Abstract:
:Therapy with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) has long been the cornerstone of pharmacologic management of patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Many patients with OA or RA, however, are at increased risk of developing clinically significant adverse events associated with NSAID therapy, particularly upper gastrointestinal (GI) complications including symptomatic and complicated ulcers. The introduction of cyclooxygenase (COX)-2-selective inhibitors (coxibs) represents a major advance in the pharmacologic approach to the signs and symptoms of arthritis. In addition to the first two members of this class, celecoxib and rofecoxib, other coxibs have been introduced or are in development (valdecoxib, etoricoxib). In numerous clinical trials, coxibs have been shown to be as effective as nonselective NSAIDs in relieving pain and inflammation associated with OA and RA, and notably, with a significantly lower risk of NSAID-type adverse events. The use of coxibs to treat OA and RA is recommended as first-line therapy when symptoms of pain and inflammation are present in patients vulnerable to potential NSAID-associated GI toxicity.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Schnitzer TJ,Hochberg MCdoi
10.3949/ccjm.69.suppl_1.si20subject
Has Abstractpub_date
2002-01-01 00:00:00pages
SI20-30eissn
0891-1150issn
1939-2869journal_volume
69 Suppl 1pub_type
杂志文章,评审abstract::Increased levels of human growth hormone (HGH) may correlate with the severity of psoriasis and native somatostatin (SRIF) may improve it by inhibiting HGH release. The synthetic SRIF analog, SMS 201-995, is a potent and long-lasting HGH inhibitor. Nine patients with chronic plaque psoriasis completed 12 weeks of open...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.57.1.71
更新日期:1990-01-01 00:00:00
abstract::An over-the-counter at-home test for human immunodeficiency virus (HIV) infection has been approved and will likely be available soon. It is intended to decrease the percentage of HIV-infected people unaware of their infection (estimated at 18% of the 1.2 million people infected in the United States). Since early and ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.79a.12128
更新日期:2012-10-01 00:00:00
abstract::Therapeutic hypothermia in acute resuscitation medicine has a long history, but its currently recommended use dates back to work in the mid-1960s by the late Dr. Peter Safar and colleagues. Compared with normothermia, mild therapeutic hypothermia, induced right after restoration of spontaneous circulation in comatose ...
journal_title:Cleveland Clinic journal of medicine
pub_type:
doi:10.3949/ccjm.76.s2.02
更新日期:2009-04-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84a.16077
更新日期:2017-08-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.9.745
更新日期:2003-09-01 00:00:00
abstract::Tailored care will increasingly become the hallmark of treatment for patients with hypertension in the 1990s. In mildly hypertensive patients, treatment should begin with nonpharmacologic approaches to lower blood pressure and reduce the patient's cardiovascular risk profile. The ever-increasing array of antihypertens...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.58.3.277
更新日期:1991-05-01 00:00:00
abstract::Mounting evidence suggests that depression, anxiety, and hostility/anger may each be an independent risk factor for acute coronary syndrome (ACS) occurrence. Data specific to the role of these negative emotional states in predisposing to imminent ACS risk are limited, however. Additionally, a number of studies have in...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.suppl_2.s15
更新日期:2008-03-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.1.73
更新日期:2005-01-01 00:00:00
abstract::Behavioral disorders in pediatric patients--primarily attention deficit hyperactivity disorder (ADHD)--pose a clinical challenge for health care providers to accurately assess, diagnose, and treat. In 2013, updated diagnostic criteria for behavioral disorders were published, including ADHD and a new diagnostic entity:...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.82.s1.01
更新日期:2015-11-01 00:00:00
abstract::Decisions about whether and how long to treat seizures in children and adolescents should be based on rational criteria and knowledge of the natural history of epileptic syndromes, rather than on the presumption that all seizures should be treated at any cost. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.62.3.176
更新日期:1995-05-01 00:00:00
abstract::Depression has been linked to cardiovascular disease and cognitive impairment, including Alzheimer disease, but the exact nature of the relationship is poorly understood. Although depression seems to progress little after the onset of Alzheimer disease, depression in earlier life increases the risk of dementia and cog...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.78.s1.07
更新日期:2011-08-01 00:00:00
abstract::Autosomal dominant polycystic kidney disease (ADPKD) has numerous systemic manifestations and complications. This article gives an overview of hypertension, cardiac complications, and intracranial aneurysms in ADPKD, their pathophysiology, and recent developments in their management. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84a.16107
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:There are now more than 31 million people 65 years of age or older in the United States, at least half of whom have systolic blood pressure 140 mm Hg or higher or diastolic blood pressure 90 mm Hg or higher or both. By the year 2050, 16 million Americans will be over age 85. OBJECTIVE:To review the current ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.62.1.29
更新日期:1995-01-01 00:00:00
