Dzhuliyan V Vasilev, Juliana M Kling, Evelyn F Carroll
Evidence from well-established studies of breast cancer risk in transgender and gender-diverse (TGD) people is lacking. As a result, current screening guidelines are based on extrapolation from cisgender populations, expert consensus, and retrospective cohort studies. Guideline recommendations focus on knowing patient baseline breast cancer risk and the risks associated with chosen gender-affirming hormone therapy and gender-affirming chest surgery. While existing guidelines are helpful, tailored protocols and research on effective breast cancer screening specific to TGD people are needed.
{"title":"Breast cancer risk and screening for transgender and gender-diverse individuals.","authors":"Dzhuliyan V Vasilev, Juliana M Kling, Evelyn F Carroll","doi":"10.3949/ccjm.92a.24088","DOIUrl":"https://doi.org/10.3949/ccjm.92a.24088","url":null,"abstract":"<p><p>Evidence from well-established studies of breast cancer risk in transgender and gender-diverse (TGD) people is lacking. As a result, current screening guidelines are based on extrapolation from cisgender populations, expert consensus, and retrospective cohort studies. Guideline recommendations focus on knowing patient baseline breast cancer risk and the risks associated with chosen gender-affirming hormone therapy and gender-affirming chest surgery. While existing guidelines are helpful, tailored protocols and research on effective breast cancer screening specific to TGD people are needed.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"92 7","pages":"439-447"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539195","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":"How should I manage my patient with cancer who is experiencing diarrhea while on immunotherapy?","authors":"Rupayan Kundu, Arjun Chatterjee, Jessica Philpott, Lucy Boyce Kennedy","doi":"10.3949/ccjm.92a.24090","DOIUrl":"https://doi.org/10.3949/ccjm.92a.24090","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"92 7","pages":"401-405"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539197","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}
Occluding the left atrial appendage during cardiac surgery for other indications reduced the risk of ischemic stroke or systemic embolism in patients with atrial fibrillation in LAAOS III (the third Left Atrial Appendage Occlusion Study) (N Engl J Med 2021; 384(22):2081-2091). But questions remain.
LAAOS III（第三次左心耳闭塞研究）表明，心脏手术期间因其他适应症闭塞左心耳可降低房颤患者缺血性卒中或全体性栓塞的风险(N Engl J Med 2021；384(22): 2081 - 2091)。但问题依然存在。
{"title":"Insights from the LAAOS III trial of left atrial appendage occlusion to prevent stroke in atrial fibrillation.","authors":"Anže Djordjević, Edward Soltesz","doi":"10.3949/ccjm.92a.25001","DOIUrl":"https://doi.org/10.3949/ccjm.92a.25001","url":null,"abstract":"<p><p>Occluding the left atrial appendage during cardiac surgery for other indications reduced the risk of ischemic stroke or systemic embolism in patients with atrial fibrillation in LAAOS III (the third Left Atrial Appendage Occlusion Study) (N Engl J Med 2021; 384(22):2081-2091). But questions remain.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"92 7","pages":"415-419"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539201","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}
Oscar L Morey-Vargas, Mona Gossmann, Jeffrey M Ketz, Basem B Abdelmalak
Preoperative management of noninsulin glucose-lowering medications can be challenging as clinicians navigate adjustment amid decreased oral intake while maintaining euglycemia and avoiding hyper- or hypoglycemia. The authors review current published guidelines, along with the local protocol currently in place at Cleveland Clinic, to help clinicians determine which noninsulin glucose-lowering drugs may need to be held preoperatively and for how long.
{"title":"Managing noninsulin glucose-lowering medications before surgery: A comparison of clinical practice guidelines.","authors":"Oscar L Morey-Vargas, Mona Gossmann, Jeffrey M Ketz, Basem B Abdelmalak","doi":"10.3949/ccjm.92a.24118","DOIUrl":"10.3949/ccjm.92a.24118","url":null,"abstract":"<p><p>Preoperative management of noninsulin glucose-lowering medications can be challenging as clinicians navigate adjustment amid decreased oral intake while maintaining euglycemia and avoiding hyper- or hypoglycemia. The authors review current published guidelines, along with the local protocol currently in place at Cleveland Clinic, to help clinicians determine which noninsulin glucose-lowering drugs may need to be held preoperatively and for how long.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"92 7","pages":"429-437"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539202","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}
Risheng Xu, Nicola Abate, Nalini Ram, Kristina Little
{"title":"In Reply: Most elderly patients with subclinical hypothyroidism do not need to be treated.","authors":"Risheng Xu, Nicola Abate, Nalini Ram, Kristina Little","doi":"10.3949/ccjm.92c.07002","DOIUrl":"https://doi.org/10.3949/ccjm.92c.07002","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"92 7","pages":"395"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539200","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":"Managing right ventricular failure in the setting of pulmonary embolism.","authors":"Anup Katyal, Ashwani Joshi","doi":"10.3949/ccjm.92c.07003","DOIUrl":"https://doi.org/10.3949/ccjm.92c.07003","url":null,"abstract":"","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"92 7","pages":"396"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539203","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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