- Email: [email protected]
THE SOCIETY OF CRITICAL CARE MEDICINE TEXTBOOK OF CRITICAL CARE
not recommend it to cardiologists who might benefit from a more analytical, physiologically based exposition.
Continued from ptJge 6
OlCtJr B. Garjdn, M.D.
New YorkCUy
fOr the next year. The fOurth section analyzes specific inteJ"Yelltions, (either proved or hopefully bene&cial) among surviwn of infarction. 'Ibis new book provides the medical specialist with a pleasant link between his current protessional development and an uncertain but probably exciting
future.
WtllitJm H.
WehnntlC~
M.D. ChictJgo
SYMPOSIUM ON CARDIOVASCULAR-PULMONARY INTERAcrION IN NORMAL AND DISEASED LUNG. CLINICS IN CHEST MEDICINE, VOL 4, NO 2, MAY 1983. By R. A. MATTHAY, M. A. MATTHAY, AND D. R. DAN'IZUR. Philadelphia: W. B. Saunden, 325 pp, '22.50.
'Ibis volume is a collection of articles, each concerning some aspect of the relationship between the cardiovascular and pulmonary systems. The topic is timely and there is a need tor a good text on the subject. The editors have assembled a group of well-known and respected authors and they have in general produced excellent articles. Although each paper deals with some aspect of the vascular and pulmonary systems, there is no unifying theme to this volume, nor is there an attempt to be comprehensive. As with most symposia, there is a disparity of styles and some redundancy. The papers range from thorough review articles to briefbut Pertinent overviews to expositions of the authors' work and opinions. Although each article is valuable in its own way, it is a bit disconcerting for the reader to go from a discussion of experimental models of pulmonary hypertension to a list of how to prevent arterial line complications in the span of 25 pages. The symposium is published in good quality hard cover and is remarlcably free from typographic or technical erron-it is exceptionally well done for a Periodical. If the reader requires a comprehensive textbook on cardiopulmonary interactions, written with a central theme, consistent style and lack of redundancy, he will be disappointed. On the other hand, this volume is far superior to most symposium-style collections ant! contains much valuable intormation. The basic science papen should be required reading for every physician involved in critical care; the clinical papen are more appropriate for residents and fellows learning the practical aspects of critical care and cor pulmonale. This volume should be in the library of every hospital and every physician practicing critical care. Although a subscription Periodical, it is available for purchase in medical book stores. lbul M. Cox,jr., M.D. Portland, Maine
EXERCISE ELECTROCARDIOGRAPHY-PRACTICAL APPROACH,
2ND ED. By EDWARD K. CHUNG. Baltimore: Williams & WtIkins, 1983, 400 pp. $47.00.
Dr. Chung has edited a very practical handbook covering many aspects of exercise electrocardiography and presented it at a level aimed at and reaching a broad spectrum of physicians, students, and nurses. It is easily read, lucidly written, liberally (although not always wisely) illustrated, and generally accurate. Chapten include descriptions ofpatient preparation, indications for and contraindications to exercise testing, various treadmill protocols, interpretation of the tests, physiology of the response, and computer analysis of the exercise electrocardiogram, along with many other specialized chapters. 1Wo major areas omitted are bicycle and arm ergometry and detailed information concerning currently available stress testing equipment. Summaries at the end of many of the chapten are very helpful as are tables within many of the chapten emphasizing salient features. Several chapters provide excellent coverage and are particularly artfully written, notably Dr. Nanette Wengeri chapter on recommendations fOr exercise in cardiac and healthy patients, and Savvides and Froelichers section on computer analysis of the exercise ECC. References are generally up to date, pertinent, and accurately quoted although one, a citation &om New York MtJgt.WM, might be considered of marginal signmcance. The flaws of the book are many in number, but do not significantly detract from its overall value. The writing is often not particularly graceful. There are many anecdotes, and much dogma and personal prejudice are presented as fact. An example of thisis fOund in Chapter 19 where Dr. Chung unequivocally states that in an asymptomatic individual a positive stress test followed by a positive thallium scan makes a coronary arteriogram mandatory. The overall organization of the book is poor with chapten on exercise training in chronic obstructive lung disease and comparison of ambulatory and exercise electrocardiography placed between cbapten on interpretation of the test and exercise-induced arrhythmias. A chapter on the Master test is histOrically interesting but without practical value. On balance, this is a useful, somewhat expensive volume that will be valuable to many health care profeSSionals involved in stress testing. I would
