J Am Board Fam Pract: first published as 10.3122/jabfm.12.6.506c on 1 November 1999. Downloaded from http://www.jabfm.org/ on 17 December 2024 by guest.

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Book Reviews

Appleton & Lange Specialty Board Review: Family Prac- Headache. Volume 1. By Egiluis L. Spierings. 236pp. Woburn,
tice. Sixth edition. By Ernest Yuh-ring Yen. 277 pp. Stamford, Mass, Butterworth-Heinemann, 1998. $25 (paper). ISBN
Conn, Appleton & Lange, 1999.$45. ISBN 0-8385-8739-9. 0-7506-7128-9.

This book is a concise overview of a common and often

In preparation for board certification or recertification challenging problem encountered in family practice. The
examinations, many family physicians help to define their book is divided into three sections covering acute, sub-
knowledge strengths or deficits by answering a series of acute, and chronic headaches. Each section begins with a
practice questions. This sixth edition of the Appleton & general discussion of the clinical approach, examination,
Lange Specialty Board Review: Family Practice was de- and diagnostic considerations of these three types of
signed, as are so many similar workbooks on the market, headaches. Subsequent chapters briefly review the inci-
to provide samples of questions comparable in content dence, cause, clinical symptoms, and diagnosis of specific
and style to the actual board examination. The author headache conditions.
notes that residents in training are his intended primary The author provides excellent case studies to help
reading audience, although recertifying practitioners differentiate the different types of headaches. In the
would also benefit. chapters on abortive and preventive treatment of mi-
The workbook begins with a brief discussion of test- graines, convenient tables list medications, dosage, route
taking tips and review of the various types of formatted of administration, side effects, and contraindications. It is
questions. The following eight chapters include multiple a small book that is well organized and a quick read.
questions (approximately 1500) in the topic areas of psy- That Headache is not an evidence-based review of
current knowledge about headache management is a ma-
chiatry, surgery, gynecology, obstetrics, community
jor weakness. Although the author at times uses original
medicine and geriatrics, internal medicine, pediatrics,
research to support his conclusions, he admits in his intro-
and several medicine specialties. Answers to questions are
duction that the approach to management draws heavily
of varying length and cite 1 of 85 reference texts, gener-
from his own experience in diagnosing and treating head-
ally published from 1992 to 1996. No works published
aches. He justifies this approach by saying that he trained
after 1996 are referenced despite the declaration in the with Dr. John Graham, who he states has been referred to
Preface that this volume has been reviewed and updated as the "father of headache management. " Nevertheless, it is
by academic faculty. difficult to assess the validity of this expert's opinion.
Most of the questions in the text are fairly typical of Another weakness of this book is that the discussion of
board examination questions in general content and type the management of headaches is inconsistent. For exam-
of question, including true-false and best-response mul- ple, an entire chapter is dedicated to the treatment of
tiple choice. There are no K-format questions. One cluster headaches and one line to the treatment of head-
drawback is the lack of questions based on photographs ache with meningitis, and in the chapter on chronic daily
(such as those of dermatologic problems), electrocardio- headaches, no reference to treatment is made.
grams, radiographs, and graphic information. These for- This book is easy to read and provides excellent case
mats typically are part of board examinations, and their studies to illustrate the many different headache conditions,
omission represents a potential handicap for the board but it would have been strengthened by a more systematic
candidate. Another problem, although of a lesser degree, review of the medical literature on headache management.
is that discussions of answers refer to a single entire text. Sara Cate, MD
This characteristic is in contradistinction to other board- Central Washington of Family Medicine
sponsored preparation publications, such as The Core Yakima, Wash
Content Review of Family Medicine, which include specific
page references to several texts. Managing Mental Health Problems: APractical Guide for
Overall, this workbook will suffice as a good source of Primary Care. By Nick Kates and Marilyn Craven. 374 pp.
typical questions for board examination preparation. Kirkland, Wash, Hogrefe & Huber, 1998. $39. ISBN 0-88937-
Readers will need to supplement this text with additional 124-5.
workbooks that have pictorial-based questions and an-
swers, and they might be somewhat limited by the time In writing this text, the authors' goals were "to acknowl-
necessary to locate topic-specific references. Cost could edge the major role played by the primary care providers
playa factor in choosing this work rather than another. in the delivery of mental health care, and to provide a
Kathryn M. Larsen, MD practical, problem-based approach to the detection and
University of California, Irvine treatment of the problems they encounter most frequent-
Orange, Calif Iy." They recognized the challenge the nonpsychiatrist

