G R A N D R O U N D S

New guidelines streamline 10 diabetes diagnosis Recent changes in the screening guidelines

for diabetes should simplify the diagnostic

process and identify more people who are at risk.

S.S .K . R E D D Y

Proton-pump inhibitors 27 for gastric acid-related disease Proton-pump inhibitors are the most effective

drugs for suppressing gastric acid production.

Concerns over potential ill effects of

hypergastrinemia have proved unfounded.

T.G. F R A N K O AND J .E. R I C H T E R

Strategies for detecting 14 and treating problem drinking Alcohol use is now seen as a continuum

from total abstinence to alcohol dependence,

rather than an all-or-nothing condition.

J .H . I S A A C S O N AND G .B . C O L L I N S

C U R R E N T D R U G T H E R A P Y

New hypertension guidelines 18 set aggressive goals based on risk factors The JNC VI report updates the standard of care

in hypertension, advising physicians to be more

diligent in lowering blood pressure, especially in

patients with known risk factors.

I N T E R P R E T I N G K E Y F I N D I N G S

Anorectic drugs 35 and valvular heart disease: A biological and clinical perspective The echocardiography appearance of valvular

lesions associated with the use of fenfluramine

and dexfenfluramine, and current suggestions

on how to follow patients who took these drugs.

J. W O N G , S .S .K . REDDY, AND A . L . KLEIN

CONTINUED ON PAGE 7

R . W . G I F F O R D JR

CLEVELAND CLINIC JOURNAL OF MEDICINE V O L U M E 65 • N UMBER 1 JANUARY 1 9 9 8 4

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TABLE OF C O N T E N T S

CONTINUED fROM PAGE 4

C A N C E R D I A G N O S I S A N D M A N A G E M E N T

Chronic lymphocytic leukemia: 42 A brief review CLL, the most common type of leukemia, is often

discovered incidentally when a routine complete

blood count is performed. This paper reviews the

pathology, diagnosis, and treatment of CLL.

J . C . K R A U S S

D E P A R T M E N T S

Instructions for Authors 17

Change of Address 24

Correction 48

Letter to the Editor 49

CME Credit Test 51

CME Calendar 56

The Cleveland Clinic Journal of Medicine is peer reviewed and indexed in Index Medicus.

F E A T U R E S N e w series o n h e a r t f a i lu re An ongoing series on the diagnosis and treatment of what is becoming the most important and expensive problem in cardiovascular medicine

A n a s y m p t o m a t i c p a t i e n t w i t h mi ld ly e l e v a t e d l iver e n z y m e s When is an extensive workup needed and when isn't it needed?

W h a t physicians n e e d t o k n o w a b o u t h e r b a l m e d i c i n e Many patients are taking herbal medicines; physicians need to ask more questions about their use of these products.

R e n e w e d h o p e fo r t h e i m p a i r e d physician Prevention of alcohol and drug abuse is the best remedy for this difficult problem

C L E V E L A N D C L I N I C J O U R N A L OF M E D I C I N E V O L U M E 6 5 • N U M B E R 1 J A N U A R Y 1 9 9 8 7

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