Abstract:
:Stress echocardiography is a cost-effective and reliable diagnostic test for patients with suspected coronary artery disease. Stress echocardiography should be used in preference to exercise electrocardiography as the primary test in patients with uninterpretable ST segments. It is attractive for use as the primary test in patients with coexisting valvular disease. It probably is the optimal test for women. Stress echocardiography should be used as a secondary test when the result of exercise electrocardiography is inconsistent with the clinical status. In patients requiring nonexercise stress testing, an imaging test is mandatory. The ability of stress echocardiography to identify the location and extent of myocardial ischemia makes it appropriate in situations where decisions regarding revascularization will be made on these grounds. The overall accuracy of stress echocardiography and perfusion scintigraphy is comparable in expert hands. but one must always consider the expertise of the operator and the quality of each test in the environment in which it is performed.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Marwick Tdoi
10.3949/ccjm.62.4.227subject
Has Abstractpub_date
1995-07-01 00:00:00pages
227-34issue
4eissn
0891-1150issn
1939-2869journal_volume
62pub_type
杂志文章,评审abstract::Lung resection provides the greatest likelihood of cure for patients with localized lung cancer, but is associated with a risk of mortality, decreased postoperative lung function, and other complications. Lung function testing using spirometry, diffusing capacity of the lung for carbon monoxide, and peak oxygen consum...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.79.s2.04
更新日期:2012-05-01 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::Obesity is a potent risk factor for the development and progression of type 2 diabetes, and weight loss is a key component of diabetes management. Bariatric surgery results in significant weight loss and remission of diabetes in most patients. After surgery, glycemic control is restored by a combination of enforced ca...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.77a.09135
更新日期:2010-07-01 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::Although a low level of high-density lipoprotein (HDL) cholesterol is a useful clinical predictor of coronary heart disease, raising the HDL cholesterol level does not necessarily lower this risk. Part of the explanation for this paradox may be that, under certain conditions, HDL either can be less functional as an an...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.10.697
更新日期:2007-10-01 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::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::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::Although there is still no consensus on how to diagnose hypertension, opinion is moving toward incorporating out-of-office blood pressure measurements into the process. The SPRINT trial poses potential opportunities and challenges. Simplified antihypertensive drug regimens incorporating single pill combinations are ve...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.82.s2.06
更新日期:2015-12-01 00:00:00
abstract::Because type 2 diabetes mellitus is a progressive disease, most patients eventually need insulin. When and how to start insulin therapy are not one-size-fits-all decisions but rather must be individualized. This paper reviews the indications, goals, and options for insulin therapy in type 2 diabetes. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.82a.14069
更新日期:2015-08-01 00:00:00
abstract::Behavioral disorders in pediatric patients--primarily attention deficit hyperactivity disorder (ADHD)--pose a clinical challenge for health care providers to accurately assess, diagnose, and treat. In 2013, updated diagnostic criteria for behavioral disorders were published, including ADHD and a new diagnostic entity:...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.82.s1.01
更新日期:2015-11-01 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::Cyclospora cayetanensis, an emerging pathogen with worldwide distribution, causes diarrhea in both immunocompetent and HIV-infected patients. We review the epidemiology of Cyclospora infection and how to diagnose and treat it. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.64.6.299
更新日期:1997-06-01 00:00:00
abstract::Glomerulonephritis (GN) is a common manifestation of the antineutrophil cytoplasmic antibody-associated systemic vasculitides (AASV), which include granulomatosis with polyangiitis and microscopic polyangiitis. The level of renal involvement at presentation is highly predictive of survival and should be assessed early...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.79.s3.05
更新日期:2012-11-01 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::The patient-centered medical home is a rapidly growing concept in reforming American health care. It has spread from its origins in primary care pediatrics to family practice and, more recently, into internal medicine. This review article describes how primary care geriatricians can obtain certification from the Natio...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.79a.11103
更新日期:2012-05-01 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::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::Primary care physicians must initiate a discussion of overactive bladder and urinary incontinence with their patients who are at risk. A stepwise approach to evaluation and diagnosis and the use of systematic evaluation and treatment algorithms suitable to the primary care setting will improve identification and effec...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.2.149
更新日期:2005-02-01 00:00:00
abstract::Patients with pulmonary arterial hypertension (PAH) may present to internists, rheumatologists, cardiologists, or pulmonologists. This breadth of clinicians who encounter PAH patients, together with the complicated nature of PAH as a disease entity, argues for a shared-care approach to the management of these patients...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.suppl_1.s28
更新日期:2003-04-01 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::Many drugs can injure the kidneys, but they cause renal injury via only a few common mechanisms. Many patients who develop renal injury after drug exposure have identifiable risk factors that could be modified or that should preclude the use of these drugs in the first place. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.69.4.289
更新日期:2002-04-01 00:00:00
abstract::One of the most important deficiency states associated with chronic renal failure is profound anemia. While it has been possible to identify differing types of anemia in patients receiving dialysis support, and thus correct the secondary causes, most patients continue to exhibit symptoms and signs of the anemic state....
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.56.1.79
更新日期:1989-01-01 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::Positive airway pressure (PAP) therapy is an open system that can generate contact, droplet, and airborne COVID-19 thereby increasing the risk of transmission of COVID-19 like other procedures such as tracheal intubation, noninvasive ventilation, and cardiopulmonary resuscitation. Medically prudent recommendations hav...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc003
更新日期:2020-05-05 00:00:00
abstract::An immunocompromised patient presented with chronic low back pain as the initial symptom and a subcutaneous abscess as the initial sign of disseminated aspergillosis. With the rising incidence of immunocompromised patients, cutaneous manifestation of aspergillosis may become more common. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.57.1.92
更新日期:1990-01-01 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::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::The care of patients with cystic fibrosis (CF) has improved over the past 30 years, and most patients now survive well into adulthood. As a result, clinicians other than pediatricians are more likely than in the past to see CF patients and manage their respiratory, gastrointestinal, pancreatic, and reproductive compli...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.12.1065
更新日期:2006-12-01 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