STREPTOKINASE IN CHRONIC ARTERIAL DISEASE. By MICHAEL MARTIN. Boca Raton, Florida: CRC Press, 1983, 194 pp '74.00. 1ieatment of peripheral arterial occlusion with plasminogen-activating drugs, most notably the thrombolytic agents streptokinase and urokinase, has enjoyed wider popularity in Europe thanin America. The European literature is replete with reports of their effectiveness in a variety of clinical settings, administered by an assortment of methods. The American literature has tended to emphasize a limited applicability of thrombolytic thenpy, stressing the necessity tor selective infusionof the drug directly into the thrombus, the difBculties inherent in achieving satisfactory monitoring of the fibrinolytic e8"ects of a given dosage, the hazards of induced bleeding, particularly into the central nervous system, and the general consensus that thrombolytic thenpy is only effective in the treatment of acute thrombotic arterial or graft occlusion of sewn days' duration or less. Strepto1dtatue in Chrorak ArteriIIl DUetue attempts to dissuade most of these notions, and may be paraphrased simply as "everything you ever wanted to know about streptokinase but were a&aid, or perhaps too ambivalent, to ask." The monograph is based on Dr. Martin's Personal experience, collected in Bonn, Germany, with 600 consecutive patients who bad thrombotic aortic and Peripheral arterial stenosis or occlusion. 1i'eatment consisted of systemic intravenous infusion of streptokinase over periods of one to four days at dosage schedules varying from 5,000 unitslhour to 100,000unitslhour. Anticoagulant thenpy with heparin or warfarin was often used concomitantly. Results of thenpy are described and representative cases are exhibited angiographically. Indications and contraindications to the use of streptokinase are discussed, as well as guidelines on laboratory monitoring and the incidence and management of side effects, including bleeding, fever, allergy and new arterial occlusions. Follow-up data extending to six years are presented. The books main deficiency is in its credibility. From the definition of terms to the presentation of data representing results of therapy, inconsistencies and generalities interfere with the author's message and ultimately undermine its reliability. For example, &om the title one might expect a discussion of the effectiveness of lytic thenpy in thrombotic arterial occlusions of various chronicdurations. Instead, we learn that "most" of the 600 arterial occlusions which make up the data base were "chronic" in nature, although the age of these occlusions and indeed the distinction between acute and chronic arterial occlusions is never satisfactorily established. Similarly, most of the data are displayed in semi-quantitative graphic form which conceals the size of the sample and weakens the effectiveness of the presentation. Furthermore, no attempt is made to establish a dose-response relationship. or even to present a scientific rationale for the treatment protocol ultimately selected by the author. Notable exceptions to the books' vagariesare mund in chapter 9: "Systemic Streptokinase 1reatment of Arterial Occlusions-Clinical 8esults," which is the nucleus of the monograph; chapter 13: "Occurrence and Treatment of Bleeding Accidents;" and the appendix which includes a large number of excellent arteriographic representations of stenotic and occlusive arterial lesions treated e&ectively by systemic streptokinase infusion. Indeed, these pictures conbibute more validity to the authors thesis than most of the text. Beneath its veneer as a comprehensive monograph are a few useful clinical guidelines and a great deal that leaves the reader confused or skeptical.
PeterMcComIn, M.D. PhaadslphlG THE SOCIETY OF CRITICAL CARE MEDICINE TEXTBOOK OF CRITICAL CARE. Edited by w. C. SHOEMAKER, W. L. THOMPSON, ~ R. HOLBROOK. Philadelphia: W. B. Saunders, 1984, 1063 pp, '75.00. Like goldfish, specla1ists spend too much time back-and-forthing over territory between invisible walls. This interdisciplinary book can transfer us to a larger tank. It emphasizes that ..the problems of the patient with several organ systems failing are not resolved by narrow parochial arguments of the traditionalsubspecialities, but by balancing physiologic criteria so that sewral organs may be partially failing, while the patient is improving overall." Instead of juxtaposing sections on Pathophysiology with othen that anecdotally relate clinical experience-a common failing of many texts-most cbapten, eg, right and left ventricular preload and diastolic compliance, successfully m.gnate the basic sciences into the discussion. The section on shock as a whole likewise takes a hard, empirical look at what it talces to survive, and thus enables the reader to set appropriate goalsand to titrate care to individual patients. Diagnostic, therapeutic, and monitoring techniques (plus their indications, contraindications, and complications) are all well covered. The topmost taper on the golden candelabrum of critical care-a compassionate undemanding of the psychology of life-threatening illness and death-is well displayed, as exemplified by the essays on brain death, permanently lost consciousness, and critical care psychiatry. As this book bad a brief gestation period (two yean), a few shortcomings
Conflnued on page 17
13
•__._1-
MOULD ALLERG~ Edited by YOUSEF AL-DooRYand JOANNE E DoMSON• Philadelphia: Lea and Febige~ 1984, 287 pp, US $28.50.
