Abstract:
:Myasthenia gravis most commonly affects the ocular muscles. Abnormal fatigability of the involved muscle groups is the most remarkable feature of the physical examination. Recent studies have demonstrated that a thymus-derived antibody plays a role in the pathogenesis of myasthenia gravis, which is now thought to be an autoimmune disorder. Its association with other autoimmune disorders has been recognized for some time. A high index of suspicion is the most essential element in diagnosis. Rapid and reproducible response to administration of anticholinesterase leaves little doubt of the diagnosis, but characteristic EMG findings in myasthenic muscle evoked by repetitive stimulation of peripheral motor nerve are definitive. Anticholinesterase drugs are the mainstay of therapy. Thymectomy is indicated in patients with thymoma and in some young persons with serious disease. Patients who respond poorly to anticholinesterase therapy or surgery are candidates for steroid therapy.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Winkler LH,Winkler GFdoi
10.1080/00325481.1979.11715218subject
Has Abstractpub_date
1979-08-01 00:00:00pages
50-6, 59-63issue
2eissn
0032-5481issn
1941-9260journal_volume
66pub_type
杂志文章abstract::Good personal hygiene is one of the most important measures for control of hepatitis infection. Hepatitis is transmitted by close contact with an infected person or nonhuman primate, exposure to infected food or water, transfusion of infected blood, dialysis, or contact with hepatitis-containing laboratory specimens. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715590
更新日期:1980-11-01 00:00:00
abstract::Many drugs with which to treat reversible obstructive airway disease are available. Beta-adrenergic aerosols are the first line of defense; these are followed, when necessary, by either timed-release theophylline or oral beta-adrenergics. Often, a combination of these drugs must be used to achieve effective relief of ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699911
更新日期:1987-07-01 00:00:00
abstract::Because rates of both opioid prescribing and opioid abuse have increased, drug companies have responded by considering strategies to make opioid formulations less attractive for abuse without compromising safety or efficacy for patients with legitimate pain management needs. The emergence of tamper-resistant opioid fo...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2012.09.2588
更新日期:2012-09-01 00:00:00
abstract::To help you save time in identifying those meetings and courses of greatest interest to you, POSTGRADUATE MEDICINE offers this objectively rated listing as a regular reader service. Each event has been rated on the factors that matter most to you: relevance of the subject to primary care, number of credit hours, cost ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714671
更新日期:1977-11-01 00:00:00
abstract::Preview Although heartburn is the most common symptom of gastroesophageal reflux, many patients with reflux have other, more obscure manifestations. Recognition of all potential signs and symptoms of reflux is important for expeditious management. This article focuses on these atypical presentations and discusses how ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946110
更新日期:1996-04-01 00:00:00
abstract::The primary care physician can often delineate the cause of chest pain in a patient under 21 years of age after a thoughtful, careful, and thorough history and physical examination. Occasionally, an ECG and a chest x-ray film may be helpful. Noncardiac causes for the chest pain should be explored, and if found, the ch...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697888
更新日期:1983-06-01 00:00:00
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 th...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 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::Patients with nonpsychotic mental health and emotional problems are commonly seen by primary care physicians. The objective of this study was to expand the Provisional Diagnostic Instrument-4 (PDI-4) to include a short self-report screen for 5 common anxiety-related diagnoses: panic attack (PA), social phobia (SP), ob...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2011.09.2463
更新日期:2011-09-01 00:00:00
abstract::Hypertension in diabetic patients must be treated aggressively if patients are to benefit from reduced risk of morbidity and mortality. Diabetes itself must be diagnosed promptly, particularly in at-risk patients, so appropriate lifestyle modifications can be made at the earliest opportunity. Although this may reduce ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.04.990
更新日期:2000-04-01 00:00:00
abstract::Unresolved grief refers either to the absence or to the prolongation of normal grief. It is identified by (1) painful response to recall of the deceased, (2) realization of not having accepted the loss or of not being able to grieve, and (3) unaccountable depression, emergence of medical symptoms on the anniversary of...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714374
更新日期:1976-05-01 00:00:00
abstract::Stroke survivors can be plagued by numerous medical complications, including aspiration pneumonia, heart disease, depression, and venous thromboembolism. Given the impairment already caused by stroke itself, these patients require careful management by a comprehensive rehabilitation team. Dr Harvey discusses common st...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.08.552
更新日期:1998-08-01 00:00:00
abstract::When a patient presents with a hard, painless lump in the neck, one should assume that it is a cancer and that it is metastatic from a primary lesion located above the clavicle. A careful physical examination with the appropriate instruments most often will determine the site of the primary lesion. Laryngograms or lat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11714054
更新日期:1975-05-01 00:00:00
