- Email: [email protected]
Glucagon in acute medicine: Pharmacological, clinical and therapeutic implications
Reviews: Books and Other Media
written and does include in-depth focus on the areas of importance for the emergency physician. The management of airways and other procedures, as well as ACLS protocols, are helpful. The tables and tigorithrns in these sections are very good in their attention to the way emergency physicians need to respond to critical problems. Strong early chapters include the chapter on trauma, which has excellent tables. The chapter on shock is a good overview with somewhat less detail than one might expect in an emergency medicine textbook. The SIDS chapter is well written with in-depth detail on possible mechanisms and on the acute life-threatening event management in the emergency department. The child and sexual abuse sections are well done with very good photographs where they are helpful. The next sections are organ related. The Cardiology section is fairly detailed and descriptive in nature. I would have enjoyed a greater overview of the emergencymedicine perspective of how patients with acute cardiac diseasepresent, how a clinical diagnosis s made in the emergency department, how stabiliza:tion for evaluation is achieved in a pediatric center, and how to manage such patients on later emergency department visits with complications of their disease. Much of what was covered is more of the descriptive material I would expect in a general pediatric text. I found the Pulmonary section of greater value. The chapters on pneumonia, upper airway diseases,and cystic fibrosis are well written and have sufficient detail to be of some value to the emergency physician. Bill Spivey wrote the asthma chapter and covered the recent literature fairly well. He attempted to describe some of the potential pitfalls in the management of childhood diseasesby adult emergency physicians. This is an area that could have made the book more useful to an emergency medicine readership if this had been done for more areas of pediatric emergencymedicine. Another section worth noting is Toxicology. This is fairly detailed and covers a large number of toxicological agents. One of the strengths of the Trauma section is a description of how to best triage serious childhood injury in a non-trauma-center emergency department. Overall, the Trauma section lack the kind of detail that would truly benefit emergency physicians caring for children. The Orthopedics section is better detailed and well written. The last sections on ethics and brain death and organ donation are important parts of a text in pediatric emergency medicine. Currently there are a number of texts in the field of pediatric emergency medicine on the market.
425
Clearly there is an advantage in this text for the editors to have an emergency medicine background. This separatesthis text from others where the expertise comes generally from the pediatric side. I am not sure that the editors took enough advantage of this in this edition. Although the authorship in many of the areas is excellent, many of the chapters are authored by physicians who do not seem to have a focused area of expertise in the subject they authored. Richard Ruddy, MD Director of Emergency Medicine Children’s Hospital Medical Center Cincinnati, Ohio 0736-467?y!M)Eoo17-P
PMARMA0 GLUCAGON CNACUTE EUTIC IMCOLOGICAL, CLMCAL A PLICATIONS. Edited by J. Picazo. Boston, Ktuwer Academic Publishers, 1993,172 pages, hardcover, $38.50. Readers of The Journal of Emergency Medicine who were intrigued by the diverse actual and potential clinical utility of glucagon in the emergency department as reported in the March/April 1993 issue should also peruse Dr. Picazo’s very readable review. These published proceedings of an international workshop that included participants from Europe, the United States, and Japan are arranged in a manner well suited for study by emergencyphysicians. The role of glucagon in hypoglycemia, toxicologic emergencies,esophagealfood bolus impactions, and radiographic procedures is discussedthoroughly and practically. The clinical experience to date of glucagon in cardiovascular emergencies,respiratory emergencies (particularly asthma), and biliary system pathology is summarized well and presented in such a manner as to encourage further trials in the emergency department setting. More theoretic indications - for example, glucagen for acute mesenteric ischemia and hepatic failure- are explored from a mechanistic, pathophysiologic perspective that remains pleasantly understandable. The theory for several potential emergency department-based research projects is readily discernible in these pages. While perhaps only the most interested reader
426
should purchase a copy of this text, it is an excellent investment for the Emergency Medicine departmental or residency library. Familiarity with this information now may be quite beneficial in the near future.
