- Email: [email protected]
Infections: Recognition, Understanding, Treatment
354
Mayo Clin Proc, May 1985, Vol 60
BOOK REVIEWS
effluent plasma. Finally, the ingenious approaches and technology developed may help to determine whether putative pathologic materials in plasma have any effect on the pathogenesis of the diseases they are designed to treat. David S. Terman, M.D. Carmel, California
Practical Pediatric Radiology, by Saskia von Waldenburg Hilton, David K. Edwards, and John W. Hilton, 608 pp, with illus, $62, Philadelphia, W. B. Saunders Company, 1984 This unusual text has been designed for radiologists who occasionally practice pediatric radiology and who, by the nature of their practice, may be uncertain of their ability to provide high-quality diagnostic imaging of children. Pediatric radiology is highly specialized in tertiarycare medical centers. The text, however, will be useful to pediatricians and family practitioners who are either in residency training or in medical practice. It should also be extremely valuable for physicians who work in emergency rooms that admit a large volume of children. The unique aspect of the book is its chapter headings, which were selected on the basis of a 3-year analysis of the symptoms in children who were outpatients in the largest primary-care facility in San Diego, California. The most frequent symptoms of these pediatric patients were stridor, wheezing, cough, fever, heart murmur, abdominal pain, vomiting, diarrhea, bloody stools, constipation, limp, accidental and nonaccidental trauma, urinary tract infections, and bed wetting. In addition to chapters that address the pertinent radiologic procedures for pediatric patients with these symptoms, a chapter that describes the radiation effects associated with these procedures and the appropriate protection for children has been included. The objective of the authors was to produce a text that would be useful to primary-care physicians. One helpful feature is the presentation of an outline at the beginning of each chapter, a format that assists physicians in rapidly pinpointing a subject of concern for a specific patient at a particular time. For each condition discussed, the initial clinical findings, a differential diagnosis, and, in appropriate situations, the physiology involved are also very well presented. As expected, the illustrations selected are outstanding, and their reproduction is excellent. The chapter on the accidentally injured child and the abused child is particularly helpful. The appalling inci-
dence of child abuse is currently in public focus, and physicians in the emergency room should be able to identify such victims. Another helpful chapter presents a discussion on court testimony in cases of nonaccidental trauma. That physicians must increasingly appear in court to testify as expert witnesses is deplorable; furthermore, most are ill prepared for such an appearance. This chapter will inform physicians about contacts with attorneys, preparation of background data, and review of relevant films and radiographic reports before the trial and in the courtroom. Cross-examination, attitude and demeanor, hypothetical questions, and, as the authors label it, "the big question" are thoroughly reviewed. In my opinion, this valuable text should be included not only in outpatient departments and emergency rooms but also in the offices of all physicians who provide medical care for children. Edmund C. Burke, M.D. Department of Pediatrics
Infections: Recognition, Understanding, Treatment, edited by J.-C. Pechere, J. Acar, M. Armengaud, B. Grenier, R. Moellering, Jr., M. Sande, F. Waldvogel, and S. Zinner, 606 pp, with illus, $32.50, Philadelphia, Lea & Febiger, 1984 This book provides a tremendous amount of information at a reasonable cost, and it is enhanced by 179 illustrations (50 in color). The format seems unique among textbooks about infectious diseases: the information is divided into specific problems in infectious diseases, and for each problem, one or more objectives, the diagnosis, the recommended treatment, and an in-depth discussion are presented. Because additional background data such as microbiologic and epidemiologic aspects are arranged in separate boxed-in areas, this information is available but does not obscure the clinical material. The book abounds with tables and figures that help to clarify the text. Common conditions such as sore throat and urinary tract infections are thoroughly covered, as are unusual and newly recognized infectious diseases such as Lyme disease and Campylobacter diarrhea. Although the information about acquired immunodeficiency syndrome (AIDS) was current at the time of writing, rapid expansion of the literature on this subject has somewhat outdated this section of the text. The chapters entitled " H o w To Approach a Fever," "Travel to Tropical Countries," and
