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Blood lead sampling has demonstrated an almost universal low-level elevation in inner-city children. The ingestion of lead paint chips is questioned as the main source of this exposure. Dust containing lead was found on the hands of inner-city children and interior household surfaces in substantially larger amounts than in similar suburban settings. It is possible that children may ingest this lead through typically frequent mouthing activity.

Lead poisoning in the 1970s has changed. The dramatic picture of a comatose child with lead encephalopathy seen from time to time in a municipal hospital has fortunately become a rarity. Instead, we are now in the midst of a "silent epidemic" of lead poisoning that may, by conservative estimates, involve hundreds of thousands of children. Risks to these children are uncertain, environmental correction is at best frustrating, and medical management decisions falter under the staggering numbers of children, unclear treatment guidelines, and inadequate follow-up. As concerned pediatricians, we are in the middle, in a key position to formulate plans and press for appropriate action, yet we are faced with new issues in unfamiliar territory. Since people will look to us for guidance, how should we act and by what should we be guided? FORMER APPROACH Formerly, we dealt with the problem on a single case basis. Over the years,

The "house officer's bible" has been revised once more, this time with Jerry Finkelstein as the solo editor. This handy pocket-sized book, by now a classic for the hassled pediatric house officer, has been a standard compendium of laboratory values, drugs, dosages, growth tables, and pediatric procedures for as long as most of us have been seeing children. Its purpose and design has changed little over the years; there's no need for it to change, for it fills a niche in the reference material needed by the largely inpatient-oriented physician caring for children. The user must be careful not to use it as more than a convenient source of refreshing the memory on material easily forgotten or impossible to learn. It is not a text to be read for understanding diseases or to use in selecting laboratory tests to help in making a diagnosis.The last manual was published in

This is an important and timely book. Although the title suggests that the province of Nova Scotia has made a routine review of factors in child abuse, this volume is actually a unique and comprehensive study of an entire protective care system. The authors and their team have undertaken an extensive and critical review of all cases of abuse and maternal deprivation identified in Nova Scotia's hospitals over a five-year period. This case review looked carefully at the children who were presented to and studied in hospitals, examined a number of social factors in their families, and made a careful follow-up of the children's later progress. The case study then proceeds to examine the management of the children by the welfare workers and to review the way in which the courts handled those referred for court action. The review is often critical and points out a number of inadequacies in

The tenth edition of the "Handbook" is an excellent updating of previous texts. Much material has been rewritten and reorganized in better and more logical style. The stated purposes of the book are stringently adhered to: to provide a compact, clinically oriented, abbreviated and yet extensive survey of pediatric diseases and their management. This little pocket-sized book, now translated into eight foreign languages, is quite clearly written to serve a wide diversity of audiences around the world. The American user must keep this in mind when he sees that entities such as tularemia, amebiasis, and poliomyelitis are given more complete coverage than gonorrhea, renal tubular defects, and minor orthopedic problems of the foot.Coverage of the newborn has been particularly well done, I believe. In the ninth edition, the organization was divided among the newborn infant, the premature infant, and the low-birthweight infant. With this edition, however, the authors have