Table of Contents
Highlights from Medical Grand Rounds
- Unresolved Questions in Breast Cancer Therapy
When is radical mastectomy preferable to modified radical mastectomy? Which patients may benefit from chemotherapy, radiotherapy, or hormonal therapy?
- Improved Laboratory Diagnosis of Septicemia
Optimal timing of blood cultures and proper skin disinfection are two ways to facilitate the diagnosis.
Radiology Pathology Grand Rounds
- Headache and hypertension in a 15-year-old
A 15-year-old girl with a 4-year history of throbbing occipital headaches presents with hypertension in the range of 180/140 mm Hg.
Memorial
- Irvine Heinly Page, MD (1901–1991)
The former director of research at the Cleveland Clinic is remembered for his substantial contributions to medicine, especially in the field of hypertension research.
Contributions
- Cardiac rhythm and conduction disturbances in patients undergoing mitral valve surgery
Mitral valve replacement and repair were compared as to their effect on the incidence of supraventricular rhythm and conduction disturbances in a group of patients with isolated mitral valve disease.
- Eosinophilia-myalgia syndrome: the Cleveland Clinic experience
Significant nerve and muscle involvement, diffuse fasciitis, and weight loss were adverse prognosticating factors in this group of patients. Those who survived the acute phase and stabilized were more likely to continue to improve.
State of the Art: Hematology
- Disorders of platelet function: evaluation and treatment
A detailed history provides the best clues to the clinical significance of a bleeding diathesis and is key to selecting appropriate laboratory tests and treatment.
Current Drug Therapy
- Omeprazole: a new drug for the treatment of acid^peptic diseases
Gastroesophageal reflux disease, Zollinger-Ellison syndrome, duodenal ulcer, and gastric ulcer are among the disorders that have responded to treatment with this agent—the first of a new class of gastric antisecretory drugs.
- Managing the hypertensive patient: reasonable goals
Any approach to treating hypertension should be based on multiple blood pressure readings to establish the diagnosis, aggressive nondrug therapy, and use of low doses when initiating drug therapy.
- Treating hypertension to prevent coronary disease
Past successes and failures in treating hypertension suggest ways to provide better overall therapy and reduce the incidence of coronary heart disease.
Review
- Initial studies with FK506 in renal transplantation
Advantages of this immunosuppressive agent include relatively few side effects and high potency, eliminating the need for steroids in some patients.
