Abstract:
:Severe gastroesophageal reflux disease is usually a chronic problem with periods of relapse, but effective medical and surgical therapies are available. Two recently introduced agents, omeprazole (Prilosec) and cisapride (Propulsid), represent advances in medical therapy; the safety of long-term, continuous omeprazole therapy is under investigation. Used by surgeons with sufficient experience, the new laparoscopic approach offers potential advantages over conventional anti-reflux surgery in suitable candidates. The decision of whether to recommend long-term medical therapy or surgery must be individualized. Medical therapy may be the best choice in elderly patients and poor surgical candidates, in patients whose symptoms are well controlled with omeprazole and who accept its benefit-risk profile, and when a highly experienced anti-reflux surgeon is not available. Surgery may be appropriate (assuming a skilled surgeon is available) in patients who are young, have trouble taking medication, need multiple agents to control symptoms, and need continuous omeprazole therapy but are unwilling to accept the theoretical risk of gastric carcinoid tumors that accompanies it.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Marshall JBsubject
Has Abstractpub_date
1995-05-01 00:00:00pages
98-106issue
5eissn
0032-5481issn
1941-9260journal_volume
97pub_type
杂志文章,评审abstract::A carefully taken history and thorough physical examination remain the most crucial aspects of diagnosing rheumatic disorders. Non-rheumatologic conditions also need to be kept in mind. Laboratory tests should be looked on as mostly supportive or confirmatory, because many of the tests are relatively nonspecific and m...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700818
更新日期:1991-02-01 00:00:00
abstract::The mere presence of uterine fibroids is not, since qua non, an indication for their surgical removal. Knowing when not to operate is probably more important for the physician than knowing when to operate. It is easy to fall into diagnostic and therapeutic traps when uterine fibroids are known to be present, especiall...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::Recurrent herpes simplex labialis (HSL), also known as orofacial herpes or cold sores, is a common clinical presentation of herpes simplex virus (HSV) infection. It may manifest as painful, distressing, and cosmetically displeasing vesicles on the lips, nose, and nasal septum. Although oral or topical treatment with a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.09.2216
更新日期:2010-09-01 00:00:00
abstract::The maximal exercise stress test continues to be an important diagnostic and prognostic tool in the primary care office setting. But are you getting the most accurate information possible? Drs Driggers and Marchant discuss several factors that are crucial to the test's validity--and thus to its usefulness in your clin...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.05.1.737
更新日期:1999-05-01 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::In an era when air travel is commonplace, middle ear block is not unusual. Educating patients about the simple techniques they can perform at the first signs of a problem may save a business trip or vacation from becoming a trip to the emergency department and a train ride home. The most important preventive measure i...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract::Syncope is a common complaint that is frequently evaluated without identifying a precipitating cause. Gelastic (laughter-induced) syncope is an uncommon and poorly understood condition. We describe 3 patients who experienced loss of consciousness during vigorous laughter. Each patient had an extensive medical evaluati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.11.2231
更新日期:2010-11-01 00:00:00
abstract::Since the introduction of estimated glomerular filtration rate (GFR), the number of patients with chronic kidney disease (CKD) has considerably increased. This is particularly true for elderly patients as the majority have a low GFR. Chronic kidney disease has a significant impact on a patient's outcome. We have revie...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.11.1943
更新日期:2008-11-01 00:00:00
abstract::Preview Although headaches in elderly patients are usually benign, they are common and some can be life-threatening. Precise diagnosis is imperative for optimum pain management and early detection of underlying organic disorders. Dr Ruoff discusses the primary types of benign headache, current diagnostic criteria, and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945773
更新日期:1993-12-01 00:00:00
abstract::Primary prophylaxis is advisable for all patients with moderate-sized or large esophageal varices. After the first episode of bleeding, secondary prophylaxis should be initiated to prevent rebleeding. Multiple treatment modalities are available for each circumstance. Optimal regimens have not yet been established but ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2006.11446045
更新日期:2006-09-01 00:00:00
abstract::The sexual addiction model enables physicians to understand the self-destructive behavior of patients whose actions may otherwise appear inexplicable. When a person is preoccupied with sex and continues to engage in compulsive sexual activity despite adverse consequences (eg, loss of marriage, job, health, freedom), h...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701111
更新日期:1991-11-01 00:00:00
abstract::Thymomas may be discovered during routine evaluation, through reported symptoms, or increasingly, during evaluation for myasthenia gravis. Histologic details of these tumors have little bearing on prognosis or evaluation of malignant potential. Malignancy is determined by evidence of invasion through the tumor capsule...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699321
更新日期:1986-03-01 00:00:00
abstract::Proper treatment of non-insulin-dependent (type II) diabetes presents the physician with a number of choices. Diet and exercise should be tried first in many patients; if this regimen is unsuccessful, treatment with either insulin or a first- or second-generation sulfonylurea must be considered. Theoretically, second-...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699825
