CHANGES IN HARRISON’S PRINCIPLES OF INTERNAL MEDICINE CATEGORISED. SYNOPSIS OF MAIN CHANGES IN 16TH EDITION! • this edition focuses more directly and extensively than ever on crucial aspects of clinical practice. Areas of emphasis include the approach to the patient, differential diagnosis, state-of-the-art treatment options, and disease prevention. • Key topics, such as the immune system and HIV infection/AIDS, are covered in chapters amounting to "mini-textbooks." • New sections offer information on the formidable challenges posed by critical care medicine and by the threat of bioterrorism. • New chapters provide coverage of highly relevant clinical topics such as disease screening, perimenopausal management and hormone replacement therapy, and end-of-life care. • Virtually every chapter in this edition has been substantially rewritten, and 46 chapters either are entirely new or have new authors. These is the changes in Harrison’s principles of internal medicine based on the information provided in the preface of the new edition. The changes, modifications and additions are listed under three headings I. New sections. II. New chapters III. Revised, rewritten or changed – topics revised from pervious editions,rewritten by new authors. IV. Categorical changes – Some topics have been grouped under specific headings for better understanding or few topics have been discussed in separate sections(eg. Infections by retroviruses.)because of the importance of such topics. I.NEW SECTIONS PART SEVEN — BIOTERRORISM AND CLINICAL MEDICINE • Microbial Terrorism — H. Clifford Lane/Anthony S. Fauci • Chemical Bioterrorism — Charles G. Hurst/Jonathan Newmark/James A. Romano Radiation Bioterrorism — Zelig A. Tochner/Ofer Lehavi/Eli Glatstein PART TEN — CRITICAL CARE MEDICINE • SECTION 1: RESPIRATORY CRITICAL CARE • Principles of Critical Care Medicine — John P. Kress/Jesse B. Hall • Respiratory Failure — Craig Lilly/Edward P. Ingenito/Steven D. Shapiro • Acute Respiratory Distress Syndrome — Bruce D. Levy/Steven D. • Shapiro • Mechanical Ventilatory Support — Edward P. Ingenito/Jeffrey M. Drazen • Section 2: Shock and Cardiac Arrest • Approach to the Patient with Shock — Ronald V. Maier • Severe Sepsis and Septic Shock — Robert S. Munford • Cardiogenic Shock and Pulmonary Edema — Judith S. Hochman/David Ingbar • Cardiovascular Collapse, Cardiac Arrest, and Sudden Cardiac Death — Robert J. Myerburg/Agustin Castellanos • Section 3: Neurologic Critical Care • Acute Confusional States and Coma — Allan H. Ropper • Critical Care Neurology — J. Claude Hemphill this part deals with three main areas: respiratory critical care, shock and cardiac arrest, and neurologic critical care. II. NEW CHAPTERS. PART 1-"INTRODUCTION TO CLINICAL MEDICINE," • Screening and Prevention of Disease — Gary J. Martin contains a new chapter discusses the principles and guidelines used in screening for common conditions such as cancer, hypertension, lipid disorders, and osteoporosis. • Medical Evaluation of the Surgical Patient — Gerald W. Smetana offers a pragmatic approach to the medical evaluation of patients who are about to undergo surgical procedures. • Palliative and End-of-Life Care — Ezekiel J. Emanuel / Linda L. Emanuel new chapter on this complex topic provides insights, information, and guidance to practitioners dealing with dying patients and their families PART THREE, -"GENETICS AND DISEASE," • Stem Cell and Gene Transfer in Clinical Medicine — David Bodine/J. Larry Jameson/Ron McKay The new chapter on stem cell and gene transfer in clinical medicine addresses a timely and controversial topic, defining different types of stem cells and discussing their potential clinical applications. PART SIX, "INFECTIOUS DISEASES • Clostridium difficile - Associated Disease, Including Pseudomembranous Colitis — Dale N. Gerding/Stuart Johnson The new chapter offers key information on the management of the complex clinical issues raised by Clostridium difficile-associated disease, including pseudomembranous colitis. • Common Viral Respiratory Infections & Severe Acute Respiratory Syndrome — Raphael Dolin Includes thorough coverage of severe acute respiratory syndrome (SARS). PART EIGHT, "DISORDERS OF THE CARDIOVASCULAR SYSTEM • ST-Segment Elevation Myocardial Infarction — Elliott M. Antman/Eugene Braunwald A new chapter covers the clinically important topics of unstable angina and non-ST-segment elevation myocardial infarction revised to reflect the latest trends and strategies for management. These include primary percutaneous coronary intervention for ST-segment elevation myocardial infarction as well as new drugs and devices for the treatment of heart failure PART NINE, "DISORDERS OF THE RESPIRATORY SYSTEM," • Lung Transplantation — Elbert P. Trulock/ G. Alexander