Abstract：
OBJECTIVE:To review recent advances in the diagnosis and treatment of gastroesophageal reflux disease (GERD). MATERIAL AND METHODS:Original English language reports were obtained through a Medline search of the National Library of Medicine up to and including 1993. The reference lists of all original reports and review articles were searched to locate any further material. In the evaluation of therapeutic efficacy, randomized studies were preferentially considered; greatest priority was given to double-blind, placebo-controlled trials. Abstracts, nonrandomized trials, and non-English language publications were considered only when other data were unavailable. RESULTS:Information obtained from histories and physical examinations suggests that GERD occurs in many patients. Evaluation of mucosal injury with use of either endoscopy or air contrast barium radiography is an important early step in the diagnosis of GERD. Endoscopy obtains tissue for histologic study, especially in Barrett's esophagus. Prolonged esophageal pH monitoring is the most useful determinant of the presence and amount of reflux of acid. Patients with GERD should be counseled on lifestyle modification and the use of antacids and antirefluxants. Histamine type 2 receptor antagonists provide symptomatic relief in 32 to 82% of patients with GERD and resolution of verified esophagitis in 0 to 82%. Responses with omeprazole therapy are higher; symptomatic responses were noted in 62 to 94% of patients, and healing of esophagitis occurred in 71 to 96%. Promotility agents and surgical therapy have a role in selected patients. CONCLUSION:GERD is a chronic disorder that often necessitates individualized lifelong therapy. Many questions remain to be answered about the cost-effectiveness of both diagnostic tests and therapy for GERD.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
DeVault KR,Castell DOdoi
10.1016/s0025-6196(12)61790-xsubject
Has Abstractpub_date
1994-09-01 00:00:00pages
867-76issue
9eissn
0025-6196issn
1942-5546pii
S0025-6196(12)61790-Xjournal_volume
69pub_type
杂志文章,评审abstract：:Eighty-two consecutive orthopedic patients were assessed nutritionally at the time of hospital admission and then at 10-day intervals until hospital dismissal. Forty-eight percent of the patients had one or more abnormal findings suggestive of protein-calorie malnutrition. In spite of this prevalence of abnormal findi...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:Hypothyroidism and hyperthyroidism are common medical disorders that are often accompanied by diverse types of neurologic and neuromuscular dysfunction. Although some of these associated disorders are well known to physicians, others are not. All of these neurologic manifestations are important because they can severe...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：:The metabolic syndrome is an insulin-resistant state characterized by a cluster of cardiovascular risk factors, including various combinations of abdominal obesity, glucose intolerance, hypertension, and atherogenic dyslipidemia (elevated triglyceride values, low high-density lipoprotein cholesterol levels, and small ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/81.12.1615
更新日期：2006-12-01 00:00:00
abstract：OBJECTIVE:To investigate a recent association between the use of the angiotensin receptor-blocker (ARB) olmesartan and a severe enteropathy resembling celiac disease. PATIENTS AND METHODS:We searched our endoscopy database for all outpatient esophagogastroduodenoscopy (EGD) or colonoscopy examinations in patients aged...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2014.05.012
更新日期：2014-09-01 00:00:00
abstract：:Atherosclerosis is a diffuse, systemic disease that affects the coronary, cerebral, and peripheral arterial trees. Disruption of atherosclerotic plaques leads to thrombus formation and arterial occlusion. This unpredictable and potentially life-threatening atherothrombotic sequence underlies clinical events such as an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/81.1.59
更新日期：2006-01-01 00:00:00
abstract：:Severe hypocalcemia may require prompt intervention to avoid life-threatening consequences. We report a case in which a 78-year-old man had a critically low serum calcium level measured with use of standard colorimetric assay after gadodiamide administration during magnetic resonance angiography. Reanalysis of the sam...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/80.12.1655
更新日期：2005-12-01 00:00:00
abstract：OBJECTIVE:To assess the efficacy and safety of hyperbaric oxygenation (HBO) therapy as adjunctive treatment for diabetic foot ulcers with a systematic review and meta-analysis of the literature. METHODS:MEDLINE, EMBASE, and the Cochrane Library were searched to find relevant articles published up to April 20, 2012, wi...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2012.10.021
