Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine Sixth,
It is with the greatest enthusiasm that I’ introduce Pocket Medicine. In an era of information glut, It wlll logically be asked, “Why anotller manual for medical house officers?” Yet. despite enormous information readily available in any number of textbooks, or at the push of a key on a computer, it is often that the harried house officer is less helped by the description of differential diagnosis and therapies than one would wish.
Pocket Medicine is the joint venture between house staff and faculty expert in a number of medical specialties. This collaboration is designed 10 provide a rapid but thoughtful initial approach to medical problems seen by house officers with great frequency. Questions that frequently come from faculty to the house staff on rounds, many hours after the initial interaction between patient and doctor. have been anticipated and import.ant pathways for arrivi1,g at diagnoses and initiating therapies are presented. This approach will facilitate the evidence-based medicine discussion that will follow the workup of the patient. This wellonceived handbook should enhance the ability of every medical house officer to properly evaluate a patient in a timety fashion ::ind to be stimulated co think of the evidence supporting the diagnosis and the likely outcome of therapeutic intervention. Pocket Medicine will prove to be a worthy addition to medical education and to lhe care of our patients.
Written by residents, fellows, and attendings. the mandate for Packet Medidne was to provide. in a concise a manner as possible, the key information a clinician needs for the initial approach to and management of the most common inpatient medical problems.
The tn,mendous response to the previous editions suggestS we were able to help fill an important need for clinicians. With this sixth edition come several major Improvements. We have updated every topic thoroughly. In particular, we have included the latest phannacotherapy for acute coronary syndromes, heart failure, pulmonary hypertension. hepatitis C, HIV, and diabetes, as well as the latest devicebased treltmencs for valvular heart disease, aerial fibrillation, and stroke. Recent paradigm shifts in the guidefines for hypertension and cholesterol have been distilled and incorporated. We have expanded coverage of the molecular classification of malignancies and the corresponding biologic therapies.We have added new sections on mechanical circulatory support. angioedema, non-invasive ventilation, toxicology. lung transplantation, GI motility disorders. and the cardiorenal syndrome, just to name a few. We have also updated the section on Consults in which non-internal medicine specialists provide expert guidance in terms of establishing a differential diagnosis for common presenting symptoms and initiating an evaluation in anticipation of calling a consult. As always, we have incorporated key references to the most recent high-tier reviews and important studies published right up to the time Pocket
Medicine went to press. We welcome any :suggestions for further improvement
Of course medicine is far coo vast a field to ever summarize in a textbook of any size. long monographs have been devoted to many of the topics discussed herein. Pocket Medicine is meant only as a starting point to guide one during the initial phases of diagnosis and management until one has time to consult more definitive resources. Although the recommendations herein are as evidence-based as possible. medicine is both a science and an art. As atways, sound clinical judgement must be applied to every scenario.
I am graceful for the support of the house officers, fellows. and actendings at the Massachusetts General Hospital. It is a privilege co work with such a knowledgeable, dedicated, and compassionate group of physicians. I always look back on my time there as Chief Resident as one of the best experiences I have ever had. I am grateful to several outstanding clinical mentors, including Hasan Sazari, Larry Friedman, Nesli Basgoz. Eric lsselbacher, Bill Dec. Mike Fifer. and Roman DeS3nccis, as well as the late Charlie McCabe, Mort Swartz, and Peter Yurchak.
This edition would not have been possible without the help of Melinda Cuerda, my acaden,jc coordinator. She shepherded every Mpect of the project from start co finish. with an incredible eye co detail co ensure that each page of this book was the very best it could be,
lastly. special thanks to my parents for their perpetual encouragement and love and, of course, co my wife, Jennifer Tseng, who, despite being a surgeon, is my closest advisor, my best friend. and the love of my IWe.
I hope that you find Pocket Medicine useful throughout the arduous but incredibly rewarding journey of practicing medicine.
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