Andreoli and Carpenter’s Cecil Essentials of Medicine

983 Pages·2008·502.58 MB·Turkish

by  Doç Dr Selçuk Mıstık

BaşEditör
homas E.Andreoli, M.D., M.A.C.P., F.R.C.P.(Edin.), SC.D.(hon.),
Docteu ( on), Professor (hon.), M.D. (hon.)
Distinguished Professor
Department ofInternal Medicine
Department ofPhysiology and Biophysics
University ofArkansas College ofMedicine
Little Rock,Arkansas
ANDREOLI and CARPENTER'S
CECIL Essentials of
MEDICINE
TÜRKÇE 7'nci Edisyon
Editör
Charles c.J Carpenter, M.D., M.A.C.P.
Professor ofMedicine
Brown Medical School
Director, Brown University AIDS Center
Providence, Rhode Island
Robert C.Griggs, M.D., F.A.C.P.,F.A.A.N.
Edward A. and Alma Vollertsen Rykenboer Professor ofNeurophysiology
Chair, Department ofNeurology
Professor ofMedicine, Pathologyand Laboratory Medicine, and Pediatrics
University ofRochester School ofMedicine and Dentistry
Rochester, New York
Ivor J. Benjamın, M.D., F.A.C.C.,F.A.H.A.
Professor ofMedicine
Christi T.Smith Chair forCardiovascular Research
Chief, Division ofCardiology
University ofUtah School ofMedicine
Salt Lake City, Utah
Çeviri Editörü
Doç. Dr. Selçuk MISTIK
Erciyes Üniversitesi Tıp Fakültesi
Aile Hekimliği AD. Kayseri
© 2008 COPYRIGHT:
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ANDREOLI AND CARPENTER'S CECIL ESSENTIALS OF MEDICINE ISBN-l3: 978-1-4160-2933-5
ISBN-W: 1-4160-2933-8
Copyright © 2007, 2004, 2001, 1997, 1993, 1990, 1986 by Saunders, an imprint of Elsevier Ine.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval
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Permissions may be sought directly from Elsevier's Health Sciences Rights Department in Philadelphia, PA,
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Library of Congress Cataloging-in-Publieation Data
Andreoli and Carpenter's Cecil essentials of medicine /editor-in-chief, Thomas E. Andreoli; editors,
Charles C.J. Carpenter, Robert C. Griggs, and Ivor J. Benjamin.-7th ed.
p.; cm.
Rev. ed. of: Cecil essentials of medicine, c2004
Includes bibliographical references and index.
ISBN 1-4160-2933-8
1. Internal medicine. i. Andreoli, Thomas E., 1935- II. Carpenter, Charles C.J. (Charles Colcock J.)
III. Cecil, Russell L. (Russell La Fayette), 1881-1965. İV. Cecil essentials of medicine. V. Titles:
Essentials
of medicine.
[DNLM: 1. Internal Medicine. WB 115A559 2007]
RC46.C42 2007
616-dc22
2006045276
Acquisitions Editor: James Merritt
Developmental Editor: Rebecca Gruliow
Publishing Services Manager: Linda Van Pelt
Project Manager: Melanie Peirson Johnstone
Design Direction: Steven Stave
ISBN 978-975-420-637-1
EDİTÖR Doç. Dr. Selçuk MISTIK
DÜZENLEME YÜCE reklam/yayım/dağıtım a.ş
YÜCE reklam/yayım/dağıtım a.ş. &
(Serkan DÜ(;ÜN)
Nobel Tıp Kitabevleri Ltd. ŞtL Ortak
Yayımıdır. BASKı ve CİLT Özgün Ofset
Charles C.J. Carpenter
Brown Üniversitesi'nde iç hastalıkları profesörü olan Charles C. 1.Carpenter, Ce-
cil Essentials of Medicine'nin kurucu Editörlerinden biridir. O, aynı zamanda te-
mel kavramlardan biri olan ve tüm kurucu Editörlerin uyum gösterdiği her yaşta-
ki tıp öğrencisi için okunabilir bir ders kitabı oluşturma fikrine de büyük katkı
sağlamıştır. Günümüzde artık Andreoli ve Carpenter'ın Cecil Essentials of Medi-
cine adı verilen bu Cecil Essentials 'ın Yedinci baskısı, Chuck'ın aktif katkıda bu-
lunacağı son Essentials olacaktır;·o nedenle Editörler, kitaba onun adını kalıcı ola-
rak vermekle kalmayıp, aynı zamanda Essentials'ın bu son baskısını Chuck Car-
penter'a adamanın onur ve gururunu yaşamaktadır.
