Clinicians Guide to Asthma
Author: Kian Fan Chung
Asthma is incredibly common in this country, indeed one statistic that sticks in my mind, is that around 10% of schoolchildren are affected. The majority of General Practitioners are reasonably conversant with the disease and could be forgiven an ill-concealed groan when the subject of asthma guidelines is offered as a discussion point at yet another drug company sponsored meeting. "Tell me something I don’t know!" is the frequently heard cry. It has to be said that GPs are in general a pragmatic bunch, interested only in the diagnosis and treatment of asthma in their patients. And with that in mind, does this book measure up? Well, yes - and no.
It is in Chapter 4: mechanisms of asthma; risk factors and pathophysiology, that most of us will start to flag, with much of the information from page 44 to 59 sailing clean over our heads. Rather a shame when the whole book is only 165 pages long and the last 19 pages are bibliography and index.
In Chapter 5, (pharmacology and therapy) again as far as the GP is concerned, there is excess unnecessary detail about the mode of action of corticosteroids and the diagrams of steroid and bronchodilator molecules are pretty but superfluous. Nearly two pages is devoted to cromoglycate, which along with nedocromil is said to be "used in prophylaxis and particularly effective in preventing asthma attacks induced by exposure to allergens or following exercise". Rather confusingly and later in the same paragraph, published trials of both drugs revealed unimpressive positive effects. Yet in the very next paragraph a trial of either is recommended before resorting to inhaled steroids! What’s a poor GP supposed to think?
Salvation for the GP comes in Dr Andrew Bush’s excellent chapter on asthma in infants and children. His eighteen thoroughly practical and entertaining pages are a pleasure to read and rescue an otherwise humdrum text. Not enough for this GP to wholeheartedly recommend the book, though I can see that the respiratory physician in training may feel differently.
| Publisher: | Edward Arnold Ltd
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| ISBN: 0-340-76287-X
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