Abstract:
:Cyclosporine-A is primary therapy for organ transplantation. Its immunosuppressive effect might suggest a therapeutic role in autoimmune diseases, including several idiopathic and secondary glomerular conditions. Various forms of idiopathic nephrotic syndrome, including focal segmental glomerulosclerosis (FSGS), minimal change disease (MCD), and membranous nephropathy (MN), may respond well to cyclosporine in selected patients. However, frequent relapse limits its use to those who have failed to respond to, or were intolerant of, steroids or cytotoxics. Cyclosporine's efficacy in other glomerulopathies, such as IgA nephropathy (IgAN) and membranoproliferative glomerulonephritis (MPGN) remains poorly studied and, given the risk of nephrotoxicity, cannot be recommended for treatment of these entities until further data are available. Cyclosporine demonstrates some efficacy in treating proliferative lupus nephritis and, based on pilot study data, membranous lupus as well. Again, given relapse rates and potential nephrotoxicity, it should be used only in combination with azathioprine and steroids, assuming cytotoxic therapy has failed. Finally, cyclosporine toxicity is briefly reviewed.
journal_name
Annu Rev Medjournal_title
Annual review of medicineauthors
Klein M,Radhakrishnan J,Appel Gdoi
10.1146/annurev.med.50.1.1subject
Has Abstractpub_date
1999-01-01 00:00:00pages
1-15eissn
0066-4219issn
1545-326Xjournal_volume
50pub_type
杂志文章,评审abstract::Over the past several years a combination of diverse steps has culminated in a significant improvement in our ability to save ischemic extremities. Encompassing all phases of vascular surgery, these advances in diagnosis, therapy, and long-term management are outlined. These and future improvements hold promise for ex...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.38.020187.002013
更新日期:1987-01-01 00:00:00
abstract::Precision medicine was conceptualized on the strength of genomic sequence analysis. High-throughput functional metrics have enhanced sequence interpretation and clinical precision. These technologies include metabolomics, magnetic resonance imaging, and I rhythm (cardiac monitoring), among others. These technologies a...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev-med-041316-090905
更新日期:2018-01-29 00:00:00
abstract::Monoclonal antibodies of defined specificity can be produced using hybridoma technology. New attempts are being made to explore the potential of antibody therapy for cancer. Preliminary studies show that problems such as antigenic modulation, circulating free antigen, effector cell shortage, and host anti-mouse immuno...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.34.020183.000543
更新日期:1983-01-01 00:00:00
abstract::The purpose of the psychiatric hospital changed dramatically during the twentieth century. Formerly the primary location for psychiatric treatment, the hospital now plays a more circumscribed role within a community-based system of care. Crisis stabilization, safety, and a focus on rapid discharge are the critical com...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.60.042607.080257
更新日期:2009-01-01 00:00:00
abstract::The development of an HIV vaccine is proving to be an unprecedented challenge. The difficulty in creating this vaccine arises from the enormous genetic variation of the virus and the unusual importance of cytotoxic T lymphocytes (CTL) in controlling its spread. Whereas traditional vaccine strategies are unlikely to co...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.54.101601.152349
更新日期:2005-01-01 00:00:00
abstract::Tuberculosis (TB) remains an important public health problem worldwide, resulting in a estimated 8 to 10 million new cases and 2 to 3 million deaths each year. Between 1953 and 1985, the number of TB cases in the US declined by an average of 6% per year. However, since 1985, TB has been increasing in the US. Approxima...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.46.1.47
更新日期:1995-01-01 00:00:00
abstract::The National Diabetes Data Group and the World Health Organization recently made recommendations concerning the classification of diabetes mellitus and proposed new diagnostic criteria. These recommendations are summarized and their bases elucidated. Certain discrepancies between the recommendations are apparent and t...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.34.020183.001455
更新日期:1983-01-01 00:00:00
abstract::Volume reduction surgery is based on the removal of volume-occupying but nonfunctioning emphysematous lung, which is thought to improve pulmonary elastic recoil. The reduction in thoracic volume may also improve thoracic cage and inspiratory muscle function. In addition, dyspnea is lessened, exercise tolerance is incr...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.48.1.387
更新日期:1997-01-01 00:00:00
abstract::Implantable cardiac pacing and defibrillation devices are effective and commonly used therapies for patients with cardiac rhythm disorders. Because device implantation is not easily reversible, as well as the high healthcare costs inherent in device use, a clear understanding of the clinical benefits relative to costs...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev-med-043015-123540
更新日期:2017-01-14 00:00:00
abstract::Catastrophic antiphospholipid syndrome (CAPS) is a potentially lethal disease that presents with rapidly progressive multiple organ thromboses. Anticoagulation, corticosteroids, intravenous immunoglobulin, and plasma exchange are the most commonly used treatments for CAPS patients. However, the high mortality despite ...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev-med-042915-102529
更新日期:2017-01-14 00:00:00
abstract::Following the demonstration of the nature of the enzymatic defects in the sphingolipid storage disorders in the mid-1960s, consideration was directed to the development of therapy for patients with these conditions. High on the list of possibilities was enzyme supplementation or replacement. Many years of arduous inve...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.57.110104.115650
更新日期:2006-01-01 00:00:00
abstract::Heart transplantation has evolved over the past 30 years into a mainstay of therapy for heart failure patients. As the surgical technique and basic immunology were defined, heart transplantation became a real therapeutic option. Over the next few decades, thoracic transplant teams at Stanford University and other inst...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.53.082901.104050
更新日期:2002-01-01 00:00:00
abstract::The incidence of esophageal adenocarcinoma (EAC) has risen dramatically over the past three decades in western countries. The importance of Barrett's esophagus (BE) derives from its potential to transform to adenocarcinoma. BE is characterized by endoscopically recognized displacement of the squamocolumnar junction pr...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.59.061206.112706
更新日期:2009-01-01 00:00:00
abstract::Both genetic and environmental factors contribute to the etiology of non-insulin-dependent diabetes. The genetic component is heterogeneous and in some patients is probably complex, involving multiple genes. Specific genetic defects have been identified for rate monogenic forms of NIDDM: maturity-onset diabetes of the...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.47.1.509
更新日期:1996-01-01 00:00:00
abstract::Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncolo...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev-med-062016-050343
更新日期:2018-01-29 00:00:00
abstract::Remarkable progress made in the past few years has brought pancreatic islet transplantation to the threshold of human clinical trials. Islet transplants have reversed diabetes in experimental animals and prevented or reversed early diabetic complications in the recipients. Methods have been developed that prevent reje...
