Recent Advances in Paediatrics –23

The latest in this popular series of paediatric reviews provides a useful update for general paediatricians and primary care practitioners. The topics range from common conditions such as asthma and epilepsy to the more specialised area of transfusion medicine in neonatology. Edge's chapter on cerebral oedema in diabetic ketoacidosis highlights the difficulties in initially recognising the onset of this life threatening condition. However, she clearly stresses early warning signs such as headache and emphasises the importance of meticulous nursing care in these vulnerable young people. She recommends the useful consensus statement on management available from the British Society of Paediatric Endocrinology and Diabetes and offers useful key points for clinical practices such as delaying insulin treatment for at least an hour after starting fluids. Titus K Ninan provides a good review of a difficult topic in his chapter on ‘brittle asthma’. It is clearly pitched at the general paediatrician. He discusses conditions that might masquerade as asthma and factors that may contribute to loss of control in asthma using clear lists and text boxes. Therapy options are discussed and also thresholds for referral for a tertiary respiratory opinion, useful guidance for primary care physicians. Many primary care doctors will find the chapter on ADHD helpful. It provides a succinct overview of the condition with diagnostic criteria and suggested therapies. Importantly, Rappley considers mental health conditions that could mimic or co-exist with ADHD. The only drawback for UK doctors is the use of the DSM IV subtype criteria rather than ICD 10. However, clear clinical descriptions of the diagnostic criteria should avoid confusion. This book refreshed my knowledge on less common conditions such as autoimmune brain disorders and lupus. The chapter on medication errors is a worthwhile read for all doctors. The literature reviews accompanying each chapter were good on the whole. The final literature review dated from 2004 which was a little disappointing as the book has gone to press in 2006 nevertheless it is a useful quick reference for topics such as infant feeding, child abuse and screening. Overall a worthwhile read providing easy to follow comprehensive reviews.