Abstract:
:The term "brain failure" implies only dysfunction of a major organ system, not that an exact diagnosis has been made. Assessment and treatment of older patients with diminished cognitive ability can be challenging; however, the experience can also be extremely rewarding when a reversible condition is alleviated and the patient is given added years of productive life. The first step in patient evaluation is to rule out delirium. The presence of delirium is a medical emergency in a patient of any age. Abrupt onset of cognitive deficit, waxing and waning of symptoms, and worsening of symptoms at night are the hallmarks of delirium. The second step is careful history taking and physical examination to rule out "apparent dementia," a potentially reversible form of brain failure that can mimic irreversible dementia. The third step is to treat what is treatable. Finally, extreme care must be taken in making the diagnosis of true dementia. Diagnosis of such a condition (eg, Alzheimer's disease, multi-infarct dementia, dementia of Parkinson's disease) has a profound effect on the patient and the family. These conditions are largely nontreatable, but physicians still have an important role in helping caregivers find appropriate assistance and support.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Paist SS 3rd,Martin JRsubject
Has Abstractpub_date
1996-05-01 00:00:00pages
125-8, 130-4, 136issue
5eissn
0032-5481issn
1941-9260journal_volume
99pub_type
杂志文章,评审abstract::Although evidence indicates that the incidence of stroke has declined over the past 30 years, stroke remains one of the leading causes of disability and death in the United States. Prevention appears to be the best treatment. According to the Straub Stroke Registry, 52% of strokes in its patient population can be attr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699535
更新日期:1986-09-15 00:00:00
abstract::Both recreational and elite athletes often sustain musculoskeletal injuries. Common problems--muscle cramps, burners (or stingers), and ankle and shoulder injuries--can be managed effectively with certain basic techniques. Initial measures are particularly important in facilitating the injured athlete's rapid return t...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1992-08-03 00:00:00
abstract::When considering conventional therapy with insulin for patients who have type 2 diabetes mellitus, healthcare providers must weigh the advantages and disadvantages of 3 primary approaches to treatment. Understanding the pros and cons of the various options will help physicians more readily identify the treatment appro...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.11.2002.suppl21.112
更新日期:2002-11-01 00:00:00
abstract::Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.05.2148
更新日期:2010-05-01 00:00:00
abstract::Albuminuria has a strong, continuous, direct, linear relationship with adverse cardiovascular (CV) outcomes and chronic kidney disease progression. Even at levels below the accepted upper limit of what is considered "normal" daily albumin excretion (< 30 mg/24 h), a relationship between albumin excretion level and adv...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.07.2031
更新日期:2009-07-01 00:00:00
abstract::Extracorporeal shock wave lithotripsy has become a valuable asset to the urologist and greatly benefits urologic stone patients. Eight years of clinical use have proven its clinical efficacy, with more than 400,000 successfully performed treatments worldwide. In a short period of time, ESWL has completely changed the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700265
更新日期:1988-05-01 00:00:00
abstract::Preview The number of cardiac drugs is growing every day, and their indications are changing as more is learned about each one. Choosing the appropriate drug for each patient is made difficult by these complexities, especially when a patient has already had a heart attack. The authors review the latest trials of the m...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945746
更新日期:1993-11-01 00:00:00
abstract::Gastroesophageal reflux is not synonymous with sliding hiatus hernia. It should be approached as a condition dependent on the intrinsic strength of the lower esophageal sphincter rather than on the presence of a hiatus hernia. The patient's account of symptoms is probably the most important means of diagnosis, but in ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11713946
更新日期:1975-01-01 00:00:00
abstract::Oculoglandular syndrome and swelling of the parotid gland are unusual manifestations of cat-scratch disease. Although exposure to cats is considered an important part of the patient history, an actual cat scratch is not required to establish the diagnosis. Oral fluoroquinolones show promise in the treatment of the inf...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701289
更新日期:1992-04-01 00:00:00
abstract::Preview Early diagnosis of sickle cell disease enables physicians to initiate prompt treatment and provide appropriate education and counseling for patients and their families. In this article, Dr Burdick reviews the management of major complications of the disorder, discusses the psychosocial impact, and examines the...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945940
更新日期:1994-12-01 00:00:00
abstract::Although coronary heart disease (CHD) remains the No. 1 cause of death in the United States, the CHD mortality rate has shown a recent decline. This has been attributed to lower fat consumption in the general population, with associated lower serum cholesterol levels. Thus, diet seems to be an important factor in cont...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698970
更新日期:1985-04-01 00:00:00
abstract::The three most common types of vertiginous episodes area benign positional vertigo, postural vertigo, and endolymphatic hydrops. One of these conditions will be found in more than 90% of patients who present with vertigo as their main complaint. A clear understanding of the differences among these three entities will ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715757
更新日期:1981-05-01 00:00:00
abstract::Objective: Abnormal pro-inflammatory regulation of the immune system might contribute to the pathogenesis of hyperglycemia during pregnancy. We examined the correlations of neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR) with disease severity and assessed their predictive values. Methods: This re...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1764235
更新日期:2020-11-01 00:00:00