Continued from page 13
exist. Vascu1arsurgeons, mr instance, will not see anything on urgent cerebral revascularization for strokes-in-evolution. And certain academicians may Bnd that the chapter on experimental design ovel'-displays the authors prejudices and does not carefully summarize the references it sites. Reiteration and contradiction are amazingly absent considering that the book has 152 anthon. Only 39 of the 123 chapten mimic what is present in CriticGl Care, Stateof tM Art, Volumes I-N Physicians planning to take the board examinations in Critical Care Medicine, to be offered in the summer of 1985, will value this compendium.
Altm 'f. Marly, M.D., EC.C.P.
EOOMVille, IN
ECHOCARDIOGRAPHY: AN INTEGRATED APPROACH. By STEPHEN ARvAN. New York: Churchill Livingston, 1984,513 pp, $60.00. This text on cardiacultrasound is different boomalmost all others: in addition to the usual descriptions of M-mode and two-dimensional echocardiographic abnormalities associated withvarious entities, diagnostic ini>rmation obtained by other noninvasive techniques (radionuclide angiography, phonocardiography, and Doppler echocardiography) is frequently mentioned and illustrated in the text. This welcome innovation is bound to enhance the value of the book to cardiologists in training. Likewise, practitionen of clinical cardiology, often uncertain as to the relative importance and indications ofthe array of different investigative methods now available, will appreciate being shown how these other noninvasive techniques can supplement or amplify echocardiography to achieve the optimal diagnostic yield. Largely a one-author book, it has uniformity of style and approach. Drs. Beerman and Park contribute a useful chapter on common congenital cardiac anomalies. An excellent and profusely illustrated chapter by On. Plehn and Liebson on prosthetic valves constitutes one of the best features of the text. Dr. Arvan has rightly emphasized the practical aspects of echo recording and the recognition of potential pitfalls. In his words, "acquiring a meaningful echocardiogram is more demanding than the actual interpretation itself;" many cardiologists without personal "hands-on" experience are unaware of this truth. The illustrations are well chosen and of good quality throughout the book. I was disappointed, howeve~ to Bnd no references later than 1981 in a textbook bearing a 1984 publication date. In conclusion, Dr. Arvans book can be strongly recommended to internists, clinical cardiologists and cardiologists in training who wish to update their ecbocardiographic skills and keep abreast of important advances in the cardiac noninvasive arena.
Ivan A D'Cruz, M.D. Chicago MANUAL OF INTENSIVE CARE MEDICINE. Edited by JAMES M. RIpp and MARIE E. CSETE. Boston: Little Brown and Company, 1983, 465 pp,
$16.95.
This concise, practical manual systematically deals with some of the major issues con&onted by critical care physicians. Most of the chapters are well written and provide a remarkable depth and breadth of infOrmation in a very small amount of space. It is particularly admirable that techniques and methods ofdata interpretation are included because it has been the weakness of similar publications to tell you what to do but not tell you how to do it or what it all means. The tables are clear and do not reiterate material presented in the text. The section on noning problems in the intensive care unit is important not only tOrnurses reading the book, but alsotOrphysiCians who are sometimes unaware ofwhat the nurses in the unit are responsible to do, how some of these tasks are done, and what special stresses complicate their mission. The main deficits of this book are in the area of surgical intensive care. For example. wound management is only cunorily handled. Little attention is paid to postoperative 8uid and electrolyte problems, even though they are often managed quite differently from the more chronic ones seen in medical patients. Obviously, any manual can express only a limited number of views about any given subject. Thisbook clearly presents medically acceptable ways to handle and interpret most clinical intensive care unit situations. It is useful reading tOr virtually anyone who has patients in an intensive care unit, but particularly helpful to house ofIicers, fellows and critical care specialists. It would be an excellent reference to have available within the unit tOr "on-thescene" access to pertinent infOrmation. The selected readings at the end of each chapter provide an excellent annotated bibliography on each of the subjects covered. The choice of references is excellent. Most chapters have references up to 1982. I do not think that many more useful books could be obtained for the modest price of this one.
Maria D.
su« M.D.
Baltimore
Allergy to molds (or moulds) and the somewhat breeder Beld of fungal G1lergy-a term which the editors state they p~ yet do not use as their title-often is approached hesitatingly, becausethe science of mycology seems too remote from medical practice and full of diftlcult Greek and Latin names. Thisoutstanding volume will correct any such negative attitudes. It represents a very inbmative, yet also quite readable introduction to the subject. The 17 contributon present well-documented, sdenti6ca1ly thorough and clinically useful accounts of their topics. These range from classi6cation and sampling techniques (Ormolds to clinical and immunologic types of reactions and treatment methods. Some environmental surveys might have been more meaningful if more statistical data, with indices of variability, etc could have been included. 'The careful delineation of taxonomic categories and nomenclature could have included a briefcomment on the d6rence of genders, eg, the distinction between -tU (masculine) and -tim (neuter). This becomes especially important in mrming the plural: hgpha (fem) becomes hf/PhtIe, but phomtJ (neut) in plural is phomattJ. With all these uncommon terms. both the editon and the publisher Iuwe succeeded remarkably in &Widing typographicalerrors. I caught only one in the generally excellent Glossary and thatwasin the word Dem4ti11ceotu, which is spelled correctly elsewhere in the text. Also, surprisingly, the Norwegian word ho"ntGlet is printed incorrectly under the name of one of the anthon. The book is full of excellent illustrations, graphs and tables. The five-page "Glossary of Mycology" will be a very useful reference list fOr all readen. There is also a very comprehensive inda:, but some of the page numbers in it do not correspond with the main text pages where a particular topic is discussed. Corutantine]. FaUjen, M. D.
Denver
PEDIATRIC ANESTHESIA, VOL 1 AND 2. Edited by GEORCEA. GRECORY. New York: Churchill-Livingstone. 1983. 1020pp, 198.00 (US). The goal of this new book is "to produce a book that provided physiologic and pbannacologic approach to anesthesia for the pediatric patient, as well as clinical infOrmation needed to care tOr these patients." The fint part of Volume 1 stresses basic physiology, embryology, and anatomy by organ system. A great amount of important infOrmation has been condensed into these Bnt chapters. It is dry reading but worth the e8Ort. The latter part of Volume 1 covers pharmacology, equipment, monitoring, preoperative evaluation and sedation, induction and maintenance of anesthesia, outpatient anesthesia, and regional anesthesia. The chapter, "Developmental Metabolism and Nutrition; coven material that is quite helpful to the anesthesiologist during the perioperative period. The chapter on pharmacology emphasizes much of the recent investigation of pharmacokinetiCS in infants and children. The chapter on regional anesthesia is unique and helpful. Volume 2 addresses special problems and techniques such as deliberate hypothermia, hypotension and hemodilution. Anesthesia fOr special surgical procedures including otolaryngology, ophthalmology, neurosurgery and other situations, is presented. This volume emphasizes "how to do it," but also contains a great deal of physiology. There is also a chapter on intensive care. The book is of good quality and, considering the volume of material presented, and the number of anthon (23), it is relatively free of typographical errors, although some do exist. Table 12-4 is inaccurate and the dosage for nitroprusside infusions on page 975 is incorrectly listed as "mg" rather than " ....g," Occasionally one may disagree with some of the statements. For example, I would not advocate the use of bupivicaine tOr infants. A fair amount of repetition exists. For example, malignant hyperthermia, an important subject, appearsin several chapten as does anesthetic management when the patient has a full stomach. 'The addition of a comprehensive chapter on 8uid management and blood products and replacement would be valuable. In summary, this is a comprehensive textbook that can be used by the pediatric anesthesiologist, the house officer, and theanesthesiologist who only occasionally anesthetizes a child.
Shirley A Grove., M.D. Gtrinemlle, FL
BOOKS RECEIVED CONTROVERSIES IN CORONARY ARTERY DISEASE (Cardiovascular Clinics, Vol 13, No 1). By SHAHBUDIN H. RAHIMTOOLA. Philadelphia: F: A. Davis, 1982, 367 pp, $45.00. COMPREHENSIVE CARDIAC REHABILITATION (Advances in Cardiology, Vol 31, series editor: J. J. KELLERMANN). Basel, Switzerland: S. Karger, 1982, 246 pp, '72.00 (US). PEDIATRIC RESPlRAlORY PHYSIOWGY AND CLINICAL ASPECTS OF PAEDIATRIC PNEUMOWGY (Modern Problems in Paediatrics, Vol 21, series editors F: FALI'NER, N. KRETCHMER. E. RoSSI). Basel. Switzerland: S. Karger, 1982, 248 pp, $99.00 (US).
