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 disorders. This review discusses likely causes of elevated aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase levels and provides algorithms for evaluating high liver enzyme values in apparently healthy patients in the primary care setting.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Aragon G,Younossi ZMdoi
10.3949/ccjm.77a.09064subject
Has Abstractpub_date
2010-03-01 00:00:00pages
195-204issue
3eissn
0891-1150issn
1939-2869pii
77/3/195journal_volume
77pub_type
杂志文章,评审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::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::The clinical care of women with epilepsy entails special considerations over the life span. Endogenous depression is more prevalent in persons with epilepsy than in the general population and may be unrecognized. Seizure frequency may be influenced by hormonal fluctuations, as reflected by catamenial patterns in up to...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.71.suppl_2.s49
更新日期:2004-02-01 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::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::Intravascular ultrasonography (IVUS) can precisely measure plaque burden and is being used to test new drug therapies. Other imaging tests may also prove useful to monitor treatment of atherosclerosis and identify populations at risk for coronary artery disease (CAD). ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.6.487
更新日期:2005-06-01 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::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::Studies published during the past year on the treatment of several infectious diseases provide valuable information that should enable us to treat our patients more effectively. Among those findings: Oral vancomycin (Vancocin) is superior to oral metronidazole (Flagyl) for treating patients with severe Clostridium dif...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.8.584
更新日期:2008-08-01 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::The treatment of hepatitis C has evolved rapidly since the identification of the hepatitis C virus (HCV) in 1989. Since the first accepted therapy for HCV infection, recombinant interferon, received marketing approval a little more than a decade ago, it has come to be used in combination with ribavirin for improved ra...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.71.suppl_3.s3
更新日期:2004-05-01 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::Often patients with immune hemolytic anemias present with symptoms that are common in anemia of any cause. In the different types of immune hemolytic anemia, red blood cells are destroyed by processes mediated by antibodies. This article reviews the pathophysiology, diagnosis, and treatment of this group of diseases. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.65.2.89
更新日期:1998-02-01 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::Of the imaging techniques currently available to evaluate women for breast disease, mammography remains the mainstay of breast cancer screening, but recent guidelines have included magnetic resonance imaging (MRI) for the screening of some women at high risk. Whole-breast ultrasonography for screening has not been est...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.12.897
更新日期:2007-12-01 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::The Internet can be useful for physicians, but beginning users are apt to encounter two problems: too much irrelevant information, and difficulty finding the desired information. This paper offers some practical tips that can prevent frustration and wasted time when searching for medical information on the Internet. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.66.9.543
更新日期:1999-10-01 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::In the article "Quitting smoking: Still a challenge, but newer tools show promise," (Collins GB, Jerry JM, Bales R. Cleve Clin J Med 2015; 82:39-48), the reference sequencing has been corrected. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 已发布勘误
doi:
更新日期:2015-02-01 00:00:00
abstract::Depression has been linked to cardiovascular disease and cognitive impairment, including Alzheimer disease, but the exact nature of the relationship is poorly understood. Although depression seems to progress little after the onset of Alzheimer disease, depression in earlier life increases the risk of dementia and cog...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.78.s1.07
更新日期:2011-08-01 00:00:00
abstract::Fraud in scientific research is a widespread problem. It can involve falsifying data or documents, or knowingly failing to comply with regulations protecting research participants. Fraud can be committed by individuals, institutions, or corporations; in the context of research, fraud often is motivated by consideratio...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.74.suppl_2.s63
更新日期:2007-03-01 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::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::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::Complications of chronic gastroesophageal reflux disease (GERD) run the gamut from erosive esophagitis to esophageal cancer, but all are linked to repeated exposure of the esophagus to caustic gastric and duodenal acid. Progression from one complication to another is not clearly established across the GERD continuum, ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.suppl_5.s33
更新日期:2003-11-01 00:00:00
abstract::Autosomal dominant polycystic kidney disease (ADPKD) has numerous systemic manifestations and complications. This article gives an overview of hypertension, cardiac complications, and intracranial aneurysms in ADPKD, their pathophysiology, and recent developments in their management. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84a.16107
更新日期:2017-06-01 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::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::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::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