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Dual antiplatelet therapy in coronary artery disease: A case-based approachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: RAYMOND, C., MENON, V. Tags: Review Source Type: journals

Beyond office sphygmomanometry: Ways to better assess blood pressureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Several new devices provide more information than does traditional sphygmomanometry about the patient’s true hypertensive status, blood pressure control, and risk of end-organ damage. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: RAFEY, M. Tags: Medical Grand Rounds Source Type: journals

Managing diabetes in hemodialysis patients: Observations and recommendationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Both uremia and dialysis can complicate glycemic control by affecting the secretion, clearance, and peripheral tissue activity of insulin. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: SHRISHRIMAL, K., HART, P., MICHOTA, F. Tags: Review Source Type: journals

Current therapies to shorten postoperative ileusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Rather than merely wait for bowel sounds to return after patients undergo surgery, we can try to get the gut working again sooner. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: JOHNSON, M. D., WALSH, R. M. Tags: Review Source Type: journals

Pleural effusion from a candy wrapperEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 60-year-old man presents with worsening shortness of breath and productive cough. Flexible bronchoscopy reveals the surprising cause. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: ANTOUN, S. A., WEHBE, E. Tags: The Clinical Picture Source Type: journals

A 19-year-old man with progressive lung infiltratesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
After undergoing induction chemotherapy for acute myeloid leukemia, he developed fever, lung infiltrates, and severe neutropenia. What is the most likely cause? (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: TONELLI, A. R., OLSON, E. L. Tags: The Clinical Picture Source Type: journals

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(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: KLEIN, E. A. Tags: Reply Source Type: journals

Prostate cancer prevention (AUGUST 2009)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: KELLER, D. L. Tags: Letters to the Editor Source Type: journals

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(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: BUENCAMINO, M. C. A., PALOMO, L., THACKER, H. L. Tags: Reply Source Type: journals

Menopause, vitamin D, and oral health (AUGUST 2009)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: MASCITELLI, L., PEZZETTA, F., GOLDSTEIN, M. R. Tags: Letters to the Editor Source Type: journals

Low-tech tools, high-pressure stakesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite the many ways to introduce inaccuracies in low-tech cuff measurements of blood pressure, the benefits of treating high blood pressure diagnosed this way can be great. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - November 2, 2009 Category: Journals (General) Authors: MANDELL, B. F. Tags: From The Editor Source Type: journals

Autoimmune pancreatitis: A mimic of pancreatic cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune pancreatitis is an idiopathic inflammatory disease that produces pancreatic masses and ductal strictures. This benign disease resembles pancreatic carcinoma both clinically and radiographically. The diagnosis of autoimmune pancreatitis is challenging to make. However, accurate and timely diagnosis may preempt the misdiagnosis of cancer and decrease the number of unnecessary pancreatic resections. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: LAW, R., BRONNER, M., VOGT, D., STEVENS, T. Tags: Review Source Type: journals

Recognizing and treating cutaneous signs of liver diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cutaneous changes may be the first clue that a patient has liver disease. Recognizing these signs is crucial to diagnosing liver conditions early. Here we describe the spectrum of skin manifestations that may be found in various liver diseases. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: HAZIN, R., ABU-RAJAB TAMIMI, T. I., ABUZETUN, J. Y., ZEIN, N. N. Tags: Review Source Type: journals

Less-invasive ways to remove stones from the kidneys and uretersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Less-invasive interventions for upper tract urolithiasis are extracorporeal shock-wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Each has advantages and disadvantages, depending on the location, size, and composition of the stone and on the patient’s renal anatomy, body habitus, and comorbidities. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: SAMPLASKI, M. K., IRWIN, B. H., DESAI, M. Tags: Review Source Type: journals

Nephrolithiasis: Treatment, causes, and preventionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Factors that promote stone formation include low daily urine volumes; saturation of the urine with calcium, oxalate, calcium phosphate, uric acid, or cystine; acidic urine; and bacterial infection. The author identifies the mechanisms of stone formation and outlines management aimed at preventing recurrences. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: HALL, P. M. Tags: Review Source Type: journals

Update on 2009 pandemic influenza A (H1N1) virusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The pandemic of a novel strain of swine-origin influenza A (H1N1) is expected to make this a difficult flu season. Fortunately, this strain is relatively mild, and the principles of prevention, diagnosis, and treatment remain the same. Physicians will have a number of complex decisions to make about when to test, when to treat, and when to simply reassure. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: GORDON, S. M. Tags: Medical Grand Rounds Source Type: journals

