Halting the progression of heart failure: finding the optimal combination therapy.

abstract：BACKGROUND:Nicotinic acid, widely used to lower serum cholesterol levels, may rarely cause cholestatic jaundice. SUMMARY:A 61-year-old white man with hypercholesterolemia complained of marked pruritus and became jaundiced after taking 3.0 g of crystalline nicotinic acid daily for 13 months. His total serum bilirubin l...

journal_title：Cleveland Clinic journal of medicine

authors： Patel SD,Taylor HC

更新日期：1994-01-01 00:00:00

abstract：:The most important component of the treatment of irritable bowel syndrome (IBS) is to establish a therapeutic physician-patient relationship, coupled with patient education. We describe a stepwise approach to management, including judicious use of invasive tests, and setting realistic treatment goals that address the ...

journal_title：Cleveland Clinic journal of medicine

authors： Shen B,Soffer E

更新日期：2001-03-01 00:00:00

abstract：:The Internet can be useful for physicians, but beginning users are apt to encounter two problems: too much irrelevant information, and difficulty finding the desired information. This paper offers some practical tips that can prevent frustration and wasted time when searching for medical information on the Internet. ...

journal_title：Cleveland Clinic journal of medicine

authors： Mehta N

更新日期：1999-10-01 00:00:00

abstract：:Biochemical markers of bone turnover provide clinically useful evidence of the normal and pathologic processes that reflect bone cell activity in the skeleton. Understanding the behavior of markers of bone formation and bone resorption should aid in managing patients with a variety of skeletal disorders. ...

journal_title：Cleveland Clinic journal of medicine

authors： Singer FR,Eyre DR

更新日期：2008-10-01 00:00:00

abstract：:Although stress-related mucosal damage is common (and potentially serious) in critically ill patients, the risk of clinically significant gastrointestinal bleeding appears to be confined to patients with certain factors: mechanical ventilation, coagulopathy, multiple trauma, increased intracranial pressure, and multio...

journal_title：Cleveland Clinic journal of medicine

authors： Bobek MB,Arroliga AC

更新日期：1997-11-01 00:00:00

abstract：:Paget disease of bone is a focal disorder of aging bone that may be asymptomatic or may present with pain, bowing deformity, fracture, or a nonspecific rheumatic complaint. It is the second most common disease of bone in the elderly after osteoporosis, and the loss of structural integrity in affected bone conveys a ri...

journal_title：Cleveland Clinic journal of medicine

authors： Seton M

更新日期：2013-07-01 00:00:00

abstract：:Women infected with human immunodeficiency virus (HIV) have unique needs. Treatment recommendations are the same for men and women, but in women, fertility desires, pregnancy, contraception, and aging must be taken into account in their medical care. ...

journal_title：Cleveland Clinic journal of medicine

authors： Short WR,Anderson JR

更新日期：2014-11-01 00:00:00

abstract：:The American Heart Association issued a science advisory on depression and coronary heart disease (CHD) in 2008. This paper reviews the purpose and content of the advisory and discusses reactions and new information that have followed the advisory's release. Both the advisory and subsequent data support routine screen...

journal_title：Cleveland Clinic journal of medicine

authors： Bigger JT,Glassman AH

更新日期：2010-07-01 00:00:00

abstract：:Heart failure is the most important public health problem in cardiovascular medicine, and is increasing in both prevalence and expense. Programs that use an interdisciplinary team to improve outpatient treatment and prevent hospitalizations will help improve care and control costs. But the most important long-term str...

journal_title：Cleveland Clinic journal of medicine

authors： Starling RC

更新日期：1998-07-01 00:00:00

abstract：:Evidence is mounting that depression is a risk factor for the development of cardiovascular disease and portends a worse outcome in cardiac patients. Depression can be easily diagnosed and safely treated in cardiac patients, but it is undertreated. ...

journal_title：Cleveland Clinic journal of medicine

authors： Kemp DE,Malhotra S,Franco KN,Tesar G,Bronson DL

更新日期：2003-09-01 00:00:00

abstract：:Treatment of anemia in the perioperative period of major orthopedic surgery decreases the need for blood transfusion and improves perioperative outcomes. Use of epoetin alfa in this setting is FDA-approved and provides significant benefit to qualified and carefully chosen patients. ...