Chuck, çok çarpıcı bir kişi olmasının yanında mükemmel bir insandır. Fotoğ-
rafı kişiliğini tam olarak yansıtmaktadır: zarif bir insan, tam bir beyefendi, sıcak
bir kişilik ve davranışlarında sevecen ve iyi huyludur.
Bir akademisyen olarak Chuck kendini aşmıştır. İç hastalıkları uzmanlık eğiti-
mini Johns Hopkins Üniversitesi'nde A. McGehee Harvey'in baş asistanlığını ya-
parak tamamlamıştır. Daha sonra, Case Western Reserve Üniversitesinde, 1973-
1986yılları arasında İç Hastalıkları bölüm başkanlığı yapmıştır. Bölüm başkanlı-
ğı sırasında sergilediği mükemmel yönetim nedeniyle 2007 yılında Association of
American Physicians tarafından Robert H. Williams Üstün Hizmet Tıp Ödülünü
almıştır. Chuck, daha sonra Brown Üniversitesi'nde 1986 yılından bu yana İç
Hastalıkları Profesörü olarak görev yapmıştır. Halen Brown AIDS Araştırma
Merkezi Direktörlüğünü yürütmektedir.
Chuck'ın akademik kariyeri bu sunuma sığdırılamayacak bir başarı öyküsüdür.
Ancak, bazı önemli dönüm noktalarına değinmekte yarar vardır. Akademik yılla-
rının erken döneminde sıvı veelektrolit dengesi üzerinde çalışmalar yaptı vealdos-
teron salgısının birincil uyaranı olarak anjiyotensin lI'yi tanımlayan ilkbilim insa-
nıdır. Kolera ve kolera benzeri sendromların fizyopatolojilerinin anlaşılmasına
önemli katkılarda bulundu ve bu deneysel ve klinik çalışmaları özellikle Hint ya-
rımadasında olmak üzere gelişmekte olan ülkelerdeki yaygın sulu diyare olguları-
nın tedavisinde kullanılan oral rehidrasyon sıvılarının geliştirilmesine yol açtı.
AIDS'in ortaya çıkmasından neredeyse haman sonra Chuck gerek deneysel ge-
rekse klinik olarak AIDS tanı ve tedavi çalışmalarının içinde buldu ve AİDS'den
etkilenen hastalara yardım çalışmalarına katıldı. Bundan yaklaşık yirmi yıl önce
Brown Üniversitesinde geliştirdiği özgün bir program sayesinde fakülte çalışanla-
rı Rhode Island hapishane sistemi içindeki tüm HIV/AIDS hastalarının bakımın-
da sorumluluk üstlendi.
Chuck, American College of Physicians tarafından verilen Üstün Öğretim Ni- .
şanı ilede yansıtıldığı gibi sıradışı bir öğretmendir. İçHastalıklarının her yönü ile
donanımlı üstün bir klinisyendir. O nedenle de 'Master of the American College
of Physicians' onurunu kazanmıştır ve akademik tıpta hemen herkesten fazla pa-
yeye sahiptir.
Sevgili arkadaşım Chuck Carpenter ile birlikte çalışmış olmaktan büyük onur
duyuyorum. Tüm Editörler adına konuştuğumun bilincinde olarak ona kendisini
çok özleyeceğimizi söylemek istiyorum vekendisinin yerini alacak aynı beceri ve
yetilerle donanmış başka birini bulmanın da son derece güç olacağını belirtmek
istiyorum.
