HARRISON'S IS MEDICINE! Introducing the Landmark Twentieth Edition of the Global Icon of Internal Medicine The definitive guide to internal medicine is more essential than ever with the latest in disease mechanisms, updated clinical trial results and recommended guidelines, state-of-the art radiographic images, therapeutic approaches and specific treatments, hundreds of demonstrative full-color drawings, and practical clinical decision trees and algorithms Recognized by healthcare professionals worldwide as the leading authority on applied pathophysiology and clinical medicine, Harrison's Principles of Internal Medicine gives you the informational foundation you need to provide the best patient care possible. Essential for practice and education, the landmark 20th Edition features: Thoroughly revised content-covering the many new breakthroughs and advances in clinical medicine that have occurred since the last edition of Harrison's. Chapters on acute and chronic hepatitis, management of diabetes, immune-based therapies in cancer, multiple sclerosis, cardiovascular disease, HIV, and many more, deliver the very latest information on disease mechanisms, diagnostic options, and the specific treatment guidance you need to provide optimal patient care. State-of-the-art coverage of disease mechanisms: Harrison's focuses on pathophysiology with rigor, and with the goal of linking disease mechanisms to treatments. Improved understanding of how diseases develop and progress not only promotes better decision-making and higher value care, but also makes for fascinating reading and improved retention. Harrison's summarizes important new basic science developments, such as the role of mitochondria in programmed and necrotic cell death, the immune system's role in cancer development and treatment, the impact of telomere shortening in the aging and disease processes, and the role of the microbiome in health and disease. Understanding the role of inflammation in cardiovascular disease, the precise mechanisms of immune deficiency in HIV/AIDS, prions and misfolded proteins in neurodegenerative diseases, and obesity as a predisposition to diabetes are just a few examples of how this edition provides essential pathophysiology information for health professionals. All-new sections covering a wide range of new and emerging areas of vital interest to all healthcare professionals. New sections include: Sex and Gender-based Issues in Medicine; Obesity, Diabetes Mellitus, and Metabolic Syndrome; and Consultative Medicine- Plus, a new Part covering cutting-edge topics in research and clinical medicine includes great new chapters on the role of Epigenetics in Health and Disease, Behavioral Strategies to Improve Health, Genomics and Infectious Diseases, Emerging Neuro-Therapeutic Technologies, and Telomere Function in Health and Disease, and Network System Medicine. Important and timely new chapters-such as Promoting Good Health, LGBT Health, Systems of Healthcare, Approach to Medical Consultation, Pharmacogenomics, Antimicrobial Resistance, Worldwide Changes in Patterns of Infectious Diseases, Neuromyelitis Optica, and more-offer the very latest, definitive perspectives on must-know topics in medical education and practice. Updated clinical guidelines, expert opinions, and treatment approaches from world-renowned editors and authors contribute to the accuracy and immediacy of the text material and present a clear blueprint for optimizing patient outcomes. End-of-chapter suggested readings reinforce the text material and provide a robust platform for further study and research.
