Cleveland Clinic journal of medicine
-
Restless legs syndrome (RLS) is a common and clinically significant motor disorder increasingly recognized by physicians and the general public, yet still underdiagnosed, underreported, and undertreated. Effective therapies are available, but a high index of suspicion is required to make the diagnosis and start treatment quickly. We now have enough data to support the use of dopaminergic agents, benzodiazepines, antiepileptics, and opioids in these patients.
-
Migraine aura without headache should be considered as a diagnosis in anyone who has recurrent episodes of transient symptoms, especially those that are visual or neurological or involve vertigo. Visual and neurological symptoms due to migraine are not unusual and most commonly occur in older persons with a history of migraine headaches. Migraine aura without headache should be diagnosed only when transient ischemic attack and seizure disorders have been excluded.
-
Review Comparative Study
Helicobacter pylori: why it still matters in 2005.
Despite falling prevalence rates in the developed world, H pylori is still present in the United States and is particularly prevalent among racial minorities and recent immigrants. H pylori infection is clearly associated with an increased risk of peptic ulcer disease, gastric cancer, and MALT lymphoma, and it is associated with some cases of uninvestigated dyspepsia. ⋯ It is uncertain whether H pylori eradication will improve outcomes in patients with gastric cancer. Decision analytic models suggest that a test-and-treat strategy for H pylori is rational and cost-effective for patients with uninvestigated dyspepsia.
-
Intimate partner violence is as prevalent as many conditions for which we routinely screen. Yet intimate partner violence remains underdiagnosed and undertreated. Physicians and other health care workers are in a unique position to detect it and intervene. This article reviews what we can do, what we should do, and what we legally and ethically must do.
-
For over 50 years, anticoagulant options for the treatment and prevention of thrombosis have been limited mainly to traditional agents such as unfractionated heparin and oral vitamin K antagonists such as warfarin. These traditional agents are fraught with limitations that complicate their clinical use. ⋯ Specifically, progress has been made in the development of low-molecular-weight heparins, factor Xa inhibitors, and direct thrombin inhibitors. Because of their convenience and ease of use, some of these novel compounds are competing with the traditional anticoagulants and are needed additions to the antithrombotic arsenal.