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NONINVASIVE DIAGNOSTIC TECHNIQUES IN VASCULAR DISEASE
_[]
the bookshelf
NONINVASIVE 3rd ed. Edited 1985,
919 pp.
Interest surgeons
DIAGNOSTIC by EUGENE
TECHNIQUES F BERNSTEIN.
IN VASCULAR St. Louis: CV Mosby
DISEASE. Company,
$89.95
in noninvasive vascular technology to a broader group: eg, neurologists,
has spread from vascular radiologists, cardiologists, and
internists. And, with the 1500 vascular laboratories that have mushroomed across the United States, an even larger crop of vascular technologists has emerged. Now that the field has advanced to another level of maturity, the most comprehensive and balanced text on this subject has come out with its third edition. About 50 of the 85 chapters are either new or extensively revised. Throughout, the text addresses the important questions: Is the clinical classification of disease accepted and standard? Has the diagnostic test been properly validated with safeguards to prevent bias? Can the test be used in the clinical situation fur which it was designed? and, Will the test provide information that is useful fur both diagnostic purposes and long-term follow up? As such, all the noninvasive techniques that have progressed from early enthusiasm
to a documented
level
of usefulness
and
reliability
are
placed
in
proper perspective. Detection and documentation of vascular disease, the characteristics of obstruction, its functional significance, and anatomical localization, etcetera, are well covered. Methods of evaluating asymptomatic carotid disease (along with objective proof that once carotid stenosis is more than 80 percent. the patient should probably have elective surgery) are clearly presented. The newest advances in vascular imaging, digital positron emission tomography, nuclear resonance, etcetera, are all here, along with practical items predict amputation level healing, or how to pick up stenoses. (These can be angioplastied or reoperated surgery is required.) Remaining problems, such as how to standardize reporting data so that data can be transferred from time to time, are also addressed. While computers and bookkeeping purposes, the ambiguities current vascular labs from taking full advantage lie in this direction are also well-summarized
subtraction angiography, radionuclide application, such as how to correctly clinically silent recurrent before more extensive testing, classifying, and lab to lab, as well as from are being used fur analytic
still challenge of computers. by this superb Alan
T Marty,
and prevent The hopes that text. M.D.,
Evansville, HELPING CARDIAC PATIENTS. THERAPEUTIC APPROACHES. Jossey-Bass
Publishers,
1985,
230
BIOBEHAVIORAL By ANDREW M. pp.
F.C.C.P
Indians
AND PSYCHORAZ5N. San Francisco:
$21.95
The authors have successfully compiled research studies reflecting biobehavioral and psychotherapeutic interventions fur cardiovascular diseases including hypertension, cardiac arrhythmia, cardiac surgery, and coronary artery disease. In addition to discussion of the etiology of the diseases, the writers explicitly outline treatment approaches used in these fuur areas. In chapter one, the focus is on hypertension and nonpharmacologic treatments. Interventions which have reported measures of success are relaxation training, biofeedback, and meditation. The authors also introduce an exciting new concept in treatment which they term “transactional psychophysiology.” In the treatment of cardiac arrhythmia (chapter two), emphasis is placed on identification of specific psychologic, psychosocial, behavioral, and psychophysiologic factors associated with the initiation, exacerbation, and maintenance of arrhythmia. Biobehavioral intervention combined with medical management is advised to eliminate risk factors and to alleviate depression and anxiety. In chapter three, improvement of assessment techniques in heart surgery patients is recommended to uncover those who are at risk fur postoperative cardiac delirium. This chapter presents a thorough expose on cardiac surgery, postoperative problems, recovery and rehabilitation. One must surely be impressed by the wealth of information presented here. In chapter four on coronary artery disease. Razin organizes research on psychosocial interventions into three sections: prevention, acute-phase, and convalescent/rehabilitation phase. In spite of the exhaustive survey of studies cited, Bazin sees the need fur more specific tested hypotheses in order to obtain conclusive evidence. This book promotes the importance of interpersonal and environmental factors in the etiology and/or management of heart disease. Illustrative case samples highlight thought-provoking passages and enrich the learning experi-
A-20
ence of the reader. Although the authors bemoan the lack of clinical research available, they nevertheless provide a springboard fur more profound studies in the future. This book is easily read and the material well-presented. It provides an exemplary reference source and is highly recommended fur all disciplines who profess an interest in cardiac disease.
