Abstract:
:Complications of chronic gastroesophageal reflux disease (GERD) run the gamut from erosive esophagitis to esophageal cancer, but all are linked to repeated exposure of the esophagus to caustic gastric and duodenal acid. Progression from one complication to another is not clearly established across the GERD continuum, although there is a clear progression from the serious complication of Barrett's esophagus to esophageal adenocarcinoma. This review examines the range of complications that can arise from chronic GERD, underscoring the need to view heartburn as a symptom of a potentially serious condition.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Fennerty MBdoi
10.3949/ccjm.70.suppl_5.s33subject
Has Abstractpub_date
2003-11-01 00:00:00pages
S33-50eissn
0891-1150issn
1939-2869journal_volume
70 Suppl 5pub_type
杂志文章,评审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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.64.8.437
更新日期:1997-09-01 00:00:00
abstract::The effects of estrogenic steroid hormones in women are apparent, but the circulating androgen levels are much higher. Compared with serum estrone and estradiol levels, circulating testosterone levels are five to 10 times higher, androstenedione levels 30 times higher, dehydroepiandrosterone levels 100 times higher, a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.57.2.161
更新日期:1990-03-01 00:00:00
abstract::Women with heart failure differ from their male counterparts in a number of ways, including etiology, pattern of cardiac remodeling, and prognosis. They may even respond differently to medical therapy. But until prospective, sex-specific studies show that we should do otherwise, we recommend that women with heart fail...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.6.423
更新日期:2007-06-01 00:00:00
abstract::Thirty-four young patients (28 male and 6 female) underwent aortic valve replacement between 1972 and 1988. Ages ranged from 11 to 20 years (mean 17.7 years). Including reimplantation in the follow-up period, 40 valves were implanted, among which were 17 (43%) St. Jude, 7 (16%) Bjork-Shiley, and 4 (10%) Carpentier-Edw...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.59.5.473
更新日期:1992-09-01 00:00:00
abstract::Clinical imaging and serologic testing are increasingly replacing biopsy for diagnosing hepatic diseases. However, more biopsies are being done to stage and grade hepatitis C and fatty liver disease, to diagnose space-occupying lesions (typically with fine-needle aspiration biopsy), and to assess response to therapy. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.3.199
更新日期:2005-03-01 00:00:00
abstract::Intermittent claudication (IC) is the classic complaint associated with peripheral arterial disease (PAD) and can significantly limit a patient's lifestyle and workplace abilities. IC is defined as reproducible pain affecting the muscles of the lower extremities that begins and increases with activity and resolves wit...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.suppl_4.s38
更新日期:2006-10-01 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::Although hypertension has been defined numerically as blood pressure levels above 140/90 mmHg, there is no doubt that a blood pressure level within the "normal" range increases the stress on a diseased heart. For this reason, vasodilator therapy is often successful in treating congestive heart failure. The authors pro...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.56.4.447
更新日期:1989-06-01 00:00:00
abstract::The patient-centered medical home is a rapidly growing concept in reforming American health care. It has spread from its origins in primary care pediatrics to family practice and, more recently, into internal medicine. This review article describes how primary care geriatricians can obtain certification from the Natio...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.79a.11103
更新日期:2012-05-01 00:00:00
abstract::The history and physical examination, rather than routine laboratory, cardiovascular, and pulmonary testing, are the most important components of the preoperative evaluation. The history should include a complete review of systems (especially cardiovascular and pulmonary), medication history, allergies, surgical and a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.71.1.63
更新日期:2004-01-01 00:00:00
abstract::This paper reviews the clinical presentation of gallstone disease, acalculous cholecystitis, biliary dyskinesia, and gallbladder cancer, as well as how to make best use of current diagnostic and treatment methods, particularly ultrasonography, cholescintigraphy, laparoscopic cholecystectomy, and endoscopic retrograde ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.12.977
更新日期:2002-12-01 00:00:00
