Abstract:
:The antidiuretic hormone arginine vasopressin (AVP) is primarily responsible for regulating osmotic and volume homeostasis of body fluids, largely through binding to vasopressin type 1A (V(1A)) and type 2 (V2) receptors. Increased AVP secretion leads to decreased free water excretion with resulting water retention, and can cause dilutional hyponatremia. A new class of medications known as AVP receptor antagonists induces free water diuresis without natriuresis or kaliuresis, an effect termed aquaresis. Numerous clinical trials show AVP antagonists to be effective at increasing free water excretion and serum sodium in patients with hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion or edema-forming states such as congestive heart failure and cirrhosis. This article reviews clinical trial data on the AVP antagonists in late development (lixivaptan, satavaptan, and tolvaptan) and recently approved for marketing (conivaptan).
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Verbalis JGdoi
10.3949/ccjm.73.suppl_3.s24subject
Has Abstractpub_date
2006-09-01 00:00:00pages
S24-33eissn
0891-1150issn
1939-2869journal_volume
73 Suppl 3pub_type
杂志文章,评审abstract::Thrombotic thrombocytopenic purpura, Shiga toxin hemolytic uremic syndrome, atypical hemolytic uremic syndrome, and antiphospholipid syndrome are thrombotic microangiopathies that present similarly but arise from different causes. Management depends on distinguishing them promptly and providing targeted therapy. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84gr.17001
更新日期:2017-02-01 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::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::The role of the immune system in the pathogenesis of beryllium lung disease has been suspected for years. The observation of cutaneous hypersensitivity to beryllium led to the development of the lymphocyte blast transformation test; the test clearly distinguishes between healthy subjects, who show little or no blast t...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.58.2.157
更新日期:1991-03-01 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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.suppl_5.s13
更新日期:2008-07-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.11.793
更新日期:2008-11-01 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::Clinicians are bombarded with information daily by social media, mainstream television news, e-mail, and print and online reports. They usually do not have much control over these information streams and thus are passive recipients, which means they get more noise than signal. Accessing, absorbing, organizing, storing...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.83a.15001
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Ovarian cancer can be cured if detected early enough, but usually has already metastasized when diagnosed. A family history of ovarian cancer is still the strongest known risk factor. OBJECTIVE:To identify women at risk for ovarian cancer and design a program of surveillance. METHODS:Prospective registry o...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.62.2.129
更新日期:1995-03-01 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::Vascular surgery is associated with a high risk of perioperative morbidity and mortality that is partly attributable to inflammatory stress induced by the surgical procedure. Preoperative initiation of a long-acting statin is a strategy intended to reduce the inflammatory stress response and the excess risk associated...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76.s4.13
更新日期:2009-11-01 00:00:00
abstract::Epidemiologic and experimental data suggest that isoflavones have benefits for preventing and treating some prostate disease. Isoflavone supplements may therefore be an important tool for men concerned about prostate disease, such as those with benign prostatic hypertrophy undergoing watchful waiting or those concerne...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.3.203
更新日期:2003-03-01 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 increasing array of treatments such as immunosuppressive drugs and tumor necrosis factor inhibitors can offer patients with ulcerative colitis and Crohn disease improved relief from symptoms with fewer adverse effects. Several additional drugs have shown promise, including nicotine, antimicrobials, and heparin. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.8.621
更新日期:2002-08-01 00:00:00
abstract::Several studies have documented that hypercholesterolemia is common in American children. Other studies have shown that elevated cholesterol levels in childhood remain elevated well into adult life. Autopsy studies of adolescents have also found a strong positive correlation between antemortem cholesterol levels and e...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.57.8.715
更新日期:1990-11-01 00:00:00
abstract::Although the safety profiles of drug-eluting stents are similar to those of bare metal stents in the short term, concern has arisen about their potential for late thrombosis (occurring > 30 days after implantation). Stent thrombosis is rare but potentially devastating and can result in ST-segment elevation myocardial ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.2.129
更新日期:2007-02-01 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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.81a.14009
更新日期:2014-11-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.77a.09163
更新日期:2010-09-01 00:00:00
abstract::Reproductive maturation, the menstrual cycle, and the transition to postreproductive life are complex processes. Detailed understanding of reproduction underlies logical patient management. Greater understanding of physiology has brought about better control of ovulatory problems and the beginnings of a logical approa...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.57.2.169
更新日期:1990-03-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.suppl_1.s30
更新日期:2007-02-01 00:00:00
abstract::Cholesterol is a fat-like substance that is in our blood. Our bodies naturally produce some cholesterol. The other portion comes from animal products such as meat, eggs, butter, cheese, and whole milk. Foods from plants do no contain cholesterol. When you have a high level of cholesterol in your blood, it builds up in...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.68.7.623
更新日期:2001-07-01 00:00:00
abstract::Obesity is epidemic and dangerous. Weight loss is difficult but worth the effort. Although new weight-loss drugs are available, there are no magic bullets: to lose weight and keep it off, people must eat less and exercise more. This article presents a practical approach on how physicians can help their patients lose w...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.67.10.739
更新日期:2000-10-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.4.289
更新日期:2002-04-01 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
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc029
更新日期:2020-05-14 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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.79gr.12003
更新日期:2012-06-01 00:00:00
abstract::Positive airway pressure (PAP) therapy is an open system that can generate contact, droplet, and airborne COVID-19 thereby increasing the risk of transmission of COVID-19 like other procedures such as tracheal intubation, noninvasive ventilation, and cardiopulmonary resuscitation. Medically prudent recommendations hav...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc003
更新日期:2020-05-05 00:00:00
abstract::Patients with alcohol use disorder (AUD) are at higher risk of pneumonia and of poor outcomes. This article reviews the etiology of pneumonia in patients with AUD, its impact on mortality and resource utilization, and its implications for treatment. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.87a.19105
更新日期:2020-07-31 00:00:00