- Email: [email protected]
Manual of medical therapeutics
The Journal
of Emergency
Pergamon
Medicine, Voll2, No 5, pp 723-725, 1994 Copyright 0 1994 Elsevier Science Ltd Printed in the USA. All rights reserved 0736-4679/94 $6.00 + .OO
Reviews: BOOkS
mneumonic for writing admission orders (ADC VAAN DISML). It also contains two well-written sections on topics in which, in my experience, residents are particularly under-informed, dermatology and ophthalmology. The chapter on nutritional therapy was always a lifesaver for me; I could never remember those TPN solutions, and the table in this chapter has the standard, heart failure, renal failure, and low electrolyte formulations. A book such as this, to be fully appreciated, has to be used “under fire.” So I used it exclusively during several shifts in the emergency department. Even though I have my own method of treating various problems, I used this manual for every question with regard to therapeutics that arose and compared it with my method. Malaria, gastroparesis, cardiogenic shock, hemophilia, DKA, thyroid storm, hyperkalemia, gout, spinal cord injury, alcohol withdrawal, anaphylaxis, hypertensive crisis, various dysrhythmias, and all types of infections were seen and treated. The manual not only had a complete treatment regimen for these problems but it also had what I usually could not come up with, namely, a recent reference supporting the recommendation. Although I was familiar with the use of quinidine for malaria and erythromycin for gastroparesis, I did not know where to direct the resident to find the right article. The manual uses a novel method of referencing material. The reference is included parenthetically at the end of the statement rather than at the end of the chapter or the bottom of the page. This method seems to work okay if only one or two references are required, and generally this is sufficient for a busy house officer to digest before morning rounds. Overall, this text performed admirably with a few notable exceptions. The use of whole bowel irrigation is not recommended for toxic ingestions, the pneumatic antishock garment is recom-
2 MANUAL OF MEDICAL THERAPEUTICS (27th ed.). Edited by Woodley M, Whelan A. Boston, Little, Brown and Company, 1992,603 pages, paperback (spiral bound), $25. A physician not familiar with “The Washington Manual,” as this tome is commonly known, must have been on a desert island since 1944, when the first edition was published. Every intern, resident, and attending physician has at some time, usually at 3:00 a.m., pulled this spiral bound, usually dog-eared book out of a lab coat pocket to look up the treatment for hypercalcemia, the dose of amphotericin B, or the alveolar gas equation. Designed originally as a guide for fourth-year medical students, this book can arguably be called the most popular medical text published. The spiral bound format has been so successful that Little Brown now publishes 56 other titles under the “Spiral Manual Series,” including the Manual of Nutritional Therapeutics and the Manual of Diagnostic Imaging, neither as popular as the original. The authors are all fellows and junior faculty at the Washington University School of Medicine in St. Louis, and this text reflects the approach of that institution. These physicians are presumably more familiar with the care of patients due to their intimate association with the residents, who are the real caregivers. The editors mention that senior faculty also have “significant input,” which indicates that they feel that experience still counts for something. The book is organized into 26 chapters and 9 Appendices with a 56-page index. The chapters are loosely organized according to Internal Medicine subspecialties, that is, cardiology, infectious disease, endocrinology, rheumatology, and so forth. Chapter one, “Patient Care in Internal Medicine,” is an excellent overview of basic therapeutics with a great
Reviews of Books and Other Media is coordinated by Edward J. Otten, College of Medicine, Cincinnati, Ohio 723
MD,
of the University of Cincinnati
724
The Journal
mended for shock, and multiple doses of methylene blue are recommended for methemoglobinemia. The Appendices are particularly helpful for looking up laboratory values, drug interactions, dosage in renal failure, basal metabolic rates, and intravenous drug mixtures. The index is complete and well organized. My only complaint about this work is the paucity of toxicologic material. Many patients with calcium channel blocker, beta blocker, theophylline, and other therapeutic drug overdoses have poor outcomes and deserve an organized clinical approach such as that given for hypertension and congestive heart failure. In summary, the “Washington Manual” should be found in the possession of everyone taking care of patients whether they be medical students, residents, or attendings. I carry mine with me constantly and use it frequently, and I am rarely disappointed with its performance.
Edward J. Otten, MD Department
of Emergency Medicine University of Cincinnati Cincinnati, Ohio 0736~4679(94)ooo69-7
Cl CURRENT MEDICAL DIAGNOSIS AND TREATMENT 1993. Edited by Tierney LM, McPhee SJ, Papadakis MA, Schroeder SA. Norwalk, Connecticut, Appleton & Lange, 1993, 1418 pages, paperback, $39.95.
