Clinical cornerstone最新文献_第6页

Assessment of severity measures for acute asthma outcomes: A first step in developing an asthma clinical prediction rule 评估急性哮喘结果的严重程度措施:制定哮喘临床预测规则的第一步

Clinical cornerstone Pub Date : 2008-01-01 Epub Date: 2008-08-16 DOI: 10.1016/S1098-3597(08)80014-2

Arnold DH, Gebretsadik T, Minton PA, Richard A. Johnson MD

引用次数: 3

Asthma management and prevention: Current perspectives 哮喘管理和预防:当前的观点

Clinical cornerstone Pub Date : 2008-01-01 Epub Date: 2008-08-16 DOI: 10.1016/S1098-3597(08)80011-7

Stuart W. Stoloff MD

{"title":"Asthma management and prevention: Current perspectives","authors":"Stuart W. Stoloff MD","doi":"10.1016/S1098-3597(08)80011-7","DOIUrl":"10.1016/S1098-3597(08)80011-7","url":null,"abstract":"<div><p>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 <em>Expert Panel Report 3</em> 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. In the area of treatment, inhaled corticosteroids (ICSs) remain first-line therapy for longterm asthma management in children and adults. For patients whose severity of asthma requires more than low-dose ICSs, or whose asthma cannot be well controlled on monotherapy with low-dose ICSs, evidence supports the efficacy of combination therapy consisting of an ICS plus an inhaled long-acting β2-agonist (LABA) or an increase to medium-dose ICSs. For children >5 years of age and adults not controlled on low-dose ICSs, the combination of a low-dose ICS plus an inhaled LABA is equivalent in terms of outcomes to the use of medium-dose ICS. For children <5 years of age not controlled on low-dose ICSs, increasing the dose of ICSs is preferred to the addition of a LABA to low-dose ICS therapy as no studies using combination therapy have been conducted for patients in this age group. With regard to asthma prevention, approaches to primary prevention (to avoid allergen sensitization) and secondary prevention (to avoid disease progression) are still very much in the developmental stage, while tertiary prevention (to avoid asthmatic stimuli) has been more successful particularly in pediatric patients. Written action plans as part of self-management processes appear to improve physician-patient communication and disease status tracking. Other considerations in successful asthma management include patient education and monitoring of adherence to treatment regimens.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 4","pages":"Pages 26-43"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(08)80011-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27605674","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}

引用次数: 7

Coblation: improving outcomes for children following adenotonsillectomy. 研究:改善儿童腺扁桃体切除术后的预后。

Clinical cornerstone Pub Date : 2007-01-01 DOI: 10.1016/s1098-3597(07)80005-6

Michael Benninger, David Walner

{"title":"Coblation: improving outcomes for children following adenotonsillectomy.","authors":"Michael Benninger, David Walner","doi":"10.1016/s1098-3597(07)80005-6","DOIUrl":"https://doi.org/10.1016/s1098-3597(07)80005-6","url":null,"abstract":"<p><p>Tonsillectomy and adenoidectomy, 2 of the most common childhood surgeries, are performed for a number of indications, the most common being airway obstruction caused by adenotonsillar hypertrophy. Other indications for tonsillectomy include recurrent pharyngotonsillitis, streptococcal carriage, recurrent peritonsillar abscess, halitosis, and presumed neoplasia. Although adenotonsillar surgery is a safe and effective technique for treating disease and obstruction, parents remain concerned about postoperative morbidity, for which the potential is much greater after tonsillectomy than adenoidectomy. Postoperative pain and hemorrhage are 2 unpleasant side effects that can prolong postoperative recovery. Surgeons use a variety of surgical techniques to remove the tonsils and adenoids. When compared with older techniques, such as cold steel dissection and monopolar electrocautery, a new technique named Coblation that uses lower temperatures than electrocautery to remove tonsil tissue and achieve hemostasis, has been shown to reduce pain and decrease postoperative narcotic use, leading to shorter recovery times and a quicker return to normal in children.</p>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"9 Suppl 1 ","pages":"S13-23"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26791084","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}

引用次数: 25

Dyslipidemia and glucose dysregulation in overweight and obese patients 超重和肥胖患者的血脂异常和葡萄糖调节异常

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2008-04-29 DOI: 10.1016/S1098-3597(07)80027-5

Derek LeRoith MD, PhD (Professor and Chief)

引用次数: 24

Treatment of Dyslipidemia to Reduce Cardiovascular Risk in Patients with Multiple Risk Factors 治疗血脂异常以降低多重危险因素患者的心血管风险

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-22 DOI: 10.1016/S1098-3597(07)80010-X

Christie M. Ballantyne MD

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引用次数: 22

Overcoming Patient Barriers to Initiating Insulin Therapy in Type 2 Diabetes Mellitus 克服2型糖尿病患者启动胰岛素治疗的障碍

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2009-05-03 DOI: 10.1016/S1098-3597(09)60006-5

David G. Marrero PhD

{"title":"Overcoming Patient Barriers to Initiating Insulin Therapy in Type 2 Diabetes Mellitus","authors":"David G. Marrero PhD","doi":"10.1016/S1098-3597(09)60006-5","DOIUrl":"10.1016/S1098-3597(09)60006-5","url":null,"abstract":"<div><p><span>Data from clinical trials<span> underscore the fact that loss of β-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 </span></span>sulfonylurea<span><span> 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<span> after oral agents have failed to maintain glycemic control. Nonetheless, both patients and providers are reluctant to begin insulin therapy. Research has shown that providers often delay modification of the diabetes treatment regimen because they believe their patients would be concerned about starting insulin therapy. In addition, they are concerned about </span></span>patient nonadherence to nonpharmacologic and pharmacologic therapy. There are multiple reasons for patient nonadherence to insulin therapy; however, patients must be made to understand, early in the course of the disease, the progressive nature of type 2 diabetes and that exogenous insulin is an additional therapeutic option to help them achieve and maintain adequate glycemic control.</span></p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 2","pages":"Pages 33-43"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(09)60006-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27336954","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}

引用次数: 34

New Therapies for Diabetes 糖尿病新疗法

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2009-05-03 DOI: 10.1016/S1098-3597(09)60008-9

Dina E. Green MD

引用次数: 8

CME Test Questions CME考试问题

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-23 DOI: 10.1016/S1098-3597(07)80020-2

引用次数: 0

CME Information 芝加哥商品交易所的信息

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-23 DOI: 10.1016/S1098-3597(07)80015-9

引用次数: 0

The Benefits of Tight Glycemic Control in Type 2 Diabetes Mellitus 严格控制血糖对2型糖尿病的益处

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-23 DOI: 10.1016/S1098-3597(07)80018-4

Derek LeRoith MD, PhD, Elliot J. Rayfield MD

引用次数: 22