17
Continued from ptJge 6
OlCtJr B. Garjdn, M.D.
New YorkCUy
fOr the next year. The fOurth section analyzes specific inteJ"Yelltions, (either proved or hopefully bene&cial) among surviwn of infarction. 'Ibis new book provides the medical specialist with a pleasant link between his current protessional development and an uncertain but probably exciting
future.
WtllitJm H.
WehnntlC~
M.D. ChictJgo
SYMPOSIUM ON CARDIOVASCULAR-PULMONARY INTERAcrION IN NORMAL AND DISEASED LUNG. CLINICS IN CHEST MEDICINE, VOL 4, NO 2, MAY 1983. By R. A. MATTHAY, M. A. MATTHAY, AND D. R. DAN'IZUR. Philadelphia: W. B. Saunden, 325 pp, '22.50.
'Ibis volume is a collection of articles, each concerning some aspect of the relationship between the cardiovascular and pulmonary systems. The topic is timely and there is a need tor a good text on the subject. The editors have assembled a group of well-known and respected authors and they have in general produced excellent articles. Although each paper deals with some aspect of the vascular and pulmonary systems, there is no unifying theme to this volume, nor is there an attempt to be comprehensive. As with most symposia, there is a disparity of styles and some redundancy. The papers range from thorough review articles to briefbut Pertinent overviews to expositions of the authors' work and opinions. Although each article is valuable in its own way, it is a bit disconcerting for the reader to go from a discussion of experimental models of pulmonary hypertension to a list of how to prevent arterial line complications in the span of 25 pages. The symposium is published in good quality hard cover and is remarlcably free from typographic or technical erron-it is exceptionally well done for a Periodical. If the reader requires a comprehensive textbook on cardiopulmonary interactions, written with a central theme, consistent style and lack of redundancy, he will be disappointed. On the other hand, this volume is far superior to most symposium-style collections ant! contains much valuable intormation. The basic science papen should be required reading for every physician involved in critical care; the clinical papen are more appropriate for residents and fellows learning the practical aspects of critical care and cor pulmonale. This volume should be in the library of every hospital and every physician practicing critical care. Although a subscription Periodical, it is available for purchase in medical book stores. lbul M. Cox,jr., M.D. Portland, Maine
EXERCISE ELECTROCARDIOGRAPHY-PRACTICAL APPROACH,
2ND ED. By EDWARD K. CHUNG. Baltimore: Williams & WtIkins, 1983, 400 pp. $47.00.
Dr. Chung has edited a very practical handbook covering many aspects of exercise electrocardiography and presented it at a level aimed at and reaching a broad spectrum of physicians, students, and nurses. It is easily read, lucidly written, liberally (although not always wisely) illustrated, and generally accurate. Chapten include descriptions ofpatient preparation, indications for and contraindications to exercise testing, various treadmill protocols, interpretation of the tests, physiology of the response, and computer analysis of the exercise electrocardiogram, along with many other specialized chapters. 1Wo major areas omitted are bicycle and arm ergometry and detailed information concerning currently available stress testing equipment. Summaries at the end of many of the chapten are very helpful as are tables within many of the chapten emphasizing salient features. Several chapters provide excellent coverage and are particularly artfully written, notably Dr. Nanette Wengeri chapter on recommendations fOr exercise in cardiac and healthy patients, and Savvides and Froelichers section on computer analysis of the exercise ECC. References are generally up to date, pertinent, and accurately quoted although one, a citation &om New York MtJgt.WM, might be considered of marginal signmcance. The flaws of the book are many in number, but do not significantly detract from its overall value. The writing is often not particularly graceful. There are many anecdotes, and much dogma and personal prejudice are presented as fact. An example of thisis fOund in Chapter 19 where Dr. Chung unequivocally states that in an asymptomatic individual a positive stress test followed by a positive thallium scan makes a coronary arteriogram mandatory. The overall organization of the book is poor with chapten on exercise training in chronic obstructive lung disease and comparison of ambulatory and exercise electrocardiography placed between cbapten on interpretation of the test and exercise-induced arrhythmias. A chapter on the Master test is histOrically interesting but without practical value. On balance, this is a useful, somewhat expensive volume that will be valuable to many health care profeSSionals involved in stress testing. I would
STREPTOKINASE IN CHRONIC ARTERIAL DISEASE. By MICHAEL MARTIN. Boca Raton, Florida: CRC Press, 1983, 194 pp '74.00. 1ieatment of peripheral arterial occlusion with plasminogen-activating drugs, most notably the thrombolytic agents streptokinase and urokinase, has enjoyed wider popularity in Europe thanin America. The European literature is replete with reports of their effectiveness in a variety of clinical settings, administered by an assortment of methods. The American literature has tended to emphasize a limited applicability of thrombolytic thenpy, stressing the necessity tor selective infusionof the drug directly into the thrombus, the difBculties inherent in achieving satisfactory monitoring of the fibrinolytic e8"ects of a given dosage, the hazards of induced bleeding, particularly into the central nervous system, and the general consensus that thrombolytic thenpy is only effective in the treatment of acute thrombotic arterial or graft occlusion of sewn days' duration or less. Strepto1dtatue in Chrorak ArteriIIl DUetue attempts to dissuade most of these notions, and may be paraphrased simply as "everything you ever wanted to know about streptokinase but were a&aid, or perhaps too ambivalent, to ask." The monograph is based on Dr. Martin's Personal experience, collected in Bonn, Germany, with 600 consecutive patients who bad thrombotic aortic and Peripheral arterial stenosis or occlusion. 1i'eatment consisted of systemic intravenous infusion of streptokinase over periods of one to four days at dosage schedules varying from 5,000 unitslhour to 100,000unitslhour. Anticoagulant thenpy with heparin or warfarin was often used concomitantly. Results of thenpy are described and representative cases are exhibited angiographically. Indications and contraindications to the use of streptokinase are discussed, as well as guidelines on laboratory monitoring and the incidence and management of side effects, including bleeding, fever, allergy and new arterial occlusions. Follow-up data extending to six years are presented. The books main deficiency is in its credibility. From the definition of terms to the presentation of data representing results of therapy, inconsistencies and generalities interfere with the author's message and ultimately undermine its reliability. For example, &om the title one might expect a discussion of the effectiveness of lytic thenpy in thrombotic arterial occlusions of various chronicdurations. Instead, we learn that "most" of the 600 arterial occlusions which make up the data base were "chronic" in nature, although the age of these occlusions and indeed the distinction between acute and chronic arterial occlusions is never satisfactorily established. Similarly, most of the data are displayed in semi-quantitative graphic form which conceals the size of the sample and weakens the effectiveness of the presentation. Furthermore, no attempt is made to establish a dose-response relationship. or even to present a scientific rationale for the treatment protocol ultimately selected by the author. Notable exceptions to the books' vagariesare mund in chapter 9: "Systemic Streptokinase 1reatment of Arterial Occlusions-Clinical 8esults," which is the nucleus of the monograph; chapter 13: "Occurrence and Treatment of Bleeding Accidents;" and the appendix which includes a large number of excellent arteriographic representations of stenotic and occlusive arterial lesions treated e&ectively by systemic streptokinase infusion. Indeed, these pictures conbibute more validity to the authors thesis than most of the text. Beneath its veneer as a comprehensive monograph are a few useful clinical guidelines and a great deal that leaves the reader confused or skeptical.
PeterMcComIn, M.D. PhaadslphlG THE SOCIETY OF CRITICAL CARE MEDICINE TEXTBOOK OF CRITICAL CARE. Edited by w. C. SHOEMAKER, W. L. THOMPSON, ~ R. HOLBROOK. Philadelphia: W. B. Saunders, 1984, 1063 pp, '75.00. Like goldfish, specla1ists spend too much time back-and-forthing over territory between invisible walls. This interdisciplinary book can transfer us to a larger tank. It emphasizes that ..the problems of the patient with several organ systems failing are not resolved by narrow parochial arguments of the traditionalsubspecialities, but by balancing physiologic criteria so that sewral organs may be partially failing, while the patient is improving overall." Instead of juxtaposing sections on Pathophysiology with othen that anecdotally relate clinical experience-a common failing of many texts-most cbapten, eg, right and left ventricular preload and diastolic compliance, successfully m.gnate the basic sciences into the discussion. The section on shock as a whole likewise takes a hard, empirical look at what it talces to survive, and thus enables the reader to set appropriate goalsand to titrate care to individual patients. Diagnostic, therapeutic, and monitoring techniques (plus their indications, contraindications, and complications) are all well covered. The topmost taper on the golden candelabrum of critical care-a compassionate undemanding of the psychology of life-threatening illness and death-is well displayed, as exemplified by the essays on brain death, permanently lost consciousness, and critical care psychiatry. As this book bad a brief gestation period (two yean), a few shortcomings
Conflnued on page 17
13
•__._1-
MOULD ALLERG~ Edited by YOUSEF AL-DooRYand JOANNE E DoMSON• Philadelphia: Lea and Febige~ 1984, 287 pp, US $28.50.
