Search our Database of Scientific Publications and Authors

I’m looking for a

    303 results match your criteria Clinical Cornerstone [Journal]

    1 OF 7

    Treatment of overweight and obesity: lifestyle, pharmacologic, and surgical options.
    Clin Cornerstone 2009 ;9(4):55-68; discussion 69-71
    Harvard Medical School Cardiovascular Division Brigham and Women's Hospital Boston, Massachusetts, USA.
    Recent statistics indicate that overweight and obesity have become an increasingly serious clinical and socioeconomic problem worldwide, and one of the greatest public health challenges of our time. In the United States, 133.6 million (66%) adults are overweight or obese (body mass index [BMI] >/=25 kg/m(2)), with 63. Read More

    Guiding clinical decisions on abdominal obesity and cardiometabolic risk.
    Clin Cornerstone 2009 ;9(4):43-52; discussion 53-4
    Department of Cardiovascular Medicine, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA.
    Studies have shown that obesity increases cardiometabolic risk across the span of life. Obesity results in increased production of proinflammatory adipokines and decreased production of the anti-inflammatory adipokine, adiponectin, which eventually leads to atherosclerosis and type 2 diabetes mellitus. Lifestyle changes are the cornerstone for treatment of overweight and obese patients; however, pharmacotherapy and surgery are 2 additional treatment options that may be considered when lifestyle changes alone are unsuccessful. Read More

    Overweight and obesity: the pathogenesis of cardiometabolic risk.
    Clin Cornerstone 2009 ;9(4):30-40; discussion 41-2
    Louisiana State University Medical Center Baton Rouge, Louisiana, USA.
    Obesity, particularly abdominal adiposity, is increasingly recognized as a cause of elevated cardiometabolic risk--the risk of developing type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). The predominate mechanisms appear to involve the promotion of insulin resistance, driven largely by excess free fatty acids secreted by an expanded adipose tissue mass, and the development of an inflammatory milieu due to increased secretion of inflammatory cytokines and adipokines from adipose tissue. Key proinflammatory cytokines secreted by adipocytes include tumor necrosis factor-alpha, interleukin-6, leptin, resistin, and plasminogen activator inhibitor-1. Read More

    Obesity as a disease state: a new paradigm for diagnosis and treatment.
    Clin Cornerstone 2009 ;9(4):9-25; discussion 26-9
    Weill Cornell Medical College, New York, New York, USA.
    While global prevalence of obesity continues to increase dramatically, treatment options remain less than optimal. The etiology of obesity is multifactorial, ranging from lifestyle choices such as excess food intake and insufficient physical activity, to use of medications that have weight gain as an undesirable side effect. Economic and political determinants of available foodstuffs and even social networks may also contribute to obesity. Read More

    Should clinicians routinely determine rhinitis subtype on initial diagnosis and evaluation? A debate among experts.
    Clin Cornerstone 2009 ;9(3):54-60
    David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
    Rhinitis is one of the most prevalent conditions affecting Americans today. Twenty to 40 million Americans (10%-30% of adults and up to 40% of children) are estimated to have allergic rhinitis. In recent decades, its prevalence in Western societies has increased dramatically, and studies from around the world are reporting similar trends. Read More

    Hydrofluoroalkane mandate in effect January 1, 2009: Switch from chlorofluorocarbon- to hydrofluoroalkane-propelled inhalers requires active transition.
    Clin Cornerstone 2009 ;9(3):50-3
    Section on Pulmonary and Critical Care Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
    The manufacture, sale, and distribution of chlorofluorocarbon-propelled albuterol metered-dose inhalers ceased as of December 31, 2008. Clinicians should actively transition patients to currently available hydrofluoroalkane-propelled devices, providing concise education and instruction for using the newer devices. Read More

    Inhaled anticholinergics and the long-term treatment of chronic obstructive pulmonary disease: Weighing benefits and risks.
    Clin Cornerstone 2009 ;9(3):45-9
    Alpha One Antitrypsin Deficiency Clinical Resource Center, Pulmonary Rehabilitation, and Advanced Bronchoscopy Unit, University of Chicago, Chicago, Illinois 60637, USA.
    A meta-analysis recently published in the Journal of the American Medical Association found an increased risk of nonfatal myocardial infarction, stroke, and cardiovascular death associated with inhaled anticholinergic use in patients with chronic obstructive pulmonary disease (COPD); however, inherent limitations in the meta-analysis and contradictory results from other studies cast uncertainty onto its conclusions. For example, the Understanding Potential Long-term Impacts on Function with Tiotropium trial, a large, prospective, 4-year outcome study in nearly 6000 patients with COPD, did not demonstrate an increase in cardiovascular events with anticholinergic therapy. Until more data are available, clinicians should always carefully weigh safety and efficacy data and help patients make informed decisions about their COPD care. Read More