Mayo Clin Proc, May 1985, Vol 60
"Principles of Antimicrobial Treatment" are particularly concise and informative. Because the contributors are from many countries (the United States, Canada, Belgium, France, England, and Switzerland), occasionally drugs that are unfamiliar to the American reader are mentioned (only a minor inconvenience). The unique organization and innovative approach in this book are useful. Medical students, residents, and practicing physicians who are responsible for the care of patients with infections should find this text a valuable source of information. Conrad J. Wilkowske, M.D. Division of Infectious Diseases and Internal Medicine
Major Issues in Critical Care Medicine, edited by Joseph E. Parrillo and Stephen M. Ayres, 297 pp, with illus, $38, Baltimore, Williams & Wilkins, 1984 This book presents a summary of the testimony given at a consensus development conference on critical-care medicine sponsored by the National Institutes of Health and held in Bethesda, Maryland, in 1983. The conference panel consisted of 16 experts in the medical and legal professions. Their charge was to develop a consensus statement on the six prepublished questions that the meeting was to consider: (1) Is there empiric evidence that intensive care units (ICUs) cause a decrease in patient morbidity or mortality? Which patients are most likely to benefit from intensive care? (2) What skills are essential for personnel in a critical-care unit? How should these personnel be trained and organized to ensure the best care for patients most in need? (3) What special technology and therapeutic interventions should routinely be available for the most effective ICU function? (4) How is a hospital's critical-care delivery system best structured: one large multispecialty unit or multiple small subspecialty units? (5) How has the development of ICUs affected the traditional functions of a hospital? (6) What direction should critical-care research follow? The book is divided into the following six major sections: "Overall Survival Results," "Critical Care Medicine and Cardiovascular Disease," "Critical Care Medicine and Pulmonary Disease," "Other Organ System Dysfunction," "Critical Care Medicine and the Issues of Training, Education, Staffing and Administrative Structure," and "The Consensus Statement." The sections were seemingly designed primarily for the purpose of influencing the consensus development panel and not for
BOOK REVIEWS
355
the purposes of teaching or informing medical peers of latest advances in knowledge. The most interesting part of the book for the critical-care specialist and other medical personnel is the 11 pages that present the consensus statement (Chapter 31), although some of the other chapters do provide helpful summaries of a particular viewpoint (and allow considerable insight into the bias of specific authors). In a variety of guises, critical care has become an established, albeit expensive, part of medical practice in most major medical institutions in the United States. Throughout the medical profession, attempts to control escalating costs have become important, and this conference focuses in part on the issue of costs versus benefits from ICU services. The foremost problem in the analysis of this issue is inadequate data, and although little new information is presented in the volume, the book does provide a useful compilation of the available data. In addition, a "turf" battle is currently raging within the confines of the American Board of Medical Specialties, with medical and surgical subgroups vying for control of the subspecialty training and certification for critical-care practice. This book provides some glimpses of the "smoke" generated by this battle but correctly leaves the outcome unresolved. In my opinion, this book will have long-term appeal to only a few health-care planners who are interested in critical-care medicine. Practitioners in the field, however, would be well advised to think about the issues raised in this text and to attempt to gain a voice in the debate. This book would then serve as a useful introduction to the issues. H. Michael Marsh, M.B. Critical Care Service
Life Support Systems in Intensive Care, edited by Robert H. Bartlett, Walter M. Whitehouse, Jr., and Jeremiah G. Turcotte, 615 pp, with illus, $49.95, Chicago, Year Book Medical Publishers, 1984 As the practice of critical-care medicine becomes more prominent, authors continue to attempt to present the broad spectrum of knowledge about this field in one definitive textbook. Life Support Systems in Intensive Care is another such attempt. Like the previous publications, this book does not achieve that goal. As clearly stated in the preface, the book is not a primer or manual to be used by the initiate in the intensive care field. Nevertheless, when considered as a source to keep
