Clinical cornerstonePub Date : 2007-01-01Epub Date: 2007-12-23DOI: 10.1016/S1098-3597(07)80021-4
{"title":"CME Test Answer Sheet and Evaluation Form for Management and prevention of glucose dysregulation","authors":"","doi":"10.1016/S1098-3597(07)80021-4","DOIUrl":"https://doi.org/10.1016/S1098-3597(07)80021-4","url":null,"abstract":"","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S45-S46"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80021-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137221948","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 : 2007-01-01Epub Date: 2008-04-29DOI: 10.1016/S1098-3597(07)80033-0
{"title":"CME test answer sheet and evaluation form for cardiometabolic risk and risk management","authors":"","doi":"10.1016/S1098-3597(07)80033-0","DOIUrl":"https://doi.org/10.1016/S1098-3597(07)80033-0","url":null,"abstract":"","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 3","pages":"Pages 87-88"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80033-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138196743","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 : 2007-01-01Epub Date: 2008-04-29DOI: 10.1016/S1098-3597(07)80028-7
John E. Gerich MD
{"title":"Type 2 diabetes mellitus is associated with multiple cardiometabolic risk factors","authors":"John E. Gerich MD","doi":"10.1016/S1098-3597(07)80028-7","DOIUrl":"10.1016/S1098-3597(07)80028-7","url":null,"abstract":"<div><p>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. Currently, however, the focus in treatment is on preventing CVD rather than controlling glucose, lipid, or blood pressure (BP) levels. The American Diabetes Association guidelines identify low-density lipoprotein cholesterol as the first priority of lipid lowering, with optimal level set at <100 mg/dL (2.6 mmol/L). To reach the target BP level of <130/85 mm Hg, >65% of patients with DM and hypertension will require 2 or more different antihypertensive drugs. Strategies that combine thiazolidinediones and statins may have complementary effects on cardiovascular risk-factor profiles in type 2 DM, in addition to controlling glycemia. Despite the range of treatment options available, therapeutic agents that target new steps in the progression of CVD are needed, as patients with type 2 DM remain at increased risk and many do not achieve therapeutic targets with the drugs available.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 3","pages":"Pages 53-68"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80028-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27417671","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 : 2007-01-01Epub Date: 2009-05-03DOI: 10.1016/S1098-3597(09)60011-9
{"title":"CME Test Answer Sheet and Evaluation Form for Insulin Therapy in Type 2 Diabetes Volume 8, Number 2","authors":"","doi":"10.1016/S1098-3597(09)60011-9","DOIUrl":"https://doi.org/10.1016/S1098-3597(09)60011-9","url":null,"abstract":"","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 2","pages":"Pages 79-84"},"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)60011-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137345226","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}
{"title":"Obstructive sleep-disordered breathing in children.","authors":"Michael Benninger, David Walner","doi":"10.1016/s1098-3597(07)80004-4","DOIUrl":"https://doi.org/10.1016/s1098-3597(07)80004-4","url":null,"abstract":"<p><p>Obstructive sleep-disordered breathing in children is a spectrum of disorders of breathing during sleep characterized by snoring and upper airway obstruction. In its most severe form, obstructive sleep apnea, prolonged complete upper airway obstruction occurs, disrupting normal ventilation and sleep patterns. The hallmark feature of the disorder is habitual and loud snoring. Adenotonsillar hypertrophy is the most common cause of obstructive sleep-disordered breathing. Left untreated, obstructive sleep-disordered breathing may lead to problems related to sleep disruption such as inattention, poor learning, behavioral problems, and attention deficit/hyperactivity disorder or may cause more serious morbidity, including growth failure and pulmonary hypertension. The diagnosis of obstructive sleep-disordered breathing in most children is made through a thorough sleep-based history and physical examination. Adenotonsillectomy, the cardinal treatment for obstructive sleep-disordered breathing, is curative in a large proportion of patients and markedly improves quality of life for children with the disorder.</p>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"9 Suppl 1 ","pages":"S6-12"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26791085","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 : 2007-01-01Epub Date: 2007-12-23DOI: 10.1016/S1098-3597(07)80019-6
Paul S. Jellinger MD, MACE
{"title":"Metabolic consequences of hyperglycemia and insulin resistance","authors":"Paul S. Jellinger MD, MACE","doi":"10.1016/S1098-3597(07)80019-6","DOIUrl":"10.1016/S1098-3597(07)80019-6","url":null,"abstract":"<div><p>Insulin is a pleiotropic hormone that exerts a multitude of effects on metabolism and various cellular processes in the body. The main metabolic actions of insulin are to stimulate glucose uptake in skeletal muscle and the heart and to suppress the production of glucose and very-low-density lipoprotein in the liver. Other metabolic effects of insulin include inhibition of glucose release from the liver, inhibition of the release of free fatty acids (FFAs) from adipose tissue, and stimulation of the process by which amino acids are incorporated into protein. Insulin resistance (IR) is a condition in which defects in the action of insulin are such that normal levels of insulin do not trigger the signal for glucose absorption. An excess of FFAs is implicated in the pathogenesis of IR. The effects of this condition can have profound pathophysiologic effects on various organs and tissues of the body. For example, IR is associated with impaired insulin signaling, impaired fibrinolysis, and inflammation. The clinical consequences include hyperglycemia-induced tissue damage, hypertension, dyslipidemia, metabolic syndrome, and cardiovascular disease. Pharmacotherapies that target IR include metformin and the thiazolidinediones. Endocannabinoid antagonists, agents that target obesity and associated cardiovascular and metabolic risk factors, are currently being developed.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S30-S42"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80019-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27186704","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 : 2007-01-01Epub Date: 2008-04-29DOI: 10.1016/S1098-3597(07)80029-9
James Early MD
{"title":"Comprehensive management of cardiometabolic risk factors","authors":"James Early MD","doi":"10.1016/S1098-3597(07)80029-9","DOIUrl":"10.1016/S1098-3597(07)80029-9","url":null,"abstract":"<div><p>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. Periodic reassessment of a patient's risk can assist in guiding long-term therapy to achieve optimal cardiometabolic health.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 3","pages":"Pages 69-80"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80029-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27417673","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}