Book and Multimedia Reviews

W the ABA written examination looming in the not too distant future, many residents, this reviewer included, may struggle to determine the best approach to Board preparation. There is no shortage of resources and a great variety of formats for different learning styles. Anesthesiology Board Review is another addition to a large collection of Board preparation texts. The editors, however, intend to provide a novel approach to the standard question-and-answer review book. Their purpose is to create a book for the final push of Board studying. With this in mind, they have collected hundreds of questions from institutions around the nation. Only the correct answers are provided. No distracters, no K type questions. As the editors state in the introduction, “right before the exam . . . it’s time to focus on correct answers.” For the most part, and given the stated purpose of the review book, this approach works well. The questions are organized into 42 topic chapters: Acid Base, Fluids and Electrolytes, Anesthesia Risks, Chronic Pain Management, etc. Most of the questions are straightforward and the answers tend to be appropriately brief. Almost all of the major topics one would expect to find on the written board exam are included in the book’s 400 pages. There are several especially useful chapters, including Endocrine, Obstetrics, Orthopedic Surgery, Respiratory Physiology & Anesthesia, Thoracic Surgery, and Chronic Pain Management. Orthopedic Surgery, for instance, includes several excellent questions based on clinical scenarios, with succinct and relevant answers that are particularly helpful for the review of regional anesthesia. There are a few areas in which future editions could improve. The editing, at times, is uneven. Occasional typographic errors are distracting to the reader and potentially life-threatening. The infusion dose for isoproterenol, for example, is given as 2–10 mg/min not mcg/min. Some of the chapters would benefit from editing to improve the flow of questions and eliminate unnecessary repetition. The Acid Base, Fluids, and Electrolytes chapter was a bit frustrating to read. It includes two essentially identical questions on the clinical manifestations on hypernatremia. More important to the Board candidate, there are inconsistencies. For example, regarding the effects of thiazides and furosemide on acid base status, one answer correctly describes the potential for a metabolic alkalosis (p.13) yet another answer a few pages later states that these drugs can cause a metabolic acidosis (p.15). With questions coming from so many different contributors, it is easy to imagine the challenge of editing, but relatively small changes would be helpful to the reader. It would also be useful to the reader if each topic chapter included its own bibliography. In the current format, there is an exhaustive bibliography at the book’s conclusion, but it is not organized by topic and therefore not especially useful when looking for a quick way to find additional information on a topic. Lastly, for the visual learner, there are no graphics, charts, tables, or figures to assist with quick review. These concerns aside, Anesthesiology Board Review largely delivers on its promise to provide a helpful review in the final weeks leading up to the ABA Board exam. Finally, although the book is clearly tailored to the ABA exam, the approach and content will likely be useful to trainees preparing for certification exams in other countries.

