Diabetes Mellitus

Diabetes Mellitus

244 Monitoring Patients in The Operating Room. Edited by J. S. Gravenstein, R. S. Newbower, A. K. Ream and N. Ty Smith. Published by Charles C. Thoma...

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Monitoring Patients in The Operating Room. Edited by J. S. Gravenstein, R. S. Newbower, A. K. Ream and N. Ty Smith. Published by Charles C. Thomas, Springfield, Illinois. Pp. 270; illustrated; indexed. Price $22.50. In April 1977, sponsored by a consortium of instrumentation companies, a workshop on 'Tatient Monitoring in the Operating Room" was held in Cleveland, Ohio, with 17 contributors and 35 guests. This book is an account of the proceedings, including appreciations of each paper and summaries of the ensuing discussion. Unfortunately, many of the contributions were long on homespun philosophy and short on facts, so that the riinirinn looking for useful information will be disappointed. There were exceptions. Savarese and Ah' presented an excellent review of neuromuscular monitoring, with proposals for standardized recording conditions; Dauchot considered in depth the possible uses of systolic time intervals, and Ty Smith gave a useful over-view of developing trends in computer-aided e.e.g. monitoring. Even these contributions are now a little dated, because of the 2-year delay in publication. The chapter on "Legal Aspects" made me glad to be in England. C. J. Hull Diabetes MeUitus. By M. I. Drury. Published (1979) by Blackwell Scientific Publications, Oxford, London, Edinburgh. Pp. 125; indexed. Price £3.50. The author, who is physician in charge of the Diabetes and Endocrine Unit of the Mater Misericordiae Hospital, Dublin, stresses that this book is intended as a short source of background information for the general physician and specialists in other fields. The opening three chapters summarize current thinking as to the aetiology, classification and diagnosis of diabetes in such a way that the non-endocrinologist can understand. This is followed by a chapter which lists all the hypoglycaemic drugs and forms of insulin which are available; there are details of half-life, onset of action etc. Important drug interactions are also discussed.

The chapters on vascular changes and sltin and hand disorders will show readers the difficulties facing the expert in diabetes in carrying out his everyday work. The management of diabetes in pregnancy and in childhood are best managed by the experts, but this book contains guidance which is helpful and points to the need for co-operation between obstetricians, anaesthetists and neonatologists. While each chapter has a list of references for further reading, it would be helpful to include the works of authors mentioned in the text. Those working in the field of diabetes arc undoubtedly familiar with the large number of abbreviations used (GGT, JDD, SAA, NLA etc.). Although these are denned when first mentioned, it would be helpful to have a comprehensive list. The book is attractively produced with clear print and a simple style of writing, both easy to read. At £3.50 it is good value for money. J. W.Dundee M. P. CTNeUl Practical Anesthetic Pharmacology. Edited by Rank R. Attia and Alan W. Grogono. Published (1978) by Appleton-Century-Crofts, New York. Pp. 293; illustrated; indexed. Price £12.90. It is difficult to imagine that many British anaesthetists will find this book of use. This is a pity, since the aims of the editors are to provide a compact pharmacology text for trainees and practitioners in anaesthesia. The text consists of concise pharmacological descriptions followed by many tables of facts, so that readers might quickly refresh their memories about a subject or drug. This makes the book too tedious to read for pleasure and even as a last-minute read for examinations it fails on several points. First of all, it is almost entirely American, with little or no attempt to describe drugs which are available in the U.K. but not in America, for example lorazepam, buprenorphine, metoclopramide and etomidate. Other aspects of this flaw, such as describing cylinder colour codes only according to the American system and using entirely American approved names without the British names even in parentheses, are annoying for the British reader. A more serious flaw, however, is the relative allocation of importance to different groups of drugs. For example, i.v. anaesthetic agents are dealt with very briefly, in less than six pages, while anticoagulants receive more than eight pages. The table of facts about vitamins is much larger and more comprehensive than that for i.v. anaesthetic agents. Only two chapters (Local Anaesthetic Agents, and Drug and Disease Interactions) contain references; the others have a bibliography. In the chapter on analgesia, although some statements have numbers to represent references, these do not appear at the end of the chapter. There are a few inaccuracies, for example naloxone's effects last for as long as 4 h, and others in the section on anti-inflammatory drugs. The section on local anaesthetic agents by Dr Covino is excellent and the chapters on neuromuscular blockade and drug and disease interactions are very good. The Appendix contains much information which appears irrelevant to the title of the book, but the index is good and the book is clearly laid out. Walter S. Nimmo

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section on respiratory failure) that "an unconscious patient's head should be tilted backward as far as possible to open the nasopharynx and permit breathing." It is, of course, easy to find numerous errors and omissions in a book of this size, and to wonder at the inclusion of such philosophical chapters as "Qualitative Aspects of Therapeutic Decision Making" and "Economics and Epidemiology of Drug Use", but this should not detract from its overall quality. Many chapters, especially those on cardiovascular and respiratory systems, give an account of scientific therapeutics which is in a class of its own. The section on drug reactions and interactions is well classified and truly comprehensive. As a work of reference, this book should find a place in every departmental library, and the "basic principles" chapters are especially commended to those preparing for the primary F.FAJt.C.S. C.J. Hull