Thomas E. Andreolİ
Baş Editör
v

Andreoli and Carpenter's Cecil Essentials of Medicine
Uluslararası Danışma Kurulu
İsİM BRANŞ ÜLKE
Professor J. S. Bajaj Endokrinoloji Hindistan
Chief Consultant and Director
Department of Diabetes, Endocrine
and Metabolic Medicine
Batra Hospital &Medical Research Centre
New Delhi, India
[email protected]
Professor Massimo G. Colombo, M.D. Hepatoloji/Gastroenteroloji İtalya
Professor and Chairman
Department of Gastroenterology and Endocrinology
IRCCS Maggiore Hospital
University of Milan
Milan, Italy
[email protected]
Professor Bertrand Fontaine, M.D. Neroloji Fransa
Professor of Neurology
Faculte de Medecine
Federation des Maladies du Systeme Nerveux
Groupe Hospitalier Pitie-Salpetriere
Paris, France
bertrand. [email protected]
Professor Arnoldo Guzman-Sanchez Kadın Sağlığı Meksika
Professor and Chair
Department of Obstetrics and Gynecology
Hospital Civil de Guadalajara
Guadalajara, Jalisco, Mexico
[email protected]
Professor Kiyoshi Kurokawa, M.Db Nefroloji Japonya
President, Science Council of Japan
Professor Emeritus, University of Tokyo
Roppongi, Minato-ku
Tokyo,Japan
[email protected]
Professor Umesh G. LaHoo, M.D., FC.C.P. Genel İç HastalıklanlHIV Güney Afrika
Head, Department of Pulmonology and HIV
Nelson R. Mandela School of Medicine
University of Kwa-Zulu Natal
Durban, South Africa
[email protected]
Professor Pal Magyar Göğüs Tıbbı Macaristan
Head, Department of Pulmonary Medicine
Semmelweis University
Budapest, Hungary
[email protected]
Professor John Newsom-Davis, M.D. Neroloji İngiltere
Emeritus Professor of Clinical Neurology
Radcliffe Infirmary
Woodstock Road
Oxford, United Kingdom
[email protected]
x Yazarlar ve Katkıda Bulunanlar
Wanpen Vongpatanasin, M.D. Thomas E.Andreoli, M.D.
Associate Professor of Internal Medicine Distinguished Professor
The University of Texas Southwestern Medical Center Department of Internal Medicine
at Dallas Department of Physiology and Biophysics
Dallas, Texas University of Arkansas College of Medicine
[email protected] Little Rock, Arkansas
[email protected]
Kevin J.Whitehead, M.D.
Assistant Professor
Michelle W. Krause, M.D.
Division of Cardiology
Assistant Professor
University of Utah School of Medicine
Department of Internal Medicine
Salt Lake City, Utah
University of Arkansas for Medical Sciences
[email protected]
Little Rock, Arkansas
KrauseMichelleW@uaıns.edu
Kısım i .Pulmoner ve Yoğun
m ıbb Jayant Kumar, M.D.
Assistant Professor of Medicine
LeadAuthor UAMS Division of Nephrology
Kenneth L.Brigham, M.D. University of Arkansas for Medical Sciences
Professor of Medicine Little Rock, Arkansas
Vice-Chairman for Research, Department of Medicine [email protected]
Director, Center for Translational Research in the Lung
Associate Director for Research, McKelvey Lung Didier Portiıla, M.D.
Transplantation Center Associate Professor of Medicine
Emory University School of Medicine Department of Internal Medicine
Whitehead Biomedical Building University Hospital
Eınory University School of Medicine Internal Medicine-Nephrology
Atlanta, Georgia University of Arkansas for Medical Sciences
kbrigha@Eınory.edu Staff Physician, Internal Medicine and Nephrology
Central Arkansas Veterans Hospital
Contributors Little Rock, Arkansas
JesseRoman, M.D. portilladidier@uaıns.edu
Associate Professor
Department of Medicine Division Robert L.Safirstein, M.D.
