Table of Contents
September 01, 2011; Volume 78, Issue 9-
From the Editor
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When to stop treating the bones
Brian F. Mandell, MD, PhD- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 563;
- DOI: https://doi.org/10.3949/ccjm.78b.11009
Don’t let the argument about how long to treat osteoporosis with bisphosphonate drugs stand in the way of initiating therapy in patients at risk of fracture.
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Medical Grand Rounds
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Accountable care organizations, the patient-centered medical home, and health care reform: What does it all mean?
David L. Longworth, MD- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 571-582;
- DOI: https://doi.org/10.3949/ccjm.78gr.11003
Central to fixing the broken US health care system are two concepts: the patient-centered medical home and accountable care organizations.
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Review
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Allergy blood testing: A practical guide for clinicians
Roxana I. Siles, MD and Fred H. Hsieh, MD- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 585-592;
- DOI: https://doi.org/10.3949/ccjm.78a.11023
These tests can confirm the diagnosis of an allergic disorder, supplementing the clinical history. They are particularly useful when skin testing cannot or should not be done.
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The Clinical Picture
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Oral plaques and dysphagia in a young man
Amber S. Tully, MD and Carol Dao, MD- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 594-596;
- DOI: https://doi.org/10.3949/ccjm.78a.10150
A 23-year-old man presents with oral plaques, a sore throat, dysphagia, malaise, and weight loss. What is the most likely diagnosis?
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Review
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Hepatic encephalopathy: Suspect it early in patients with cirrhosis
Jamilé Wakim-Fleming, MD, FACG- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 597-605;
- DOI: https://doi.org/10.3949/ccjm.78a10117
Prompt identification and treatment are essential, since the prognosis worsens rapidly once overt encephalopathy develops.
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The Clinical Picture
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Unmasking gastric cancer
Faysal Altahawi, Abdul Hamid Alraiyes, MD and M. Chadi Alraies, MD, FACP- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 606-608;
- DOI: https://doi.org/10.3949/ccjm.78a.10129
Screening with diagnostic imaging may be justified in high-risk groups, although the issue is debatable.
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Review
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Venous thromboembolism: What to do after anticoagulation is started
Scott Kaatz, DO, MSc, FACP, Waqas Qureshi, MD and Robert C. Lavender, MD, FACP- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 609-618;
- DOI: https://doi.org/10.3949/ccjm.78a.10175
Three issues need to be addressed: the length of therapy, measures to prevent postthrombotic syndrome, and a basic workup for possible underlying malignancy.
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Current Drug Therapy
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What is the optimal duration of bisphosphonate therapy?
Susan M. Ott, MD- Cleveland Clinic Journal of Medicine September 2011, 78 (9) 619-630;
- DOI: https://doi.org/10.3949/ccjm.78a.11022
It is reasonable to stop bisphosphonates after 5 years of use and then to follow patients with markers of bone turnover.
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