Physician's Bookshelf

Book Reviews

Am Fam Physician. 1999 Oct 1;60(5):1580-1582.

The Guide to Living with HIV Infection

By John Bartlett and Ann K. Finkbeiner. Pp. 422. Price $15.95/$42.00. Johns Hopkins University Press, 2715 N. Charles St., Baltimore, MD 21218-4319, 1998. Phone: 800-537-5487.

This informative and well-written book can function as a guide for anyone whose life is affected by human immunodeficiency virus (HIV) infection. While mainly written as a resource for people with acquired immunodeficiency syndrome (AIDS) and their caregivers, The Guide to Living with HIV Infection could also be a useful reference for social service workers, clergy or even health care providers. The book is written in an open, conversational tone, perhaps modeling an idealized interaction with a health care provider.

After an inspirational prologue written by a person living with AIDS, the book begins with a brief section answering some basic questions: What is HIV/AIDS? How is HIV transmitted? How can HIV infection change people's lives? The structure of the book is described so that the casual reader will know where information can be found. The authors point out that information is frequently repeated in different sections and, thus, there is no need to read the book from cover to cover.

Following the introduction, there are 13 chapters on topics such as understanding and communicating about HIV; HIV infection and its emotional effects; making legal, financial and medical decisions; and preparing for and accepting death. The chapter entitled “What to Do When: Guidelines for Medical Care” goes into significant detail about particular presenting symptoms and which opportunistic conditions they could represent. There is an entire chapter on HIV-associated dementia, which is a condition of particular concern to many people with HIV infection. The chapter titled “Medical Treatments: The Range of Available Therapies” has a slightly out-of-date section on antiretroviral therapy, although it would be difficult for any book to be completely updated on this constantly changing field. This chapter also includes a section on alternative medicine. Although not outwardly dismissive of most approaches other than allopathic medicine, the authors' stance is evidence-based and, when listing benefits, they present them as largely psychologic. The book ends with sections on national resources and understanding tests for HIV, as well as an extensive and understandable glossary, covering everything from the CDC to hydroxyurea.

One troubling feature of this book for primary care physicians who care for patients with HIV/AIDS is that the authors endorse the view that all patients with HIV infection should be cared for by an HIV specialist. When presenting information from studies that suggested that experience of the health care provider was an important factor in competent care for persons with HIV infection, the book fails to describe how much experience is necessary for the providers to be considered “experienced.” It also fails to point out that the motivated primary care provider can indeed keep up with this field and can augment personal knowledge with consultation when necessary. Before recommending this book to their patients, primary care clinicians should caution their patients about this aspect of its contents.

Despite this precaution, the book can certainly be recommended by the physician or other primary care provider to patients and those that care about and for them. It can serve as a useful resource at any stage of HIV infection and is written in such a way that the reader feels very supported in his or her own experience of the disease.

Drugs for the Gut: A Practical Guide to Gastrointestinal and Liver Therapy

By Peter Pritchard, Robert Walt and Roger Chapman. Pp. 443. Price, $35.00. W.B. Saunders Co., 625 Walnut St., Philadelphia, PA 19106, 1998. Phone: 800-831-7799.

Drugs for the Gut is a small reference book, meant to be carried in the pocket of a white laboratory coat. Written by an Australian physician and two British physicians, it is quite appropriate for the American medical student or resident but is less useful for a family physician or a generalist. Although small in size, the text is fairly well organized and the content is comprehensive. However, because of its style and prose listing of medications, it is better suited for inpatient use or for use on a gastroenterology rotation, rather than as a quick reference in the office.

The book is divided into two parts, an organ system section and a medication section. Although touted as a medication reference, the book focuses as much on etiology, pathophysiology and patient presentation as it does on pharmacology. The entire gastrointestinal system is covered, from esophagus to colon, and common and not-so-common diseases are discussed with seemingly no special emphasis on treatment. The information is comprehensive but concise.

The chapter on infectious diarrhea in the organ system section is particularly useful. Charts clarifying the presenting symptoms of bacterial, parasitic and viral diarrheas help make diagnosis easier, and management of these symptoms is clearly outlined with appropriate dosing charts. The viral hepatitis review chapter is also helpful, and the chart contrasting hepatitis A-G is excellent.

