J Pediatr Adolesc Gynecol (2003) 16:391–392
Book Reviews ON CALL Obstetrics and Gynecology, 2nd Edition. Homer G. Chin IBSN 0-7216-9254-0, Philadelphia, W.B. Saunders Company, 2001, pp. 448 Reviewed by Jeanie D. Dassow, MD, University of Kentucky College of Medicine, Lexington, Kentucky
This pocket-sized update of the 1997 first edition is intended to help medical students, residents, and other providers manage on-call patient care situations in OB/GYN. The book has chapters on 20 Obstetrical topics and 13 Gynecological topics. Each chapter sequentially discusses background and definitions, and clinical presentation, followed by a section called “Phone Call” which lists important questions for the provider to ask at the initial contact. Next is “Elevator Thoughts” which summarizes information in list form to be reviewed on the way to see the patient. A section called “Major threat to Life” aims to instruct the provider in the degree of urgency typically encountered in the scenario. Fetal threats are discussed separately from maternal ones in the Obstetrics portion. Each chapter’s section called “Bedside” reviews the directed history, physical exam, and orders tailored to the situation described. The chapters conclude with a discussion of Diagnostic Tests and Management. This repeated format allows the reader to become familiar with its use and then the needed information can be found readily. In general, the organization of the material works well, but related topics often include repeated information. For example, detailed directions for doing an amniotic fluid “shake test” are included in the both the section on premature rupture of the membranes and that on preterm labor. Additionally, protocols for the administration of corticosteriods to promote fetal lung maturation are repeated, as is information on evaluating the hypovolemic patient. The text could be streamlined by referring the reader to the initial mention in the book. Graphs are used throughout the text. The ones on techniques for managing postpartum hemorrhage are especially helpful although a discussion of the B-Lynch technique of applying “uterine suspenders” is noticeably absent from this 2001 volume. Illustrations of surgical technique in the management of ectopic pregnancies are most thorough. However, a drawing would have elucidated the detailed description of the anatomic location 쑖 2003 North American Society for Pediatric and Adolescent Gynecology Published by Elsevier Inc.
of Bartholin’s abscess and the differential diagnosis of vulvar inflammatory lesions. The choice of chapter subjects is good and broad. Certainly most on-call situations are included. However, a discussion of diabetic ketoacidosis in pregnancy is notably missing and would be greatly appreciated by a resident facing such a daunting patient at 3 am. The gynecology chapters cover the essentials, but also include the rare situations of molar pregnancy and toxic shock syndrome. This text concludes with useful appendices containing such things as a chart of the movements in the mechanisms of labor, a graph of the expected HCG rise in normal gestations, and tables such as “common laboratory values in pregnancy.” The final appendix is an on-call formulary for OB/GYN which serves as a quick guide to drug use in pregnancy. As a reference text that can be carted around in a white coat pocket, this book is valuable to the inexperienced clinician. It cannot replace in-depth reading that should serve as the foundation for growth of medical knowledge in the medical student and house staff physician. doi:10.1016/j.jpag.2003.09.010
Surgery at a Glance, 2nd Edition. Pierce A. Grace and Neil R. Borley. ISBN 0-632-05988-5, Oxford, Blackwell Science Ltd, 2002 Reviewed by Jeanie D. Dassow, MD, University of Kentucky College of Medicine, Lexington, Kentucky
Intended for an audience of medical students preparing for ward duty and rounds, this book is one in a series which aim to give the student a concise overview in both diagrammatic and textual form. The slim paperback is divided into two portions. Part 1, “Clinical Presentations at a Glance”, focuses on signs and symptoms which cause patients to seek medical care. Twentyseven topics from dysphagia to dysuria to abdominal pain are covered in good detail. The graphics include diagnostic and treatment sequences as well as excellent illustrations which serve to reinforce to the student the anatomic implications of the patients’ complaints. An example of this is the coverage of rectal bleeding. A schematic of the intestines vividly illustrates various possible maladies according to location from the small gut to the anus. The text on the opposing page contains 1083-3188/03/$22.00
key points in a bulleted format, important diagnostic features, and “key investigations,” which discuss appropriate laboratory and radiological studies. Part 1 of the book allows the reader to rapidly generate differential diagnoses and understand basic approaches to the patient. The clear drawings aid the student in memory and recall of essentials in general surgery. Part 2 of the book is called “Surgical Diseases at a Glance.” It has 50 two-page layouts which cover the gamut of surgical practice—acute traumatic and surgical disorders, surgical oncology, vascular disease, and surgical disorders of a variety of organ systems. Epidemiology, pathology, clinical features, appropriate studies, and the management essentials are presented in outline form on the text pages and the drawings again are simple yet amazingly clear. Cancer staging, complications, and prognosis are included where appropriate. The five chapters that explain endocrinological disease are especially excellent as they combine the laboratory and exam findings with the etiologies comparing hypofunction
and hyperfunction of the organs side by side. Cushing’s disease and Addison’s disease line up to produce understanding in the reader. Surgical techniques are only briefly mentioned in this broad overview. The notable absence of consideration of the female genital tract is due to the availability of the companion volume, Obstetrics and Gynecology at a Glance (ISBN 0632043415). Published in the United Kingdom, Surgery at a Glance is replete with British spellings of common medical words such as oesophogus, goitre, and diarrhoea. Although noticeable, this different spelling is familiar to most American medical practitioners. In conclusion, this text provides a lot of basic information in a readable and easy-to-remember format for the intended goal of helping teach medical students. The text is too basic for practicing surgeons, but would be useful for primary care physicians and allied health professionals wishing to review general surgical knowledge. doi:10.1016/j.jpag.2003.09.012