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-generation agents are more advantageous than first-generation agents because they do not interact with other drugs. I do not believe that they are more efficacious, however, and they probably do not have fewer side effects if chlorpropamide (Diabinese) is eliminated from consideration. Future well-designed crossover studies may help to clarify this issue. Combined insulin and sulfonylurea therapy can be tried in obese patients resistant to large doses of insulin, although results are not dramatic. In all patients the goal is to reach acceptable fasting glucose levels and near-normal glycosylated hemoglobin values.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Nelson RLdoi
10.1080/00325481.1987.11699825subject
Has Abstractpub_date
1987-05-01 00:00:00pages
177-81, 184-6issue
6eissn
0032-5481issn
1941-9260journal_volume
81pub_type
杂志文章abstract::Electroconvulsive therapy is controversial and readily arouses the passions of both its supporters and detractors. In this article, Dr Schoen, an internist, discusses various aspects of this 50-year-old technique, including risks, contraindications, and physiologic effects. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716347
更新日期:1990-05-01 00:00:00
abstract::Combination therapy is a cost-effective and rational approach to treatment of severe hypertension and of mild to moderate hypertension that is refractory to monotherapy. The method has several advantages, most notably improved tolerability and enhanced antihypertensive efficacy. Long-term prospective studies are neede...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.09.581
更新日期:1998-09-01 00:00:00
abstract::The use of topical tretinoin (Retin-A) for comedonal lesions, benzoyl peroxide for inflamed papules and pustules, and topical or oral antibiotics for more severe or widespread disease gives excellent results for the majority of patients with acne. At present, oral isotretinoin (13-cis-retinoic acid) (Accutane) should ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698996
更新日期:1985-05-01 00:00:00
abstract::Inflammatory bowel disease is a conglomeration of disorders of unclear etiology and pathogenesis. Confirming the diagnosis of active disease may be difficult but is critical to judicious therapy. Sulfasalazine (Azulfidine) and its newer derivatives mesalamine (Asacol, Rowasa) and olsalazine sodium (Dipentum) are used ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701512
更新日期:1992-11-01 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::Over the past decade, despite the controversies surrounding prostate cancer screening, significant refinements have improved its application. PSA screening, although it has been questioned, appears to confer a mortality benefit and remains the most effective way to identify the possible presence of prostate cancer. Me...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1822067
更新日期:2020-12-01 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::Bedside pulmonary artery catheterization has proven to be an important addition to the clinical assessment of critically ill patients. Properly used, the procedure may provide hemodynamic information that is not apparent from physical examination or radiography. It may be safely accomplished through various venous rou...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700825
更新日期:1991-02-01 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
abstract::Anemia is one of the consistent findings with inflammation. Whether the anemia is helpful or harmful in the general context of the illness is unclear. It may be recognized by demonstration of iron-deficient erythropoiesis due to an internal block in iron supply. Only when its severity is disproportionate to the severi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714951
更新日期:1978-10-01 00:00:00
abstract:BACKGROUND:Prescription opioids have substantial abuse potential. This study compared the positive subjective drug effects of a newly developed extended-release (ER) oxycodone (OC)/acetaminophen (acetyl-para-aminophenol [APAP]) formulation with those of immediate-release (IR) OC/APAP. METHODS:This randomized, double-b...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2014.07.2780
更新日期:2014-07-01 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::Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association w...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2015.1032180
更新日期:2015-04-01 00:00:00
abstract::As understanding of the natural history of breast cancer has increased, radical mastectomy has given way to a preference for breast-sparing surgery and greater reliance on radiation therapy and chemotherapy. Probably the most important factor for selection of treatment is consultation with a multidisciplinary team ski...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704444
更新日期:1989-10-01 00:00:00
abstract::A woman with excessive body hair may visit a physician with concerns about fertility and general health as well as appearance. Fortunately, the cause is usually benign, most often polycystic ovarian syndrome. However, life-threatening causes must be quickly ruled out. Hirsutism secondary to endocrinopathies and tumors...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::Venous thromboembolism is a serious and, often, asymptomatic complication of hip surgery. A reliable screening test is needed to detect thrombi early to prevent death from pulmonary emboli. Noninvasive screening tests were ineffective in our study of 453 patients. We recommend early use of ventilation/perfusion lung s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699529
