Topic:

Patients with allergic asthma, intermittent (seasonal) or persistent (perennial) allergic rhinitis, represent a significant proportion of primary care consultations. There is growing awareness of allergy and the possibility of an allergic component as the cause of a wide variety of symptoms. It is important to understand how to diagnose atopy to ensure appropriate management and care of our patients. Diagnosing allergy is initially about asking the right questions, followed by confirming or refuting the diagnosis by objective testing. In this article, we explore history taking and objective testing that will help us to manage and advise patients appropriately.

Diagnosing chronic obstructive pulmonary disease (COPD) can be complex and requires considerable clinical skill. It is rather like putting together the pieces of a jigsaw puzzle. But don’t despair. In this article, we take you through the key steps. A careful history, particularly in smokers or ex-smokers who complain of breathlessness, followed by clinical examination may indicate possible COPD. Further steps must then be taken to exclude other causes of respiratory symptoms and spirometry is essential in diagnosing airflow obstruction, which may help to confirm the diagnosis of COPD.

The year is racing by – autumn is already upon us! It’s a time which fills me with great expectations, with memories of starting a new academic year at school or university. Many of you may still be experiencing this through your children! I love the feeling of opening a clean ‘exercise book’! Some of you may even be contemplating starting up studies again. The Education for Health graduation ceremony is being held in October; it is one of the most thrilling events in our academic calendar – seeing the smiles on the faces of the mature graduates and their families as they attain awards that they never felt would be possible! Let them be an inspiration to you all; it is never too late to start! Our team here at Education for Health would be delighted to discuss any programmes you might be interested in.

Welcome to the first edition of 2008 and my first as Editor in Chief. I want to thank Jan Procter-King, my predecessor, who has performed an outstanding role and left the journal in a robust position. I would also like to thank the members of the Editorial Board – in particular those who have left us or joined since the last edition. Education for Health (formerly the National Respiratory Training Centre) has a long reputation in respiratory disease and we are delighted to be bringing this expertise to the BJPCN Editorial Board.

It’s birthday celebrations all round. We are celebrating the 20th anniversary of the General Practice Airways Group (GPIAG). Founded in 1987 as a small respiratory special-interest group of six general practitioners, the GPIAG has developed and grown into the largest primary care specialist society in the UK. It is also coming up to the first birthday of the journal – and we are hoping that we are giving you a useful ‘goody bag’ of ‘party gifts’ to take back to your practice after reading this issue.

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.

As we reach the end of the year, BJPCN looks back at the challenges that have been met in the care of patients with respiratory and allergic disease over the past few years and looks forward to the new situations we will have to face in the coming year. I have really enjoyed launching this exciting journal and wish Monica Fletcher, Chief Executive of Education for Health, the very best as she takes on the editor’s role from the next issue.

We are about to hit the festive season, but it is also a time when many people reflect on the past year and make plans for the next – including thinking about giving up smoking. In this issue we reflect on the impact of the smoking ban in the UK. Hilary Wareing and Nina Gotz from the Tobacco Control Collaborating Centre show how there have been significant benefits in terms of air quality and increased numbers of quitters since the smokefree legislation came into force between March 2006 and July 2007. This has been a significant step forward in improving public health, and provides a foundation to encourage more of your patients to quit.