Abstract
The seventh edition of Clinical Chemistry, one of the pre-eminent student textbooks of clinical biochemistry, is a vibrant proof that the printed book is not only alive and well but thriving. One's first impression on picking it up is of pleasure in a beautifully produced volume that fits comfortably in the hand and is very easy to navigate thanks to a different colour-coded page header for each chapter. Colour is also used for good effect in many figures and diagrams. Having skimmed through Clinical Chemistry for the first time, I was sufficiently enthused (a rare event) to wave it under the nose of a bibliophile arts graduate to show her that beautiful books do still sometimes emerge from the sciences in the age of the e-book and the Internet.
It goes without saying that the content of this long-established student textbook written by three senior, respected UK clinical biochemists is extremely sound. The authors clearly share the belief of most clinical biochemists that efficient and effective patient investigation and management depends on a sound understanding of the underlying physiology and pathophysiology. The latter are clearly and succinctly described throughout. In many of the areas covered, little has changed over the 24 years since the first edition, and veteran readers will recognize some material from then, including the ‘box and arrow’ diagnostic algorithms that have been so helpful to students and practitioners over the years (even some of these have had a colour makeover). The seventh edition brings the reader fully up to date with current practice, for example in use of estimated glomerular filtration rate and in prenatal diagnosis. There are, inevitably in a textbook such as this, other areas where individual readers may feel that the tone is slightly out of date; the discussion of coronary heart disease and troponins perhaps falling into this category.
Twenty-one chapters cover each key topic, from water, sodium and potassium to clinical nutrition. The emphasis throughout is on providing just the right amount of pathophysiology to enable the student to understand the range of common disorders he or she is likely to encounter in general clinical practice. Where appropriate, reference is made to other diagnostic techniques including imaging and molecular tests. In practice, patients present as clinical cases, not metabolic disorders. The authors provide a liberal number of typical short case histories throughout the text to set the clinical biochemistry in context and reinforce the learning points made. Each chapter concludes with a summary box, reminding the reader about the key points covered.
To whom should this book be recommended? As a firm believer in the core importance of clinical biochemistry across the whole range of clinical specialties, I will certainly be recommending it to medical students. Those who have digested its contents (it is readily digestible) will have no difficulty in passing our undergraduate clinical biochemistry exam. Given its focus on clinical relevance, I will also be making sure that my hospital library stocks a copy, which I will point out especially to Foundation Programme doctors. I will also keep a copy on the shelf in my laboratory office. It will provide a useful resource to trainee biomedical scientists and I suspect will be insightful to the new breed of Modernizing Scientific Careers higher specialist trainees in their first two years of training. Medics entering clinical biochemistry training would do well to read it as a refresher, and I am not ashamed to admit that, as a consultant chemical pathologist, I myself will almost certainly reach for it from time to time. Well done, Marsall, Bangert and Lapsley – the 2012 can be declared another good vintage.