J. Paediatr. Child Health

(2003)

39

, 722–725

Book Reviews

PEDIATRIC CARDIOLOGY HANDBOOK, 3rd edition, byMK Park; 2003. Philadelphia: Mosby (available from ElsevierAustralia). pp. xvi + 311; includes index. Price: AU$86.68.

This is the 3rd edition of ‘The Pediatric Cardiology Handbook’by Dr MK Park, the first having been published in 1991. ThePreface indicates it has been extensively revised since the 1997edition with the addition of a new section on pulmonaryhypertension.

This book is clearly intended as a handy reference guide forjunior hospital staff and paediatricians. The information is pre-sented in a logical sequence, proceeding from routine cardiacevaluation and diagnostic tools to congenital and acquiredcardiac defects, arrhythmias, neonatal heart disease, specialproblems (cardiomyopathy, hypercholesterolemia, systemicand pulmonary hypertension, long QT syndrome), managementof surgical patients and cardiovascular drug dosages.

The information is presented clearly and concisely. Thediagnosis and management of both congenital and acquiredcardiac lesions in paediatric life is dealt with in appropriatedetail. There is good use of line drawings to illustrate a varietyof congenital lesions and the usual surgical illustrationsapproaches to these. The appendices contain tables whichinclude among other things recurrence risks for future siblingsor offspring of children with differing cardiac malformations,normal echocardiographic values, percentiles for systolic anddiastolic blood pressure in normal children aged 5–15 years,and the American Heart Association guidelines for bacterialendocarditis prophylaxis.

Dr Park has admirably drawn together the diverse strands ofpaediatric cardiology. His view of the timing of correctivesurgical procedures is sometimes conservative, for exampleelective repair of aortic coarctation at 3–4 years of age. As aguide for paediatricians making therapeutic decisions, thishandbook is limited by incorporation of some outdatedmanagement strategies, for example beta-blocking agents forprevention of cyanotic spells in tetralogy of Fallot or theroutine use of digoxin for heart failure. The listed aetiologies ofcardiomyopathy lack detail and the section on pulmonaryhypertension does not include drugs that improve survival andfunctional status. Fetal echocardiography in at-risk families isnot mentioned. The comment that mitral valve prolapse occursin up to 5% of normal children arises from an outdatedechocardiographic definition of this condition.

The most useful addition would have been the practicalmanagement of arrhythmias. There is no mention of the need toobtain a 12 lead ECG during the suspected arrhythmia, or theneed to record a continuous rhythm strip during reversion.Contrary to the text, eyeball pressure should not be usedbecause of the risk of retinal detachment, and digoxin is nolonger preferred therapy for the chronic management ofsupraventricular arrhythmias. Non-pharmacological manage-ment of the common problem of vaso-vagal syncope is notdiscussed.

Despite these omissions, this is a useful reading guidewith good quality background information for those involvedwith the care of children with cardiac problems.

R Weintraub

Department of CardiologyRoyal Children’s Hospital

Parkville, VictoriaAustralia

INFANT FORMULA: CLOSER TO THE REFERENCE,edited by NCR Raiha and FF Rubaltelli; 2002. Philadelphia:Lippincott Williams & Wilkins. pp. xvi + 238; includes index.Price: AU$195.80.

This book is one of a series of the proceedings of the NestléNutrition Workshops. The workshops, hosted by Nestlé, gatherinternational experts to engage in discussion around a topicalpaediatric subject that is relevant to nutrition. With increasingawareness of the impact of early feeding on long-term healthoutcome, there is interest in understanding further the capacityof breast milk to provide the best outcomes in development andthe lowest morbidity. There is interest also in the mechanismsby which infant formula may best achieve the closest possibleoutcome; a result not necessarily achieved through the sameformulation. The challenge is especially relevant for infantsborn preterm. There is therefore strong interest in developmentsin infant formula which may improve outcomes, and there havebeen several recent changes in design of infant formula whichare available in Australia. Practitioners often are concernedabout the basis of the products, their use and effectiveness. Themeeting documented in this publication, held in Italy, discusseda range of issues around infant feeding and particularly theapplication to design of infant formula, for both preterm andterm infants.