Director, Pulmonary, Allergy and CriticaiCare Medicine Vice Chairman of Internal Medicine
Emory University School of Medicine University of Arkansas for Medical Sciences
Atlanta, Georgia Little Rock, Arkansas
[email protected] [email protected]
Bonnie S.Slovis,M.D., M.S.H.S. Patrick D.Walker, M.D.
Assistant Professor of Medicine Professor of Pathology
Department of Medicine, Division of Allergy, University of Arkansas for Medical Sciences
Pulmonology, and Critical Care Director, Neuropathology Associates
Vanderbilt University Little Rock, Arkansas
Director, Pulmonology Patient Care Center [email protected]
Vanderbilt University Medical Center
Nashville, Tennessee
Kısımvı: Gastrointestinal SistemHastalıkları
v:
Kısım Böbrek Hastalığı
LeadAuthor
LeadAuthor M. Michael Wolfe, M.D.
Sudhir V. Shah, M.D. Professor of Medicine
Professor of Internal Medicine Director, Division of Gastroenterology
Director, Division of Nephrology Boston University School of Medicine
University of Arkansas College of Medicine Boston, Massachusetts
Little Rock, Arkansas [email protected]
[email protected]
Contributors
Contributors Charles M. Biiss,Jr.,M.D.
Sameh R.Abul-Ezz, M.D. Assistant Professor of Medicine
Associate Professor of Internal Medicine Boston University Medical School
Division of Nephrology Staff Physician, Medicine/Gastroenterology
University of Arkansas College of Medicine Boston Medical Center
Little Rock, Arkansas Boston, Massachusetts
[email protected] [email protected]
Muhammad G.Alam, M.D.
FrancisA. Farraye, M.D.
Assistant Professor of Medicine
Associate Professor of Medicine and Epideıniology
UAMS Division of Nephrology
University of Arkansas for Medical Sciences Boston University School of Medicine
Little Rock, Arkansas Boston, Massachusetts
[email protected] [email protected]
Yazarlar ve Katkıda Bulunanlar Xi
Christopher S.Huang, M.D. KısımVii: Karaciğer ve Safra
Instructor of Medicine Sistemi Hastalıkları
Boston University School of Medicine
Boston, Massachusetts LeadAuthor
[email protected] Michael B.Fallon, M.D.
Associate Professor of Medicine
Brian C.Jacobson, M.D., M.P.H. Division of Gastroenterology and Hepatology
Assistant Professor of Medicine University of Alabama School of Medicine
Associate Director of Endoscopy Birmingham, Alabama
Gastroenterology Section [email protected]
Boston University Medical Center
Boston, Massachusetts Contributors
[email protected]
Gary A. Abrams, M.D.
UAB Liver Center
David R.Lichtenstein, M.D.
Department of Medicine
Brigham &Women' sHospital
University of Alabama at Birmingham
Boston, Massachusetts
Birmingham, Alabama
[email protected]
[email protected]
Robert C.Lowe, M.D.
Boston Medical Center Miguel R.Arguedas, M.D.
Section of Gastroenterology UAB Liver Center
Boston, Massachusetts Department of Medicine
[email protected] University of Alabama at Birmingham
Birmingham, Alabama
Daniel S.Mishkin, M.D., C.M. [email protected]
Instructor of Medicine
Boston University School of Medicine
Joseph R.Bloomer, M.D.
Boston, Massachusetts
Department of Medicine
[email protected]
University of Alabama at Birmingham
Jaime A. Oviedo, M.D. Birmingham, Alabama
Instructor of Medicine, Section of Gastroenterology [email protected]
Boston University School of Medicine
Boston Medical Center Rudolf Garcia-Gallont, M.D.
Boston, Massachusetts Hospital Roosevelt
[email protected] Guatemala City, Guatemala
Brendan M. McGuire, M.D.
Lawrence J.Saubermann, M.D. UAB Liver Center
Assistant Professor of Medicine and Staff Physician Department of Medicine
Department of Gastroenterology University of Alabama at Birmingham
Boston University Medical Center Birmingham, Alabama
Boston, Massachusetts [email protected]
[email protected]
Aasim M. Sheikh, M.D.
