Abstract
This book has been written primarily for first and second year students on biomedical science degree courses, to provide information on the scientific basis of diseases that they will encounter during the course of their studies, with a particular emphasis on those for which laboratory investigations are important in diagnosis and management.
An admirably succinct opening chapter describes the causes, nature, manifestations and outcomes of diseases and the techniques available for their investigation. The role of laboratory tests, their evaluation and matters such as reference intervals are outlined, although in my view the authors have missed a trick here. Laboratory investigations are only one of the tools available to the clinician seeking a diagnosis, and their results often reflect pathological processes rather than providing a complete diagnosis. Emphasizing the importance of imaging and physiological testing (and the different nature of the information that they provide) might have given readers a better perspective of the role of laboratory investigations overall.
Subsequent chapters deal with organs or organ systems (e.g. cardiovascular disease), conditions with a common pathogenesis (e.g. autoimmune disease, nutritional disorders) and conditions with related pathological features (e.g. cancer, disorders of ageing). Each follows a standard pattern with a summary of the relevant anatomy and physiology followed by a more detailed review of the pathology, a number of case studies with questions to be considered by the reader (answers are provided at the end of the book) and multiple choice and other questions (also with answers). The numerous tables and Mick Hoult's line diagrams are well designed but the quality of many of the (monochrome) photographs is poor and in general they add little to the text. Boxes containing marginal notes expand on selected topics and prevent the text becoming unbalanced, and case studies (including Napoleon and arsenic poisoning, and haemophilia in the royal families of Europe) provide insight to particular conditions and bring their topics alive.
Although all four authors are UK-based, American spelling conventions have been adopted, presumably because the book is intended for the North American market as well as the UK. However, concentrations are expressed in molar units only, although curiously with dm−3 rather than L as the denominator; at least osmolality is expressed in mmol/kg and not mosmol. In the chapter on acid–base disorders, the authors seem undecided as to whether to use hydrogen ion concentration or pH, with the text switching between the two, although only hydrogen ion concentrations are given in the case histories. The use of first names in the case histories adds nothing to them and grated with this reviewer. And surely one of the authors is aware that autoimmune thyrotoxicosis is named after Robert Graves and is thus Graves’ disease, not Grave's?
But there is much that is good in this book. It should certainly be valuable to biomedical science students, but I would also recommend it to first year trainee clinical scientists in clinical biochemistry. They may find the overviews of haematology, genetics, medical microbiology and immunology useful in setting their chosen discipline in context. Newcomers to clinical science often find the jargon of medicine and pathology intimidating: the preliminary pages of this book include a glossary that contains many of the terms that they will encounter in their early days in training.