Table of Contents
From the Editor
- A New Year’s transition and looking forward
Time to take stock of advances in—and obstacles to—the delivery of quality healthcare.
The Clinical Picture
- Hypothermia and severe first-degree heart block
A 96-year-old woman with hypertension, diabetes, and dementia was found unresponsive and was transferred to the hospital.
- Dysmorphic red blood cell formation
A 23-year-old woman presented with hematuria and dysmorphic red blood cells in the urinary sediment.
Editorial
- Quality in urine microscopy: The eyes of the beholder
The renal patient is best served when the nephrologist familiar with the case performs the urine microscopy
Review
- High users of healthcare: Strategies to improve care, reduce costs
A minority of patients called “high users” consume a lot of healthcare, especially in the emergency department. But therein lies an opportunity.
1-Minute Consult
- What is the hepatitis B vaccination regimen in chronic kidney disease?
For those with advanced chronic kidney disease, the authors recommend a higher dose, more doses, or both.
- Do cardiac risk stratification indexes accurately estimate perioperative risk in noncardiac surgery patients?
Neither of the 2 indexes most often used is completely accurate, and neither is better than the other.
IM Board Review
- A 50-year-old woman with new-onset seizure
After prodromal symptoms, she lost consciousness for about 1 minute, with jerking.
Review
- Idiopathic hypercalciuria: Can we prevent stones and protect bones?
Patients should increase their fluid intake, follow a diet low in salt and animal protein, and take a thiazide diuretic.
- Preventing cardiovascular disease in older adults: One size does not fit all
The balance of risk and benefit may differ considerably for 2 patients of the same age if one is fi t and the other is frail.
Editorial
- Frailty and cardiovascular disease: A two-way street?
Frailty may be both a cause and a consequence of cardiovascular disease.
Review
- Detecting and managing device leads inadvertently placed in the left ventricle
How it happens, how to prevent it, how to detect and correct it immediately, and how to manage cases discovered long after.