This is the 32nd annual volume of a general medical text that was initially designed as a single source reference for practitioners of all specialties in both the ambulatory and the hospital settings. The prime beneficiaries of the current volume, however, are more likely to be medicine house officers. Physicians in specialties other than internal medicine and family practice will also find this book useful as a basic internal medicine reference. In addition, nurses and other health practitioners will find that the concise format and broad scope of this reference book facilitates their understanding of diagnostic principles and therapeutic management. As a medical resident, this book represented “The Bible” of my on-call nights, providing easy access to up-to-date information. Since then, however, several changes have occurred. First of all, Dr. Marcus Krupp, who was the lead editor for the past three
of Emergency
Medicine
decades, is no longer associated with this text. Having worked with Dr. Krupp and knowing how particular he is, I was concerned that the quality of the book would suffer-fortunately, it has not. Major adaptations and changes have been made in this edition. Indeed, the chapters on cardiovascular disease, fluid and electrolytes, endocrinology, and genitourinary disorders have been largely rewritten. There are new chapters on hypertension and lipid abnormalities. The number of contributors has decreased from 45 to 42, of whom 10 are new to this edition. These new changes have made this edition more complete and up-to-date. This book is generally organized by organ systems, with a total of 38 chapters. However, some of the chapters deal with selected topics (such as HIV infection, medical genetics, imaging). The text covers more than 1,000 diseases and disorders. The chapters are well written and provide a review of general medicine. The writing style makes the information accessible to readers at all levels of expertise. As with any multiauthored work, however, there is some overlap of information among different chapters. The table of contents is descriptive and accessible. There is a “Quick Reference” index on the inside front cover of the book. At the beginning of a new subject there is a brief paragraph that includes the “Essentials of Diagnosis.” This provides the physician with limited time (like in the Emergency Department setting) with the basic minimal information necessary to make the diagnosis. The numerous tables are well done and useful. The availability of an extensive list of references at the end of each one of the 38 chapters enhances this book’s practical utility for those interested in pursuing its contents in greater depth. Although not strictly oriented toward emergency medicine, acute care medicine topics are well covered, providing adequate and concise information for the emergency physician. Generally, the chapters contain sufficient detail for an emergency physician to understand clearly most of the commonly encountered problems in general internal medicine. Appropriate biochemical and pathophysiologic background information is provided in this book as necessary to facilitate understanding of concepts. Emergency physicians will find those chapters dealing with disorders due to physical agents and poisoning of particular interest. In addition, basic dermatologic, gynecologic and obstetric, ophthalmologic, otolaryngologic, and psychiatric emergencies are well covered. One of the most important features of this book is that it is revised and updated every year. This is probably the only book of its kind that includes an annual
of Emergency
Pergamon
Medicine, Voll2, No 5, pp 723-725, 1994 Copyright 0 1994 Elsevier Science Ltd Printed in the USA. All rights reserved 0736-4679/94 $6.00 + .OO
Reviews: BOOkS
mneumonic for writing admission orders (ADC VAAN DISML). It also contains two well-written sections on topics in which, in my experience, residents are particularly under-informed, dermatology and ophthalmology. The chapter on nutritional therapy was always a lifesaver for me; I could never remember those TPN solutions, and the table in this chapter has the standard, heart failure, renal failure, and low electrolyte formulations. A book such as this, to be fully appreciated, has to be used “under fire.” So I used it exclusively during several shifts in the emergency department. Even though I have my own method of treating various problems, I used this manual for every question with regard to therapeutics that arose and compared it with my method. Malaria, gastroparesis, cardiogenic shock, hemophilia, DKA, thyroid storm, hyperkalemia, gout, spinal cord injury, alcohol withdrawal, anaphylaxis, hypertensive crisis, various dysrhythmias, and all types of infections were seen and treated. The manual not only had a complete treatment regimen for these problems but it also had what I usually could not come up with, namely, a recent reference supporting the recommendation. Although I was familiar with the use of quinidine for malaria and erythromycin for gastroparesis, I did not know where to direct the resident to find the right article. The manual uses a novel method of referencing material. The reference is included parenthetically at the end of the statement rather than at the end of the chapter or the bottom of the page. This method seems to work okay if only one or two references are required, and generally this is sufficient for a busy house officer to digest before morning rounds. Overall, this text performed admirably with a few notable exceptions. The use of whole bowel irrigation is not recommended for toxic ingestions, the pneumatic antishock garment is recom-