Issues under discussion include the role of pro-biotics ininfancy and their clinical application, both in formula and asmedication, iron requirements, protein requirements, the roleand function of nucleotides and of long-chain polyunsaturatedfatty acids, and the feeding and requirements of preterminfants. There are several papers on each subject, generally abackground discussion and a paper outlining specific studyresults; the discussion arising from the paper is included, alongwith a bibliography. Contributors are recognized within theirfields. In this case, contributors include J Saavedra writing onpro-biotics, G Moro reviewing protein in preterm infants andO Hernell reviewing iron requirements in the first 6 months oflife. Of particular interest are the articles re-evaluating proteinrequirements in healthy infants, with the implications thesemay have on current infant formula standards.

The discussion on iron fortification of infant formula and therecommended level of iron fortification is also very interesting;less crucial in Australia where all formula is fortified and anon-fortified or low-iron product is no longer available. Thesummation does perhaps foreshadow a decreased level offortification in the future.

The consideration of preterm feeding comes from a positionof accepting that breast milk does not adequately provide forthe needs of the preterm infant, and is therefore of greaterinterest and challenge. There is relatively little work in thisarea, which is able to draw on outcome data. As infants survivefrom earlier gestation and are discharged relatively earlier,post-discharge nutrition requires additional consideration.There is some discussion included of the nutritional differencesbetween those infants appropriate for conceptional age andthose with intrauterine or postnatal growth retardation.

The chapters are easy to read, and collect current thinkingand reviews in this specialized area in a single source. Thebook would be of interest to a reader with particular interest ininfant feeding, or seeking information about one of the specificareas, such as neonatologists or paediatric dietitians. It istimely, given the current state of transition of Australian infant

Book Reviews 723

formula standards from an earlier version to a revised standard.The book is not a general reference guide to infant formula, oran outline of nutritional needs and requirements for medicalor health students. It would make a useful addition to a refer-ence library for those with specialist interest.

K Gibbons

Nutrition and Food ServicesRoyal Children’s Hospital

Parkville, VictoriaAustralia

PAEDIATRIC SPORTS MEDICINE FOR PRIMARY CAREPRACTITIONERS, edited by RB Birrer, BA Griesemer andMB Cataletto; 2002. Philadelphia: Lippincott Williams andWilkins. pp. xix + 520; includes index. Illustrated. Price:AU$110.00.

It is salutary to reflect on contemporary issues impacting onchild sporting endeavours. Financial return to elite athletes, theaccompanying media exposure and the recent moral and ethicalissues have raised significantly sport profile overall. This has asecondary impact on the younger athlete seeking to emulatetheir sporting heroes. Sport profiling and the application ofideas and principles available to the adult participants placegreater pressures on the young athlete whose physiology isdifferent. Competitive edges are highly sought in this drive toyouth success. This comes at a time when issues of safety,accountability and legality are critical. Furthermore, the explo-sion and accessibility of knowledge to the athlete consumerfurther heighten the difficulties encumbered in providingprimary health care in this increasingly complex environment.

Against this background, the primary care practitioner hasspecific requirements for a text that needs to provide contemp-orary information over a broad topic base. Major guidelinesneed to be simple, practical and workable. In the paediatricsense, the impact of physiology and growth as a basis tounderstanding management principles is critical, as is the safetyand medico-legal issues as addressed above.

‘Paediatric Sports Medicine for Primary Care’ has well metthe above criteria. The book is structured in three sections:

The first section outlines the demographic, social, safety andprotection issues. Especially useful are the appendices. Theethical issues are described in the text, with the appendixproviding a frame work for implementation and reporting.

The second section deals with medical issues in a system-by-system review. However, the topic selection is targeted at theprimary care practitioner with a practical succinct review ofcommonly read topics. For example, diabetes and amenorrhoeaare the endocrine topics. Scoliosis, a source of significantdifficulty in management at the primary care level, is dealt withrefreshingly and clearly with practical guidelines on manage-ment (‘idiopathic scoliosis is not painful’), radiology and aprotocol for follow up.

Section three deals with musculo-skeletal presentations.Again the advice is sound and practical. For example, I waskeen to learn how the book would deal with controversialtopics such as anterior cruciate rupture in the skeletallyimmature athlete and the management of spondylolysis. Theapproach to both topics was practical, clear and along similarguidelines to our thoughts in Australia.

I was particularly pleased to see the practical approachoutlined in Principles of Rehabilitation. Simple concepts oftenglossed over (settle the pain, regain flexibility, regain strength

and a graded return to activity). Controversial issues not yetresolved, such as the use of anti-inflammatory agents in anearly post-injury setting are addressed and humbly left open.