Mayo Clin Proc, May 1985, Vol 60
BOOK REVIEWS
effluent plasma. Finally, the ingenious approaches and technology developed may help to determine whether putative pathologic materials in plasma have any effect on the pathogenesis of the diseases they are designed to treat. David S. Terman, M.D. Carmel, California
Practical Pediatric Radiology, by Saskia von Waldenburg Hilton, David K. Edwards, and John W. Hilton, 608 pp, with illus, $62, Philadelphia, W. B. Saunders Company, 1984 This unusual text has been designed for radiologists who occasionally practice pediatric radiology and who, by the nature of their practice, may be uncertain of their ability to provide high-quality diagnostic imaging of children. Pediatric radiology is highly specialized in tertiarycare medical centers. The text, however, will be useful to pediatricians and family practitioners who are either in residency training or in medical practice. It should also be extremely valuable for physicians who work in emergency rooms that admit a large volume of children. The unique aspect of the book is its chapter headings, which were selected on the basis of a 3-year analysis of the symptoms in children who were outpatients in the largest primary-care facility in San Diego, California. The most frequent symptoms of these pediatric patients were stridor, wheezing, cough, fever, heart murmur, abdominal pain, vomiting, diarrhea, bloody stools, constipation, limp, accidental and nonaccidental trauma, urinary tract infections, and bed wetting. In addition to chapters that address the pertinent radiologic procedures for pediatric patients with these symptoms, a chapter that describes the radiation effects associated with these procedures and the appropriate protection for children has been included. The objective of the authors was to produce a text that would be useful to primary-care physicians. One helpful feature is the presentation of an outline at the beginning of each chapter, a format that assists physicians in rapidly pinpointing a subject of concern for a specific patient at a particular time. For each condition discussed, the initial clinical findings, a differential diagnosis, and, in appropriate situations, the physiology involved are also very well presented. As expected, the illustrations selected are outstanding, and their reproduction is excellent. The chapter on the accidentally injured child and the abused child is particularly helpful. The appalling inci-
dence of child abuse is currently in public focus, and physicians in the emergency room should be able to identify such victims. Another helpful chapter presents a discussion on court testimony in cases of nonaccidental trauma. That physicians must increasingly appear in court to testify as expert witnesses is deplorable; furthermore, most are ill prepared for such an appearance. This chapter will inform physicians about contacts with attorneys, preparation of background data, and review of relevant films and radiographic reports before the trial and in the courtroom. Cross-examination, attitude and demeanor, hypothetical questions, and, as the authors label it, "the big question" are thoroughly reviewed. In my opinion, this valuable text should be included not only in outpatient departments and emergency rooms but also in the offices of all physicians who provide medical care for children. Edmund C. Burke, M.D. Department of Pediatrics
Infections: Recognition, Understanding, Treatment, edited by J.-C. Pechere, J. Acar, M. Armengaud, B. Grenier, R. Moellering, Jr., M. Sande, F. Waldvogel, and S. Zinner, 606 pp, with illus, $32.50, Philadelphia, Lea & Febiger, 1984 This book provides a tremendous amount of information at a reasonable cost, and it is enhanced by 179 illustrations (50 in color). The format seems unique among textbooks about infectious diseases: the information is divided into specific problems in infectious diseases, and for each problem, one or more objectives, the diagnosis, the recommended treatment, and an in-depth discussion are presented. Because additional background data such as microbiologic and epidemiologic aspects are arranged in separate boxed-in areas, this information is available but does not obscure the clinical material. The book abounds with tables and figures that help to clarify the text. Common conditions such as sore throat and urinary tract infections are thoroughly covered, as are unusual and newly recognized infectious diseases such as Lyme disease and Campylobacter diarrhea. Although the information about acquired immunodeficiency syndrome (AIDS) was current at the time of writing, rapid expansion of the literature on this subject has somewhat outdated this section of the text. The chapters entitled " H o w To Approach a Fever," "Travel to Tropical Countries," and
