Search our Database of Scientific Publications and Authors

I’m looking for a

    3699 results match your criteria Cleveland Clinic Journal of Medicine[Journal]

    1 OF 74

    Renal denervation: What happened, and why?
    Cleve Clin J Med 2017 Sep;84(9):681-686
    Director, Center for Blood Pressure Disorders, Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
    Despite promising results in initial trials, renal denervation failed to achieve its efficacy end points as a treatment for resistant hypertension in the SYMPLICITY HTN-3 trial, the largest trial of this treatment to date (N Engl J Med 2014; 370:1393-1401). Is renal denervation dead, or will future trials and newer technology revive it? Read More

    Antibiotic stewardship: Why we must, how we can.
    Cleve Clin J Med 2017 Sep;84(9):673-679
    Associate Director for Healthcare Associated Infection Prevention Programs, Division of Healthcare Quality Promotion, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
    Improving our antibiotic use is critical to the safety of our patients and the future of medicine. This can improve patient outcomes, save money, reduce resistance, and help prevent negative consequences such as Clostridium difficile infection. The US Centers for Disease Control and Prevention (CDC) is undertaking a nationwide effort to appropriately improve antibiotic use in inpatient and outpatient settings. Read More

    Reproductive planning for women after solid-organ transplant.
    Cleve Clin J Med 2017 Sep;84(9):719-728
    Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.
    Women who receive transplants require contraception counseling because of the teratogenicity of immunosuppressant medications and the risks posed by pregnancy after transplant. Fortunately, pregnancy can succeed with careful planning and monitoring. Read More

    A minimally invasive treatment for early GI cancers.
    Cleve Clin J Med 2017 Sep;84(9):707-717
    Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, OH, USA.
    Endoscopic submucosal dissection (ESD) allows curative resection of early malignant gastrointestinal (GI) lesions, potentially avoiding open surgery. Unfortunately, awareness of this technique is low, and many patients undergo surgery without consideration of ESD. This article reviews the indications for ESD and its advantages and limitations, and guides internists in their approach to patients with early GI cancer. Read More

    Necrotizing pancreatitis: Diagnose, treat, consult.
    Cleve Clin J Med 2017 Aug;84(8):639-648
    Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
    Necrosis significantly increases rates of morbidity and mortality in acute pancreatitis. Hospitalists and general internists are on the front lines in identifying severe cases and consulting the appropriate specialists for optimal multidisciplinary care. Read More

    Combined hormonal contraceptives and migraine: An update on the evidence.
    Cleve Clin J Med 2017 Aug;84(8):631-638
    Education Director, Primary Care Women's Health, Cleveland Clinic, Independence, OH, USA.
    Combined hormonal contraceptives are contraindicated in women who have migraine with aura, in whom these drugs can increase the risk of ischemic stroke. However, this contraindication is based on data from the 1960s and 1970s, when oral contraceptives contained much higher doses of estrogen. Stroke risk is not significantly increased with today's preparations, many of which contain less than 30 μg of ethinyl estradiol. Read More

    Concussion: Evaluation and management.
    Cleve Clin J Med 2017 Aug;84(8):623-630
    Director, Mitchell Center for Sports Injury Prevention, Waltham, MA, USA.
    Concussion is a common problem often managed by nonneurologists. It is often accompanied by headaches, dizziness, sleep disturbance, psychiatric symptoms, and cognitive issues. Here, we outline how to evaluate and manage concussion, including treatment of the most common symptoms. Read More

    Delirium in hospitalized patients: Risks and benefits of antipsychotics.
    Cleve Clin J Med 2017 Aug;84(8):616-622
    Consult-Liaison Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
    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. Here, we review the use of haloperidol, olanzapine, quetiapine, risperidone, and aripiprazole for this purpose. Read More

    Metabolic surgery for treating type 2 diabetes mellitus: Now supported by the world's leading diabetes organizations.
    Cleve Clin J Med 2017 Jul;84(7 Suppl 1):S47-S56
    Department of Metabolic and Bariatric Surgery, Diabetes and Nutrition Science Division, King's College London, UK.
    The term metabolic surgery describes bariatric surgical procedures used primarily to treat type 2 diabetes and related metabolic conditions. Originally, bariatric surgery was used as an alternative weight-loss therapy for patients with severe obesity, but clinical data revealed its metabolic benefits in patients with type 2 diabetes. Metabolic surgery is more effective than lifestyle or medical management in achieving glycemic control, sustained weight loss, and reducing diabetes comorbidities. Read More

    Antiobesity drugs in the management of type 2 diabetes: A shift in thinking?
    Cleve Clin J Med 2017 Jul;84(7 Suppl 1):S39-S46
    Division of Endocrinology, Assistant Professor of Medicine, Medical Director of the Shared Decision Making National Resource Center Investigator, Knowledge and Evaluation Research Unit, Mayo Clinc, Rochester, MN, USA.
    Antiobesity medications can improve metabolic control for patients with type 2 diabetes mellitus (DM) and obesity, but are underutilized. In this review, we describe the role of antiobesity drugs in the context of medically supervised and comprehensive weight-loss interventions and propose a pragmatic therapeutic algorithm for patients with type 2 DM and obesity that incorporates the use of antiobesity drugs early in the course of management. Read More

