Table of Contents
Medical Grand Rounds
- Diagnosing infective endocarditis
The diagnosis has been based on the presence of fever, a new heart murmur, peripheral stigmata, and sustained bacteremia with a typical microorganism—all of which are not invariably present. New criteria offer greater diagnostic accuracy.
- Assessing depression in medical patients
Suicidal ideation is an intensely personal matter, and many patients may be alarmed by questions about it. A less threatening approach is described.
Internal Medicine Board Review
Clinical Applications of Research
- Preglomerular and postglomerular blood flow: relationship to kidney disease and treatment
Clinicians are taking the first steps toward preventing or slowing kidney failure, thanks to special techniques for studying renal microcirculation.
Reviews
- Prophylaxis of opportunistic infections in persons with HIV infection
Effective regimens are available for preventing some of these infections. Studies are in progress to establish optimum regimens for others.
- Chemotherapy-induced Raynaud's phenomenon
Cure of malignancy is most important, but detecting delayed toxic effects of antineoplastic therapy deserves close attention, as well.
Original Studies
- Metastasis or adenoma? CT evaluation of the adrenal mass
Documenting the stability of adrenal lesions should be done for longer than usual to increase the likelihood of identifying malignant adenomas.
- Azathioprine vs cyclosporine in recipients of HLA-identical renal allografts
These two agents produce equally satisfactory outcomes in this immunologically favored group. The need for continued steroid therapy in these patients requires further study.
Cardiology Dialogues
- Transesophageal echocardiography: why and when to use it
In this open discussion of an important health care utilization issue, panelists expound on the appropriateness of TEE in several clinical situations.
Clinical Pathological Conference
- A 51-year-old man with a history of stroke and red streaks in the legs
A diagnostically challenging case is worked up. Based on a presentation at a Cleveland Clinic Foundation Clinical Pathological Conference.
Case Reports
Editorial
- Clinical practice guidelines for HIV infection: progress towards making AIDS a primary care disease
An appraisal of the guidelines released in January by the Agency for Health Care Policy and US Public Health Service.