2 MANUAL OF MEDICAL THERAPEUTICS (27th ed.). Edited by Woodley M, Whelan A. Boston, Little, Brown and Company, 1992,603 pages, paperback (spiral bound), $25. A physician not familiar with “The Washington Manual,” as this tome is commonly known, must have been on a desert island since 1944, when the first edition was published. Every intern, resident, and attending physician has at some time, usually at 3:00 a.m., pulled this spiral bound, usually dog-eared book out of a lab coat pocket to look up the treatment for hypercalcemia, the dose of amphotericin B, or the alveolar gas equation. Designed originally as a guide for fourth-year medical students, this book can arguably be called the most popular medical text published. The spiral bound format has been so successful that Little Brown now publishes 56 other titles under the “Spiral Manual Series,” including the Manual of Nutritional Therapeutics and the Manual of Diagnostic Imaging, neither as popular as the original. The authors are all fellows and junior faculty at the Washington University School of Medicine in St. Louis, and this text reflects the approach of that institution. These physicians are presumably more familiar with the care of patients due to their intimate association with the residents, who are the real caregivers. The editors mention that senior faculty also have “significant input,” which indicates that they feel that experience still counts for something. The book is organized into 26 chapters and 9 Appendices with a 56-page index. The chapters are loosely organized according to Internal Medicine subspecialties, that is, cardiology, infectious disease, endocrinology, rheumatology, and so forth. Chapter one, “Patient Care in Internal Medicine,” is an excellent overview of basic therapeutics with a great
Reviews of Books and Other Media is coordinated by Edward J. Otten, College of Medicine, Cincinnati, Ohio 723
MD,
of the University of Cincinnati
724
The Journal
mended for shock, and multiple doses of methylene blue are recommended for methemoglobinemia. The Appendices are particularly helpful for looking up laboratory values, drug interactions, dosage in renal failure, basal metabolic rates, and intravenous drug mixtures. The index is complete and well organized. My only complaint about this work is the paucity of toxicologic material. Many patients with calcium channel blocker, beta blocker, theophylline, and other therapeutic drug overdoses have poor outcomes and deserve an organized clinical approach such as that given for hypertension and congestive heart failure. In summary, the “Washington Manual” should be found in the possession of everyone taking care of patients whether they be medical students, residents, or attendings. I carry mine with me constantly and use it frequently, and I am rarely disappointed with its performance.
Edward J. Otten, MD Department
of Emergency Medicine University of Cincinnati Cincinnati, Ohio 0736~4679(94)ooo69-7
Cl CURRENT MEDICAL DIAGNOSIS AND TREATMENT 1993. Edited by Tierney LM, McPhee SJ, Papadakis MA, Schroeder SA. Norwalk, Connecticut, Appleton & Lange, 1993, 1418 pages, paperback, $39.95.
This is the 32nd annual volume of a general medical text that was initially designed as a single source reference for practitioners of all specialties in both the ambulatory and the hospital settings. The prime beneficiaries of the current volume, however, are more likely to be medicine house officers. Physicians in specialties other than internal medicine and family practice will also find this book useful as a basic internal medicine reference. In addition, nurses and other health practitioners will find that the concise format and broad scope of this reference book facilitates their understanding of diagnostic principles and therapeutic management. As a medical resident, this book represented “The Bible” of my on-call nights, providing easy access to up-to-date information. Since then, however, several changes have occurred. First of all, Dr. Marcus Krupp, who was the lead editor for the past three
of Emergency
Medicine
decades, is no longer associated with this text. Having worked with Dr. Krupp and knowing how particular he is, I was concerned that the quality of the book would suffer-fortunately, it has not. Major adaptations and changes have been made in this edition. Indeed, the chapters on cardiovascular disease, fluid and electrolytes, endocrinology, and genitourinary disorders have been largely rewritten. There are new chapters on hypertension and lipid abnormalities. The number of contributors has decreased from 45 to 42, of whom 10 are new to this edition. These new changes have made this edition more complete and up-to-date. This book is generally organized by organ systems, with a total of 38 chapters. However, some of the chapters deal with selected topics (such as HIV infection, medical genetics, imaging). The text covers more than 1,000 diseases and disorders. The chapters are well written and provide a review of general medicine. The writing style makes the information accessible to readers at all levels of expertise. As with any multiauthored work, however, there is some overlap of information among different chapters. The table of contents is descriptive and accessible. There is a “Quick Reference” index on the inside front cover of the book. At the beginning of a new subject there is a brief paragraph that includes the “Essentials of Diagnosis.” This provides the physician with limited time (like in the Emergency Department setting) with the basic minimal information necessary to make the diagnosis. The numerous tables are well done and useful. The availability of an extensive list of references at the end of each one of the 38 chapters enhances this book’s practical utility for those interested in pursuing its contents in greater depth. Although not strictly oriented toward emergency medicine, acute care medicine topics are well covered, providing adequate and concise information for the emergency physician. Generally, the chapters contain sufficient detail for an emergency physician to understand clearly most of the commonly encountered problems in general internal medicine. Appropriate biochemical and pathophysiologic background information is provided in this book as necessary to facilitate understanding of concepts. Emergency physicians will find those chapters dealing with disorders due to physical agents and poisoning of particular interest. In addition, basic dermatologic, gynecologic and obstetric, ophthalmologic, otolaryngologic, and psychiatric emergencies are well covered. One of the most important features of this book is that it is revised and updated every year. This is probably the only book of its kind that includes an annual