Cecil Essentials of Medicine 10th edition 


Cecil Essentials of Medicine 10th edition

Cecil Essentials of Medicine presents a core of internal medicine and neurology information that every physician should know. This book provides an essential framework so physicians can appropriately assemble the key elements of history, physical examination, and laboratory data to understand their patient’s illness and develop an appropriate diagnostic and therapeutic strategy. Furthermore, in order to under-stand advances in medicine, physicians must have a strong background for the acquisition and categorization of new medical knowledge.

Cecil Essentials of Medicine is designed for medical students as well as physicians in training, and we hope it will be an appropriate vehicle for course and examination review. We also believe, however, that physicians at all stages in their careers will find it to be a valuable resource for review and reference. This book also serves as a companion to the 26th edition of Goldman-Cecil Medicine, which is more comprehensive in scope and detailed in its content.

Cecil Essentials of Medicine is organized into sections, most often representing organ systems, with introductory and then organ- specific, disease-based chapters. The chapters themselves are subdivided. For example, the cardiovascular disease chapter is divided into Epidemiology, Anatomy, Psychophysiology, Clinical Diagnosis, and Treatment. The Suggested Readings sections at the end of each chapter include selected critical reviews, guidelines, and important randomized controlled trials. They are not meant to be an exhaustive reference list, but rather to highlight the essential information that physicians should know.

We believe that the information in Cecil Essentials of Medicine will encourage evidence-based diagnostic and therapeutic decision making. Importantly, the rational approach to medical problem-solving must be interwoven with the attentive presence of the physician at the bedside, clinic or office, undistracted by electronic devices (particularly the computer), displaying mindful humanistic patient care. Humanistic practice includes integrity, compassion, altruism, respect, service, and empathy, but also excellence. Both the art and the science of medicine must be part of the approach to any patient encounter. The editors believe that these concepts have been best expressed by Frances Peabody, who famously stated that “the significance of the intimate personal relationship between physician and patient cannot be too strongly emphasized, for in an extraordinary large number of cases both the diagnosis and treatment directly depend upon it. One of the essential qualities of the clinician is interest in humanity for the secret of the care of the patient is in caring for the patient,” and by Sir William Osler, who said, “The practice of medicine is an art not a trade; a calling not a business; a calling in which your heart will be exercised equally with your head.”

We believe that the fundamentally important bond between care-giver and patient is the starting point to the care of the patient. This is followed by a thorough history and a directed physical examination, which allow a diagnosis in the great majority of encounters. Laboratory data and imaging are supplementary. The focus of the diagnostic process should be on diseases that are common and treatable. Common presentations of common diseases account for the vast majority of cases; next in frequency are unusual presentations of common diseases; less common are typical presentations of rare diseases. Concentrate on common diseases, but know the rare ones as well.

We sincerely hope that Cecil Essentials of Medicine will be used to provide the basic and clinical data that are essential for us to practice medicine in a manner informed by both compassion and evidence, so that we may truly heal those with whose care we are entrusted.

Thomas E. Andreoli, MD

Dr. Thomas Andreoli, along with Drs. Lloyd Hollingsworth (Holly) Smith, Jr., Fred Plum, and Charles C.J. Carpenter, was one of the four founding editors of Cecil Essentials of Medicine. He served as editor for editions one through eight before he passed away on April 14, 2009. Dr. Andreoli was born in the Bronx, New York, in 1935, attended Catholic primary and high schools, and graduated from St. Vincent College and the Georgetown School of Medicine. He trained as a resident at Duke University under legendary Chair of Medicine Dr. Eugene Stead, who recognized him as a brilliant physician and scientist and encouraged his research career. Dr. Andreoli received his research training at the NIH and then in the laboratory of Dr. Tosteson at Duke. His research focused on the biochemical and biophysical properties of renal tubular cell membranes and their role in water and electrolyte transport. He made fundamental discoveries on the normal renal physiology, illuminating the way to subsequent work by many others on renal health and disease. His research was recognized with numerous awards and election to honorific societies both in the United States and in Europe. Dr. Andreoli also served as editor of The American Journal of Physiology: Renal Physiology and Editor in Chief of Kidney International.

Tom’s national prominence and leadership qualities were recognized early in his career when he became head of Nephrology at the University of Alabama in Birmingham. There he helped faculty and trainees develop outstanding research, organized clinical services, and created a hemodialysis program to build one of the out-standing Divisions of Nephrology in the country. In 1979, Dr. Andreoli was appointed Chair of the Department of Internal Medicine at the University of Texas, Houston, where he assembled an outstanding faculty focused on research, clinical care, and teaching. In 1988, he accepted the position as Chairman of Internal Medicine at the University of Arkansas School of Medicine, a position he held until his death. There he again assembled a distinguished faculty who were outstanding researchers but also dedicated to outstanding clinical care and teaching. Morning report and clinical rounds with Dr. Andreoli were rigorous and riveting, focusing on the individual patient, not only their diagnoses and treatment but also on each patient’s personal concerns and well- being. Dr. Andreoli was revered by medical students, his house staff, faculty, and colleagues, and I (EJW) personally can attest to what he regarded as his most cherished role—the mentorship and education of the next generation of physicians.

One of Dr. Andreoli’s great interests was Cecil Essentials of Medicine, for which he was the editor/chief editor for eight of its ten editions, an interest that reflected his commitment to the education of students, house staff, and other physicians in the “essentials” of Internal Medicine.

Dr. Andreoli was devoted to his family. He was married to Elizabeth Berglund Andreoli from 1987 until his death. He was previously married to Dr. Kathleen Gainor Andreoli, mother of his three children and their ten grandchildren. Being of Italian ancestry and from Bronx, New York, it is not surprising that Dr. Andreoli was a passionate fan of the New York Yankees, Italian opera, which he could sing in Italian, and Frank Sinatra.

Dr. Andreoli’s legacy lives on in his numerous previous students, house staff, colleagues, and in this book.





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