MS.
Shi,-Iemj Thrnsh, Evansville, ASSESSMENT OF CARDIOVASCULAR SON, C. FURBERC, 374 pp. $34.50
QUALITY OF THERAPIES. and J. EUNSON.
Indiana
LIFE IN CLINICAL TRIALS OF Edited by N. WENCER, M. MArs’. New York: LeJacq Publishing, 1984,
There is swelling realization among health professionals of the necessity to take into account quality of life, fur better and fur worse, as a major determinant in health care outcome. Set in the context of cardiovascular therapy, this book sharply illuminates the importance of expanding the evaluation of risks and benefits of medical intervention from traditional mortality and morbidity outcomes to include outcome domains such as emotional stability, cognitive functioning, social adjustment, and role performance. The style of print in this softbound volume is at once friendly to the eye. The title and contents derive from a workshop organized by the National Heart, Lung, and Blood Institute and held in June, 1983. The editors, together with more than 40 contributors, make up a distinguished group from both academic and governmental sectors. Interdisciplinary in scope, the book is not bus” dened with jargonistic exposition. The first of the book’s three main parts contains major presentations that impressively address conceptual perspectives and methodologic issues. McCullough’s philosophic model is neat, and Bush’s analogy elegantly illustrates technical problems in measurement. Participant discussions following each presentation, and though bothersomely discontinuous at points, raise some valuable issues and answers. In the second part, six measures are fully described by their developers and shown to have had applications in a considerable diversity of trials and conditions. Reader, take note that the six test instruments are reproduced in an appendix. The third part summarizes reports of feasible assessment strategies and recommendations for research focused on four cardiovascular disorders along the spectra of severity and treatment: mild hypertension, acute myocardial infarction, congestive heart failure, and coronary artery bypass graft surgery. Finally, a supplemental bibliography exhaustively cites instruments, and applications. This is a comprehensive and book is salutatorily recommended.
some
140
works
categorized
thorough state-of-the-art It prompts the scholar
into
concepts,
presentation. to better refine
concept of quality of life. It prompts the researcher to resolve some methodologic issues. And it prompts the clinician to more systematically quality of life assessment to clinical trials. Preston
IDEAL CARDIAC Saunders. 1984,
PACING. Edited 174 pp. $35.00
by
A.
HAicxs.
D. Phillips, Evansville, Philadelphia:
The the of the apply
Ph.D.
Indiana W.
B.
The pacemaker is the only implanted device which may be the sole support for life, second after second, without any awareness of the patient, who leads a normal life. The purpose of a pacemaker is to detect heart activity and pace whenever that rate is failing. Despite that simple function, the increasing complexity of the device, due to advanced technology, such as multiprogrammation or physiologic pacing, makes periodical updating mandatory for the physician. It is the aim of such a book as the “ideal pacemaker”. An historic overview by Paul Zoll, one of the fathers of modern pacing, introduces the subject, followed by a study on anatomy and pathology of the conduction system. Then, a chapter on electrophysiology of pacing explains clearly the phenomenon of cellular excitability and the electrical engineering problems related to pacing and sensing. The section on hemodynamics of pacing deals, in fact, with the heart function, and its changes with incremental atrial and ventricular pacing in normal patients. There is special emphasis on patients with coronary artery disease, and the use of atrial pacing as a diagnostic tool. That chapter lacks synthesis in the hemodynamic response to exercise in patients with implanted pacemakers. Indications fur cardiac pacing should compose an important chapter in such a book. Unfortunately, it is here just a simple overview without any strategy for
Continued
on page 22
the bookshelf
NONINVASIVE 3rd ed. Edited 1985,
919 pp.
