Physician's Bookshelf

Book Reviews



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Am Fam Physician. 1999 Dec 1;60(9):2714-2716.

Atlas of Infectious Diseases/Pediatric Infectious Diseases

Edited by Gerald Mandell. Pp. 230. Price, $125.00. Vol. 11. Current Medicine, 400 Market St., Ste. 700, Philadelphia, PA 19106, 1999. Phone: 800-427-1796.

The Atlas of Infectious Diseases/Pediatric Infectious Diseases represents the final book in the 11-volume series edited by Gerald L. Mandell, one of the preeminent experts in the field of infectious diseases. This concluding volume covers a full spectrum of pediatric infectious disease topics with 16 chapters written by 24 authors. Topics covered include six chapters on viral illnesses, a chapter each on streptococcal and staphylococcal infections and a chapter on tick-borne diseases. Other, more selective chapters include Kawasaki disease, tuberculosis, congenital infections and central nervous system infections. As the number of pediatric human immunodeficiency virus (HIV) cases continues to decline in the United States, the chapter dealing with HIV/AIDS will hopefully become more historical interest than necessity.

To complete the text, there are two final chapters on infections in immunocompromised children. The first chapter deals with acquired immunodeficiency from oncologic disorders and their treatment. The second chapter discusses congenital conditions such as hyperimmunoglobinemia E (Job's syndrome) and Chédiak-Higashi syndrome. These sections contain the most esoteric and least clinically useful material for primary care physicians. This statement is made not as an offense toward family physicians (this writer included, who has a large practice of immunocompromised adults). However, in the majority of cases, children with these infrequently encountered conditions are managed by a pediatric subspecialist or at a pediatric tertiary care center. That being said, outstanding photographs, photomicrographs and tables, as is the case with most of this book, strengthen these last two sections.

Collectively, the 16 chapters are arranged to give a brief introduction to the specific diseases followed by information on basic science, pathogenesis and epidemiology. This material is interesting but often not clinically relevant. Usually what follows is a section on clinical manifestations with a superb array of photographs. For example, in the chapter on streptococcal infections, there are six photographs that display the nonsuppurative complications of scarlet fever. A laboratory or radiologic diagnosis section is next, followed by a section on treatment. Finally, each chapter nicely lists the references and selected readings on a single page.

For a textbook, which can often lag two years or more behind in current information because of publication delays, this book is generally up to date. I compared the chapter on Kawasaki disease with a recent review in American Family Physician on the same topic and found little difference in the materials presented. However, the chapter on tick-borne diseases does lag behind, by not including the most recent treatment recommendations for Lyme disease and by omitting any mention of the Lyme vaccine.

A true strength of this book is its extensive collection of photographs, which beautifully illustrate many of the clinical diseases covered in the text. Each chapter has an average of 15 to 25 glossy color photographs. In addition, frequently present are radiographs, some rather dramatic gross pathology specimens (including cross-sections of brains, and detached limbs), and routine and electronmicroscopic reproductions. An additional strength of this book is the excellent collection of tables and graphs throughout every chapter.

On a positive note, the fonts are generally large and easily readable. However, the downside is the awkward size of the text, which measures 12.5 × 10 in. I found it was rather cumbersome to transport between home and the hospital during the course of my review.

The Pediatric Atlas of Infectious Diseases, although a delight to page through if you have the time, would not be highly useful to the busy family physician who often needs quick access to concise material to diagnose and treat patients in the office or clinic. My preferences for a prompt review in the acute care setting are Schwartz's The 5-Minute Pediatric Consult or Lange's Current Pediatric Diagnosis and Treatment, both of which are updated by the publisher on a regular basis. However, this atlas would be an appropriate addition to a residency program in family medicine or pediatrics, or a hospital library where faculty members and residents would have more time to absorb the contents of the book. Another benefit that comes to mind with this atlas—and one I hope to take advantage of—is the potential for reproducing the multitude of tables, charts and photographs for teaching presentations. The text is reasonably priced at $125 and, for the more ambitious clinician or residency program, the entire series of all 11 books can be purchased for $1,375.

The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines

Edited by Mark Blumenthal. Pp. 685. Price, $189.00. Integrative Medicine Communications, 221 Scott Dr., Annapolis, MD 21401, 1998.

