Clinical cornerstonePub Date : 2006-01-01Epub Date: 2006-10-11DOI: 10.1016/S1098-3597(06)80019-0
MD Ellen H. Miller (Clinical Associate Professor of Medicine)
{"title":"Vitamin D insufficiency in male osteoporosis","authors":"MD Ellen H. Miller (Clinical Associate Professor of Medicine)","doi":"10.1016/S1098-3597(06)80019-0","DOIUrl":"10.1016/S1098-3597(06)80019-0","url":null,"abstract":"<div><p>Osteoporosis is an important public health issue among men, affecting up to 20% of all men in the United States >50 years of age. The social and economic costs of male osteoporosis are profound but can be minimized by a preventive approach, including early identification and treatment of men at risk for this potentially crippling disease. As part of this preventive approach, clinicians should screen susceptible patients for vitamin D deficiency, a commonly occurring, highly correctable risk factor for osteoporosis. Appropriate detection of vitamin D deficiency in men at risk for osteoporosis and adequate correction of this deficiency will significantly reduce morbidity and mortality associated with male osteoporosis.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S14-S19"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80019-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26314369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical cornerstonePub Date : 2006-01-01Epub Date: 2007-03-23DOI: 10.1016/S1098-3597(06)80056-6
{"title":"CME Information Neutropenia: overview and current therapies","authors":"","doi":"10.1016/S1098-3597(06)80056-6","DOIUrl":"https://doi.org/10.1016/S1098-3597(06)80056-6","url":null,"abstract":"","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S29-S30"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80056-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138246483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical cornerstonePub Date : 2006-01-01Epub Date: 2007-03-23DOI: 10.1016/S1098-3597(06)80055-4
MD Janice L. Gabrilove
{"title":"An analysis of current neutropenia therapies, including pegfilgrastim","authors":"MD Janice L. Gabrilove","doi":"10.1016/S1098-3597(06)80055-4","DOIUrl":"10.1016/S1098-3597(06)80055-4","url":null,"abstract":"<div><p>Currently, 2 granulocyte colony-stimulating factors are available in the United States-filgrastim and pegfilgrastim. In patients receiving chemotherapy for solid tumors, lymphoma, and acute myelogenous leukemia, these agents reduce the duration of severe neutropenia, decrease the incidence of febrile neutropenia, and facilitate on-time delivery of scheduled doses of chemotherapy. In addition, substantial data document the benefits of using these agents in patients undergoing peripheral blood progenitor cell mobilization and in patients who have undergone bone marrow transplantation or peripheral blood progenitor cell transplantation. Recent studies suggest that for all of these indications, the efficacy of pegfilgrastim, the newest agent, is comparable to or greater than that of filgrastim. Like filgrastim, pegfilgrastim is generally well tolerated. An important advantage of pegfilgrastim, however, is its once-per-cycle schedule of administration. Patients and health care providers are likely to prefer the administration schedule of pegfilgrastim to the daily administration schedule required with the use of filgrastim. Furthermore, the more convenient schedule of pegfilgrastim may be associated with greater treatment adherence and increased patient quality of life.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S19-S28"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80055-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26220612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical cornerstonePub Date : 2006-01-01Epub Date: 2006-08-28DOI: 10.1016/S1098-3597(06)80011-6
MD Stephen A. Brunton (Director of Faculty Development), MD, FRCP Stephen N. Davis (Chief, Division of Diabetes, Endocrinology & Metabolism Rudolph Kampmeier Professor), CRNP, CDE Susan M. Renda
{"title":"Early intervention to achieve optimal outcomes in type 2 diabetes: A case presentation","authors":"MD Stephen A. Brunton (Director of Faculty Development), MD, FRCP Stephen N. Davis (Chief, Division of Diabetes, Endocrinology & Metabolism Rudolph Kampmeier Professor), CRNP, CDE Susan M. Renda","doi":"10.1016/S1098-3597(06)80011-6","DOIUrl":"10.1016/S1098-3597(06)80011-6","url":null,"abstract":"<div><p>Type 2 diabetes mellitus (DM) is a progressive disease characterized by insulin resistance and impaired insulin secretion. To compensate for these metabolic dysfunctions, pancreatic β-cells begin to overproduce insulin; however, it is this compensatory mechanism that eventually results in β-cell exhaustion, impaired insulin secretion, and relative insulin deficiency. The metabolic abnormalities associated with diabetes also contribute to vascular dysfunction and an increased risk of coronary heart disease. Among patients with type 2 DM, cardiovascular disease, particularly macrovascular disease, is the primary cause of mortality, accounting for 55% of deaths. Management of the disease, therefore, must address all of the contributing factors, including a sedentary lifestyle and diet that contribute to overweight/obesity, and comorbidities such as hypertension and dyslipidemia. In this paper, we present a case study based on actual clinical experience to illustrate an evidence-based rationale for early and aggressive intervention for patients with type 2 DM, including lifestyle modification, oral antidiabetic agents, and insulin.