Saunders Manual of Pediatric Practice

Edited by Laurence Finberg. Pp. 1,088. Price, $75.00. Saunders, 625 Walnut St., Philadelphia, PA 19106, 1998.

Saunders Manual of Pediatric Practice serves as a clear, precise, pertinent reference for the clinician. This textbook is an excellent resource for residents, mid-level practitioners or busy physicians needing a quick review of a subject.

The textbook is divided into 22 parts, and the style is readable, with large color headings used to highlight key information. Prevention covers nutrition, neonatology and adolescent medicine.

Diseases are covered under general topics and systems. For example, neonatology is divided into symptoms of newborns, normal newborns and disorders of newborns. I appreciate the chapter on newborn symptoms because it offers a clinically practical way to evaluate the newborn with respiratory distress, lethargy, cyanosis, pallor, plethora, vomiting, inappropriate passage of meconium, and jaundice.

Separate chapters cover etiology, pathogenesis, clinical findings, laboratory findings, diagnosis, treatment and prevention. After each topic, a short bibliography is provided for further reference. Key concepts are highlighted throughout the chapters: key clinical findings, laboratory findings and treatment.

Pertinent procedures are discussed in detail throughout the book to provide a guide for infrequently performed procedures, such as suprapubic aspiration and thoracentesis. Indications for procedures are outlined in tables. Additionally, tips for successful performance of procedures are given in tables.

The chapter on home pulmonary care lists skills parents must be able to understand and perform before a child with a tracheostomy can be discharged. Although brief, the chapter covers clothing, neck skin care and tracheostomy tube changes.

Although many treatments were described in detail, some treatments were left to the physician's discretion, such as choices of antibiotics for a particular treatment. Although this allows the text to remain current, physicians may be required to consult different sources for optimal antibiotic choice.

Overall, I found the textbook to be easy to read and a beneficial tool in my practice of pediatrics.

12-Lead ECG's: A “Pocket Brain” for Easy Interpretation

By Ken Grauer. Pp. 64. Price, $10.00. KG/EKG Press, P.O. Box 141258, Gainesville, FL 32614-1258, 1998.

Arrhythmia Management and Cardiac Arrest: A “Pocket Brain” Approach

By Ken Grauer. Pp. 68. Price, $10.00. KG/EKG Press, P.O. Box 141258, Gainesville, FL 32614-1258, 1998.

These pocket-sized books are intended to provide the physician with a convenient reference for electrocardiogram (ECG) interpretation, arrhythmia recognition and cardiac arrest management. The author has compressed a wealth of information into two concise guides that family physicians will find useful on rounds and in the office.

12-Lead ECG's: A “Pocket Brain” for Easy Interpretation provides a compact, yet comprehensive review of ECG interpretation. It concisely covers the basics of systematic ECG interpretation. The table of contents conveniently allows the reader to find specific topics. Key points and terms have been boxed and highlighted for prompt recognition.

All of the basics, from rate calculation to diagnosing ischemia and infarct, are presented in a sensible manner. The sections on rate and rhythm, and particularly the section on tachycardia, provide a logical approach to those difficult to diagnose arrhythmias. The author has made the often forgotten criteria for chamber hypertrophy and conduction disturbances readily accessible. Illustrations and ECG tracings adequately demonstrate key points.

This book is not meant to be a comprehensive guide for the student without previous experience in interpreting ECGs. There are no practice tracings typically found in larger textbooks on ECG interpretation. However, students with a basic understanding of ECGs will find this guide useful. It should be standard issue for residents.

Arrhythmia Management and Cardiac Arrest: A “Pocket Brain” Approach also provides a quick-reference table of contents, and key points have been highlighted or boxed.

The text begins with a quick review of rhythm diagnosis and the “ABCs.” The key points of specific arrhythmias are reviewed and are followed by specific treatment recommendations. The latter sections of the text provide a more thorough review of cardiac medications, defibrillation, vagal maneuvers and pacing. Illustrations and rhythm strips are sufficient in demonstrating diagnostic points.

