advice for house surgeons
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Advice for House Surgeons C. D. Jolinson. 210 x 140 nmi. Pp. 52. Not illustrateri. 1992. Beuconsfielil. U K : Beaconsfeld Puhlishers. f4 .50.
This is a slim volume designed to fit in the house officers pocket. It is easily read, clear and concise, and full of essential, practical advice unclouded by theory. It attempts to cover the problems and procedures commonly encountered by junior doctors and, for the most part, provides simple, clear instructions. However, the depth of advice is somewhat variable. For example, there are precise details of heparin treatment, pain relief and fluid management, but premedication is sketched over and warfarin therapy and the management of the diabetic patient after operation not mentioned at all. The problem with writing such a book is to steer a path between ones own approach to a situation and that adopted by other people. The author avoids appearing too didactic. making ample allowance for local variation in custom, but in doing so sometimes fails to provide sufficient advice. In addition to practical guidance, this volume is an essay on communication, impressing on the reader the importance of liaison with other hospital and outside staff, from the porter to the radiographer and the staff nurse to the coroners officer. In summary, this is an excellent book that provides a mass of useful advice on all sorts of situations important to the house surgeon. The information is packed into a small easily read volume that should be readily assimilated by the apprehensive fledgling house officer.
J olin Rarkliffe Hospital O.~ford OX3 9DU UK
Atlas of Cutaneous Laser Surgery D. B. Apfelberg (et i . ) . 281 x 222 i m i . Pp. 483. Nlustratctl. New York: Rareti Press. 1992. US $244.
This well illustrated book is truly an atlas of cutaneous laser surgery. There are multiple authors; the text is divided into one chapter on physical principles of lasers, two on laser safety. and thereafter takes case-report form covering patients treated with carbon dioxide (CO, 1, argon, yttrium-aluminium-garnet. tunable-dye and. lastly, newer laser technologies. Each case occupies around two pages, with multiple pictures of before-and-after results accompanied by a fairly brief text. The section on the COz laser is largest and, while it includes many conditions that one would accept are well treated by this laser, such as rhinophyma and actinic cheilitis, there are others which are rather surprising, such as pyogenic granulomas and onychomycosis. 1 was impressed by the results, shown photographically, of treating scarring of chronic discoid lupus by CO, laser and also by the cosmetic improvement in a patient with extensive neurofibromatosis. but. overall, 1 did feel that some of the indications for laser therapy were slight. In the argon laser section - as one would expect - angiomatous lesions predominate, and there was a tendency to treat those that dermatologists would observe in the justified belief that natural regression will take place. However, both angiofibromas and tuberous sclerosis were impressively treated in this section.
In the section on tunable-dye therapy, telangiectasis, cherry angiomas and spider angiomas are discussed; it would have been useful to have had a comparison with results using the infra-red coagulator. Overall this is a well illustrated book, but I felt it would have been more valuable with clear indications as to what to treat and when, and thereafter some discussion on the reasons for choosing the particular laser selected for therapy. The book tends to leave one with the overall impression that those who have access to a laser are naturally enthusiastic to maximize its use without. perhaps, critically assessing the value of this therapy compared with other available methods. In general. the colour pictures are of high quality and those interested in laser therapy will see a wide range of approaches.
R. M. Mackie Unirersitj, qf Glusgo~t~ Glusgow GI1 6NU UK
Case Presentations in Arterial Disease D. Boucliier-Hayes, P . J . Broe, P . A . Grace and D. Mehigun. 210 x 130 nini. Pp. 139. Not illustrated. 1991. 0.ufortl: Butteru.ortk- Huineniann. f14.95.
This little book gives 69 case histories of patients with vascular disease. No attempt is made to provide feedback to the reader on how well or badly they have diagnosed and assessed each case, although each history is followed by a comment where the diagnosis is discussed and a discussion that expands on the original topic. This is the method by which most of us learn our medicine. althcugh a text rather than a patient means that the clinical examination cannot be assessed and is simply provided. Unfortunately, clinical examination skills are often the most difficult part of a students education. I personally do not like this type of exercise and would not encourage students to go out and buy this book, although I recognize that there are many students who do find this type of presentation attractive and for them the book may prove useful. It is a pity that the volume is broken up into different sections as this makes it considerably easier to guess at the diagnosis. It is extremely doubtful whether many students need such a specialized text as they are hard-pressed to read even small surgical textbooks in 1992.
K. G. Burnand St Tlionius Hospital Lanibetli Palace Rood London SEI 7EH UK
Principles of Cardiac Diagnosis and Treatment - A Surgeons Guide. 2nd ed. D. Ross, T. English mid R . McKuy. 243 x 169 nini. Pp, 269. Illustroteii. 1992. London: Springer- Vr.rluy. f49.50.
The second edition of this book, which is already well established as a surgeons guide. has been thoroughly revised and updated by a triumvirate of distinguished cardiac surgeons. The text is directed towards residents and trainees in cardiothoracic surgery but will find a ready audience among nurses, radiologists and physiotherapists who are engaged in this branch of surgical management.
The book is of convenient size and weight; it is produced in clear type and beautifully and copiously illustrated by Barbara Hyams with 169 clear line drawings. There are many additional carefully selected photographs and radiographs.
The entire text is relevant and represents the basic knowledge required by those who are learning to work eflectively in this complex field. The surgeon who is ultimately responsible for the patients safe passage during and after operation must be confident of the exact diagnosis of the patients condition and familiar with the tools of diagnosis that are now available to the cardiologist before the patient is selected for surgery. Modern developments and special investigations are outlined in the context of the way this subject has developed historically. Brief descriptions of echocardiographic techniques, radionuclide studies. computed tomography and magnetic resonance imaging are included. These complement Donald Rosss excellent essay on the Clinical aspects of cardiac diagnosis, which is reproduced from the first edition. A new section of ten pages describes methods that are now available for circulatory and respiratory support. A large section of 100 pages is devoted to a detailed description of congenital heart defects and, although no mention of its incidence was found, this is comprehensive and based on the nomenclature and sequential analysis of cardiac anatomy. A shorter section of 48 pages is devoted to acquired valvular, coronary artery and miscellaneous heart disease.
This updated edition is beautifully written and presented. It is essential reading for all who wish a sound grounding in the principles of modern cardiac surgery and patient management.
D. 1. Hamilton Tlic Ro.rul Infirniury Edinburgh EH3 9Y W U K
1112 Br. J. Surg., Vol. 79, N o . 10, October 1992