Physiologic basis of respiratory disease
Physiologic basis of respiratory disease
复制标题
呼吸系统疾病的生理基础
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
James G. Martin
中科院分区：
文献类型：
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作者：
Q. Hamid;J. Shannon;James G. Martin
尽管医学是一门相对年轻的科学，但它已经经历了许多阶段，在这些阶段中，不同的学科一直是研究和临床护理的重点。解剖学、物理诊断、器官生理学、细胞生理学和流行病学都被强调为医学发展的关键基础。循证医学，最新的兴趣，通过建立源自数千名患者经验的方案，减少了对病理生理学的依赖。虽然这些方案为临床医生提供了一种安全感，但在护理危重患者时，对生理学的理解仍然是知识的基石，特别是那些呼吸或血液动力学受损的患者。这本书由哈米德，香农和马丁是一个受欢迎的医学文献补充，因为它重新审视了呼吸系统疾病的生理学和病理生理学，加强了临床医生和医学院教师器官生理学的基础。它还提供了世界上最伟大的呼吸生理学实验室之一的历史视角：麦吉尔大学的meakinchristie实验室。这本书汇集了100多位作者的作品，共64章。作者是世界级的呼吸生理学家谁写在他们的研究兴趣领域，并将他们与呼吸系统疾病的病理生理学。大多数作者都与meakinchristie实验室有联系，以前是教员或实习生。每一章都写得很简洁，从6到14页不等，集中在一个特定的生理方面。这些章节分为8个部分，包括(1)解剖学，(2)呼吸力学，(3)通气，肺循环和气体交换，(4)呼吸肌和呼吸控制，(5)气道和肺部疾病，(6)运动生理学，(7)睡眠呼吸障碍，(8)临床呼吸生理学。这些章节主要用图形和图画来说明，这些图形和图画代表了生理学的概念。总的来说，这些章节被很好地引用，但他们倾向于引用20世纪70年代和80年代的作品。这并不是说最近的研究被忽视了，而是在这些主题上相对较少的“新”研究。这本书附带了一张CD-ROM，它以可移植显示格式（PDF）文件包含了书中的所有章节，这些文件很容易用Adobe Acrobat程序打开。CD-ROM被声明为“双平台”，我认为这意味着与Windows或Macintosh计算机兼容。没有迹象表明它是否可以被Linux操作系统读取。我能够在运行OS X操作系统的Macintosh上打开所有章节。光盘上有一个名为“Startme”的应用程序，需要Macintosh OS 9和经典模式才能运行。它还需要旧版本的QuickTime，而且这个应用程序不适合我。这些章节作为电子文件的包含允许读者使用计算机阅读这本书。另一个很大的好处是，如果书中的数字可以在幻灯片中使用（并适当地归功于作者）。不幸的是，我不能从PDF文件中复制和粘贴图形。这本合集的优点在于它不试图成为百科全书，并且每章的覆盖深度都很好地平衡。这本书比韦斯特的经典著作《呼吸生理学：要领》和《肺病理生理学：要领》更详细，但比美国生理学会出版的《生理学手册：呼吸系统》详细得多。许多章节采用定量方法，使用数学公式来表示概念。一般来说，有比呼吸医生需要知道的更多的细节。尽管编辑们在序言中声明，这本书在呼吸生理学主题上可能不公平，但根据主题的不同，覆盖的深度是高度可变的。例如，关于呼吸机制的章节有丰富的细节，可以作为参考的主要来源，而肺循环只是表面上覆盖，右心和肺血管的血流动力学根本没有解决。很明显，这些主题的选择更多是因为作者的特殊兴趣，而不是因为主题对呼吸医学的重要性，而主题的选择反映了Meakins-Christie实验室的研究兴趣。鉴于对呼吸力学的关注，尤其令人失望的是没有看到任何关于呼吸衰竭和机械通气的生理学和病理生理学的章节。有些章节似乎与呼吸生理学没有明确的联系，比如关于肺移植和肺部疾病中的类二十烷酸的章节。一般来说，这些章节是对20-30年前出版的作品的重写。在大多数章节中，几乎没有努力以更现代的风格重写工作，这可能更容易被当前一代的临床医生所接受。此外，有些章节不包括有关其主题的最新研究成果；最新的作品是20世纪80年代的。人们很容易猜测写这本书的原因。这本书的前言，巴恩斯；前言，由编辑撰写；麦克勒姆写的关于梅金-克里斯蒂实验室历史的那一章表明，写这本书的动机来自于一种感知到的需要，即记录梅金-克里斯蒂实验室进行的广泛研究及其对呼吸生理学的影响。它还汇集了许多与米金斯-克里斯蒂实验室有历史联系的科学家的作品。这本书的内容并没有真正填补任何概念或信息的漏洞，在现有的教科书。许多作者在其他书中也写过类似的章节。写这本书动机的模糊性转化为目标读者的不确定性。详细的生理学将是非常感兴趣的一些呼吸临床医生，但病理生理学的部分似乎错过的标志是有价值的护理呼吸系统疾病的病人。这本书将可能是最感兴趣的学术呼吸医生/研究员，呼吸生理学的老师，或呼吸治疗师谁想要一个单一的参考资源
Despite its relatively young age as a science, medicine has grown through a number of phases in which different disciplines have been the focus of research and clinical care. Anatomy, physical diagnosis, organ physiology, cellular physiology, and epidemiology have all been emphasized as key foundations to medicine throughout its evolution. Evidence-based medicine, the latest interest, deemphasizes dependence on pathophysiology by instituting protocols derived from the experience with thousands of patients. While the protocols provide a sense of security to the clinician, the understanding of physiology remains the cornerstone of knowledge when caring for critically ill individuals, especially those with respiratory or hemodynamic compromise. This book by Hamid, Shannon, and Martin is a welcome addition to the medical literature because it revisits the physiology and pathophysiology of respiratory diseases, strengthening the foundation of organ physiology for clinicians and medical-school teachers. It also provides a historical perspective on one of the greatest respiratory physiology laboratories in the world: the MeakinsChristie Laboratories at McGill University. The book is a collection of works from over 100 authors, who contributed to 64 chapters. The authors are world-class respiratory physiologists who write on their areas of research interest and relate them to the pathophysiology of respiratory diseases. Most of the authors have a tie to the MeakinsChristie Laboratories as prior faculty or trainees. Each chapter is succinctly written, ranging from 6 to 14 pages, and focusing on a specific physiologic aspect. These chapters are organized into 8 sections, covering (1) anatomy, (2) mechanics of breathing, (3) ventilation, pulmonary circulation, and gas exchange, (4) respiratory muscles and control of breathing, (5) airways and lung disease, (6) exercise physiology, (7) sleepdisordered breathing, and (8) clinical respiratory physiology. The chapters are illustrated primarily with graphs and drawings that represent the physiologic concepts. In general, the chapters are well referenced but they tend to cite work from the 1970s and 1980s. It is not that recent work was