    Using long-acting beta2-agonists safely: What will be the impact of the US Food and Drug Administration's panel recommendations?
    Clin Cornerstone 2009 ;9(3):40-4
    Asthma and Allergy Center, DuPage Medical Group, Glen Ellyn, Illinois 60l37, USA.
    The US Food and Drug Administration (FDA) has launched an investigation into the safety of long-acting beta(2)-agonists (LABAs). While the impact of this investigation is yet to be seen, clinicians should be circumspect in the use of these agents and prescribe them according to the recommendations of current asthma guidelines, informing patients and their caretakers about potential risks. As clinical trials attempt to address the question of whether LABAs are safe for use in pediatric and adult populations, current data provide no clear answers. Read More

    A 12-year-old student athlete with exercise-induced bronchospasm: Getting Jenny B. back on track: A case 360 degrees patient presentation.
    Clin Cornerstone 2009 ;9(3):30-9
    Rush University Medical Center, Chicago, Illinois 60612, USA.
    Jenny B. is an active 12-year-old white female who recently stopped participating in junior high school track because of respiratory symptoms she experiences while running. On presentation to her pediatrician's office for a consultation, it immediately became apparent that she was anxious to rejoin her team to compete. Read More

    Clinical importance of identifying immunoglobulin E-mediated disease in patients with asthma.
    Clin Cornerstone 2009 ;9(3):20-9
    Allergy/Immunology, Creighton University, Omaha, Nebraska, USA.
    The strong association between allergy and asthma is well documented; however, few practitioners-even asthma specialists-accurately estimate the percentage of patients with asthma who have clinically relevant allergies. Because allergen exposure can prompt airway inflammation, trigger asthma exacerbations, and possibly lead to negative health outcomes for patients with asthma, identifying allergies and immunoglobulin E (IgE)-mediated disease in patients with persistent asthma is crucial. Updated Expert Panel 3 asthma guidelines from the National Asthma Education and Prevention Program reinforce the need for clinicians to identify allergic sensitivities in patients with persistent asthma and determine their clinical relevance. Read More

    From the page to the clinic: Implementing new National Asthma Education and Prevention Program guidelines.
    Clin Cornerstone 2009 ;9(3):9-19
    Allergy and Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
    The National Asthma Education and Prevention Program's (NAEPP) revised guidelines, the Expert Panel Report 3 (EPR-3), published in 2007, represents a shift in the approach to asthma: the EPR-3 recommends that clinicians think of asthma as a chronic disease with an inflammatory basis. EPR-3 guidelines also represent a shift in the treatment paradigm for asthma in line with the shift in approach: although symptomatic relief is still necessary, the primary goal of asthma treatment is now long-term control, with the aim of minimizing exacerbation frequency and severity and limiting possible permanent airway damage that can result from frequent asthma exacerbations. To help clinicians implement the new EPR-3 guidelines into daily practice, the NAEPP's Guidelines Implementation Panel has identified 6 key action-focused recommendations. Read More

    The management of hypertension with angiotensin receptor blockers in special populations.
    Clin Cornerstone 2009 ;9 Suppl 3:S5-17
    Division of Cardiology Emory University School of Medicine, Atlanta, Georgia 30349, USA.
    Angiotensin receptor blockers (ARBs) are the most recently approved major class of antihypertensive agents. The primary mechanism of action of ARBs is the selective blockade of the AT(1) receptor. There are 7 ARBs presently approved for clinical use in the United States, several with other indications in addition to blood pressure reduction in patients with hypertension. Read More

    The management and treatment of hypertension.
    Clin Cornerstone 2009 ;9 Suppl 3:S27-33
    Department of Internal Medicine, Orland Primary Care Specialists, Orland Park, Illinois 60467, USA.
    High blood pressure (HBP) is one of the most prevalent conditions seen today by clinicians, affecting an estimated 73 million--or 1 in 3--adult Americans, only one third of whom have achieved control of their hypertension (HBP). Central to the management of this pervasive medical condition are the issues of accurate diagnosis and maintaining control through appropriate treatment. Accurate diagnosis depends primarily on reliable measurement. Read More

