A novel approach to determining the cause of pacemaker lead failure.

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

authors： Koval CE

更新日期：2012-10-01 00:00:00

abstract：:Community-acquired bacterial meningitis is still a significant cause of morbidity and mortality. Clinicians should know how to quickly diagnose it, perform a lumbar puncture, order the necessary tests, and start appropriate empiric therapy promptly. ...

journal_title：Cleveland Clinic journal of medicine

authors： Bhimraj A

更新日期：2012-06-01 00:00:00

abstract：:Much scientific and anecdotal data demonstrate favorable metabolic responses to very-low-carbohydrate diets. We believe that very-low-carbohydrate diets merit further study for weight loss, and that criticisms of these diets lack scientific evidence. ...

journal_title：Cleveland Clinic journal of medicine

authors： Volek JS,Westman EC

更新日期：2002-11-01 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

authors： Helm TN,Mazanec D

更新日期：1990-01-01 00:00:00

abstract：:Gout management requires a comprehensive strategy that considers both acute and chronic aspects of the disease. Acute gout flares should be treated with anti-inflammatory agents as rapidly as possible. The underlying hyperuricemia may be treated with urate-lowering agents initiated at a time appropriate for the indivi...

journal_title：Cleveland Clinic journal of medicine

authors： Schumacher HR Jr,Chen LX

更新日期：2008-07-01 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：: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

authors： Carman TL,Fernandez BB Jr

更新日期：2006-10-01 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：:In hospitalized medical patients, randomized trials have established that anticoagulant prophylaxis has an acceptable benefit-to-risk ratio: ie, it lowers the incidence of clinically silent and symptomatic venous thromboembolism (VTE), including fatal pulmonary embolism, more than it raises the risks of bleeding and o...

journal_title：Cleveland Clinic journal of medicine

authors： Pai M,Douketis JD

更新日期：2010-02-01 00:00:00

abstract：:Cyclospora cayetanensis, an emerging pathogen with worldwide distribution, causes diarrhea in both immunocompetent and HIV-infected patients. We review the epidemiology of Cyclospora infection and how to diagnose and treat it. ...

journal_title：Cleveland Clinic journal of medicine

authors： Gumbo T,Gordon SM,Adal KA

更新日期：1997-06-01 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：:Patients with pulmonary arterial hypertension (PAH) may present to internists, rheumatologists, cardiologists, or pulmonologists. This breadth of clinicians who encounter PAH patients, together with the complicated nature of PAH as a disease entity, argues for a shared-care approach to the management of these patients...

journal_title：Cleveland Clinic journal of medicine

authors： Mughal MM,Mandell B,James K,Stelmach K,Minai OA

更新日期：2003-04-01 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：: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：:Obstructive sleep apnea (OSA) is a serious condition associated with impaired quality of life, depression, drowsy driving and motor vehicle accidents, metabolic disease, and cognitive decline. The mechanisms accounting for OSA and metabolic disease include hypoxia, sleep fragmentation, and systemic inflammation. OSA a...

journal_title：Cleveland Clinic journal of medicine

authors： Walia HK

更新日期：2019-09-01 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

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

authors： Sperrazza JC,Flanagan RA Jr,Katlic MR

更新日期：1992-03-01 00:00:00

abstract：:Patients with systemic lupus erythematosus (SLE, lupus) have a markedly better survival rate today than they did 50 years ago, but they face a greater risk of cancer, cardiovascular disease, and osteoporosis at early ages. With better understanding of the immunological mechanisms of the disease, new avenues of therapy...

journal_title：Cleveland Clinic journal of medicine

authors： Manzi S

更新日期：2009-02-01 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：:Stress echocardiography is a cost-effective and reliable diagnostic test for patients with suspected coronary artery disease. Stress echocardiography should be used in preference to exercise electrocardiography as the primary test in patients with uninterpretable ST segments. It is attractive for use as the primary te...

journal_title：Cleveland Clinic journal of medicine

authors： Marwick T

更新日期：1995-07-01 00:00:00

abstract：:Exercise stress electrocardiography is unreliable as a test for obstructive coronary artery disease (CAD) if the patient has left bundle branch block. The authors provide an algorithm for using alternative tests: exercise stress echocardiography, dobutamine echocardiography, computed tomographic (CT) angiography, and ...

journal_title：Cleveland Clinic journal of medicine

authors： Xu B,Cremer P,Jaber W,Moir S,Harb SC,Rodriguez LL

更新日期：2018-03-01 00:00:00

abstract：:The importance of glycemic control in preventing the chronic and devastating complications of diabetes is well established. Insulin administration is an important therapeutic option for managing diabetes, particularly for patients with profound insulin deficiency. Many insulin formulations are on the market, including...

journal_title：Cleveland Clinic journal of medicine

authors： Meneghini L

更新日期：2016-05-01 00:00:00

abstract：:SARS-CoV-2, the virus that causes COVID-19, is transmitted through respiratory secretions and saliva. The virus can also live for short periods of time (1 to several hours) on fomites such as doorknobs, handrails, and tables. Aerosolization of the virus can occur during procedures including bronchoscopy, endotracheal ...

journal_title：Cleveland Clinic journal of medicine

authors： Miller R,Englund K

更新日期：2020-05-14 00:00:00

abstract：:One of the most important deficiency states associated with chronic renal failure is profound anemia. While it has been possible to identify differing types of anemia in patients receiving dialysis support, and thus correct the secondary causes, most patients continue to exhibit symptoms and signs of the anemic state....

journal_title：Cleveland Clinic journal of medicine

authors： Paganini EP,Garcia J,Abdulhadi M,Lathim D,Giesman J,Weick JK

更新日期：1989-01-01 00:00:00

abstract：BACKGROUND:Mediastinal extension of pancreatic pseudocysts has caused rare cases of cardiac compression, but to our knowledge, congestive heart disease due to cardiac compression by a pancreatic pseudocyst has never been reported. SUMMARY:A 48-year-old man presented with dyspnea, swelling of both lower limbs, left-sid...

journal_title：Cleveland Clinic journal of medicine

authors： Lee FY,Wang YT,Poh SC

更新日期：1994-03-01 00:00:00

abstract：:In patients with long-standing, poorly controlled diabetes and peripheral neuropathy, a red, hot, swollen foot without open ulceration should raise the suspicion of Charcot neuroarthropathy, an often-overlooked diabetic foot complication. The authors discuss key diagnostic features and how to differentiate this condit...

journal_title：Cleveland Clinic journal of medicine

authors： Botek G,Anderson MA,Taylor R

更新日期：2010-09-01 00:00:00

abstract：:The elderly are at increased risk for dehydration and associated fluid and electrolyte imbalances. Changes in functional and mental status, medication effects, and changes in the aging renal system all may be factors. Furthermore, hypodipsia, or insensibility to thirst, may be a physiologic process of aging. These and...

journal_title：Cleveland Clinic journal of medicine

authors： Silver AJ

更新日期：1990-06-01 00:00:00

abstract：:The clinical care of women with epilepsy entails special considerations over the life span. Endogenous depression is more prevalent in persons with epilepsy than in the general population and may be unrecognized. Seizure frequency may be influenced by hormonal fluctuations, as reflected by catamenial patterns in up to...

journal_title：Cleveland Clinic journal of medicine

authors： Penovich PE,Eck KE,Economou VV

更新日期：2004-02-01 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