506 JABFP November-December 1999 Vol. 12 No.6

 J Am Board Fam Pract: first published as 10.3122/jabfm.12.6.506c on 1 November 1999. Downloaded from http://www.jabfm.org/ on 17 December 2024 by guest. Protected by copyright.
faces when dealing with patients who have physical com- marize the most salient points of the chapter. Tables are
plaints with components that relate to stress, relationship simple and easy to read.
problems, bereavement, or the emotional sequelae of My recommendation would be to start by reading the
chronic physical illness. clinical pearls and then refer to the text if the reader
Many times these patients must be evaluated in a 10- wants more information. Residents and medical students
to I5-minute visit, when it is incumbent on the physician might find this text interesting, but my bias is that an
to make the diagnosis, assess the potential for change, overabundance of texts like this already exists; we do not
and use his or her skills to bring about that change or to need another. Although the information seems relevant
refer to another provider, if appropriate. to what family physicians see in their offices, it is impos-
This book is an excellent source of information for the sible to assess its validity.
primary care provider. It is organized the wayan encounter Sara Cate, MD
would flow-interviewing, assessing the problem, and then Central Washington Family Medicine
developing a management plan. Chapters that follow take Yakima
up such specific topics as family problems, using commu-
nity resources, and mental health services. The mental Clinical Management of the Child and Teenager with
health problems are then addressed-depression, anxiety, Diabetes. Edited by Leslie p/()tnicJz and Randi Henderson. 268
grief psychosis, schiwphrenia, and bipolar affective disor- pp. Baltimore,johns Hopkins University Press, 1998. $24.95 (pa-
der. The authors offer suggestions regarding emotional per). ISBN 0-8018-5909-3,
components of medical conditions and problems involving
sleep, alcohol, the older patient, abuse, and sexuality.
The authors intend this text to be a practical, how-to
There are many educational aids throughout the
book with a goal of providing the information that pri-
book, and several mnemonics are included for various
mary care clinicians need to treat children and adoles-
conditions. The authors also include several tables of
cents with type 1 diabetes. The book is well written and
medications, equivalent doses, and common adverse ef-
well organized. It would be of interest to primary care
fects for drugs prescribed for patients with mental health
physicians as well as other providers who care for patients
problems. At the end of each chapter, criteria are recom-
with type 1 diabetes, including dietitians, mental health
mended for referral to a consultant and a list of reason-
counselors, parents, and even older children with diabe-
able expectations of the primary care provider.
tes. Thirteen brief chapters provide the important as-
As many of us realize as we practice, the more skilled
pects of well-child care, patient education, insulin and
we become with mental health problems, the better our
dietary management, complications, and psychological
care of the patient. Because we provide continuity of care
issues. Case studies are included throughout, and the
for our patients and their families, we are in an ideal
appendix includes valuable assessment and medical
position to help in all aspects of their health care. Their
record tools.
mental health should be a major aspect of that care.
This volume would be worthwhile reading for any
Primary care providers would do well by reading this
trainee or provider who cares for patients with type 1
book and following the suggestions that are made.
diabetes. The appendices and guidelines would also be use-
Ralph E. Berggren, MD
ful for any practitioner who would like to improve practice
Venice, Fla
efficiency and quality-of-care provided to these patients.
Arlo Kahn, MD
Neurology in Primary Care. By joseph Friedman. 219 pp. University of Arkansas for Medical Sciences
Woburn, Mass, Butterworth-Heinemann, 1999. $25 (paper). Little Rock, Ark
ISBN 0-7506-7036-3.
Gellis &: Kagan's Current Pediatric Therapy. Volume 16.
The goal of this pocket-sized reference book is to pro- Edited by Frederick D. Burg, julie R. Inge/finger, Ellen R. Wald,
vide a framework for approaching common neurologic and Richard A. Polin. 1298 pp. Philadelphia, WE Saunders,
conditions in primary care settings. The author also 1999. $98. ISBN 0-7216-6998-0.
hopes that those using this text will reduce inappropriate
referrals to neurologists. These goals are extremely rel- This book, which is in its 16th edition, has been a
evant to family physicians. This monograph, however, is pediatric standard for more than 30 years. The tide still
weighted too heavily on the author's personal practice carries the names of the original editors, but the reins
experience. References in the book are scant, making it have been passed to new editors. In the current edition of
appear to be based on expert opinion. The book is pre- this multiauthored text, the number of contributors has
sented in a conversational style that is not succinct. In increased from 445 to 521, and an impressive lineup of
fact, the author states that he used a lecture to medical recognized authorities represent many areas of pediatric
students as a basis for this book. medicine. In addition, the size of the book has increased
There are 12 chapters on common neurologic diag- by more than 25%; the content has been rearranged to
noses in primary care, including headache, dizziness, gait include additional sections on immunology, cancer, and
disorders, transient ischemic attacks, and epilepsy. At the dentistry; and diabetes and metabolism are separated
end of each chapter, a half-page of clinical pearls sum- from the endocrine section. Contributions from pediatric

Book Reviews 507