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WAO Medical Book Review

Posted: October 2009

Chronic Obstructive Pulmonary Disease Exacerbations
Series: Lung Biology in Health and Disease, Volume 228
Jadwiga A. Wedzicha and Fernando J. Martinez (Editors)
2008 Informa Healthcare
ISBN-10: 142007086X
ISBN-13: 978-1420070866
List Price: $ 249.95 USD; 125.00 GBP
Available from Informa Healthcare

Dr. Graeme A. Thompson, M.B.B.S. (Hons1), FRACP
Respiratory Physician and Conjoint Lecturer
Campbelltown Hospital and University of Western Sydney

Chronic Obstructive Pulmonary Disease (COPD) is a disorder that is rising in prevalence, adding an ever increasing burden on health care systems and is a disease characterized by exacerbations that ultimately accelerate the progression of the disease. Increasingly, COPD is being thought of as an inflammatory disorder with systemic features far reaching beyond the lung, driven by the immunology of the disease. It is hoped that the immuno-pathogenesis of COPD will provide novel agents for targeting the slow but relentless disease progression. This text book reviews the most up to date physiological, environmental and biological causes and effects of COPD exacerbations.

The textbook provides an extremely comprehensive review of COPD exacerbations including addressing the clinical, immunobiology and health economics of the disease. The text book also provides consideration for the way forward, both clinically and in terms of research.

The textbook is undoubtedly beneficial for all clinicians and trainees in the area of pulmonary medicine and related disciplines. In addition, the book handsomely provides for researchers in the area with extensive sections dedicated to animal models of COPD, trial design, unique statistical considerations in COPD trials and future and novel areas for exploration.

The text book is subdivided into five main areas: Introduction, Mechanisms and Pathophysiology, Impact of Exacerbations, Management of Exacerbations, Prevention of COPD exacerbations, and Issues for Studies of COPD Exacerbations.

The initial chapters comprehensively review the clinical, epidemiological and the airway immunobiology of COPD exacerbations. The roles of bacterial, viral, environmental and co-morbid factors are extensively analysed in the subsequent chapters. The impact of the disease on the individual and the health economics of the disease are then reviewed. Appraisal of the therapeutic modalities including physical therapy and rehabilitation follow. The clinical recommendations are based on the best available evidence based medicine and adequately referenced for further analysis.

The comprehensive nature of the clinical and immunobiology content ensure that the text will be a valuable resource for both clinicians and researchers at all levels of expertise. The book adds a certain amount of optimism for clinicians and researchers involved with a disease that has previously been shrouded in nihilism.