Bick R L:

3rd edition, 464 pp, Baltimore, Lippincott Williams & Wilkins, 2002 ($125.00).

Bleeding and thrombotic disorders are common and challenging medical problems. Health care professionals who frequently encounter these patients would welcome a reference textbook that emphasizes the practical aspects of diagnosis and treatment. This multiple-authored textbook, which is now in its 3rd edition, was written to meet this need.

The book is organized into 20 chapters. The first is an introductory chapter on the basic physiology of hemostasis, focusing on blood vessels, platelets, and plasma proteins that comprise the coagulation and fibrinolytic systems. The remainder of the book is devoted to inherited and acquired bleeding disorders (nine chapters), inherited and acquired thrombotic disorders (four chapters), prophylaxis and treatment of thrombosis (five chapters), and hemostatic factors in atherothrombotic disease (one chapter).

There are several features that will be useful for diagnosis. Two separate chapters are devoted to the initial clinical evaluation of the bleeding patient and the thrombotic patient, respectively. This information will be useful in distinguishing inherited from acquired bleeding disorders, accurately diagnosing venous thromboembolism, and prioritizing further diagnostic testing. There are numerous tables providing comprehensive lists of vascular, platelet, coagulation, and thrombotic defects. These will be useful in developing differential diagnoses. There is a comprehensive listing of drugs that cause vascular defects and platelet function defects. The medicines are listed alphabetically by both generic and brand name to allow a quick search for a particular drug of interest.

There are also several features that will be useful for treatment. Detailed treatment recommendations with references are made for disorders that are common or difficult to manage, such as immune thrombocytopenic purpura and acquired factor VIII inhibitors. The sections on anticoagulant therapy contain useful protocols for the dosing and laboratory monitoring of warfarin, unfractionated heparin, and low molecular weight heparin. The section on thrombolytic therapy contains a useful table of dosing protocols for a variety of thrombolytic agents in different clinical conditions (e.g., catheter clearance, deep venous thrombosis, pulmonary embolism, acute ischemic stroke, etc.).

In summary this is a well-written, comprehensive, and extensively referenced textbook. It will be a valuable aid to pathologists, medical technologists, hematologists, and other medical specialists involved in the care of patients with hemostasis disorders.