Table of Contents
From the Editor
- We try to walk the line
Whenever we publish a review of a new drug, we run the risk of being perceived as promoting the drug.
Review
- ‘I’m not that sick!’ Overcoming the barriers to hospice discussions
We describe the role and services of hospice care, explore misconceptions about hospice and barriers to discussing the issue, and suggest ways to facilitate conversations with patients with terminal illness.
Cardiovascular Board Review
- An elderly man with syncope caused by right ventricular infarction and anomalous coronary vasculature
Up to half of inferior infarctions involve the right ventricle. Typical signs of right ventricular infarction include hypotension, jugular venous distention, clear lung fields, ST-segment depression in V1 and V2, and elevations in V3R and V4R.
Medical Grand Rounds
- Sexually transmitted diseases 2006: A dermatologist’s view
How to recognize, diagnose, and manage common sexually transmitted diseases, and how their presentation and treatment differ in patients with human immunodeficiency virus.
The Clinical Picture
- A young man with unexplained dyspnea
He has Wegener granulomatosis, and pulmonary function testing shows flattening of the inspiratory and expiratory limbs of his flow-volume loop. What is the cause?
1-Minute Consult
- Should beta-blockers be discontinued when a patient is admitted to the hospital with acutely decompensated heart failure?
Hard data on this topic are scant, but the answer depends on the patient’s perfusion status and vital signs.
Review
- Evaluating and managing adrenal incidentalomas
When an adrenal mass is found unexpectedly on imaging in a patient with no other evidence of adrenal disease, how can one determine if it is clinically benign or needs treatment?
- Inhaled human insulin: An inspiration for patients with diabetes mellitus?
We discuss the pharmacology, efficacy, important clinical trials, and practical aspects of inhaled insulin, and potential concerns associated with its use.
Editorial
- Inhaled human insulin: Coup or caution?
Inhaled human insulin is a big step forward, but it comes with cautions, concerns, and additional responsibilities.
Imaging in Practice
- Diagnostic imaging:Radiation dose and patients’ concerns
Radiologic procedures carry small but real risks from radiation exposure. What should we tell patients?