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Manual of Asthma Management
Book reviews One Minute Asthma, Second Edition. Thomas F. Plaut, M.D. Amherst Massachusetts, Pedipress, Inc. 1995. 45 pages, $4.95 This update of a classic asthma education pocket reference for patients and parents presents current concepts of asthma management in short bulleted lists, generally making one point per page. Although short, and thus an ideal asthma education tool for busy people, it is remarkably comprehensive. Like the text, illustrations are simple and concise, clearly demonstrating proper technique for use of a peak flow meter or metered dose inhaler, or how to keep a peak flow diary. The only glaring omission is information on the role of allergen avoidance and immunotherapy as essential parts of a successful asthma management program in patients with allergic asthma. The book’s various sections clearly review pathophysiology of acute and chronic asthma, asthma triggers, home monitoring, symptoms, and warning signs of an asthmatic episode. The section on asthma pharmacotherapy is absolutely up-to-date and contains valuable instructions on appropriate medication usage. A resource section contains addresses and telephone numbers of the major organizations dedicated to the needs of individuals with asthma. One Minute Asthma is an ideal beginning for new patients and is an excellent complement to traditional oneon-one office-based asthma education. If you provide One Minute Asthma to your new asthma patients, you will not need redundant patient information handouts and you will make your asthma nurse educator’s life a lot easier. Although somewhat outdated, the companion book, Children with Asth-
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ma: A Manual for Parents, is the logical next step in patient education. WILLIAM K DOLEN, MD Associate Professor, Pediatrics and Medicine Medical College of Georgia Augusta, Georgia Manual of Asthma Management, Edited by P. O’Byrne and N.C. Thomson, W.B. Saunders, 1995, 865 pages, $39. This new text offers thorough, contemporary coverage of the disease of asthma. With contributors mostly from the UK and Canada, and other former colonies, including the US, and also from elsewhere in Europe, this can truly be characterized as an international effort. Forty-six chapters are grouped under headings of “Epidemiology and Pathogenesis,” “Diagnosis and Investigations,” “Assessment and Treatments,” “Management,” and finally, “Running an Asthma Service.” The chapters themselves are occasionally redundant, although this sometimes represents approaching the same topic from different, but defensible points of view. Each chapter is exceedingly well-referenced, allowing the reader to access the original work cited for more study in depth to form his or her own judgement. Particularly important references have been highlighted. Summary tables are used generously and well, and all chapters conclude with key points or “take home” lessons. The initial chapter offers a particularly useful classification scheme for asthma based on frequency of symptoms and medication required. Other chapters use the more often-cited “mild, moderate, and severe” categories, which seem less useful since they include criteria that can change day-to-
day. The chapter on triggers of asthma is a very broad overview. Notes indicating that readers can find more thorough discussions of these topics in later chapters would have been helpful. Pulmonary function tests are covered in a chapter heavy on pulmonary physiology but light on the use of these tests in the management of asthma. Chapters on assessment of asthma control with conventional measures as well as quality of life measures are well-written and useful, as these assessments will no doubt become critical to “outcome” studies for cost-effective care. A discussion of allergen avoidance offers practical advice for patients. The chapters on medications are particularly strong, covering everything from mechanism of action, to use and side effects, to future developments. Not only are standard medications such as corticosteroids and bronchodilators covered well, but attention is also given to newer agents on the horizon. The section on asthma management addresses both acute and chronic management in both adults and children. There is a fair amount of overlap here with other chapters and the section on children seems quite long, while that on adults quite short. Another very strong section is that on “Specific Problems” addressing such important and often vexing areas as occupational asthma, nonsteroidal anti-inflammatory drug asthma, gastroesophageal reflux, sinusitis and steroid resistance. Each topic is given coverage in concise well-written chapters. Overall, this book is a thorough compilation of up-to-date information on an important disease. Asthmologists should find it a very useful reference. JOHN M KELSO, MD Allergy Clinic Naval Medical Center San Diego, California
ANNALS OF ALLERGY, ASTHMA, & IMMUNOLOGY
428
ma: A Manual for Parents, is the logical next step in patient education. WILLIAM K DOLEN, MD Associate Professor, Pediatrics and Medicine Medical College of Georgia Augusta, Georgia Manual of Asthma Management, Edited by P. O’Byrne and N.C. Thomson, W.B. Saunders, 1995, 865 pages, $39. This new text offers thorough, contemporary coverage of the disease of asthma. With contributors mostly from the UK and Canada, and other former colonies, including the US, and also from elsewhere in Europe, this can truly be characterized as an international effort. Forty-six chapters are grouped under headings of “Epidemiology and Pathogenesis,” “Diagnosis and Investigations,” “Assessment and Treatments,” “Management,” and finally, “Running an Asthma Service.” The chapters themselves are occasionally redundant, although this sometimes represents approaching the same topic from different, but defensible points of view. Each chapter is exceedingly well-referenced, allowing the reader to access the original work cited for more study in depth to form his or her own judgement. Particularly important references have been highlighted. Summary tables are used generously and well, and all chapters conclude with key points or “take home” lessons. The initial chapter offers a particularly useful classification scheme for asthma based on frequency of symptoms and medication required. Other chapters use the more often-cited “mild, moderate, and severe” categories, which seem less useful since they include criteria that can change day-to-
day. The chapter on triggers of asthma is a very broad overview. Notes indicating that readers can find more thorough discussions of these topics in later chapters would have been helpful. Pulmonary function tests are covered in a chapter heavy on pulmonary physiology but light on the use of these tests in the management of asthma. Chapters on assessment of asthma control with conventional measures as well as quality of life measures are well-written and useful, as these assessments will no doubt become critical to “outcome” studies for cost-effective care. A discussion of allergen avoidance offers practical advice for patients. The chapters on medications are particularly strong, covering everything from mechanism of action, to use and side effects, to future developments. Not only are standard medications such as corticosteroids and bronchodilators covered well, but attention is also given to newer agents on the horizon. The section on asthma management addresses both acute and chronic management in both adults and children. There is a fair amount of overlap here with other chapters and the section on children seems quite long, while that on adults quite short. Another very strong section is that on “Specific Problems” addressing such important and often vexing areas as occupational asthma, nonsteroidal anti-inflammatory drug asthma, gastroesophageal reflux, sinusitis and steroid resistance. Each topic is given coverage in concise well-written chapters. Overall, this book is a thorough compilation of up-to-date information on an important disease. Asthmologists should find it a very useful reference. JOHN M KELSO, MD Allergy Clinic Naval Medical Center San Diego, California
ANNALS OF ALLERGY, ASTHMA, & IMMUNOLOGY