    Recent advances in cardiovascular risk reduction: implications of ONTARGET.
    Clin Cornerstone 2009 ;9 Suppl 3:S18-26
    Department of Emergency Medicine, The Ohio State University Columbus, Ohio 43212, USA.
    Renin-angiotensin-aldosterone system (RAAS) overactivity is associated with increased cardiovascular risk, a finding that may be explained by the key role of the RAAS in stimulating vascular and cardiac remodeling. Inhibition of RAAS activity with the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) has been shown to reduce cardiovascular mortality in patients with heart failure. ACE inhibitors have also been shown to reduce the incidence of stroke, myocardial infarction (MI), and heart failure in high-risk patients without heart failure. Read More

    The endocannabinoid system as a target for obesity treatment.
    Clin Cornerstone 2008 ;9(1):52-64; discussion 65-6
    Weill Cornell Medical College, New York, New York, USA.
    Overweight and obesity are major factors contributing to the development of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). In addition to the many physical and metabolic consequences of obesity, there are also mental health consequences, in particular, the risk for depression. Depression can lead to poor self-care, poor treatment compliance, and possible increased morbidity and mortality from such illnesses as type 2 DM and CVD. Read More

    Fundamentals of cardiometabolic risk factor reduction: achieving and maintaining weight loss with pharmacotherapy or bariatric surgery.
    Clin Cornerstone 2008 ;9(1):41-8; discussion 49-51
    Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
    Obesity is a major health problem in the United States and many other countries because of its high prevalence and causal relationship with serious medical comorbidities. The therapeutic options currently available to help obese patients lose weight are: (1) therapeutic lifestyle change (behavioral, dietary, and physical activity modification); (2) pharmacotherapy; and (3) bariatric surgery. Lifestyle modification is the first therapeutic choice; however, achieving a successful long-term weight loss with lifestyle intervention alone is difficult. Read More

    Endocrine functions of adipose tissue: focus on adiponectin.
    Clin Cornerstone 2008 ;9(1):32-8; discussion 39-40
    University of Missouri-Columbia School of Medicine, Department of Medicine, Harry S. Truman VA Medical Center, USA.
    Accumulating evidence indicates that obesity and overweight are associated with, and contribute to, the development of type 2 diabetes mellitus (DM), cardiovascular disease (CVD), and chronic kidney disease (CKD). The adipocyte-derived cytokine, adiponectin, has been shown to improve insulin sensitivity, increase rates of fatty acid oxidation, decrease muscle lipid content, and reduce inflammation and vascular injury. However, adiponectin levels have been found to be reduced in persons with obesity and type 2 DM. Read More

    Obesity, abdominal obesity, and insulin resistance.
    Clin Cornerstone 2008 ;9(1):23-29; discussion 30-1
    Maricopa Medical Center, Phoenix, Arizona, USA.
    The correlation of body mass index (BMI) with both adiposity and risk for type 2 diabetes mellitus (DM) is positive. An elevated BMI is also associated with increased mortality from cardiovascular disease (CVD). However, for any given BMI measurement, some persons are at risk for type 2 DM and CVD, while others are not. Read More

    Obesity-related cardiometabolic complications.
    Clin Cornerstone 2008 ;9(1):11-9; discussion 20-2
    Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.
    Obese patients are at increased risk for developing numerous cardiometabolic complications, including hypertension, insulin resistance, diabetes mellitus, dyslipidemia, and cardiovascular disease (CVD). These complications are associated with an increase in mortality and appear to be related to the changes in adipocytcs that occur with obesity. The enlarged adipocytes found in obese individuals release more glycerol, free fatty acids, and proinflammatory factors and less adiponectin. Read More

    Advances in therapy for adult asthma.
    Clin Cornerstone 2008 ;8(4):62-75
    Department of Pediatrics, National Jewish Medical Center, Denver, Colorado 80206, USA.
    There are >22 million Americans with asthma. Chronic asthma is a worldwide problem with an increasing socioeconomic burden on individuals and on society. Recent advances have been made in diagnostic lung imaging, defining control of asthma, as well as in the education of patients with asthma. Read More