This collection of monographs on herbal medicines is a must for every practicing family physician's reference bookshelf. It is one of the most comprehensive and reliable compilations of information on herbal medicine available in the world today. In 1996, an estimated 60 million Americans spent $3.24 billion on herbs and phytomedicinal products. Individual Americans spent an average of $54 per year on these products. Spending on herbal supplements grossed $4.4 billion in 1997. The explosion in mass-marketing of herbal medicines has outpaced efforts in the United States to study and regulate the products our patients are taking.

The German Ministry of Health has been a world leader in regulating, evaluating and integrating medicinal plant products into the health care system. In 1978, the Ministry established Commission E, a panel of medical professionals, pharmaceutical company representatives and lay persons, to systematically study the safety and efficacy of more than 300 herbal remedies. This book is a summary of their ongoing study and recommendations.

Included in this volume is a complete list of approved and nonapproved herbs along with descriptions of their uses, indications and contraindications. Each drug is fully described with information on dosing, composition, actions and side effects. There are also helpful lists of the drugs by side effect, indication, contraindication, pharmacologic action and duration of use. The list of interactions of herbs with conventional drugs is particularly useful. Cross-reference lists help clinicians identify drugs by English, German, botanical and pharmaceutical names.

However, the monographs do have some limitations. Unlike the United States, Germany has defined quality standards for the manufacturing of herbal medicines. Caution should be used in recommending herbal medicines to patients in the United States because composition, potency and quality can vary considerably. Also, although the process used for collecting information for the monographs is explicit, there are no references to guide the reader in an independent evaluation of the literature. Clearly, more research and regulation are needed in the United States to assure that the herbal medicines our patients consume are safe and effective. In the meantime, the German monographs are an invaluable resource.

Sacred Space: Stories from a Life in Medicine

By Clif Cleaveland. Pp. 210. Price, $21.95. American College of Physicians, Independence Mall West, Sixth St. at Race, Philadelphia, PA 19106-1572, 1998. Phone: 800-523-1546.

Stories drawn from a physician's experience suffer from the limitations of genre, yet in many ways Clif Cleaveland's book, which is about his medical career and patients he encountered along the way, transcends these confining literary boundaries. Doctors often only know their patients in the restricted office setting. The patient may have a fascinating quirk or unusual diagnosis, but without the drama of character or the tension of narrative development, it is difficult to build true stories from anecdotes. Therefore, it is no wonder that Cleaveland's most powerful accounts are those in the last third of the book, where he describes patients he has known for many years and in a variety of settings. In these stories, he held my interest long enough for me to become involved with each patient and to care about the individual outcomes of each of the stories.

In one story, “A Call from Bologna,” Cleaveland describes a patient whom his medical team suspected of being poisoned by arsenic. The patient dies; the true diagnosis is never discovered. Earlier in the book, such anecdotes are frustrating, because the reader's interest is piqued but not satisfied. Here, however, this brief account serves instead as a prologue to another, more fully fleshed-out story of an unrelated poisoning episode that reads like a mystery and contains enough detail to give a sense of closure. Incorporated in this way, the first poisoning story gives background and depth to the second.

Interestingly enough, in these last dozen or so stories, we learn more about the author and the kind of doctor he is than we did in the more autobiographical sections preceding them. All along, Cleaveland's sly humor and gentle compassion are evident, but in these later pages we see him interacting more specifically as a person. For example, when he describes his state of mind in the presence of a patient with a particularly intense temperament, he states: “I found myself sitting expectantly at the edge of my chair with my mind revved up to deal with Bill's inquiries. The oral portion of my medical board examinations required no more mental effort than these visits . . . .” In the process of reading, we discover Cleaveland to be a modest, gentle, compassionate and intelligent human being, which makes readers want to call him up and ask him if he would become their personal physician.

In addition, we see that Cleaveland's scope of action extends far beyond the office. In one story, he attempts to trace the cause of a patient's death to contaminated well water and to the spraying of pesticides. In another story, he attempts to intervene in a case of domestic violence. In yet another case, he serves as spiritual guide and counselor over a period of 16 years. All of these roles show how rich a physician's life can be in general, and how deeply caring this man, Clif Cleaveland, is in particular.

The common thread of compassionate tone and commitment make it easy to overlook the flaws of Sacred Space. These flaws include its disjointedness, the suspended anecdotes and the lighthearted story' titles, (“Too Tough for Me,” “Here Comes Trouble”), which seem glib compared with the depth of feeling the actual narratives convey. Instead of being merely entertained, the reader comes away thoughtful, inwardly surveying his own life to see if it contains the kind of courage, humor and resourcefulness expressed by Cleaveland and his patients.