overlooked, but, rather, there has been relatively little “new” research on these subjects. A CD-ROM is included with the book, and it includes all the book’s chapters in portable display format (PDF) files that are easily opened with the Adobe Acrobat program. The CD-ROM is stated to be “dualplatform,” which I assume means compatible with Windows or Macintosh computers. There is no indication as to whether it can be read by the Linux operating system. I was able to open all of the chapters on a Macintosh running the OS X operating system. On the disc there is an application named “Startme” that requires the Macintosh OS 9 and the classic mode to run. It also requires an older version of QuickTime and the application did not work for me. The inclusion of the chapters as electronic files allows the reader to use a computer to read the book. Another great advantage would be if the figures from the book could be used in slide presentations (with appropriate credit to the authors). Unfortunately, I was not able to copy and paste figures from the PDF files. The strengths of this collection are that it does not attempt to be encyclopedic, and the depth of coverage in each chapter is well balanced. There is more detail than in West’s classic books Respiratory Physiology: The Essentials and Pulmonary Pathophysiology: The Essentials, but considerably less detail than in the Handbook of Physiology: The Respiratory System, published by the American Physiological Society. Many of the chapters take a quantitative approach, using mathematical formulas to represent the concepts. In general, there are considerably more details than need to be known by the respiratory practitioner. Though the editors state in their preface that the book may not be evenhanded in the respiratory-physiologysubjects it covers, the depth of coverage is highly variable, depending on the subject matter. For example, the chapters on the mechanics of breathing are rich in detail and could serve as primary sourcesof reference,whereaspulmonarycirculation is only superficially covered and hemodynamics of the right heart and pulmonary vasculature are not addressed at all. It is clear that these topics were chosen more because of the authors’ special interests than because of the importance of the topics to respiratory medicine, and the topic-selection reflects the research interests of the Meakins-Christie Laboratories. Given the focus on respiratory mechanics, it was especially disappointing not to see any chapters on the physiology and pathophysiology of respiratory failure and mechanical ventilation. And some chapters appear to have been thrown in without clear ties to respiratory physiology, such as those on lung transplantation and eicosanoids in lung disease. In general, the chapters are rewrites of work published 20–30 years ago. There has been little effort in most of the chapters to rewrite the work in a more contemporary style that might be more accessible to the current generation of clinicians. Also, some of the chapters do not include the most recent research findings on their subjects; the newest works referenced are from the 1980s. It is tempting to speculate why this book was written. The book’s foreword, by Barnes; the preface, by the editors; and the chapter on the history of the MeakinsChristie Laboratories, by Macklem, suggest that the incentive to write the book came from a perceived need to document the broad research performed at Meakins-Christie Laboratories and its impact on respiratory physiology. It also brings together the works of a number of scientists who share a historical link to the Meakins-Christie Laboratories. The book’s content does not really fill any conceptual or informational holes in available textbooks. Many of the authors have written similar chapters in other books. The ambiguity in the incentive for writing this book translates into an uncertainty in the intended readership. The detailed physiology will be of great interest to some respiratory clinicians, but the sections on pathophysiology seem to miss the mark for being of value in caring for patients with respiratory diseases. This book will probably be of greatest interest to the academic respiratory physician/researcher, a teacher of respiratory physiology, or the respiratory therapistwhowantsasingle referencesource