abstract::The metabolic syndrome is likely to develop in patients in whom genetic predisposition, chronic stress, negative emotion, and unhealthy lifestyle habits converge. In light of the psychophysiologic aspect of most of these factors, biofeedback, relaxation, and other psychophysiologic interventions have been studied and ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.77.s3.12
更新日期:2010-07-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.66.7.415
更新日期:1999-07-01 00:00:00
abstract::Development of medical devices requires interaction between physicians and industry that is considerably more intimate than that in pharmaceutical development. Progress in procedure-based medicine would be stalled if this collaboration were eliminated. This degree of interaction, however, creates conflicts of interest...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.74.suppl_2.s26
更新日期:2007-03-01 00:00:00
abstract::Because type 2 diabetes mellitus is a progressive disease, most patients eventually need insulin. When and how to start insulin therapy are not one-size-fits-all decisions but rather must be individualized. This paper reviews the indications, goals, and options for insulin therapy in type 2 diabetes. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.82a.14069
更新日期:2015-08-01 00:00:00
abstract::We reviewed the population of a surgical intensive care unit from July 1, 1987 to June 30, 1988, adjusting for severity of illness using the APACHE II system. Nineteen different departments admitted a total of 613 patients to the surgical intensive care unit. Predicted mortality was 22.9%; actual mortality was 15.7%. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.58.6.477
更新日期:1991-11-01 00:00:00
abstract::Research into heart rate variability (HRV) and respiration over the past 150 years has led to the insight that HRV with deep breathing (HRVdb) is a highly sensitive measure of cardiovagal or parasympathetic cardiac function. This sensitivity makes HRVdb an important part of the battery of cardiovascular autonomic func...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76.s2.08
更新日期:2009-04-01 00:00:00
abstract::Lifestyle modifications in conjunction with antidiabetes medications can produce near-normal blood glucose concentrations in patients with type 2 diabetes mellitus (T2DM). Because these patients have increased cardiovascular morbidity and mortality, treatment strategies should also address the cardiovascular aspects o...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76.s5.04
更新日期:2009-12-01 00:00:00
abstract::Annular pancreas is a congenital anomaly which, though present at birth, may cause few symptoms until adulthood. A case of annular pancreas with intermittent duodenal obstruction is described in a 49-year-old alcoholic man. Few other entities cause such obstruction. In similar cases, clinical suspicion of annular panc...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.59.2.208
更新日期:1992-03-01 00:00:00
abstract::In 1988, a new do-not-resuscitate policy aimed at assisting professional staff, nurses, patients, and families in end-of-life choices replaced the existing policy at The Cleveland Clinic Foundation. We conducted a retrospective chart review to examine the effects of the new policy on length of stay. Data were collecte...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.59.6.591
更新日期:1992-11-01 00:00:00
abstract::Giant cell arteritis is a common systemic vasculitis that affects the elderly and has a variable clinical presentation. Physicians should be aware of its different clinical phenotypes so that they can recognize it early and promptly initiate glucocorticoids, the mainstay of therapy. Clinicians should also be familiar ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.86a.18103
更新日期:2019-07-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.80a.12142
更新日期:2013-07-01 00:00:00
abstract::Omega-3 fatty acids are abundant in fish oil. A high dietary intake of omega-3 fatty acids has been strongly linked to lower rates of cardiovascular disease in epidemiologic studies. Fish oil supplements lower triglyceride levels and may have other benefits such as preventing arrhythmias, reducing inflammation (althou...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76a.08042
更新日期:2009-04-01 00:00:00
abstract::Nonspinal musculoskeletal disorders frequently cause neck and back pain and thus can mimic conditions of the spine. Common mimics are rotator cuff tears, bursitis in the hip, peripheral nerve compression, and arthritis in the shoulder and hip. A thorough history and physical examination, imaging studies, and ancillary...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.1.50
更新日期:2008-01-01 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
pub_type: 临床试验,杂志文章
doi:10.3949/ccjm.57.7.643
更新日期:1990-10-01 00:00:00
abstract::Studies published during the past year on the treatment of several infectious diseases provide valuable information that should enable us to treat our patients more effectively. Among those findings: Oral vancomycin (Vancocin) is superior to oral metronidazole (Flagyl) for treating patients with severe Clostridium dif...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.8.584
更新日期:2008-08-01 00:00:00
abstract::Early restoration of patency of the infarct-related artery is a universally accepted goal in the treatment of acute myocardial infarction. However, even with the most successful fibrinolytic regimen only approximately 50% of patients achieve restoration of normal flow at 90 minutes. "Rescue" angioplasty, the mechanica...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.67.5.341
更新日期:2000-05-01 00:00:00
abstract::Genetics may account for much of the variability in our patients' responses to drug therapies. This article offers the clinician an up-to-date overview of pharmacogenomic testing, discussing implications and limitations of emerging validated tests relevant to the use of warfarin (Coumadin), clopidogrel (Plavix), stati...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.78a.10145
更新日期:2011-04-01 00:00:00