Birth Defects Encyclopedia.

The Center for Birth Defects Information Services is an independent, nonprofit, international scientific collaborative. One of its primary objectives is to provide ongoing communication of and access to current information about birth defects. The achievement of this objective is reflected in the publication of the Birth Defects Encyclopedia.

The preface touches on the challenges that clinicians face in diagnosing and treating birth defects and that also led to the creation of the Center. Part 1 contains instructions on how to use the Encyclopedia and descriptions of the related services that the Center offers.

Contributions from an international pool of over 1,000 authors, editors, and illustrators make up the over 2,000 articles and 1,700 illustrations contained in part 2. Articles are arranged alphabetically, with encyclopedia headings at the top of each page. Each article follows a specific format with consistent elements arranged in a consistent order. Illustrations are made up primarily of photographs, but other graphic material such as diagrams are also included.

Listings in the encyclopedia are anatomically and biomedically based. Conditions that are known by more than one name are extensively cross-referenced in the article itself and in the Master Index. Outdated names, if still in use, are listed in the article, but are followed by the word "obsolete." The word "pejorative" may also appear if objections to use of the term exist.

Major diagnostic criteria and descriptive summaries of the clinical features associated with each condition or syndrome are presented.

Information on the frequency of clinical findings is included if available. Complications resulting from the primary condition and other anomalies that are frequently associated with the primary condition are described. Each article also includes information on the etiology, pathogenesis, incidence, and prevalence of the condition; sex ratio; risk of recurrence for the patient's siblings and for the patient's child if appropriate; age of detectability; gene mapping and linkage; and prevention, treatment, prognosis, and detection of the carrier. A "special considerations" element is used to present information that is not appropriate for inclusion in other sections of the article, such as facts of historical interest, theories, or work in progress.

Support groups are listed when they are known to exist. In most instances, only the name of the organization, the city, and the country, if outside the United States, are given. Additional sources that may be helpful in locating support services are listed in part 1.

Articles conclude with a short list of references. The objective is not to provide an exhaustive bibliography, but rather to provide the reader with key sources and an appropriate entry point into the literature on each subject.

The Center's related services are also worth mentioning. A FAX service is available that allows readers to request a current, updated version of any article in the encyclopedia. Of interest to researchers and diagnosticians is an on-line database that makes the full text of the encyclopedia available for on-line search and retrieval. In addition, the Center offers a medical diagnostic support software program called Micro BDIS that is designed for personal computers. Readers interested in these services should contact the Center for more detailed information.

A true encyclopedia, this reference book attempts to provide the maximum amount of information in the least amount of space. With this objective in mind, I found it to be quite comprehensive in scope and variety. Individuals looking for basic information on a rare or unfamiliar condition would welcome this reference. Also, a particular advantage to this reference is the ability to obtain updated copies of articles through the Center's FAX line. However, readers looking for more exhaustive information on a particular topic would probably wish to search the literature further.

The consistency of the organization and format of each article and the extensive cross-referencing enhances the Encyclopedia's ease of use. Because the language of the text is anatomically and biochemically based, however, some of the terminology may be difficult for the nonphysician to understand without further explanation or clarification.

The price of this text may make it prohibitive for the individual therapist's library. Pediatric rehabilitation departments, however, particularly those associated with large regional medical centers, teaching hospitals, or diagnostic centers, that see a wide and varied number of clients may find this a worthwhile reference to add to their libraries.

Gretchen Meyer, PT Easter Seal Rehabilitation Center Peoria, Ill