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Neurohospitalist Medicine
Edited by: S. Andrew Josephson, W. David Freeman, and David J. Likosky
Pages: 244    Soft Cover
ISBN:
9780521172547
Cambridge University Press  November 2011
List Price:  $69.95

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Medical Science Books .com  Medical Book Review:    

     The improvements in medical imaging and advancements in clinical knowledge regarding the possibilities of positive intervention in pathological nervous system functioning are changing the daily practice of Neurology.  Neurohospitalist Medicine is one of the first publications that recognize these changes on a large scale which reaches beyond advancements in particular aspects of practice.  It is the stated goal of the editors that their book serve as a preliminary guide for those involved with inpatient care of those with neurological symptoms.  In particular, Neurohospitalist Medicine was written with an eye toward beginning the preparation of a select group of neurologists who will fill the gaps in the medical system by dedicating the majority of their clinical activities to inpatient care. 

     An excellent choice and arrangement of neurological issues commonly addressed in the hospital was made by the editors within relatively few pages, making it highly accessible to the busy professional.  They effectively combine both traditional emergency/critical care issues like acute stroke care with patient management issues dealing with a variety of other procedures and conditions such as perioperative management of patients with Parkinson’s disease.  It also includes a chapter on the brain death evaluation, an area of expertise on which neurologists are routinely consulted in the ICU. 

     Beyond the inclusion of particular topics pertinent to the hospitalist which could be found in many other sources, the final two chapters deal directly with the work of outlining and speculating on the potential new roles neurologists will begin to take on in the hospital.  The first of these chapters deals with the special ethical dilemmas which arise from many of the common neurological consultations done in the hospital, such as determining the capacity of a patient to make decisions about their care.  Neurologists should presumably be among the most versed in facilitating touch decisions that need to be made regarding patients with critical injuries with poor prognoses based on neurological functioning.  The book goes on to mention several other ethical scenarios commonly seen in patient management in which the Neurohospitalist might also be an appropriate source of support and guidance.  The final chapter of the book is a more comprehensive view of how the Neurohospitalist might function within the context of several different medical center models of care, specifically academic, hospital employee, and private practice. 

     Overall, the final chapter which discusses the administration of Neurohospitalist practice is the most unique and original aspect of this title.  Unfortunately, it is also one of the shortest chapters and further expansion on the ideas expressed would have made a much stronger statement for both the need and proposed functioning of such subspecialty practice.  Nonetheless, the editors have placed this discussion of neurology practice and care for hospitalized patients on a larger scale and made it more accessible for further consideration and the addition of fresh ideas as managed care moves toward the expansion of hospital medicine.

     This title will be of interest to all physicians involved in hospital medicine and should be given special consideration by neurologists in training as the integration of neurology with internal medicine and hospital medicine will likely be a prominent part of their practice.

Ratings (1-4 , 4 being the highest):

Organization of information:    3

Usefulness of book:     3.5

Suitable for intended audience:    4

Author’s objectives met:  3.5   

Significant number of illustrations:     2

Quality of illustrations:    3

 

Description:   

Over the past decade, the hospitalist model has become a dominant system for the delivery of inpatient care. Forces such as national mandates to improve safety and quality, and intense pressure to safely reduce length of hospital stays, are now exerting pressure on neurologists. To meet these challenges, a new neurohospitalist model is emerging. This is the first authoritative text to detail the advances and strategies for treating neurologic disease in a hospital setting. It includes chapters on specific acute neurologic diseases including stroke, epilepsy, neuromuscular disease and traumatic brain injury and also addresses common reasons for neurologic consultation in the hospital including encephalopathy, electrolyte disturbances and neurologic complications of pregnancy. Ethical and structural issues commonly encountered in neurologic inpatients are also addressed. This will be a key resource for any clinician or trainee caring for neurologic patients in the hospital including practising neurologists, internists and trainees across multiple subspecialities.

Features:

• Includes recommended treatment plans for many neurologic inpatient conditions for quick and accurate treatment
• Contains practical algorithms that help clinicians care for inpatients with neurologic disorders
• Explores important and ethical issues related to neurohospitalist care

Table of Contents:

1. Cerebrovascular disease: ischemic Kevin M. Barrett and Thomas G. Brott
2. Cerebrovascular disease: hemorrhagic Edward M. Manno
3. Seizures and status epilepticus David McCollum and William O. Tatum IV
4. Neuromuscular disorders Marcarena Cabrera Serrano and Alejandro Rabinstein
5. Coma, delirium and other disorders of consciousness Arielle Davis and Sandeep Khot
6. Neurologic complications of electrolytes Dimitriy Levin and Jeffrey J. Glasheen
7. Inpatient management of neuro-oncology patients John W. Henson and Jennifer Wulff
8. CNS infections Todd Czartoski
9. Spinal cord disease in the hospitalized patient Leslie A. Gillum and John W. Engstrom
10. Neurologic complications of systemic disorders Brian J. Scott
11. Management of traumatic brain injury David Palestrant
12. Perioperative neurologic disorders David J. Blacker and Janavi Danuwille
13. Neurological complications of pregnancy Carmel Armon and Glenn R. Markenson
14. Hypoxic ischemic brain injury Sarkis Morales-Vidal, Maria Baldwin, Michael J. Schneck and José Biller
15. The diagnosis of brain death David M. Greer and Patricia D. Scripko
16. Ethical issues in hospitalist and inpatient neurology Winston Chiong
17. Structural issues for neurohospitalists Ira Chang
Index.