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Neonatology & laboratory medicine
  1. I A Laing
  1. Simpson Centre for Reproductive Health, 51 Little France Crescent, Edinburgh EH16 4SU, Scotland, UK; ian.laingluht.scot.nhs.uk

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    A Green, I Morgan, K Gray. Guildford: ACB Venture Publications, 2003, £30.00, pp 312. ISBN 0902429418

    Neonatology & laboratory medicine is a novel concept and a valuable addition to our literature. The book brings together a clinical biochemist, a neonatologist, and a medical microbiologist as authors in a successful attempt to describe appropriate laboratory investigation and clinical management of the neonate. This paperback aims to provide junior doctors, laboratory scientists, and neonatal nurses with background information that will help solve common neonatal problems. The chapters deal systematically with common biochemical and infective problems that may befall neonates. There are also sections on breast feeding, parenteral nutrition, and therapeutics. Best of all it finishes with appendices including normal reference ranges and a useful glossary.

    The expenditure of £30 rewards the reader with more than 300 pages which are clear and well arranged. Tables and flow diagrams are easy to dip into. More senior readers may be frustrated that the book is not referenced, but recommended reading is provided at the end of each chapter.

    Three small criticisms and suggestions for the next edition.

    • The chapter entitled “Drugs and the neonate” is too short. The figure referring to biochemical and haematological monitoring cites only 11 drugs, ignoring commonly used drugs such as vecuronium, insulin, surfactant, salbutamol, 5-flucytosine, and steroids. Even those lucky 11 have curious omissions—for example, the oliguria and fluid retention associated with indomethacin.

    • Secondly the book recurrently ignores the unusual demands of the extreme preterm infant—for example, dilutional exchange for polycythaemia is said to be carried out in 10 ml aliquots, and does not recommend smaller volumes for the infant of 500 g whose total blood volume may be little more than 40 ml.

    • Thirdly the section on viral disease and transmission should be more detailed. “Low risk” is not quantitated, and CMV is described variously as “largely inactivated by freezing” and (one page later) “does not survive freezing”—an inconsistency that leaves the reader feeling insecure about such an important safety issue.

    Nevertheless this is a volume that is informative and attractive, from the cartoon of a neonate’s head (front cover) to the photograph of the three distinguished and pathologically cheerful authors at the end. For all professional staff there are 300 pages of clear descriptions containing information that will prove useful in organising investigations in the neonatal unit. There are also modern data which can be used to defend the embattled SHO against the predatory instincts of the consultant ward round. Every neonatal unit should purchase a copy. I predict that these valuable pages will be well thumbed within a month. I look forward to a further edition, and hope that it will extend its scope to include other laboratory disciplines such as genetics and electrophysiology. The three authors deserve success with this winner.

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