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Asthma is a common disease affecting millions of children and adults worldwide and it is the most common chronic disease of children. The pathophysiology of asthma is complex, and there is an important interplay of genetics and environment causing a variety of manifestations. There are many national and international guidelines for the stepwise approaches to therapy and education for both maintenance care and acute episodes of asthma. ABC of Asthma is in the ABC book series by BMJ books and is updated in this 6th edition. It is divided into 17 concise chapters that cover all pertinent aspects of asthma, including pathology, prevalence, diagnostic testing, monitoring, clinical course, precipitating factors, and treatment guidelines for both chronic and acute management in both adults and children. The first 10 chapters discuss management in adults, followed by 5 chapters that discuss management issues in children. The last 2 chapters recap the clinical aspects of asthma care in a primary care setting and the organization of an asthma clinic. A short index follows, which is useful.
The stepwise approach and guidelines are based on those of the British Thoracic Society, the Scottish Intercollegiate Guidelines Network, and the Global Initiative for Asthma (GINA) guidelines for asthma therapy, which differs somewhat from the guidelines outlined in the United States. For instance, during asthma exacerbation treatment, very specific oxygen suggestions are given (40–60% oxygen delivery for all patients) in addition to intravenous aminophylline and intravenous β-agonists as adjuncts in severe attacks, which are not recommended in the Expert Panel Report from the United States National Asthma Education and Prevention Program because of insufficient evidence of benefit. In addition, there are some spelling and wording differences between the United Kingdom and United States guidelines. In general, the authors achieved their stated aims, selected and organized the material in a logical fashion, and supported the material with appropriate current references.
This soft-cover, lightweight book is easy to read and would be useful to respiratory therapists, nurses, medical students, and allied health professionals. It would also be useful to primary care clinicians as a thorough overview of asthma, with pertinent aspects for care. It is well written and would take about 3 hours to read in depth. Each chapter begins with a bulleted boxed overview of the key points to convey, which organizes the reader's thoughts. There are simple diagrams and figures that accurately illustrate the data of each chapter. Key sections are expanded in boxes, which include lists of symptoms, descriptions of specific tests, and causes of occupational asthma. There are also a few tables. The layout is helpful to readers, as it breaks down the chapters to make it easier to read, and each chapter is only a few pages (7 at most).
Though asthma is similar in adults and children, there are 5 dedicated chapters on the differences in children, which will be helpful to those unfamiliar with specific pharmacotherapy and differences in younger patients with asthma. The chapters all end with a further-reading section, and some in addition have a reference section with current literature cited within that chapter. Several topics are covered in multiple chapters, and this reinforces the message being conveyed. The book is well referenced with current literature to support its statements. Compared to other books on the basics of asthma, this book is reader-friendly and comparable to other works in the realm and is reasonably priced.
My only criticism relates to some of the color photographs, which are really unnecessary. For instance, all readers would know what a teenager is, or an obese child, or what vacuuming is, yet there are figures with color photographs for “asthma diagnosed in a teenager,” “childhood obesity is linked to asthma,” and a man vacuuming a chair, which don't add anything to the context of the book as they are obvious, but they do add color. Perhaps more data on obesity and asthma, and specific precipitating allergens would make the text more useful. On the other hand, some of the photographs are very important, including those of patients demonstrating inhaler technique and nebulizer technique, spacer devices, and examples of thrush. One diagram I would like to see added is a specific step-by-step outline of the appropriate way to instruct a patient in inhaler technique, though this is briefly relayed in the text. It might be helpful to put that information in a box to reinforce correct inhaler technique on each visit to the provider.
The author has disclosed no conflicts of interest.
- Copyright © 2011 by Daedalus Enterprises Inc.