However, the book is not without its problems. It is redundant at times, as evidenced by verbatim repeats in the chapters dealing with gastric ulcer, duodenal ulcer and Helicobacter pylori infection, and it fails to give dosages clearly at times, as in the nausea chapter. These problems make the book difficult to use as a quick reference.

The medication section, in the back, lists drugs by functional category and is handy because clinical uses, side effects, contraindications, dosage, drug interactions, and the mechanism of action are included. In addition, it lists hints and clinical pearls concerning the medications that might otherwise go unnoticed. Despite the book's British and Australian authorship, the drugs are familiar but listed by generic names only.

The book is most useful when read as a text and not when used as a quick reference. Although several chapters are excellent, treatments for the various gastrointestinal diseases are often lost in the prose and would benefit from tables listing medications and dosages clearly. In some chapters, the dosages are not even given in the treatment section and are only listed in the medication section.

Overall, this book has the value of being small and concise, while retaining comprehensive information. The quality of the organization and the use of charts are unfortunately inconsistent, making some chapters less effective than others. In addition, several distracting typographic errors occur throughout the text. Although written for a primary care physician, this book would be best used by a medical student or resident who needs a small pocket manual containing fairly complete information on gastroenterologic pharmacology.

Also Received

Anxiety and Depression: Your Questions Answered

By Cosmo Hallstrom and Nicola McClure. Pp. 214. Price, $19.95. Churchill Livingstone, Robert Stevenson House, 1–3 Baxter's Place, Leith Walk, Edinburgh EH1 3AF, UK, 1998. Phone: 800-553-5426.

Churchill's Pocketbook of General Practice

By Simon Cartwright and Carolyn Godlee. Pp. 349. Price, $25.00. Churchill Livingstone, Edinburgh, Great Britain EH1 0GF, 1998. Phone: 800-553-5426.

Delivering Health Care in America

By Leiyu Shi and Douglas H. Singh. Pp. 597. Price, $49.00. Aspen Publisher, 200 Orchard Ridge Dr., Ste. 200, Gaithersburg, MD 20878, 1998. Phone: 800-638-8437.

Family Doc: The Making of a Family Practitioner

By Robert E. Brown. Pp. 168. Price, $17.95. Parthenon Publishing Group, One Blue Hill Plaza, P.O. Box 1564, Pearl River, NY 1095, 1998. Phone: 914-735-9363.

Griffith's Five Minute Clinical Consult

Edited by Mark P. Dambro. Pp. 1,345. Price, $54.95. Lippincott, 227 E. Washington Square, Philadelphia, PA 19106, 1998. Phone: 800-241-6551.

Maximizing the Arthritis Cure

By Jason Theodosakis, Brenda Adderly and Barry Fox. Pp. 302. Price, $6.50. St. Martin's Press, 175 Fifth Ave., New York, NY 10010, 1998. Phone: 800-221-7945.

Merriam Webster's Medical Audio Dictionary (CD-ROM)

Price, $39.95. Merriam-Webster, 47 Federal St., P.O. Box 281, Springfield, MA 01102, 1998. Phone: 800-828-1880.

The MGH Guide to Psychiatry in Primary Care

Edited by Theodore A. Stern, John B. Herman and Peter L. Slavin. Pp. 696. Price, $45.00. McGraw-Hill, 1221 Avenue of the Americas, New York, NY 10020, 1998. Phone: 800-262-4729.

The Molecules Within Us

By Charles A. Pastermak. Pp. 275. Price, $28.95. Plenum Press, 233 Spring St., New York, NY 10016, 1998. Phone: 800-221-9369.

Pharmacotherapeutics and Advanced Nursing Practice

By Laurel A. Eisenhauer and Margaret A. Murphy. Pp. 494. Price, $42.00. McGraw-Hill Educational and Professional Publishing, 2460 Kerper Blvd., Dubuque, IA 52001-2224, 1998. Phone: 800-262-4729.

Pocket Companion to Accompany Psychiatry

By Allan Tasman, Jerald Kay and Jeffrey Lieberman. Pp. 631. Price, $38.95. W.B. Saunders, Curtis Center, Independence Square West, Philadelphia, PA 19106, 1998. Phone: 800-545-2522.

Provider Sponsored Organizations

Edited by Allan Fine and Colleen E. Dowd. Pp. 260. Price, $79.00. Aspen Publishers, 200 Orchard Ridge Dr., Ste. 200, Gaithersburg, MD 20878, 1998. Phone: 800-638-8437.


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