Table of Contents
From the Editor
- We have a greater understanding of ‘cardiac syndrome X,’ but questions remain
A better understanding of angina due to ischemia and no obstructive coronary artery disease has led to recognition of coronary microvascular dysfunction in many of these patients.
The Clinical Picture
- Revisiting the ‘great masquerader’
An HIV patient presents with scaly brown lesions on the palms and soles, mildly painful oral erosions, and a buzzing sound in the right ear for the past 20 days.
- Chest pain: The importance of serial ECGs
Repeat electrocardiograms in a 44-year-old man who presented with severe hypertension revealed de Winter and Wellens patterns.
Editorial
- Fungus among us: A poster child for diagnostic stewardship
When interpreting the significance of Aspergillus species in respiratory culture, first ask if the culture was clinically indicated, or if this was an incidental finding.
1-Minute Consult
- Is Aspergillus isolated from respiratory cultures clinically significant?
Aspergillus is ubiquitous, so the significance of the finding depends on the patient’s symptoms, underlying lung condition, immune status, and radiologic fi ndings.
Review
- Ketogenic diets in the management of type 1 diabetes: Safe or safety concern?
A review of the potential risks and benefits for managing type 1 diabetes based on available evidence.
Guidelines to Practice
- Risk-based guidelines: Redefining management of abnormal cervical cancer screening results
A shift from results-based to risk-based management, based on the patient’s immediate and 5-year risks of grade 3 or higher cervical intraepithelial neoplasia.
Review
Coronary microvascular dysfunction: Considerations for diagnosis and treatmentA review of pathophysiology, considerations for invasive and noninvasive coronary function testing, management, and remaining knowledge gaps.
Symptoms to Diagnosis
- Rapid cognitive decline and myoclonus in a 52-year-old woman
Symptoms also included confusion, blank staring, blurred vision, incoordination of the extremities, decreased verbal communication, and holding her left hand in a fist.