journal_title：Cleveland Clinic journal of medicine

authors： Kumar A,Dimov V

更新日期：2006-09-01 00:00:00

abstract：:Hirsutism is a source of significant anxiety in women. While polycystic ovary syndrome or other endocrine conditions are responsible for excess androgen in many patients, other patients have normal menses and normal androgen levels ("idiopathic" hirsutism). The goal of the evaluation is to rule out any underlying path...

journal_title：Cleveland Clinic journal of medicine

authors： Harrison S,Somani N,Bergfeld WF

更新日期：2010-06-01 00:00:00

abstract：:Elevated serum urate levels are recognized as leading to gouty arthritis, tophi formation, and uric acid kidney stones. While serum urate elevations have long been associated with renal disease, they are not usually considered to have a causal role in kidney dysfunction. However, recent epidemiologic studies have iden...

journal_title：Cleveland Clinic journal of medicine

authors： Edwards NL

更新日期：2008-07-01 00:00:00

abstract：:Although most patients with emphysema are managed medically, a small subset of severely disabled patients may become candidates for surgery. This paper discusses for the internist who works with emphysema patients the risks, benefits, patient selection criteria, and outcome data for three procedures in current use: bu...

journal_title：Cleveland Clinic journal of medicine

authors： Dasgupta A,Maurer J

更新日期：1999-07-01 00:00:00

abstract：:Platelet activation is one of the essential steps in the genesis and propagation of atherothrombosis. Accumulating clinical evidence suggests that an elevated platelet count, platelet activation, and platelet hyperreactivity (defined as residual platelet activity despite antiplatelet drug therapy) may be associated wi...

journal_title：Cleveland Clinic journal of medicine

authors： Kottke-Marchant K

更新日期：2009-04-01 00:00:00

abstract：:Although the literature is limited, early evidence suggests that patients with chronic kidney disease, end-stage kidney disease, and kidney transplant recipients are at increased risk for severe COVID-19 disease and death. Hence, management should focus on both infection prevention and treatment. There is currently a ...

journal_title：Cleveland Clinic journal of medicine

authors： Radhakrishnan Y,Hassanein M,Stephany B

更新日期：2020-12-03 00:00:00

abstract：:Many drugs can injure the kidneys, but they cause renal injury via only a few common mechanisms. Many patients who develop renal injury after drug exposure have identifiable risk factors that could be modified or that should preclude the use of these drugs in the first place. ...

journal_title：Cleveland Clinic journal of medicine

authors： Guo X,Nzerue C

更新日期：2002-04-01 00:00:00

abstract：:Morbidity and mortality rates of human immunodeficiency virus (HIV) have plummeted where highly active antiretroviral therapy (HAART) is available. However, therapy is out of reach for most people who need it in developing nations, where the infrastructure to deliver care and resources for medications is lacking. Worl...

journal_title：Cleveland Clinic journal of medicine

authors： Armstrong W,Calabrese L,Taege AJ

更新日期：2005-01-01 00:00:00

abstract：:The decline in testosterone with age has been associated with specific physical changes that affect quality of life and life expectancy, although a cause-and-effect relationship is yet to be established. While female menopause is rapid and well described, "male menopause" or androgen decline in older men is gradual an...

journal_title：Cleveland Clinic journal of medicine

authors： McGill JJ,Shoskes DA,Sabanegh ES

更新日期：2012-11-01 00:00:00

abstract：:Patients with refractory epilepsy face an elevated risk of sudden death, with rates as high as 1% per year. This phenomenon, known as sudden unexpected death in epilepsy (SUDEP), is believed to be a seizure-related occurrence, but the exact underlying mechanisms are uncertain. Both pulmonary and cardiac pathophysiolog...

journal_title：Cleveland Clinic journal of medicine

authors： Jehi L,Najm IM

更新日期：2008-03-01 00:00:00

abstract：:Special problems of Asian patients have considerable impact on diagnosis and treatment, and the number of persons of Asian ancestry seen in primary care in the United States is increasing. Knowledge of how to provide optimal care despite language barriers, low socioeconomic status, different health beliefs and practic...