Patterson/Joel D. Cooper a chapter by a new author that focuses on the selection of patients for lung transplantation • Pneumonia — Thomas J. Marrie/G. Douglas Campbell/David H. Walker/Donald E. Low New authors have also taken on the broad topic of pneumonia and lung abscess, providing focus and a clinical perspective to help the reader grasp the central issues involved in the diagnosis and management of both community-acquired and nosocomial disease. PART TWELVE, "DISORDERS OF THE GASTROINTESTINAL SYSTEM," • Familial Mediterranean Fever and Other Hereditary Recurrent Fevers — Daniel L. Kastner new chapter on familial Mediterranean fever. • Common Diseases of the Colon and Anorectum and Mesenteric Vascular Insufficiency — L. Gearhart/Gregory Bulkley PART THIRTEEN, "DISORDERS OF THE IMMUNE SYSTEM, CONNECTIVE TISSUE, AND JOINTS," • Fibromyalgia, Arthritis Associated with Systemic Diseases, and Other Arthritides — Bruce C. Gilliland Covers fibromyalgia, arthritis associated with systemic disease, and other arthritides. PART FOURTEEN, "Endocrinology and Metabolism • The Menopause Transition and Postmenopausal Hormone Therapy — JoAnn E. Manson/Shari S. Bassuk new chapter on the perimenopause transition and hormone replacement therapy. The writing of the latter chapter coincided with publication of results from the Women's Health Initiative that unexpectedly showed an increased risk of cardiovascular disease among women who received estrogen treatment, provides practical algorithms for the management of patients during this transition. • Disorders of Sexual Differentiation — John C. Achermann/J. Larry Jameson Newer chapter on disorders of sexual differentiation highlight novel insights derived from elucidation of the genetic basis of sex determination. • Wilson Disease — George J. Br new chapter on Wilson's disease reports on the substantially modified treatment recommendations for this entity. Disorders of Sexual Differentiation — John C. Achermann/J. Larry Jameson Newer chapter on disorders of sexual differentiation highlight novel insights derived from elucidation of the genetic basis of sex determination. PART FIFTEEN, "NEUROLOGIC DISORDERS • Parkinson's Disease and Other Movement Disorders — Mahlon R. DeLong/Jorge L. Juncos The new chapter on Parkinson's disease reviews the recent genetic findings and provides an authoritative approach to therapy, including surgical options • Prion Diseases — Stanley B. Prusiner/Bruce Miller Finally, the recognition of bovine spongiform encephalopathy in many regions of the world has focused the global health care community on the biology and clinical manifestations of prion diseases; the 16th edition of Harrison's includes a comprehensive review of this subject by Nobel Laureate Stanley Prusiner. • Alzeimer's Disease and Other Dementias — Thomas D. Bird/Bruce L. Miller A comprehensive new chapter on Alzheimer's disease and related dementias summarizes the recent explosion of knowledge on this topic, highlighting the new understanding of the genetics of these dementias and the molecules that trigger them as well as providing a clinical guide to diagnosis, differential diagnosis, and the latest treatments • Cerebrovascular Diseases — Wade S. Smith/S. Claiborne Johnston/J. Donald Easton The chapter on cerebrovascular diseases has been extensively rewritten, offering an evidence-based approach to the treatment and prevention of stroke, the third leading killer in the Western world • Multiple Sclerosis and Other Demyelinating Diseases — Stephen L. Hauser/Douglas S. Goode The updated chapter on multiple sclerosis presents the most recent advances in therapy and a practical approach to management of different stages of the disease. III. REVISED,REWRITTEN OR CHANGED. PART 1 INTRODUCTION TO CLINICAL MEDICINE • Women's Health — Andrea Dunaif entirely revised and offers a broad overview of the approach to disorders that affect women disproportionately PART 2 CARDINAL MANIFESTATIONS AND PRESENTATION OF DISEASES • Sexual Dysfunction — Kevin T. McVary The chapter on sexual dysfunction now addresses disorders in both men and women. PART 3 GENETICS AND DISEASE (revised) PART 4 NUTRITION(not much change I presume) PART 5 ONCOLOGY AND HEMATOLOGY Principles of Radiation Therapy — Stephen M. Hahn/Eli Glatstein The chapter delineating the principles of radiation therapy has been entirely rewritten by Eli Glatstein and is a companion piece to this author's chapter on radiation bioterrorism • Acute and Chronic Myeloid Leukemia — Meir Wetzler/John C. Byrd/Clara D. Bloomfield • Malignancies of Lymphoid Cells — James O. Armitage/Dan L. Longo The hematology section features the World Health Organization's new classification of lymphoid and myeloid neoplasms. • Antiplatelet, Anticoagulant, and Fibrinolytic Therapy — Steven R. Deitcher With development of novel agents to interfere with blood coagulation, the chapter on anticoagulant, fibrinolytic, and antiplatelet therapy reviews all these new products and their indications. PART 6 INFECTIOUS DISEASES • Viral Gastroenteritis — Umesh D. Parashar/Roger I. Glass • Staphylococcal Infections — Franklin D. Lowy • Brucellosis — Michael J. Corbel/Nicholas J. Beeching The latest advances in the management of diseases caused by staphylococci and nontuberculous mycobacteria, viral gastroenteritis, and brucellosis have been added. Common Viral Respiratory Infections & Severe Acute Respiratory Syndrome — Raphael Dolin • The superb chapter by Raphael Dolin on common viral respiratory infections has been expanded to include thorough coverage of severe acute respiratory syndrome (SARS). • Human Immunodeficiency Disease: AIDS and Related Disorders — Anthony S. Fauci/H. Clifford Lane Now placed in a separate section with the overview of the human retroviruses, the chapter on HIV infection and AIDS by Anthony S. Fauci and H. Clifford Lane has been completely revised and updated, with an emphasis on therapeutic strategies. This chapter is widely considered to be a classic in the field. PART 9 DISORDERS OF THE RESPIRATORY SYSTEM • New authors have taken on the broad topic of pneumonia and lung abscess, providing focus and a clinical perspective to help the reader grasp the central issues involved in the diagnosis and management of both community-acquired and nosocomial disease. PART 12 DISORDERS OF THE GASTROINTESTINAL SYSTEM • Approach to the Patient with Gastrointestinal Disease — William L. Hasler/Chung Owyang The chapter on the approach to the patient with gastrointestinal disease has been completely reworked by a new author • Acute Viral Hepatitis — Jules L. Dienstag/Kurt J. Isselbacher • Toxic and Drug-Induced Hepatitis — Jules L. Dienstag/Kurt J. Isselbacher • Chronic Hepatitis — Jules L. Dienstag/Kurt J. Isselbach The SE chapters on the various categories of viral hepatitis have been extensively revised and updated to reflect breakthrough advances in treatment. PART 13 DISORDERS OF THE IMMUNE SYSTEM, CONNECTIVE TISSUE, AND JOINTS • Disorders of Immune-Mediated Injury In the section on disorders of immune-mediated injury, the spondyloarthropathies have been grouped together in one chapte discusses the similarities and dissimilarities among the various diseases in this category • Autoimmunity and Autoimmune Diseases — Peter E. Lipsky/Betty Diamond Includes the advances in immunomodulatory therapy that have been realized in rheumatology over the past few years • Systemic Lupus Erythematosus — Bevra Hannahs Hahn • Rheumatoid Arthritis — Peter E. Lipsky the extensively revised chapters on rheumatoid arthritis and systemic lupus erythematosus. PART 14 ENDOCRINOLOGY AND METABOLISM • Bone and Mineral Metabolism in Health and Disease — F. Richard Bringhurst/Marie B. Demay/Stephen M. Krane/Henry M. Kronenberg outstanding new review of bone and mineral metabolism • Disorders of Lipoprotein Metabolism — Daniel J. Rader/Helen H. Hobbs chapter on disorders of lipoprotein metabolism offers a much sharper focus on the classification, diagnosis, and treatment of disorders of cholesterol and triglyceride metabolism, emphasizing the use of statins for the reduction of cardiovascular risk. PART 15 NEUROLOGIC DISORDERS • Cerebrovascular Diseases — Wade S. Smith/S. Claiborne Johnston/J. Donald Easton The chapter on cerebrovascular diseases has been extensively rewritten, offering an evidence-based approach to the treatment and prevention of stroke, the third leading killer in the Western world • Multiple Sclerosis and Other Demyelinating Diseases — Stephen L. Hauser/Douglas S. Goode The updated chapter on multiple sclerosis presents the most recent advances in therapy and a practical approach to management of different stages of the disease. PART 16 POISONING, DRUG OVERDOSE, AND ENVENOMATION(revised) IV.CATEGORICAL CHANGES. PART 6 INFECTIOUS DISEASES • Human Immunodeficiency Disease: AIDS and Related Disorders — Anthony S. Fauci/H. Clifford Lane Now placed in a separate section with the overview of the human retroviruses, the chapter on HIV infection and AIDS by Anthony S. Fauci and H. Clifford Lane has been completely revised and updated, with an emphasis on therapeutic strategies. This chapter is widely considered to be a classic in the field. PART 13 DISORDERS OF THE IMMUNE SYSTEM, CONNECTIVE TISSUE, AND JOINTS • Disorders of Immune-Mediated Injury In the section on disorders of immune-mediated injury, the spondyloarthropathies have been grouped together in one chapter discusses the similarities and dissimilarities among the various diseases in this category
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