CONTRIBUTORSPREFACEPart 1: The Profession of Medicine 1 The Practice of MedicineThe Editors 2 Promoting Good HealthDonald M. Lloyd-Jones, Kathleen M. McKibbin 3 Decision-Making in Clinical MedicineDaniel B. Mark, John B. Wong 4 Screening and Prevention of DiseaseKatrina A. Armstrong, Gary J. Martin 5 Health Care Systems in Developed CountriesRichard B. Saltman 6 The Safety and Quality of Health CareDavid W. Bates 7 Racial and Ethnic Disparities in Health CareJoseph R. Betancourt, Alexander R. Green 8 Ethical Issues in Clinical MedicineBernard Lo, Christine Grady 9 Palliative and End-of-Life CareEzekiel J. Emanuel Part 2: Cardinal Manifestations and Presentation of Diseases Section 1: Pain 10 Pain: Pathophysiology and ManagementJames P. Rathmell, Howard L. Fields 11 Chest DiscomfortDavid A. Morrow 12 Abdominal PainDanny O. Jacobs 13 HeadachePeter J. Goadsby 14 Back and Neck PainJohn W. Engstrom Section 2: Alterations in Body Temperature 15 FeverCharles A. Dinarello, Reuven Porat 16 Fever and RashElaine T. Kaye, Kenneth M. Kaye 17 Fever of Unknown OriginChantal P. Bleeker-Rovers, Jos W. M. van der Meer Section 3: Nervous System Dysfunction 18 SyncopeRoy Freeman 19 Dizziness and VertigoMark F. Walker, Robert B. Daroff 20 FatigueJeffrey M. Gelfand, Vanja C. Douglas 21 Neurologic Causes of Weakness and ParalysisMichael J. Aminoff 22 Numbness, Tingling, and Sensory LossMichael J. Aminoff 23 Gait Disorders, Imbalance and FallsJessica M. Baker, Lewis R. Sudarsky 24 Confusion and DeliriumS. Andrew Josephson, Bruce L. Miller 25 DementiaWilliam W. Seeley, Bruce L. Miller 26 Aphasia, Memory Loss, Hemispatial Neglect, Frontal Syndromes and Other Cerebral DisordersM.-Marsel Mesulam 27 Sleep DisordersThomas E. Scammell, Clifford B. Saper, Charles A. Czeisler Section 4: Disorders of Eyes, Ears, Nose, and Throat 28 Disorders of the EyeJonathan C. Horton 29 Disorders of Smell and TasteRichard L. Doty, Steven M. Bromley 30 Disorders of HearingAnil K. Lalwani 31 Sore Throat, Earache, and Upper Respiratory SymptomsMichael A. Rubin, Larry C. Ford, Ralph Gonzales 32 Oral Manifestations of DiseaseSamuel C. Durso Section 5: Alterations in Circulatory and Respiratory Functions 33 DyspneaRebecca M. Baron 34 Cough Christopher H. Fanta 35 HemoptysisAnna K. Brady, Patricia A. Kritek 36 Hypoxia and CyanosisJoseph Loscalzo 37 EdemaEugene Braunwald, Joseph Loscalzo 38 Approach to the Patient with a Heart MurmurPatrick T. O'Gara, Joseph Loscalzo 39 PalpitationsJoseph Loscalzo Section 6: Alterations in Gastrointestinal Function 40 DysphagiaIkuo Hirano, Peter J. Kahrilas 41 Nausea, Vomiting, and IndigestionWilliam L. Hasler 42 Diarrhea and ConstipationMichael Camilleri, Joseph A. Murray 43 Unintentional Weight LossJ. Larry Jameson 44 Gastrointestinal BleedingLoren Laine 45 JaundiceSavio John, Daniel S. Pratt 46 Abdominal Swelling and AscitesKathleen E. Corey, Lawrence S. Friedman Section 7: Alterations in Renal and Urinary Tract Function 47 Dysuria, Bladder Pain, and the Interstitial Cystitis/ Bladder Pain SyndromeJohn W. Warren 48 Azotemia and Urinary AbnormalitiesDavid B. Mount 49 Fluid and Electrolyte DisturbancesDavid B. Mount 50 Hypercalcemia and HypocalcemiaSundeep Khosla 51 Acidosis and AlkalosisThomas D. DuBose, Jr. Section 8: Alterations in the Skin 52 Approach to the Patient with a Skin DisorderKim B. Yancey, Thomas J. Lawley 53 Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin DisordersLeslie P. Lawley, Calvin O. McCall, Thomas J. Lawley 54 Skin Manifestations of Internal DiseaseJean L. Bolognia, Irwin M. Braverman 55 Immunologically Mediated Skin DiseasesKim B. Yancey, Thomas J. Lawley 56 Cutaneous Drug ReactionsRobert G. Micheletti, Misha Rosenbach, Bruce U. Wintroub, Kanade Shinkai 57 Photosensitivity and Other Reactions to LightAlexander G. Marneros, David R. Bickers Section 9: Hematologic Alterations 58 Interpreting Peripheral Blood Smears Dan L. Longo 59 Anemia and PolycythemiaJohn W. Adamson, Dan L. Longo 60 Disorders of Granulocytes and MonocytesSteven M. Holland, John I. Gallin 61 Bleeding and ThrombosisBarbara A. Konkle 62 Enlargement of Lymph Nodes and SpleenDan L. Longo Part 3: Pharmacology 63 Principles of Clinical PharmacologyDan M. Roden 64 PharmacogenomicsDan M. Roden Part 4: Oncology and Hematology Section 1: Neoplastic Disorders 65 Approach to the Patient with CancerDan L. Longo 66 Prevention and Early Detection of CancerJennifer M. Croswell, Otis W. Brawley, Barnett S. Kramer 67 Cancer GeneticsFred Bunz, Bert Vogelstein 68 Cancer Cell BiologyJeffrey W. Clark, Dan L. Longo 69 Principles of Cancer TreatmentEdward A. Sausville, Dan L. Longo 70 Infections in Patients with CancerRobert W. Finberg 71 Oncologic EmergenciesRasim Gucalp, Janice P. Dutcher 72 Cancer of the SkinBrendan D. Curti, Sancy