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S6-S18"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80011-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26226744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical cornerstonePub Date : 2006-01-01Epub Date: 2007-06-22DOI: 10.1016/S1098-3597(06)80065-7
MD Richard A. Johnson
{"title":"Commentary on current literature","authors":"MD Richard A. Johnson","doi":"10.1016/S1098-3597(06)80065-7","DOIUrl":"https://doi.org/10.1016/S1098-3597(06)80065-7","url":null,"abstract":"","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 1","pages":"Page 55"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80065-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137340111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical cornerstonePub Date : 2006-01-01Epub Date: 2007-06-22DOI: 10.1016/S1098-3597(06)80061-X
MD Andrea Singer (Associate Professor)
{"title":"Osteoporosis diagnosis and screening","authors":"MD Andrea Singer (Associate Professor)","doi":"10.1016/S1098-3597(06)80061-X","DOIUrl":"10.1016/S1098-3597(06)80061-X","url":null,"abstract":"<div><p>Osteoporosis and osteoporotic fracture are major causes of morbidity and mortality in the United States and worldwide. Nearly half of all women and one quarter of men >50 years of age will experience an osteoporosis-related fracture during their lifetime. The diagnosis of osteoporosis in postmenopausal women and older men can be made definitively by comparing bone mineral density (BMD) measurements from dual-energy x-ray absorptiometry (DXA) to mean peak bone mass in young adults. Efforts to increase access to DXA and improve the sensitivity and specificity of osteoporosis risk assessment instruments may help ensure that individuals with osteoporosis are diagnosed early. The early identification of individuals with low BMD and/or clinical risk factors, accurate diagnosis of osteoporosis and osteopenia, and initiation of appropriate treatment are crucial to reducing the incidence of vertebral and nonvertebral fractures. The World Health Organization is moving toward absolute risk assessment and this may help to better identify patients for screening and treatment in the future.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 1","pages":"Pages 9-18"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80061-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26795115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical cornerstonePub Date : 2006-01-01Epub Date: 2007-01-05DOI: 10.1016/S1098-3597(06)80039-6
MD Abhimanyu Garg (Professor of Internal Medicine Chief, Division of Nutrition and Metabolic Diseases)
{"title":"Adipose tissue dysfunction in obesity and lipodystrophy","authors":"MD Abhimanyu Garg (Professor of Internal Medicine Chief, Division of Nutrition and Metabolic Diseases)","doi":"10.1016/S1098-3597(06)80039-6","DOIUrl":"10.1016/S1098-3597(06)80039-6","url":null,"abstract":"<div><p>The primary function of adipose tissue is to store energy in the form of triglycerides during periods of energy excess and to release the energy during fasting or starvation as free fatty acids and glycerol. Adipose tissue secretes a variety of peptides called adipocytokines (eg, leptin, adiponectin, tumor necrosis factor-α, interleukin-6, resistin, visfatin) that have endocrine, autocrine, and paracrine effects on the brain, liver, and skeletal muscles. These peptides play an important role in the regulation of energy homeostasis and intermediary metabolism. Adipose tissue also aromatizes androgens to estrogens, and some adipose tissue depots (mechanical fat) serve a protective or cushioning function. Dysfunction of adipose tissue can result in insulin resistance and its metabolic complications in patients with excess body fat (obesity) or markedly reduced body fat (lipodystrophy). Alterations in free fatty acid and adipocytokine release from adipose tissue may underlie metabolic complications.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S7-S13"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80039-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26476682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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