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), statins, tamoxifen (Nolvadex), codeine, and psychotropic drugs. It also discusses the future role of pharmacogenomic testing in medicine.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Kitzmiller JP,Groen DK,Phelps MA,Sadee Wdoi
10.3949/ccjm.78a.10145subject
Has Abstractpub_date
2011-04-01 00:00:00pages
243-57issue
4eissn
0891-1150issn
1939-2869pii
78/4/243journal_volume
78pub_type
杂志文章,评审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::Intermittent claudication (IC) is the classic complaint associated with peripheral arterial disease (PAD) and can significantly limit a patient's lifestyle and workplace abilities. IC is defined as reproducible pain affecting the muscles of the lower extremities that begins and increases with activity and resolves wit...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.suppl_4.s38
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:There are now more than 31 million people 65 years of age or older in the United States, at least half of whom have systolic blood pressure 140 mm Hg or higher or diastolic blood pressure 90 mm Hg or higher or both. By the year 2050, 16 million Americans will be over age 85. OBJECTIVE:To review the current ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.62.1.29
更新日期:1995-01-01 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::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::Women infected with human immunodeficiency virus (HIV) have unique needs. Treatment recommendations are the same for men and women, but in women, fertility desires, pregnancy, contraception, and aging must be taken into account in their medical care. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.81a.14009
更新日期:2014-11-01 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::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::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::As evidence on COVID-19 continues to emerge, its impact on the eyes is becoming more apparent, leading to a better understanding of ocular manifestations and transmission. This article details the recent information regarding COVID-19 from an ophthalmologic context, including prevalence, clinical features, impact on t...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc068
更新日期:2020-12-08 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::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:BACKGROUND:Coronary artery disease is a major cause of death in transplant recipients. PURPOSE:To review current approaches for the detection, evaluation, and treatment of coronary artery disease in transplant recipients. SUMMARY:Renal transplantation promotes the development of coronary artery disease primarily beca...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.61.5.370
更新日期:1994-09-01 00:00:00
abstract::Hirsutism is a source of significant anxiety in women. While polycystic ovary syndrome or other endocrine conditions are responsible for excess androgen in many patients, other patients have normal menses and normal androgen levels ("idiopathic" hirsutism). The goal of the evaluation is to rule out any underlying path...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.77a.08079
更新日期:2010-06-01 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
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::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::Interleukin 1 (IL-1) is a potential target of therapy in COVID-19 during the severe respiratory-inflammatory phase ("cytokine release syndrome"), when pulmonary macrophages are hyperactivated, releasing IL-1 and other cytokines. Preliminary evidence indicates that anakinra and canakinumab, drugs that block the action ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc044
更新日期:2020-07-09 00:00:00
abstract::Although the literature is limited, early evidence suggests that patients with chronic kidney disease, end-stage kidney disease, and kidney transplant recipients are at increased risk for severe COVID-19 disease and death. Hence, management should focus on both infection prevention and treatment. There is currently a ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc067
更新日期:2020-12-03 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::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::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::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::COVID-19 infection is associated with several cardiac complications with high rates of adverse outcomes. Cardiac imaging has different utility in different clinical scenarios, and the importance of minimizing healthcare worker exposure should be considered. Cardiac imaging should only be ordered if its benefits outwei...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc020
更新日期:2020-05-14 00:00:00
abstract::Several theories have been put forth to explain the pathogenesis of syringomyelia, the formation of longitudinal, fluid-filled cavities within the spinal cord. Chief among them is Gardner's hydrodynamic theory, widely accepted for more than two decades. Gardner attributed the genesis of syringomyelia to craniospinal p...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.59.4.373
更新日期:1992-07-01 00:00:00
abstract::The focus of palliative care is to alleviate pain and suffering for patients, potentially while they concurrently pursue life-prolonging or curative therapy. The potential breadth of palliative care is recognized by the Medicare program, but the Medicare hospice benefit is narrowly defined and limited to care that is ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.80.e-s1.07
更新日期:2013-01-01 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::Non-Q-wave infarction is associated with a significant incidence of infarction and death. We followed 52 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) within three months of non-Q-wave myocardial infarction. Thirty-eight patients had single-vessel disease, 12 had double-vessel disease, a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.56.2.141
更新日期:1989-03-01 00:00:00
abstract::The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84.s4.07
更新日期:2017-12-01 00:00:00
abstract::Arthroscopy for degenerative conditions of the knee is among the most commonly employed orthopedic procedures, but its effectiveness (like the effectiveness of many surgical operations) has never been proven in prospective trials. Moreover, the precise mechanism by which arthroscopy improves the course of degenerative...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.70.5.401
更新日期:2003-05-01 00:00:00