Interest surgeons
DIAGNOSTIC by EUGENE
TECHNIQUES F BERNSTEIN.
IN VASCULAR St. Louis: CV Mosby
DISEASE. Company,
$89.95
in noninvasive vascular technology to a broader group: eg, neurologists,
has spread from vascular radiologists, cardiologists, and
internists. And, with the 1500 vascular laboratories that have mushroomed across the United States, an even larger crop of vascular technologists has emerged. Now that the field has advanced to another level of maturity, the most comprehensive and balanced text on this subject has come out with its third edition. About 50 of the 85 chapters are either new or extensively revised. Throughout, the text addresses the important questions: Is the clinical classification of disease accepted and standard? Has the diagnostic test been properly validated with safeguards to prevent bias? Can the test be used in the clinical situation fur which it was designed? and, Will the test provide information that is useful fur both diagnostic purposes and long-term follow up? As such, all the noninvasive techniques that have progressed from early enthusiasm
to a documented
level
of usefulness
and
reliability
are
placed
in
proper perspective. Detection and documentation of vascular disease, the characteristics of obstruction, its functional significance, and anatomical localization, etcetera, are well covered. Methods of evaluating asymptomatic carotid disease (along with objective proof that once carotid stenosis is more than 80 percent. the patient should probably have elective surgery) are clearly presented. The newest advances in vascular imaging, digital positron emission tomography, nuclear resonance, etcetera, are all here, along with practical items predict amputation level healing, or how to pick up stenoses. (These can be angioplastied or reoperated surgery is required.) Remaining problems, such as how to standardize reporting data so that data can be transferred from time to time, are also addressed. While computers and bookkeeping purposes, the ambiguities current vascular labs from taking full advantage lie in this direction are also well-summarized
subtraction angiography, radionuclide application, such as how to correctly clinically silent recurrent before more extensive testing, classifying, and lab to lab, as well as from are being used fur analytic
still challenge of computers. by this superb Alan
T Marty,
and prevent The hopes that text. M.D.,
Evansville, HELPING CARDIAC PATIENTS. THERAPEUTIC APPROACHES. Jossey-Bass
Publishers,
1985,
230
BIOBEHAVIORAL By ANDREW M. pp.
F.C.C.P
Indians
AND PSYCHORAZ5N. San Francisco:
$21.95
The authors have successfully compiled research studies reflecting biobehavioral and psychotherapeutic interventions fur cardiovascular diseases including hypertension, cardiac arrhythmia, cardiac surgery, and coronary artery disease. In addition to discussion of the etiology of the diseases, the writers explicitly outline treatment approaches used in these fuur areas. In chapter one, the focus is on hypertension and nonpharmacologic treatments. Interventions which have reported measures of success are relaxation training, biofeedback, and meditation. The authors also introduce an exciting new concept in treatment which they term “transactional psychophysiology.” In the treatment of cardiac arrhythmia (chapter two), emphasis is placed on identification of specific psychologic, psychosocial, behavioral, and psychophysiologic factors associated with the initiation, exacerbation, and maintenance of arrhythmia. Biobehavioral intervention combined with medical management is advised to eliminate risk factors and to alleviate depression and anxiety. In chapter three, improvement of assessment techniques in heart surgery patients is recommended to uncover those who are at risk fur postoperative cardiac delirium. This chapter presents a thorough expose on cardiac surgery, postoperative problems, recovery and rehabilitation. One must surely be impressed by the wealth of information presented here. In chapter four on coronary artery disease. Razin organizes research on psychosocial interventions into three sections: prevention, acute-phase, and convalescent/rehabilitation phase. In spite of the exhaustive survey of studies cited, Bazin sees the need fur more specific tested hypotheses in order to obtain conclusive evidence. This book promotes the importance of interpersonal and environmental factors in the etiology and/or management of heart disease. Illustrative case samples highlight thought-provoking passages and enrich the learning experi-
A-20
ence of the reader. Although the authors bemoan the lack of clinical research available, they nevertheless provide a springboard fur more profound studies in the future. This book is easily read and the material well-presented. It provides an exemplary reference source and is highly recommended fur all disciplines who profess an interest in cardiac disease.
