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  1. R A F BELL
  1. Horton General Hospital

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    Recent advances in paediatrics. Edited by David, T J. (Pp 258, paperback; £36.95) Edinburgh: Churchill Livingstone. ISBN 0443 06184 X

    Over the years, I have experienced a lifting of the spirit whenever I encounter books in the “Recent advances in paediatrics” series, and the year 2000 edition is the eighteenth in the succession, which suggests that many paediatricians, young and old, find the series worth acquiring.

    The formula is simple: a dozen or so essays on a topical matter by an acknowledged expert in a field, often written with the assistance of a junior colleague, followed by a review of the recent papers with pithy one sentence summaries.

    For anthologies such as these to succeed, the essays must attract the interest of readers who are not experts in the topics covered, be capable of being read in a single session, must have something more than can be found in review articles in the journals, and, most of all, be written by experts who can communicate their messages with clarity and enthusiasm, so that the reader is left not just better informed, but enthused, and resolved to put the new knowledge to practical use as soon as the opportunity arises.

    Being an anthology, the standard of presentation is variable: some authors get their messages across better than others.

    Those who have attended John Stephenson's sessions on reflex anoxic seizures at the RCPCH meetings will recognise his enthusiastic, but somewhat inchoate style. Rennie and Boylan's essay on neonatal seizures is good, and so is Chamnanavanakaj and Perlman's review of current ideas regarding the genesis and treatment of hypoxic ischaemic encephalopathy, although there isn't much new information that will assist the practising paediatrician with the management of an asphyxiated infant.

    Selvadurai and Fitzgerald give a simple traversal of the methods of measuring oxygen in the blood, and Brand is very good on the value of flow/volume curves.

    The three articles on psychological topics: family support when a child is critically ill, autism, and cognitive behavioural treatment are less gripping, if informative. The last topic could have benefitted from more vigorous editing: a paragraph of 41 lines does not lend itself to easy reading.

    Non-accidental injury of children makes for uncomfortable reading, yet Shouldice and Huyer give an excellent review of the mechanism and recognition of non-accidental rib fractures, and Levin's essay on retinal haemorrhages and child abuse is really a 70 page monograph. He gives clear information regarding the relationship between retinal haemorrhages and birth injury, and emphasises that if the haemorrhages are present later than six weeks after birth, the baby is likely to be a victim of shaking.

    I was fascinated by Levin's explanation of why the woodpecker does not suffer retinal haemorrhages, but magnificent as his essay is, like Wagner's “Ring”, it would have been better had it been somewhat shorter.

    This is all good stuff, although the crisp summaries of more than 300 papers and reviews demonstrate a capacity for brevity and clarity which, if understood by some of the authors of these “recent advances”, would have made this good book even better.

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