Latest Issue – Editors’ Choice
The art of medicine: recognising influenza and pneumonia
Consultations for acute respiratory tract infection (RTI) account for 15-20% of all primary care consultations. A large proportion of these patients have a mild self-limiting illness, but for the remainder a key challenge is whether to prescribe antibiotics for presumed community acquired pneumonia (CAP) or antivirals. On pg 421, Nakanishi et al. report a cohort study describing the symptoms and signs that distinguished CAP from influenza during the 2009 influenza A/H1N1 pandemic in Japan. At 48 hours, the presence of coarse crackles, sputum production, dyspnoea and chest pain in an older patient increased the likelihood of CAP as opposed to influenza. In his linked editorial on pg 353, Lim puts the paper in context, and emphasises the challenges in diagnosing influenza and whether or not to treat it with antivirals.
Efficacy of indacaterol in the treatment of COPD
Long-acting inhaled bronchodilators are the most effective pharmacological agents for reducing COPD symptoms. There are now four available: the twice-daily long-acting β2-agonists (LABAs) salmeterol and formoterol, the once-daily anticholinergic tiotropium, and a new once-daily LABA indacaterol which was introduced in 2009. In their review on pg 380, Jones et al. evaluate the efficacy and safety of indacaterol in comparison to the other three bronchodilators based on the evidence from four recently-published clinical trials, and they discuss its use in the treatment of COPD.
Assessing inflammatory markers in patients with respiratory infection…
Increased levels of antibiotic resistance and the need to decrease antibiotic prescribing – particularly in primary care where most antibiotic prescriptions are issued – is increasing interest in the use of biomarkers that can reliably predict the presence or absence of bacterial infection. Procalcitonin is one such inflammatory marker, albeit used much less widely than C-reactive protein (CRP). In their review on pg 360, Aabenhus and Jensen discuss the procalcitonin assays currently available and its use in guiding antibiotic prescribing in RTIs. Melbye et al. (pg 367) put this in context, emphasising the different levels of incidence and severity of lower RTIs, and the need for sound consultation skills when discussing treatment options with patients.
…and in patients with asthma and COPD
Similarly, there is increasing interest in the use of inflammatory markers for differentiating between asthma and COPD. As Thomas and Taylor point out on pg 349, the presenting symptoms of both diseases overlap, and as a consequence there may be diagnostic confusion. Since asthma and COPD treatment algorithms differ, every effort should be made to obtain objective confirmation of the diagnosis before starting long-term treatment. On pg 407, Tilemann et al. report distinctive inflammatory profiles in 210 patients presenting to their GP with symptoms suggestive of obstructive airways disease: asthma patients had higher levels of exhaled nitric oxide, higher IgE and eosinophil levels, and lower levels of CRP, than the patients with COPD.
Pulmonary rehabilitation: a nurse-led multidisciplinary programme
On pg pg 427, Zakrisson et al. report the results of a nurse-led COPD programme in Swedish primary care. Exacerbation frequency was reduced in the intervention group, but this didn’t translate into better quality of life. George and Fletcher discuss the implications and possible reasons in their linked editorial (pg 355), and Kruis and Chavannes comment on the results in their correspondence (pg 357).
Telehealth: bridging the gap between theory and practice
Telehealth is one potential mechanism for providing health care to populations in remote areas. As Morrison and Mair discuss (pg 351), one of the key problems is how to integrate telehealth into the standard working practices of healthcare professionals (HCPs). After analysing the population distribution in the remote Highlands of Scotland, and using qualitative interviews to assess HCPs’ attitudes towards telehealth, Godden and King (pg 415) examine the potential for telehealth in this region of the UK.
Is it time to reject sex-based stereotypes in COPD?
In their review on pg 370, Ohar et al. discuss why sex-based stereotypes of COPD are now out of date and should be rejected. COPD prevalence in women is increasing, and women have increased disease susceptibility, a faster rate of decline in FEV1, more hospitalisations, more dyspnoea, and more deaths. DunnGalvin provides comment on pg 378.
