Abstract:
:Patients with refractory epilepsy face an elevated risk of sudden death, with rates as high as 1% per year. This phenomenon, known as sudden unexpected death in epilepsy (SUDEP), is believed to be a seizure-related occurrence, but the exact underlying mechanisms are uncertain. Both pulmonary and cardiac pathophysiologies have been proposed. The cardiac mechanism of greatest interest is the precipitation of arrhythmias by seizure discharges via the autonomic nervous system. SUDEP prevention has centered on effective seizure control, and epilepsy surgery has reduced SUDEP incidence in a number of studies. Additional prophylaxis methods are needed, however, for the large number of patients with treatment-refractory epilepsy. Future research should aim to clarify whether the association between seizures and autonomic dysfunction and cardiac arrhythmias extends to a demonstrable cardiac mechanism for SUDEP.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Jehi L,Najm IMdoi
10.3949/ccjm.75.suppl_2.s66subject
Has Abstractpub_date
2008-03-01 00:00:00pages
S66-70eissn
0891-1150issn
1939-2869journal_volume
75 Suppl 2pub_type
杂志文章,评审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, an...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.suppl_3.s24
更新日期:2006-09-01 00:00:00
abstract::Cutaneous changes may be the first clue that a patient has liver disease. Recognizing these signs is crucial to diagnosing liver conditions early. Here we describe the spectrum of skin manifestations that may be found in various liver diseases. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76A.08113
更新日期:2009-10-01 00:00:00
abstract::Many effective treatments for scleroderma have emerged in recent years, including bosentan, an endothelin receptor antagonist, and epoprostenol, a prostacyclin, both of which target vasoconstriction. Cyclophosphamide may soon be proven effective against interstitial lung disease. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.70.11.954
更新日期:2003-11-01 00:00:00
abstract::Weight-loss drugs are being evaluated for their role in obesity management. This article reviews the available weight-loss drugs, their efficacy and side effects, and their best clinical use. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84a.16094
更新日期:2017-12-01 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
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::The aromatase inhibitors are established first-line drugs for treating metastatic breast cancer in postmenopausal women, and are gaining acceptance as adjuvant treatment as well. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.7.561
更新日期:2002-07-01 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::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::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:BACKGROUND:Stereotactic and computer-assisted techniques have revolutionized the diagnosis and treatment of many disorders of the brain by directing surgical instruments, the surgeon's hands, or focused radiation to an imaged target along predefined routes. METHODS:This report reviews the basic principles and techniqu...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.60.5.399
更新日期:1993-09-01 00:00:00
abstract::Recommendations exist for preparticipation physical examinations, but there is no national standard, and the recommendations are not widely followed. The most common reasons for denying clearance to play are musculoskeletal conditions, hypertension, and visual acuity problems. Although detecting potentially life-threa...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.71.7.587
更新日期:2004-07-01 00:00:00
abstract::The article "Total pancreatectomy and islet cell autotransplantation: Definitive treatment for chronic pancreatitis" (Arce KM, Lin YK, Stevens T, Walsh RM, Hatipoglu BA. Cleve Clin J Med 2016; 83:435-442) incorrectly stated that Paul Lacy and David Scharp performed research at the University of Washington at Seattle. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 已发布勘误
doi:
更新日期:2016-09-01 00:00:00
abstract::A subdural empyema developed in a young man after craniotomy for evacuation of a hematoma in a sylvian fissure arachnoid cyst and the subdural space. Despite prolonged systemic and subdural antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elev...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.56.3.311
更新日期:1989-05-01 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::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::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::Food allergies have increased in prevalence significantly in the past decade and so, apparently, has eosinophilic esophagitis. Although the cause of eosinophilic esophagitis is unknown, allergic responses including food allergies have been implicated. This article reviews both conditions, focusing on how to detect and...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.77a.09018
更新日期:2010-01-01 00:00:00
abstract::Concern has been raised about whether the fluid retention caused by thiazolidinediones (TZDs, ie, rosiglitazone and pioglitazone) can cause or exacerbate congestive heart failure. Although fluid retention is a worrisome side effect of TZDs, current evidence does not link fluid retention caused by TZDs with worsening h...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.4.390
更新日期:2006-04-01 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::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
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::Patients with muscle diseases are often seen initially by general practitioners. This article reviews how to evaluate and manage such patients, including those taking a statin, how to interpret creatine kinase (CK) test results, and how to recognize common as well as potentially dangerous myopathies. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.86gr.19001
更新日期:2019-10-01 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::Pancreas transplantation can improve quality of life for patients with type 1 diabetes by eliminating hypoglycemic and hyperglycemic episodes, the need for insulin injections, frequent self-monitoring of blood glucose levels, and dietary restrictions. Increasing evidence suggests that it may slow the progression of lo...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.67.4.281
更新日期:2000-04-01 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::Glomerulonephritis (GN) is a common manifestation of the antineutrophil cytoplasmic antibody-associated systemic vasculitides (AASV), which include granulomatosis with polyangiitis and microscopic polyangiitis. The level of renal involvement at presentation is highly predictive of survival and should be assessed early...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.79.s3.05
更新日期:2012-11-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.71.11.907
更新日期:2004-11-01 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::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::Anticonvulsant hypersensitivity syndrome, a potentially fatal but rare reaction, manifests as rash, fever, tender lymphadenopathy, hepatitis, and eosinophilia. To manage hypersensitivity syndrome successfully, one must recognize the symptoms early, stop the offending drug immediately, and substitute a safe, alternativ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.66.4.239
更新日期:1999-04-01 00:00:00