Ulcerative leg nodules in a transplant recipientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: CHUA, A.-P., BILLINGS, S. D., BUDEV, M. M., MEHTA, A. C. Tags: The Clinical Picture Source Type: journals

A middle-aged man with progressive fatigueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: McDIVIT, A. M., ASKARI, A. T. Tags: Cardiovascular Board Review Source Type: journals

No pig in a pokeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - October 1, 2009 Category: Journals (General) Authors: MANDELL, B. F. Tags: From The Editor Source Type: journals

Ablation of atrial fibrillation: What can we tell our patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
More patients are asking their physicians about radiofrequency ablation. Although it has shown promising clinical results, some patients may have unrealistic expectations. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: CHOWDHURY, P., LEWIS, W. R., SCHWEIKERT, R. A., CUMMINGS, J. E. Tags: Review Source Type: journals

Beta-blockers for hypertension: Are they going out of style?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The outcomes of clinical trials have been disappointing, and the value of beta-blockers in treating hypertensive patients who do not have compelling indications for them has been questioned. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: CHE, Q., SCHREIBER, M. J., RAFEY, M. A. Tags: Current Drug Therapy Source Type: journals

Role of MRI in breast cancer managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
MRI might be indicated for workup of possible breast cancer, but not for screening except in women at high risk. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: ENRIQUEZ, L., LISTINSKY, J. Tags: Review Source Type: journals

Influenza in long-term care facilities: Preventable, detectable, treatableEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Vaccination is the most important preventive measure. Early detection, infection control measures, prompt treatment, and preventive treatment of contacts can also help curtail an outbreak. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: Mossad, S. B. Tags: Review Source Type: journals

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(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: ISAACSON, J. H. Tags: Reply Source Type: journals

Diabetic ketoacidosis (JULY 2009)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: JENKINS, I. Tags: Letters to the Editor Source Type: journals

Should catheter ablation be the first line of treatment for atrial fibrillation?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Antiarrhythmic drugs should remain the first line of treatment until trials prove otherwise. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: Lindsay, B. D. Tags: Editorial Source Type: journals

Vertebroplasty, evidence, and health care reform: What is quality care?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Two recent trials found that a popular procedure for fixing vertebral fractures lacks efficacy. Like it or not, in the future, such evidence is going to affect whether insurers pay for care. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - September 1, 2009 Category: Journals (General) Authors: MANDELL, B. F. Tags: From the Editor Source Type: journals

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(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: KIM, L., LIPTON, S., DEODHAR, A. Tags: Reply Source Type: journals

Pregabalin for fibromyalgia (APRIL 2009)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: ABELES, M., ABELES, A. Tags: Letters to the Editor Source Type: journals

Recurrent pyelonephritis as a sign of 'sponge kidney'Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Intravenous urography is the gold standard for the diagnosis of medullary sponge kidney. Computed tomography and ultrasonography have limited ability to clearly show tubular ectasia. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: CHU, H.-Y., YAN, M.-T., LIN, S.-H. Tags: The Clinical Picture Source Type: journals

Q: Does measuring natriuretic peptides have a role in patients with chronic kidney disease?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Measuring them can help diagnose decompensated heart failure and predict the risk of death and hospitalization, but whether it helps in chronic kidney disease is unclear. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: HAJJAR, V., SCHREIBER, M. J. Tags: 1-Minute Consult Source Type: journals

How menopause affects oral health, and what we can do about itEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
After menopause, women become more susceptible to periodontal disease. The problem may stem in large part from estrogen deficiency. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: BUENCAMINO, M. C. A., PALOMO, L., THACKER, H. L. Tags: Review Source Type: journals

Managing osteoporosis: Challenges and strategiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To identify those at high risk of fracture, we can use the Fracture Risk Assessment Tool, or FRAX. Patients who are prescribed a drug must also be educated about how and why to take it. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: LEWIECKI, E. M. Tags: Commentary Source Type: journals

A 35-year-old Asian man with jaundice and markedly high aminotransferase levelsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The patient acquired hepatitis B virus at birth and was never treated for it. What is his present infection status? (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: HANOUNEH, I. A., KHORIATY, R., ZEIN, N. N. Tags: IM Board Review Source Type: journals

