Table of Contents

January 01, 2014; Volume 81,Issue 1

From the Editor

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Return of the ‘pisse-mongers,’ this time with data
Brian F. Mandell, MD, PhD

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 9-10; DOI: https://doi.org/10.3949/ccjm.81b.01014

Urinalysis may be the oldest surviving laboratory test. Both Hippocrates and Galen recognized its value.

Commentary

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New cholesterol guidelines: Worth the wait?
Chad Raymond, DO, Leslie Cho, MD, Michael Rocco, MD and Stanley L. Hazen, MD, PhD

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 11-19; DOI: https://doi.org/10.3949/ccjm.81a.13161

An appraisal of the controversial new guidelines, with case scenarios illustrating their advantages and shortcomings.

The Clinical Picture

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Deep T waves and chest pain
M. Chadi Alraies, MD, Wael Aljaroudi, MD, Usman Ayub Khan, MBBS and Abdul Hamid Alraiyes, MD

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 21-22; DOI: https://doi.org/10.3949/ccjm.81a.12176

After 3 hours of chest pain, a 67-year-old man presented with deep symmetric T-wave inversions in the precordial leads, a prognostically significant finding.

1-Minute Consult

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Do all hospitalized patients need stress ulcer prophylaxis?
Naseem Eisa, MD, Fateh Bazerbachi, MD, Abdul Hamid Alraiyes, MD and M. Chadi Alraies, MD

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 23-25; DOI: https://doi.org/10.3949/ccjm.81a.13070

No. Only critically ill patients who meet specific criteria should receive it.

Im Board Review

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An 85-year-old with muscle pain
David Snipelisky, MD and Fernando Stancampiano, MD

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 27-30; DOI: https://doi.org/10.3949/ccjm.81a.13086

When preventive therapy causes side effects, physicians face a dilemma.

Personalizing Patient Care

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How to spot heritable breast cancer: A primary care physician’s guide
Marissa Smith, MS, CGC, Jessica Mester, MS, CGC and Charis Eng, MD, PhD

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 31-40; DOI: https://doi.org/10.3949/ccjm.81a.13051

Because breast cancer is common, primary care physicians will encounter many patients who have a personal or family history of it. Many patients may benefit from referral to a cancer genetics program for assessment, genetic counseling, and consideration of genetic testing. This article discusses the complexities of risk assessment in cancer genetics (focusing on breast cancer), and highlights the primary care physician’s role in identifying and caring for patients at risk.

Review

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Albuminuria: When urine predicts kidney and cardiovascular disease
Reejis Stephen, MD, SM, Stacey E. Jolly, MD, MAS, Joseph V. Nally, MD and Sankar D. Navaneethan, MD, MPH

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 41-50; DOI: https://doi.org/10.3949/ccjm.81a.13040

Albuminuria is common. Traditionally considered a precursor to diabetic nephropathy, it has now been directly linked to adverse cardiovascular outcomes and death, independent of other risk factors. In this review, we compare the measures of albuminuria, examine the evidence linking it to renal failure, cardiovascular disease, and death, and provide recommendations for its testing and management.
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Obesity in the elderly: More complicated than you think
Derrick C. Cetin, DO and Gaelle Nasr, BA

Cleveland Clinic Journal of Medicine January 2014, 81 (1) 51-61; DOI: https://doi.org/10.3949/ccjm.81a.12165

The number of obese older adults is on the rise, although we lack a proper definition of obesity in this age group. The ambiguity is primarily related to sarcopenia, the progressive loss of muscle and gain in fat that come with aging. Whether to treat and how to treat obesity in the elderly is controversial because of a paucity of established guidelines, but also because of the obesity paradox—ie, the apparently protective effect of obesity in this age group.