更新日期:1987-05-01 00:00:00
abstract::An exploratory subgroup analysis of a prospective, randomized, double-blind, forced-titration study comparing the efficacy and safety of once-daily olmesartan medoxomil (OM) and losartan potassium (LOS) in patients with stage 1 or stage 2 hypertension is reported. After a 3- to 4-week placebo run-in period, eligible p...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3810/pgm.2012.05.2549
更新日期:2012-05-01 00:00:00
abstract::Prompt, thorough evaluation is needed when patients present with symptoms of renal colic, acute urinary retention, prostatitis, pyelonephritis, and other urologic emergencies. Primary care physicians have an important role in initial workup and treatment. Once the diagnosis is determined, urologic consultation may be ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.10.100
更新日期:1996-10-01 00:00:00
abstract::Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used to treat inflammatory pain for decades. More recently, newer NSAIDs were developed to target the inducible isoform of cyclooxygenase (COX), COX-2, with the aim of reducing gastrointestinal toxicity. While the COX-2 selective inhibitors were effective...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1412799
更新日期:2018-01-01 00:00:00
abstract::Sleep is increasingly being recognized as an important factor in the homeostasis of multiple body functions, including blood glucose metabolism. One of the most common sleep disorders, obstructive sleep apnea, is not only highly prevalent in patients with type 2 diabetes mellitus, but may contribute to the development...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2012.07.2573
更新日期:2012-07-01 00:00:00
abstract::Recent effectiveness studies have shown that over a year and a half, 3 of 4 study patients either stopped or changed their antipsychotic medication. This finding highlights the fact that psychopharmacologic treatments do not remain stable over the course of treatment. Our own interpretation is that these findings emph...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:Our aim was to investigate the association of liver fibrosis and necroinflammation with HS in untreated young patients with chronic hepatitis B (CHB). MATERIALS AND METHODS:A retrospective study was conducted in a military hospital in Turkey. A total of 254 subjects with CHB were included in this study. The...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1221733
更新日期:2016-09-01 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::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:BACKGROUND:The use of 2-way audiovisual (AV) technology for delivery of acute stroke evaluation and management, termed "telestroke," is supported by a rapidly growing literature base. A systematic review that provides a comprehensive, easily digestible overview of telestroke science and practice is lacking. PURPOSE:To...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.01.2623
更新日期:2013-01-01 00:00:00
abstract::In 90% of children, otitis media with effusion resolves within 3 months. When it persists longer, it is considered chronic. Initial treatment of chronic otitis media with effusion is repeated courses of antibiotics, and a short course of steroids may be appropriate. Use of antihistamines and decongestants has not been...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the pharmacokinetics of lisdexamfetamine dimesylate (LDX), a long-acting prodrug stimulant, and mixed amphetamine salts extended-release (MAS XR), alone or with omeprazole, a proton pump inhibitor (PPI). METHODS:This open-label, randomized, 4-period crossover study enrolled healthy adults (18-45 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2009.09.2048
更新日期:2009-09-01 00:00:00
abstract::Oxygen therapy is tremendously valuable for patients with chronic respiratory insufficiency. A physician's prescription is needed to obtain Medicare, Medicaid, or insurance-company reimbursement, and certain guidelines must be followed: Patients are selected if significant hypoxemia is present, appropriate pharmacolog...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700464
更新日期:1988-11-01 00:00:00
abstract::Heparin and warfarin sodium (Coumadin, Panwarfin, Sofarin) are used most often to treat acute and recurrent venous thromboembolic disease, arterial disease, valvular heart disease, and atrial fibrillation. These agents along with dextran, pneumatic compression devices, and gradient stockings are also used to prevent d...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700985
更新日期:1991-07-01 00:00:00
abstract::Although statin therapy has revolutionized management of coronary heart disease (CHD), the lowering of low-density lipoprotein cholesterol (LDL-C) levels is not the whole story. Increased plasma concentrations of high-density lipoprotein cholesterol (HDL-C) have a cardioprotective effect that is just as important for ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2005.04.1610
更新日期:2005-04-01 00:00:00
abstract::Severe illness of any type predictably leads to abnormal results on thyroid function tests. The first apparent changes are a decrease in total triiodothyronine (T3) and an increase in reverse T3. As disease progresses, a marked decline in thyroxine and an increase in T3 resin uptake are observed. Thyrotropin levels re...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700751
更新日期:1989-06-01 00:00:00
abstract::Hyponatremia (serum sodium <135 mEq/L) is a common electrolyte disorder in community or hospitalized patients. Serum sodium levels should be corrected at a proper rate in patients with hyponatremia, since overcorrection of serum sodium levels is related to devastating neurologic consequences, such as the osmotic demye...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1186488
更新日期:2016-06-01 00:00:00
abstract::The diagnostic survey of the infertile couple usually takes about three months. After semen analysis, the husband is referred for general and urologic examination. The wife is given a general physical and pelvic examination and returns during the next two months for ovulation studies. Tubal patency tests are also perf...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714654
更新日期:1977-10-01 00:00:00