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Lung Biology in Health and Disease. Volume 111. Dyspnoea. Mahler Donald A. (Pp 432; $165.00). New York: Marcel Dekker, 1998. ISBN 08247 9814 7.
The preface states that the aim of this volume is to focus on the problem of dyspnoea as a symptom (the manifestation of a pathophysiological condition) and as an illness (the entire range of a person’s understanding and response to breathing difficulty).
Fifteen experts in the field have contributed to the 11 chapters in the book. The first presents a conceptual model that considers dyspnoea as a sensation, symptom and illness, and the next chapter explores the language of dyspnoea and the various descriptors that patients with different diseases use to describe their experience of breathlessness. The mechanisms of breathlessness, the diagnosis of the cause, together with how to assess and measure the severity of breathlessness and its impact upon the patient are covered in the chapters that follow. Three further chapters address treatment strategies for relieving breathlessness. These include those specific to the underlying disease process, a very useful chapter on coping strategies, physical modalities such as exercise training and inspiratory muscle training as well as oxygen and other medications. The final chapter evaluates the management of dyspnoea in patients receiving ventilatory assistance. Whilst there is some similarity between the chapters contributed by the same authors to both Mahler’s earlier book on dyspnoea (published in 1990 by Futura) and this volume, in each instance the chapters have been expanded to take into account more recent developments. Similarly, whilst some overlap exists with the recent volume onRespiratory Sensation in this series, this is largely complementary rather than repetitive.
This book is enjoyable to read. It achieves its stated aims and represents the most comprehensive and up to date summary of knowledge concerning the management of dyspnoea in this format. It is essential reading for professionals involved in research into dyspnoea and is highly recommended to those whose clinical practice largely involves caring for breathless patients.
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