Cleveland Clinic journal of medicine
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Editorial Comparative Study
Avian influenza: a wake-up call from birds to humans.
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Review Meta Analysis Comparative Study
Tricyclics, not SSRIs, effective for chronic back pain.
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Review Comparative Study
Hypoglycemia in diabetes: common, often unrecognized.
Hypoglycemic episodes in patients with diabetes often go unrecognized, and over time, patients may lose the ability to sense hypoglycemia, increasing their risk. Intensive diabetes control is beneficial for patients with diabetes, but it increases their risk of hypoglycemia, underscoring the complexity of diabetes management.
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Review Comparative Study
Head injury: which patients need imaging? Which test is best?
Some patients with head injuries definitely need to undergo an imaging study--usually computed tomography (CT). Most, however, are in a category of "apparently mild" injury, and controversy continues about which of them need to undergo imaging studies to rule out intracranial injuries.
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In persons with epilepsy, both seizures and antiepileptic drugs can disturb reproductive health. For example, seizures can alter the release of hypothalamic and pituitary hormones, while some antiepileptic drugs alter concentrations of sex steroid hormones. Women with epilepsy are at increased risk for polycystic ovary syndrome and disorders of the menstrual cycle. ⋯ The reasons for this reduction in fertility are likely to be both psychosocial and physiologic, and again, both epilepsy itself and antiepileptic drugs are implicated. Sexual dysfunction is common among patients with epilepsy and can have a somatic, psychological, or social basis. To provide the best care for patients with epilepsy, particularly women of reproductive age, clinicians must consider both the gender-based biology of epilepsy and the effects of antiepileptic drugs on reproductive health.