Table of Contents
From the Editor
- Hypertension: Don’t worry about the J curve—treat the patient
Concerns over being too aggressive remain theoretical. A far greater problem is that we are still not successfully treating hypertension to even a conservative target.
1-Minute Consult
- How should one investigate a chronic cough?
First, take the history, perform a physical examination, and order a chest radiograph.
Medical Grand Rounds
- Seek and treat: HIV update 2011
Clinicians should routinely and matter-of-factly test patients for human immunodeficiency virus infection, just as they screen for other diseases.
Review
- Airway pressure release ventilation: An alternative mode of mechanical ventilation in acute respiratory distress syndrome
This mode may be useful in situations in which the lungs need to be recruited (reinflated) and held open.
Air travel and venous thromboembolism: Minimizing the riskBlood clots can occur during air travel, although the absolute risk is low. People with hypercoagulable conditions are at greater risk and may need prophylaxis.
Patient Information
Review
- Goal-directed antihypertensive therapy: Lower may not always be better
At least 16 trials have been done in which patients were randomly assigned different blood pressure goals. Surprisingly, they did not show that a lower target offered significant clinical benefit, and they suggest the potential for harm.
Departments
- Gout in patients with chronic kidney disease (December 2010)
The last three references were numbered incorrectly in the paper by Drs. Hossam El-Zawawy and Brian F. Mandell, “Managing gout: How is it different in patients with chronic kidney disease?” (Cleve Clin J Med 2010; 77:919–928).
- MAO inhibitors (December 2010)
A reader comments on the use of monoamine oxidase inhibitors to treat depression (December 2010) and on the treatment of gout in patients with chronic kidney disease (December 2010).
- Gout and chronic kidney disease (December 2010)
A reader comments on the use of monoamine oxidase inhibitors to treat depression (December 2010) and on the treatment of gout in patients with chronic kidney disease (December 2010).
Commentary
When the patient is a “very important person,” the health care team should resist pressure to bend the rules.