The new vaccines against respiratory syncytial virus (RSV) reduce the risk of RSV illness, which is common in older people and carries the risk of hospitalization with its attendant risks such as delirium and physical decline leading to loss of function and independence. Individualized discussions regarding vaccination should weigh the risks of vaccination, which are minor, against the preventive benefits. Discussions incorporating these elements may lead to greater vaccine uptake, especially by those at high risk.
{"title":"Having the conversation: Individualizing RSV vaccination in older patients.","authors":"Ronan Factora","doi":"10.3949/ccjm.91.s1.05","DOIUrl":"10.3949/ccjm.91.s1.05","url":null,"abstract":"<p><p>The new vaccines against respiratory syncytial virus (RSV) reduce the risk of RSV illness, which is common in older people and carries the risk of hospitalization with its attendant risks such as delirium and physical decline leading to loss of function and independence. Individualized discussions regarding vaccination should weigh the risks of vaccination, which are minor, against the preventive benefits. Discussions incorporating these elements may lead to greater vaccine uptake, especially by those at high risk.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9 suppl 1","pages":"S26-S33"},"PeriodicalIF":3.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2023 and 2024, 3 vaccines were approved by the US Food and Drug Administration (FDA) against respiratory syncytial virus (RSV) in adults. In addition, the first long-acting RSV monoclonal antibody for infants and young children was approved. This review provides clinicians with practical guidance to navigate this new era of RSV prevention.
{"title":"RSV immunization in adults and children: A practical guide for clinicians.","authors":"Trate DeVolld, Kaitlyn R Rivard","doi":"10.3949/ccjm.91.s1.03","DOIUrl":"https://doi.org/10.3949/ccjm.91.s1.03","url":null,"abstract":"<p><p>In 2023 and 2024, 3 vaccines were approved by the US Food and Drug Administration (FDA) against respiratory syncytial virus (RSV) in adults. In addition, the first long-acting RSV monoclonal antibody for infants and young children was approved. This review provides clinicians with practical guidance to navigate this new era of RSV prevention.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9 suppl 1","pages":"S11-S18"},"PeriodicalIF":3.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle D Lundholm, Jayachidambaram Ambalavanan, Pratibha Pr Rao
Primary adrenal insufficiency is rare but serious; it puts patients at risk of acute decompensation and adrenal crisis due to insufficient cortisol and aldosterone production. Further, its diagnosis is often delayed, or it is mistaken for secondary adrenal insufficiency, which can have life-threatening consequences. Early recognition and appropriate treatment can greatly improve patient outcomes and quality of life.
{"title":"Primary adrenal insufficiency in adults: When to suspect, how to diagnose and manage.","authors":"Michelle D Lundholm, Jayachidambaram Ambalavanan, Pratibha Pr Rao","doi":"10.3949/ccjm.91a.23072","DOIUrl":"https://doi.org/10.3949/ccjm.91a.23072","url":null,"abstract":"<p><p>Primary adrenal insufficiency is rare but serious; it puts patients at risk of acute decompensation and adrenal crisis due to insufficient cortisol and aldosterone production. Further, its diagnosis is often delayed, or it is mistaken for secondary adrenal insufficiency, which can have life-threatening consequences. Early recognition and appropriate treatment can greatly improve patient outcomes and quality of life.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"553-562"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leen Al-Yacoub, Elias Bassil, George Thomas, Luke Laffin, Aravinda Nanjundappa, Khaled Ziada, Ali Mehdi
{"title":"Should my patients with hypertension be referred for renal denervation?","authors":"Leen Al-Yacoub, Elias Bassil, George Thomas, Luke Laffin, Aravinda Nanjundappa, Khaled Ziada, Ali Mehdi","doi":"10.3949/ccjm.91a.24029","DOIUrl":"https://doi.org/10.3949/ccjm.91a.24029","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"539-543"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abdominal pain without physical findings is not always without physical cause.","authors":"Brian F Mandell","doi":"10.3949/ccjm.91b.09024","DOIUrl":"10.3949/ccjm.91b.09024","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"527-528"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mesenteric ischemia occurs because of inadequate intestinal blood flow. Its severity depends on the vessels involved and whether collateral blood vessels are available to prevent malperfusion. Mesenteric ischemia is an uncommon cause of abdominal pain, but it is associated with high mortality and often poses a diagnostic challenge to clinicians because its symptoms are nonspecific. Early recognition and treatment are imperative to improve patient outcomes.
{"title":"Mesenteric ischemia: Recognizing an uncommon disorder and distinguishing among its causes.","authors":"Teresa Wu, Aravinda Nanjundappa","doi":"10.3949/ccjm.91a.23094","DOIUrl":"https://doi.org/10.3949/ccjm.91a.23094","url":null,"abstract":"<p><p>Mesenteric ischemia occurs because of inadequate intestinal blood flow. Its severity depends on the vessels involved and whether collateral blood vessels are available to prevent malperfusion. Mesenteric ischemia is an uncommon cause of abdominal pain, but it is associated with high mortality and often poses a diagnostic challenge to clinicians because its symptoms are nonspecific. Early recognition and treatment are imperative to improve patient outcomes.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"545-550"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Should every patient with an unprovoked venous thromboembolism have a hypercoagulable workup?","authors":"Jaime Tan, Neeladri Misra, Sivakumar Reddy","doi":"10.3949/ccjm.91a.24016","DOIUrl":"https://doi.org/10.3949/ccjm.91a.24016","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"531-533"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaideep Singh Bhalla, G Jay Bishop, Scott J Cameron
{"title":"Stop the clot: When is laboratory evaluation for thrombophilia warranted?","authors":"Jaideep Singh Bhalla, G Jay Bishop, Scott J Cameron","doi":"10.3949/ccjm.91a.24058","DOIUrl":"https://doi.org/10.3949/ccjm.91a.24058","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"535-536"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaccine hesitancy in the time of COVID: How to manage a public health threat.","authors":"H Clifford Lane, Steven M Gordon","doi":"10.3949/ccjm.91a.24062","DOIUrl":"https://doi.org/10.3949/ccjm.91a.24062","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 9","pages":"565-573"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Foxglove, not quite gone or forgotten.","authors":"Brian F Mandell","doi":"10.3949/ccjm.91b.08024","DOIUrl":"10.3949/ccjm.91b.08024","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 8","pages":"458-459"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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