Abstract:
:When a patient reports constipation, a careful history and physical examination may identify the underlying cause. In many patients, though, no underlying cause is identified. Empiric treatment with exercise, hydration, fiber supplementation, and mild laxatives is often effective. If constipation does not resolve with these measures, then the physician may refer the patient for further testing for slow colonic transit, pelvic floor dysfunction, or anatomical defects, and in difficult and recalcitrant cases for surgical treatment.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Soffer EEdoi
10.3949/ccjm.66.1.41subject
Has Abstractpub_date
1999-01-01 00:00:00pages
41-6issue
1eissn
0891-1150issn
1939-2869journal_volume
66pub_type
杂志文章,评审abstract::An over-the-counter at-home test for human immunodeficiency virus (HIV) infection has been approved and will likely be available soon. It is intended to decrease the percentage of HIV-infected people unaware of their infection (estimated at 18% of the 1.2 million people infected in the United States). Since early and ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.79a.12128
更新日期:2012-10-01 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::Despite the availability of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection, there has not been a dramatic decrease in the frequency of progressive multifocal leukoencephalopathy (PML) in the HIV-infected population. Usually a multifocal progressive diseas...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.78.s2.06
更新日期:2011-11-01 00:00:00
abstract::Although most patients with emphysema are managed medically, a small subset of severely disabled patients may become candidates for surgery. This paper discusses for the internist who works with emphysema patients the risks, benefits, patient selection criteria, and outcome data for three procedures in current use: bu...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.66.7.415
更新日期:1999-07-01 00:00:00
abstract::Congestive heart failure is the most common cause of death in patients with thalassemia, as chronic accumulation of iron due to regular blood transfusions leads to biventricular systolic dysfunction and death at a very young age. The quantity of iron deposited in the heart is a key determinant of outcome. Early diagno...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.11.807
更新日期:2007-11-01 00:00:00
abstract::By incorporating additional data, clinicians can transform the exercise stress test from a poor diagnostic test to a good prognostic one. These additional data include indices of how the patient's heart rate and blood pressure respond to exercise. Computerized measures of electrocardiographic ST-segment changes that a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.66.5.278
更新日期:1999-05-01 00:00:00
abstract::Transitions of care-when patients move from one health care facility to another or back home-that are poorly executed result in adverse effects for patients. Fortunately, programs can be implemented that enhance collaboration across care settings and improve outcomes including reducing hospital readmission rates. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.81a.13106
更新日期:2014-05-01 00:00:00
abstract::Patients with systemic lupus erythematosus (SLE, lupus) have a markedly better survival rate today than they did 50 years ago, but they face a greater risk of cancer, cardiovascular disease, and osteoporosis at early ages. With better understanding of the immunological mechanisms of the disease, new avenues of therapy...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.76a.gr005
更新日期:2009-02-01 00:00:00
abstract::Exercise helps prevent and improve atherosclerosis and other chronic diseases, and physicians should encourage their patients to exercise more. Unfortunately, there are many barriers to prescribing exercise. To help patients start exercising and stay with it, clinicians need to address specifics. Several guidelines ar...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.72.8.645
更新日期:2005-08-01 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::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::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::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::The importance of glycemic control in preventing the chronic and devastating complications of diabetes is well established. Insulin administration is an important therapeutic option for managing diabetes, particularly for patients with profound insulin deficiency. Many insulin formulations are on the market, including...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.83.s1.05
更新日期:2016-05-01 00:00:00
abstract::Infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) can cause rapidly progressive renal disease, so prompt recognition and management are critical. Viral glomerulonephropathy can now often be successfully managed with a specific combination of antiviral therapy, immun...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.74.5.353
更新日期:2007-05-01 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::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::Patients typically lose more than 50% of their excess weight after bariatric surgery. Obesity-related diseases markedly improve, reducing cardiovascular risk and improving life expectancy. Obese patients lose more weight with bariatric surgery than with medical weight-loss treatment. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.73.11.993
更新日期:2006-11-01 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::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::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::In 1988, a new do-not-resuscitate policy aimed at assisting professional staff, nurses, patients, and families in end-of-life choices replaced the existing policy at The Cleveland Clinic Foundation. We conducted a retrospective chart review to examine the effects of the new policy on length of stay. Data were collecte...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.59.6.591
更新日期:1992-11-01 00:00:00
abstract::Numerous immunomodulating agents are currently being studied in clinical trials for the treatment of COVID-19, including interferon therapies. Interferons are naturally occurring host antiviral proteins upstream of the inflammatory pathway that are released by host cells in response to the presence of viral pathogens....
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.87a.ccc066
更新日期:2020-12-03 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::Many patients are donating their own blood before surgery to avoid blood-borne infections, often on the advice of their physicians. But autologous blood transfusion, while safer than allogeneic transfusion, is not completely risk-free. It is also expensive, its benefits are difficult to assess, and its increasing popu...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.63.5.295
更新日期:1996-09-01 00:00:00
abstract::The history and physical examination, rather than routine laboratory, cardiovascular, and pulmonary testing, are the most important components of the preoperative evaluation. The history should include a complete review of systems (especially cardiovascular and pulmonary), medication history, allergies, surgical and a...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.71.1.63
更新日期:2004-01-01 00:00:00
abstract::Eating disorders are common in adolescents and young adults, including those with a history of overweight or obesity, and are associated with numerous systemic sequelae. Understanding the differences in presentation between these patients and those who have a more classic anorexia nervosa phenotype is critical to ensu...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.87a.19034
更新日期:2020-03-01 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::Patients with refractory epilepsy face an elevated risk of sudden death, with rates as high as 1% per year. This phenomenon, known as sudden unexpected death in epilepsy (SUDEP), is believed to be a seizure-related occurrence, but the exact underlying mechanisms are uncertain. Both pulmonary and cardiac pathophysiolog...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.75.suppl_2.s66
更新日期:2008-03-01 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