Table of Contents

August 01, 2019; Volume 86,Issue 8

From the Editor

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Deciding when a picture is worth a thousand words and several thousand dollars
Brian F. Mandell, MD, PhD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 509-510; DOI: https://doi.org/10.3949/ccjm.86b.08019

Physical examination is cheap but not highly reproducible. Imaging is expensive but may be more sensitive and specific.

The Clinical Picture

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Osteonecrosis of the femoral head with subchondral collapse
Nicolas S. Piuzzi, MD, Hiba K. Anis, MD and George F. Muschler, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 511-512; DOI: https://doi.org/10.3949/ccjm.86a.19004

A 45-year-old woman had been taking corticosteroids long-term after organ transplant.

Smart Testing

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When does acute pyelonephritis require imaging?
Mary E. Lacy, MD, Navneet Sidhu, MD and Justin Miller, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 515-517; DOI: https://doi.org/10.3949/ccjm.86a.18096

Imaging is recommended for those at risk of complications.

1-Minute Consult

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Should we stop aspirin before noncardiac surgery?
Anbazhagan Prabhakaran, MD, MRCP (Edin), FACP and Christopher Whinney, MD, SFHM, FACP

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 518-521; DOI: https://doi.org/10.3949/ccjm.86a.18075

It depends on the type of surgery and the reason the patient is taking aspirin.

Editorial

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Aspirin: 4,000 years and still learning
Kenneth C. Cummings, MD, MS, FASA

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 522-524; DOI: https://doi.org/10.3949/ccjm.86a.19041

What we know about aspirin—and what we still need to learn.

Commentary

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Primary care: Practice meets technology
Cristina I. Pravia, MD, FACP, MBA and Yvonne M. Diaz, MD, FACP

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 525-528; DOI: https://doi.org/10.3949/ccjm.86a.18122

Technology has infiltrated all parts of our lives. Physicians need to adapt and adjust.

Editorial

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Running in place: The uncertain future of primary care internal medicine
Craig Nielsen, MD, FACP and Pelin Batur, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 530-534; DOI: https://doi.org/10.3949/ccjm.86a.19075

If we don’t demand change, who will be there to take care of us when we grow old?

Symptoms to Diagnosis

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An unusual cause of bruising
CME article

Tahani Atieh, DO and Alan Lichtin, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 535-542; DOI: https://doi.org/10.3949/ccjm.86a.18119

The coagulation assay, particularly the prothrombin time and aPTT, is key in initially assessing a bleeding abnormality.

Review

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Adults with autism spectrum disorder: Updated considerations for healthcare providers
CME article

Carol Swetlik, MD, MS, Sarah E. Earp, MD and Kathleen N. Franco, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 543-553; DOI: https://doi.org/10.3949/ccjm.86a.18100

Social support, community programs, and behavioral therapies can help. Caregivers may also need support.

Editorial

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Where have all the children gone? Intentional communities for adults with autism
Carl R. Brass, LPCC-S, MA and Debra J. Mandell, OTR/L, MA

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 554-558; DOI: https://doi.org/10.3949/ccjm.86a.19080

Children with ASD grow to be adults with ASD, with complex healthcare needs.

Review

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Infective endocarditis: Beyond the usual tests
CME article

Nkemdilim Mgbojikwe, MD, Steven R. Jones, MD, Thorsten M. Leucker, MD, PhD and Daniel J. Brotman, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 559-567; DOI: https://doi.org/10.3949/ccjm.86a.18120

Newer imaging tests are increasingly used as alternatives or adjuncts to echocardiography for selected patients.

Letters to the Editor

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Gastroparesis
Amos Lal, MD, Pantea Ebrahimpour, MD and Nitin Trivedi, MD, FACP, FACE

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 514; DOI: https://doi.org/10.3949/ccjm.86c.08001

A reader raises questions about diabetic gastroparesis (April 2019).
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In reply: Gastroparesis
Ahmad Muneer Sharayah, MD, Noor Hajjaj, MD, Ramy Osman, MD and Douglas Livornese, MD

Cleveland Clinic Journal of Medicine August 2019, 86 (8) 514; DOI: https://doi.org/10.3949/ccjm.86c.08002