MS.
Shi,-Iemj Thrnsh, Evansville, ASSESSMENT OF CARDIOVASCULAR SON, C. FURBERC, 374 pp. $34.50
QUALITY OF THERAPIES. and J. EUNSON.
Indiana
LIFE IN CLINICAL TRIALS OF Edited by N. WENCER, M. MArs’. New York: LeJacq Publishing, 1984,
There is swelling realization among health professionals of the necessity to take into account quality of life, fur better and fur worse, as a major determinant in health care outcome. Set in the context of cardiovascular therapy, this book sharply illuminates the importance of expanding the evaluation of risks and benefits of medical intervention from traditional mortality and morbidity outcomes to include outcome domains such as emotional stability, cognitive functioning, social adjustment, and role performance. The style of print in this softbound volume is at once friendly to the eye. The title and contents derive from a workshop organized by the National Heart, Lung, and Blood Institute and held in June, 1983. The editors, together with more than 40 contributors, make up a distinguished group from both academic and governmental sectors. Interdisciplinary in scope, the book is not bus” dened with jargonistic exposition. The first of the book’s three main parts contains major presentations that impressively address conceptual perspectives and methodologic issues. McCullough’s philosophic model is neat, and Bush’s analogy elegantly illustrates technical problems in measurement. Participant discussions following each presentation, and though bothersomely discontinuous at points, raise some valuable issues and answers. In the second part, six measures are fully described by their developers and shown to have had applications in a considerable diversity of trials and conditions. Reader, take note that the six test instruments are reproduced in an appendix. The third part summarizes reports of feasible assessment strategies and recommendations for research focused on four cardiovascular disorders along the spectra of severity and treatment: mild hypertension, acute myocardial infarction, congestive heart failure, and coronary artery bypass graft surgery. Finally, a supplemental bibliography exhaustively cites instruments, and applications. This is a comprehensive and book is salutatorily recommended.
some
140
works
categorized
thorough state-of-the-art It prompts the scholar
into
concepts,
presentation. to better refine
concept of quality of life. It prompts the researcher to resolve some methodologic issues. And it prompts the clinician to more systematically quality of life assessment to clinical trials. Preston
IDEAL CARDIAC Saunders. 1984,
PACING. Edited 174 pp. $35.00
by
A.
HAicxs.
D. Phillips, Evansville, Philadelphia:
The the of the apply
Ph.D.
Indiana W.
B.
The pacemaker is the only implanted device which may be the sole support for life, second after second, without any awareness of the patient, who leads a normal life. The purpose of a pacemaker is to detect heart activity and pace whenever that rate is failing. Despite that simple function, the increasing complexity of the device, due to advanced technology, such as multiprogrammation or physiologic pacing, makes periodical updating mandatory for the physician. It is the aim of such a book as the “ideal pacemaker”. An historic overview by Paul Zoll, one of the fathers of modern pacing, introduces the subject, followed by a study on anatomy and pathology of the conduction system. Then, a chapter on electrophysiology of pacing explains clearly the phenomenon of cellular excitability and the electrical engineering problems related to pacing and sensing. The section on hemodynamics of pacing deals, in fact, with the heart function, and its changes with incremental atrial and ventricular pacing in normal patients. There is special emphasis on patients with coronary artery disease, and the use of atrial pacing as a diagnostic tool. That chapter lacks synthesis in the hemodynamic response to exercise in patients with implanted pacemakers. Indications fur cardiac pacing should compose an important chapter in such a book. Unfortunately, it is here just a simple overview without any strategy for
Continued
on page 22