Abstract:
:Tailored care will increasingly become the hallmark of treatment for patients with hypertension in the 1990s. In mildly hypertensive patients, treatment should begin with nonpharmacologic approaches to lower blood pressure and reduce the patient's cardiovascular risk profile. The ever-increasing array of antihypertensive drugs and drug classes will enable clinicians to select agents based on the advantages and disadvantages for a particular patient, while continuing to move away from the rigid guidelines of stepped care. Physicians more often will base their choice of antihypertensive therapy not on safety and efficacy alone, but rather on the safety and efficacy of the drug in the long-term care and the impact of therapy on quality of life.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Vidt DGdoi
10.3949/ccjm.58.3.277subject
Has Abstractpub_date
1991-05-01 00:00:00pages
277-84issue
3eissn
0891-1150issn
1939-2869journal_volume
58pub_type
杂志文章,评审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::Too often, physicians, patients, and families make end-of-life care decisions despite poor physician-patient communication and misunderstanding by the patient and family about the effectiveness of cardiopulmonary resuscitation. We describe an approach to resolving conflict and reaching consensus on end-of-life care. T...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.67.6.392
更新日期:2000-06-01 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::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::Stroke is a deadly and disabling disease that preferentially afflicts older adults. It shares common risk factors with myocardial infarction (MI), such as hypertension, diabetes, and hyperlipidemia. Blood pressure control, cholesterol reduction with statins, and glucose control reduce the risk for both stroke and MI. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.suppl_3.s14
更新日期:2005-10-01 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::Mild cognitive impairment (MCI) is a common heterogeneous syndrome that in some cases is transitional between normal age-related cognitive changes and dementia. Identifying it early may lead to prompt recognition of reversible causes and allows for timely future planning. This article describes definitions of MCI and ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.79a.11126
更新日期:2012-12-01 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::Transitions of care-when patients move from one health care facility to another or back home-that are poorly executed result in adverse effects for patients. Fortunately, programs can be implemented that enhance collaboration across care settings and improve outcomes including reducing hospital readmission rates. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.81a.13106
更新日期:2014-05-01 00:00:00
abstract::Percutaneous transluminal coronary angioplasty (PTCA) of stenotic saphenous vein grafts is less invasive than repeat coronary bypass grafting; however, this procedure is complicated by atheromatous embolization in 2.5%-3.0% of cases, an incidence significantly higher than in angioplasty of native coronary vessels. We ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.56.6.581
更新日期:1989-09-01 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
pub_type: 杂志文章
doi:10.3949/ccjm.59.2.208
更新日期:1992-03-01 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::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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.suppl_5.s22
更新日期:2008-07-01 00:00:00
abstract::Deep brain stimulation (DBS) is among the most effective approaches for the treatment of patients with advanced movement disorders. In patients with essential tremor, stimulation typically targets the ventral intermediate nucleus of the thalamus. Results of several studies have shown that over a follow-up period of 1 ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.79.s2a.08
更新日期:2012-07-01 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::To date, there are no effective antiviral medications for COVID-19. Drug repurposing, a strategy that uses existing drugs, offers potential prevention and treatment options for COVID-19. We discuss one treatment strategy that combines anti-inflammatory (melatonin) and antiviral (toremifene) agents for patients infecte...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc037
更新日期:2020-06-30 00:00:00
abstract::The metabolic syndrome is likely to develop in patients in whom genetic predisposition, chronic stress, negative emotion, and unhealthy lifestyle habits converge. In light of the psychophysiologic aspect of most of these factors, biofeedback, relaxation, and other psychophysiologic interventions have been studied and ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.77.s3.12
更新日期:2010-07-01 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::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::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::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::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::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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.85a.17051
更新日期:2018-03-01 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
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: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::You can find evidence-based answers to clinical questions quickly by searching online medical databases. The key is to be selective, on the basis of the type of information you need. Online textbooks, consensus guidelines systematic reviews, and MEDLINE are all available. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.68.4.307
更新日期:2001-04-01 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::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