Clinics in Developmental Medicine

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This book is meant for librarians; how- ever, doctors ... ences to reviews of the book in journals. I am convinced .... textbook of family medicine. Drs. Shires and ...
Book Reviews Reference Shelf Health Sciences Information Sources. Ching-Chih Chen. 767 pp. The MIT Press, Cambridge, Massachusetts, 1981. $50 (US). ISBN 0-262-03074-8 This book is meant for librarians; however, doctors should be aware of it. It lists some 3800 books and audiovisual materials in the health sciences, giving a brief but uncritical description of each. Thus, for the "Medical and Health Information Directory" the entry states that "indexes and references are given", although only 13 of the 36 sections are indexed. The 24 chapters cover the following: selection tools; guides to the literature; bibliographies; encyclopedias; dictionaries; handbooks; tables, almanacs, data books and statistical sources; manuals, laboratory manuals, workbooks and source books; guides; atlases; directories, yearbooks and biographic.sl sources; historical works; important series and other reviews of progress; treatises; monographs; abstracts, indexes and current awareness services; periodicals; technical reports and government documents; conference proceedings, translations, dissertations, research in progress, preprints and reprints; classifi-

cations, standards and patents; trade literature; nonprint materials; professional societies and their publications; and data bases. Within each of these chapters the arrangement is alphabetic by specialty (e.g., allergy and immunology, anesthesiology and general surgery), and within each specialty the arrangement is alphabetic by title. The rest of the entry contains author, place of publication, publisher, date of publication, a brief description and references to reviews of the book in journals. I am convinced that the author's decision to arrange the chapters by type of publication and not by medical specialty (like, for instance, "Medical Reference Works 1679-1966") was a bad error in judgement. What scientists want to know is what is available in anatomy; they do not know the difference between a monograph and a treatise - and, what's more, they don't care. A scientist would not want to go through 24 chapters to pick out the items on anatomy, and a librarian shouldn't have to either. I also question the wisdom of leaving out items published before 1970 on principle. For instance, no English-Russian dictionary

is listed. Either Multanovakii's 1958 dictionary should be mentioned or a provocative statement should be made that there isn't such a book, which may spur readers to write to the author to correct the statement. Some headings need amendment: placing a RussianLatin- Azerbaijani dictionary under the rubric English-Russian is going to give a monolingual English reader a rude awakening. The subject index is not adequate. It lists works by the first word in the title, so there is no easy way to find, for example, the "Handbook of Medical Library Practice" without knowing the title. A keyword-out-of-context (KWOC) index to titles would solve this problem, and I suggest that the author prepare a separate one for references. This sounds like a very negative review, but I have been mainly concerned with ease of use. This is still a useful work to make you aware of books in your field, but I would also doublecheck to ensure in each case that there is no later edition available.

Clinics in Developmental Medicine. No. 79. The N.uroIogica1 Assessment of the Preterm and Full-term Newborn Infant. Lilly Dubowitz and Victor Dubowitz. 103 pp. Illust. Spastics International Medical Publications, London, 1981. Price not stated. ISBN 0-0433-07903-1

movement and tone, reflexes and neurobehavioural aspects. The assessment is described in detail, with the aid of charts and figures. Results of the complete examination can be recorded on two charts that may occupy each side of a page that can then be placed in the patient's chart. The authors describe using the method to outline normal intrauterine maturation of individual signs, to follow the postnatal evolution of neurologic signs in preterm infants, to compare preterm infants of various gestational ages with infants born at term, and to perform longitudinal studies on individual infants to identify deviations in the pattern of particular neurologic signs. Later sections contain case histories of normal and abnormal infants and dem-

onstrate the use of the method with infants of various gestational ages and birthweights. The final chapter discusses the results of a prospective study comparing neurologic assessment using this method with serial ultrasound examination of the head for the diagnosis of intraventricular hemorrhage. The authors suggest that repeated careful examination using this method provides an objective means of alerting clinicians to the possible presence of intraventricular hemorrhage. Neurologic problems of the newborn have become extremely common, principally as a result of advances in neonatal intensive care and the consequent increase in the rate of survival of premature infants. In this context a method

Lilly and Victor Dubowitz have had considerable experience with existing methods for neurologic assessment of newborns. In this book they describe their experience over 3 years with a new method that is suitable for staff with no particular expertise in neonatal neurology, suitable for preterm and term infants and takes less than 15 minutes to perform. Its simplicity allows frequent serial assessment. The individual items of the assessment are included under the general headings of habituation,

ANDREW SHERRINOTON, MA, BM, MMSBC, DHMSA

Contributing editor Canadian Medical Association Journal

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for frequent serial neurologic evaluation of infants of various gestational ages is desirable; such a method is provided in this book. My onjy criticism is of the small print in many of the charts, which makes reading them somewhat difficult. This book should be of interest to pediatricians involved in the inteq.ive care of newborns. ALAN HILL, PH 0. MD, FRCP(CJ

Hospital for Sick Children Toronto, Ont.