abstract::The ongoing outbreak of Zika virus infection that began in South America and Central America in 2014 is worrisome because of associations with fetal microcephaly and with Guillain-Barré syndrome. Here we summarize what has happened and what is known so far. As the outbreak continues to evolve, we urge clinicians to wa...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.83a.16027
更新日期:2016-04-01 00:00:00
abstract::Obesity is associated with higher rates of death due to cancer. Possible explanations for this association include physiological factors associated with obesity, lower cancer screening rates in obese people, and technical difficulties in treating obese patients. These problems represent opportunities to improve the ca...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.10.945
更新日期:2006-10-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.86a.18033
更新日期:2019-06-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.11.807
更新日期:2007-11-01 00:00:00
abstract::Newer theories suggest that patients with fibromyalgia have a biologic predisposition to perceiving pain with more sensitivity than people without fibromyalgia. Several biologic triggers are implicated as possibly initiating or worsening the symptoms of fibromyalgia. Treatments to manage pain, help with sleep, and, wh...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.68.10.830
更新日期:2001-10-01 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::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::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::Carefully designed, monitored rehabilitation regimens can benefit patients with significant cardiac disease, such as life-threatening arrhythmias or congestive heart failure, or who have concurrent systemic disease such as diabetes. Patients with heart failure can tolerate minimal workloads but, with conditioning, the...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.58.1.70
更新日期:1991-01-01 00:00:00
abstract::Coronary artery disease is different in women than in men in its pathogenesis, symptoms, and prognosis. Needed is a strategy for detecting and assessing coronary disease specifically in women. This review highlights recent evidence on sex differences in coronary artery disease. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.8.585
更新日期:2007-08-01 00:00:00
abstract::Both diabetic and prediabetic patients have abnormal vascular reactivity and should be considered to have occult cardiovascular disease. Angiotensin-converting-enzyme (ACE) inhibitors are particularly beneficial in diabetes because they reduce the incidence of both cardiovascular events and diabetes-related complicati...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.67.11.807
更新日期:2000-11-01 00:00:00
abstract::Nephrotic syndrome can now be treated effectively in most cases. All patients should be treated with a low-salt diet, diuretics to reduce edema, and statins to normalize serum lipid concentrations. Patients with nephrotic syndrome are prone to deep vein thrombophlebitis, renal vein thrombosis, and pulmonary emboli. De...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.2.161
更新日期:2006-02-01 00:00:00
abstract::Although there is still no consensus on how to diagnose hypertension, opinion is moving toward incorporating out-of-office blood pressure measurements into the process. The SPRINT trial poses potential opportunities and challenges. Simplified antihypertensive drug regimens incorporating single pill combinations are ve...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.82.s2.06
更新日期:2015-12-01 00:00:00
abstract::Obsessive-compulsive disorder (OCD) is the fourth most common psychiatric disorder. Yet patients often avoid seeking help because they are ashamed. Diagnosis is difficult, but familiarity with the nature of OCD and its current management helps primary care physicians identify patients with OCD and make informed judgme...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.10.824
更新日期:2003-10-01 00:00:00
abstract::Because 1% to 9% of people without symptoms have elevated liver enzymes, extensive evaluation of all abnormal test results would expose many patients to undue risks and expenses. On the other hand, failure to evaluate minor liver enzyme elevations could mean missing the early diagnosis of potentially treatable disorde...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.77a.09064
更新日期:2010-03-01 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
pub_type: 杂志文章
doi:10.3949/ccjm.61.1.70
更新日期:1994-01-01 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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.71.4.289
更新日期:2004-04-01 00:00:00
abstract::An immunocompromised patient presented with chronic low back pain as the initial symptom and a subcutaneous abscess as the initial sign of disseminated aspergillosis. With the rising incidence of immunocompromised patients, cutaneous manifestation of aspergillosis may become more common. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.57.1.92
更新日期:1990-01-01 00:00:00