The new data on prostate cancer screening: What should we do now?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Does screening have a benefit? We have new data, but do we have the answer? (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: GILLIGAN, T. Tags: Editorial Source Type: journals

Newer modes of mechanical ventilation (JULY 2009)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Tags: Correction Source Type: journals

What's new in prostate cancer screening and prevention?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Two large trials of screening with prostate-specific antigen measurements came to seemingly opposite conclusions. Furthermore, a large trial of selenium and vitamin E found that neither has value in preventing prostate cancer. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: KLEIN, E. A. Tags: Medical Grand Rounds Source Type: journals

The internist, alphabet soup, and the hepatologistEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Given the widening spectrum of viral hepatitis types and clinical syndromes, prompt referral to and consultation with a hepatologist are in our patients’ best interests. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - August 2, 2009 Category: Journals (General) Authors: MANDELL, B. F. Tags: From The Editor Source Type: journals

Alternative modes of mechanical ventilation: A review for the hospitalistEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Newer ventilators can be set to modes other than the pressure-control and volume-control modes of older machines. We review how they work and contrast their theoretical benefits and actual evidence of benefit. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: MIRELES-CABODEVILA, E., DIAZ-GUZMAN, E., HERESI, G. A., CHATBURN, R. L. Tags: Review Source Type: journals

A 48-year-old man with uncontrolled diabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
His type 2 diabetes has been well controlled for 6 years. Now, his blood sugar levels have been rising for the past week, and he has large amounts of glucose and ketones in the urine. What has happened? (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: HU, M., ISAACSON, J. H. Tags: IM Board Review Source Type: journals

Painful eye with a facial rashEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Six days ago, the patient had an intense headache; 4 days ago, painful herpetiform lesions appeared on his face. What is the diagnosis? (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: VALLEJO-GARCIA, J. L., VANO-GALVAN, S., RAYWARD, O., MORENO-MARTIN, P. Tags: The Clinical Picture Source Type: journals

Clinical approach to colonic ischemiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ischemic colitis is one of the diagnoses that should be considered when patients present with abdominal pain, diarrhea, and intestinal bleeding. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: ELDER, K., LASHNER, B. A., SOLAIMAN, F. A. Tags: Review Source Type: journals

Black esophagusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 60-year-old man with gastrointestinal bleeding due to alcoholic cirrhosis has necrosis of the distal esophagus. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: AKKINEPALLY, S., POREDDY, V., MORENO, A. Tags: The Clinical Picture Source Type: journals

Back pain made simple: An approach based on principles and evidenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Low back pain is a common and costly medical condition with only a weak correlation between symptoms and pathologic changes. The authors offer a simple, evidence-based approach. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: BHANGLE, S. D., SAPRU, S., PANUSH, R. S. Tags: Review Source Type: journals

Q: What is the role of probiotics in the treatment of acute Clostridium difficile-associated diarrhea?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Overall, the evidence does not support using probiotics to treat Clostridium difficile-associated diarrhea. More studies are needed to determine if they are helpful and, if so, which ones and at what dosages. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: MILLER, K., FRASER, T. Tags: 1-Minute Consult Source Type: journals

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(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: CHELLMAN-JEFFERS, M. Tags: Reply Source Type: journals

Radiologic workup of a palpable breast mass (MARCH 2009)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: KELLER, D. L. Tags: Letters to the Editor Source Type: journals

The blade, the flea, and the colonEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ischemic colitis often gives the internist and surgeon a chance to commiserate on the power of informed watchful waiting. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 30, 2009 Category: Journals (General) Authors: MANDELL, B. F. Tags: From The Editor Source Type: journals

Soft tissue atrophy after corticosteroid injectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although it is rare, patients still need to be told about this potential adverse effect. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 1, 2009 Category: Journals (General) Authors: PAPADOPOULOS, P. J., EDISON, J. D. Tags: The Clinical Picture Source Type: journals

Is telemetry overused? Is it as helpful as thought?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cardiac telemetry is widely used in hospitals, but it is expensive and labor-intensive. Therefore, it should be used only in those most likely to benefit. (Source: Cleveland Clinic Journal of Medicine)
Source: Cleveland Clinic Journal of Medicine - June 1, 2009 Category: Journals (General) Authors: HENRIQUES-FORSYTHE, M. N., IVONYE, C. C., JAMCHED, U., KAMUGUISHA, L. K. K., OLEJEME, K. A., ONWUANYI, A. E. Tags: Review Source Type: journals