Book Reviews

Book 1Book Title: Getting into Residency: A Guide for Medical StudentsBook Author: Kenneth V. IsersonPp. xviii + 431. $28,95. Tucson: Galen Press. 1993. ISBN 1-883620-10-4.Book 2Book Title: Molecular Biology of Digestive DiseaseBook Author: Ed. by Philip QuirkePp. vii + 116. £15. London: BMJ. 1994. ISBN 0-7279-0827-8.Book 3Book Title: Parkinson's DiseaseBook Author:  Ed. by Merton Sandler.Pp. ix + 65. £12/US$24. London: John Libbey, 1993. ISBN 0-86196-404-7.Book 4Book Title: Brain Work and Mental Activity: Quantitative Studies With Radioactive TracersBook Author: Ed. by N. A. Lassen, D. A. Ingvar, M. A. Raichle & L. FribergPP. 446. Illustrated. Copenhagen: Munksgaard. 1991. ISBN 87-16-10698-9.Book 5Book Title: Guidelines for Quality Assurance Programmes for Blood Transfusion ServicesBook Author: WHOPp. IV + 50. (Available in English; French and Spanish in preparation). SFr.12/US$10,80 (in developing countries SFr.8,40). Geneva: WHO. 1993. ISBN 92-4-154448-1. Order No. 1150392.Book 6Book Title: ABC of AlcoholBook Author: Ed. by Alex PatonPp. ix + 32. illustrated. £10. London: BMJ. 1994. ISBN 0-7279-D812-X.Book 7Book Title: Atlas of Surgical Exposures ofthe Lower ExtremityBook Author: A. Masquelet, C. McCullough, R Tubiana, I. Fyfe, L. Klenerman, E. LetoumelPp. 414. Illustrated. London: Manin Dunitz. 1993. ISBN 1-85317-D03-8

Intoxication, criminal offences and suicide attempts in a group of South African problem drinkers

Background. Incidence rates of crime and alcohol abuse in South Africa are unacceptably high. Research suggests a relationship between alcohol and both crime and suicide. This study aims to add to the information base on this topic in South Africa. Methods. This is a cross-sectional record study of criminal offences and suicide attempts in 269 admissions to an alcohol rehabilitation unit in the Western Cape. Types of criminal offences and suicide attempts are described. Relationships are sought between crime, violent crime and suicide attempts on the one hand, and demographic and alcohol-related variables on the other. Results. One hundred and four subjects (39%) had criminal convictions, the majority of which were committed while the subjects were intoxicated. The commonest alcohol-related crimes were driving-related (17% of subjects) and crimes of violence (15%). Male gender, younger age at initiation of drinking, and earlier onset of problem drinking were significantly associated with criminal behaviour. Violent crime was associated with earlier onset of initial, regular and problem drinking, and maternal alcohol abuse. Suicide attempts (24% of subjects) were associated with female gender, white racial group, not being in a marital relationship, younger current age and early age of problem drinking. Conclusions. There was an association between intoxication and both violent crime and suicide attempts. The importance of population studies and the need for intervention programmes aimed at teenagers who are drinking, are emphasised.Articl

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran