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

authors： Davidson KW

更新日期：2008-03-01 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

authors： Jehi L,Najm IM

更新日期：2008-03-01 00:00:00

abstract：:Nonspinal musculoskeletal disorders frequently cause neck and back pain and thus can mimic conditions of the spine. Common mimics are rotator cuff tears, bursitis in the hip, peripheral nerve compression, and arthritis in the shoulder and hip. A thorough history and physical examination, imaging studies, and ancillary...

journal_title：Cleveland Clinic journal of medicine

authors： Pateder DB,Brems J,Lieberman I,Bell GR,McLain RF

更新日期：2008-01-01 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

authors： Nemec CF,Listinsky J,Rim A

更新日期：2007-12-01 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

authors： Jabbar DA,Davison G,Muslin AJ

更新日期：2007-11-01 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

authors： Ansell BJ

更新日期：2007-10-01 00:00:00

abstract：:Primary care physicians play a key role in the diagnosis and the nonoperative management of knee osteoarthritis (OA), including monitoring for problems in patients who have undergone knee replacement surgery. This article reviews key clinical and radiographic findings of knee OA, options for conservative management, a...

journal_title：Cleveland Clinic journal of medicine

authors： Rosneck J,Higuera CA,Tadross N,Krebs V,Barsoum WK

更新日期：2007-09-01 00:00:00

abstract：:Coronary artery disease is different in women than in men in its pathogenesis, symptoms, and prognosis. Needed is a strategy for detecting and assessing coronary disease specifically in women. This review highlights recent evidence on sex differences in coronary artery disease. ...

journal_title：Cleveland Clinic journal of medicine

authors： Bellasi A,Raggi P,Merz CN,Shaw LJ

更新日期：2007-08-01 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

authors： Mezu U,Bott-Silverman C,Hsich E

更新日期：2007-06-01 00:00:00

abstract：:Overactive bladder (OAB) is a prevalent condition in both men and women that imposes significant burdens on the patient and his or her quality of life. Nevertheless, only a small percentage of patients with OAB receive diagnosis and treatment. The identification of OAB is well within the scope of the primary care prov...

journal_title：Cleveland Clinic journal of medicine

authors： Rosenberg MT,Newman DK,Tallman CT,Page SA

更新日期：2007-05-01 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

authors： Appel G

更新日期：2007-05-01 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

authors： Stolar M

更新日期：2007-03-01 00:00:00

abstract：:Development of medical devices requires interaction between physicians and industry that is considerably more intimate than that in pharmaceutical development. Progress in procedure-based medicine would be stalled if this collaboration were eliminated. This degree of interaction, however, creates conflicts of interest...

journal_title：Cleveland Clinic journal of medicine

authors： LaViolette PA

更新日期：2007-03-01 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

authors： Sheehan JG

更新日期：2007-03-01 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

authors： Rabbat MG,Bavry AA,Bhatt DL,Ellis SG

更新日期：2007-02-01 00:00:00

abstract：:SCS is an efficacious, reversible, and safe therapy that improves quality of life, increases exercise tolerance, and relieves angina pectoris, but clinical trials in North America are needed to confirm the data coming from Europe. Neuronal convergence onto STT cells underlies the referred pain associated with angina p...

journal_title：Cleveland Clinic journal of medicine

authors： Foreman RD

更新日期：2007-02-01 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

authors： Collop N

更新日期：2007-01-01 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

authors： Gershman AJ,Mehta AC,Infeld M,Budev MM

更新日期：2006-12-01 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

authors： Brethauer SA,Chand B,Schauer PR

更新日期：2006-11-01 00:00:00

abstract：:Obesity is associated with higher rates of death due to cancer. Possible explanations for this association include physiological factors associated with obesity, lower cancer screening rates in obese people, and technical difficulties in treating obese patients. These problems represent opportunities to improve the ca...

journal_title：Cleveland Clinic journal of medicine

authors： Bordeaux BC,Bolen S,Brotman DJ

更新日期：2006-10-01 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

authors： Carman TL,Fernandez BB Jr

更新日期：2006-10-01 00:00:00

abstract：:The antidiuretic hormone arginine vasopressin (AVP) is primarily responsible for regulating osmotic and volume homeostasis of body fluids, largely through binding to vasopressin type 1A (V(1A)) and type 2 (V2) receptors. Increased AVP secretion leads to decreased free water excretion with resulting water retention, an...

journal_title：Cleveland Clinic journal of medicine

authors： Verbalis JG

更新日期：2006-09-01 00:00:00

abstract：:Treatment of anemia in the perioperative period of major orthopedic surgery decreases the need for blood transfusion and improves perioperative outcomes. Use of epoetin alfa in this setting is FDA-approved and provides significant benefit to qualified and carefully chosen patients. ...

journal_title：Cleveland Clinic journal of medicine

authors： Kumar A,Dimov V

更新日期：2006-09-01 00:00:00

abstract：:The neurohormone arginine vasopressin (AVP) is a promising target in the treatment of heart failure because AVP promotes congestion and hyponatremia, each of which is associated with poor outcomes. Diuretics are standard therapy for heart failure, but they have several limitations, including worsening renal function a...

journal_title：Cleveland Clinic journal of medicine

authors： Gheorghiade M

更新日期：2006-06-01 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

authors： Tang WH

更新日期：2006-04-01 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

authors： Appel GB

更新日期：2006-02-01 00:00:00

abstract：:Recent advances in our understanding of the diagnosis, imaging, pathology, and clinical monitoring of multiple sclerosis (MS) have significantly increased our ability to successfully treat this often perplexing neurologic disorder. Magnetic resonance imaging (MRI) is now integral to the diagnostic process. Treatment o...

journal_title：Cleveland Clinic journal of medicine

authors： Fox RJ,Bethoux F,Goldman MD,Cohen JA

更新日期：2006-01-01 00:00:00

abstract：:Stroke is a deadly and disabling disease that preferentially afflicts older adults. It shares common risk factors with myocardial infarction (MI), such as hypertension, diabetes, and hyperlipidemia. Blood pressure control, cholesterol reduction with statins, and glucose control reduce the risk for both stroke and MI. ...

journal_title：Cleveland Clinic journal of medicine

authors： Ling GS,Ling SM

更新日期：2005-10-01 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

authors： Wexler L,Javaheri S

更新日期：2005-10-01 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

authors： Fletcher G,Trejo JF

更新日期：2005-08-01 00:00:00

abstract：:Intravascular ultrasonography (IVUS) can precisely measure plaque burden and is being used to test new drug therapies. Other imaging tests may also prove useful to monitor treatment of atherosclerosis and identify populations at risk for coronary artery disease (CAD). ...

journal_title：Cleveland Clinic journal of medicine

authors： Schoenhagen P,Nissen SE

更新日期：2005-06-01 00:00:00

abstract：:Clinical imaging and serologic testing are increasingly replacing biopsy for diagnosing hepatic diseases. However, more biopsies are being done to stage and grade hepatitis C and fatty liver disease, to diagnose space-occupying lesions (typically with fine-needle aspiration biopsy), and to assess response to therapy. ...

journal_title：Cleveland Clinic journal of medicine

authors： Siegel CA,Silas AM,Suriawinata AA,van Leeuwen DJ

更新日期：2005-03-01 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

authors： Rosenberg MT,Dmochowski RR

更新日期：2005-02-01 00:00:00

abstract：:Morbidity and mortality rates of human immunodeficiency virus (HIV) have plummeted where highly active antiretroviral therapy (HAART) is available. However, therapy is out of reach for most people who need it in developing nations, where the infrastructure to deliver care and resources for medications is lacking. Worl...

journal_title：Cleveland Clinic journal of medicine

authors： Armstrong W,Calabrese L,Taege AJ

更新日期：2005-01-01 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

authors： Bramstedt KA

更新日期：2004-11-01 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

authors： Mick TM,Dimeff RJ

更新日期：2004-07-01 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

authors： Saadeh S,Davis GL

更新日期：2004-05-01 00:00:00

abstract：:In patients with morbid obesity, surgery is the only treatment known to produce sustained weight loss and to reduce comorbidities. Traditional (open) gastric bypass surgery is associated with postoperative complications that include wound infection, pulmonary embolism, and pneumonia. Laparoscopic techniques achieve si...

journal_title：Cleveland Clinic journal of medicine

authors： Brody F

更新日期：2004-04-01 00:00:00

abstract：:The clinical care of women with epilepsy entails special considerations over the life span. Endogenous depression is more prevalent in persons with epilepsy than in the general population and may be unrecognized. Seizure frequency may be influenced by hormonal fluctuations, as reflected by catamenial patterns in up to...

journal_title：Cleveland Clinic journal of medicine

authors： Penovich PE,Eck KE,Economou VV

更新日期：2004-02-01 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

authors： Michota FA,Frost SD

更新日期：2004-01-01 00:00:00