Table of Contents
From the Editor
- Myasthenia gravis: An update for internists
Recognizing the spectrum of the disease in patients’ complaints enhances our clinical reasoning skills when faced with the extremely commonly expressed symptom of “fatigue.”
The Clinical Picture
- Oral leukoplakia and oral cancer
A 53-year-old male who had smoked for 36 years was referred by his dentist for worsening vitiligo diagnosed as leukoplakia 3 years earlier.
1-Minute Consult
- What are the treatment options for myasthenia gravis if first-line agents fail?
From 5% to 20% of patients may have a suboptimal response or prohibitive adverse effects over a period of a few weeks to 3 months.
Editorial
- Vitamin D: A metabolic bone disease perspective
When checking levels, clinicians should keep in mind that vitamin D levels fluctuate by season and time of day, and that different laboratories may use different assays that yield different results.
Symptoms to Diagnosis
- A 50-year-old man presents with shortness of breath
Red flags included low voltage, normal sinus rhythm, and Q waves on electrocardiography, a history of carpal tunnel syndrome, and evidence of renal dysfunction.
Review
- Myasthenia gravis: Frequently asked questions
Who is at risk? Which tests should be ordered? How does the disease course affect management decisions? What instructions should you give patients? And other questions.
- Resistant hypertension: A stepwise approach
The authors review the definition and prevalence of resistant hypertension and its diagnostic workup and management, including lifestyle modifications, drugs, and experimental therapies.
Commentary
An astronomic increase in vitamin D testing and supplementation is happening in the absence of an evidence-based rationale.