Table of Contents
September 01, 2019; Volume 86, Issue 9-
From The Editor
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Clinical outcomes in diabetes: It’s not just the glucose (and it’s not so simple)
Brian F. Mandell, MD, PhD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 573-574;
- DOI: https://doi.org/10.3949/ccjm.86b.09019
As we dig deeper into the reduction in cardiovascular deaths seen with some newer drugs, several questions arise.
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The Clinical Picture
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Diabetic dyslipidemia with eruptive xanthoma
Yu-Chun Hsueh, MD, Chuan-Liang Chou, MD and Ting-I. Lee, MD, PhD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 575-576;
- DOI: https://doi.org/10.3949/ccjm.86a.18104
Off medications for 1 year, her triglyceride level was 10,250 mg/dL, hemoglobin A1c 12.4%.
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Pseudo-Ludwig angina
Andrew Tiu, MD and Kamolyut Lapumnuaypol, MD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 577-578;
- DOI: https://doi.org/10.3949/ccjm.86a.19014
A woman on heparin developed a hematoma on the floor of her mouth that threatened to block her airway.
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Mediastinal granuloma due to histoplasmosis in a patient on infliximab
Takaaki Kobayashi, MD and Christine Cho, MD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 579-581;
- DOI: https://doi.org/10.3949/ccjm.86a.18138
Immunosuppressive drugs can predispose to invasive fungal infection.
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1-Minute Consult
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Are daily chest radiographs and arterial blood gas tests required in ICU patients on mechanical ventilation?
Shyam Ganti, MD, Ravinder D. Bhanot, MD, Jasleen Kaur, MD, Cassondra Cramer-Bour, MD and Ayman O. Soubani, MD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 582-585;
- DOI: https://doi.org/10.3949/ccjm.86a.18141
Although routine testing is common, it has low diagnostic yield and is unlikely to alter patient management.
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Symptoms to Diagnosis
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A young man with acute chest pain
Gregory W. Rutecki, MD, Amir Farid, MD, Neil Beri, MD, David Torres-Barba, MD, PhD and Charles Whitcomb, MD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 586-594;
- DOI: https://doi.org/10.3949/ccjm.86a.19025
A young man presents with severe, pressure-like, midsternal, nonradiating pain, rated 10 on a scale of 10.
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Current Drug Therapy
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Diabetes management: Beyond hemoglobin A1c
Vinni Makin, MBBS, MD, FACE and M. Cecilia Lansang, MD, MPH- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 595-600;
- DOI: https://doi.org/10.3949/ccjm.86a.18031
Other factors include cardiovascular benefit, weight control, hypoglycemia risk, and cost.
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ACE inhibitors and ARBs: Managing potassium and renal function
Tasnim Momoniat, MBCHB, MRCP (UK), Duha Ilyas, MBBS, MRCP (UK) and Sunil Bhandari, MBCHB, FRCP, PhD, M CLIN EDU, FHEA- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 601-607;
- DOI: https://doi.org/10.3949/ccjm.86a.18024
Concern about hyperkalemia and a decline in renal function has led to underuse of these drugs.
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Editorial
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ACE inhibitor and ARB therapy: Practical recommendations
Hernan Rincon-Choles, MD, MS- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 608-611;
- DOI: https://doi.org/10.3949/ccjm.86a.19016
Inhibitors of the renin-angiotensin-aldosterone system are cornerstones of therapy of cardiovascular disease.
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Review
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Hemorrhoids: A range of treatments
Turgut Bora Cengiz, MD and Emre Gorgun, MD, FACS, FASCRS- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 612-620;
- DOI: https://doi.org/10.3949/ccjm.86a.18079
Each patient is unique, and with the range of options available, treatment can be individualized.
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Disparities in cardiovascular care: Past, present, and solutions
Quentin R. Youmans, MD, Lindsey Hastings-Spaine, MD, Oluseyi Princewill, MD, MPH, Titilayo Shobayo, BS and Ike S. Okwuosa, MD- Cleveland Clinic Journal of Medicine September 2019, 86 (9) 621-632;
- DOI: https://doi.org/10.3949/ccjm.86a.18088
Cardiovascular disease makes no distinction in race, sex, age, or socioeconomic status, and neither should clinicians.
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