Obsessive-compulsive disorder: unearthing a hidden problem.

abstract：:Although atrial fibrillation is well tolerated by most patients, in some patients the consequences may be severe. The Maze procedure is a new open-heart operation that creates a carefully designed maze of incisions in the atrial myocardium; this maze then acts as an electrical conduit to channel atrial impulses from t...

journal_title：Cleveland Clinic journal of medicine

authors： McCarthy PM,Castle LW,Trohman RG,Simmons TW,Maloney JD,Klein AL,White RD,Cox JL

更新日期：1993-03-01 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：:When a patient reports constipation, a careful history and physical examination may identify the underlying cause. In many patients, though, no underlying cause is identified. Empiric treatment with exercise, hydration, fiber supplementation, and mild laxatives is often effective. If constipation does not resolve with...

journal_title：Cleveland Clinic journal of medicine

authors： Soffer EE

更新日期：1999-01-01 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

authors： Austerman J

更新日期：2015-11-01 00:00:00

abstract：:Congestive heart failure is the most common cause of death in patients with thalassemia, as chronic accumulation of iron due to regular blood transfusions leads to biventricular systolic dysfunction and death at a very young age. The quantity of iron deposited in the heart is a key determinant of outcome. Early diagno...

journal_title：Cleveland Clinic journal of medicine

authors： Jabbar DA,Davison G,Muslin AJ

更新日期：2007-11-01 00:00:00

abstract：:Patients with panic disorder often believe they are suffering a myocardial infarction or another life-threatening illness. The history and physical examination and a few tests usually suffice to diagnose this disorder, which is treatable with behavioral therapy, antidepressants, and benzodiazepines. ...

journal_title：Cleveland Clinic journal of medicine

authors： Muzina DJ,Malone DA

更新日期：1997-09-01 00:00:00

abstract：:The neurohormone arginine vasopressin (AVP) is a promising target in the treatment of heart failure because AVP promotes congestion and hyponatremia, each of which is associated with poor outcomes. Diuretics are standard therapy for heart failure, but they have several limitations, including worsening renal function a...

journal_title：Cleveland Clinic journal of medicine

authors： Gheorghiade M

更新日期：2006-06-01 00:00:00

abstract：:Percutaneous transluminal coronary angioplasty (PTCA) of stenotic saphenous vein grafts is less invasive than repeat coronary bypass grafting; however, this procedure is complicated by atheromatous embolization in 2.5%-3.0% of cases, an incidence significantly higher than in angioplasty of native coronary vessels. We ...

journal_title：Cleveland Clinic journal of medicine

authors： Trono R,Sutton C,Hollman J,Suit P,Ratliff NB

更新日期：1989-09-01 00:00:00

abstract：:A surprising number of apparently healthy people harbor unsuspected pituitary tumors, which are being discovered incidentally on computed tomography (CT) or magnetic resonance imaging (MRI) performed for other reasons. The majority can be safely observed; for others, medical therapy or surgical resection is necessary....

journal_title：Cleveland Clinic journal of medicine

authors： Serhal D,Weil RJ,Hamrahian AH

更新日期：2008-11-01 00:00:00

abstract：:SCS is an efficacious, reversible, and safe therapy that improves quality of life, increases exercise tolerance, and relieves angina pectoris, but clinical trials in North America are needed to confirm the data coming from Europe. Neuronal convergence onto STT cells underlies the referred pain associated with angina p...

journal_title：Cleveland Clinic journal of medicine

authors： Foreman RD

更新日期：2007-02-01 00:00:00

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：:Thrombotic thrombocytopenic purpura (TTP) is a spectrum of syndromes characterized by thrombocytopenia and microangiopathic hemolytic anemia, manifested by an elevated blood lactate dehydrogenase (LDH) concentration and red blood cell fragments. It classically occurs in patients with a hereditary or acquired lack of A...

journal_title：Cleveland Clinic journal of medicine

authors： Crowther MA,George JN

更新日期：2008-05-01 00:00:00

abstract：:A case is reported of lambda light chain multiple myeloma complicated by a myelomatous pleural effusion. Pleural effusions are uncommon in multiple myeloma, and most are secondary to nonmalignant causes. The clinical characteristics, natural history and pathophysiology of myelomatous pleural effusions are reviewed. ...

