July - September 2010: 
Volume 23, Issue 3

Click on the image to download the Issue in PDF format.


Pneumon 2010, 23(3):312-313
Demosthenes Bouros - "Pleural Disease"
Full text

Pleural Disease 2nd Edition, edited by Professor Demosthenes Bouros of the Democritus University of Thrace, provides updated information in the wide area of pleural disease, as a continuum to the successful 1st edition of six years ago. The area covered by this book incorporates some of the most common problems in respiratory clinical practice and some of the most intriguing research aspects in modern respiratory medicine. It is of interest that a PubMed search in early July 2010 revealed more than 50,000 items on “pleural disease” that were reduced only to a little under 30,000 items when the limits “human” and “English” were used. This 816-page book that includes 45 chapters covering all aspects of pleural disease will be of great interest to every respiratory physician, but also to various other medical specialists, including general internists, cardiologists, oncologists, radiologists, intensivists, thoracic surgeons and paediatricians. As it covers practically all the aspects of pleural disease, it can also be useful to researchers and young physicians and students in training.

This book follows a clear and logical sequence in its structure. It starts with the basics that may be necessary for the understanding of the underlying mechanisms of the pleura in health and disease (physiology and pathophysiology of the pleura) and moves on to the imaging modalities, including the rapidly evolving area of ultrasonography of the pleura. The basic diagnostic and minimally interventional procedures follow, including very interesting chapters on interventional radiology of pleural disease and medical thoracoscopy (covered from both the diagnostic and the therapeutic point of view). The chapters that follow provide the basics for any clinician who is involved in the management of pleural disease, including the evaluation of the most common types of effusions, with notably a chapter on “Management of the Undiagnosed Persistent Pleural Effusion” by Richard Light. A significant section of the book deals with the infectious and the malignant pleural effusions, including all the contemporary modalities for interventional management. Thoracic surgeons and respiratory physicians will find attractive the chapters on “Post Surgical Pleural Infection”, “Surgical Management of Empyema”, and “Extrapleural Pneumonectomy for Early-Stage Diffuse Malignant Mesothelioma”, which deal with uncommon but difficult problems in everyday practice. Other pulmonary disorders that are complicated by pleural disease have also been covered in detail, including interstitial lung disease and pulmonary embolism. All the modern diagnostic tests along with new surgical and non-surgical techniques for identifying and diagnosing pleural diseases have been covered, including medical thoracoscopy, pleural lavage, intrapleural use of fibrinolytics, image-guided insertion of small bore catheters, pleuroperitoneal shunt, and video-assisted thoracoscopic surgery (VATS).

Several chapters are particularly useful for general practitioners and internists, as practically all areas of extrapulmonary causes of pleural effusion have been covered, with a well-defined classification, including pleural effusions in haematological, cardiac, gynaecological and gastrointestinal diseases. Pleural disease in HIV patients, a common medical problem in several parts of the world at the present time has also been covered, as well as pleural effusions in critically ill patients in the ICU and in recipients of organ transplantation. Paediatricians will find answers for their challenges in clinical practice in Chapter 39 on “Pleural Effusions in Children”. The clinical problems of Pneumothorax, Haemothorax and Chylothorax-pseudochylothorax have been extensively reviewed in the corresponding chapters and the book is completed by two chapters dealing with iatrogenic pleural diseases, namely those caused by radiotherapy and the rest of the iatrogenic and rare effusions, just in time to remind us of the essential principle of “primum non nocere” (“first do no harm”). Last but not least, it would be amiss not to stress the continuous hints that this book provides to the researcher with special interest in pleural disease, providing information on biomarkers, proteomics, and molecular biology, and even dealing with “Translational Research in Pleural Disease” in Chapter 12.

Involving an internationally recognized panel of experts each of whom provides a particular insightful view, this book represents one of the most comprehensive collections of information on pleural disease of our day. Updated to reflect the latest scientific advances and technologies in the diagnosis and treatment of pleural diseases, this Second Edition of Pleural Disease will be an invaluable tool in the hands of both the clinician and the researcher for the next few years to come (probably until its Third edition). The fact that this initiative comes from the periphery of Greece to target the centre of developments in a wide area of modern Respiratory Medicine is truly a cause for pride.