更新日期：2013-02-01 00:00:00
abstract：:Health-care organizations have recognized the need to prepare physicians for various leadership and management positions within their own institutions. In the past, those who desired further education had to search beyond the boundaries of their practice to fulfill this need. The demands of a dynamic and changing heal...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63574-X
更新日期：1997-07-01 00:00:00
abstract：OBJECTIVE:To estimate the prevalence of healthy lifestyle characteristics and to examine the association between different combinations of healthy lifestyle characteristics and cardiovascular disease biomarkers. PATIENTS AND METHODS:The prevalence of healthy lifestyle characteristics was estimated for the US adult pop...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2016.01.009
更新日期：2016-04-01 00:00:00
abstract：:Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). Rapid eye movement sleep behavior disorder is strongly associated with neurodegenerative disease, especi...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2017.09.007
更新日期：2017-11-01 00:00:00
abstract：:Multiple sclerosis is thought, by many investigators, to be an immunologic disease. Therefore, a rationale exists for treating this disease by immunosuppressive therapy. In exacerbating-remitting multiple sclerosis, corticosteroids and adrenocorticotropic hormone are the most widely used drugs; high doses of intraveno...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章,评审
doi：10.1016/s0025-6196(12)65345-2
更新日期：1989-06-01 00:00:00
abstract：OBJECTIVE:To investigate an association between tumor necrosis factors-alpha (TNFα) inhibitors or other immunosuppressants and the development of uveal and cutaneous melanoma. PATIENTS AND METHODS:We performed a retrospective incidence and case-control analysis of patients in Olmsted County, MN, who were diagnosed wit...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2018.11.033
更新日期：2019-07-01 00:00:00
abstract：:The sport of snow skiing by the physically disabled, which originated in Europe in 1935 and first received attention in the United States in the 1940s, is reviewed in terms of opportunities available, instructions, adaptive equipment necessary, and benefits provided. Persons with a wide variety of disabilities (such a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60488-1
更新日期：1991-02-01 00:00:00
abstract：OBJECTIVES:To describe the development and implementation process and assess the effect on self-reported clinical practice changes of a multidisciplinary, collaborative, interactive continuing medical education (CME)/continuing education (CE) program on chronic obstructive pulmonary disease (COPD). METHODS:Multidiscip...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2012.02.028
更新日期：2012-09-01 00:00:00
abstract：:We treated a patient who developed transient multifocal encephalopathy with extrapyramidal symptoms (oromandibular dystonia, oculogyric crisis, and limb dystonia) in temporal proximity to ondansetron administration on emergence from general anesthesia. No other medications known to cause extrapyramidal reactions were ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/78.9.1150
更新日期：2003-09-01 00:00:00
abstract：:Considerable advances in the diagnosis and treatment of migraine headache have occurred during the past decade, but treatment options for acute migraine attacks have expanded at a faster rate than those for prophylaxis. We describe a patient whose migraine headaches responded dramatically to sustained-release niacin a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/78.6.770
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVE:To map the occurrence of amyloid types in a large clinical cohort using mass spectrometry-based shotgun proteomics, an unbiased method that unambiguously identifies all amyloid types in a single assay. METHODS:A mass spectrometry-based shotgun proteomics assay was implemented in a central reference laborator...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2020.06.029
更新日期：2020-09-01 00:00:00
abstract：OBJECTIVE:To report a case of eosinophilic myocarditis with remarkable initial clinical manifestations and outcome. MATERIAL AND METHODS:A 67-year-old woman with hypertension and a history of asthma and drug hypersensitivity was referred to our institution with a diagnosis of acute myocardial infarction on the basis o...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：
更新日期：1997-07-01 00:00:00
