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_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Abbate SL,Jaff MR,Fishleder AJ,Meeker DPdoi
10.3949/ccjm.58.3.235subject
Has Abstractpub_date
1991-05-01 00:00:00pages
235-9issue
3eissn
0891-1150issn
1939-2869journal_volume
58pub_type
杂志文章,评审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::Although atrial fibrillation is well tolerated by most patients, in some patients the consequences may be severe. The Maze procedure is a new open-heart operation that creates a carefully designed maze of incisions in the atrial myocardium; this maze then acts as an electrical conduit to channel atrial impulses from t...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.60.2.161
更新日期:1993-03-01 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::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::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
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.1.50
更新日期:2002-01-01 00:00:00
abstract::Numerous immunomodulating agents are currently being studied in clinical trials for the treatment of COVID-19, including interferon therapies. Interferons are naturally occurring host antiviral proteins upstream of the inflammatory pathway that are released by host cells in response to the presence of viral pathogens....
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc066
更新日期:2020-12-03 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::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::The neurohormone arginine vasopressin (AVP) is a promising target in the treatment of heart failure because AVP promotes congestion and hyponatremia, each of which is associated with poor outcomes. Diuretics are standard therapy for heart failure, but they have several limitations, including worsening renal function a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.73.suppl_2.s24
更新日期:2006-06-01 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:BACKGROUND:Newer immunosuppressive agents are permitting transplantation to be performed more frequently. OBJECTIVES:To review the mechanisms of action and toxicity of cyclosporine. DISCUSSION:Graft rejection is mainly cell-mediated, although a humoral (antibody) response may also be involved. Cyclosporine and relate...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.61.4.308
更新日期:1994-07-01 00:00:00
abstract::In 1988, a new do-not-resuscitate policy aimed at assisting professional staff, nurses, patients, and families in end-of-life choices replaced the existing policy at The Cleveland Clinic Foundation. We conducted a retrospective chart review to examine the effects of the new policy on length of stay. Data were collecte...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.59.6.591
更新日期:1992-11-01 00:00:00
abstract::Blood tests are available that measure levels of immunoglobulin E (IgE) against specific allergens such as foods, inhalants, medications, latex, and venoms. These tests can confirm the diagnosis of an allergic disorder, supplementing a clinical history consistent with an immediate allergic reaction. They are particula...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.78a.11023
更新日期:2011-09-01 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::Extent of resection in temporal lobectomy has been traditionally based on intraoperative linear measurements. The complex geometrical contour of the temporal lobe limits the precision and accuracy of such measurements, and it is often difficult to verify the extent of actual resection after surgery. The authors propos...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.56.8.833
更新日期:1989-11-01 00:00:00
abstract::Abnormal hemodynamic responses to exercise treadmill testing may indicate an increased risk of coronary events and death, even if evidence of ischemia is absent. Exercise duration and the blood pressure, heart rate, and heart rhythm responses to exercise have prognostic significance. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.6.424
更新日期:2008-06-01 00:00:00
abstract::A case of pacemaker lead dysfunction with subsequent removal by a unique transvenous extraction system is presented. This technique allows detailed examination of the extracted pacemaker lead and identification of unsuspected causes of lead failure. Information relative to specific causes of lead failure may result in...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.59.1.91
更新日期:1992-01-01 00:00:00
abstract::Most patients find some relief with current agents, even though a poor understanding of the causes of chronic primary headache limits prophylaxis and treatment. The author reviews current preventive and treatment strategies for migraine, chronic tension headache, cluster headache, and substance withdrawal headache. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.68.11.904
更新日期:2001-11-01 00:00:00
abstract::Caring for very important persons (VIPs), including celebrities and royalty, presents medical, organizational, and administrative challenges, often referred to collectively as the "VIP syndrome." The situation often pressures the health care team to bend the rules by which they usually practice medicine. Caring for VI...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.78a.10113
更新日期:2011-02-01 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::Obsessive-compulsive disorder (OCD) is the fourth most common psychiatric disorder. Yet patients often avoid seeking help because they are ashamed. Diagnosis is difficult, but familiarity with the nature of OCD and its current management helps primary care physicians identify patients with OCD and make informed judgme...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.10.824
更新日期:2003-10-01 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::Patients with panic disorder often believe they are suffering a myocardial infarction or another life-threatening illness. The history and physical examination and a few tests usually suffice to diagnose this disorder, which is treatable with behavioral therapy, antidepressants, and benzodiazepines. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.64.8.437
更新日期:1997-09-01 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::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::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::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::By incorporating additional data, clinicians can transform the exercise stress test from a poor diagnostic test to a good prognostic one. These additional data include indices of how the patient's heart rate and blood pressure respond to exercise. Computerized measures of electrocardiographic ST-segment changes that a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.66.5.278
更新日期:1999-05-01 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::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