Table of Contents
From the Editor
- A guideline is like a prescription
We should not worship the idol of guidelines alone, but neither should we ignore them and make decisions based only on anecdote and experience.
The Clinical Picture
- A 47-year-old man with chest and neck pain
While boarding a bus, a 50-pack-year smoker with chronic obstructive pulmonary disease heard popping sounds, which were followed by chest and neck pain. What do his radiographs show?
- Right upper-abdominal pain in a 97-year-old
Physical findings and laboratory studies are normal. What is the cause of this patient’s pain?
1-Minute Consult
- When do Raynaud symptoms merit a workup for autoimmune rheumatic disease?
Clues to systemic disease include prolonged and painful attacks that can cause ulceration or gangrene. Other clues are older age at onset, male sex, and asymmetric involvement.
Medical Grand Rounds
- Advanced heart failure: Transplantation, LVADs, and beyond
Patients with advanced heart failure far outnumber hearts available for transplantation. Mechanical devices are filling the gap.
Review
- A short story of the short QT syndrome
Short QT syndrome is a recently recognized cause of cardiac rhythm disorders, including sudden cardiac death. Though rare, it is worth thinking about.
Human papillomavirus vaccine: Safe, effective, underusedBecause HPV is sexually transmitted, HPV vaccination has met with public controversy. A review of the data and the challenges.
Departments
- Correction
A sentence was omitted from the abstract of McGill JJ, Shoskes DA, Sabanegh ES Jr. Androgen deficiency in older men: indications, advantages, and pitfalls of testosterone replacement therapy. Cleve Clin J Med 2012; 79:797–806.
Commentary
Treatment approaches differ depending on the patient’s clinical presentation and on the preferences of the patient and the physician. Often, more than one approach is possible.