The Epidermis in Disease. Based on the Proceedings of the European Society for Dermatological Research Symposium, held at the Welsh National School of Medicine, Cardiff, on April 18-20, 1979. Edited by R. Marks and E. Christophers. 597 pp. Illust. J.P. Lippincott Company, Toronto, 1981. Price not stated. ISBN 0-397-58274-9 This book provides pathological and pathophysiological reviews of disorders of the epidermis and of keratinization, as well as immunopathological reviews of the diseased epidermis. Photobiologic features of the epidermis and Langhans' cells are considered in four chapters each. The book is well laid out, illustrated and indexed, and will be of value to dermatologists and biologists interested in epidermal disease. The editors have chosen an elegant format, which has entailed some delay in publication, over more rapid methods of presentation, and they manage to successfully present the recent state of investigative science in this area. IC. MITCHELL. MD

Shaughnessy Hospital 4500 Oak St. Vancouver, BC

Family Medicine. A Guidebook for Practitioners of the Art. David B. Shires and Brian K. Hennen. 512 pp. Illust. McGraw-Hill Book Con.pany, New York, 1980. $l5.9. (US), paperbound. ISBN 0-07-056920-7 A need exists for a short, readable textbook of family medicine. Drs. Shires and Hennen have met that need with this study, which covers topics from continuity of care to continuing medical education. Their book is written for medical students, residents and practising physicians. The information and views they express are in the mainstream of current family medicine philosophy. Unfortunately, as with all short texts, their book suffers from the compromises made between a set of lecture notes and an authoritative tome: The book begins with a discussion of the family, presenting it as both a source of illness and a treatment resource; family anatomy is as useful to 1316

the general practitioner as physical anatomy is to the surgeon. Next, the book provides a series of up-to-date, detailed protocols for the management of 16 common health problems. The flow charts are clear and sensible, and they provide a treatment of choice and a basis for further discussion. Maintenance of health is covered in chapters on community and occupational medicine, screening and prevention. The authors point out that clinical identification of risk factors does not necessarily lower morbidity and, if the factors are unmodifiable, merely increases patient anxiety. A section entitled "Life protocols" provides interesting perspectives on noncrisis visits to family physicians. The protocol describes a schedule of immunizations, screening and counselling, but is only one view in this controversial field. There are some weaknesses in this section. For example, the authors mention amniocentesis but not tests for occult blood, they note the identity crisis of the mid-40s for men but not for women, and they conclude that for seniors (anyone over 56 years old, in their definition) "a friendly visit with their doctor is as good as any tonic". (Presumably this visit does not dwell too heavily on the risk factors of old age.) For this age group it is advised that noncrisis visits be less frequent than during earlier years, yet illness occurs more often in later life. The patient management section presents three premises: that physicians should treat patients, not illnesses; that physical disease and emotional reactions cannot be managed separately; and that patients should make final decisions on treatment. Self-medication, the doorentry symptom, the difficult patient and patient compliance are discussed. No profound insights are presented, but the advice is sound, and reading it will increase the general physician's armamentarium. Another section discusses medical teamwork, communications in consultations and the referral threshold. The chapter on the family practice nurse provides a check list of functions and responsibilities, yet ignores the wide range of personnel with different qualifications who function in practice as the office "nurse". There are short, useful, well illustrated chapters on dental problems and chronic physical and mental disorders in children. These are two areas in which traditional training is lacking and that often raise anxieties. Family practice research, practice audit and a technique for patient care are discussed. This last technique involves having specially

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trained health record abstractors assess clinical records, looking for predetermined acceptable standards. This expensive process may lead to healthy charts; whether it influences the outcome of patient care is debatable. A large section deals with aspects of practice organization, including group practice, time management (time for oneself is not forgotten), patient comfort, records, appointments, the doctor's bag, office supplies, staff protocols, legal problems, computers in practice, doctor and patient education, and ethics. A self-help reading list and a resource list for the patient's education are included. This book will be of value to those contemplating taking the certification examination of the College of Family Physicians of Canada and to anyone uncertain about the current scope of family medicine. It forms a basis for the codification of family practice management, and it gives sound and sensible advice. Although it suffers from the compromise between brevity and authority, it is a valuable source of information on family medicine. JAMES WARREN. MD

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Department of family medicine Vancouver General Hospital Vancouver, BC

The Vital Probe. My Life as a Brain Surgeon. 1.5. Cooper. 346 pp. Illust. W.W. Norton & Company, Inc., New York, 1981. $20.95 (US). ISBN 0-393-01 469-X It is now 30 years since a young neurosurgeon discovered, quite by accident, that occlusion of the anterior choroidal artery abolished the tremor and rigidity of parkinsonism. His tireless work in applying this discovery to the treatment of involuntary movement disorders (through chemothalamectomy and, later, cryosurgery) by no means brought him acceptance and fame. On the contrary, these efforts led to years of rejection and struggle for Irving S. Cooper. Many of the most prominent neurosurgeons, anatomists and neurologists initially discounted his work, some calling it "fraud" and "ballyhoo". This may have had something to do with Cooper's personality. He was not a conformist: he set up his surgery in a run-down home for the aged in the Bronx, he confronted his opponents with circus-like displays of his successful cases, and for 6 years he commuted by boat from his Westchester home to Bellevue Hospital in Manhattan. Some powerful figures, including Houston Merritt, at one time president not only of the American Neurological Association but also of the International Neurological Association, consistently opposed him. Others, who had at first