The Fourth Edition of this textbook teaches the artful science of the patient interview and the physical examination-from the fundamentals to the most advanced levels. Written in an artful storytelling style, the book describes methods in step-by-step detail, with clinical pearls, vignettes, practical clinical experience, personal history, explanations of the physiologic significance of findings, and extensive discussions of evidence-based medicine. Highlights of this new edition include - 'Points to Remember' boxes with three or four bullets per chapter; more than 300 questions with answers and discussion; revisions based on new material from journals (especially "JAMA", "New England Journal of Medicine", "Mayo Clinic Proceedings", and "Annals of Internal Medicine"); CME conferences, especially the weekly grand rounds at Carondelet St. Joseph's Hospital; specialty conferences pertaining to orthopedics and neurology; and cases that recently came up in practice. It includes more than 120 additional references, some new and some old classics newly discovered by the author; expanded discussion of evidence-based medicine, both its appropriate usage and pitfalls, with additional information on sensitivity, specificity, and other features of various findings from recent studies and review articles; insights on the development of expertise have been added; expanded discussion of sleep apnea, blast injury, 'minor' head trauma, and cervical spine involvement in rheumatoid arthritis; new findings pertaining to transplantation-related graft-versus-host problems, AIDS and the adverse effects of therapy, drug abuse, especially methamphetamine, and egg donation; and additional maneuvers include the scapulohumeral reflex, the head thrust test, the apprehension test, and a newly described test for intercostal muscle innervation. It also includes: additional information on dementia, hysteria, missed aneurysms, pulmonary embolism, evaluation of dehydration/malnutrition, and compressions - only cardiopulmonary resuscitation; updated and substantially simplified discussion of carotid stenosis and indications for carotid endarterectomy; more historical tidbits, for example, on the development of thermometry; and companion website with fully searchable text and 300-question online test bank. Even with all of today's sophisticated laboratory and imaging technology, a skillfully performed patient interview and physical examination can be a quicker and more cost-effective route to an accurate diagnosis. The Fourth Edition of "Sapira's Art and Science of Bedside Diagnosis" is your guide to gaining the most reliable information from your patients, developing a differential diagnosis and an efficient diagnostic strategy.
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