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Vascular Surgery Highlights 2000-1 Edited by Alun Davies Health Press £15.00 ISBN 1899541845
This is the third edition of this book which is provided by Sulzer Vaskutek as a service to the medical profession. It follows the same format as the previous two editions. The book consists of a number of chapters on topics of current interest or controversy, each written by a member of a world-wide panel of experts.
The chapters each follow a specific format. The current literature on the topic is reviewed and at the end of the chapter a table summarises "What's in", "What's out", "What's controversial" and "What's needed". All the chapters are extensively referenced with the current literature.
The current edition has good chapters on Carotid artery disease, vascular trauma and varicose veins.
This book is a good summary of the current topics in vascular surgery and is produced in a very user-friendly format. The chapters provide very sensible summaries of the current status of the topic and all are written by experts with considerable experience and knowledge of the subject.
This is an excellent book for the vascular surgeon as a summary of the current status and as a source of refererence for firther in-depth study. It is an excellent review text for those about to take the Specialty Fellowship.
Mr RC Smith, Falkirk Royal Infirmary
Surgery John D Corson and Robin CN Williams Mosby 2002 £130.00 ISBN 0723430691
This book is well set out. The style presentation is excellent. There is good use of key points, tables, graphics and sundry other figures. All in all this is probably one of the best presented books that I have seen in quite some time.
The content is good; it includes all the necessary areas in a reasonable amount of detail without becoming too concerned with minutiae.
I believe this book fufills its brief. I would, therefore, heartily recommend this to all trainees preparing for College and Intercollegiate examinations and as a very good textbook for a general surgeon who may or may not have a subspecialty interest. Of particular interest the book comes with a CD Rom containing a slide presentation of some of the graphics. This is an excellent principle.
Mr DAD MacLeod, Vice President, Royal College of Surgeons of Edinburgh
Cancer of the Lung: from molecular biology to
treatment guidelines
Edited by Alan B Weitberg
Humana Press, USA
ISBN 0896038300
This textbook has an extended title: 'Cancer of the lung from molecular biology to treatment guidelines,' which it lives up to. By analogy one might come across a physics text entitled 'Atomic substructure from the Higg's boson to ethical considerations.' That is, both start in theory and end in social science. What may be implied from the real title about cancer and the imaginary one about physics is that we do not yet have much of a clue about either. The saving grace in this publication on lung cancer is that the authors do not pretend to knowledge not yet discovered and present an account, albeit highly compressed, of lung cancer as seen from an American perspective.
The fourteen chapters are edited into conformity where the elements in any chapter are clearly headed and numbered so that it is unusually easy to find ones way about. In addition, there is a complete and up to date bibliography of references attached to each chapter. The most fascinating, but almost unreadable to this surgeon, part of the book is the opening section where the aetiology, pathology and molecular biology are described. The molecular biology, thank goodness, is written in two parts, firstly a 'primer' and only then a 'detailed analysis.'
Surgery's value in diagnosis, staging and treatment is given about the correct weight since only a minority of victims of the disease come to operation and the results of surgery clearly shown here merely point up the even more extreme poverty of other methods of treatment. Radiotherapy and chemotherapy deservedly occupy more space which of necessity is tedious reading since the authors feel the need to present a precis of the multitude of trials, controlled, half-controlled or prematurely closed, which make up the evidence base for oncological treatment, SIGN guidelines etc. Bewildering combinations of drugs and radiotherapy techniques are recited but, honour where honour is due, the authors from time to time draw conclusions from their data or point out where no conclusions can be drawn. The latter state is more frequent than the former.
The final chaper, 'A guide to the use of practice guidelines,' gathers the trivial amount of evidence there is about the efficacy or otherwise of guidelines. The message from this book is that no meaningful improvement in lung cancer treatment has happened in recent years, that current controversies about treatment and guidelines are akin to medieval arguments about angels dancing on pins and that the likely source of 'penicillin' for cancer is to be found somewhere in the early but not the later chapters.
Mr EWJ Cameron, Edinburgh Royal Infirmary
Vascular and Endovascular Surgery; Second Edition Edited by Jonathan D Beard and Peter A Grimes WB Saunders, UK 2002 ISBN 0702025917
This is the second edition of this book in the series, Companion Specialist Surgical Practice. The foreword indicates that the book is aimed at higher surgical trainees and to prepare them for the final FRCS examination. The book aims to provide references for any statements made in order to live up to the present world of evidence based surgery. For a book of this size, the choice of topics is obviously not comprehensive. It contains a number of chapters that can be found in other textbooks mentioned in the further reading by the authors.
