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Am Fam Physician. 1998;58(6):1493-1494

Textbook of Women's Health

Edited by Lila A Wallis. Pp 1044. Price, $99.50. Lippincott-Raven, 227 E. Washington Square, Philadelphia, PA 19106-3780, 1997.

Spanning the psychologic, medical and gender-specific aspects of women's health, this textbook is broad in scope and raises strong advocacy issues and strategic plans for health initiatives related to women. The primary author stresses that gender biases may hinder delivery of health care to women and that gender-specific differences beyond the reproductive tract should be recognized. Several chapters are devoted to the history of the women's health movement, including the woman's changing role in society as it relates to economic, educational and child-rearing issues. The authors maintain a strong perspective regarding the role that female physicians have in promoting humane and rational care of female patients.

The chapters are arranged according to the four life phases: adolescence, young adult, perimenopausal and advanced. Some chapters, such as urinary tract health and sexuality, cover all four life phases. Much of the book reflects on gender dissimilarities over a wide range of medical conditions, including atherosclerotic heart disease, and psychiatric and infectious disease.

The introductory chapters present a sociologic perspective regarding issues of gender, race, ethnicity and sexual orientation. Discussions of legal issues, communication between the practitioner and various patient populations and the patient as an advocate for her health care are well handled. The exploration of cultural diversity and the importance of understanding the multiple characteristics and dimensions of each cultural group are especially important and are the best-written chapters in the book. Other chapters discussing violence, occupational trauma and nutrition are comprehensive and informative.

Almost one third of the book is devoted to psychiatric disease and reflects significant contributions from psychiatric experts. The chapters on menopause are among the best written, with a strong emphasis on preventive strategies.

Common procedures performed on women are also discussed. There is a chapter on rape evaluation that is extensive and well documented. The other procedural chapters, however, read like the rest of the text in the book. The chapters are difficult to read and would have benefited from a better format and more practical descriptions of techniques, highlighting the key points.

The chapter on women's health research is informative and discusses both national and international initiatives to include women in research. There is a strong message about the need to include women in research to reduce gaps in understanding and improve knowledge across the life span.

An appendix on the woman's health record is included. It contains a comprehensive questionnaire for patients, a physical examination record and a report of test results. It can be readily used in any practitioner's office.

It is stated in the introductory remarks that when women are confronted with fragmentation of health care, they may subsequently choose alternative health care approaches and reject traditional medicine. It is proposed that women might be best served by practitioners engaged in a multidisciplinary approach to health care. The family medicine approach is not mentioned, and it is disappointing to find that there is only one family physician who contributed to the book. If, as the introduction states, there is a need for comprehensive information to be applied to every speciality that treats female patients, family medicine's unique approach should have been included and recognized.

Practical Dermatology

Edited by Beth G. Goldstein and Adam O. Goldstein. Pp. 384. Price, $59.95. 2d ed. Mosby, 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, 1997.

Practical Dermatology is a working manual on dermatologic diagnosis, technique and patient education for primary care physicians. The textbook is meant to be used and not shelved as an erudite reference.

The book is organized into four sections: the art of dermatology, common skin dermatoses, cutaneous manifestations of systemic disease and patient education handouts. The first section succinctly discusses the problem of formulating a differential diagnosis and the pitfalls in doing so. General information and medical costs are reviewed for the dermatologic conditions dicussed. A discussion of corticosteroids is included, with overviews of topical, intralesional and systemic applications. Perhaps the most useful part of the book is the detailed and specific discussions of diagnostic office procedures, such as fungal cultures, Tzanck smear, cryosurgery, punch and shave biopsy, elliptical excision and cyst excision. The clear descriptions lend confidence to the reader that these procedures can and should be performed when indicated by the primary care physician.

While other textbooks certainly cover the same territory, this textbook differs in that it attempts to adhere to practicality. Differential diagnoses are presented for each lesion, each spelled out to some degree. The language is easy to understand. Treatment issues are thoroughly discussed, attempting to lend a clear picture of indicated medication and appropriate dosing. Each dermatosis has a self-contained description.

The organization of the book is easy to follow, and the book is successful in being user friendly for its intended primary care audience. The photographs, while not abundant, are well chosen, showing “classic” presentations of each disease. Where appropriate, there are longer discourses on disease process and work-ups, such as in the chapter on connective tissue disorders. A section on tropical dermatoses is included for those practicing overseas. For those practicing in the United States, ICD-9 codes are included. The book concludes with 29 thoughtfully-written pages of patient education materials.

The very real problem for the family physician remains in making a correct diagnosis for an unknown skin lesion. Inside the front and rear covers of the book are differential diagnoses listed by morphology, characteristic distribution and lesions seen in particular groups. The book offers the counseling that “Clinicians wishing to become more proficient in dermatologic diagnosis must practice making a differential diagnosis for every rash or lesion encountered even when the diagnosis seems easy.” Making such a differential diagnosis is often difficult, in which case biopsy or referral may be the next correct management step.

Also Received

Cambridge Handbook of Psychology, Health and Medicine

Edited by Andrew Baum, Stanton Newman, John Weinman, Robert West and Chris McManus. Pp. 660. Price, $69.95. Cambridge University Press, 40 W. 20th St., New York, NY 10011-4211, 1997.

Clinical Dermatology: A Regional Approach

By John R.T. Reeves and Howard I. Maibach. pp. 431. Price, $52.95. 3d ed. F.A. Davis, 1915 Arch St., Philadelphia, PA 19103, 1997.

Pediatric Infectious Diseases: A Comprehensive Guide to the Subspecialty

Edited by Gary J. Noel, Joseph J. Stavola and Victoria Schauf. pp. 361. Price, $28.95. Johns Hopkins University Press, 2715 N. Charles St., Baltimore, MD 21218-4319, 1997.

Psychiatry for Primary Care Physicians

Edited by Larry S. Goldman, Thomas N. Wise and David Brody. Pp. 389. Price, $49.95. American Medical Association, 515 N. State St., Chicago, IL 60610, 1997.

Racing to the Beginning of the Road: The Search for the Origin of Cancer

By Robert A. Weinberg. Pp. 274. Price, $14.95. WH Freeman & Co., 41 Madison Ave., New York, NY 10010, 1998.

Self-Management of Asthma

Edited by Harry Kotses and Andrew Harver. Pp. 440. Price, $175.00. Marcel Dekker, Inc., 270 Madison Ave., New York, NY 10016, 1998.

SI Units for Clinical Measurement

Edited by Donald S. Young and Edward J. Huth. Pp. 331. Price, $36.00. American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106. 1998.

Soap, Water and Sex: A Lively Guide to the Benefits of Sexual Hygiene and to Coping With Sexually Transmitted Disease

By Jacob Lipman. Pp. 191. Price, $18.95. Promethues Books, 59 John Glenn Dr., Amherst, NY 14228, 1998.

Stand Tall: Every Woman's Guide to Preventing and Treating Osteoporosis

By Morris Notelovitz, Marsha Ware and Diana Tonnessen. Pp. 240. Price, $24.95. 2d ed. Triad Publishing Co., P.O. Box 13355, Gainesville, FL 32605, 1998.

The Successful Physician: A Productivity Handbook for Practitioners

By Marshall O. Zaslove. Pp. 307. Price, $29.00. Aspen Publishers, 200 Orchard Ridge Dr., Gaithersburg, MD 20878, 1998.

Systematic Reviews: Synthesis of Best Evidence for Health Care Decisions

Edited by Cynthia Mulrow and Deborah Cook. Pp. 117. Price, $27.00. American College of Physicians, Books Program, Independence Mall West, Philadelphia, PA 19106, 1998.

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