Latest Articles

  • Fragility fractures in chronic kidney disease: An opinion-based approach
    Paul D. Miller, MD
    Cleveland Clinic Journal of Medicine December 2009, 76 (12) 715-723; DOI: https://doi.org/10.3949/ccjm.76a.08108

    When a patient with chronic kidney disease suffers a fragility fracture, a key question is whether the patient has osteoporosis or, instead, renal osteodystrophy. Bone densitometry does not help in this distinction.

  • Prasugrel for acute coronary syndromes: Faster, more potent, but higher bleeding risk
    Lawrence D. Lazar, MD and A. Michael Lincoff, MD
    Cleveland Clinic Journal of Medicine December 2009, 76 (12) 707-714; DOI: https://doi.org/10.3949/ccjm.76a.09116

    Prasugrel (Effient) is faster and more consistent in its effects, but patients at high bleeding risk should still receive clopidogrel (Plavix).

  • An algorithm for managing warfarin resistance
    Olusegun Osinbowale, MD, MBA, RPVI, Monzr Al Malki, MD, Andrew Schade, MD, PhD and John R. Bartholomew, MD
    Cleveland Clinic Journal of Medicine December 2009, 76 (12) 724-730; DOI: https://doi.org/10.3949/ccjm.76a.09062

    Some patients need higher-than-expected doses of warfarin to reach their target INR. The cause can be acquired (poor compliance, drug interactions) or hereditary.

  • Low bone density is not always bisphosphonate deficiency
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine December 2009, 76 (12) 683; DOI: https://doi.org/10.3949/ccjm/76a.12001

    Low bone density is not a one-size-fits-all disorder. We need to carefully consider the diagnostic and therapeutic options before assuming that low bone density is osteoporosis.

  • Perioperative fluid management: Progress despite lingering controversies
    Mark A. Hamilton, MBBS, MRCP, FRCA
    Cleveland Clinic Journal of Medicine November 2009, 76 (10 suppl 4) S28-S31; DOI: https://doi.org/10.3949/ccjm.76.s4.05
  • Case studies in perioperative management: Challenges, controversies, and common ground
    Steven L. Cohn, MD and Bobbiejean Sweitzer, MD
    Cleveland Clinic Journal of Medicine November 2009, 76 (10 suppl 4) S72-S78; DOI: https://doi.org/10.3949/ccjm.76.s4.12
  • Nuts and bolts of preoperative clinics: The view from three institutions
    Angela M. Bader, MD, MPH, Bobbiejean Sweitzer, MD and Ajay Kumar, MD
    Cleveland Clinic Journal of Medicine November 2009, 76 (10 suppl 4) S104-S111; DOI: https://doi.org/10.3949/ccjm.76.s4.17
  • Current therapies to shorten postoperative ileus
    Michael D. Johnson, MD and R. Matthew Walsh, MD
    Cleveland Clinic Journal of Medicine November 2009, 76 (11) 641-648; DOI: https://doi.org/10.3949/ccjm.76a.09051

    Rather than merely wait for bowel sounds to return after patients undergo surgery, we can try to get the gut working again sooner.

  • Statins and noncardiac surgery: Current evidence and practical considerations
    Don Poldermans, MD, PhD
    Cleveland Clinic Journal of Medicine November 2009, 76 (10 suppl 4) S79-S83; DOI: https://doi.org/10.3949/ccjm.76.s4.13
  • Dual antiplatelet therapy in coronary artery disease: A case-based approach
    Chad Raymond, DO and Venu Menon, MD
    Cleveland Clinic Journal of Medicine November 2009, 76 (11) 663-670; DOI: https://doi.org/10.3949/ccjm.76a.09045

    Many patients need the combination of aspirin and clopidogrel (Plavix) or prasugrel (Effient) to reduce their risk of cardiovascular events, as shown in recent trials.

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