W ith the ABA written examination looming in the not too distant future, many residents, this reviewer included, may struggle to determine the best approach to Board preparation. There is no shortage of resources and a great variety of formats for different learning styles. Anesthesiology Board Review is another addition to a large collection of Board preparation texts. The editors, however, intend to provide a novel approach to the standard question-and-answer review book. Their purpose is to create a book for the final push of Board studying. With this in mind, they have collected hundreds of questions from institutions around the nation. Only the correct answers are provided. No distracters, no K type questions. As the editors state in the introduction, "right before the exam . . . it's time to focus on correct answers." For the most part, and given the stated purpose of the review book, this approach works well. The questions are organized into 42 topic chapters: Acid Base, Fluids and Electrolytes, Anesthesia Risks, Chronic Pain Management, etc. Most of the questions are straightforward and the answers tend to be appropriately brief. Almost all of the major topics one would expect to find on the written board exam are included in the book's 400ϩ pages. There are several especially useful chapters, including Endocrine, Obstetrics, Orthopedic Surgery, Respiratory Physiology & Anesthesia, Thoracic Surgery, and Chronic Pain Management. Orthopedic Surgery, for instance, includes several excellent questions based on clinical scenarios, with succinct and relevant answers that are particularly helpful for the review of regional anesthesia.
There are a few areas in which future editions could improve. The editing, at times, is uneven. Occasional typographic errors are distracting to the reader and potentially life-threatening. The infusion dose for isoproterenol, for example, is given as 2-10 mg/min not mcg/min. Some of the chapters would benefit from editing to improve the flow of questions and eliminate unnecessary repetition. The Acid Base, Fluids, and Electrolytes chapter was a bit frustrating to read. It includes two essentially identical questions on the clinical manifestations on hypernatremia. More important to the Board candidate, there are inconsistencies. For example, regarding the effects of thiazides and furosemide on acid base status, one answer correctly describes the potential for a metabolic alkalosis (p.13) yet another answer a few pages later states that these drugs can cause a metabolic acidosis (p.15). With questions coming from so many different contributors, it is easy to imagine the challenge of editing, but relatively small changes would be helpful to the reader. It would also be useful to the reader if each topic chapter included its own bibliography. In the current format, there is an exhaustive bibliography at the book's conclusion, but it is not organized by topic and therefore not especially useful when looking for a quick way to find additional information on a topic. Lastly, for the visual learner, there are no graphics, charts, tables, or figures to assist with quick review.
These concerns aside, Anesthesiology Board Review largely delivers on its promise to provide a helpful review in the final weeks leading up to the ABA Board exam. Finally, although the book is clearly tailored to the ABA exam, the approach and content will likely be useful to trainees preparing for certification exams in other countries. A tlas of Airway Management is a unique, comprehensive review of airway management technique using cadavaric prosections to demonstrate techniques and apparatus. The book is filled with great pictures demonstrating airway management techniques in both living models and cadavers. Written text is limited as most of the story is told with pictures, making the book a quick and easy read. It starts with a good review of airway anatomy, which is well demonstrated with diagrams, pictures, a cadavaric sagittal section through the head, and MRI images.

Matthew Aldrich, MD
Subsequent chapters are set up with the same general format for each skill set -concept, evidence, description of preparation for and the procedure itself, practicality, indications, contraindications, complications, and references. This repetitive pattern allows one to easily identify the specific points of each technique. Each section has limited descriptive text and relies on the visual media to complete the concepts. Many of the pictures are unique images of the airway, the device, or pathologies. Much can be learned simply by looking at the pictures.
For the most part, the concept for each technique is outlined and provides the reader a quick insight into the mechanical aspects of each technique. The overview of the evidence is scanty, with some papers that experts may consider critical notably absent. However it is evident that a detailed review of the literature was not the intention of the author.
In the preparation and procedure section, the author outlines essential equipment and drugs required to perform the technique and then goes on to detail each step in point form. This approach is helpful and allows the reader to quickly review the steps. It lacks, however, sufficient description of the pearls for success and teaching the reader how to evaluate the suitability of a technique for a clinical situation.
The section on practicality, indications, contraindications, and complications is once again in an easy-to-read list format. Although this allows for a quick scan by the reader, depth in the real-life triage of the technique is lacking, though good lists are provided which may be useful for students. These sections are not referenced, which leads this reviewer to surmise that they are heavily influenced by the opinion of the author.
Most airway management techniques are well represented, although some limitations are noted. There is no mention of the newer video laryngoscope techniques. The author devotes a chapter to the special airway situation in pediatrics, which is very brief and only hits a few highlights. A section in the book is reserved for difficult airway management, including recognition, training, and management. Interestingly, in this section there is no mention of the Vol. 105, No. 3, September 2007 special high-risk situation posed by the pregnant patient. In this section, there are some tables and illustration borrowed from a text book edited by R. M. Walls, Manual of Airway Management. These charts are labeled A-D, but there is no explanation of the significance of the labels or the sequence of the charts.
Overall, this book was fun to review. However, it should not be used as a definitive reference for airway management, but as a quick guide to available airway techniques. T ransesophageal echocardiography is a comparatively young diagnostic discipline and as such is being readily adopted not only by cardiac anesthesiologists, but also by general anesthesia practitioners in various settings, including the ICU. A Practical Approach to Transesophageal Echocardiography by Perrino and Reeves published in 2003 in paperback form (a second edition is projected for October 2007) ranks among the standard texts of the discipline. It is the basis for this PDA version.