Elihu M. Schimmel, M.D.
Assistant Professor
Professor of Medicine
UAB Liver Center
Boston University School of Medicine
Department of Medicine
Staff Physician, Gastroenterology
University of Alabama at Birmingham
VA Boston Healthcare System
Birmingham, Alabama
Boston, Massachusetts
[email protected]
[email protected]
PaulC.Schroy III, M.D., M.P.H. Shyam Varadarajulu, M.D.
Associate Professor of Medicine Assistant Professor of Medicine
Boston University School of Medicine University of Alabama at Birmingham
Director, Clinical Research School of Medicine
Section of Gastroenterology Birmingham, Alabama
Boston Medical Center [email protected]
Boston, Massachusetts
[email protected]
KısımVIII: Hematolojik Hastalıklar
Satish K.Singh, M.D.
Boston University School of Medicine
LeadAuthor
Department of Medicine
Boston, Massachusetts Nancy Berliner, M.D.
[email protected] Arthur and Isabel Bunker Associate Professor of
Medicine and Genetics
Chi-Chuan Tseng, M.D. Yale University School of Medicine
Associate Professor of Medicine
New Haven, Connecticut
Boston University School of Medicine
[email protected]
Boston, Massachusetts
[email protected]
xii Yazarlar ve Katkıda Bulunanlar
Contributors
Kısım X' M~tabolikHastalıklar
JiIILacy,M.D.
UAMS Division of Nephrology
LeadAuthor
University of Arkansas for Medical Sciences
Reed E.Pyeritz, M.D., Ph.D.
Little Rock, Arkansas
Professor of Medicine
Jilı[email protected]
Chief, Division of Medical Genetics
University of Pennsylvania School of Medicine
Henry M. Rinder, M.D.
Philadelphia, Pennsylvania
Associate Professor
[email protected]
Department of Laboratory Medicine and Internal
Medicine (Hernatology)
tdeceased
Yale University
New Haven, Connecticut
Contributor
[email protected]
David G.Brooks, M.D., Ph.D.
Medical Genetics Division
Michal G.Rose,M.D.
Maloney Building
Assistant Professor
University of Pennsylvania
Medical Oncology
Philadelphia, Pennsylvania
YaleCancer Center
[email protected]
New Haven, Connecticut
[email protected]
okrln Hastalık
Stuart Seropian, M.D.
Department of Internal Medicine and Oncology LeadAuthor
Yale University School of Medicine Glenn D. Braunstein, M.D.
New Haven, Connecticut Professor of Medicine
stuart.seropian @yale.edu UCLA School of Medicine
Chair, Department of Medicine
RichardTorres, M.D. Cedars-Sinai Medical Center
Department of Laboratory Medicine Los Angeles, California
Yale University School of Medicine [email protected]
New Haven, Connecticut
Richard. [email protected] Contributors
Philip S.Barnett, M.D., Ph.D.
EuniceS.Wang, M.D. Cedars-Sinai Medical Center
Research Assistant Professor, Leukemia Service Pituitary Center
Departments of Medicine and Immunology Los Angeles, California
Roswell Park Cancer Institute [email protected]
New York, New York
[email protected] Theodore C.Friedman, M.D.
Department of Endocrinology
Cedars-Sinai Medical Center
Kısım iX' Onkolojik Hastalıklar
Los Angeles, California
[email protected]
LeadAuthors
Christopher E.Desch,M.D.t
Vivien S.Herman-Bonert, M.D.
Virginia Cancer Institute
Associate Clinical Professor
Richmond, Virginia
Clinical Coordinator
[email protected]
UCLA School of Medicine
[email protected]
Los Angeles, California
[email protected]
Jennifer J.Griggs, M.D.
[email protected]
University of Michigan
Ann Arbor, Michigan
[email protected] Kısım XII: Kadın Hastalığı
Contributors LeadAuthor
Barbara A. Burtness, M.D. Anne L.Taylor, M.D.
