying it and to give some examples of its application in relation to breathless patients. |
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| Spirometry in general practice – where are we now? |
David MG Halpin MA DPhil FRCP Consultant Physician & Senior Lecturer in Respiratory Medicine, Royal Devon & Exeter Hospital |
No doctor or nurse would contemplate diagnosing or treating hypertension without measuring the patient’s blood pressure, yet every day diagnoses of COPD are made – and therapy is adjusted – without measuring patients’ airway calibre. Spirometry is a quick and accurate way of assessing the severity of airflow obstruction, but there still appears to be considerable apprehension about its use in primary care. |
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| Contact screening for tuberculosis |
John P Watson MRCP DTM&H Consultant Physician Department of Respiratory Medicine, Leeds General Infirmary |
Tuberculosis is on the increase in Britain. After a century of declining incidence, the trend has been reversed since the late 1980s. The number of cases notified in England and Wales in 2000 was 6,797, an increase of 10.6% over 1999.1 Recent well publicised outbreaks, such as the one centred on a Leicester school,2 have increased public awareness of the disease. |
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| Weaning from mechanical ventilation – Part 2 |
Ian Sutcliffe MRCP MBBS Specialist Registrar in Respiratory and General Medicine, Bradford Royal Infirmary; Mark W Elliott MD FRCP Consultant Respiratory Physician, St James’s University Hospital, Leeds |
In the previous issue of RDIP, Part 1 of Weaning from mechanical ventilation discussed strategies for idiscontinuing mechanical ventilation in patients in the ICU. Part 2 takes a more in-depth look at the weaning process itself, and at the relative pros and cons of the various techniques. |
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