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A Guide To Laboratory Investigations.
  1. S J IQBAL, Consultant in Biochemical Medicine
  1. Leicester Royal Infirmary, Leicester, UK

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    A Guide To Laboratory Investigations. 3rd Edition. By Michael McGhee. (Pp 163; £17.95.) Radcliffe Medical Press, 2000. ISBN 1-85775-357-7.**

    This book aims to be a reference for general practitioners, their practice nurses, and hospital doctors “alike”. There are six sections: haematology, microbiology, fertility and pregnancy testing, rheumatology, biochemistry, miscellaneous and there is a useful glossary of acronyms. In each section there are lists of laboratory tests and interpretative comments.

    Much of the book is useful. However, some tests are given disproportionate description relative to the importance of utility, for example, faecal urobilinogen—has it ever been requested by anyone? Faecal fats and toxoplasmosis, including treatment, are mentioned extensively but nothing on treatment of urinary tract infections. Many tests are obsolete: urinary keto/oxosteroid, plasma oestriols, Rose-Waaler test, Lange curve. Some results units are unsuitable, for example, urinary sodium, given as mean and range, in mmol/l and mEq/l (not used in the UK). Some interpretative advice is worryingly misleading; “decreased sodium may be found in: diarrhoea and vomiting, glycosuria . . ..” but no mention of mineralocorticoid deficiency—including Addison's disease or dilutional hyponatraemia. “Hypercalcaemia . . .. at >3.7 mmol/l cardiac complications can be fatal”, yet no mention of possible serious dysrhythmias with a high potassium. “Samples for suspected primary hyperparathyroidism should be taken on three consecutive days”; this is no longer necessary.

    Although a small book, trying to cater for the varying needs is unlikely to meet everyone's expectations, there are too many examples of a lack of reliable information in how to undertake tests and how to interpret the results. It is not on my recommended list.