Both of these pocket-sized books are well written. I carried the “pocket brain” on ECGs with me for two weeks and found it to be a handy, quick-reference tool. The pocket brain on arrhythmia management and cardiac arrest would be useful for family physicians who work in the emergency department or the coronary care unit.

The preface to both texts states that they were designed to review key concepts and lighten the “memory load.” Dr. Grauer's pocket brains effectively accomplish both of these goals.

Nelson Essentials of Pediatrics

Edited by Richard E. Behrman and Robert M. Kliegman. Pp. 864. Price, $42.50. 3d ed. Saunders, 625 Walnut St., Philadelphia, PA 19106-3399, 1998.

Nelson Essentials of Pediatrics was designed to meet the educational needs of medical students participating in a pediatric clerkship. The authors hope this textbook will teach students the essentials of pediatric problems and provide an understanding about “both the common illnesses of childhood and the less common disorders of special educational importance that exemplify pathophysiologic mechanisms and disease processes.” The goal is for a student to find the 781 pages of text a reasonable length to read during a clerkship.

The textbook has 19 chapters beginning with developmental and behavioral pediatrics, genetics, fetal and neonatal medicine and adolescent medicine. The textbook then moves into system-specific chapters. Topics are covered succinctly, and each major section is followed by a reference to the appropriate portion of Nelson Textbook of Pediatrics, 15th edition. At times it feels like reading the “cliff notes” for the larger textbook.

Because it is designed to be a teaching tool for medical students, the textbook is full of many excellent tables listing differential diagnoses, therapies for a given condition, history and physical findings, signs and symptoms, complications, prognostic factors, and criteria for diagnoses such as Kawasaki disease, acute rheumatic fever or systemic lupus erythematosus. There is also a very useful appendix about drug doses that lists drugs by generic name, states the forms in which it is available, how and when it is used, important toxicities or limitations, and trade names.

This textbook contains reproductions of many of the forms used in pediatrics, including the Denver Developmental Screening Test, the Dubowitz criteria to estimate gestational age, the Centers for Disease Control and Prevention immunization schedule and the National Institutes of Health stepwise approach to asthma therapy. The diagrams are simple and easy to understand. However, the book contains few photographs, and most are of morphologic abnormalities of red blood cells in black and white, an occasional radiograph and photos showing Tanner staging.

Some information did not seem to be in a logical place, such as the discussion of immunizations in the section on fever of unknown origin instead of in the section describing routine care. Also, there is no discussion of what should be included in sports preparticipation physical examinations.

Nelson Essentials of Pediatrics is an excellent choice for the student who wants to gain a good understanding of the field of pediatrics. The practicing family physician could find it useful in reviewing for the family practice boards if he or she is not doing a lot of pediatrics in everyday care. The book could also be used as a reference to quickly look up complications, etiologies and differential diagnoses in the many tables in each chapter. The plethora of tables and the useful information they contain is probably the strongest feature of the textbook. However, it is weak on detailed discussions of treatment, and those needing that information should look elsewhere.

Also Received

AIDS Capitation

Edited by David Alex Cherin and G.J. Huba. Pp. 115. Price, $34.95. Haworth Press, 10 Alice St., Binghamton, NY 13904-1580, 1998.

Dietary Management of Food Allergies and Intolerances

By Janice Vickerstaff Joneja. Pp. 426. Price, $49.00. 2d ed. JA Hall Publications, 1733 H St., Ste. 330-1010, Blaine, WA 98230-5107, 1998.

Facing Death

Edited by Howard M. Spiro, Mary G. McCrea Curnen and Lee Palmer Wandel. Pp. 240. Price, $32.50. Yale University Press, P.O. Box 209040, New Haven, CT 06520-9040, 1998.

The Healing Mind: The Vital Links Between Brain and Behavior, Immunity and Disease

By Paul Martin. Pp. 384. Price, $25.95. St. Martin's Press, 175 Fifth Ave., New York, NY 10010, 1998.

The Managed Health Care Dictionary

By Richard Rognehaugh. Pp. 261. Price, $19.95. 2d ed. Aspen Publishers, 200 Orchard Ridge Dr., Gaithersburg, MD 20878, 1998.