The Journal of Emergency Medicine
Charles V. Pollack, Jr., MA, M D Department of Emergency Medicine Maricopa Medical Center Phoenix, Arizona 0736-4679(94)EOOl%Q
written and does include in-depth focus on the areas of importance for the emergency physician. The management of airways and other procedures, as well as ACLS protocols, are helpful. The tables and tigorithrns in these sections are very good in their attention to the way emergency physicians need to respond to critical problems. Strong early chapters include the chapter on trauma, which has excellent tables. The chapter on shock is a good overview with somewhat less detail than one might expect in an emergency medicine textbook. The SIDS chapter is well written with in-depth detail on possible mechanisms and on the acute life-threatening event management in the emergency department. The child and sexual abuse sections are well done with very good photographs where they are helpful. The next sections are organ related. The Cardiology section is fairly detailed and descriptive in nature. I would have enjoyed a greater overview of the emergencymedicine perspective of how patients with acute cardiac diseasepresent, how a clinical diagnosis s made in the emergency department, how stabiliza:tion for evaluation is achieved in a pediatric center, and how to manage such patients on later emergency department visits with complications of their disease. Much of what was covered is more of the descriptive material I would expect in a general pediatric text. I found the Pulmonary section of greater value. The chapters on pneumonia, upper airway diseases,and cystic fibrosis are well written and have sufficient detail to be of some value to the emergency physician. Bill Spivey wrote the asthma chapter and covered the recent literature fairly well. He attempted to describe some of the potential pitfalls in the management of childhood diseasesby adult emergency physicians. This is an area that could have made the book more useful to an emergency medicine readership if this had been done for more areas of pediatric emergencymedicine. Another section worth noting is Toxicology. This is fairly detailed and covers a large number of toxicological agents. One of the strengths of the Trauma section is a description of how to best triage serious childhood injury in a non-trauma-center emergency department. Overall, the Trauma section lack the kind of detail that would truly benefit emergency physicians caring for children. The Orthopedics section is better detailed and well written. The last sections on ethics and brain death and organ donation are important parts of a text in pediatric emergency medicine. Currently there are a number of texts in the field of pediatric emergency medicine on the market.
425
Clearly there is an advantage in this text for the editors to have an emergency medicine background. This separatesthis text from others where the expertise comes generally from the pediatric side. I am not sure that the editors took enough advantage of this in this edition. Although the authorship in many of the areas is excellent, many of the chapters are authored by physicians who do not seem to have a focused area of expertise in the subject they authored. Richard Ruddy, MD Director of Emergency Medicine Children’s Hospital Medical Center Cincinnati, Ohio 0736-467?y!M)Eoo17-P
PMARMA0 GLUCAGON CNACUTE EUTIC IMCOLOGICAL, CLMCAL A PLICATIONS. Edited by J. Picazo. Boston, Ktuwer Academic Publishers, 1993,172 pages, hardcover, $38.50. Readers of The Journal of Emergency Medicine who were intrigued by the diverse actual and potential clinical utility of glucagon in the emergency department as reported in the March/April 1993 issue should also peruse Dr. Picazo’s very readable review. These published proceedings of an international workshop that included participants from Europe, the United States, and Japan are arranged in a manner well suited for study by emergencyphysicians. The role of glucagon in hypoglycemia, toxicologic emergencies,esophagealfood bolus impactions, and radiographic procedures is discussedthoroughly and practically. The clinical experience to date of glucagon in cardiovascular emergencies,respiratory emergencies (particularly asthma), and biliary system pathology is summarized well and presented in such a manner as to encourage further trials in the emergency department setting. More theoretic indications - for example, glucagen for acute mesenteric ischemia and hepatic failure- are explored from a mechanistic, pathophysiologic perspective that remains pleasantly understandable. The theory for several potential emergency department-based research projects is readily discernible in these pages. While perhaps only the most interested reader
426
should purchase a copy of this text, it is an excellent investment for the Emergency Medicine departmental or residency library. Familiarity with this information now may be quite beneficial in the near future.
The Journal of Emergency Medicine
Charles V. Pollack, Jr., MA, M D Department of Emergency Medicine Maricopa Medical Center Phoenix, Arizona 0736-4679(94)EOOl%Q