Respiratory disease in practice - 2011

Comment: Food allergy in relation to asthma
Philip W Ind
pp 3-3
Food allergy (FA) remains a very difficult area. Its importance in asthma is controversial and there is a lack of clear definitions. FA is defined as immunologically mediated reactions to food –immediate, late-phase or delayed. Conditions from atopic eczema, asthma, eosinophilic oesophagitis and coeliac disease to protein intolerance are included. Perhaps only one in five patients presenting with an adverse reaction to food has a true FA. Most are thought to be non-IgE mediated.

Malnutrition in chronic obstructive pulmonary disease
David Proud and Charlotte Bolton
pp 5-7
Chronic obstructive pulmonary disease (COPD) has respiratory symptoms – breathlessness, impaired exercise tolerance, cough, excess sputum production, and wheeze – but also systemic consequences, including altered body composition, osteoporosis, cardiovascular (CV) disease and depression. Malnutrition is thus an important area, highlighted in the COPD guidelines from the National Institute for Health and Clinical Excellence (NICE); however, identification and subsequent management can be challenging.

Current developments in lung volume reduction for advanced emphysema
Zaid Zoumot and Nicholas S Hopkinson
pp 8-11
Chronic obstructive pulmonary disease (COPD) is characterised by damage to small airways and, in emphysema, to alveolar walls, with an associated reduction of lung elastic recoil leading to airflow limitation.