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March 5, 1982

Thoracic Medicine

JAMA. 1982;247(9):1348. doi:10.1001/jama.1982.03320340094054

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Although rifampin seldom upsets the stomach, it induces hepatic enzymes. As a result, tuberculous women taking the drug and relying on the contraceptive pill become pregnant, and addicts in methadone programs have withdrawal symptoms. In his book, Thoracic Medicine, Emerson warns about treating pregnant women. If a woman receives antituberculous drugs during the first 12 weeks of pregnancy (either because her condition demands it or more usually because she becomes pregnant in the course of treatment), he monitors her α-fetoprotein levels. Raised levels often indicate serious fetal abnormality such as open neural tube.

The 30 contributors to Thoracic Medicine give an in-depth view of pulmonary disease, often referring to illustrative x-ray films and physiological data. Collins, for example, tells how he uses peak expiratory flow rates to assess bronchial asthma. He describes new aerosols of high active topical steroids that may help us treat severely asthmatic children without retarding their