Volume 2, Number 3, June 2008
EDITORIALEditorial
Monica Fletcher Summer is here and time for a new issue of the BJPCN – packed full of
useful information and news from the respiratory and allergy world.
We cover a lot of different topics in the main articles this month – from
pleural effusions to angioedema, from asbestosis to urticaria. A scan
through the summaries of the latest research in the Evidence in Practice
section will reveal interesting studies with dogs, trees and alcohol! Have
a great read. EVIDENCE IN PRACTICEEvidence in Practice
There are just not enough hours in the day to read all the research journals, even if you wanted to. This section of BJPCN –
Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library.
Each review gives you a bite-size summary of new research, pulling out key points for primary care and recommending the action
that you might consider taking. NEWSNews from Education for Health
NEWSNews from General Practice Airways Group (GPIAG)
DISEASE FOCUSAsbestos and the lung
Dr John Wiggins Although the use of asbestos in this country has been tightly controlled for over 30 years
the incidence of asbestos-related lung diseases has increased dramatically over the
last few years. It is expected that this increase will continue during the next decade.
This article describes some of the different lung diseases caused by asbestos and their
management, and provides a useful clinical background to the issues for healthcare workers in
primary care. DISEASE FOCUSManaging pleural effusions in primary care
Ram Gulrajani Patients with recurrent pleural effusions have, to date, mainly been cared for in hospital.
Many have had to undergo repeated hospital admissions, extended hospitalisation,
discomfort and time away from home. This is particularly the case in patients with
recurrent malignant pleural effusion (MPE). However, new technologies mean that these
patients may be managed by close co-operation between primary and secondary care. This
article describes some exciting developments in the management of pleural effusions in a PCT. POPULAR
TOPICBACK TO BASICSMechanisms of allergy
POPULAR
TOPICPREVENTION IN PRACTICEHow to do an asthma review
Dr Mark L Levy UK primary care health professionals work under increasing demands and time
pressures. While a large proportion of their workload is demand-led (ie by patients
presenting with specific clinical problems), a significant amount of the work relates to
ongoing monitoring and care of patients with chronic illness. While most practices in
the UK achieve a high level of points in the Quality and Outcome Framework (QOF) for caring for
patients with asthma, the standard of the reviews for these patients may not reach a level
recommended in national and international guidelines. A structured approach may, therefore, be
helpful in ensuring quality of care for these patients. This article describes an approach to
reviewing patients with asthma, whether they present in surgery acutely, for follow-up of
uncontrolled episodes or for routine review. POPULAR
TOPICMONITORINGThe effects of the weather on COPD
Chris Loveridge Those of us working with patients suffering from COPD know anecdotally that cold
weather directly impacts exacerbation rates and hospital admissions in the same way
as thunderstorms affect those with asthma (see BJPCN Vol 1, Issue 2, March 2007).
This article explores the links between COPD and weather patterns. You may not want
to be thinking about the winter but action now should give time to put preventive systems in
place to help at-risk patients before the cold weather appears again. PATIENTS AS PARTNERSTravel tips for patients with respiratory conditions and allergy
Jeremy Bray, Samantha Walker, Shona Shires Many of your patients will be planning their holidays, but some may be worrying
unnecessarily about their respiratory condition. There are a host of resources and
information available for them, and practice nurses can make sure they provide the
right information about travelling with asthma, COPD or allergies. This article
provides practical tips on how best to advise patients who are thinking of going on holiday. DID YOU KNOW?Urticaria and angioedema
Samantha Walker Allergic diseases such as hayfever and allergic asthma are becoming increasingly common
in westernised countries such as the United Kingdom, with an estimated 25% of the
population now suffering from some form of allergic condition. Urticaria and angioedema
are commonly thought of as allergic problems although in general only acute symptoms
are related to allergen exposure. Here we discuss the diagnosis and management of urticaria and
angioedema in primary care, with particular focus on identifying allergic triggers and managing
long-term symptoms successfully. POPULAR
TOPICDIAGNOSISNon-respiratory causes of breathlessness
Rachel Booker Abnormal breathlessness is a common symptom with a wide variety of causes and it can
be quite a challenge to diagnose the cause and plan appropriate treatment. Practice
nurses are often the first point of contact for patients with these conditions and play an
important role as part of the multidisciplinary healthcare team. This article completes a
series of three on causes of breathlessness (‘The breathless patient: is it asthma or COPD?’ Vol 2,
Issue 1, December 2007 and ‘Respiratory causes of breathlessness.’ Vol 2, Issue 2, March 2008). HAVE YOU HEARD?Have you heard?
POPULAR
TOPICRESEARCH MADE EASYWhat is a 'double-dummy' trial?
Jane Upton We continue our series of articles on research concepts by explaining what ‘double-dummy’ trials are and why researchers
use them to compare medications that are delivered using different types of inhalers. POPULAR
TOPICGUIDELINESBTS/SIGN Guideline on the management of asthma
Monica Fletcher
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