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P M A Calverley, W MacNee, N B Pride, P M Rennard, Editors. London: Arnold, 2003, £110.00, ISBN 0 340 807180
If I want to find the latest research papers quickly, the internet is the place to go. For advice on management there is no shortage of reputable guidelines. So what use is the old style textbook? The editors of the second edition of Chronic Obstructive Pulmonary Disease touch on this question as they introduce their own book and suggest that what they offer is time and depth. A textbook allows consideration of all aspects of a disease—not just the latest trials in COPD but the development and pathophysiology of the condition—and time to address the full background to active research topics even if the very latest advances cannot be incorporated. Contributors to a textbook have the opportunity to present a detailed exposition of a topic in a way that few readers could manage themselves via a trawl of the internet.
So has this opportunity been taken in Chronic Obstructive Pulmonary Disease? Overall, I think it has. No textbook is meant to be read from cover to cover and I haven’t tried, but I did start at the beginning and, if thoughtful consideration is the hallmark of a textbook, then the opening chapter on definitions certainly sets the correct tone. Anyone who weaves Alice in Wonderland and Karl Popper into the first few pages of a medical book is doing rather more than going through the motions. This is a nice start, but perhaps the real test of any textbook is how well it explains the topics on which the reader is ignorant. I found myself worryingly spoilt for choice but decided to start with the chapters on “Oxidative Stress” and “Airway Repair”, both of which are written by members of the editorial team. The styles are different but I learned from both. The chapter on “Oxidative Stress” is certainly detailed but worth the effort, and the briefer chapter on “Airway Repair” provided an extremely useful summary for an uninitiated person like myself. Several other chapters also brought rewards, not least those on “Lung Mechanics” and “Exercise” and the well written summary of “Pulmonary Rehabilitation”. The smaller number of chapters whose subject matter I like to think I know well inevitably seemed a little less informative, but there are none anywhere near poor enough to be highlighted here. There is far more to applaud than to be disappointed with.
No-one will believe a review free of complaints, so I should list some. I think the editors might consider the balance of the chapters. Should there be seven pages on “α1-Antitrypsin” when the whole “Pathology” chapter only gets the same? Or just nine pages on “Inflammation” when “Oxidative Stress” contains 20? There are also a few omissions. Despite the explanation in the Preface, I think it would be nice to have a chapter summarising the role of cigarette smoking and the mechanisms underlying this (a chapter on “Smoking Cessation” compensates in part). A good chapter on “Oxygen Therapy” offers little about short burst oxygen, and I struggled to find anything on the current debate regarding the role of inhaled steroids in preventing a decline in FEV1 (it’s actually under the slightly misleading subheading “Short-term Treatment with Inhaled Corticosteroids”).
But these are minor quibbles. The package as a whole is of high quality and pitched at a level which will be appreciated by respiratory trainees, consultants, and the interested general physician.
A walk through the average medical school or hospital library suggests that there is still an appetite for textbook learning, and those wishing to know more about COPD will be well served by this title.
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