Abstract:
:Established postsplenectomy sepsis syndrome, although infrequent, may carry a mortality rate of over 90%. Pneumococcus (Streptococcus pneumoniae) has been the infective organism in more than 50% of published cases. Certain groups, such as infants, patients with hematologic malignancy, and those with compromised humoral immunity, may be especially susceptible. However, even healthy individuals who have been splenectomized because of trauma may be affected. Within the general population there is a significant pool of asplenic or functionally hyposplenic patients who are not aware of their condition. Efforts must be made to identify any such individual at risk for the postsplenectomy sepsis syndrome. The new 23-valent polysaccharide pneumococcal vaccine should be made available to any asplenic or functionally hyposplenic individual. A high index of suspicion must be maintained for febrile illness in asplenic patients, and if such an illness occurs, a vigorous investigation is mandatory.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Brigden MLdoi
10.1080/00325481.1985.11699039subject
Has Abstractpub_date
1985-06-01 00:00:00pages
215-8, 221, 224-6issue
8eissn
0032-5481issn
1941-9260journal_volume
77pub_type
杂志文章abstract::Legg-Calvé-Perthes disease affects children, mostly boys, in the age range of 3 to 12 years. Severity and duration are quite variable. Catterall's classification of disease according to degree of femoral head involvement is of real prognostic value. Other factors of prognostic importance are loss of motion, metaphysea...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714449
更新日期:1976-10-01 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::Providing medical care for patients with mental disabilities may be challenging and financially unappealing because of the need for extra time and effort. Nonetheless, primary care physicians can meet the medical needs of these patients and benefit from working with a team approach that fosters open communication and ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.1999.11.776
更新日期:1999-11-01 00:00:00
abstract::When patients have a clear understanding of the etiology and pathophysiology of Parkinson's disease, management is easier for the physician and the patient is better able to cope with the disease. Patients also should be made aware of the proper use of antihistamines and anticholinergics that control tremor, as well a...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715531
更新日期:1980-09-01 00:00:00
abstract::The patient with jaundice may be accurately diagnosed through clinical history, physical findings, and noninvasive laboratory and radiologic examinations available in most community hospitals. Ultrasonography is usually the procedure of choice in initial evaluation, but if acute cholecystitis is suspected, hepatobilia...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::In the next 30 years, the average age of the population will continue to increase, as will the prevalence of dementia. The management of advanced dementia requires the careful orchestration of communication, prognostication, patient care, and caregiver education. Understanding the specific tools available to establish...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2014.10.2826
更新日期:2014-10-01 00:00:00
abstract::Acute intermittent porphyria is an unusual syndrome that may be very difficult to differentiate from acute intraabdominal processes. Diagnosis requires the documentation of increased urinary porphobilinogen. Failure to perform appropriate tests early in the attack may necessitate diagnostic laparotomy to rule out intr...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704454
更新日期:1989-10-01 00:00:00
abstract::The important causes of hypoglycemia unrelated to known diabetes are relatively few. Postprandial hypoglycemia is a relatively benign disorder. Fasting hypoglycemia is more serious and may be caused by metabolic disturbances or tumors. Several hereditary disorders cause hypoglycemia in infants and must be diagnosed an...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716369
更新日期:1990-07-01 00:00:00
abstract::Preview Manifestations of thyroid dysfunction may be totally misleading in severely ill and elderly patients, often confounding clinical diagnosis. To prevent undue morbidity and mortality in these patients, appropriate selection and accurate interpretation of thyroid function tests are crucial. In this article, Dr Is...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945709
更新日期:1993-09-01 00:00:00
abstract::Obesity is currently a worldwide epidemic, and will likely only increase in prevalence in the coming years. The incidence of the metabolic syndrome (MetS) seems to be paralleling obesity. The MetS is strongly linked to insulin resistance, abdominal obesity, diabetes mellitus, and dyslipidemia. Nonalcoholic fatty liver...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.07.1800
更新日期:2008-07-31 00:00:00
abstract::Lyme disease can be difficult to recognize because not all patients have erythema migrans or other classic symptoms. Therefore, laboratory testing has become an important aid to clinical diagnosis. But the story doesn't end there-serologic testing presents another set of problems and concerns. Drs. Still and Ryan expl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.1997.07.260
更新日期:1997-07-01 00:00:00
abstract::Chronic neck and shoulder pain is a complex, multifactorial problem. Often many months have passed since its onset. During this time the patient may have seen many physicians and tried many medications, some with abuse potential. Most patients are depressed and have lost their ability to cope with the stresses of dail...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698897
更新日期:1985-02-15 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::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::All lumps in the parotid region must be assumed to originate in the parotid gland. A mobile, superficial-appearing lesion cannot be assumed to be located just beneath the skin. Open incisional biopsy should never be used in approaching lumps in this region because of the danger of tumor seeding or damage to the facial...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699754
更新日期:1987-03-01 00:00:00
abstract::Despite a plethora of clinical guidelines and evidence outlining the efficacy of inhaled corticosteroids, these medications continue to be underused in the treatment of asthma. This article reviews the justification for prescribing inhaled steroids as first-line therapy, discusses indications for their use, and compar...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.05.924
更新日期:2001-05-01 00:00:00
abstract::An understanding of the causes and course of acute allergic contact dermatitis aids in recognition of this common problem. The most frequent cause is the Rhus group (poison ivy, oak, and sumac), and a large percentage of the US population is sensitized to this group of allergens. With severe cases, prompt administrati...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704608
更新日期:1990-03-01 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::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::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::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::The first step in evaluation of a presumed seizure is to determine whether the event was indeed a seizure and which diagnostic studies are needed. The second step is to correctly diagnose the seizure on the basis of the medical history and findings from the physical, neurologic, and laboratory evaluation. The third st...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2002.01.1074
更新日期:2002-01-01 00:00:00
abstract::Although chronic hepatitis B is a relatively common disease that may have a serious outcome, the outlook is by no means uniformly poor. Alpha interferon therapy may be helpful in up to one third of patients who have hepatitis B e antigen in serum and elevated serum aminotransferase levels. New drugs that may have even...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 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::Vasculitis encompasses a wide variety of diseases. Because diagnosis may be difficult, a careful evaluation is essential, including a detailed patient history, thorough physical examination, and appropriate laboratory studies. Diagnosis is based on clinicopathologic features that permit identification of the condition...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700988
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVES:We aimed to determine the prevalence of chronic diseases and unhealthy lifestyle behaviors of Turkish doctors as compared with the general population and the frequency of compliance with preventive clinical practices among doctors. METHODS:This was an observational, prospective cohort study that enrolled gr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2017.1272399
更新日期:2017-04-01 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::The toxic effects of cocaine are becoming more widely recognized as the popularity of the drug increases. Although overdose is usually fatal, treatment is available for users who experience agitation, seizure, arrhythmias, severe hypertension, or other side effects. Hospital admission is often necessary to allow monit...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701173
更新日期:1992-01-01 00:00:00
abstract::Diarrhea is a common gastrointestinal problem in diabetes, and its prevalence has been underestimated. The cause of diabetic diarrhea is unknown, but it is probably related to gastrointestinal motility disturbances secondary to diabetic autonomic neuropathy. Other causes (especially primary malabsorption syndromes and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701372
更新日期:1992-06-01 00:00:00
abstract::When many physicians think of managed care, they think first of Kaiser Permanente, the nation's largest HMO. That perception is misguided, according to David M. Lawrence, MD, the chief executive officer and chairman of the boards of the Kaiser Foundation health plan and hospitals. During a phone interview recently, La...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945854
更新日期:1994-05-15 00:00:00