Abstract:
:Difficult or painful coitus is a symptom, not a pathologic entity. It may be caused by a congenital anomaly, an organic lesion, or a functional disorder of the vulva or vagina, or it may be psychic in origin. Although its cause can usually be determined relatively easily, a conditioned reflex created by a preexisting organic lesion, an anatomic malformation, or a deep-seated psychogenic problem producing fear of or aversion to sexual contact may tax the examiner's diagnostic ability. Reassurance, sexual counseling, deconditioning by vaginal dilation, and psychotherapy help most patients overcome dyspareunia. Surgery for the correction of congenital anomalies or the removal of organic lesions is sometimes required, but diligent evaluation to exclude a psychogenic factor for dyspareunia is first advisable.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Huffman JWdoi
10.1080/00325481.1983.11697774subject
Has Abstractpub_date
1983-02-01 00:00:00pages
287-96issue
2eissn
0032-5481issn
1941-9260journal_volume
73pub_type
杂志文章abstract::Sjögren's syndrome is a chronic, systemic, autoimmune inflammatory disorder characterized by lymphocytic infiltration of exocrine glands, most notably the salivary and lacrimal glands. It results in loss of functional epithelium, diminished exocrine function, and gradual onset of dryness of the eyes, mouth, and other ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2004.09.1587
更新日期:2004-09-01 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::The present staging methods for non-small-cell lung cancer provide little more than epidemiologic assessment of prognosis for grossly defined groups of patients. Except in extreme instances, physicians can tell patients very little about their prognosis or the need for supplemental therapy. More effective and less tox...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704526
更新日期:1990-01-01 00:00:00
abstract::Not all of the costs of private practice, particularly those related to government regulation, are within your control. However, there are steps, both large and small, that you can take to get fees under control and to eliminate or reduce expenditures. Dr Orient suggests a number of these. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1994-02-15 00:00:00
abstract::The cutaneous manifestations of systemic diseases are diverse. In some cases, they are the first signs of an underlying disorder, such as Cowden's disease, dermatomyositis, and Lyme disease. Sister Mary Joseph's nodule (metastatic involvement of the umbilicus) is an ominous sign of internal malignant disease. Drug-ind...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::In most cases, the cause of facial paralysis can be determined on the basis of the clinical evaluation, and expensive diagnostic tests can be avoided. Because Bell's palsy is not always the cause, physicians need to be able to identify critical findings on history and physical examination that indicate an alternative ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.06.522
更新日期:1998-06-01 00:00:00
abstract:STUDY OBJECTIVES:To compare the safety and efficacy of U.S. Food and Drug Administration (FDA)-recommended doses of labetalol and nicardipine for hypertension (HTN) management in a subset of patients with renal dysfunction (RD). DESIGN:Randomized, open label, multicenter prospective clinical trial. SETTING:Thirteen U...
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.2014.07.2790
更新日期:2014-07-01 00:00:00
abstract::The esophageal obturator airway is a relatively new addition to equipment for emergency resuscitation. It is simple to use after minimal training and can be inserted quickly without laryngoscopic visualization. Problems are uncommon. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715374
更新日期:1980-02-01 00:00:00
abstract::High blood pressure is unquestionably a risk factor for premature morbidity and mortality, especially from coronary artery disease and stroke. Risk of clinical manifestations of coronary artery disease increases dramatically if other risk factors, such as a history of cigarette smoking, hypercholesterolemia, left vent...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11704482
更新日期:1989-11-01 00:00:00
abstract::A varied and balanced diet is usually adequate to meet the energy, protein, vitamin, and mineral requirements of adults and the elderly. However, some high-risk groups may require supplementation or special dietary recommendations. Some examples are persons on a weight-loss diet, alcoholics, premenopausal women, women...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699819
更新日期:1987-05-01 00:00:00
abstract::A young man with exertional dyspnea, maculopapular skin lesions, and generalized lymphadenopathy was found to have a posterior mediastinal density on a chest roentgenogram. Sarcoidosis was diagnosed on the basis of lymph node and skin biopsy findings, and corticosteroid therapy was started. After six months of treatme...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11715957
更新日期:1982-01-01 00:00:00
abstract::Pulmonary artery hypertension (PAH) refers to several subgroups of disease in which the mean pulmonary artery pressure (mPAP) is elevated to more than 25 mm Hg, pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg, and an elevated pulmonary vascular resistance (PVR) > 3 Wood units as confirmed by right heart catheterizati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1188664
更新日期:2016-06-01 00:00:00
abstract::When ascites is the presenting symptom and the underlying disease is not apparent, the physician must be aware of the various diseases that may be associated with the accumulation of serous fluid in the abdominal cavity and the various approaches that are available to aid in the differential diagnosis. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11712201