Leachman, Walter J. Urba 73 Head and Neck CancerEverett E. Vokes 74 Neoplasms of the LungLeora Horn, Christine M. Lovly 75 Breast CancerDaniel F. Hayes, Marc E. Lippman 76 Upper Gastrointestinal Tract CancersRobert J. Mayer 77 Lower Gastrointestinal CancersRobert J. Mayer 78 Tumors of the Liver and Biliary TreeJosep M. Llovet 79 Pancreatic CancerDaniel D. Von Hoff 80 Neuroendocrine Tumors of the Gastrointestinal Tract and PancreasRobert T. Jensen 81 Renal Cell CarcinomaRobert J. Motzer 82 Cancer of the Bladder and Urinary TractNoah M. Hahn 83 Benign and Malignant Diseases of the ProstateHoward I. Scher, James A. Eastham 84 Testicular CancerDavid J. Vaughn 85 Gynecologic MalignanciesDavid Spriggs 86 Primary and Metastatic Tumors of the Nervous SystemLisa M. DeAngelis, Patrick Y. Wen 87 Soft Tissue and Bone Sarcomas and Bone MetastasesShreyaskumar R. Patel 88 Carcinoma of Unknown PrimaryGauri R. Varadhachary, James L. Abbruzzese 89 Paraneoplastic Syndromes: Endocrinologic/HematologicJ. Larry Jameson, Dan L. Longo 90 Paraneoplastic Neurologic Syndromes and Autoimmune EncephalitisJosep Dalmau, Myrna R. Rosenfeld 91 Late Consequences of Cancer and Its TreatmentCarl E. Freter, Dan L. Longo Section 2: Hematopoietic Disorders 92 Hematopoietic Stem CellsDavid T. Scadden, Dan L. Longo 93 Iron Deficiency and Other Hypoproliferative Anem iasJohn W. Adamson 94 Disorders of HemoglobinEdward J. Benz, Jr. 95 Megaloblastic AnemiasA. Victor Hoffbrand 96 Hemolytic Anemias Lucio Luzzatto 97 Anemia Due to Acute Blood LossDan L. Longo 98 Bone Marrow Failure Syndromes Including Aplastic Anemia and MyelodysplasiaNeal S. Young 99 Polycythemia Vera and Other Myeloproliferative NeoplasmsJerry L. Spivak 100 Acute Myeloid LeukemiaWilliam Blum, Clara D. Bloomfield 101 Chronic Myeloid LeukemiaHagop Kantarjian, Jorge Cortes 102 Acute Lymphoid LeukemiaDieter Hoelzer 103 Chronic Lymphocytic LeukemiaJennifer A. Woyach, John C. Byrd 104 Non-Hodgkin's LymphomaCaron A. Jacobson, Dan L. Longo 105 Hodgkin's Lymphoma Caron A. Jacobson, Dan L. Longo 106 Less Common Hematologic MalignanciesAyalew Tefferi, Dan L. Longo 107 Plasma Cell DisordersNikhil C. Munshi, Dan L. Longo, Kenneth C. Anderson 108 AmyloidosisJohn L. Berk, Vaishali Sanchorawala 109 Transfusion Biology and TherapyJeffery S. Dzieczkowski, Pierre Tiberghien, Kenneth C. Anderson 110 Hematopoietic Cell TransplantationFrederick R. Appelbaum Section 3: Disorders of Hemostasis 111 Disorders of Platelets and Vessel WallBarbara A. Konkle 112 Coagulation DisordersValder R. Arruda, Katherine A. High 113 Arterial and Venous ThrombosisJane E. Freedman, Joseph Loscalzo 114 Antiplatelet, Anticoagulant, and Fibrinolytic DrugsJeffrey I. Weitz Part 5: Infectious Diseases Section 1: Basic Considerations in Infectious Diseases 115 Approach to the Patient with an Infectious DiseaseNeeraj K. Surana, Dennis L. Kasper 116 Molecular Mechanisms of Microbial PathogenesisGerald B. Pier 117 Approach to the Acutely Ill Infected Febrile PatientTamar F. Barlam, Dennis L. Kasper 118 Immunization Principles and Vaccine UseNancy Messonnier, Anne Schuchat, Lisa A. Jackson 119 Health Recommendations for International TravelJay S. Keystone, Phyllis E. Kozarsky 120 Climate Change and Infectious DiseaseAaron S. Bernstein Section 2: Clinical Syndromes: Community-Acquired Infections 121 PneumoniaLionel A. Mandell, Richard G. Wunderink 122 Lung AbscessRebecca M. Baron, Miriam Baron Barshak 123 Infective EndocarditisAdolf W. Karchmer 124 Infections of the Skin, Muscles, and Soft TissuesDennis L. Stevens 125 Infectious ArthritisLawrence C. Madoff 126 OsteomyelitisWerner Zimmerli 127 Intraabdominal Infections and AbscessesMiriam Baron Barshak, Dennis L. Kasper 128 Acute Infectious Diarrheal Diseases and Bacterial Food PoisoningRichelle C. Charles, Stephen B. Calderwood, Regina C. LaRocque 129 Clostridium difficile Infection, Including Pseudomembranous ColitisDale N. Gerding, Stuart Johnson 130 Urinary Tract Infections, Pyelonephritis, and ProstatitisKalpana Gupta, Barbara W. Trautner 131 Sexually Transmitted Infections: Overview and Clinical ApproachJeanne M. Marrazzo, King K. Holmes 132 EncephalitisKaren L. Roos, Kenneth L. Tyler 133 Acute Mening