BOOKS,FILMS,TAPES,&SOFTWARE

are: “Fundamentals never change,” “When Pleural Disease. Demosthenes Bouros, ed- pseudochylothorax, hemothorax, and the in doubt, check it out,” “Airway manage- itor. (Lung Biology in Health and Disease management of the undiagnosed and per- ment in difficult situations can be a hum- series, volume 186, Claude Lenfant, exec- sistent pleural effusion. The concluding bling experience,” “Light travels in a straight utive editor.) New York: Marcel Dekker. chapter is on animal models for ongoing line,” “To master a technique, perform the 2004. Hard cover, illustrated, 1,044 pages, pleural investigation. same technique in different patients, not dif- $250. Overall, the chapters are concise, well ferent techniques in different patients,” “The This 1,044-page book, which includes 51 organized, and well written. Each chapter patient’s well-being should always come be- chapters and an index, is one of the most has an up-to-date and extensive reference fore the desire to practice a technique,” and, comprehensive texts on pleural disease. Var- list at the end. The chapters are well illus- finally, in the chapter on extubation and tube ious medical specialists, including pulmo- trated with appropriate tables that are easily replacement “Any tube is better than no nologists, general internists, cardiologists, referenced. Several chapters are devoted to tube.” oncologists, radiologists, thoracic surgeons, the role of imaging techniques, both radio- In a tome of this size it would be aston- and pediatricians are faced with the diagno- logic and ultrasound, in the diagnosis and ishing if there were no missteps. In the chap- sis and management of pleural disease. management of various pleural diseases. The ter on transtracheal jet ventilation, the au- Each chapter provides a comprehensive, authors of these chapters wrote a nice re- thor avers that insufflating high oxygen flow state-of-the-art presentation of various pleu- view of the subject and provided numerous “will provide oxygen but no ventilation and ral diseases, written by the world’s leading excellent illustrations, including radio- will prevent the buildup of carbon dioxide.” authorities. The authors are from renowned graphs, tomograms, ultrasound images, and There are a couple of typographical errors medical institutions and from many coun- magnetic resonance images, which have ap- too, such as “humblimg” and “Inadition.” tries, which gives the book an international propriate arrows pointing to the abnormal- And in the chapter on flexible fiberoptic perspective. Contributors include Steven ities. scopes, the author proposes that the endo- Sahn, Veena Antony, John Heffner, Andreas Diagnosis and management of pleural tracheal tube used for flexible fiberoptic en- Diacon, Philippe Camus, Paul Van Schil, diseases are well elucidated. There are chap- doscopy should be “not larger than a 7-mm and Richard Light, to name a few. ters on thoracentesis, closed pleural biopsy, tube for adult patients.” The chapters follow a nice, logical chest tube thoracostomy, pleural lavage, scheme; chapter foci include pleural disease, medical thoracoscopy, and video-assisted When one looks at the entire work, the pleural anatomy, pleural space physiology, thoracoscopic surgery. The chapters follow previous paragraph just picks some very in- respiratory function in pleural effusion, im- a logical order, beginning with an introduc- significant nits. This book should be in the aging of the pleura, utility of ultrasonogra- tion, indications, equipment, technique, con- library of every respiratory therapy educa- phy, medical thoracoscopy, video-assisted traindications, complications, clinical appli- tion program and of every respiratory ther- thoracoscopic surgery, transudative and ex- cations, and the limitations of the various apy service department. The neophyte could udative pleural effusions, limitations of pleu- procedures. use it as an introductory text; the more ex- ral fluid tests, and clinical evaluation of pa- A substantial portion of the book is ded- perienced practitioner could use it to review tients with pleural effusions. The remainder icated to pleural-space infections. There is a a seldom-used technique. Although at first of the book discusses transudate pleural ef- fairly comprehensive review of tuberculosis the atlas’s 575 pages present a formidable fusions, empyema/parapneumonic effu- pleuritis, HIV-related pleural complications, mountain to climb, once the therapist be- sions, drug-induced pleural disease, malig- empyema/parapneumonic effusions, and gins, he or she will make rapid progress. nant pleural effusions, benign and malignant fungal infections. Chapters on those sub- And the price is more than reasonable for tumors of the pleura, immunological dis- jects are seldom found in other pleural-dis- such a complete