更新日期:1977-05-01 00:00:00
abstract::Chronic stable angina (CSA) impairs patient quality of life, is associated with increased patient mortality, and is a prominent symptom of coronary artery disease (CAD), the latter being prevalent worldwide in patients. Currently, therapeutic options for patients with CSA include β-blockers, calcium channel blockers, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.11.2711
更新日期:2013-11-01 00:00:00
abstract::The case described here illustrates the need to consider milk-alkali syndrome in the differential diagnosis of hypercalcemia, even in this age of histamine2 blockers and mucosal protectors. Thorough history taking and gastrointestinal workup help rule out alternative causes of hypercalcemia, such as cancer, hyperparat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11701690
更新日期:1993-05-01 00:00:00
abstract::Viral diseases are an important cause of morbidity and mortality in elderly patients, whether they live in the community or in long-term care facilities. Management of viral infections in older adults is complicated by factors that include the infrequency or absence of common signs and symptoms of infection and advers...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2005.11.1687
更新日期:2005-11-01 00:00:00
abstract::The evaluation of the bleeding patient starts with the integration of data from the history and physical examination. From this results either one probable explanation that can easily be substatniated by laboratory studies or, as more commonly occurs in practice, several possibilities that are reasonable and must be i...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11712257
更新日期:1977-07-01 00:00:00
abstract::Bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to min...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.07.607
更新日期:1999-07-01 00:00:00
abstract::Nearly 1 in 5 Americans will struggle with major depression in their lives; some will have recurring bouts. Recent psychiatric research has given new attention to the prevalence of cognitive deficits in major depression and the impact such deficits have on remission and overall life functioning. When depression is par...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1221318
更新日期:2016-09-01 00:00:00
abstract::Two cases of Listeria monocytogenes infection in patients receiving immunosuppressive treatment after kidney transplantation are described. In the first, the infection, which occurred soon after transplantation and was accompanied by signs of mild chronic rejection, was the immediate cause of death. The other case occ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715622
更新日期:1980-12-01 00:00:00
abstract::Although the link between cigarette smoking and its cardiovascular effects is well established, the mechanisms through which smoking raises blood pressure remain to be clarified. Possible mechanisms include nicotine-induced peripheral and central sympathetic nervous system stimulation, persisting levels of nicotine in...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.11.114
更新日期:1996-11-01 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::With use of the International Normalized Ratio (INR), physicians can accurately assess the intensity of anticoagulation in treatment programs and trials. Bleeding is the major complication of oral anticoagulant therapy, and its incidence can be lessened, with no loss of efficacy, by using less intense therapy (INR, 2 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVES:The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misu...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1448207
更新日期:2018-05-01 00:00:00
abstract::During the last few years, the number, variety, and complexity of nuclear medical examinations that can be performed in children have increased impressively, due partly to recent accomplishments in radiopharmaceutical development and the availability of gamma scintillation cameras and computer systems for acquisition,...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11713991
更新日期:1975-03-01 00:00:00
abstract::Looking back at the long history of cancer, we can still relate to that POSTGRADUATE MEDICINE editorial written 50 years ago: "None of the basic problems of cancer has been solved. The death rate is constantly mounting. Small wonder that many doctors face cancer with a pessimism bordering on resignation." The temptati...
journal_title:Postgraduate medicine
pub_type: 历史文章,杂志文章
doi:10.3810/pgm.1997.09.307
更新日期:1997-09-01 00:00:00
abstract::Granulomatous inflammation of the peritoneal surfaces resulting from exposure to cornstarch granules from surgical gloves produces a syndrome of abdominal pair, adynamic ileus, fever, peritonitis, variable white blood cell count, and inflammatory ascites. Symptoms develop three to four weeks after a routine abdominal ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11716541
更新日期:1976-01-01 00:00:00
abstract::Primary care physicians often encounter epistaxis. Its treatment may involve nasal sponge tampons, double-balloon nasal catheters, and anterior gauze with posterior Foley catheters, depending on the location of the bleed. Topical anesthetic and decongestant agents are essential, and intravenous analgesia, which enhanc...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2006.06.1647
更新日期:2006-06-01 00:00:00
abstract::Preview Congestive heart failure (CHF) is a common and serious problem, and its diagnosis and treatment should not be the exclusive province of the cardiologist. Primary care physicians can very adequately manage most cases in a cost-effective manner. In this article, Dr Seager gives guidelines for a standard approach...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946074
更新日期:1995-11-01 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