Cleveland Clinic journal of medicine
-
Although the 2022 policy statement on breastfeeding from the American Academy of Pediatrics primarily addresses clinicians caring for pediatric patients, the Academy urges clinicians of all disciplines who may interact with breastfeeding mothers and babies to increase their understanding of breastfeeding and their ability to support this population. Studies published since the 2012 update continue to reinforce the cumulative short-term and long-term infant and maternal health benefits of breastfeeding and human milk consumption.
-
Many patients with chronic kidney disease have chronically elevated cardiac troponin levels, and if they present with symptoms suggesting an acute coronary syndrome, it is often difficult to determine if this is the correct diagnosis. This article briefly reviews the major challenges in diagnosing acute coronary syndrome in patients with chronic kidney disease, describes the mechanisms and prognostic significance of troponin elevation in chronic kidney disease, and provides a diagnostic algorithm to risk-stratify patients with chronic kidney disease who have troponin elevation and suspected acute coronary syndrome.
-
Survivors of allogeneic hematopoietic cell transplant (HCT) face the risk of many serious complications in the long term, which primary care physicians play an integral role in recognizing and treating. In this review, the authors summarize the most common complications that primary care physicians see after HCT recipients return to their care: chronic graft-vs-host disease; cardiovascular, metabolic, endocrine, rheumatologic, orthopedic, infectious, neurologic, and cognitive complications; secondary malignancies; psychiatric disorders; and impairments in quality of life and sexual health. Also discussed are health maintenance and screening recommendations for this patient population.
-
The terms hoarseness and dysphonia are used interchangeably, and both describe a type of altered vocal quality affecting one-third of patients. While hoarseness may be secondary to benign conditions such as reflux or viral laryngitis, it may suggest benign or malignant vocal-fold pathology. It is important for caregivers to know how to evaluate, treat, and when to refer patients for direct visualization via laryngoscopy. In this article, we review basic laryngeal anatomy and function, symptoms of vocal-fold pathology, and current guidelines from the American Academy of Otolaryngology-Head and Neck Surgery on the diagnosis and treatment of dysphonia, including patient referral.