abstract::Systolic dysfunction of the heart represents a state of "prerenal" azotemia, in which the excess of total body salt and water is redistributed to venous and interstitial fluid compartments. This results in a diminished effective circulating blood volume and thereby decreases tissue perfusion. The kidneys perceive the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 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::Patients taking immunosuppressive drugs are susceptible to various forms of infection, including dermatologic disease. Recently, atypical manifestations of scabies have been reported in such patients. In the case reported here, a 26-year-old woman who had had a renal transplant and was taking immunosuppressive drugs h...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11699070
更新日期:1985-07-01 00:00:00
abstract::Acquired immunodeficiency syndrome (AIDS) is a new and frightening epidemic. Epidemiology has clearly delineated the mechanisms of spread as sexual intercourse, transfer of blood, and vertical transfer from infected mother to newborn child. Although much remains to be answered about infection with the AIDS virus, pres...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11700636
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVES:Lorcaserin is a selective 5-HT2C (5-hydroxytryptamine 2C) receptor agonist indicated for weight management. Here, we assess the impact of lorcaserin on progression from prediabetes to type 2 diabetes (T2D) and on reversion from prediabetes to euglycemia. METHODS:This is a post hoc analysis of pooled data fr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1178590
更新日期:2016-05-01 00:00:00
abstract::Ingested ethylene glycol is readily absorbed and metabolized into toxic metabolites that can cause CNS depression, cardiopulmonary failure, and renal failure. Thorough history taking, physical examination, and laboratory testing are essential for diagnosis. Careful differential diagnosis is important because symptoms ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.1999.10.1.734
更新日期:1999-10-01 00:00:00
abstract::Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Recent major publications, such as the Action to Control Cardiovascular Risk in Diabetes trial, the Advance in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation tria...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.11.2501
更新日期:2011-11-01 00:00:00
abstract::In some families, predisposition to cancer is caused by a germline mutation in a single gene, which produces an autosomal dominant pattern of cancer transmission. Several hereditary cancer syndromes have been identified and for many of them, genetic testing is clinically available. Determining which patients are at ri...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2000.04.1000
更新日期:2000-04-01 00:00:00
abstract::Evaluation and diagnosis of obstructive lung disease call for careful history taking to distinguish asthma from chronic obstructive pulmonary disease (COPD). A history of atopy and intermittent, reactive symptoms points toward a diagnosis of asthma, whereas smoking and advanced age are more indicative of COPD. Clinica...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2005.03.1593
更新日期:2005-03-01 00:00:00
abstract::The majority of patients can be easily weaned from mechanical ventilation, but a substantial minority pose considerable difficulty. In such cases, the cause of ventilator dependency should be identified and correctable factors should be rectified. An organized plan of management, a team approach, optimal pulmonary and...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700795
更新日期:1991-01-01 00:00:00
abstract::More than half of new mothers may be affected by mood disorders after childbirth. Possible causes and recommended management depend on the type of disorder and its severity. In this article, Dr Knops discusses recognition, prevention, and management of three types of postpartum mood disorders as well as the need for s...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1993.11701624
更新日期:1993-02-15 00:00:00
abstract::Preview The risks associated with diagnostic cardiac catheterization have declined through the years, but the question remains as to which patients should be referred for the procedure. In this article, Drs Walder and Schaller examine present guidelines for different types of heart disease and also review qualificatio...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945967
更新日期:1995-03-01 00:00:00
abstract::The cause, depth, and location of a laceration are major determining factors in its treatment. In all cases, the wound must be completely cleansed with irrigation under pressure and then examined radiographically if necessary and debrided. Successful repair depends on understanding and using the principles of wound he...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700310
更新日期:1988-06-01 00:00:00
abstract::Asthma is a common and eminently treatable disease. Most asthma patients are initially seen by primary care physicians, who are likely to have a significant part in management. Research has provided physicians with a better understanding of the pathophysiologic basis of asthma and new antiasthma agents. Guidelines hav...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.03.416
更新日期:1998-03-01 00:00:00
abstract::The increased utilization of diagnostic procedures has prompted interest in cost-effective laboratory testing. Clinically useful tests-useful in the sense that the patient benefits-are cost effective. The choice of test(s) is determined by the risks and benefits of proposed management. In practice, the first step in c...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715687
更新日期:1981-02-01 00:00:00
abstract::Type 2 diabetes, which is increasing in prevalence, is a multifaceted disease that presents a challenge to the primary care physician. In this article, Drs Flemmer and Vinik review the significant findings of several important clinical trials and present a method of comprehensive staged management to improve the quali...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.5.1.1064
更新日期:2000-05-01 00:00:00
abstract::Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes mellitus (T2DM) and is associated with poor clinical outcomes, including an increased risk of all-cause and cardiovascular mortality, as well as adverse economic and social effects. Slowing the development and progression of CKD remains an unme...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2019.1601404
更新日期:2019-05-01 00:00:00