    Asthma in infants and children.
    Clin Cornerstone 2008 ;8(4):44-61
    Capital Allergy & Respiratory Disease Center, Sacramento, California 95819, USA.
    Asthma is the most common chronic illness in childhood and represents a significant burden to health care and educational systems. Between one quarter and two thirds of childhood asthma cases persist into adulthood. Childhood asthma may be particularly difficult to diagnose because of the high prevalence of episodic wheezing and cough in childhood illnesses such as upper respiratory tract infections. Read More

    Asthma management and prevention: current perspectives.
    Clin Cornerstone 2008 ;8(4):26-43
    Family and Community Medicine, University of Nevada School of Medicine Reno, Nevada, USA.
    The continuing evolution of asthma treatment and prevention are reflected in updated guidelines from the National Asthma Education and Prevention Program and Global Initiative for Asthma as well as other recent publications. The 2007 Expert Panel Report 3 guidelines designate severity and control, mediated by considerations of current impairment and future risk, as the primary concepts in assessing and monitoring asthma. Severity should ideally be determined at the time of diagnosis, after which control becomes the central focus of asthma management. Read More

    ABCs of Asthma.
    Clin Cornerstone 2008 ;8(4):9-25
    Department of Internal Medicine, Division of Immunology & Allergy, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.
    Asthma results from chronic airway inflammation involving a diversity of activated cells including mast cells, eosinophils, T-lymphocytes, neutrophils, macrophages, and epithelial cells. These cells release proinflammatory cytokine mediators that augment and regulate airway inflammation, leading to airway hyperresponsiveness responsible for the chronic asthma symptoms of dyspnea, wheezing, and chest tightness. It is hypothesized, but unproven, that inflammatory effects can lead to irreversible structural and functional airway changes. Read More

    Comprehensive management of cardiometabolic risk factors.
    Clin Cornerstone 2007 ;8(3):69-80
    Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas 67214-3199, USA.
    Comprehensive management of cardiometabolic risk requires management of a patient's underlying risk factors. The initial approach to treatment demands a careful assessment of patient risk, using formal risk assessment tools (eg, the Framingham Risk Score and the National Cholesterol Education Program Adult Treatment Panel III definition of metabolic syndrome), combined with comprehensive knowledge of the patient. There is increasing evidence that lifestyle modification and pharmacotherapy can delay or prevent the progression of insulin resistance to diabetes and cardiovascular disease. Read More

    Type 2 diabetes mellitus is associated with multiple cardiometabolic risk factors.
    Clin Cornerstone 2007 ;8(3):53-68
    Endocrinology and Metabolism Unit, University of Rochester School of Medicine, Rochester, New York 14627, USA.
    The risk for cardiovascular disease (CVD) is multifactorial and includes such risk factors as diabetes, hypertension, smoking, and dyslipidemia. Thus, targeting the hyperglycemia in type 2 diabetes mellitus (DM) alone will not eliminate all of the excess cardiovascular risk; rather aggressive treatment is needed for all of the modifiable cardiometabolic risk factors. Therapeutic lifestyle change is considered primary therapy for hyperglycemia in type 2 DM. Read More

    Dyslipidemia and glucose dysregulation in overweight and obese patients.
    Clin Cornerstone 2007 ;8(3):38-52
    Division of Endocrinology, Diabetes and Bone Disease Department, Medicine Mount Sinai School of Medicine, New York, New York 10024, USA.
    Inactivity and a sedentary lifestyle contribute to overweight, obesity, and cardiometabolic risk. Overweight and obesity can lead to metabolic abnormalities, insulin resistance, type 2 diabetes mellitus (DM), lipid disorders, and cardiovascular disease. Diet and exercise can effectively reverse overweight and obesity and their related comorbidities. Read More

    Overweight and obesity: key components of cardiometabolic risk.
    Clin Cornerstone 2007 ;8(3):29-37
    Weill Medical College of Cornell University, New York, New York 10065, USA.
    The current obesity epidemic is a major public health concern worldwide, in both developed and developing countries, and in adults and children alike. Obesity confers physical stress on multiple biologic processes and is associated with an increased risk of developing cardiovascular disease, type 2 diabetes mellitus, osteoarthritis, and certain forms of cancer, among other serious diseases. Therefore, it is essential that all health care providers take an active role in addressing the issue of obesity with their patients to reduce their cardiometabolic risks. Read More

