Nelson Textbook of Pediatrics

Nelson Textbook of Pediatrics

Book Reviews Vascular Disorders of the Upper Extremity, edited by Herbert I. Machleder, 292 pp, with illus, $37.50, Mount Kisco, New York, Futura Publ...

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Book Reviews Vascular Disorders of the Upper Extremity, edited by Herbert I. Machleder, 292 pp, with illus, $37.50, Mount Kisco, New York, Futura Publishing Company, 1983 Vascular diseases of the upper extremities follow the classic patterns of disorders experienced in the legs, but the events are far less frequent and often better tolerated, and, of importance, diagnostic permutations are far more diverse: the overlap of the vasospastic phenomenon and numerous systemic processes complicates the diagnostic challenge substantially. Except for a solitary chapter by Spittell, the English literature forces the clinician to review scattered, multiple sources when faced with a clinical problem. This monograph addresses the need for a cohesive overview of vascular disease of the arms and hands in a competent manner. The surgeon, diagnostician, angiographer, and vascular laboratory all face these multifaceted problems, and expert experiences from each are presented, assembled by a perceptive editor. D. Sumner provides a seasoned essay, with excellent clinical observations, on the capabilities and limitations of the vascular laboratory to substantiate occlusive arterial disease, venous problems, shunt function, and arteriovenous malformations. It is apparent, however, that pure vasospastic phenomenon cannot always be distinguished from digital occlusive disease. The techniques and applications of angiography are lucidly discussed by A. Gomes. The text and plates reflect a broad experience. Few authors write with the authority of D. Roos on the complexities of the thoracic outlet syndromes. This particular chapter is valuable for the stepwise logic of his approach to diagnosis and medical or surgical treatment. The extensive experience and careful studies of J. Porter on Raynaud's phenomenon and digital ischemia are thoughtfully presented and warrant thorough attention. In addition, he identifies a special subset of patients with digital ischemia referred to as "hypersensitivity angiitis"; as he acknowledges, the term is in conflict with a broader usage by many in classifying the arteritides. Emeritus Professor W . Bean contributes a vignette on the anatomy and clinical findings in patients with the superior vena cava syndrome. Editor Machleder covers major arterial and venous obstructions of the upper extremities in a clearly written, carefully documented fashion; the material is rich in both overview and needed detail. This and the following chapter on systemic vascular disorders that affect the arm and hand provide a wealth of informaMayo Clin Proc 59:359, 1984

tion and are the heart of the monograph. The latter chapter, by Paulus and Kono, classifies the arteritides in a useful fashion, reviews a complex subject succinctly, and offers a large but selective bibliography. Such a monograph has long been needed. I strongly recommend it to all persons who are interested in vascular disease and to institutional libraries. John W. Joyce, M.D. Division of Cardiovascular Diseases and Internal Medicine

Nelson Textbook of Pediatrics, 12th ed, by Richard E. Behrman and Victor C. Vaughan III, 1,899 pp, with illus, $75, Philadelphia, W. B. Saunders Company, 1983 This textbook is the 12th edition of what has become the standard reference source for this specialty. Dr. Waldo Nelson, the original author of this text, is still involved in its revisions after almost 45 years. In the 11th edition, which was published in 1979, Dr. Vaughan was the senior editor and Dr. Behrman was one of the contributing authors. In this most recent edition, Dr. Behrman is the senior author. The 12th edition is less a departure from the 11th edition than the 11th edition was from the 10th edition. The table of contents is improved in that the type is larger, the discussion of disorders has been somewhat rearranged, and immediately after the table of contents are color plates that are entirely new in this edition. In comparison with the previous edition, this edition has approximately 200 fewer pages and 40 more contributors. In addition, the format is more attractive and more visually appealing than that in the previous edition. This textbook, which initially appeared in the late 1940s or early 1950s, has established and maintained its place as a number one textbook for students, residents, and practitioners in the field of pediatrics. Most of the nation's 25,000 or more pediatricians are thoroughly familiar with it and literally went to bed with it in the course of their residency programs. The proliferation of texts in subspecialties in pediatrics or in general pediatrics itself has not diminished the lofty position attained by Nelson's Pediatrics. Although the contents have been changed minimally from the previous edition, in my opinion the adolescent issues are better covered and somewhat improved in the current text. 359