Medical Science Division Professor of Medicine
Fox Chase Cancer Center Associate Dean for Faculty Affairs
Philadelphia, Pennsylvania University of Minnesota School of Medicine
[email protected] Minneapolis, Minnesota
[email protected]
Alok A. Khorana, M.D.
Assistant Professor of Medicine Contributors
James P.Wilmot Cancer Center Sharon S.Alien, M.D., Ph.D.
University of Rochester
Professor
Rochester, New York
Department ofFamily Medicine and Community Health
alok_khorana @urmc.rochester.edu
University of Minnesota Cancer Center
Minneapolis, Minnesota
allenOÜı@umn.edu
Yazarlar ve Katkıda Bulunanlar XIII
Karyn D.Baum, M.D. G.David Roodman, M.D., Ph.D.
Associate Professor of Medicine University of Pittsburgh
University of Minnesota Medical School Division of Endocrinology
Minneapolis, Minnesota Pittsburgh, Pennsylvania
[email protected] [email protected]
Sally L.Hodder, M.D.
KısımXV: Kas-iskelet ve Bağ
Executive Vice Chair, Department of Medicine
Dokusu Hastalığı
Professor of Medicine
Division of Infectious Disease
University of Medicine &Dentistry of New Jersey LeadAuthor
Newark, New Jersey Robert W. Simms, M.D.
[email protected] Associate Professor of Medicine
Arthritis Center
Nancy L.Raymond, M.D. Boston University School of Medicine
Associate Professor Boston, Massachusetts
Department of Psychiatry [email protected]
University of Minnesota
Minneapolis, Minnesota Contributor
[email protected] Peter A. Merkel, M.D., M.P.H.
Massachusetts General Hospital
Arthritis Unit
Kısım XIII: Erkek Sağlığı
Boston, Massachusetts
[email protected]
LeadAuthor
JosephA. Smith, Jr.,M.D.
Professor and Chair Kısım XVI: Enfeksiyon Hastalıkları
Department of Urologic Surgery
Vanderbilt University School of Medicine LeadAuthor
Nashville, Tenness~e Charles c.J.Carpenter, M.D.
[email protected] Professor of Medicine
Brown University School of Medicine
Contributors
Director, Lifespanffufts/Brown Center for
Douglas F.Milam, M.D.
AIDS Research
Associate Professor of Urologic Surgery
The Miriam Hospital
Department of Urologic Surgery
Providence, Rhode Island
Vanderbilt Medical Center
[email protected]
Vanderbilt University
Nashville, Tennessee
Contributors
[email protected]
Keith B.Armitage, M.D.
Associate Professor of Medicine
Jonathan S.Starkman, M.D.
Division of Infectious Diseases
Instructor of Urologic Surgery
Case Western Reserve University
Vanderbilt University School of Medicine
University Hospitals of Cleveland
Nashville, Tennessee
Cleveland, Ohio
[email protected]
[email protected]
KısımXIV: Kemik Hastalıkları Curt G.Beckwith, M.D.
ve Kemik Mineral Metabolizması Assistant Professor of Medicine
Division of Infectious Diseases
LeadAuthor Brown Medical School
Andrew F.Stewart, M.D. Providence, Rhode Island
Professor of Medicine [email protected]
Chief, Division of Endocrinology and Metabolism
University of Pittsburgh School of Medicine David B.Blossom,M.D.
Pittsburgh, Pennsylvania Division of Infectious Disease
[email protected] Case Western Reserve University
School of Medicine
Contributors
Cleveland, Ohio
SusanL.Greenspan, M.D.
David_B [email protected]
Professor of Medicine
University of Pittsburgh
David A. Bobak, M.D.
Pittsburgh, Pennsylvania
Associate Professor of Medicine
[email protected]
Division of Infectious Diseases
Mara J.Horwitz, M.D. Case Western Reserve University
University of Pittsburgh University Hospitals of Cleveland
Division of Endocrionology Cleveland, Ohio
Pittsburgh, Pennsylvania
[email protected]
[email protected]