The first chapter on epidemiology is informative and goes through the usual risk factors in peripheral arterial disease. It contains a number of up to date references and should be useful. There is a chapter on assessment of chronic lower limb ischaemia which sets out the various tests that can be used, both clinically and in the laboratory to assess the extent of the disease.
There follows a chapter on the treatment of chronic lower limb ischaemia which again covers risk factors and then examines the place of surgery and the vascular techniques in the treatment of this condition. These three chapters provide standard information and a large number of current references. There then follows a good chapter on rehabilitation and amputation, which is comprehensive and useful. There is a chapter on diabetic foot which describes the treatment of various kinds of diabetic foot, including surgery.
There is a chapter on revisional vascular surgery which is probably necessary in view of the large number of revisions that are currently required as patients live longer. Acute ischaemia is then covered and its management, by thrombolysis or surgical treatment. Again up to date references are mentioned.
Chapters on vascular trauma, upper limb disease, (both medical and surgical), aortic aneurysms, renal, intestinal vascular disease and cerebrovascular disease, all of which are useful for the trainee.
There are then chapters on vascular grafts and sutures and angioplasty and stents, which repeats to a certain extent what has already been mentioned previously. The management of thrombophilia and so-called complex thrombo-embolism is then covered and at the end of the book venous insufficiency, varicose veins and venous malformations.
One has to ask what does the book offer, which other books do not. The answer must be that it is shorter and focussed on a number of topics which the authors have chosen as being important for the FRCS examination. The chapters on medical treatment of the upper limb and thrombophilia are useful. There is no indication in the book as to how any procedure should be done and it will mean that the purchaser has to buy a book that provides operative details. It does, however, contain alot of useful up to date references.
Professor RF Bell, University of Leicester
Surgeons at War: Medical arrangements for the
treatment of the sick and wounded in the British Army
during the late 18th and 19th Centuries
Matthew H Kaufman
Greenwood Press, UK. 2001
ISBN 0313316651 £44.95
This fascinating book, one of a series of mongraphs in military studies, does not restrict itself to the activities of surgeons in the battlefield, but is a highly readable account of medicine and surgery in the Army during the 18th and early 19th centuries. During this time the major European powers were engaged in several major conflicts. In many of these Britain was involved and the brunt of the deaths and injuries was borne by the officers and men of the British Army. At this time most European nations had appropriate military medical academies and those who planned to enter military medical services received several years of specialist training for their future needs. Britain had no comparable institution until some years after the Crimean War.
Unfortunately the power of armies to do damage to the participants far outstripped their capability to save life or treat serious wounds - bayonet and sabre as well as gunshot. Infectious diseases were common in crowded unsanitary barracks and death was welcome to frozen debilitated soldiers for whom evacuation from the battlefield was delayed or indeed absent. Although these awful conditions affected all armies, the British soldiery were ill served by the military establishment.
Matthew Kaufman provides graphic accounts of the Wars against France and the Crimean War. In each case he gives a lucid description of the various engagements and the environments in which they were fought. There are penetrating pen-portraits of the several medical and military men at the time. The important contribution of the book is, however, an account of their appalling record of the higher echelons of the army medical services.
During the 18th century, most who practiced medicine and surgery were poorly qualified for war surgery. Specialist knowledge was acquired on the battlefield. The members of the Army Board, who were often appointed on the basis of influence, had little military knowledge and appointed to senior clinical posts only recently qualified Oxbridge graduates despite the fact that they had no previous military or administrative experience. As a result most serving officers, many with considerable experience, were not promoted, leading to a breakdown in service morale.
There were interesting differences in the Crimean War. Initially there were severe tensions between the military high command and the medical branches that were technically civil departments. The opinions and advice of the latter were often not sought and, when given, ignored. Military inefficiency and incompetence were rife. Even the transport of the wounded from the battlefield was a national disgrace.
However, in contrast to previous wars, that in the Crimea was reported in detail at home. The clamour in the press and the influence of such people as Florence Nightingale ensured that finances were allocated and medical supplies ultimately were provided. It was several years after the Crimean War that the Government established the Army Medical School, 100 to 150 years after comparable institutions were set up elsewhere in Europe.
Kaufman has done a great service to military medical history by describing the contributions of the Regius Chair of Military Surgery in the University of Edinburgh to the training of the army and naval surgeons. The Chair was established in 1806 and was funded to a pathetic degree by the Government that withdrew its financial support in 1856. The Chair, along with that in Dublin that functioned between 1855 and 1860, not only trained medical officers in the armed forces in the specialties of military medicine, surgery and hygiene, but also had a disproportionately valuable effect on the education of many medical students in the two centers. In the current parlous recruitment situation of our armed services, such academic institutions could be most effective.