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Pediatricians are branching out in their coverage of child health care to include adolescent issues. Residency training programs depend on the contributions of prominent authors in this field. Substance abuse, the legal issues involved in dealing with adolescents, sexual misuse, adolescent pregnancy, and sexually related social diseases are all included in this book. Relatively new problems to pediatrics, such as acquired immune deficiency disease and Kawasaki disease, are effectively reviewed by recognized authorities. Hypertension, an uncommon problem in pediatric patients, is adequately addressed, and the criteria for its diagnosis are emphasized. This text will continue to be regarded as a standard for students, residents, and practitioners in pediatrics, and each new edition only "polishes" the luster acquired during 41/2 decades. The libraries of medical schools, pediatric departments, and hospitals and the pediatric practitioner's office itself will not be complete without the "bible" of the specialty. Edmund C. Burke, M.D. Department of Pediatrics

Congenital Heart Disease: Morphologic Echocardiographic Correlations, by Elma J. Gussenhoven and Anton E. Becker, 217 pp, with illus, $79, Edinburgh, Churchill Livingstone (distributed by Longman, Inc., New York), 1983 This book is an excellent example of what collaboration can accomplish. The two authors work at different institutions in the Netherlands and are trained in different specialties, cardiology and pathology. In addition, one is just beginning her academic career, whereas the other has been an established authority in his field for some time. This heterogeneity seems to have been an asset rather than a handicap, however, as the product of their efforts is a book that will be of value to anyone who is interested in the application of echocardiography to patients with congenital heart disease. This text is primarily an atlas in which photographs of anatomic specimens are compared with two-dimensional echocardiograms of similar anatomic sites and pathologic conditions. The anatomic specimens are beautifully sectioned and prepared, and the photographs produced from them are of excellent quality. The echocardiograms are also well done and certainly convey the intended message, although direct comparisons of echocardiograms and high-quality photographs of cardiac anatomy reemphasize the fact that even though rapid progress has


been made in the quality of echocardiographic images during the past 5 years, there is still room for substantial improvement with this modality. In addition, two-dimensional echocardiography is a dynamic imaging tool that puts its best foot forward only when the images obtained are displayed in real time on a television monitor or videotape; selected still-frame reproductions inevitably lose something in clarity and in the amount of information conveyed. The authors have deliberately and wisely limited their book to a demonstration and discussion of normal cardiac anatomy and the common congenital cardiovascular malformations, not attempting to cover the entire spectrum of complex and rare congenital lesions. In addition to the anatomic and echocardiographic photographs, the nicely integrated text discusses possible pitfalls in echocardiographic technique which can lead to mistaken interpretations, and it also carefully discusses anatomic features that are especially important in the diagnosis of the various malformations. The text is particularly valuable in that both the echocardiographic and the anatomic observations are based on the principle of sequential chamber analysis, a concept that has greatly simplified and clarified the description of the pathologic changes associated with congenital cardiovascular lesions in recent years. This book is very well done and will be useful to anyone who is interested in the field of congenital heart disease. I suspect that it will be of particular value to the student or resident who is relatively early in his training, as the format in which the material is presented and the approach that is used simplify what can be a complex and confusing field. Douglas D. Mair, M.D. Division of Pediatric Cardiology

Objective Medical Decision-Making; Systems Approach in Acute Disease (Lecture Notes in Medical Informatics, Vol 22), edited by J. E. W . Beneken and S. M. Lavelle, 243 pp, with illus, $18, New York, SpringerVerlag, 1983 This soft-cover book contains the papers of a workshop by the same name that was held during April 1983. The book begins with two keynote papers. The remainder of the material is divided into four groups of presentations that address diagnosis, monitoring, therapy and control, and evaluation of criteria and procedures. The segment on diagnosis consists of five papers. These deal with assessment of preoperative risks, use of a