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AIRWAY SMOOTH MUSCLE IN HEALTH AND DISEASE
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CLINICAL CARDIOVASCULAR THERAPEUTICS, VOL I. HYPERTENSION. Edited by HENRY A. PENZI and WALTER FUNEMBAUM. Mount Kisco, NY: Futura Publishing Co, 1990, 402 pp, $49.00 This multiauthor monograph provides a concise guide for all physicians treating hypertensive patients. Twenty chapters-each written by recognized authorities in their particular areas of interest-are devoted to pathology, diagnosis and treatment. As with all multiauthor texts, stylistic differences do occur, but due to good editing these do not alter readability. The first chapter discussed brieRy but adequately the pathology of the disease process. The next two chapters relate to diagnosis, including a fine discussion of the role of ambulatory blood pressure monitoring. A fourth chapter, divided into three sections, takes up core organ effects, including heart, brain, and kidney. Renovascular hypertension is discussed in detail in later chapters, one from the radiologist's point of vievv, the other from the internist's, thus providing a good balance on a subject on which there is still much controversy. Chapter 5 provides an extensive discussion of nonpharmacologic treatment. Pharmacologic treatment (including all classes ofdrugs now currently utilized) constitutes six chapters. All are discussed in depth, and the authors have succeeded in presenting what is the most currently accepted rationale for the use of particular agents, emphasizing majority rather than personal opinions. In every case, stress is placed on the need for individualization of therapy. Chapters are provided for discussion of quality of life and hypertension in concomitant disease, the elderly, the perioperative period, and pregnancy. There is also an excellent chapter on the treatment of hypertensive cases. References were provided at the end of pertinent chapters for those who may wish to seek additional information. In addition to being of great use to all physicians treating hypertensive patients, it can be of tremendous value to residents as a ready source of much valuable information in a brief, concise form, and deserves to be in the medical library of any hospital with a training program. john E. Gajewski, M.D.
Evansville, Indiana
EGAN'S FUNDAMENTALS OF RESPIRATORY CARE, 5th ed. Edited by C. S. SCANLAN. St. Louis: CV Mosby Co, 1990, 1037 pp, $51.95 Respiratory therapy is an essential component of the health-care system and has evolved into a complex area of expertise with therapeutic applications ranging from rescuing patients with life-threatening cardiopulmonary emergencies to improving or maintaining the best possible quality of life in chronically dyspneic ambulatory patients. Egan is the classic textbook for the profession of respiratory care. It is a pleasure to read the new edition. The book is divided into eight sections: foundations of respiratory care, scientific bases for respiratory care, applied life science, essentials of patient care, the need for respiratory care, basic therapeutics, care of the critically ill, and new horizons in respiratory care. In the first section, two chapters present the standards for the organization of a modern, comprehensive respiratory care department and discuss its place in the overall health-care system. The strength of the chapters is their fascinating details. The second section, divided into three chapters, introduces the physical principles underlying respiratory therapy. The "gas law" section traditionally was a strong point in previous editions of this book and, in the new edition, has further improved by assuming no previous knowledge by the reader and laying out step by step each concept and how it is measured or derived. In the third section, the structure and function of the normal respiratory and cardiovascular systems are discussed in approximately 150 pages, emphasizing physiologic aspects. The section on essentials of patient care deals in general terms with many practical aspects of daily patient care, including principles of infection control. The fifth section provides an introduction to pathophysiologic patterns of disease in patients with respiratory symptoms. In the basic therapeutics section, therapeutic tools are discussed (drugs, aspects of airway care, humidity and aerosols, intermittent positive pressure, medical gases, and chest physical therapy). Section seven (care of the critically ill) contains five chapters, providing much needed detail on the physiologic and pathophysiologic principles of ventilatory support. Technical advances in assisted mechanical ventilation have made intensive care more complex for the health practitioner but probably are of improved benefit to many patients. The chapters are presented with many detailed circuit diagrams for several types of ventilatory support systems. The critical presentation of modern ventilatory support is essential for an improved understanding and better
16
patient care. Practical aspects are included which are critically important for particular patient care. The last section deals with home care, pulmonary rehabilitation, and computer applications in respiratory care, an aspect which is still evolving. There are many features which make this book very appealing. The format of the chapters is uniform throughout the book. Each chapter is preceded by a set of objectives, followed by an explanation of terms used in the chapter, and supplemented by a comprehensive list of references at the end. Illustrations, graphs, and tables are used effectively to further summarize and clarify the text. Tables of commonly used conversion factors, a very extensive glossary of terms, and an excellent index complete the book. This is an excellent textbook for respiratory care students and practitioners. Because of its comprehensiveness, it is very well suited to be a reference source for respiratory care specialists and should be readily available not only in intensive care units, but in all respiratory care departments as well as the offices of pulmonary physicians. Barbara Gothe, M.D. Cleveland
