Table of Contents

August 01, 2017; Volume 84,Issue 8

From the Editor

  • Understanding the bell-ringing of concussion
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 583; DOI: https://doi.org/10.3949/ccjm.84b.08017

    Back in the day, if we could count the coach’s fingers, we could go back into the game. Now we are more attuned to injury.

The Clinical Picture

  • Breast calcifications mimicking pulmonary nodules
    Moiz Salahuddin, MD, Thomas Reilly, MD and Jorge Mora, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 584-585; DOI: https://doi.org/10.3949/ccjm.84a.16048

    Radiography suggested the lesions were in the lungs, but CT and mammography said otherwise.

  • Pseudo-Wellens syndrome after heavy marijuana use
    Michael Lawrenz Ferreras Co, MD, Anshuman Das, MD and Tochukwu Okwuosa, DO
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 590-591; DOI: https://doi.org/10.3949/ccjm.84a.16133

    Acute marijuana intoxication is associated with reversible changes in the P and T waves and ST segments.

  • A lump on the hip
    Morteza Khodaee, MD, MPH, Seth Mathern, MD, Wendy S. Madigosky, MD, MSPH and Jonathan T. Bravman, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 594-596; DOI: https://doi.org/10.3949/ccjm.84a.16065

    The patient had fallen on his hip while playing basketball about 2 weeks earlier.

Smart Testing

  • Is spirometry necessary to diagnose and control asthma?
    Mani Latifi, MD and Sumita Khatri, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 597-599; DOI: https://doi.org/10.3949/ccjm.84a.16078

    Asthma is a clinical diagnosis, but spirometry can improve how we diagnose, assess, and control it.

Im Board Review

  • Weight loss, fatigue, and renal failure
    Qiwei Paulson, MD, Christopher A. Stearns, MD and Paul Nader, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 601-607; DOI: https://doi.org/10.3949/ccjm.84a.16053

    A 37-year-old man has gradually lost 100 lb over the past 2 years, with progressive fatigue and malaise.

Review

  • Delirium in hospitalized patients: Risks and benefits of antipsychotics
    Robyn Pauline Thom, MD, Clare Kelleher Mock, MD and Polina Teslyar, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 616-622; DOI: https://doi.org/10.3949/ccjm.84a.16077

    No drug is approved for delirium, but antipsychotics can be used in certain situations.

  • Concussion: Evaluation and management
    Concussion: Evaluation and management
    Alexandra Stillman, MD, Michael Alexander, MD, Rebekah Mannix, MD, Nancy Madigan, PhD, Alvaro Pascual-Leone, MD, PhD and William P. Meehan, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 623-630; DOI: https://doi.org/10.3949/ccjm.84a.16013

    Initial therapy involves several days of cognitive and physical rest, then a gradual return to activities.

  • Combined hormonal contraceptives and migraine: An update on the evidence
    Anne H. Calhoun, MD, FAHS and Pelin Batur, MD, FACP, NCMP
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 631-638; DOI: https://doi.org/10.3949/ccjm.84a.16033

    These contraceptives are contraindicated in women who have migraine with aura, but benefit vs risk is debatable.

  • Necrotizing pancreatitis: Diagnose, treat, consult
    Tiffany Y. Chua, MD, R. Matthew Walsh, MD, FACS, Mark E. Baker, MD and Tyler Stevens, MD
    Cleveland Clinic Journal of Medicine August 2017, 84 (8) 639-648; DOI: https://doi.org/10.3949/ccjm.84a.16052

    Patients may need intensive care, nutritional support, antibiotics, and radiologic, endoscopic, or surgical interventions.

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