This monograph is a most authoritative account of a formative period in military medicine and surgery in Britain. It has been a pleasure to read. Even the notes at the end of each chapter have been an enjoyment as well as being informative.
Professor Sir Robert Shields, Edinburgh
Management of complex cardiovascular problems: the
Consultant’s Approach.
2nd Edition. Edited by TN Nguyen, D Hu, S Saito,
V Dave, K Rocha-Singh, and CL Grines.
ISBN
0-87993-493-X.
Cardiovascular diseases are among the leading causes of morbidity and premature mortality world-wide.
Increasing understanding of the causes and pathophysiological features of these diseases, of which atherosclerosis is the foremost, has led to effective strategies for prevention. There has also been rapid evolution of therapeutic measures available for treatment, including thrombolysis, more effective control of thrombosis, and endovascular interventions with angioplasty and stenting.
Together with this expansion in knowledge has come a wealth of clinical information, including clinical trial outcomes, which make the practice of evidence-based medicine theoretically possible for most cardiovascular conditions. However, to make this feasible, it is essential for clinicians to have easy access to up to date information, together with guidelines for appropriate application of this information in a clinical setting. This book fills this need admirably.
Acute coronary syndromes include a spectrum of clinical conditions ranging from unstable angina to myocardial infarction, sharing a common pathology based on instability of coronary plaque. Prompt and effective intervention has revolutionised the outcome for patients with these clinical manifestations, and all physicians seeing such patients will find the first 3 chapters of this book helpful in sifting through the formidable literature now available, and formulating effective, evidence-based management.
Coronary surgery is dealt with in terms of the joint American College of Cardiology and American Heart Association guidelines - probably the most authoritative and comprehensive guidelines available.
Effective management of hypertension can forestall many serious complications and favourably modify the progress of arterial disease. Heart failure is one of the commonest causes of morbidity and death in the ageing populations of many countries. Therapeutic advances have made great impact in both conditions. Evidence-based recommendations for management of these common diseases are clearly presented.
Risk factor modification has importance to whole populations, preferably before the onset of cardiovascular disease manifestations, and recommendations are comprehensive and clear.
The management of dysrhythmias, congenital heart disease in adults, and mitral and aortic insufficiency are comprehensively described. For those accustomed to conservative management for the elderly and infirm (or major, invasive surgery for those able to tolerate it), endovascular interventions for peripheral arterial disease will be particularly impressive. The enlarging scope and success of these minimally invasive procedures need to be drawn to the attention of all physicians handling any manifestation of vascular disease.
This book does not cover all cardiovascular conditions, but concentrates on those which are common, and for which effective management which is changing rapidly. The style of the book makes it easy to read. The references to recent sources of evidence make this book a most valuable resource for clinicians for a wide range of practice. It can be highly recommended.
Professor DJ Wheatley, Glasgow Royal Infirmary
Radiology for Surgeons by RR Misra, MC Uthappa and PK Datta Greenwich Medical Media 2002 UK £24.50 ISBN 1841100331
Looking at the title, it was not without some trepidation that I opened the cover. However, as two of its authors have a proven track record in providing texts in diagnostic imaging, and the third is a consultant surgeon, I should have known better. “Imaging for Surgeons” gives little clue to the nature of this excellent book.
Rather than being a “This is what you need to know” book written by Radiologists for Surgeons, this is instead an excellent set of well-illustrated picture tests in surgical imaging. Yes, the clinical scenarios make the likely diagnosis fairly obvious, but the real strength of this book lies in the in-depth additional questions supplied with each of the 95 images. So while you might spot the fracture of the cervical spine, do you know what imaging to ask for next, what the classification of injury is, and what are the basic principles of treatment?
The images themselves are of excellent quality, covering a range of General, Vascular, Urological, Orthopaedic and Neurosurgical cases. As well as plain radiography, there has been a judicious use of CT, MRI, ultrasound images, diagrams and even pathology specimens. While the reader will not leave this book enlightened about the finer points of MRI, their basic knowledge of surgical radiology will be significantly tested, and probably greatly enhanced.
The preface to this book sets out the primary aim of this book as an aid to the MRCS examination. The topics, and style in which they are covered are certainly within the scope of this examination. The additional questions with each case scenario would sit comfortably on the lips of many an examiner. Oh, to have had this as a primer before my part 2B!
The scope and depth of this book is such that it would also make an excellent text for groups as diverse as medical students approaching their finals to surgical trainees approaching exit examinations. Radiologists in training would find much in here that would greatly enhance their knowledge and understanding of the relevance of the tests they are asked to perform.
If I were to criticise this book it would be simply that the title might limit its readership. With such a range of good quality images and well-researched additional information, this book deserves a broad readership.
Simon McGurk, Aberdeen Royal Infirmary