Holly Muir, MD, FRCPC
When evaluating PDA software, the focus should be on how much "assistance" in everyday practice can be obtained. Obvious advantages like easy access and mobility square off with inherent limitations such as limited storage and screen size. Although clinical PDA software is quite popular for concise text blocks such as drug information, it is a matter of individual preference to read complex text as presented in a text book.
This raises the question of where and how TEE-PDA software would be most beneficial for the anesthesiologist. The most appealing clinical environment appears to be in the OR, where textbooks or computer access may not be readily available. To be a helpful asset in this situation, the software must provide instantaneous and wellorganized access to pertinent information. Images and video loops must be of sufficient quality to be viewable under bright lights in the operating room. Lastly, the software should assist the clinician with basic calculations occasionally required during a TEE examination.
It should be noted that the author of this review has used Palm software for many years, preferentially for drug reference, calculations, and occasional use of text-based information. The installation of the PDA software on a Treo 680 (Palm) was fairly challenging and required additional software download from the Internet. However, it should be acknowledged that the online (chat) technical support was extremely helpful. To avoid these problems, it is possible to obtain all the relevant software on a memory card for an additional $25.00 from the same distributor. Once installed, the program appears as a standard icon on the familiar Palm interface. One click leads to the main index that can be searched by simple alphabetical query. Alternatively, a figure index and a table of contents view can be chosen as a starting point. Navigation through the pages is highly intuitive and facilitated by additional shortcut buttons in the right corner. The TEE practitioner will find the additional calculator index view that allows access to 19 common cardiac calculations, such as aortic valve area by continuity equation and diverse pressure gradients, particularly useful.
Even though the information is easy to read and well cross-linked, it is not always straightforward to find the specific information sought for. For example: "Commissural mitral view" is not indexed and had to be located by searching through multiple levels. Once found, the image plane and orientation is well described, including specific leaflet nomenclature. Unfortunately, this leaflet specification is missing on the image that is linked to the text. In general, the image quality and annotations are quite good, although appreciation of detail is limited by the small screen size. Regretfully, the included zoom function only works negatively (i.e., zooms farther out). The total number of TEE images is limited to 100 and does not match the abundance of text information that includes a variety of tables. Presumably, as a concession to limited storage space, video loops have not been included in the software.
In summary, A Practical Approach to Transesophageal Echocardiography on PDA is interesting, although for the immediate application in the OR the use may be limited. It may appeal to TEE practitioners who seek to refresh their basic knowledge between cases. Since the second edition of the printed version is to be published in October 2007, the author of this review is looking forward to an updated version of the PDA software as well. Improvements in indexing, zoom function, and inclusions of video loops as well as the ability to perform a free text search would make the software a much better companion for the perioperative echocardiographer. W ritten mostly by acknowledged expert clinicians and researchers, Current Diagnosis and Treatment of Pain is a welcome addition to the sector of pain-related literature that is directed predominantly to primary care specialists whose practice includes pain management. That it is targeted to a more generalist audience, however, heightens rather than reduces the importance of this book to the specialist. More effective integration of pain management into the mainstream of medical practice should properly stimulate a more robust and productive interaction among pain specialists and primary care providers. Acceptance of pain management as a legitimate subspecialty and a broadening mandate to ensure adequate treatment of pain in all arenas has translated into demands for care that exceeds the current capacity of specialists. This argues for the deliberate cultivation of primary care resources capable of providing a fundamental level of safe and effective pain management that is likewise poised to recognize the need for appropriate specialist referral. Thus, familiarity with and support for the production and dissemination of texts like this is an important measure in which specialists and generalists share a common stake in meeting contemporary culture's demand for optimizing the delivery of effective pain management.

Martin M. Stechert, MD
Edited by a triumvirate of expert Northwestern University pain clinicians and researchers with backgrounds in oncology and palliative care, internal medicine, and advanced nursing, the resulting content is even and balanced. While some variety is apparent, there is an overall consistency of tone and style that though authoritative is still relaxed, thus Vol. 105, No. 3, September 2007