    Optimizing diabetes treatment in the presence of obesity.
    Cleve Clin J Med 2017 Jul;84(7 Suppl 1):S22-S29
    Associate Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
    Evidence of a neurophysiologic mechanism that involves hormones from adipocytes, pancreatic islet cells, and the gastrointestinal tract implicated in both obesity and diabetes has led to a search for drugs that not only either target obesity and diabetes or reduce hemoglobin A1c, but also have weight loss as a potential side effect. The authors review medications approved for the treatment of type 2 diabetes mellitus (including pramlintide, also approved for type 1 diabetes) that also have weight loss as a side effect. Drugs discussed include glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, neuroendocrine peptide hormones, alpha-glucosidase inhibitors, and metformin. Read More

    The essential role of exercise in the management of type 2 diabetes.
    Cleve Clin J Med 2017 Jul;84(7 Suppl 1):S15-S21
    Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
    Exercise is typically one of the first management strategies advised for patients newly diagnosed with type 2 diabetes. Together with diet and behavior modification, exercise is an essential component of all diabetes and obesity prevention and lifestyle intervention programs. Exercise training, whether aerobic or resistance training or a combination, facilitates improved glucose regulation. Read More

    Diabetes with obesity--Is there an ideal diet?
    Cleve Clin J Med 2017 Jul;84(7 Suppl 1):S4-S14
    Associate Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
    For individuals who are overweight or obese, weight loss is effective in preventing and improving the management of type 2 diabetes. Together with other lifestyle factors like exercise and behavior modification, diet plays a central role in achieving weight loss. Diets vary based on the type and amount of carbohydrate, fat, and protein consumed to meet daily caloric intake goals. Read More

    Tickborne diseases other than Lyme in the United States.
    Cleve Clin J Med 2017 Jul;84(7):555-567
    Associate Program Director, National Capitol Consortium Infectious Diseases Fellowship; Associate Professor of Medicine, Uniformed Services University of the Health Sciences, Department of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, MD, USA.
    Tickborne diseases are increasing in the United States, and the geographic range of tick vectors is expanding. Tickborne diseases are challenging to diagnose, as they present with vague symptoms such as fever, constitutional symptoms, and nonspecific laboratory abnormalities. A high degree of clinical suspicion is required to make a diagnosis, as patients often do not recall a tick bite. Read More

    Optimizing diagnostic testing for venous thromboembolism.
    Cleve Clin J Med 2017 Jul;84(7):545-554
    Associate Professor, Department of Medicine, Division of Hematology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
    Diagnostic algorithms for venous thromboembolism exist, but most do not provide detailed guidance as to which patients, if any, may benefit from screening for thrombophilia. This article provides an overview of the optimized diagnosis of venous thromboembolism, with a focus on the appropriate use of thrombophilia screening. Read More

    Patients with challenging behaviors: Communication strategies.
    Cleve Clin J Med 2017 Jul;84(7):535-542
    Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, OH, USA.
    Some patients have behaviors that make interactions unpleasant, sometimes contributing to suboptimal outcomes and physician burnout. Understanding common difficult personality types can help doctors plan effective strategies for dealing with each, resulting in more effective communication, less stress, and better health outcomes. Read More

    Living with hematologic cancer: Recommendations, solutions.
    Cleve Clin J Med 2017 Jul;84(7):528-534
    Medical Director, Express Care Online, Cleveland, OH, USA.
    Patients with hematologic cancers such as leukemia, lymphoma, and multiple myeloma are living longer than ever. The survival rate of patients with most hematologic cancers has doubled since 1974, and these once-terminal diagnoses are now chronic health conditions. This article reviews the care of patients with hematologic cancers, including those previously treated for childhood, adolescent, and young-adult cancers, discusses the role of primary care in a multidisciplinary team approach, and reviews innovative ways to deliver needed care. Read More

    Breast cancer screening: Does tomosynthesis augment mammography?
    Cleve Clin J Med 2017 Jul;84(7):522-527
    Attending Physician, and Former Director of the Women Veterans' Program, VA Puget Sound Health Care System, Seattle, WA, USA.
    Digital breast tomosynthesis (DBT) is a relatively new imaging technology that is being adopted widely for breast cancer screening. Initial evidence suggests that it may reduce recall rates and increase cancer detection rates when added to digital mammography screening. However, more rigorous, prospective studies are needed to determine whether it improves long-term clinical outcomes of breast cancer screening. Read More

    Autosomal dominant polycystic kidney disease and the heart and brain.
    Cleve Clin J Med 2017 Jun;84(6):471-481
    Consultant Nephrologist, Adult-Pediatric Kidney Disease/Hypertension, Department of Nephrology, Cleveland Clinic Akron General and Akron Children's Hospital, Akron, OH, USA.
    Autosomal dominant polycystic kidney disease (ADPKD) has numerous systemic manifestations and complications. This article gives an overview of hypertension, cardiac complications, and intracranial aneurysms in ADPKD, their pathophysiology, and recent developments in their management. Read More

    1 OF 74