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Notes on Paediatrics: Cardiorespiratory Disease
  1. JULIE JOHNSON, Specialist Registrar

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    Notes on Paediatrics: Cardiorespiratory Disease (Pp 160; £14.99 paperback; ISBN 0-7506-2444-2 ); Notes on Paediatrics: Neurology (Pp104; £12.99 paperback; ISBN 0-7506-2445-0 ); Notes on Paediatrics: Neonatology(Pp144; £12.99 paperback; ISBN 0-7506-2446-9 ). By Alex Habel, Rod Scott. Butterworth-Heinmann, 1998.

    Chopping big books into little books seems to be a current literary trend, and further evidence for this is to be found in the new Notes on Paediatrics series. Rows and rows of tiny paperbacks are replacing the huge “Complete Works of . . .” tomes in bookshops all over the country. I have even heard rumours that the Oxford English Dictionary will soon be available in 26 sections. It is hardly surprising that textbooks should go the same way as it solves the perennial problem of being at least 10 years out of date before they even go to press. Publishing one chapter at a time as soon as each is updated seems the ideal solution.

    Chopping big books into little books seems to be a current literary trend, and further evidence for this is to be found in the newNotes on Paediatrics series. Rows and rows of tiny paperbacks are replacing the huge “Complete Works of . . .” tomes in bookshops all over the country. I have even heard rumours that the Oxford English Dictionarywill soon be available in 26 sections. It is hardly surprising that textbooks should go the same way as it solves the perennial problem of being at least 10 years out of date before they even go to press. Publishing one chapter at a time as soon as each is updated seems the ideal solution.

    The textbook under the chop in this case is Habel and Scott’sSynopsis of Paediatrics and the three cuttings to emerge so far are updates of the cardiorespiratory disease, neurology, and neonatology sections.

    The key features promised in the introduction include coverage of recent developments and controversial issues in a clinically relevant context using a problem orientated approach that is, of course, evidence-based. I think that on the whole the authors adhere to this manifesto.

    The books are not intended to be used as reference texts for the subspecialties they address. Instead the authors have tried to focus on subjects that are most relevant to the day to day practice of paediatrics. They highlight areas where there have been recent advances in the understanding of pathophysiological processes, and they also discuss new treatment strategies and ongoing debates about management issues. Consequently these volumes are neither exhaustive nor exhausting, and can easily be read on a long train journey in about the time it takes to read a Terry Pratchett novel.

    The volume on cardiorespiratory disease starts with a brief summary of basic physiology, embryology, and epidemiology. The practical symptom led approach soon becomes apparent with advice on what to do with wheezy infants, lumps in the neck, blue babies, murmurs, and so forth. Also worth mentioning are the comprehensive reviews of asthma, cystic fibrosis, and congenital heart disease. The wide ranging effects of these diseases on children and their families, such as the genetic implications and psychosocial repercussions, are discussed along with the routine coverage of aetiology, symptoms, investigations, and management.

    Scattered throughout the text are small, digestible chunks of relevant pathophysiology with emphasis on how it explains the clinical presentation and enables the interpretation of investigations and examination findings.

    The neurology section also begins with a résumé of basic sciences including a neurochemistry update that covers the role of neurotransmitters in epilepsy. Development and disability are discussed with emphasis on the multidisciplinary approach. There is practical advice about the range of services and allowances available to handicapped children. This is a subject not covered by the more academic texts but which often comes up in the membership examinations (as well as in real life). Equally useful are the reviews of epilepsy, cerebral palsy, coma, floppy infants, and headaches.

    The neonatology chapter starts with a series of minireviews of recent advances and currently debated issues such as nitric oxide, ECMO, and group B streptococcus. Ethical dilemmas are considered as well as the financial and emotional costs of caring for sick neonates. As in the other two volumes, the bulk of the text addresses the most frequently encountered problems and presents them in a concise and readily accessible format.

    In conclusion, the authors have attempted to provide a current, theoretical foundation to back up their proposed management strategies. In other words they supply a map with a suggested route and not just a set of directions. I would recommend this series to membership candidates above all, but also to compilers of ward protocols, and anyone with a long train journey ahead of them.

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