Abstract:
:Postherpetic neuralgia is defined as pain persisting, or recurring, at the site of shingles at least three months after the onset of the acute rash. Thus defined, at least half of shingles sufferers over the age of 65 years develop postherpetic neuralgia. In addition to increasing age, less important risk factors for postherpetic neuralgia are pain severity of acute shingles and trigeminal distribution. Postherpetic neuralgia accounts for 11-15% of all referrals to pain clinics and would, in fact, be far more effectively dealt with in primary care. Effective treatment of acute shingles by systemic antivirals at the appropriate time may have some effect in reducing the incidence of postherpetic neuralgia, making it easier to treat with tricyclics and greatly reducing scarring (25% of all cases affect the face). Pre-emptive treatment with low-dose tricyclics (ami- or nor-triptyline 10-25 mg nocte) from the time of diagnosis of acute shingles reduces the incidence of postherpetic neuralgia by about 50%. Established postherpetic neuralgia should be vigorously treated with adrenergically active tricyclics in a dose rising over two or three weeks from 10-25 mg to 50-75 mg. Positive relaxation should also be used. Carbamazepine, like conventional analgesics, is of little or no value. Failure of tricyclics to effect relief within eight weeks calls for specialist treatment. North American practitioners in particular believe that some opioids (e.g., oxycodone) may be helpful in otherwise intractable cases.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Bowsher Ddoi
10.1136/pgmj.73.864.623subject
Has Abstractpub_date
1997-10-01 00:00:00pages
623-9issue
864eissn
0032-5473issn
1469-0756journal_volume
73pub_type
杂志文章,评审abstract::Malignant hyperthermia is a rare autosomal dominant trait that predisposes affected individuals to great danger when exposed to certain anaesthetic triggering agents (such as potent volatile anaesthetics and succinylcholine). A sudden hypermetabolic reaction in skeletal muscle leading to hyperthermia and massive rhabd...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.867.11
更新日期:1998-01-01 00:00:00
abstract::The first case of the Zollinger-Ellison syndrome treated from the outset continuously for more than a year with the histamine H2-receptor antagonist cimetidine is reported. Symptomatic response has been dramatic and sustained, marked endoscopic improvement has been observed with healing of oesophageal, gastric and sto...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.626.749
更新日期:1977-12-01 00:00:00
abstract:PURPOSE:Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conce...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133917
更新日期:2017-03-01 00:00:00
abstract::Synovial plicae are normal anatomical structures of the knee that may become symptomatic. MRI is an established technique for evaluating the anatomy of the knee, and it is a valuable tool for detecting plicae because of its high resolution resulting in increased tissue characterisation. At MRI, knee plicae appear as l...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2013-132176
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:Effective communication is a vital part of good clinical care. Traditionally bleep systems have been used as the mainstay of communication. Mobile technology is increasingly seen as a quicker, easier and more reliable method of communication. Our objective was to assess the use of mobile devices within a typ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133722
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::Haemorrhagic infarction of the breast induced by anticoagulant therapy is rare and has been infrequently reported in the literature. The following report illustrates such a case in which there was development of massive haemorrhagic infarction of the breast during treatment with nicoumalone for deep venous thrombosis ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.58.675.41
更新日期:1982-01-01 00:00:00
abstract::We describe a patient with primary amyloidosis in whom multiple osteolytic lesions caused by amyloid bone tumours developed, and review the clinical features of the 18 cases with primary amyloidosis in whom destructive bone lesions have been reported. In contrast to amyloidosis associated with multiple myeloma, destru...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.733.1037
更新日期:1986-11-01 00:00:00
abstract::Left ventricular function was evaluated non-invasively in hypertensive patients treated with indapamide by means of echographically determined velocity of circumferential fibre shortening (VCF). A statistically significant reduction in mean systolic and diastolic blood pressure in both the standing and supine position...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive. OBJECTIVE:To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation. SETTING:One year before and after interve...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-136992
更新日期:2021-02-01 00:00:00
abstract::Hypothyroidism over a lifetime is rare. Such a case is reported due to post-coupling dyshormonogenesis in a patient who had developed an aortic aneurysm. It is proposed that the aortic aneurysm could have arisen as a direct consequence of the hypothyroidism. Furthermore, Reilly bodies, which are deposits of mucopolysa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.58.685.706
更新日期:1982-11-01 00:00:00
abstract::Video evaluation of resuscitation is becoming increasingly integrated into practice in a number of clinical settings. The purpose of this review article is to examine how video may enhance clinical care during resuscitation. As healthcare and available therapeutic interventions evolve, re-evaluation of accepted paradi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2016-134357
更新日期:2017-08-01 00:00:00
abstract::We report a 44 year old man who developed external ophthalmoplegia and predominantly respiratory, truncal and bulbar weakness with brisk reflexes, histological evidence of an inflammatory myopathy and a high titre of acetylcholine receptor antibodies, one month after starting hydroxyurea and allopurinol for chronic my...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.810.312