Mayo Clin Proc, May 1985, Vol 60
"Principles of Antimicrobial Treatment" are particularly concise and informative. Because the contributors are from many countries (the United States, Canada, Belgium, France, England, and Switzerland), occasionally drugs that are unfamiliar to the American reader are mentioned (only a minor inconvenience). The unique organization and innovative approach in this book are useful. Medical students, residents, and practicing physicians who are responsible for the care of patients with infections should find this text a valuable source of information. Conrad J. Wilkowske, M.D. Division of Infectious Diseases and Internal Medicine
Major Issues in Critical Care Medicine, edited by Joseph E. Parrillo and Stephen M. Ayres, 297 pp, with illus, $38, Baltimore, Williams & Wilkins, 1984 This book presents a summary of the testimony given at a consensus development conference on critical-care medicine sponsored by the National Institutes of Health and held in Bethesda, Maryland, in 1983. The conference panel consisted of 16 experts in the medical and legal professions. Their charge was to develop a consensus statement on the six prepublished questions that the meeting was to consider: (1) Is there empiric evidence that intensive care units (ICUs) cause a decrease in patient morbidity or mortality? Which patients are most likely to benefit from intensive care? (2) What skills are essential for personnel in a critical-care unit? How should these personnel be trained and organized to ensure the best care for patients most in need? (3) What special technology and therapeutic interventions should routinely be available for the most effective ICU function? (4) How is a hospital's critical-care delivery system best structured: one large multispecialty unit or multiple small subspecialty units? (5) How has the development of ICUs affected the traditional functions of a hospital? (6) What direction should critical-care research follow? The book is divided into the following six major sections: "Overall Survival Results," "Critical Care Medicine and Cardiovascular Disease," "Critical Care Medicine and Pulmonary Disease," "Other Organ System Dysfunction," "Critical Care Medicine and the Issues of Training, Education, Staffing and Administrative Structure," and "The Consensus Statement." The sections were seemingly designed primarily for the purpose of influencing the consensus development panel and not for
BOOK REVIEWS
355
the purposes of teaching or informing medical peers of latest advances in knowledge. The most interesting part of the book for the critical-care specialist and other medical personnel is the 11 pages that present the consensus statement (Chapter 31), although some of the other chapters do provide helpful summaries of a particular viewpoint (and allow considerable insight into the bias of specific authors). In a variety of guises, critical care has become an established, albeit expensive, part of medical practice in most major medical institutions in the United States. Throughout the medical profession, attempts to control escalating costs have become important, and this conference focuses in part on the issue of costs versus benefits from ICU services. The foremost problem in the analysis of this issue is inadequate data, and although little new information is presented in the volume, the book does provide a useful compilation of the available data. In addition, a "turf" battle is currently raging within the confines of the American Board of Medical Specialties, with medical and surgical subgroups vying for control of the subspecialty training and certification for critical-care practice. This book provides some glimpses of the "smoke" generated by this battle but correctly leaves the outcome unresolved. In my opinion, this book will have long-term appeal to only a few health-care planners who are interested in critical-care medicine. Practitioners in the field, however, would be well advised to think about the issues raised in this text and to attempt to gain a voice in the debate. This book would then serve as a useful introduction to the issues. H. Michael Marsh, M.B. Critical Care Service
Life Support Systems in Intensive Care, edited by Robert H. Bartlett, Walter M. Whitehouse, Jr., and Jeremiah G. Turcotte, 615 pp, with illus, $49.95, Chicago, Year Book Medical Publishers, 1984 As the practice of critical-care medicine becomes more prominent, authors continue to attempt to present the broad spectrum of knowledge about this field in one definitive textbook. Life Support Systems in Intensive Care is another such attempt. Like the previous publications, this book does not achieve that goal. As clearly stated in the preface, the book is not a primer or manual to be used by the initiate in the intensive care field. Nevertheless, when considered as a source to keep