Table of Contents

August 01, 2004; Volume 71,Issue 8

From the Editor

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The angiotensin story continues: ARBs in heart failure
John D. Clough, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 606;

Considering the gravity of the problem of heart failure, it makes sense to have as many alternative pathways to success as we can find.

Commentary

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It’s what’s inside the white coat that counts
Phillip M. Hall, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 607-608;

Welcoming the first class of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

Interpreting Key Trials

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Lessons from the PROVE-IT Trial
Kiran K. Khush, MD and David Waters, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 609-616;

Patients with acute coronary syndromes should receive aggressive lipid-lowering therapy with a statin in high doses. Goal low-density lipoprotein levels may need to be lower.

Cancer Diagnosis and Management

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Cancer pain: How to measure the fifth vital sign
Mellar P. Davis, MD and Declan Walsh, MSc

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 625-632;

To control pain effectively in cancer patients, we must assess it regularly and consistently.

Review

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Acute leukemia with a very high leukocyte count: Confronting a medical emergency
Navneet S. Majhail, MD and Alan E. Lichtin, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 633-637;

From 5% to 30% of adult patients with acute leukemias present with hyperleukocytosis and leukostasis. Prompt action is needed.
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Evaluation of hyponatremia: A little physiology goes a long way
Benjamin J. Freda, DO, Michael B. Davidson, DO and Phillip M. Hall, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 639-650;

A careful and logical approach can promptly reveal the causative factor or factors in nearly all cases.

Im Board Review

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A 76-year-old woman with erratic anticoagulation
Emil P. Lesho, DO, Louise Saullo, CRTT and Szilvia Udvari-Nagy, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 651-656;

A patient previously controlled on warfarin now has bleeding and an INR of 7. What has changed?

Review

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Nonalcoholic fatty liver disease and the epidemic of obesity
Rochelle Collantes, MD, MPH, Janus P. Ong, MD and Zobair M. Younossi, MD, MPH

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 657-664;

Nonalcoholic fatty liver disease, unknown only 2 decades ago, is now ubiquitous, especially among the obese.

Interpreting Key Trials

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Angiotensin-receptor blockers in heart failure
Shyam Bhakta, MD and Mark E. Dunlap, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 665-673;

The ARB candesartan was not only a good alternative to an ACE inhibitor, it was beneficial when added to a regimen that already included an ACE inhibitor and a beta-blocker.

Editorial

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And an ARB makes nine: Polypharmacy in patients with heart failure
Josef Stehlik, MD, MPH and David O. Taylor, MD

Cleveland Clinic Journal of Medicine August 2004, 71 (8) 674-677;

Based on strong evidence, a patient with advanced ischemic cardiomyopathy should be taking nine medications. But it is difficult not to worry about polypharmacy.