更新日期:1993-04-01 00:00:00
abstract::Peyronie's disease can cause severe physical and psychological distress. Of 31 cases in this retrospective study, 12 underwent spontaneous improvement in their symptoms which makes the assessment of active treatment in other patients difficult. The indications and limitations of operative approach are discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.661.773
更新日期:1980-11-01 00:00:00
abstract::A host/vector system suitable for large-scale production of HBsAg has been constructed and optimized in terms of the expression plasmid and yeast host strain in order to permit fermentation to very high cell densities. The final expression plasmid contains the coding sequence of the major HBsAg protein (P24) flanked b...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervou...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134475
更新日期:2017-07-01 00:00:00
abstract::The aortic root links the left ventricle and ascending aorta and functions as a support structure for the aortic valve. It can be affected by a variety of congenital and acquired conditions, some of which are potentially life threatening. Echocardiography and cardiac magnetic resonance imaging are established non-inva...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2008.075531
更新日期:2009-07-01 00:00:00
abstract::This is a case report of a boy who presented with unilateral foot drop approximately 1 year after traumatic injury from skateboarding. Exploratory surgical operation was eventually performed, and histological examination of the surgical specimen revealed leprous peripheral neuropathy of the peroneal nerve. The patient...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.820.111
更新日期:1994-02-01 00:00:00
abstract::A 59 year old woman presented with acute onset of fever, chills, diaphoresis, vague chest discomfort, and was found to be hypotensive and tachypnoeic. An electrocardiogram demonstrated sinoatrial block with a junctional rhythm between 50 and 80 beats/min. All cultures were negative and imaging studies unrevealing. Her...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.937.657
更新日期:2003-11-01 00:00:00
abstract::The majority of deaths in COPD are from cardiovascular causes. Several large randomized controlled trials demonstrate that inhaled anticholinergic agents ipratropium and tiotropium increase the risk of serious cardiovascular events, including cardiovascular mortality. Tiotropium Respimat is associated with a statistic...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2011-201275rep
更新日期:2014-04-01 00:00:00
abstract::The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsucces...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.634.559
更新日期:1978-08-01 00:00:00
abstract::Three patients are described in whom one or more carotid territory transient ischaemic attacks (TIAs) were preceded by sneezing, straining, or bending over. It is argued that the mechanism involved dislodgment of embolic material from the site of carotid atheroma. This mechanism should be considered as an alternative ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.881.145
更新日期:1999-03-01 00:00:00
abstract::Episodic muscular weakness, commonly associated with alterations of serum potassium, is the cardinal feature of periodic paralysis. The combination of transient hyperkalaemia and rigors occurring during febrile episodes of malaria is suggested as the underlying cause which precipitated the muscular paralysis. Three pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.667.273
更新日期:1981-05-01 00:00:00
abstract::Vasoconstriction increases impedance to ventricular ejection and impairs the performance of the dilated myopathic heart. Vasodilator drug therapy by reducing vascular resistance, increasing vascular compliance and increasing vascular capacitance improves cardiac function and relieves the signs and symptoms of congesti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.728.599
更新日期:1986-06-01 00:00:00
abstract::A double-blind, randomized clinical trial comparing cefaclor with amoxycillin in the treatment of acute otitis media with effusion (OME) in infants and children is being conducted at Children's Hospital of Pittsburgh. Although the randomization code has not yet been broken, the results of treating the first 55 childre...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00
abstract::The treatment of renal anaemia by recombinant human erythropoietin (EPO) is now well established. Several studies have examined the pharmacokinetics and efficacy of the drug given intravenously, intraperitoneally and subcutaneously and there is increasing evidence that the subcutaneous route has several advantages inc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.67.783.9
更新日期:1991-01-01 00:00:00
abstract::Leuco-erythroblastosis has many known associations (Burkett, Cox and Fields, 1965; Weick, Hagedorn and Linman, 1974; Retief, 1964), but the only ones related to drug therapy are the well established response to haematinics (Burkett et al., 1965) and one possible case following anti-epileptic therapy (Retief, 1964). Th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.621.391
更新日期:1977-07-01 00:00:00
abstract::Between 1975 and 1982 in 2 centres in Glasgow, 53 previously untreated patients with aggressive non-Hodgkin's lymphomas received chemotherapy consisting of one of the following regimens-CVP, MOPP, CHOP or BACOP. Twenty nine patients (55%) entered complete remission (CR), 20 (38%) had partial remission (PR) and 4 (7%) ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.735.11
更新日期:1987-01-01 00:00:00
abstract::Fibrosing colonopathy is a recently described complication of cystic fibrosis, of unknown aetiology but possibly related to treatment with high-dose pancreatic enzyme supplements. We have used a whole gut perfusion technique to study subclinical gut inflammation in cystic fibrosis patients; concentrations of haemoglob...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2020-138080
更新日期:2020-07-30 00:00:00