Cleveland Clinic Journal of Medicine 

About: Cleveland Clinic Journal of Medicine is an academic journal published by Cleveland Clinic. The journal publishes majorly in the area(s): Medicine & MEDLINE. It has an ISSN identifier of 0891-1150. It is also open access. Over the lifetime, 5709 publications have been published receiving 69156 citations. The journal is also known as: Cleve Clin J Med. & CCJM.

The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system

Abstract: QThe polyvagal theory describes an autonomic nervous system that is infl uenced by the central nervous system, sensitive to afferent infl uences, characterized by an adaptive reactivity dependent on the phylogeny of the neural circuits, and interactive with source nuclei in the brainstem regulating the striated muscles of the face and head. The theory is dependent on accumulated knowledge describing the phylogenetic transitions in the vertebrate autonomic nervous system. Its specifi c focus is on the phylogenetic shift between reptiles and mammals that resulted in specifi c changes to the vagal pathways regulating the heart. As the source nuclei of the primary vagal efferent pathways regulating the heart shifted from the dorsal motor nucleus of the vagus in reptiles to the nucleus ambiguus in mammals, a face‐heart connection evolved with emergent properties of a social engagement system that would enable social interactions to regulate visceral state.

Antiepileptic Drug Development Program.

Abstract: The modern era of antiepileptic drug therapy began with the use of phenobarbital in 1912. In the years thereafter, many new drugs were introduced, including other barbiturates, hydantoins, succinimides, and oxazolidinediones. Then, for various reasons, the marketing of new antiepileptic drugs was dramatically curtailed. To help reverse this trend, the Epilepsy Branch of the National Institute of Neurological and Communicative Disorders and Stroke sponsored clinical trials of drugs which had already been marketed abroad, resulting in the distribution of clonazepam, carbamazepine, and valproic acid in the U.S. These trials were followed by the establishment of the Antiepileptic Drug Development Program, which encompasses both the preclinical and clinical elements of drug development, including the Anticonvulsant Screening Project, the Toxicology Project, and support for controlled clinical trials.

Meta-analysis: Its strengths and limitations.

Abstract: Nowadays, doctors face an overwhelming amount of information, even in narrow areas of interest. In response, reviews designed to summarize the large volumes of information are frequently published. When a review is done systematically, following certain criteria, and the results are pooled and analyzed quantitatively, it is called a meta-analysis. A well-designed meta-analysis can provide valuable information for researchers, policymakers, and clinicians. However, there are many critical caveats in performing and interpreting them, and thus many ways in which meta-analyses can yield misleading information.

Frailty in older adults: Insights and interventions

Abstract: Frailty is a state of vulnerability that carries an increased risk of poor outcomes in older adults. Common signs and symptoms are fatigue, weight loss, muscle weakness, and progressive decline in function. Frail older adults are among the most challenging for medical management. However, awareness of this syndrome and its risks can help us care for these patients more confidently and decrease their risk for adverse outcomes.

Nonalcoholic fatty liver disease: a manifestation of the metabolic syndrome.

Abstract: Nonalcoholic fatty liver disease (NAFLD) has become the most common form of liver disease, affecting 20% to 30% of the US population. Its clinical manifestations are usually absent or subtle, and it usually comes to medical attention incidentally when aminotransferase levels are found to be elevated or a radiographic study reveals that the liver is fatty. Primary NAFLD is now considered the hepatic manifestation of the metabolic syndrome. The pathogenesis is thought to be a multiple-hit process involving insulin resistance, oxidative stress, apoptosis, and adipokines. In general, the prognosis for simple steatosis is very good; however, nonalcoholic steatohepatitis (NASH) can progress to cirrhosis and hepatocellular carcinoma in 10% to 15% of patients. There is no established treatment for NAFLD except for weight loss and treating each component of the metabolic syndrome.