Table of Contents
From the Editor
- Evidence helps, but some decisions remain within the art of medicine
In bacterial meningitis, precise diagnosis by lumbar puncture both offers benefit and poses risk.
The Clinical Picture
- Ring-enhancing cerebral lesions
The patient has poorly controlled HIV, seizures, and brain lesions. Is Histoplasma or Toxoplasma the cause of the lesions?
1-Minute Consult
- When should brain imaging precede lumbar puncture in cases of suspected bacterial meningitis?
Few patients need it. Empiric antibiotic and corticosteroid therapy must not be delayed.
Medical Grand Rounds
- Thrombotic microangiopathies: Similar presentations, different therapies
Effective management depends on prompt diagnosis and targeted therapy.
Review
- Severely frail elderly patients do not need lipid-lowering drugs
Statins have no role as primary prevention in this population, and a minor role as secondary prevention.
Editorial
- Statin therapy in the frail elderly: A nuanced decision
Clinicians—and patients—may reasonably feel there is value in statin therapy—even in advanced frailty.
Im Board Review
- Man’s best friend, fatal in the end
A dog bite in a patient without a spleen can have serious consequences.
Review
- Medical management of urinary incontinence in women
It is common, underreported, and undertreated. Primary care physicians can offer conservative management.
Information for Patients
Review
Cardiopulmonary exercise testing: A contemporary and versatile clinical toolIt has a class I recommendation for evaluating dyspnea of uncertain cause and in candidates for heart transplant.
Departments
- Submassive pulmonary embolism (December 2016)
Readers comment on submassive pulmonary embolism (December 2016).