更新日期:1986-09-15 00:00:00
abstract::GRATEFUL MED is a computer program for searching the medical literature, designed with the novice in mind. It contains an extensive list of medical subject headings, so the user does not have to page through an index of key words before starting the search. Because of its efficiency and ease of operation, the program ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700124
更新日期:1988-01-01 00:00:00
abstract::Because of the broad range of physiologic problems and the many potential sources of complications, liver transplantation patients require contributions from virtually the complete spectrum of medical science. The evolving specialty of liver transplantation has eagerly assimilated advances in surgical techniques, anes...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704566
更新日期:1990-02-01 00:00:00
abstract::Human growth and development are a continuum starting at conception. Prenatal growth can only be estimated at present but is an important consideration in an evaluation of a child's developmental status. Postnatal growth can be assessed for size attained (distance curve) or change over time (velocity curve). Velocity ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714699
更新日期:1977-12-01 00:00:00
abstract::Nasal congestion is considered the most bothersome of allergic rhinitis (AR) symptoms and can significantly impair ability to function at work, home, and school. Effective management of AR-related nasal congestion depends on accurate diagnosis and appropriate treatment. Many individuals with AR and AR-related congesti...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.01.1961
更新日期:2009-01-01 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::Pseudomonas aeruginosa infections are a frequent cause of morbidity and mortality in hospitalized patients. Treatment of these infections is complicated by the intrinsic and acquired resistance of this bacterium to many commonly used antimicrobial agents. In this article, Drs Hauser and Sriram argue that careful consi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2005.01.1571
更新日期:2005-01-01 00:00:00
abstract::Hair loss is a common problem likely to be encountered by a clinical practitioner. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. In the adult population, causes to be considered are alopecia areata and hair loss associated w...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699358
更新日期:1986-04-01 00:00:00
abstract::As efforts to improve screening for colon cancer have increased, so has the importance of routine flexible sigmoidoscopy. However, the procedure is still underused, and about half of primary care physicians who recommend it refer their patients to other physicians. Increased use of this valuable screening tool is an i...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.06.622
更新日期:1999-06-01 00:00:00
abstract::Varicose veins are a common problem that still presents a major challenge to the physician and the patient. Complete surgical removal of the malfunctioning veins has proved to be the most effective management for significant varicosities, although several nonsurgical methods are available for mild cases or those not s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715178
更新日期:1979-06-01 00:00:00
abstract::Occlusive peripheral arterial disease is rather easy to diagnose because of its characteristic symptoms and the ease with which the extremities and their circulation can be examined. Elevation and dependency tests give a rough but reliable estimate of the degree of ischemia, and if more objective data are desired, the...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11715993
更新日期:1982-02-01 00:00:00
abstract::Preview Several dermatoses are potentially fatal, and the mortality rate for some is quite high; prompt recognition and treatment are essential. Dr Gannon's succinct discussions of pemphigus vulgaris, necrotizing fasciitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, toxic shock syndrome, and urticaria and a...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945875
更新日期:1994-07-01 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::In the face of deficiencies in our present system of introducing new drugs, clinicians must be committed to monitoring patients carefully. They must not be caught up in the hyperbole and excitement of the latest new drug, but instead should allow the crucible of time to teach them and the rest of the medical community...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697799
更新日期:1983-03-01 00:00:00
abstract::Sinusitis may present as an indolent infection, without the classic symptoms and signs commonly expected, and will probably be missed in children who have only cough and persistent rhinorrhea unless this diagnosis is kept in mind. Plain radiography is the most commonly used diagnostic procedure for sinusitis, but comp...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704634
更新日期:1990-04-01 00:00:00