Continued from page 13
exist. Vascu1arsurgeons, mr instance, will not see anything on urgent cerebral revascularization for strokes-in-evolution. And certain academicians may Bnd that the chapter on experimental design ovel'-displays the authors prejudices and does not carefully summarize the references it sites. Reiteration and contradiction are amazingly absent considering that the book has 152 anthon. Only 39 of the 123 chapten mimic what is present in CriticGl Care, Stateof tM Art, Volumes I-N Physicians planning to take the board examinations in Critical Care Medicine, to be offered in the summer of 1985, will value this compendium.
Altm 'f. Marly, M.D., EC.C.P.
EOOMVille, IN
ECHOCARDIOGRAPHY: AN INTEGRATED APPROACH. By STEPHEN ARvAN. New York: Churchill Livingston, 1984,513 pp, $60.00. This text on cardiacultrasound is different boomalmost all others: in addition to the usual descriptions of M-mode and two-dimensional echocardiographic abnormalities associated withvarious entities, diagnostic ini>rmation obtained by other noninvasive techniques (radionuclide angiography, phonocardiography, and Doppler echocardiography) is frequently mentioned and illustrated in the text. This welcome innovation is bound to enhance the value of the book to cardiologists in training. Likewise, practitionen of clinical cardiology, often uncertain as to the relative importance and indications ofthe array of different investigative methods now available, will appreciate being shown how these other noninvasive techniques can supplement or amplify echocardiography to achieve the optimal diagnostic yield. Largely a one-author book, it has uniformity of style and approach. Drs. Beerman and Park contribute a useful chapter on common congenital cardiac anomalies. An excellent and profusely illustrated chapter by On. Plehn and Liebson on prosthetic valves constitutes one of the best features of the text. Dr. Arvan has rightly emphasized the practical aspects of echo recording and the recognition of potential pitfalls. In his words, "acquiring a meaningful echocardiogram is more demanding than the actual interpretation itself;" many cardiologists without personal "hands-on" experience are unaware of this truth. The illustrations are well chosen and of good quality throughout the book. I was disappointed, howeve~ to Bnd no references later than 1981 in a textbook bearing a 1984 publication date. In conclusion, Dr. Arvans book can be strongly recommended to internists, clinical cardiologists and cardiologists in training who wish to update their ecbocardiographic skills and keep abreast of important advances in the cardiac noninvasive arena.
Ivan A D'Cruz, M.D. Chicago MANUAL OF INTENSIVE CARE MEDICINE. Edited by JAMES M. RIpp and MARIE E. CSETE. Boston: Little Brown and Company, 1983, 465 pp,
$16.95.
This concise, practical manual systematically deals with some of the major issues con&onted by critical care physicians. Most of the chapters are well written and provide a remarkable depth and breadth of infOrmation in a very small amount of space. It is particularly admirable that techniques and methods ofdata interpretation are included because it has been the weakness of similar publications to tell you what to do but not tell you how to do it or what it all means. The tables are clear and do not reiterate material presented in the text. The section on noning problems in the intensive care unit is important not only tOrnurses reading the book, but alsotOrphysiCians who are sometimes unaware ofwhat the nurses in the unit are responsible to do, how some of these tasks are done, and what special stresses complicate their mission. The main deficits of this book are in the area of surgical intensive care. For example. wound management is only cunorily handled. Little attention is paid to postoperative 8uid and electrolyte problems, even though they are often managed quite differently from the more chronic ones seen in medical patients. Obviously, any manual can express only a limited number of views about any given subject. Thisbook clearly presents medically acceptable ways to handle and interpret most clinical intensive care unit situations. It is useful reading tOr virtually anyone who has patients in an intensive care unit, but particularly helpful to house ofIicers, fellows and critical care specialists. It would be an excellent reference to have available within the unit tOr "on-thescene" access to pertinent infOrmation. The selected readings at the end of each chapter provide an excellent annotated bibliography on each of the subjects covered. The choice of references is excellent. Most chapters have references up to 1982. I do not think that many more useful books could be obtained for the modest price of this one.
Maria D.
su« M.D.
