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The Pediatric Lung.
  1. GEORGE RUSSELL, Consultant Paediatrician

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    The Pediatric Lung. Edited by RW Wilmott. (Pp 331 hardback; DM228.) Birkhauser Verlag AG, 1997. ISBN 3-764-35703-7.

    One of a series on respiratory pharmacology and pharmacotherapy,The Pediatric Lung deals with the drug treatment of lung disease in children. Topics range from long established medications such as cromones and corticosteroids to recent developments such as gene therapy, nitric oxide, and the pharmacological manipulation of non-CFTR ion channels in cystic fibrosis. These are dealt with comprehensively and systematically, and the editor has succeeded in imposing uniformity of style, which makes the book easy to read, and even easier to dip into. Each chapter is prefaced by a summary of its contents—which is just as well given the very brief index. For instance, accurately but obscurely, DNase (otherwise known as dornase α or Pulmozyme) is indexed under recombinant human deoxyribonuclease. Macrolide antibiotics, the non-antibiotic effects of which are discussed in the chapter on mucoactive agents, are not indexed at all.

    The editor describes his remit as being “to cover the more common of the pediatric respiratory disorders in a way that will be useful for the clinician, and with enough detail to be of value to the clinical researcher.” This is a tall order, and has resulted in a compromise between the breadth required by the clinician and the depth required by the researcher, in which breadth is usually the loser. Despite the excellence of the individual chapters, paediatric respirologists will need to have more on their shelf than this volume if they are to cope with the drug management of the wide variety of lung disorders encountered in everyday practice. Thus, although the excellent chapter on the management of viral pneumonia will be useful, there is no section on the lung infections associated with AIDS. There is nothing on pulmonary hypertension other than a brief reference in the nitric oxide chapter. The use of theophylline in acute asthma is well described, but its use in chronic asthma is dismissed as “uncertain”—which some might say is not a bad summary, but rather dismissive of the vast numbers of papers that have reported the use of theophylline as maintenance treatment in children.

    This slim volume in unlikely to grace the shelves of many British paediatricians. It is attractive and well written, but is limited in its scope and rather expensive. It will certainly be of value to the teacher wishing to save a trip to the library while preparing a lecture, or the budding researcher looking for an informed and up to date summary of current knowledge—for both, the extensive well chosen reference list at the end of each chapter will be extremely useful, provided there is a chapter on the relevant topic. As one of a series, it is likely to be followed by later volumes that will plug the gaps. Meantime, it is a book for the departmental library rather than the personal bookshelf.

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