journal_title：Cleveland Clinic journal of medicine

authors： Abbate SL,Jaff MR,Fishleder AJ,Meeker DP

更新日期：1991-05-01 00:00:00

abstract：:Informed consent in clinical research is a matter of both ethics and federal regulation. A research subject must enter a study voluntarily, be informed about risks and benefits, and understand the difference between experiment and treatment. ...

journal_title：Cleveland Clinic journal of medicine

authors： Bramstedt KA

更新日期：2004-11-01 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：:Lung resection provides the greatest likelihood of cure for patients with localized lung cancer, but is associated with a risk of mortality, decreased postoperative lung function, and other complications. Lung function testing using spirometry, diffusing capacity of the lung for carbon monoxide, and peak oxygen consum...

journal_title：Cleveland Clinic journal of medicine

authors： Mazzone P

更新日期：2012-05-01 00:00:00

abstract：:In patients with morbid obesity, surgery is the only treatment known to produce sustained weight loss and to reduce comorbidities. Traditional (open) gastric bypass surgery is associated with postoperative complications that include wound infection, pulmonary embolism, and pneumonia. Laparoscopic techniques achieve si...

journal_title：Cleveland Clinic journal of medicine

authors： Brody F

更新日期：2004-04-01 00:00:00

abstract：:To determine whether migraine exhibits a circadian rhythm or occurs randomly throughout the day, we analyzed the time of migraine onset in 15 migraine suffers (migraineurs) over 20 weeks. The patients suffered 211 migraine attacks over 20 weeks (range 3 to 30, median 13). Twelve of the 15 migraineurs had 50% or more o...

journal_title：Cleveland Clinic journal of medicine

authors： Solomon GD

更新日期：1992-05-01 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

authors： Davidson KW

更新日期：2008-03-01 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

authors： Peters AL

更新日期：2009-12-01 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：:Despite the availability of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection, there has not been a dramatic decrease in the frequency of progressive multifocal leukoencephalopathy (PML) in the HIV-infected population. Usually a multifocal progressive diseas...

journal_title：Cleveland Clinic journal of medicine

authors： Simpson DM

更新日期：2011-11-01 00:00:00

abstract：BACKGROUND:Newer immunosuppressive agents are permitting transplantation to be performed more frequently. OBJECTIVES:To review the mechanisms of action and toxicity of cyclosporine. DISCUSSION:Graft rejection is mainly cell-mediated, although a humoral (antibody) response may also be involved. Cyclosporine and relate...

journal_title：Cleveland Clinic journal of medicine

authors： Graham RM

更新日期：1994-07-01 00:00:00

abstract：:One of the factors that contribute to the progressively declining course of heart failure could be sleep apnea. Whether treating sleep apnea improves the clinical outcomes of patients with heart failure needs to be tested in randomized clinical trials. ...

journal_title：Cleveland Clinic journal of medicine

authors： Wexler L,Javaheri S

更新日期：2005-10-01 00:00:00

abstract：:Severe acute pancreatitis causes high rates of illness and death. Simple scoring predictors can help identify patients at risk so that treatment, primarily supportive, can begin promptly after presentation. Medical therapy is the mainstay, with supportive therapy consisting of controlled volume resuscitation and enter...

journal_title：Cleveland Clinic journal of medicine

authors： Baron TH

更新日期：2013-06-01 00:00:00

abstract：:The preoperative evaluation often includes more tests than are necessary. This article reviews the usefulness of and indications for nine commonly ordered preoperative tests. ...

journal_title：Cleveland Clinic journal of medicine

authors： Jones T,Isaacson JH

更新日期：1995-11-01 00:00:00

abstract：:The care of patients with cystic fibrosis (CF) has improved over the past 30 years, and most patients now survive well into adulthood. As a result, clinicians other than pediatricians are more likely than in the past to see CF patients and manage their respiratory, gastrointestinal, pancreatic, and reproductive compli...

journal_title：Cleveland Clinic journal of medicine

authors： Gershman AJ,Mehta AC,Infeld M,Budev MM

更新日期：2006-12-01 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：:Obesity is a potent risk factor for the development and progression of type 2 diabetes, and weight loss is a key component of diabetes management. Bariatric surgery results in significant weight loss and remission of diabetes in most patients. After surgery, glycemic control is restored by a combination of enforced ca...

journal_title：Cleveland Clinic journal of medicine

authors： Kashyap SR,Gatmaitan P,Brethauer S,Schauer P

更新日期：2010-07-01 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

authors： Kitzmiller JP,Groen DK,Phelps MA,Sadee W

更新日期：2011-04-01 00:00:00