journal_title：Cleveland Clinic journal of medicine

authors： Jin XW,Slomka J,Blixen CE

更新日期：2002-01-01 00:00:00

abstract：:Up to two-thirds of patients who have had a stroke have obstructive sleep apnea (OSA) afterward. These patients have worse outcomes than those without OSA in terms of short-term morbidity, functional and cognitive recovery, and mortality rates over the long term. Following a stroke, identifying OSA and treating it wit...

journal_title：Cleveland Clinic journal of medicine

authors： McKee Z,Auckley DH

更新日期：2019-06-01 00:00:00

abstract：:Consensus panel guidelines advocate for the judicious use of antipsychotic drugs to manage delirium in hospitalized patients when nonpharmacologic measures fail and the patient is in significant distress from symptoms, poses a safety risk to self or others, or is impeding essential aspects of his or her medical care. ...

journal_title：Cleveland Clinic journal of medicine

authors： Thom RP,Mock CK,Teslyar P

更新日期：2017-08-01 00:00:00

abstract：:The treatment of hepatitis C has evolved rapidly since the identification of the hepatitis C virus (HCV) in 1989. Since the first accepted therapy for HCV infection, recombinant interferon, received marketing approval a little more than a decade ago, it has come to be used in combination with ribavirin for improved ra...

journal_title：Cleveland Clinic journal of medicine

authors： Saadeh S,Davis GL

更新日期：2004-05-01 00:00:00

abstract：:Recent advances in our understanding of the diagnosis, imaging, pathology, and clinical monitoring of multiple sclerosis (MS) have significantly increased our ability to successfully treat this often perplexing neurologic disorder. Magnetic resonance imaging (MRI) is now integral to the diagnostic process. Treatment o...

journal_title：Cleveland Clinic journal of medicine

authors： Fox RJ,Bethoux F,Goldman MD,Cohen JA

更新日期：2006-01-01 00:00:00

abstract：:Fraud in scientific research is a widespread problem. It can involve falsifying data or documents, or knowingly failing to comply with regulations protecting research participants. Fraud can be committed by individuals, institutions, or corporations; in the context of research, fraud often is motivated by consideratio...

journal_title：Cleveland Clinic journal of medicine

authors： Sheehan JG

更新日期：2007-03-01 00:00:00

abstract：:A patient with progressive psoriatic arthritis refractory to methotrexate therapy was treated empirically with intravenous nitrogen mustard, or HN2. His response to therapy was compared with the responses of five rheumatoid arthritis patients treated with the same regimen. At 14 days after therapy was begun the patien...

journal_title：Cleveland Clinic journal of medicine

authors： Wilke WS,Sexton C,Steck W

更新日期：1990-10-01 00:00:00

abstract：BACKGROUND:Certain fluorocarbon polymers can produce a clinical syndrome called polymer fume fever when the products of pyrolysis are inhaled. SUMMARY:A previously healthy 21-year-old white man presented with severe chest tightness, difficulty in breathing, pyrexia, nausea, vomiting, and a dry irritating cough. These ...

journal_title：Cleveland Clinic journal of medicine

authors： Silver MJ,Young DK

更新日期：1993-11-01 00:00:00

abstract：:By incorporating additional data, clinicians can transform the exercise stress test from a poor diagnostic test to a good prognostic one. These additional data include indices of how the patient's heart rate and blood pressure respond to exercise. Computerized measures of electrocardiographic ST-segment changes that a...

journal_title：Cleveland Clinic journal of medicine

authors： Lauer MS

更新日期：1999-05-01 00:00:00

abstract：:Intravascular ultrasonography (IVUS) can precisely measure plaque burden and is being used to test new drug therapies. Other imaging tests may also prove useful to monitor treatment of atherosclerosis and identify populations at risk for coronary artery disease (CAD). ...

journal_title：Cleveland Clinic journal of medicine

authors： Schoenhagen P,Nissen SE

更新日期：2005-06-01 00:00:00