    Cardiovascular disease and modifiable cardiometabolic risk factors.
    Clin Cornerstone 2007 ;8(3):11-28
    Harvard Medical School Cardiovascular Division, Brigham and Women's Hospital Boston, Massachusetts 02115, USA.
    Cardiovascular disease (CVD) is the leading cause of death in the United States and many parts of the world. Potentially modifiable risk factors for CVD include tobacco use, physical inactivity, hypertension, elevated low-density lipoprotein cholesterol, and a cluster of interrelated metabolic risk factors. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. Read More

    Future directions in insulin therapy and treatment of diabetes mellitus: a critical comment.
    Clin Cornerstone 2007 ;8(2):66-74
    Profil Institut für Stoffwechselforschung GmbH, Neuss, Germany.
    Considerable progress has been made on our way toward optimal treatment of patients with diabetes mellitus (DM), and many insulin therapy strategies are now available for these patients. We will see further improvements in insulin therapy, and there is hope for a cure in the not too distant future. All of these developments, however, depend on the willingness of the health care and economic systems to fund these new advances. Read More

    New therapies for diabetes.
    Clin Cornerstone 2007 ;8(2):58-63; discussion 64-5
    Division of Endocrinology, Mount Sinai School of Medicine, New York, New York 10029, USA.
    The role of hormones secreted by the gut in maintaining blood glucose homeostasis has recently been recognized. This recognition has led to the emergence of several novel classes of medications--the glucagon-like peptide-1 (GLP-1) agonists and the dipeptidyl peptidase (DPP)-IV inhibitors--that may target a key element of the underlying pathophysiology of type 2 diabetes mellitus (DM). Both GLP-1 agonists and DPP-IV inhibitors may have the ability to expand beta-cell mass. Read More

    Managing hyperglycemia in hospitalized patients.
    Clin Cornerstone 2007 ;8(2):44-54; discussion 55-7
    University of North Carolina, Division of Endocrinology, Chapel Hill, North Carolina 27599-7172, USA.
    Insulin infusion is used in the critical care setting for prevention of hyperglycemia and is administered most safely under a structured, dynamic, dose-defining algorithm. The ordering of basal-prandial-correction SC insulin therapy, appropriate for most hospitalized patients who are eating, is simplified and standardized to excellence by the development of institutional order sets or computerized order entry templates. Basal insulin therapy is prescribed as intermediate-acting insulin or long-acting insulin analogue. Read More

    Overcoming patient barriers to initiating insulin therapy in type 2 diabetes mellitus.
    Clin Cornerstone 2007 ;8(2):33-40; discussion 41-3
    Division of Endocrinology & Metabolism, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
    Data from clinical trials underscore the fact that loss of beta-cell function and insulin hyposecretion are progressive in type 2 diabetes. To achieve adequate glycemic control, most patients will eventually require insulin. Addition of insulin to sulfonylurea therapy, when maximal sulfonylurea does not adequately maintain fasting plasma glucose levels at <108 mg/dL, has been found to be more effective than initiating insulin therapy after oral agents have failed to maintain glycemic control. Read More

    Treatment of diabetes: a clinical update on insulin trials.
    Clin Cornerstone 2007 ;8(2):21-9; discussion 30-2
    Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Mount Sinai School of Medicine, New York, New York 10024, USA.
    The prevalence of diabetes, along with its accompanying long-term microvascular and macrovascular complications, continues to increase. Landmark studies of both type 1 and type 2 diabetes have provided the foundations on which to investigate improved treatment strategies for type 2 diabetes. Recent evidence suggests a new paradigm for treating type 2 diabetes that adds insulin earlier in the treatment process to maintain tight glycemic control. Read More

    Identification and treatment of prediabetes to prevent progression to type 2 diabetes.
    Clin Cornerstone 2007 ;8(2):10-8; discussion 19-20
    Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.
    Overt type 2 diabetes is usually preceded by a condition known as prediabetes, which is characterized by impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Both IFG and IGT exhibit elevated glucose levels that are not sufficient to be classified as diabetes but that represent the development of insulin resistance. Achieving glycemic control in patients with prediabetes through lifestyle and pharmacologic interventions can effectively prevent or delay the development of diabetes and its associated complications. Read More

    Overcoming patient barriers to initiating insulin therapy in type 2 diabetes mellitus.
    Clin Cornerstone 2008 ;9(2):63-70; discussion 71-3
    Division of Endocrinology & Metabolism, Indiana University School of Medicine, 250 N. University Blvd., Suite 122, Indianapolis, IN 46202, USA.
    Data from clinical trials underscore the fact that loss of beta-cell function and insulin hyposecretion are progressive in type 2 diabetes. To achieve adequate glycemic control, most patients will eventually require insulin. Addition of insulin to sulfonylurea therapy, when maximal sulfonylurea does not adequately maintain fasting plasma glucose levels at < 108 mg/dL, has been found to be more effective than initiating insulin therapy after oral agents have failed to maintain glycemic control. Read More

