Robert De Niro
1
Each chapter has plentiful tables that summarise key points. This proves to be very helpful, especially if the text is used as a quick reference guide. Indications and contraindications for drug therapies, criteria for diagnosis, criteria for adequate diabetes control, patient instructions for adjusting medication or diet in response to exercise or intercurrent illness all are examples of table contents. Shortcomings are few, and do not significantly detract from the overall effectiveness of the volume. There is considerable overlap of material in many chapters regarding risk factor reduction. Some readers may be frustrated by reference to studies for which the citations are never given. An annotated bibliography does follow each chapter, but it does not necessarily include the study noted in the text of the chapter. There is inconsistent use of trade versus generic names of drugs. An introductory chapter preceding the six chapters on medications used in type II diabetes would have been helpful. Errors are rare, though the one in which NIDDM is referred to as type I diabetes in the introductory paragraph of the chapter on hyperosmolar, hyperglycae- mic, non-ketotic coma was alarming. DeFronzo laments in his preface that the morbidity and mortality from diabetes mellitus is unacceptably high because most diabetics remain poorly controlled. Every physician who treats diabetes needs to treat it more effectively. DeFronzo has enhanced the possibility of achieving this by providing the information and recommendations for diabetes management in a skilfully packaged, highly readable, and very practical book. It is a book that belongs in the office exam room. Laura M Mumford Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21287, USA T his book is one of the volumes of the Current Therapy Series. 43 chapters are presented by 61 contributing authors. Every chapter is well written. Each begins with a brief review of the pertinent patho- physiology or pharmacology, followed by clinical management issues. The issues include clinical manifestations, therapeutic options, and, importantly, specific recommendations for treatment with explicit criteria for treatment goals. The entire spectrum of diabetes management is presented in five sections. They include diagnostic criteria and classification, type I and type II diabetes in the adult and child, complications of the disease, and the special problems of gestational diabetes, diabetes in pregnancy, and diabetes in the perioperative period. Ralph DeFronzo has succeeded admirably in meeting his goals of simplicity and pragmatism for this guide to the comprehensive management of the diabetic patient in all age groups. This volume is a valuable addition to the library of all primary care physicians and other providers. The emphasis is on practicality and specificity. Recommenda- tions for intervention are precise and include drug dosage, and diet and exercise guidelines. The chapters on the use of insulin in type I and type II diabetes cover all clinical situations that the prac- titioner faces. They provide detailed and comprehen- sive management of each situation. Similarly, the authors effectively present the practical use of the oral agents, including the non- sulphonamides now avail- able (Rezulin [troglitazone], Glucophage [metformin], Precose [acarbose]), alone and in combination. They also cover the combination THE LANCET • Vol 351 • June 6, 1998 1743 DISSECTING ROOM DISSECTING ROOM Robert De Niro Philip Benson, David Perrett The figure on the left is an original photograph of the actor Robert De Niro, the one on the right a computer-generated caricature. They feature in a unique exhibition that explores the science of face perception. Each theme in the exhibition uses computer-manipulated graphics in the reproduction of portraits from the collections of the Scottish National Portrait Gallery, Edinburgh, UK, where the exhibition is being held. The displays are juxtaposed and integrated with portraits of many famous and historical people in various artistic styles including works by Richard Dadd, Alexander Moffat, and Anthony Van Dyck. The Science of the Face ends on Aug 2, 1998. Deconstructing diabetes therapy of insulin with oral agents. Importantly, the authors state explicitly what the clinical criteria are for considering each therapeutic option. Similarly, the measures of therapeutic success are precise. This readily allows the reader to have the confidence to try different drug regimens and to attempt to achieve the stringent expectations advocated by the authors for ideal diabetes control (fasting glucose <140 mg/dL and HgbA1C <7·0%). DeFronzo also used the same approach of providing practical man- agement algorithms with specific recommendations for treatment end- points or drug dosing in the chapters about the complications of autonomic and peripheral neuropathy, diabetic eye diseases, and concurrent hypertension or dyslipidaemia. He wrote the chapter on diabetic nephropathy and the use of urine microalbumin, and this chapter is especially well done. Current Therapy of Diabetes Mellitus Ralph A DeFronzo. St Louis, MO: Mosby. 1998. Pp 273. $59.95. ISBN 0-8151-2757-X Philip Benson and David Perrett
-
Upload
philip-benson -
Category
Documents
-
view
215 -
download
2
Transcript of Robert De Niro
Each chapter has plentiful tables thatsummarise key points. This proves tobe very helpful, especially if the text isused as a quick reference guide.Indications and contraindications fordrug therapies, criteria for diagnosis,criteria for adequate diabetes control,patient instructions for adjustingmedication or diet in response toexercise or intercurrent illness all areexamples of table contents.
