Latest Articles

  • Acute aortic syndromes: Time to talk of many things
    Lars G. Svensson, MD, PhD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 25-29;

    Lewis Carroll’s poem of 1872 is a useful starting point for identifying issues resulting from confusion over the various acute aortic syndromes.

  • When should a methacholine challenge be ordered for a patient with suspected asthma?
    Edina Swartz, MD and David Lang, MD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 37-40;

    This test is used if the diagnosis of asthma is in question, but it is currently not recommended for routine management of asthma.

  • Four no more: The ‘PSA cutoff era’ is over
    J. Stephen Jones, MD and Eric Klein, MD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 30-32;

    The prostate-specific antigen (PSA) value is only one of the risk factors for prostate cancer, and no PSA value rules cancer in or out. Therefore, our laboratory reports will no longer list 4.0 μg/L as the upper limit of normal. Instead, we will estimate the patient’s actual risk.

  • A New Year’s toast
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 6;

    With so many important clinical trials being published each year, it is easy to focus on the study methodology and conclusions, overlooking the years of careful clinical observaton that preceded the trial development.

  • CT imaging for acute aortic syndrome
    CT imaging for acute aortic syndrome
    Andrew D. Smith, MD, PhD and Paul Schoenhagen, MD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 7-24;

    Advances in computed tomography (CT) have made the diagnosis of acute aortic syndromes faster and easier.

  • Prostate cancer: Too much dogma, not enough data
    Derek Raghavan, MD, PhD, FRACP
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 33-34;

    In our management of prostate cancer, dogma often outweighs real data. Well-designed, randomized clinical trials are the answer.

  • A Perspective on the Fluids and Catheters Treatment Trial (FACTT)
    Herbert P. Wiedemann, MD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 42-48;

    Although most clinicians tend to manage acute lung injury and acute respiratory distress syndrome by giving more rather than less fluid, patients may actually fare better under a strategy of limited fluid intake and increased fluid excretion.

  • Masquerade: Nonspinal musculoskeletal disorders that mimic spinal conditions
    Dhruv B. Pateder, MD, John Brems, MD, Isador Lieberman, MD, FRCS(C), Gordon R. Bell, MD and Robert F. McLain, MD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 50-56;

    Sometimes pain in the neck or back is caused by a problem in the shoulder, hip, or extremities. Common mimics are rotator cuff tear, bursitis in the hip, peripheral nerve compression, and arthritis in the shoulder and hip.

  • The STAR*D study: Treating depression in the real world
    Bradley N. Gaynes, MD, MPH, A. John Rush, MD, Madhukar H. Trivedi, MD, Stephen R. Wisniewski, PhD, Donald Spencer, MD, MBA and Maurizio Fava, MD
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 57-66;

    This study found that depression can be treated successfully by primary care physicians under real-world conditions. The particular drug or drugs used are not as important as a rational plan.

  • Managing diabetes in the elderly: Go easy, individualize
    Thomas Hornick, MD and David C. Aron, MD, MS
    Cleveland Clinic Journal of Medicine January 2008, 75 (1) 70-78;

    Especially in frail, elderly patients, strict glycemic control should be emphasized less than avoiding malnutrition and hypoglycemia and achieving the best quality of life possible.

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