The return of the Clinical Picture
Sharpen your powers of observation
with our revived question-and-answer quiz.
J.D. CLOUGH

  Brief answers to specific clinical questions

 Should patients receiving long-term gastric acid inhibition therapy be evaluated for vitamin B12 deficiency?
Very few patients actually deplete their body stores of vitamin B12, but supplementation is benign.
J.E. RICHTER

A 65-year-old factory worker with dyspnea on exertion and a normal chest x-ray
What is the cause of this patient's symptoms?
A self-test on a clinical case.
W. SABER and R.A. DWEIK

Heart failure is a fever: The cytokine connection
The discovery that inflammation contributes to heart failure may lead to new therapies for this disease.
J.B. YOUNG

In diabetes, treat hidden heart disease
Both diabetic and prediabetic patients have abnormal vascular reactivity and should be considered to have occult cardiovascular disease.
W.A. HSUEH

A 70-year-old farmer with a skin lesion
Questions and answers on the visible signs of diseases.
E.F. CALLAHAN and K.J. TOMECKI

Pharmacologic aids to smoking cessation
Quitting smoking is notoriously hard. Drugs can improve the odds of quitting, but the best approach is multifactorial.
T.D. HELGE and G.Y. DENELSKY

Factor V Leiden and prothrombin G20210A. Demystifying two common genetic predispositions to venous thrombosis
Genetic testing is useful only if the knowledge gained will affect the course of treatment.
S.R. DEITCHER, E. CAIOLA, and A. JAFFER

Treatment of ovarian cancers not of epithelial origin
Some ovarian cancers carry a prognosis quite different from that of epithelial ovarian cancer, and call for totally different treatment.
M. MARKMAN

Using troponin T to diagnose acute coronary syndromes
Troponin T and creatine kinase MB have complementary roles. Includes a diagnostic algorithm.
E. MCERLEAN, F. VAN LENTE, and S.E. NISSEN

Carotid stenosis: Current strategies for choosing between medical and surgical management
Recommendations on a longstanding and contentious issue.
C.A. SILA