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 chapterMore than 300 questions with answers and discussionRevisions 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 practiceMore than 120 additional references, some new and some old classics newly discovered by the authorExpanded 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 arthritisNew findings pertaining to transplantation-related graft-versus-host problems, AIDS and the adverse effects of therapy, drug abuse, especially methamphetamine, and egg donationAdditional maneuvers include the scapulohumeral reflex, the head thrust test, the apprehension test, and a newly described test for intercostal muscle innervationAdditional information on dementia, hysteria, missed aneurysms, pulmonary embolism, evaluation of dehydration/malnutrition, and compressions-only cardiopulmonary resuscitationUpdated and substantially simplified discussion of carotid stenosis and indications for carotid endarterectomyMore historical tidbits, for example, on the development of thermometryCompanion Website with fully searchable text and 300-question online test bankEven 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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