British Thoracic Society summer meeting. 11-13 July 1990, Birmingham. Abstracts.
Authors: J Lapa, E Silva, P Cole, Poulter Host, W Freeman, R Cayton, M Fitzpatrick, T Mackay, H Driver, K Whyte, N Douglas, K Martin, D Peck
Journal: Thorax (1990)

to the end of inspiration and started at the beginning of expiration and finished half way through expiration.Crackles in AS were predominantly inspiratory (92%).They started at mid inspiration and lasted until the end of inspiration.Crackles in BE occurred mainly in inspiration (68%) but also in ex- piration.They were confined to the first half of inspiration and of expiration.Duration of crackles and frequency are shown in the table (mean and SD).Discriminant analysis, taking into account the timing of crackles as well as their duration and frequency, showed that the three conditions could be clearly distin- guished.We conclude that lung sound analysis of pulmonary crackles may dis- criminate between different lung pathologies.Crackles Highest duration frequency (ms) p (Hz) p CHF 5-5 (1 2)__NS 722 (311) * NS AS 5 2 (3 0)-°°1 531 (l11) BE 8.2 (3.0)-4---299 (150).-dSurvey of respiratory physicians' involvement in and management of opportunist pneumonia in immuno- compromised patientsPA CORRIS on behalf of the B TS Research Committee Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne The management of pneumonia in immuno- compromised hosts represents an increasing clinical problem.We were interested to survey both the degree of involvement and methods used by UK respiratory physicians in the management of such patients.Three hundred questionnaires were sent to consul- tant members of the BTS and 228 returned (76"o).Eighty five per cent of respondents had been referred such patients undergoing chemotherapy for solid tumours or haemato- logical malignancies and 39%/ following solid organ transplantation.Seventy two per cent of physicians had seen HIV positive patients.Thirty three per cent stated that it was usual for them to see all immunocompromised patients admitted to hospital with pneu- monia, but only 10% had seen more than five patients in the preceeding three months.The usual request was for a diagnostic broncho- scopy alone in one third of cases and request for advice on management, including choice of therapy in the remainder.Forty two per cent felt that patients were generally referred too late.Seventy five per cent had written a protocol for the investigation and manage- ment of such patients.A 24 hour broncho- scopy service was available in 65% of units.Although routine microbiology and cytology of bronchoalveolar lavage fluid was available in 95% of units a rapid diagnostic virology service was available in only 36%.There was no consensus in the management of those immunocompromised patients whose clinical features were described in the three case histories.It was particularly noteworthy that 30 different combinations of antibiotics were selected by those choosing to give empirical treatment to the cases.The results of the survey suggest the majority of respiratory physicians are involved in the management of such patients but approaches to management are not uniform.Fifty one per cent of physicians expressed an interest in multi- centre prospective clinical studies of prophylaxis and treatment of opportunist pneu- monias.