    Identification and treatment of prediabetes to prevent progression to type 2 diabetes.
    Clin Cornerstone 2008 ;9(2):51-9; discussion 60-1
    Professor of Medicine and Pharmacology, Tullis Tulane Alumni Chair in Diabetes, Section of Endocrinology, Tulane University Health Sciences Center, 1430 Tulane Avenue - SL 53, New Orleans, LA 70112, USA.
    Overt type 2 diabetes is usually preceded by a condition known as prediabetes, which is characterized by impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Both IFG and IGT exhibit elevated glucose levels that are not sufficient to be classified as diabetes but that represent the development of insulin resistance. Achieving glycemic control in patients with prediabetes through lifestyle and pharmacologic interventions can effectively prevent or delay the development of diabetes and its associated complications. Read More

    Pathophysiology and clinical manifestations of osteoporosis.
    Clin Cornerstone 2008 ;9(2):42-7; discussion 48-50
    Toni Stabile Osteoporosis Center, Columbia University, 180 Fort Washington Avenue, Harkness Pavillion, Room 904, New York, NY 10032, USA.
    Osteoporosis is a complex skeletal disorder in which compromised bone strength increases the risk of fragility fractures. Recent scientific advances in bone biology and immunology have greatly expanded our insights into the pathogenesis of osteoporosis. For those with osteoporotic fractures, however, the physical and psychological effects remain severe. Read More

    Cardiovascular disease and modifiable cardiometabolic risk factors.
    Clin Cornerstone 2008 ;9(2):24-38; discussion 39-41
    TIMI Study Group, Harvard Medical School, Cardiovascular Division, Brigham and Women's Hospital Boston, Massachusetts 02115, USA.
    Cardiovascular disease (CVD) is the leading cause of death in the United States and many parts of the world. Potentially modifiable risk factors for CVD include tobacco use, physical inactivity, hypertension, elevated low-density lipoprotein cholesterol, and a cluster of interrelated metabolic risk factors. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. Read More

    Asthma management and prevention: current perspectives.
    Clin Cornerstone 2008 ;9(2):6-20; discussion 21-3
    Family and Community Medicine, University of Nevada, School of Medicine, Reno, Nevada, USA.
    The continuing evolution of asthma treatment and prevention are reflected in updated guidelines from the National Asthma Education and Prevention Program and Global Initiative for Asthma as well as other recent publications. The 2007 Expert Panel Report 3 guidelines designate severity and control, mediated by considerations of current impairment and future risk, as the primary concepts in assessing and monitoring asthma. Severity should ideally be determined at the time of diagnosis, after which control becomes the central focus of asthma management. Read More

    The benefits of tight glycemic control in type 2 diabetes mellitus.
    Clin Cornerstone 2007 ;8 Suppl 7:S19-29
    Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Mount Sinai School of Medicine, New York, New York 10024, USA.
    Type 2 diabetes mellitus (DM) is associated with significantly increased risk of microvascular and macrovascular disease. Although most studies have focused on the microvascular complications of diabetes (eg, nephropathy, neuropathy, retinopathy), most patients with type 2 DM die from causes that are related to macrovascular disease (eg, myocardial infarction). Poor glycemic control increases the risk of future cardiovascular events, and prospective studies of patients with type 1 and type 2 DM have demonstrated that the incidence of vascular complications is reduced by lifestyle modifications or medications that reduce blood glucose concentrations. Read More

    Early identification and treatment of insulin resistance: impact on subsequent prediabetes and type 2 diabetes.
    Clin Cornerstone 2007 ;8 Suppl 7:S7-18
    Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.
    Insulin resistance (IR) is characterized by decreasing sensitivity of target tissues to the action of insulin, elevated blood glucose concentration, and increased hepatic production of atherogenic lipids. IR is associated with declining insulin production by the pancreas, the emergence of type 2 diabetes, and increasing risk of cardiovascular disease (CVD). Clinical markers of IR include elevated plasma glucose concentration under fasting conditions or following ingestion of an oral glucose challenge. Read More

    1 OF 7