I strongly recommend the text for the general practitionerand the paediatric generalist with an interest in sport.

P Baquie

Olympic Park Sports Medical CentreMelbourne, Victoria

Australia

CLEVELAND CLINIC INTENSIVE REVIEW OF PEDI-ATRICS, edited by C Sabella, RJ Cunningham III and DSMoodie; 2003. Philadelphia: Lippincott Williams & Wilkins.pp. xii + 526; includes index. Illustrated. Price: AU$176.00.

Attention all basic trainees, MOPS point chasers and futureFRACP re-certification candidates. For the past 8 years theFaculty of the Cleveland Clinic Foundation have contributed toan Annual Paediatric Board Review for those preparing for theAmerican Board of Pediatrics certification and re-certificationexams. The Editors of this symposium have now published, inbook-form, a series of subspecialty chapters of clinical paedi-atrics providing ‘relevant, factual material’, but avoiding anyand all areas of controversy.

This is not a textbook of paediatrics but it does cover verylarge areas of clinical paediatrics in succinct, almost pithy,chapters, each with a concise suggested reading list of refer-ences and each with a series of type A review questions andanswers/explanations. At the end of each subspecialty set ofchapters, there is a further series of ‘Board Simulation’ clinicalcase scenarios, again with type A questions, answers/explanationswhich cover the subspecialty. The book is approximately500 A4-size pages in size, is well set out including clearfigures, diagrams and photos (including colour).

Although the level of difficulty of the simulated Boardquestions may not be particularly high, the associated discussions/explanations and the succinctness of the didactic componentsof the book make this a very attractive way of revising largeareas of evidence based clinical paediatrics efficiently, as wellas allowing readers to evaluate their strengths and weaknesses,and to get experience in type A multiple choice questions.

TD Bohane

Department of GastroenterologySydney Children’s Hospital

Randwick, New South WalesAustralia

PRACTICAL CHILD PSYCHIATRY: THE CLINICIAN’SGUIDE, by B Lask, S Taylor and KP Nunn; 2003. London:BMJ Books. pp. xiii + 381; includes index. Price: £35.00.

The publication of a concise textbook of child psychiatry thatis filled with clinical wisdom is cause for celebration. ThisBMJ Books publication is particularly well set out, with clearheadings, useful lists and tables. The authors have managed tokeep the book compact by dispensing with some of the intro-ductory chapters seen in other texts that describe normativedevelopment of children, review the historical development oftreatment services and discuss the origins and controversies

724 Book Reviews

surrounding classification. In ‘Practical Child Psychiatry: TheClinicians Guide’, the authors get straight down to businesswith a brief chapter on assessment followed by chapters onclinical problems and their treatment. Referencing is economi-cal and restricted to background reading. There is no attemptto discourse on current evidence (or its absence). Rather, onegains the impression that the authors have encountered most ofthe problems described in the text, and that their advice is basedon experience.

The authors do allude to debate and controversy, but avoidgetting bogged down in detail. The authors are based in majorteaching hospitals in Australia and in Great Britain. The contentand emphasis of the book reflects the tertiary experience gainedin these institutions, but there is sufficient material in the bookfor it to be relevant to clinicians working in community centres.The authors have deliberately avoided reference to specificclassification systems, while the naming of conditions reflectssome influence from the American Diagnostic and StatisticalManual and some influence from the European InternationalClassification of Diseases. Only once did I encounter difficultywith the terminology. The authors have used the term ‘learningdisability’ to mean mental retardation, while someone morefamiliar with the American Diagnostic and Statistical Manualmight assume the term referred to specific learning disorders inreading, maths or spelling.

The text has few weaknesses. The chapter on psycho-pharmacology was very inclusive and covered medications thatwould be rarely used by most clinicians. The authors partiallyacknowledge this when they state ‘expertise with these medica-tions is difficult to gain unless seeing larger numbers (ofpatients) than most practitioners see’. The list of ‘generalprinciples for the use of psychotropics in childhood’ was verylong, and some of the principles, to this reader, seemed veryspecific.

Competing publications would be ‘Child Psychiatry’(Goodman & Scott, 1997) and ‘Massachusetts General HospitalPsychiatric Aspects of General Hospital Paediatrics’ (Jellinek& Herzog, 1991). However, ‘Practical Child Psychiatry: TheClinicians Guide’ stands up very well in comparison to thesetexts. The text will be of use to child psychiatrists, paediatri-cians, trainees in these disciplines, paediatric, child and adoles-cent mental health nurses, and allied health professionals.