Shortcomings are few, and do notsignificantly detract from the overalleffectiveness of the volume. There isconsiderable overlap of material inmany chapters regarding risk factorreduction. Some readers may befrustrated by reference to studies forwhich the citations are never given. Anannotated bibliography does followeach chapter, but it does notnecessarily include the study noted inthe text of the chapter. There isinconsistent use of trade versus genericnames of drugs. An introductorychapter preceding the six chapters onmedications used in type II diabeteswould have been helpful. Errors arerare, though the one in which NIDDM
is referred to as type Idiabetes in the introductoryparagraph of the chapter onhyperosmolar, hyperglycae-mic, non-ketotic coma wasalarming.
DeFronzo laments inhis preface that themorbidity and mortalityfrom diabetes mellitus isunacceptably high becausemost diabetics remainpoorly controlled. Everyphysician who treatsdiabetes needs to treat itmore effectively. DeFronzohas enhanced the possibilityof achieving this byproviding the informationand recommendations fordiabetes management in askilfully packaged, highlyreadable, and very practicalbook. It is a book thatbelongs in the office examroom.
Laura M MumfordDepartment of Medicine,Johns Hopkins University,School of Medicine,Baltimore, MD 21287, USA
This book is one of the volumesof the Current Therapy Series.43 chapters are presented by 61
contributing authors. Every chapter iswell written. Each begins with a briefreview of the pertinent patho-physiology or pharmacology, followedby clinical management issues. Theissues include clinical manifestations,therapeutic options, and, importantly,specific recommendations fortreatment with explicit criteria fortreatment goals.The entire spectrum ofdiabetes management is presented infive sections. They include diagnosticcriteria and classification, type I andtype II diabetes in the adult and child,complications of the disease, and thespecial problems of gestationaldiabetes, diabetes in pregnancy, anddiabetes in the perioperative period.
Ralph DeFronzo has succeededadmirably in meeting his goals ofsimplicity and pragmatism for this guideto the comprehensivemanagement of thediabetic patient in all agegroups. This volume is avaluable addition to thelibrary of all primary carephysicians and otherproviders. The emphasis ison practicality andspecificity. Recommenda-tions for intervention areprecise and include drugdosage, and diet andexercise guidelines. Thechapters on the use ofinsulin in type I and type IIdiabetes cover all clinicalsituations that the prac-titioner faces. They providedetailed and comprehen-sive management of eachsituation. Similarly, theauthors effectively presentthe practical use of the oralagents, including the non-sulphonamides now avail-able (Rezulin [troglitazone],Glucophage [metformin],Precose [acarbose]), aloneand in combination. Theyalso cover the combination
THE LANCET • Vol 351 • June 6, 1998 1743
DISSECTING ROOM
DISSECTING ROOM
Robert De Niro Philip Benson, David Perrett
The figure on the left is an original photograph of the actorRobert De Niro, the one on the right a computer-generatedcaricature.They feature in a unique exhibition that exploresthe science of face perception. Each theme in the exhibitionuses computer-manipulated graphics in the reproduction ofportraits from the collections of the Scottish NationalPortrait Gallery, Edinburgh, UK, where the exhibition isbeing held.The displays are juxtaposed and integrated withportraits of many famous and historical people in variousartistic styles including works by Richard Dadd, AlexanderMoffat, and Anthony Van Dyck. The Science of the Face endson Aug 2, 1998.
Deconstructing diabetes
therapy of insulin with oral agents.Importantly, the authors state explicitlywhat the clinical criteria are forconsidering each therapeutic option.Similarly, the measures of therapeuticsuccess are precise. This readily allowsthe reader to have the confidence to trydifferent drug regimens and to attemptto achieve the stringent expectationsadvocated by the authors for idealdiabetes control (fasting glucose <140mg/dL and HgbA1C <7·0%).
DeFronzo also used the sameapproach of providing practical man-agement algorithms with specificrecommendations for treatment end-points or drug dosing in the chaptersabout the complications of autonomicand peripheral neuropathy, diabetic eyediseases, and concurrent hypertensionor dyslipidaemia. He wrote the chapteron diabetic nephropathy and the use ofurine microalbumin, and this chapter isespecially well done.
Current Therapy of Diabetes MellitusRalph A DeFronzo. St Louis, MO: Mosby. 1998. Pp 273. $59.95.ISBN 0-8151-2757-X
Phi
lip B
enso
n an
d D
avid
Per
rett