Baltimore
Allergy to molds (or moulds) and the somewhat breeder Beld of fungal G1lergy-a term which the editors state they p~ yet do not use as their title-often is approached hesitatingly, becausethe science of mycology seems too remote from medical practice and full of diftlcult Greek and Latin names. Thisoutstanding volume will correct any such negative attitudes. It represents a very inbmative, yet also quite readable introduction to the subject. The 17 contributon present well-documented, sdenti6ca1ly thorough and clinically useful accounts of their topics. These range from classi6cation and sampling techniques (Ormolds to clinical and immunologic types of reactions and treatment methods. Some environmental surveys might have been more meaningful if more statistical data, with indices of variability, etc could have been included. 'The careful delineation of taxonomic categories and nomenclature could have included a briefcomment on the d6rence of genders, eg, the distinction between -tU (masculine) and -tim (neuter). This becomes especially important in mrming the plural: hgpha (fem) becomes hf/PhtIe, but phomtJ (neut) in plural is phomattJ. With all these uncommon terms. both the editon and the publisher Iuwe succeeded remarkably in &Widing typographicalerrors. I caught only one in the generally excellent Glossary and thatwasin the word Dem4ti11ceotu, which is spelled correctly elsewhere in the text. Also, surprisingly, the Norwegian word ho"ntGlet is printed incorrectly under the name of one of the anthon. The book is full of excellent illustrations, graphs and tables. The five-page "Glossary of Mycology" will be a very useful reference list fOr all readen. There is also a very comprehensive inda:, but some of the page numbers in it do not correspond with the main text pages where a particular topic is discussed. Corutantine]. FaUjen, M. D.
Denver
PEDIATRIC ANESTHESIA, VOL 1 AND 2. Edited by GEORCEA. GRECORY. New York: Churchill-Livingstone. 1983. 1020pp, 198.00 (US). The goal of this new book is "to produce a book that provided physiologic and pbannacologic approach to anesthesia for the pediatric patient, as well as clinical infOrmation needed to care tOr these patients." The fint part of Volume 1 stresses basic physiology, embryology, and anatomy by organ system. A great amount of important infOrmation has been condensed into these Bnt chapters. It is dry reading but worth the e8Ort. The latter part of Volume 1 covers pharmacology, equipment, monitoring, preoperative evaluation and sedation, induction and maintenance of anesthesia, outpatient anesthesia, and regional anesthesia. The chapter, "Developmental Metabolism and Nutrition; coven material that is quite helpful to the anesthesiologist during the perioperative period. The chapter on pharmacology emphasizes much of the recent investigation of pharmacokinetiCS in infants and children. The chapter on regional anesthesia is unique and helpful. Volume 2 addresses special problems and techniques such as deliberate hypothermia, hypotension and hemodilution. Anesthesia fOr special surgical procedures including otolaryngology, ophthalmology, neurosurgery and other situations, is presented. This volume emphasizes "how to do it," but also contains a great deal of physiology. There is also a chapter on intensive care. The book is of good quality and, considering the volume of material presented, and the number of anthon (23), it is relatively free of typographical errors, although some do exist. Table 12-4 is inaccurate and the dosage for nitroprusside infusions on page 975 is incorrectly listed as "mg" rather than " ....g," Occasionally one may disagree with some of the statements. For example, I would not advocate the use of bupivicaine tOr infants. A fair amount of repetition exists. For example, malignant hyperthermia, an important subject, appearsin several chapten as does anesthetic management when the patient has a full stomach. 'The addition of a comprehensive chapter on 8uid management and blood products and replacement would be valuable. In summary, this is a comprehensive textbook that can be used by the pediatric anesthesiologist, the house officer, and theanesthesiologist who only occasionally anesthetizes a child.
Shirley A Grove., M.D. Gtrinemlle, FL
BOOKS RECEIVED CONTROVERSIES IN CORONARY ARTERY DISEASE (Cardiovascular Clinics, Vol 13, No 1). By SHAHBUDIN H. RAHIMTOOLA. Philadelphia: F: A. Davis, 1982, 367 pp, $45.00. COMPREHENSIVE CARDIAC REHABILITATION (Advances in Cardiology, Vol 31, series editor: J. J. KELLERMANN). Basel, Switzerland: S. Karger, 1982, 246 pp, '72.00 (US). PEDIATRIC RESPlRAlORY PHYSIOWGY AND CLINICAL ASPECTS OF PAEDIATRIC PNEUMOWGY (Modern Problems in Paediatrics, Vol 21, series editors F: FALI'NER, N. KRETCHMER. E. RoSSI). Basel. Switzerland: S. Karger, 1982, 248 pp, $99.00 (US).
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