AIRWAY SMoafH MUSCLE IN HEALTH AND DISEASE. Edited by RONALD F. COBURN. New York: Plenum Press, 1989, 318 pp, $59.50 Seventeen world-class investigators in the field ofsmooth muscle physiology have contributed chapters to this excellent text. There has been a rapid increase of knowledge concerning airway smooth muscle in recent years. Dr Coburn has produced a collection of these recent advances that should satisfy anyone who is interested in this important field - important because it forms the basis of therapeutic advances in pulmonary anti-inflammatory strategies. The book contains state-of-the-art concepts of plasma membrane receptors, smooth muscle contraction, activation of contractile proteins, and neural signals to the airways. Of particular value are the chapters that deal with asthmatic hyperreactivity in allergic and exercise-induced bronchoconstriction. The work is well referenced and has a thorough, helpful index. Dr Coburns stated goal in producing this book was to document current knowledge about normal and abnormal airway smooth muscle function. The goal has been achieved admirably. Anthony S. Rebuck, M.D. Toronto, Canada
PROBLEMS IN CRmCAL CARE, vol I~ no 1. INFECI10NS IN CRITICAL CARE. Edited by DAVID H. GREMILLION. Philadelphia: JB Lippincott, 1990, 147 pp, $30.00 Infections in Critical Care, edited by Dr. Gremillion of the University of North Carolina at Raleigh, presents selected topics in infectious diseases in the critical care setting. It is appropriate in a monograph to cover selective topics; the guest editor has done this well. The monograph is well organized and presented with the liberal use of tables and adequate references. It is easy to read and should be very useful to clinicians engaged in treating infections in critical care. The monograph is composed of seven sections on various topics. The best sections are on "Intravascular Device-related Infections:' by Drs. Perkins and Dascombe; "Infections Associated with Nonvascular Devices:' by Dr. Levin, and the section by Dr. Gremillion entitled, "Infectious Disease Risks for Critical Care Personnel." The weaknesses of the monograph are necessarily limited to narrowness of scope, which is the main limiting factor of a monograph. The monograph would be strengthened by a section on antibiotic selection, written by a clinician, which would complement nicely the pharmacokinetic section authored by Kirby and Spivey, both doctors of pharmacology. In summary, this monograph provides an updated, readable and useful source of information on selected aspects of infection in critical care. It is very readable and well organized, which is a tribute to the guest editor. An affordable monograph, it should be used by critical care personnel and be included in all critical care libraries. Burke A. Cunha, M.D. Mineola, New York
Continued on page 21
AI.~
----f.I~.t--th-e-b-oo-ks-h-elf--------~
--====-
CLINICAL CARDIOVASCULAR THERAPEUTICS, VOL I. HYPERTENSION. Edited by HENRY A. PENZI and WALTER FUNEMBAUM. Mount Kisco, NY: Futura Publishing Co, 1990, 402 pp, $49.00 This multiauthor monograph provides a concise guide for all physicians treating hypertensive patients. Twenty chapters-each written by recognized authorities in their particular areas of interest-are devoted to pathology, diagnosis and treatment. As with all multiauthor texts, stylistic differences do occur, but due to good editing these do not alter readability. The first chapter discussed brieRy but adequately the pathology of the disease process. The next two chapters relate to diagnosis, including a fine discussion of the role of ambulatory blood pressure monitoring. A fourth chapter, divided into three sections, takes up core organ effects, including heart, brain, and kidney. Renovascular hypertension is discussed in detail in later chapters, one from the radiologist's point of vievv, the other from the internist's, thus providing a good balance on a subject on which there is still much controversy. Chapter 5 provides an extensive discussion of nonpharmacologic treatment. Pharmacologic treatment (including all classes ofdrugs now currently utilized) constitutes six chapters. All are discussed in depth, and the authors have succeeded in presenting what is the most currently accepted rationale for the use of particular agents, emphasizing majority rather than personal opinions. In every case, stress is placed on the need for individualization of therapy. Chapters are provided for discussion of quality of life and hypertension in concomitant disease, the elderly, the perioperative period, and pregnancy. There is also an excellent chapter on the treatment of hypertensive cases. References were provided at the end of pertinent chapters for those who may wish to seek additional information. In addition to being of great use to all physicians treating hypertensive patients, it can be of tremendous value to residents as a ready source of much valuable information in a brief, concise form, and deserves to be in the medical library of any hospital with a training program. john E. Gajewski, M.D.
