More articles from Review

  • High-output heart failure from arteriovenous dialysis access: A structured approach to diagnosis and management
    Maximilian C. Volk, DO, Bianca Honnekeri, MD, Joanna Ghobrial, MD, Mazen Hanna, MD, Sanjeeb Bhattacharya, MD, Lee Kirksey, MD, J. Emanuel Finet, MD and Heba Wassif, MD, MPH
    Cleveland Clinic Journal of Medicine June 2025, 92 (6) 362-371; DOI: https://doi.org/10.3949/ccjm.92a.24114

    Arteriovenous high-output heart failure is likely underdiagnosed because many clinicians are uncertain about when and how to evaluate for it.

  • Direct oral anticoagulants: Challenging prescribing scenarios in everyday practice
    CME article
    Syed Bukhari, MD, MHA, Mohamed Ghoweba, MD, Syed Zamrak Khan, MD, Ammar Saati, MD and Marcelo Gomes, MD
    Cleveland Clinic Journal of Medicine June 2025, 92 (6) 353-361; DOI: https://doi.org/10.3949/ccjm.92a.24061

    Preapproval trials of direct oral anticoagulants excluded patients with extreme body weight and advanced kidney and liver disease and those who had undergone bariatric surgery. Cautious decision-making in these patients is warranted.

  • IgA nephropathy: Update on pathogenesis and treatment
    IgA nephropathy: Update on pathogenesis and treatment
    Seshma Ramsawak, MD, Scott Cohen, MD, Andrea Linares, DO and Corey Cavanaugh, DO
    Cleveland Clinic Journal of Medicine June 2025, 92 (6) 373-383; DOI: https://doi.org/10.3949/ccjm.92a.24105

    Renin-angiotensin-aldosterone system inhibitors or corticosteroids remain the cornerstone of therapy, but new agents targeting the different “hits” in the pathogenesis of IgA nephropathy are being introduced.

  • Alpha-gal syndrome: Recognizing and managing a tick-bite–related meat allergy
    Zehra Naseem, MD, Aun Muhammad, MD, Arjun Chatterjee, MD and Alberto Rubio-Tapia, MD
    Cleveland Clinic Journal of Medicine May 2025, 92 (5) 311-319; DOI: https://doi.org/10.3949/ccjm.92a.24072

    Alpha-gal syndrome is an emerging allergic condition in which immunoglobulin E–mediated symptoms are triggered a few hours after an affected person consumes mammalian meat.

  • Managing right ventricular failure in the setting of pulmonary embolism
    Managing right ventricular failure in the setting of pulmonary embolism
    Sharmeen Sorathia, MD, Anibelky Almanzar, MD, Abhishek Bhandiwad, MD and Phoo Pwint Nandar, MD
    Cleveland Clinic Journal of Medicine May 2025, 92 (5) 301-309; DOI: https://doi.org/10.3949/ccjm.92a.24069

    The authors review current management strategies, including medical, percutaneous interventional, and surgical options, and discuss recent advances in the field.

  • 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.

  • Nociplastic pain: A practical guide to chronic pain management in the primary care setting
    CME article
    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.

  • Most elderly patients with subclinical hypothyroidism do not need to be treated
    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.

  • Coronary artery bypass grafting: Practice trends and projections
    Coronary artery bypass grafting: Practice trends and projections
    Richard Ramsingh, MD and Faisal G. Bakaeen, MD
    Cleveland Clinic Journal of Medicine March 2025, 92 (3) 181-191; DOI: https://doi.org/10.3949/ccjm.92a.23071

    Future directions include expanding the use of multiarterial grafting, offering patients less-invasive approaches, and enhancing operative recovery.

  • Cardiovascular disease in people living with HIV: Risk assessment and management
    Elizabeth Ghandakly, MD, JD, Rohit Moudgil, MD, PhD and Katherine Holman, MD
    Cleveland Clinic Journal of Medicine March 2025, 92 (3) 159-167; DOI: https://doi.org/10.3949/ccjm.92a.24055

    Because people living with HIV develop coronary artery disease much earlier than the general population, careful attention must be given to assessment and management of their cardiovascular risk.

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