journal_title:Annual review of medicine
pub_type: 临床试验,杂志文章,评审
doi:10.1146/annurev.me.37.020186.000341
更新日期:1986-01-01 00:00:00
abstract::During the past 10 years, the number of genetic tests performed more than tripled, and public concern about genetic privacy emerged. The majority of states and the U.S. government have passed regulations protecting genetic information. However, research has shown that concerns about genetic privacy are disproportionat...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.54.101601.152131
更新日期:2003-01-01 00:00:00
abstract::Atrial fibrillation is the most common dysrhythmia encountered in clinical practice. For some patients, satisfactory rate control is not possible by pharmacologic means. This led us to develop a surgical approach to its cure, which in turn has led to a deeper understanding of the electrophysiologic basis of atrial fib...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.48.1.511
更新日期:1997-01-01 00:00:00
abstract::The basis of the current treatment of rectal cancer is a radical total mesorectal excision of the rectum, and although this provides excellent oncological control, it is associated with morbidity and functional problems in cancer survivors. Organ-preservation alternatives are local excision alone for very early tumors...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev-med-062915-021419
更新日期:2017-01-14 00:00:00
abstract::Carcinoma of the head of the pancreas can be diagnosed and staged effectively by computed tomography (CT) scan and by visceral angiography. If the tumor appears to be resectable, no further studies such as percutaneous biopsy are required. Pancreaticoduodenectomy is the only potentially curable treatment. This operati...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.46.1.361
更新日期:1995-01-01 00:00:00
abstract::The familial nature of multiple endocrine neoplasia syndromes (FMEN) has been recognized for some time but little is known about their cause. Recent application of new molecular techniques has mapped FMEN syndromes to specific chromosomes and provided evidence for the mechanism through which neoplasia occurs. In this ...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.43.020192.001345
更新日期:1992-01-01 00:00:00
abstract::Societal expectations about drug safety and efficacy are rising while productivity in the pharmaceutical industry is falling. In 2004, the US Food and Drug Administration introduced the Critical Path Initiative with the intent of modernizing drug development by incorporating recent scientific advances, such as genomic...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.59.090506.155819
更新日期:2008-01-01 00:00:00
abstract::Brain imaging is increasingly applied in psychiatry, both for clinical evaluation and as a research tool. Computerized tomography (CT) and magnetic resonance imaging (MRI) have documented that structural brain abnormalities occur in some types of psychiatric patients, particularly those who suffer from schizophrenia. ...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.39.020188.002003
更新日期:1988-01-01 00:00:00
abstract::Natural killer (NK) cells are a subpopulation of lymphocytes, with azurophilic granules in their cytoplasm, that have spontaneous cytotoxicity against a variety of tumor cells, virus-infected cells, and some normal cells in the bone marrow and thymus. When lymphocytes are cultured in the presence of interleukin 2 (IL ...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.37.020186.002023
更新日期:1986-01-01 00:00:00
abstract::Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication after hematopoietic stem cell or solid organ transplantation. The majority of PTLD is of B-cell origin and associated with Epstein-Barr virus (EBV). During the past decade progress has been made in better understanding the pathogene...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.56.082103.104727
更新日期:2005-01-01 00:00:00
abstract::5-Azacytidine transiently augments fetal hemoglobin production in patients with beta-thalassemia or sickle cell anemia. This change would probably be beneficial to such patients (e.g. a normal fetal gene product is substituted for a deficient or defective adult gene product) if HbF production could be sustained at hig...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.36.020185.002413
更新日期:1985-01-01 00:00:00
abstract::Clonal populations of cells can be identified by a number of different independent approaches, including analyses of karyotype, gene rearrangements, deletions or point mutations, X-linked polymorphisms, and integration of virus into the genome. Assessment of clonality has yielded valuable and surprising clues to the p...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.42.020191.002423
更新日期:1991-01-01 00:00:00
abstract::An effective host response to infection or tissue damage requires focal accumulation of leukocytes. Leukocyte adhesion to the vessel wall, a key step in this process, depends on the ordered expression of specific endothelial cell surface molecules. The endothelial molecules that support adhesion include selectins that...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.45.1.361
更新日期:1994-01-01 00:00:00
abstract::IgG subclasses represent distinct immunoglobulin types, each defined by unique primary structures of the constant region of the heavy-chain molecule, and each with characteristic biological and functional properties. New methods and reagents to measure serum concentrations have contributed to the study of the ontogeny...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.me.38.020187.001545
更新日期:1987-01-01 00:00:00
abstract::Atrial flutter is a macroreentrant tachyarrhythmia most often contained within the right atrium. Typical atrial flutter is defined on an electrocardiogram by the classic "sawtooth" pattern of flutter waves with negative polarity in leads II, III, and aVF. In contrast to atrial fibrillation, which is sustained by multi...
journal_title:Annual review of medicine
pub_type: 杂志文章,评审
doi:10.1146/annurev.med.49.1.77
更新日期:1998-01-01 00:00:00