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PCRJ Best Abstract Award
6th IPCRG World Conference
Edinburgh 25th-28th April 2012
The PCRJ Award, worth €500, will be awarded to the best quality abstract submitted to the 6th IPCRG World conference to be held in Edinburgh on the 25th-28th April 2012. Funded by the Primary Care Respiratory Journal, this Award celebrates the high quality of international research in primary care respiratory medicine, and all research abstracts will be eligible for consideration. The PCRJ Award is aimed particularly at young researchers, to encourage them to submit their work to the world’s most important respiratory meeting for primary care professionals. The winner will be chosen by the PCRJ Editors from a shortlist selected by the Conference Scientific Committee.
Deadline for abstract submission: midnight 11th January 2012
(Greenwich Mean Time).
For further details, click here.
Online first: latest articles
 Subscribe to PCRJ Online first Page
1: Prioritising the respiratory research needs of primary care: the
International Primary Care Respiratory Group (IPCRG) e-Delphi
exercise
Hilary Pinnock, Anders Østrem, Miguel Roman Rodriguez, Dermot Ryan, Björn Ställberg, Mike Thomas, Ioanna Tsiligianni, Siân Williams, Osman Yusuf • Published online: 24 January 2012
2: Agreement between self-report and medical records on
signs and symptoms of respiratory illness
Angela M Barbara, Mark Loeb, Lisa Dolovich, Kevin Brazil, Margaret Russell • Published online: 24 January 2012
3: Asthma monitoring in primary care: time
to gather more robust evidence
Justin Beilby • Published online: 24 January 2012
4: Impact of graphic format on perception of change in
biological data: implications for health monitoring in
conditions such as asthma
Jesse Jansen, Kirsten J McCaffery, Andrew Hayen, David Ma, Helen K Reddel • Published online: 23 January 2012
5: Streptococcus pyogenes upper respiratory infection and atopic
conditions other than asthma: a retrospective cohort study
Young J Juhn, Diana Frey, Xujian Li, Robert Jacobson • Published online: 23 January 2012
Who is citing PCRJ articles?
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Fast manuscript handling
- Average time from submission to first decision = 22 days
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PCRJ now has single-blind or open peer review
Following the PCRJ International Editorial Board meeting held during the ERS Congress meeting in September, the journal’s standard peer review process will be single-blind rather than double-blind. This means that there is now no need for authors to send an anonymised manuscript when they submit an article. Referees will therefore know authors’ names when reviewing a manuscript. In addition, reviewers will be able to declare themselves to authors if they so wish, thus making for a completely open peer review process. Please see the new Guide for authors for further information regarding manuscript submission.
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See the new Guide for Authors.
This updated guidance supersedes all previous PCRJ author instructions, and highlights the fact that the PCRJ now operates single-blind or open peer review. It contains new instructions for authors wishing to submit manuscripts, including new
Statistical guidelines.
Three articles now available in Spanish
Some PCRJ articles are available in languages other than English, including Spanish, Greek, French and Italian. For an up-to-date listing, please click here.
The latest translations in Spanish are:
1. Earlier diagnosis and earlier treatment of COPD in primary care
David Price, Daryl Freeman, Jen Cleland, Alan Kaplan, Frank Cerasoli
Click to see full text in Spanish
2. Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma
David Price, Linda Kemp, Erika Sims, Julie von Ziegenweidt, Prakash Navaratnam, Amanda J Lee, Alison Chisholm, Elizabeth V Hillyer, Gokul Gopalan
Click to see full text in Spanish
3. Improvement in asthma endpoints when aiming for total control: salmeterol/fluticasone propionate versus fluticasone propionate alone
Ashley A Woodcock, Alfredas Bagdonas, Watchara Boonsawat, Michael R Gibbs, Jean Bousquet, Eric D Bateman, on behalf of the GOAL Steering Committee and Investigators
Click to see full text in Spanish (Latin American)
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All correspondence to:
The Editors-in-Chief
c/o Tricia Bryant, PCRS-UK Publications
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Waterbeck
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