abstract：OBJECTIVE:To examine the ability of 4 published osteoporosis risk indices to identify women with low bone density. SUBJECTS AND METHODS:Subjects included postmenopausal women 45 years and older consecutively recruited from US clinics, women from general practice centers in The Netherlands (age range, 50-80 years), wom...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/77.7.629
更新日期：2002-07-01 00:00:00
abstract：OBJECTIVE:To understand motivations, educational needs, and concerns of individuals contemplating whole-exome sequencing (WES) and determine what amount of genetic information might be obtained by sequencing a generally healthy cohort so as to more effectively counsel future patients. PATIENTS AND METHODS:From 2012 to...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.05.021
更新日期：2015-10-01 00:00:00
abstract：:Migraine, an episodic headache disorder, is one of the most common complaints encountered by primary-care physicians and neurologists. Nevertheless, it remains underdiagnosed and undertreated. Rational migraine treatment necessitates an accurate diagnosis, identification and removal of potential triggering factors, an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/71.11.1055
更新日期：1996-11-01 00:00:00
abstract：OBJECTIVE:To derive risk models for percutaneous coronary intervention (PCI) outcomes from clinical and laboratory variables available before the procedure so they can be used for preprocedure risk stratification. PATIENTS AND METHODS:Using the Mayo Clinic registry, we analyzed 9035 PCIs on 7640 unique patients from J...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/82.6.701
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). PATIENTS AND METHODS:We performed a retrospective search of electronic medical records of all ou...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.07.025
更新日期：2015-11-01 00:00:00
abstract：:Vitamin K antagonists were the only class of oral anticoagulants available to clinicians for decades. However, with the US Food and Drug Administration approval of new oral anticoagulants, such as dabigatran, rivaroxaban, and apixaban, clinicians now have a broader choice. Given the recent approval and availability of...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2013.03.006
更新日期：2013-05-01 00:00:00
abstract：:The evaluation of the patient with diarrhea can be complex and the treatment challenging. In this article, the definition of diarrhea and the pathophysiologic mechanisms that lead to diarrhea are reviewed. A simplified 5-step approach to the patient with diarrhea is provided and applied in a case-oriented manner appli...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2012.02.015
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:To describe the two variants of Castleman's disease--the hyaline-vascular type and the plasma-cell type--and discuss the associated histologic features. DESIGN:We present a case of the hyaline-vascular type and review the literature. RESULTS:Castleman's disease was once thought to be localized and self-limi...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/70.10.969
更新日期：1995-10-01 00:00:00
abstract：OBJECTIVE:To determine the percentage of metastatic and unexpected residual lung cancer at autopsy in patients considered for curative resection of non-small cell lung cancer during a time when computed tomography was available as a preoperative staging tool. MATERIAL AND METHODS:Clinical data and surgical and autopsy...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/79.11.1409
更新日期：2004-11-01 00:00:00
abstract：:Between December 1980 and April 1986 at our institution, 38 patients with cancer that involved the tracheobronchial tree (a total of 40 carcinomas) completed at least one course of hematoporphyrin derivative phototherapy. A complete response occurred in 13 patients (with 14 carcinomas). Eleven of these carcinomas did ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61520-1
更新日期：1987-01-01 00:00:00
abstract：:Tobacco use is a global pandemic. The most common pharmacological treatments of tobacco use and dependence include nicotine replacement therapy and nonnicotine medications. Bupropion sustained release (SR) is the only first-line nonnicotine medication recommended by the US Public Health Service Clinical Practice Guide...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/78.8.1020
更新日期：2003-08-01 00:00:00
abstract：:People with hypertension have a high prevalence of insulin resistance and are at relatively high risk of developing type 2 diabetes mellitus. It is becoming increasingly evident that antihypertensive agents have disparate metabolic effects. For example, recent clinical trials indicate that agents that interrupt the re...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/81.6.796
更新日期：2006-06-01 00:00:00
