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 ADAMTS13, a metalloproteinase that cleaves large multimers of von Willebrand factor. Other TTP-like syndromes, including TTP associated with pregnancy, organ transplantation, and certain medications, likely have different underlying causes and may require different treatment. Unless TTP is recognized promptly and treated aggressively, most patients die of it.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Crowther MA,George JNdoi
10.3949/ccjm.75.5.369subject
Has Abstractpub_date
2008-05-01 00:00:00pages
369-75issue
5eissn
0891-1150issn
1939-2869journal_volume
75pub_type
杂志文章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::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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.64.10.533
更新日期:1997-11-01 00:00:00
abstract::Decisions about whether and how long to treat seizures in children and adolescents should be based on rational criteria and knowledge of the natural history of epileptic syndromes, rather than on the presumption that all seizures should be treated at any cost. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.62.3.176
更新日期:1995-05-01 00:00:00
abstract::Treatment of anemia in the perioperative period of major orthopedic surgery decreases the need for blood transfusion and improves perioperative outcomes. Use of epoetin alfa in this setting is FDA-approved and provides significant benefit to qualified and carefully chosen patients. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.73.electronic_suppl_1.s13
更新日期:2006-09-01 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
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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.58.3.235
更新日期:1991-05-01 00:00:00
abstract::Biochemical markers of bone turnover provide clinically useful evidence of the normal and pathologic processes that reflect bone cell activity in the skeleton. Understanding the behavior of markers of bone formation and bone resorption should aid in managing patients with a variety of skeletal disorders. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.10.739
更新日期:2008-10-01 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::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::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
abstract::Many infants, children, and adolescents exhibit unusual mannerisms, behaviors, and spells. These events cause concern to parents and are frequently brought to the attention of physicians. If the spells are infrequent and do not interfere with function, no intervention may be necessary. If they are severe and recurrent...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.56.s1.206
更新日期:1989-01-01 00:00:00
abstract::The threshold for testing for hepatitis C virus (HCV) should be low for persons with any risk factor for HCV infection. Current practice calls for first screening for antibodies to HCV and then testing for HCV RNA in those in whom antibodies are detected. Viral testing can distinguish between active and resolved HCV i...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.suppl_4.s7
更新日期:2003-09-01 00:00:00
abstract::During a 10-year period, 60 patients with confirmed diagnoses of pheochromocytoma underwent a total of 63 surgical procedure. To control extreme blood pressure elevations, 6 patients received phenoxybenzamine preoperatively and 28 patients received prazosin. The remaining 29 patients received neither drug. Intravenous...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.57.7.613
更新日期:1990-10-01 00:00:00
abstract::The metabolic syndrome--the cluster of obesity, impaired fasting glucose, elevated triglycerides, low high-density lipoprotein cholesterol, and hypertension--may not be a "real" syndrome in the strict sense. It can, however, still be a useful concept if it prompts a physician to look for and treat additional risk fact...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.3.199
更新日期:2007-03-01 00:00:00
abstract::Consensus panel guidelines advocate for the judicious use of antipsychotic drugs to manage delirium in hospitalized patients when nonpharmacologic measures fail and the patient is in significant distress from symptoms, poses a safety risk to self or others, or is impeding essential aspects of his or her medical care. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84a.16077
更新日期:2017-08-01 00:00:00
abstract::Nonspinal musculoskeletal disorders frequently cause neck and back pain and thus can mimic conditions of the spine. Common mimics are rotator cuff tears, bursitis in the hip, peripheral nerve compression, and arthritis in the shoulder and hip. A thorough history and physical examination, imaging studies, and ancillary...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.1.50
更新日期:2008-01-01 00:00:00
abstract::Exercise, in conjunction with diet, is critical to losing weight and maintaining health in obese patients. While it can be challenging for an obese person to transition to a healthy lifestyle, the physical and emotional benefits of a regular exercise program make it worth the effort. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.83a.14139
更新日期:2016-02-01 00:00:00
abstract::Although most patients with emphysema are managed medically, a small subset of severely disabled patients may become candidates for surgery. This paper discusses for the internist who works with emphysema patients the risks, benefits, patient selection criteria, and outcome data for three procedures in current use: bu...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.66.7.415
更新日期:1999-07-01 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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76a.gr005
更新日期:2009-02-01 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::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::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
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::Lifestyle factors remain the bedrock of atherosclerotic cardiovascular disease (ASCVD) prevention. Statins remain the first-line therapy for primary and secondary prevention of ASCVD. Physicians are encouraged to discuss the risks and benefits of statins with patients before beginning therapy. Nonstatins and proprotei...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87.s1.02
更新日期:2020-05-01 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::Preliminary clinical trials suggest that therapeutic hypothermia might improve the outcomes of patients with acute stroke. Definitive trials are under way. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.10.770
更新日期:2002-10-01 00:00:00
abstract::Inadvertent malpositioning of a cardiac implantable electronic device lead into the left ventricle is a rare complication of transvenous pacing and defibrillation. Rapid identification of lead position is critical during implantation and just after the procedure, with immediate correction required if malpositioning is...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.85a.17012
更新日期:2018-01-01 00:00:00
abstract::Evidence of a neurophysiologic mechanism that involves hormones from adipocytes, pancreatic islet cells, and the gastrointestinal tract implicated in both obesity and diabetes has led to a search for drugs that not only either target obesity and diabetes or reduce hemoglobin A1c, but also have weight loss as a potenti...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84.s1.04
更新日期:2017-07-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) is an important cause of death in patients with liver disease, and its incidence appears to be rising in the United States. Because early diagnosis improves the chances of survival, it is important to identify patients who would benefit from surveillance. Once HCC is suspected on surveil...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.80a.12163
更新日期:2013-10-01 00:00:00