Schein's Common Sense
Emergency Abdominal Surgery Neurosurgery in
the tropics |
|
Schein's Common Sense
Emergency Abdominal Surgery Neurosurgery in
the tropics |
Schein's Common Sense Emergency Abdominal Surgery
Moshe Schein
Springer Verlag, Stuttgart
£30.50, ISBN 3540 666540
A surgeon of considerable experience may feel that they have little to learn from such a book, but this is written with short punchy chapters making it a very difficult book to put down. It is well laid out and each chapter gives one some new insight for the disease processes described. Whilst it is an American book it is centred at mid-Atlantic in its approach and no more so in its attitude to investigative technology. This book relies heavily on the patient's clinical state and the common sense approach to it. Thus the title of this book is a very good one for the content of the book. Adding to the interest are the small comments of the famous and infamous at the beginnings or the end of each chapter.
I particularly enjoyed chapters 25 and 37 on intra-abdominal abscesses and their management and the place and philosophy behind re-operating on an abdomen. In chapter 18 on the subject of hernia, a quote which caught my eye was, "full examination of the hernial orifices may mean meticulous, prolonged and disagreeable palpation of the groins which have not seen the light of day, let alone soap and water for a long time."
There perhaps could have been more editorial control, especially in chapter 17 where gastrograffin as a term is used interchangeably with soluble contrast challenge. It no where explains the properties of gastrograffin. Itwould not be used for acute enema work. This is where one needs low osmolar water-soluble media, which is by far the safest to use. Gastrograffin, being hyperosmolar, may be useful in meconium ileus, but is really harmful if aspirated in to the lungs. There are some annoying spelling mistakes and on Page 85, Table 12.1, Group 1, non-serious bleeding is labelled in the text as being Group 3, which is most disconcerting.
At £30.50 per copy, this soft-backed book may seem a little expensive, but the wealth of common sense in the book still makes it a worthwhile read and stimulates one's own bias and views and challenges one's own practice of surgery.
Mr R A B Wood, Ninewells Hospital and Medical School
Neurosurgery in the Tropics
Jeffery V Rosenfeld and David A K Waters
Macmillan Education Ltd, UK
ISBN 0333684125
This is a unique book. It is the first textbook of neurosurgery published in English for surgeons practicing in tropical and, predominantly, underdeveloped countries. It is a worthy successor to the work of pioneering tropic surgeons such as Loeffler and Burkitt. The authors both have extensive experience of surgery in countries that lack sophisticated health services and both have had the experience of developing neurosurgery services from scratch. Inevitably, this has meant learning to do without either the imaging facilities or the services of specialist neuroradiologists upon which their counterparts in more privileged countries are so dependant. The chapter on "Developing a neurosurgery service" is written by Professor Levy, who single-handedly provided such a service in Zimbabwe.
Specialist surgical services in many countries are still provided by general surgeons as was the case in Europe and North America until the 1950s. This book is aimed at these surgeons. Each section includes a discussion of the anatomical and physiological concepts needed for clinical practice. There is a strong emphasis on clinical diagnosis. The assumption is made that sophisticated diagnostic aids may be lacking - the surgeon is likely to have to be his own neuroradiologist - and the reader is guided in the use of existing facilities in order to diagnose neurosurgical conditions. Practical advice is given, for example, in the use of angiography and ventriculography - arts which were used routinely in this country until the advent of the CT scan in the 1970s and which very few practicing neurosurgeons in privileged countries will have any experience of and which do not require expenditure on costly equipment.
The authors' experience is condensed in very useful 'key points' and is well illustrated with case reports. A major section deals with operative surgical techniques, again based on the assumption that only basic surgical equipment will be available.
The reader might ask whether there is truly a place for neurosurgery in countries that are still struggling to provide the most basic of health services. The authors acknowledge the difficulty of providing the continuity of care that is required to treat, for example, children with hydrocephalus when they might live far from specialist services. On the other hand, spinal disorders are common in underdeveloped countries and timely surgical intervention can help reduce the need for recurring treatment of persisting disability. It is not suggested that specialist neurosurgery services should be able to recognise and competently treat common neurosurgical conditions.
Although this book is intended for the tropical surgeon it could also find a readership in developed countries. It gives an excellent introduction, for the trainee, to the scope and principles of neurosurgery. In Scotland, it is still necessary for the remote surgeon to deal with neurosurgical problems and this book would be a valuable addition to the library of our isolated surgical units. It deserves a place in the library of our international College.
David Currie, Aberdeen Royal Infirmary
©2000 The Royal College of Surgeons of Edinburgh, J.R.Coll.Surg.Edinb. 45, 6: 415