Evansville, Indiana
EGAN'S FUNDAMENTALS OF RESPIRATORY CARE, 5th ed. Edited by C. S. SCANLAN. St. Louis: CV Mosby Co, 1990, 1037 pp, $51.95 Respiratory therapy is an essential component of the health-care system and has evolved into a complex area of expertise with therapeutic applications ranging from rescuing patients with life-threatening cardiopulmonary emergencies to improving or maintaining the best possible quality of life in chronically dyspneic ambulatory patients. Egan is the classic textbook for the profession of respiratory care. It is a pleasure to read the new edition. The book is divided into eight sections: foundations of respiratory care, scientific bases for respiratory care, applied life science, essentials of patient care, the need for respiratory care, basic therapeutics, care of the critically ill, and new horizons in respiratory care. In the first section, two chapters present the standards for the organization of a modern, comprehensive respiratory care department and discuss its place in the overall health-care system. The strength of the chapters is their fascinating details. The second section, divided into three chapters, introduces the physical principles underlying respiratory therapy. The "gas law" section traditionally was a strong point in previous editions of this book and, in the new edition, has further improved by assuming no previous knowledge by the reader and laying out step by step each concept and how it is measured or derived. In the third section, the structure and function of the normal respiratory and cardiovascular systems are discussed in approximately 150 pages, emphasizing physiologic aspects. The section on essentials of patient care deals in general terms with many practical aspects of daily patient care, including principles of infection control. The fifth section provides an introduction to pathophysiologic patterns of disease in patients with respiratory symptoms. In the basic therapeutics section, therapeutic tools are discussed (drugs, aspects of airway care, humidity and aerosols, intermittent positive pressure, medical gases, and chest physical therapy). Section seven (care of the critically ill) contains five chapters, providing much needed detail on the physiologic and pathophysiologic principles of ventilatory support. Technical advances in assisted mechanical ventilation have made intensive care more complex for the health practitioner but probably are of improved benefit to many patients. The chapters are presented with many detailed circuit diagrams for several types of ventilatory support systems. The critical presentation of modern ventilatory support is essential for an improved understanding and better
16
patient care. Practical aspects are included which are critically important for particular patient care. The last section deals with home care, pulmonary rehabilitation, and computer applications in respiratory care, an aspect which is still evolving. There are many features which make this book very appealing. The format of the chapters is uniform throughout the book. Each chapter is preceded by a set of objectives, followed by an explanation of terms used in the chapter, and supplemented by a comprehensive list of references at the end. Illustrations, graphs, and tables are used effectively to further summarize and clarify the text. Tables of commonly used conversion factors, a very extensive glossary of terms, and an excellent index complete the book. This is an excellent textbook for respiratory care students and practitioners. Because of its comprehensiveness, it is very well suited to be a reference source for respiratory care specialists and should be readily available not only in intensive care units, but in all respiratory care departments as well as the offices of pulmonary physicians. Barbara Gothe, M.D. Cleveland
AIRWAY SMoafH MUSCLE IN HEALTH AND DISEASE. Edited by RONALD F. COBURN. New York: Plenum Press, 1989, 318 pp, $59.50 Seventeen world-class investigators in the field ofsmooth muscle physiology have contributed chapters to this excellent text. There has been a rapid increase of knowledge concerning airway smooth muscle in recent years. Dr Coburn has produced a collection of these recent advances that should satisfy anyone who is interested in this important field - important because it forms the basis of therapeutic advances in pulmonary anti-inflammatory strategies. The book contains state-of-the-art concepts of plasma membrane receptors, smooth muscle contraction, activation of contractile proteins, and neural signals to the airways. Of particular value are the chapters that deal with asthmatic hyperreactivity in allergic and exercise-induced bronchoconstriction. The work is well referenced and has a thorough, helpful index. Dr Coburns stated goal in producing this book was to document current knowledge about normal and abnormal airway smooth muscle function. The goal has been achieved admirably. Anthony S. Rebuck, M.D. Toronto, Canada
PROBLEMS IN CRmCAL CARE, vol I~ no 1. INFECI10NS IN CRITICAL CARE. Edited by DAVID H. GREMILLION. Philadelphia: JB Lippincott, 1990, 147 pp, $30.00 Infections in Critical Care, edited by Dr. Gremillion of the University of North Carolina at Raleigh, presents selected topics in infectious diseases in the critical care setting. It is appropriate in a monograph to cover selective topics; the guest editor has done this well. The monograph is well organized and presented with the liberal use of tables and adequate references. It is easy to read and should be very useful to clinicians engaged in treating infections in critical care. The monograph is composed of seven sections on various topics. The best sections are on "Intravascular Device-related Infections:' by Drs. Perkins and Dascombe; "Infections Associated with Nonvascular Devices:' by Dr. Levin, and the section by Dr. Gremillion entitled, "Infectious Disease Risks for Critical Care Personnel." The weaknesses of the monograph are necessarily limited to narrowness of scope, which is the main limiting factor of a monograph. The monograph would be strengthened by a section on antibiotic selection, written by a clinician, which would complement nicely the pharmacokinetic section authored by Kirby and Spivey, both doctors of pharmacology. In summary, this monograph provides an updated, readable and useful source of information on selected aspects of infection in critical care. It is very readable and well organized, which is a tribute to the guest editor. An affordable monograph, it should be used by critical care personnel and be included in all critical care libraries. Burke A. Cunha, M.D. Mineola, New York
Continued on page 21