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Taking control of Arthritis. Fred G.Kantrowitz. New York Harper Perennial 1991.246pp. Indexed. 10.00

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BOOK REVIEWS
Degradation of Articular Cartilage and Culture: Regulatory
Factors, gets the award for most references-569!!
As in any text with multiple authors, a certain
amount of reduplication is unavoidable. Chapter 18, on
Modulation of Cartilage Degradation, primarily discusses
rheumatoid arthritis; although excellently written, it is somewhat out of sync with the remainder of the text. Chapter 17,
Pharmacological Control of Cartilage Degradation in Osteoarthritis, is an up-to-date review of so-called “diseasemodifying agents” in osteoarthritis; it will be a useful
resource for investigators interested in specific therapeutic
intervention.
This book, although moderately expensive, deserves
a place on the shelf of anyone interested in cartilage and
osteoarthritis.
Roland W. Moskowitz, MD
Case Western Reserve University
Cleveland, OH
Arthritis and Related Affections: Clinic, Pathology, and Treatment. Arnold Soren. Berlin, Springer-Verlag, 1992. 456 p p .
Illustrated. Indexed. $198.00.
I love this book, in large part because I don’t agree
with everything in it but value the approach of a long-term
observer and original thinker about the joint. The book is
designed as a comprehensive arthritis text which also covers
clinical and radiographic features, but it is clear that the keen
interest of this orthopedist has been the pathology of joint
disease. Dr. Soren tackles concepts like post-traumatic
synovitis, liposynovitis, and intermittent hydrarthrosis (for
which he provides some support for allergic mechanisms in
some cases), as well as the standard rheumatic diseases. He
provides us impressions, but not yet the systematic studies
that will be needed.
An extensive list of 1,825 references includes many
not found in standard texts. Clear strengths are the nurnerous gross and histologic illustrations, although it is frustrating that the legends often do not identify the disease and one
must scan back through the text.
There is a lot to quibble with but also to be stimulated
by. One case is described as chronic knee arthritis secondary
to untreated gonorrhea persisting for more than 25 years.
One would like more information on such a case.
Discussion of pathology is mostly based on gross
examination and light microscopic material, with very little
electron microscopy, immunocytochemistry, or use of
other, newer techniques.
Dr. Soren has been an innovator in attempting to
codify histologic diagnosis. His earlier work has stimulated
several groups now attempting to improve prognostication
and to understand mechanisms involved in the synovitis of
rheumatoid and other diseases. Although this work is mentioned, it unfortunately is not expanded on in this text.
Arthritis and Related Affections will not be competition for standard textbooks but will be a treasured part of
my library. These pathologic descriptions and references can
be a useful starting point and a source of ideas for someone
about to investigate the articular aspects of a disease.
H. Ralph Schumacher, Jr., MD
Hospital of the University of Pennsylvania and Veterans
Affairs Medical Center
Philadelphia, P A
Taking Control of Arthritis. Fred G . Kantrowitz. New York,
Harper Perennial, 1991. 246 p p . Indexed. $10.00.
In the course of providing care to patients and
lecturing about arthritis, rheumatologists and other health
professionals encounter questions that are asked repeatedly
over the years. Our answers to these questions evolve with
time, as we gain further experience and integrate new
knowledge and perspectives about the rheumatic diseases.
In Taking Control of Arthritis, Dr. Kantrowitz provides his
thoughtful responses to such questions. Most rheumatologists would accept his information as consistent with current
concepts. The exercise of comparing his answers with our
own can potentially refine and improve the important role we
play in patient education.
Inquiring patients want to become more knowledgeable about their diseases and options for treatment. Patient
education supplied in the office or clinic by the health team
of physicians, nurses, and occupational and physical therapists can be supplemented with recommended reading. An
office or clinic lending library or reference list for patients
should include this book. Studying Dr. Kantrowitz’s answers to questions is likely to reinforce and expand what the
patient and family have learned from the rheumatology
team. New or contradictory information may stimulate important new questions for discussion at the next office visit.
The format of the book (questions followed by answers that may run several paragraphs) may make it difficult
for the reader to find organized information about specific
diseases, but the book is well indexed. For example, there is
no chapter on rheumatoid arthritis (other informational
books serve that purpose), but the index contains about 30
topics listed under “rheumatoid arthritis.”
Frequent references to well-known athletes and entertainers and their experiences with rheumatic disease add
to the interest of the book and make it more readable.
Chapters such as “Taking Control-Ways to Help Yourself’ and “Taking Charge of Your Attitude” contain strong
messages reinforced by inspirational anecdotes about respected public figures.
My father, who has longstanding rheumatoid arthritis
and osteoarthritis, now with successful bilateral knee replacements, found the book easily understandable and recommended the book for patients either early or far along in
the course of their disease. From this book, family members
of arthritis patients can also gain helpful perspectives about
arthritis and the feelings involved in coping with chronic
disease.
Larry G. Anderson, MD
Maine Medical Center
Portland, ME
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fred, york, perennial, taking, arthritis, kantrowitz, indexes, new, harper, 1991, control, 246pp
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