Table of Contents
From the Editor
- Vaccination: An option not to be ignored
Outbreaks of measles are seemingly on the rise, mainly because of lower vaccination rates, which are in part due to the unfounded fear that the vaccine causes autism.
Interpreting Key Trials
- Treating silent reflux disease does not improve poorly controlled asthma
A recent multicenter trial indicated that empirically prescribing a proton pump inhibitor does not help control asthma symptoms and that current guidelines need to be reevaluated.
Editorial
- Stenting for atherosclerotic renal artery stenosis: One poorly designed trial after another
The three randomized trials of stenting vs medical therapy published so far are so seriously flawed that it is impossible to make treatment decisions based on their results.
Review
Stenting atherosclerotic renal arteries: Time to be less aggressiveIt is time to strongly reconsider the current aggressive approach to revascularization of stenotic renal arteries and to take a more coordinated, critical approach.
Interpreting Key Trials
- Interpreting the Jupiter trial: Statins can prevent VTE, but more study is needed
The incidence of venous thromboembolism in people taking rosuvastatin (Crestor) 20 mg/day was about half that in people taking placebo. This was a relatively healthy population, and the incidence in both groups was low.
Review
- When and how to evaluate mildly elevated liver enzymes in apparently healthy patients
Not all asymptomatic people with a mildly elevated liver enzyme value need an extensive evaluation, which can be costly, anxiety-provoking, and risky.
The Clinical Picture
- Palpable purpura
A healthy 47-year-old woman presents with a 3-day history of widespread asymptomatic lesions in the extremities, fever, arthralgias, and mild abdominal pain. What is the diagnosis?
Review
- Measles: Not just a childhood rash
Outbreaks continue to be reported in communities with a high number of unvaccinated people. Most cases are linked to international travel.
Departments
- Diffuse alveolar hemorrhage (April 2008)
Errors appeared in Ioachimescu OC, Stoller JK. Diffuse alveolar hemorrhage: diagnosing it and finding the cause. Cleve Clin J Med 2008; 74:258–280, and in Samplaski MK, Irwin BH, Desai M. Less-invasive ways to remove stones from the kidneys and ureters. Cleve Clin J Med 2009; 76:592–598.
- Renal stone interventions (October 2009)
Errors appeared in Ioachimescu OC, Stoller JK. Diffuse alveolar hemorrhage: diagnosing it and finding the cause. Cleve Clin J Med 2008; 74:258–280, and in Samplaski MK, Irwin BH, Desai M. Less-invasive ways to remove stones from the kidneys and ureters. Cleve Clin J Med 2009; 76:592–598.