Also Received

At Journey's End: A Complete Guide to Funerals and Funeral Planning

By Abdullah Fatteh and Noaz Fatteh. Pp. 350. Price, $14.95. Health Information Press, 4727 Wilshire Blvd. #300, Los Angeles, CA 90010, 1999. Phone: 800-444-2524.

Clinical Obstetrics and Gynecology

Edited by Washington Clark Hill and Thomas M. Julian. Pp. 808. Williams & Wilkins, 12105 Insurance Way, Hagerstown, MD 21740, 1998. Phone: 800-241-6551.

Coding Connection—A Documentation Guide for Compliant Coding

By Patricia T. Aalseth. Pp. 288. Price, $29.00. Aspen Publishers, Inc., 200 Orchard Ridge Dr., Gaithersburg, MD 20878, 1999. Phone: 800-638-8437.

The Diet Cure

By Julia Ross. Pp. 379. Price, $22.95. Viking, 375 Hudson St., New York, NY 10014, 1999. Phone: 800-526-0275.

Drug Abuse: A Family's Guide to Detection, Treatment and Education

By A. James Giannini. Pp. 295. Price, $14.95. Health Information Press, 4727 Wilshire Blvd., Los Angeles, CA 90010, 1999. Phone: 800-444-2524.

The EMTALA Answer Book

By Mark M. Moy. Pp. 401. Price, $69.00. Aspen Publishers, Inc., 200 Orchard Drive, Gaithersburg, MD 20878, 1999. Phone: 800-638-8437.

Essentials of Family Practice

By Robert E. Rakel. Pp. 626. Price, $49.95. 2d ed. Saunders, The Curtis Center, 625 Walnut St., Philadelphia, PA 19106, 1998. Phone: 800-545-2522.

Evidence-Based Practice in Primary Care

Edited by Leone Ridsdale. Pp. 212. Price, $29.95. Saunders, The Curtis Center, 625 Walnut St., Philadelphia, PA 19106, 1998. Phone: 800-545-2522.

Gastro-Intestinal Health (Self-Help Nutrition)

By Steven R. Peikin. Pp. 349. Price, $15.00. Harper Perennial, 10 E. 53rd St., New York, NY 10022-5299, 1999. Phone: 800-242-7737.

The Hatherleigh Guide to Psychopharmacology

Edited by Editorial boards of Directions in Psychiatry, Essential Psychopharmacology, Directions in Mental Health Counseling, Directions in Clinical Counseling, Psychology, and Directions in Rehabilitation Counseling. Hatherleigh Press, 1114 First Ave., Ste. 500, New York, NY 10021-8325, 1999. Phone: 800-367-2550.

Influenza 1918: The Worst Epidemic in American History

By Lynette Iezzoni. Pp. 239. Price, $24.95. TV Books, 1619 Broadway, Ninth Floor, New York, NY 10019, 1999. Phone: 800-242-7737.

Loving Care for Alzheimer's Patients: Practical Solutions for Caregivers and Their Families

By Katie Lovette. Pp. 150. Price, $14.95. Health Information Press, 4727 Wilshire Blvd. #300, Los Angeles, CA 90010, 1999. Phone: 800-444-2524.

Lupus: A Patient Care Guide for Nurses & Other Health Professionals

By National Institutes of Health; National Institute of Arthritis and Musculoskeletal and Skin Diseases. Pp. 130. NIAMS/National Institutes of Health, 1 AMS Circle, Bethesda, MD 20592-3675, 1999. Phone: 301-495-4484.

Molecules and Mental Illness

By Samuel H. Barondes. Pp. 225. Price, $14.95. WH Freeman and Co., 41 Madison Ave., New York, NY 10010, 1999. Phone: 801-973-4660.

1999 Conn's Current Therapy

Edited by Robert E. Rakel. Pp. 1340. Price, $59.00. 51st ed. Saunders, The Curtis Center, 625 Walnut St., Philadelphia, PA 19106, 1999. Phone: 800-545-2522.

Respecting Patient Autonomy

By Benjamin H. Levi. Pp. 296. Price, $19.95. University of Illinois Press, 1325 S. Oak St., Champaign, IL 61820, 1999. Phone: 800-545-4703.


Copyright © 1999 by the American Academy of Family Physicians.
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