PL Hazell

Discipline of PsychiatrySchool of Medical Practice

Faculty of Medicine & Health SciencesUniversity of Newcastle

Callaghan, New South WalesAustralia

PEDIATRIC OPHTHALMOLOGY and STRABISMUS, 2ndedition, edited by KW Wright and PH Spiegel; 2003. NewYork: Springer. pp. xxiii + 1084; includes index. Illustrated.US$250.00.This large multi-author text is written almost exclusively byophthalmologists and ophthalmic scientists and is directedprimarily at an ophthalmic rather than a paediatric readership.It covers the field of paediatric ophthalmology in a systematicand encyclopaedic fashion. The use of multiple authors hasresulted in a reasonably up-to-date text (there is a smattering of2001 references) with minimal areas of duplication.

How might a paediatrician use such a text? It could be usedto refine clinical skills (e.g. refresh the method of examination

of a child with strabismus), review a specific problem (such asretinopathy of prematurity or the ophthalmic manifestations ofchild abuse), or to refresh one’s memory when an unfamiliarcondition is diagnosed in a patient (what is Duane’s syn-drome?). The following comments result from the above ‘roadtest’.

The chapter on the ocular motor examination is too detailedfor the majority of paediatricians and unfortunately the earlymore general chapter on paediatric eye examination does notinclude strabismus assessment at all. The discussion of retin-opathy of prematurity (ROP) gives an excellent overview of thetopic and provides a very good perspective of this subject fromthe ophthalmic viewpoint. The only criticisms are that it dwellson cryotherapy as the gold standard for treatment of moreadvanced ROP (rather than laser photocoagulation) and it failsto adequately address the evolving status of ‘threshold ROP’ inthe timing of treatment for ROP.

The ophthalmic features of child abuse are covered in twosections that are not cross-referenced. The first and moredetailed discussion appears in the chapter on eye trauma and isreferred to as the ‘battered child syndrome’ and the second is ina chapter on retinal vascular disorders entitled ‘shaken babysyndrome’. Use of uniform nomenclature would have made iteasier to find these two sections via the index.

Duane syndrome is discussed at length in two chapters(complex strabismus and ocular motility disorders within thesection devoted to neuro-ophthalmology). With little effort apaediatrician would learn all that was needed to know (and thensome) regarding Duane syndrome. The section on systemicdisease and the eye is excellent and there is a very useful‘compendium of inherited diseases with ocular involvement’ atthe conclusion of the book.

There is an excellent chapter on ‘breaking bad news’. Thishas long been identified as a deficiency in ophthalmic practiceand would be of interest to a more general readership. Thechapter of interventions for management of low vision is briefto the point of having insufficient information.

In summary, this text gives an excellent account of paediat-ric ophthalmology and strabismus but is primarily addressed atan ophthalmic audience. Paediatricians will be most likely touse it as a reference source to answer specific questions as theyarise. As a reference text it is strongly recommended forinclusion in the libraries of paediatric hospitals.

JE Elder

Department of OphthalmologyChildren’s Neuroscience Centre

Royal Children’s HospitalParkville, Victoria

Australia

PAEDIATRIC CLINICAL EXAMINATION MADE EASY,4th edition, by D Gill and N O’Brien; 2003. Marrickville:Churchill Livingstone (available from Elsevier Australia).pp. x + 266; includes index. AU$51.70.

The authors of this conveniently sized handbook aim to assistmedical students learning the craft of clinical assessment ofchildren. While most of the book is devoted to the clinicalexamination, the reader is introduced to some good, common-sense advice about the general approach to history taking andthe paediatric consultation.

The clinical examination is covered in a systematic andordered fashion. There are clear and simple diagrams with brief

Book Reviews 725

tables and lists. The authors cover the elicitation of both normaland (a limited range of) abnormal physical signs. The student isappropriately advised to look and observe closely. The differ-ences between examining children and adults are highlightedvery well.

The final chapter is given over to eponyms, tips and pearls.These short cuts will be popular with students preparing for anexam. However, I feel that the weaker student may rote learnthese tips without fully understanding the thinking behindthem.

Overall, this is an excellent book that I would recommend tomedical students and should have a place in institutionallibraries.

MK Marks

Department of PaediatricsUniversity of Melbourne

Melbourne, VictoriaAustralia