abstract::Dementia is one of the most devastating illnesses that affect the elderly. The progressive decline in memory, judgment, intellectual function, and adaptive ability places an immense burden on families, healthcare providers, and communities. Because advancing age is the leading risk factor for most types of dementia, t...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::Preview Hereditary hemochromatosis, once believed to be rare, is now known to affect 1 in 250 to 300 people of northern European descent. Untreated, the disorder can have serious complications, but for patients in whom it is discovered and treated early, the prognosis is good. In this guide to diagnosis and management...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945914
更新日期:1994-11-01 00:00:00
abstract::Many men experience sexual function disorders, the most common of which are PE and ED. However, they may hesitate to seek treatment because of the perceived embarrassment associated with discussing their symptoms with a physician. The introduction of PDE-5 inhibitors for the treatment of ED has resulted in increased a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.04.1761
更新日期:2008-04-01 00:00:00
abstract::Many aspects of Kawasaki syndrome remain a mystery. The cause of the disease has eluded researchers, and its pathophysiology is a subject of much debate. However, the diagnostic features have been identified: A significant fever for at least 5 days, bilateral nonexudative conjunctivitis, erythema of the palms and sole...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Hypoglycemia and fear of hypoglycemia threaten individuals' ability to work and drive. We studied the effect of hypoglycemia on the individual and society, with a focus on possible implications of new European union legislation on patients' continued ability to drive. METHODS:A cross-sectional survey of Dan...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2015.1045815
更新日期:2015-06-01 00:00:00
abstract::Technical advances over the past few years have rapidly increased the possibilities for filmless radiology services provided by PACS. Such systems are also financially feasible for many healthcare practices, primarily because of the goals achieved through increased efficiency and improved patient care. In coming years...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.06.960
更新日期:2001-06-01 00:00:00
abstract::Asthma continues to cause unacceptably high rates of disability and death, largely because the severity of disease is underestimated and patients are inadequately educated about their disease. When patients understand what happens during an asthma attack and its aftermath, they are more likely to notice important symp...
journal_title:Postgraduate medicine
pub_type: 指南,杂志文章,评审
doi:10.1080/00325481.1991.11701034
更新日期:1991-09-01 00:00:00
abstract::It is often difficult to determine the true extent of a burn, but most small thermal burns can be easily evaluated and managed by primary care physicians. In this article, the authors review the characteristics of different types of burns, describe those that require treatment in a burn center, and discuss appropriate...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::Fluoroquinolone-resistant variants of pandemic clones Spain(23F)-1, Spain(6B)-2, Spain(9V)-3, and Spain(14)-5 have been seen in various regions of the United States and the world, leading to the speculation that fluoroquinolone resistance among US Streptococcus pneumoniae may increase because of clonal spread. Using l...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2008.09.suppl52.283
更新日期:2008-09-01 00:00:00
abstract::The prognosis for patients with obsessive-compulsive disorder has improved dramatically in recent years. Primary care physicians, who may be the first healthcare professionals to consult with these patients, can often provide appropriate treatment or therapeutic guidance. Psychiatric consultations and the implementati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.12.807
更新日期:1999-12-01 00:00:00
abstract::The dose and dosing interval for leukotriene receptor antagonists montelukast and zafirlukast in adult asthmatic patients were determined by bronchoprovocation with exercise or leukotriene D4 inhalation. Subsequent dose-ranging studies confirmed that once-daily ingestion of a 10-mg dose of montelukast was effective an...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.09.15.2000.suppl7.40
更新日期:2000-09-15 00:00:00
abstract::The prevalence and public health importance of attention-deficit/hyperactivity disorder (ADHD) as well as its impact on public health has led various groups to develop clinical practice guidelines (CPGs). Clinical practice guidelines are systematically developed statements designed to assist practitioner and patient d...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.09.2203
更新日期:2010-09-01 00:00:00
abstract::Dealing with the complex problem of pregnancy in adolescence may involve working with many people. If the physician approaches the patient with an attitude of acceptance and understanding, the adolescent girl may be helped to make realistic decisions concerning her pregnancy and to adjust in a healthy manner. If she d...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714997
更新日期:1978-12-01 00:00:00
abstract::Simple screening tests are available to detect abnormalities in the plasma coagulation system and platelet function. Prothrombin time reflects the integrity of the extrinsic system, while activated partial thromboplastin time indicates whether the intrinsic system is intact. Thrombin clotting time is a measure of the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715704
更新日期:1981-03-01 00:00:00
abstract::Prompt and accurate diagnosis of patients presenting with symptoms suggestive of pulmonary arterial hypertension (PAH) is of outmost importance as delays in identifying this clinical entity have detrimental effects on both morbidity and mortality. Initial noninvasive assessment of these patients has traditionally incl...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1115715
更新日期:2016-01-01 00:00:00
abstract::Drug-induced jaundice is relatively uncommon but can be a diagnostic puzzle. Because so many pharmaceutical classes and individual agents can produce jaundice, a thorough history of medications taken should be obtained from a patient presenting with jaundice. Jaundice usually resolves when the offending agent is disco...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1988.11700445
更新日期:1988-10-01 00:00:00
abstract::Joint space infections continue to be among the most common forms of arthritis. Diagnosis can be difficult, particularly in the presence of underlying joint disease. Septic arthritis should be suspected in all patients who present with an acutely swollen joint. Immediate joint aspiration with Gram's stain and culture ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699270
更新日期:1986-02-01 00:00:00