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 multiorgan dysfunction. Because prophylactic therapy also poses risks, we advocate reserving it for patients in these high-risk groups.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Bobek MB,Arroliga ACdoi
10.3949/ccjm.64.10.533subject
Has Abstractpub_date
1997-11-01 00:00:00pages
533-42issue
10eissn
0891-1150issn
1939-2869journal_volume
64pub_type
杂志文章,评审abstract::The role of the immune system in the pathogenesis of beryllium lung disease has been suspected for years. The observation of cutaneous hypersensitivity to beryllium led to the development of the lymphocyte blast transformation test; the test clearly distinguishes between healthy subjects, who show little or no blast t...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.58.2.157
更新日期:1991-03-01 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::Evidence is mounting that obstructive sleep apnea causes or contributes to many chronic medical diseases, and that treatment with continuous positive airway pressure (CPAP) often improves concomitant diseases. The author reviews the association of obstructive sleep apnea with arterial hypertension, pulmonary hypertens...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.1.72
更新日期:2007-01-01 00:00:00
abstract::One of the factors that contribute to the progressively declining course of heart failure could be sleep apnea. Whether treating sleep apnea improves the clinical outcomes of patients with heart failure needs to be tested in randomized clinical trials. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.10.929
更新日期:2005-10-01 00:00:00
abstract::Elevated serum urate levels are recognized as leading to gouty arthritis, tophi formation, and uric acid kidney stones. While serum urate elevations have long been associated with renal disease, they are not usually considered to have a causal role in kidney dysfunction. However, recent epidemiologic studies have iden...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.suppl_5.s13
更新日期:2008-07-01 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::Early restoration of patency of the infarct-related artery is a universally accepted goal in the treatment of acute myocardial infarction. However, even with the most successful fibrinolytic regimen only approximately 50% of patients achieve restoration of normal flow at 90 minutes. "Rescue" angioplasty, the mechanica...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.67.5.341
更新日期:2000-05-01 00:00:00
abstract::Community-acquired bacterial meningitis is still a significant cause of morbidity and mortality. Clinicians should know how to quickly diagnose it, perform a lumbar puncture, order the necessary tests, and start appropriate empiric therapy promptly. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.79gr.12003
更新日期:2012-06-01 00:00:00
abstract::Women with heart failure differ from their male counterparts in a number of ways, including etiology, pattern of cardiac remodeling, and prognosis. They may even respond differently to medical therapy. But until prospective, sex-specific studies show that we should do otherwise, we recommend that women with heart fail...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.6.423
更新日期:2007-06-01 00:00:00
abstract::Mounting evidence suggests that depression, anxiety, and hostility/anger may each be an independent risk factor for acute coronary syndrome (ACS) occurrence. Data specific to the role of these negative emotional states in predisposing to imminent ACS risk are limited, however. Additionally, a number of studies have in...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.suppl_2.s15
更新日期:2008-03-01 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::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::The most important component of the treatment of irritable bowel syndrome (IBS) is to establish a therapeutic physician-patient relationship, coupled with patient education. We describe a stepwise approach to management, including judicious use of invasive tests, and setting realistic treatment goals that address the ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.68.3.224
更新日期:2001-03-01 00:00:00
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 antihypertens...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.58.3.277
更新日期:1991-05-01 00:00:00
abstract::Weight-loss drugs are being evaluated for their role in obesity management. This article reviews the available weight-loss drugs, their efficacy and side effects, and their best clinical use. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.84a.16094
更新日期:2017-12-01 00:00:00
abstract::Circadian variations have been observed for a number of hemodynamic and cardiovascular events including heart rate, systemic blood pressure, coronary artery blood flow, ischemic cerebrovascular accidents, myocardial ischemia, myocardial infarction, and sudden cardiac death. In addition, circadian variations in platele...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.56.7.676
更新日期:1989-10-01 00:00:00
abstract::Platelet activation is one of the essential steps in the genesis and propagation of atherothrombosis. Accumulating clinical evidence suggests that an elevated platelet count, platelet activation, and platelet hyperreactivity (defined as residual platelet activity despite antiplatelet drug therapy) may be associated wi...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76.s1.01
更新日期:2009-04-01 00:00:00
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::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::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::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::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: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::Although the safety profiles of drug-eluting stents are similar to those of bare metal stents in the short term, concern has arisen about their potential for late thrombosis (occurring > 30 days after implantation). Stent thrombosis is rare but potentially devastating and can result in ST-segment elevation myocardial ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.2.129
更新日期:2007-02-01 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::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::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::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::Lifestyle factors remain the bedrock of atherosclerotic cardiovascular disease (ASCVD) prevention. Statins remain the first-line therapy for primary and secondary prevention of ASCVD. Physicians are encouraged to discuss the risks and benefits of statins with patients before beginning therapy. Nonstatins and proprotei...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87.s1.02
更新日期:2020-05-01 00:00:00
abstract::Elderly patients pose unique challenges perioperatively. They are more likely than younger surgical patients to be mentally and physically compromised at baseline, which increases the risk of delirium and postoperative cognitive dysfunction. Postoperative cognitive risk can be predicted, however, and effective strateg...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.76.s4.03
更新日期:2009-11-01 00:00:00