Current Medical Diagnosis & Treatment 2015

Preface

Current Medical Diagnosis & Treatment 2015 (CMDT 2015)is the 54th edition of this single-source reference for practitioners in both hospital and ambulatory settings. The book emphasizes the practical features of clinical diagnosis and patient management in all fields of internal medicine and in specialties of interest to primary care practitioners and to subspecialists who provide general care.

INTENDED AUDIENCE FOR CMDT

House officers, medical students, and all other health professions students will find the descriptions of diagnostic and therapeutic modalities, with citations to the current literature, of everyday usefulness in patient care.

Internists, family physicians, hospitalists, nurse practitioners, physicians’ assistants, and all primary care providers will appreciate CMDT as a ready reference and refresher text. Physicians in other specialties, pharmacists, and dentists will find the book a useful basic medical reference text. Nurses, nurse-practitioners, and physicians’ assistants will welcome the format and scope of the book as a means of referencing medical diagnosis and treatment.

Patients and their family members who seek information about the nature of specific diseases and their diagnosis and treatment may also find this book to be a valuable resource.

NEW IN THIS EDITION OF cmdt

  • The latest 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guidelines for anticoagulation recommendations for atrial fibrillation
  • New table comparing the features of dabigatran, rivaroxaban, and apixaban for stroke prevention in nonvalvular atrial fibrillation
  • Updated information and algorithms incorporating the guidelines for treatment of valvular heart disease and indications for interventions based on the 2014 AHA/ACC guidelines
  • Discussion about the four groups of patients who benefit from statin medications based on the 2014 AHA/ACC guidelines
  • Indications for high intensity and moderate intensity statins based on the 2014 AHA/ACC guidelines
  • New evidence suggesting a cardiovascular cause for palpitations
  • Updates on target specific oral anticoagulants
  • Inclusion of Juvenile Nephronophthisis-Medullary Cystic Disease
  • Revised psychiatric diagnoses in accordance with theDiagnostic Statistical Manual, 5th edition (DSM-5), including the identification of obsessive-compulsive disorder (OCD) spectrum disorders as a separate category from the anxiety disorders and updating of terms such as the subtypes of schizophrenia, somatization disorder, hypochondriasis, and substance abuse and dependence
  • Positive and negative likelihood ratios for history, physical examination, and laboratory findings in the diagnosis of pneumonia
  • Information about contact dermatitis from cellphone covers
  • Use of omalizumab for refractory chronic urticaria
  • New discussion about electronic cigarettes and tobacco cigarette cessation
  • The new US Preventive Services Task Force (USPSTF) recommendation for universal HIV screening
  • Update on HIV/TB coinfection
  • New section on Middle East Respiratory Syndrome
  • Extensive update on Arbovirus Encephalitides, Dengue, and Influenza
  • Update on chronic pelvic pain
  • New information about breast cancer risk for women with a family history ofBRCAmutation
  • An update on mammography screening for breast cancer
  • Current recommendations for Papanicolaou smear screening
  • Updated guidelines for management of abnormal cervical cytology
  • Update on management of women at risk for preterm delivery
  • Recommendations for low-dose CT screening of the lung in high-risk patients in relatively good health who meet National Lung Screening Trial criteria
  • Risk prediction tools identifying variables that predicted postoperative myocardial infarction and cardiac arrest as well as postoperative respiratory failure
  • New section on opioids for chronic, noncancer pain
  • Update on the epidemic of opioid-based prescription drug abuse, misuse, and overdose
  • Alternatives for treatment of diabetic retinopathy, anterior ischemic optic neuropathy, and optic neuritis
  • Guidelines regarding use of ambulatory and home blood pressure measurements
  • Guidelines for initiating antihypertensive therapy based on the UK’s 2013 National Institute of Health and Care Excellence (NICE) and for blood pressure targets from the 2013 US Joint National Committee Report (JNC8) and Kidney Disease Improving Global Outcomes (KDIGO)
  • Updated classification of glucose-6-phosphate dehydrogenase (G6PD) isoenzyme activity
  • Updated treatment options forHelicobacter pylori
  • Clarification of the best tests for celiac disease
  • Clarification of the best test forClostridium difficileinfection, and an update on when to consider “fecal microbiota transplantation” for its treatment
  • Update on use of immunomodulators, anti-TNF agents, and anti-integrins in Crohn disease
  • New antivirals for treatment of hepatitis C
  • Scoring tools for assessing the severity of acute pancreatitis
  • New information on the antiphospholipid syndrome
  • Update on surgical treatment of spinal stenosis
  • New sections on IgG4-related disease and Takayasu arteritis
  • Update on HLA-B alleles and risk of serious drug-induced hypersensitivity reactions
  • New information on functional hypopituitarism, isolated hypogonadotropic hypogonadism, diagnosis of growth hormone deficiency in adults, treatment of diabetes insipidus, classification of amiodarone-induced thyrotoxicosis, preoperative parathyroid imaging, adrenal incidentaloma
  • Latest recommendations for vaccinations

OUTSTANDING FEATURES OF CMDT

  • Medical advances up to time of annual publication
  • Detailed presentation of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, toxicology, urology, geriatrics, orthopedics, women’s health, preventive medicine, and palliative care
  • Concise format, facilitating efficient use in any practice setting
  • More than 1000 diseases and disorders
  • Annual update on HIV infection and AIDS
  • Specific disease prevention information
  • Easy access to medication dosages, with trade names indexed and costs updated in each edition
  • Recent references, with unique identifiers (PubMed, PMID numbers) for rapid downloading of article abstracts and, in some instances, full-text reference articles

CMDT Online (www.AccessMedicine.com) provides full electronic access to CMDT 2015 plus expanded basic science information and five additional chapters. The five online-only chapters (Anti-infective Chemotherapeutic & Antibiotic Agents, Fundamentals of Human Genetics, Diagnostic Testing & Medical Decision Making, Information Technology in Patient Care, and Integrative Medicine) are available at www.AccessMedicine.com/CMDT. CMDT Online is updated throughout the year and includes an expanded, dedicated Media Gallery as well as links to related Web sites. Subscribers also receive access to Diagnosaurus with 1000+ differential diagnoses, Pocket Guide to Diagnostic TestsQuick Medical Diagnosis & Treatment, and CURRENT Practice Guidelines in Primary Care.

ACKNOWLEDGMENTS

We wish to thank our associate authors for participating once again in the annual updating of this important book. We are especially grateful to Patrick Hranitzky, MD, Ingrid L. Roig, MD, Marshall L. Stoller, MD, and Emmanuel T. Tavan, MD who are leaving CMDT this year. We have all benefited from their clinical wisdom and commitment. We gratefully acknowledge and thank Phil Tiso for his years of collegial work on CMDT, and the expertise and enthusiasm that he brings to the team.

Many students and physicians also have contributed useful suggestions to this and previous editions, and we are grateful. We continue to welcome comments and recommendations for future editions in writing or via electronic mail. The editors’ and authors’ institutional and e-mail addresses are given in the Authors section.

Maxine A. Papadakis, MD
papadakM@medsch.ucsf.edu
Stephen J. McPhee, MD
smcphee@medicine.ucsf.edu
Michael W. Rabow, MD
mrabow@medicine.ucsf.edu
San Francisco, California

From inability to let alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom, and science before art and cleverness before common sense; from treating patients as cases; and from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us.

–Sir Robert Hutchison


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