Infective endocarditis 2nd edition

Infective endocarditis 2nd edition

336 overview of important interactions between the two disciplines, an area which will undoubtedly expand in the future. L&ester Royal Infirmary Leic...

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overview of important interactions between the two disciplines, an area which will undoubtedly expand in the future. L&ester Royal Infirmary Leicester. UK

Consultant

R.J. Abbott Neurologist

High Density Lipoproteins & Atherosclerosis III N.E. Miller, A.R. Tall Elsevier Scientific Publishers, Amsterdam, The Netherlands, 1992; 270 pp.; g71.00; ISBN 0-444-81442-6 The importance of HDL metabolism in coronary artery disease (CAD) and its role in the pathogensis of atheroslerosis, has become more apparent over recent years. The book provides a comprehensive insight into recent advances in the understanding of HDL lipoproteins and atherosclerosis. The papers by M.C. Phillips et al. and J.F. Oram et al. on the possibilty of HDL receptor mediated movement of intracellular cholesterol, provide important possibilities for therapeutic intervention, pending further work on HDL receptor pathways. Several studies on transgenic mice expressing HDL associated apolipoproteins, seem to suggest that it is the apo A-I portion of HDL which is important in preventing or retarding the development of atheroma. It has been thought that in those patients with low HDL cholesterol and hypertriglyceridemia, it is the raised triglycerides that are responsible for the reduced level of HDL cholesterol, however the well constructed study published in this book by Brinton et al. suggests that increased apo A-I and apo A-II catabolic rates are responsible for the low HDL cholesterol, irrespective of the absence or presence of hypertriglyceridemia. The chapter on the diagnosis and management of HDL deficiency states, provides a detailed and useful classification of the causes of of reduced HDL cholesterol. Despite the known coronary artery disease risk of low HDL cholesterol, there is yet no clear guidelines for drug treatment. Schafer suggests that dietary therapy should be used initially to lower LDL cholesterol and if necessary drug treatment (the agent chosen should lower LDL cholesterol, triglycerides and raise HDL cholesterol). There is a need for prospective studies looking at raising HDL cholesterol and its effect on CAD risk reduction. In short, this book will be of particular value to those involved in lipoprotein metabolism, but may

also be of interest to the general physician and the cardiologist. Department of Cardiology Clinical Sciences Department Glenfield General Hospital Leicester, UK

Dr. N. Shaukat

Infective Endocarditis 2nd Edition Editor: Donald Kaye Raven Press, New York, USA, 1992; 512 pp.; USS106.50; ISBN O-88167-892-9 This comprehensive multi-author text on infective endocarditis is a follow-up to the editor’s first book on the subject which was published in 1976. Donald Kaye, who is Professor and Chairman of Medicine at the Medical College of Pennsylvania in Philadelphia, is of course internationally known for his many contributions to the subject over the last 30 years. The book has a whole American authorship gathered from ail over the United States as well as a number from within Dr. Kaye’s own department and medical college. The senior authors are all well known experts who have had a long association with Professor Kaye and the topics range through the clinical, pathological, laboratory, therapeutic, prognostic and preventive aspects of infective endocarditis with extensive references combining to make this, in the editor’s words, the most complete book on endocarditis to date. So does it succeed in its aim to a clear review for students and generalists as well as for experts in infectious diseases and cardiology? The student or generalist will find all he needs in the first two chapters on demography and pathogenesis, plus chapters on diagnosis and on principles and overview of antibiotic therapy together with management of complications. The specialist will dip into the book for answers to specific questions and to use the references. Does the American view differ in any important particular from English practice? In fact the treatment regimes prescribed and the indications for surgical treatment outlined are entirely consonant with British practice. Finally, the last chapter which is on prevention also now falls in with the British recommendations, except that erythromycin is still offered as an alternative to clindamycin in penicillin allergic patients and a second oral dose is advised rather than the single oral dose

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adopted in the UK. T’he AHA recommendations which were recently modified so as to be much more practical, are now much closer to those from the British Working Party. This 500 page text is highly recommended to anyone seeking guidance about particular problems or wanting to learn more about this fascinating disease. Cardiology Department Hammersmith Hospital London

Dr. CM. Oakley

Contemporary Issues in Peripheral Vascular Disease J.A. Spittell Jr. F.A. Davis, Philadelphia, USA, 1992; 271 pp.; $50.00; ISBN o-8036-80880 This book covers a wide range of topics of interest to all those involved in the management of patients with peripheral vascular disease. I assume that it is aimed at cardiologists who wish to keep in touch with developments in the periphery. The individual chapters consist mainly of reviews of the current literature, and twothirds of the authors work at the Mayo Clinic. As with many similar North American publications, there is very little reference to recent European literature. The opening chapter summarises recent developments in what has become a growth area for research, namely the endothelium. This is followed by a useful section on hypercoagulable states and a sensible over-view of what the non-invasive vascular laboratory can offer. The expanding role of duplex scanning in both arterial and venous disease is perhaps somewhat understated. The remainder of the book covers, in varying depth, a number of clinical topics related to both venous and arterial disease. The section on aneurysmal disease gives an excellent over-view of the subject, while the chapter on carotid artery disease is probably overly comprehensive for the general reader. The final chapter on angioplasty under-plays the ever improving results in both claudicant patients and those with severe ischaemia. Overall I feel this series of reviews will provide a useful update for the cardiologist with an interest in peripheral vascular disease. Department of Surgery Glenfield General Hospital Leicester. UK

Mr. D.S. Macpherson

Thrombolysis and Adjunctive Therapy for Acute Myocardial Infarction Editor: E.R. Bates Marcel Dekker Publishers, New York, USA, 1992; 536 pp.; US$99.75; ISBN O-8247-8664-5 Coronary thrombolysis has now passed its age of innocence. No longer is it adequate simply to show that Agent X produces more patent coronary arteries more quickly than Agent Y. The megatrials have confirmed beyond doubt that thrombolysis improves survival but are cumbersome instruments for determining the optimum use of thrombolytic therapy. This book is a collection of articles on various aspects of thrombolytic therapy with a particular focus on adjunctive treatments. There are some perceptive chapters by Bates and Poppma on the use of patent arteries or left ventricular function as possible endpoints. Adjunctive therapies discussed include Heparin, Warfarin, Aspirin, new antithrombotic drugs, nitrates, beta-blockers and calcium antagonists. The question of free radical mediated damage is discussed (but not resolved). Ellis discusses angioplasty, and warns against the uncritical application of the ‘oculostenotic reflex’. There is a discussion of the role of cardiopulmonary bypass surgery but unfortunately not the recent developments in modification of cardioplegia, which may give us more of an insight into the actual mechanism by which cardiac myocytes become damaged following a period of ischaemia. The book ends with a section on cost analysis which is technically excellent but, as the authors acknowledge. somewhat short on basic data. Overall the book is well produced; it has a definite ‘all American’ flavour although the references are catholic. It is a useful source of ideas and references, even if it certainly does not say the last word on the subject. Department of Cardiology Glenfield General Hospital Leicester, UK

David de Bono** Professor of Cardiology

Recent Advances in Cardiology Volume 11 Editor: D.J. Rowlands Churchill Livingstone, Edinburgh, 1992; 3 17 pp.; E34.95: ISBN O-443-04565-8 As discussed by the Editor in his excellent preface, it is five years since the previous issue of ‘Recent Advances **European Editor International Journal of Cardiology.