reference on airway man- eases of the pleura, benign asbestos-related ease textbooks and they are an excellent agement. pleural disease, pleural effusions in hema- addition to this one. The author of this text clearly knows tologic disorders, pleural effusions related Malignant pleural effusions (primary or whereof she speaks from much experience. to human immunodeficiency virus (HIV), metastatic) are a major cause of morbidity In addition, she is a professor emeritus of pneumothorax, tuberculous pleuritis, pleu- and mortality. Sahn, Froudarakis, and Four- anesthesia, and, even in this enlightened age, ral effusions encountered in the pediatric nel provide 2 well-written chapters on ma- women at the full professor level are still population, pleural effusions in pregnancy lignant pleural effusions and pleural effu- few in number. And the title “emeritus” is and gynecologic diseases, pleural disease in sions associated with lung carcinoma. awarded only to those who are truly deserv- the critically-ill patient, and pleural effusions Benign pleural tumors and mesothelioma ing; it is not automatic upon retirement from in the setting of pulmonary embolism. Two are addressed in Chapters 25 and 28. In university service. So run, don’t walk, to chapters are devoted to pleural effusions sec- Chapter 29, Sugarbaker, a pioneer in the your purchasing office and place your order ondary to fungal, nocardial, and actinomy- development of extrapleural pneumonec- for this most useful book. cotic infection as well as pleural effusions tomy, discusses that procedure’s role in treat- associatedwithparasiticinfections.Alsodis- ing diffuse malignant mesothelioma. In that Robert R Fluck Jr MSc RRT FAARC cussed are rare and iatrogenic pleural effu- chapter the mortality rates from all the re- Department of Respiratory Therapy sions such as amyloidosis, uremia, yellow ported series are shown in tables, which can Education nail syndrome, trapped lung, mediastinal be quickly referenced. State University of New York cysts, and radiation injury, and there are Pleural diseases are frequently encoun- Upstate Medical University chapters devoted to pleural effusions fol- tered in everyday clinical practice in vari- Syracuse, New York lowing organ transplantation, chylothorax, ous fields of medicine, so it is important for

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most, if not all, clinicians to possess a basic over the previous versions. Most chapters logic and epidemiologic arguments for both understanding of pleural disease, at least as have been revised and re-organized and new sides very well. This debate is followed up it applies to their patient population. contributing authors have been brought on by some general recommendations that are Few textbooks can rival the comprehen- board. Most notably, there is a new chapter similar to the current recommendations by siveness of Pleural Disease. Although the on diabetes and diving by Duke Scott and the British Thoracic Society, with one no- book has some overlap in some subjects, it Allan Marks. Those authors have also in- table exception: those guidelines recom- does improve the overall readability of the cluded a very useful appendix with a rec- mend against diving with exercise-induced book. For practicing pulmonologists about ommended protocol for diabetes manage- or cold-induced asthma. Neuman’s recom- 25% of their consultative work centers on ment during recreational scuba diving. There mendations are more permissive, in that he the diagnosis and management of pleural is also a separate chapter on medical eval- suggests that divers who pass an appropri- diseases, and most general pulmonary text- uation for sport diving, the information in ate challenge test of cold-induced or exer- books lack adequate detail in this subject, which was previously in the chapter on com- cise-induced asthma should be permitted to so practitioners usually rely on time-con- mercial and military diving. Other new ad- dive. The chapter also includes helpful dis- suming searches of the medical literature to ditions include new chapters on the kinetics cussions on chronic obstructive pulmonary answer questions about pleural disease. This of inert gas and marine poisoning and in- disease in diving and special tests of the text provides an excellent reference for the toxication. As has always been the aim of respiratory system. diagnosis and management of common and the book’s editor, each chapter is written by The editor’s aim was to provide compre- rare pleural diseases. The chapters are state- a renowned author or authors in the subject. hensive coverage of the salient areas of div- of-the-art, comprehensive, and a “must Each chapter includes a detailed, accurate ing medicine and physiology. The level of have” for any clinician who is asked to eval- reference list