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Crapo JD, Glassroth J, Karlinsky JB and King TE (Eds): Baum’s Textbook of Pulmonary Diseases, 7th edition

Philadelphia: Lippincott Williams & Wilkins. 1450 pp. Hardback. ISBN 0-7817-3727-3-2004

Many years ago, longer than I may care to admit, I had to take my Board Exam in Pulmonary Medicine. I decided to prepare for the exam by reading a reference textbook cover-to-cover. Because Dr Gerald Baum had been one of my favorite teachers while I was a medical student in Cleveland, I naturally felt inclined towards an earlier edition of Baum's Textbook of Pulmonary Medicine. It was a most fortunate decision, because not only did I pass the Board Exam, but I much enjoyed the concise yet comprehensive style of the textbook that helped me to fill several lacunae of knowledge left over from my years in training.

On the basis of that experience, I have consistently advised our entering pulmonary fellows to read Baum's textbook from cover to cover as an efficient and relatively painless introduction to the pathophysiology and treatment of pulmonary diseases. With each subsequent edition, however, Baum's textbook grew progressively bulkier until it had to be split into two volumes. This change, in my opinion, resulted in the loss of a most endearing attribute, that of being a single-volume compendium of pulmonary medicine easily carried to the office or to an on-call room and read as time permitted.

The seventh edition of Baum's textbook is a welcome return to the single-volume format. The editors have completely revamped the previous edition of the book and produced a comprehensive, easy-to-read collection of chapters on pulmonary disorders, while keeping a tight rein on the burgeoning tendencies inherent in any multi-authored book. With the present edition of Baum's textbook, the editors have achieved their aim in producing a focused, highly readable work that serves both as a textbook and desk reference for practitioners of pulmonary medicine at all levels of training.

The book's 70 chapters are written by 106 authors, many of them internationally recognized experts in their field. The chapters are grouped into 12 sections ranging from diagnostic methods to respiratory disorders of sleep. There is overall coherence in size and feel of the various chapters, which, with very few exceptions, are clearly written and abundantly referenced. The conciseness of these chapters promotes learning and stimulates the reader to learn about related issues. I found myself jumping from chapter to chapter as my curiosity was piqued. Each chapter includes a critical evaluation of the underlying literature as well as simplified evidence-based medicine tables stating the level of evidence underlying critical recommendations or conclusions, with the prospective, randomized trial considered the highest level of evidence.

The chapters on pulmonary function and clinical exercise testing are particularly well written and together serve as a clear introduction to those interested in the assessment of lung function. Similarly, there are excellent chapters on the pathophysiology and treatment of obstructive lung disease, asthma and chronic obstructive pulmonary disease. The section on infectious diseases of the lung is highly readable and up to date. I particularly enjoyed reading the chapters on fungal infections and pneumonia. The chapter on lung cancer provides the reader with an abridged yet excellent exposition of a topic that can easily fill several volumes. Given its great length, 70 pages long and 499 references, this chapter is unique among the chapters in the book.

Not coincidentally, and reflecting the clinical interest of the editors, the textbook shines best in the section on inflammatory and interstitial diseases. Taken as a whole, the various chapters comprising this section form an excellent primer on this constantly evolving, and at times confusing, area of pulmonary pathophysiology. Deserving of special mention are those chapters on connective tissue diseases and on pulmonary vasculitis. Another excellent section is that dealing with pulmonary manifestations of systemic diseases. This is a collection of 10 chapters covering the complex interaction between pulmonary pathophysiology and diseases of other organ systems. Most chapters in this section were written by the same authors, minimizing repetition while providing useful cross-reference.

The textbook suffers from built-in obsolescence, a problem intrinsic to most collaborative works and presciently acknowledged by Dr Baum in the preface to the first edition. Most references point to studies published 5 to 10 years before the book's publication date. Although most photographs are of high quality, in particular those showing chest roentgenograms and computed tomography scans, greater use could have been made of color photography. A collection of color histopathology plates, with cross references to various chapters, is located in the center of the book. This is a bit annoying for the reader, who must flip back and forth to those chapters. Notably, the bulk of these plates belong to only five chapters in the book and it might have been worth the effort and expense to print the color plates within those chapters. Greater emphasis also should have been placed on uniformity in style of line graphs. These are of uneven quality and vary from chapter to chapter. A substantial number of graphs are reprinted from familiar publications, giving the textbook a slightly dated patina and leaving the reader with a sense of déjà vu.

It should be noted that the book focuses on respiratory diseases and ignores many areas common to pulmonary and critical care medicine. For example, only three chapters are devoted to acute respiratory failure and mechanical ventilation, compared with seven chapters on environmental lung disease. I also was disappointed by the relatively superficial treatment given to the physiology of the respiratory system. However, there are excellent chapters in the book that will appeal to intensivists, such as those on diving medicine and adaptation to altitude.

On the whole, this is a textbook that best serves pulmonologists and practitioners with a particular interest in pulmonary medicine. The return to a one-volume format has forced the editors to choose between conciseness of exposition and in-depth coverage on many subjects. Intensivists wishing to own a definitive reference work on pulmonary medicine might be disappointed by the brevity of style found in the many of the book's chapters and might wish to obtain a more detailed multi-volume textbook. However, Baum's seventh edition remains my choice of a user-friendly, concise yet comprehensive textbook and reference work, one that still can be read from cover to cover as an introduction to pulmonary medicine or as review for the Board Exams. The editors should be congratulated for maintaining Dr Baum's legacy and producing a textbook that is useful to the specialist and beginning student alike. Do I still recommend Baum's textbook to our new pulmonary fellows? Yes indeed!

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Correspondence to Guillermo Gutierrez.

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Gutierrez, G. Crapo JD, Glassroth J, Karlinsky JB and King TE (Eds): Baum’s Textbook of Pulmonary Diseases, 7th edition. Crit Care 9, E15 (2005).

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