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Cleveland Clinic Journal of Medicine

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Table of Contents

April 01, 2025; Volume 92,Issue 4

From the Editor

  • You have access
    Psychedelics in the medical toolbox?
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 200-201; DOI: https://doi.org/10.3949/ccjm.92b.04025

    Given the historical association of psychedelics as “recreational” mind-altering compounds within countercultures of the 1960s and 1970s, their current introduction into several aspects of medical practice is a surprise to many.

The Clinical Picture

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    Prolonged venous filling time and dependent rubor in a patient with peripheral artery disease
    Scott L. Hagan, MD and Jeffrey W. Redinger, MD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 205-206; DOI: https://doi.org/10.3949/ccjm.92a.24056

    Physical examination in a man who presented with foot pain revealed absent bilateral posterior tibial and dorsalis pedis pulses and dusky erythema of both feet.

1-Minute Consult

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    Should glucagon-like peptide 1 receptor agonists be withheld during the preoperative period?
    Sneha Mishra, MBBS, Patress A. Persons, MD and Sophie Bersoux, MD, MPH
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 209-211; DOI: https://doi.org/10.3949/ccjm.92a.24110

    Clinical judgment should guide this decision, taking into account patient symptoms and the presence of factors that may delay gastric emptying and increase risk for aspiration.

Guidelines to Practice

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    2024 ACC/AHA guideline on perioperative cardiovascular management before noncardiac surgery: What’s new?
    Steven L. Cohn, MD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 213-219; DOI: https://doi.org/10.3949/ccjm.92a.24125

    The author highlights key changes and recommendations of the new guideline, how they differ from previous and other society guidelines, and ongoing challenges and unresolved issues in perioperative care.

Review

  • Most elderly patients with subclinical hypothyroidism do not need to be treated
    You have access
    Most elderly patients with subclinical hypothyroidism do not need to be treated
    Risheng Xu, DO, Nicola Abate, MD, Nalini Ram, MD and Kristina Little, MD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 221-231; DOI: https://doi.org/10.3949/ccjm.92a.24098

    Age-adjusted thyrotropin reference ranges, consideration of individual circumstances, and a wait-and-see approach for mild subclinical hypothyroidism might be more suitable than a universal treatment strategy.

Editorial

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    Subclinical hypothyroidism: What’s in a name?
    Jennifer S. Mammen, MD, PhD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 233-235; DOI: https://doi.org/10.3949/ccjm.92a.25028

    Clinicians should remain thoughtful about the variability in aging biology and not be blinded by a name.

Review

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    Nociplastic pain: A practical guide to chronic pain management in the primary care setting
    Rupak Thapa, MD and Dennis Ang, MD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 236-247; DOI: https://doi.org/10.3949/ccjm.92a.24101

    Nociplastic pain is characterized by amplification of pain transmission and pain perception and does not involve visible tissue injury or damage, which makes it difficult to understand and manage.

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    Psychedelics, spirituality, and existential distress in patients at the end of life
    Nicole Cornish, PharmD, Tara Coles, MD, M. Jennifer Cheng, MD, Claudia Ruiz Sotomayor, MD, DBe, Aaron Wolfgang, MD and Christopher Spevak, MD, MPH, JD
    Cleveland Clinic Journal of Medicine April 2025, 92 (4) 248-254; DOI: https://doi.org/10.3949/ccjm.92a.24100

    The authors explore the role of psychedelics in addressing patients’ spiritual and existential suffering at the end of life from a medical, ethical, and legal perspective.

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In this issue

Cleveland Clinic Journal of Medicine: 92 (4)
Cleveland Clinic Journal of Medicine
Vol. 92, Issue 4
1 Apr 2025
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
  • Complete Issue (PDF)

Issue highlights

  • Most elderly patients with subclinical hypothyroidism do not need to be treated
  • Subclinical hypothyroidism: What’s in a name?
  • Psychedelics, spirituality, and existential distress in patients at the end of life
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