with recent references. discussion provides a broad appeal, and the uate and manage complex and often diffi- The stated readership of the book is “phy- topics covered are relevant to many health cult-to-diagnose pleural disease cases. The sicians who provide care for divers,” but the care professionals. Specifically, I was book’s intended readership is fairly focused book has a far broader appeal. A wide va- pleased to see chapters on both free-diving on pulmonary medicine; however, medical riety of health care professionals would find and mixed-gas diving, both of which are oncologists, thoracic surgeons, and general this book useful. In fact, there is so much rapidly becoming more popular and there- internists would have interest in this book. background (eg, on diving equipment, phys- fore need separate treatment in a diving med- In summary, I commend Demosthenes ics, and physiology), a reader with little or icine text. Moreover, the editor chose to in- Bouros, editor of Pleural Disease for his no background in diving medicine could still clude other topics outside the standard ability to present one of the most compre- appreciate this book. Correspondingly, in a decompression illness realm, such as drown- hensive texts regarding the pleura. book of this size (623 pages) some more ing, hypothermia, and marine animal inju- experienced readers might be disappointed ries. The writing style is generally very read- John T Huggins MD that some of the chapters are not as in-depth able, although the section on bubble physics Division of Pulmonary as in other larger diving medicine texts. is relatively technical and I thought proba- and Critical Care Medicine, The fourth edition includes an excellent bly necessary. Allergy, and Clinical Immunology chapter on “Women in Diving,” by Maida Bove and Davis’ Diving Medicine is Medical University of South Carolina Beth Taylor. This fascinating chapter starts presented in an attractive, compact format. Charleston, South Carolina by discussing physiologic differences be- The price is very reasonable, especially for tween male and female divers and fetal div- a text of this quality. The illustrations and ing physiology. Taylor then tackles many figures, presented in black-and-white, are Bove and Davis’ Diving Medicine, 4th edi- female-specific clinical concerns, such as helpful additions to the material presented tion. Alfred A Bove MD PhD. Philadel- endometriosis, contraception, and menstru- in the text. Color illustrations would cer- phia: Elsevier Science/Saunders. 2004. Hard ation, as they relate to diving. Taylor even tainly be welcome in certain subjects, espe- cover, illustrated, 623 pages, $84.95. includes such details as the diving medicine cially marine poisoning, which has many Now in its fourth edition, Bove and ramifications and relative buoyancy of sa- pictures of dangerous sea creatures and their Davis’ Diving Medicine is a well-respected line versus silicone breast implants. This consequences such as rashes and enveno- resource in the field of diving medicine. It chapter also covers the recent Women’s mations. Black-and-white photographs un- is a comprehensive text of diving medicine Health Initiative study on hormone replace- fortunately do not adequately illustrate these and physiology starting at first principles ment therapy in post-menopausal women topics. Naturally, adding color plates would with diving physics and building to special- and how it relates to divers. increase the cost of the book, but it would ized chapters such as an entire chapter on RESPIRATORY CARE readers may be dis- be worthwhile for that chapter at least. From aseptic necrosis of bone. Eric Kindwall’s appointed by the shortness of the chapter on an editorial point of view, there were a few chapter on the history of diving medicine is pulmonary disorders. At 10 pages, it is one entries in the index that did not correspond a fascinating read from one of the key con- of the shortest chapters in the book. The to the text. This oversight makes the index tributors to the field. Bove and Davis’ Div- author, Tom Neuman, treats the controver- somewhat less useful. Overall, the rest of ing Medicine was first published in 1976, sial area of asthma and diving in a debate the editing appeared very professional. with more of a physiology focus. Over the format. He presents the cases both for and In conclusion, the fourth edition of Bove subsequent editions, more and more clinical against asthmatics diving. This debate for- and Davis’ Diving Medicine builds on a information has been included. This newest mat is particularly apt for such a conten- great diving medicine text. It is suitable for edition has several important improvements tious area. Neuman addresses the physio- a broad range of readers, and is a worthy

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