Differential diagnosis of jaundice. Hepatocellular versus obstructive disease.

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, hepatobiliary scintigraphy is highly reliable and easy to perform. Computed tomography (CT) should be used if ultrasonography has not yielded the information needed; however, transient biliary obstruction cannot be diagnosed with CT unless ductal dilatation is present. The presence of laboratory data indicative of almost certain parenchymal liver disease should alert the physician to avoid unnecessary tests that are both costly and potentially dangerous. The final assessment of biliary duct patency may require transhepatic or retrograde cholangiography. Both procedures are effective but carry important potential complications.

journal_name

Postgrad Med

journal_title

Postgraduate medicine

authors

Marin GA

subject

Has Abstract

pub_date

1987-01-01 00:00:00

pages

178-82, 187-8

issue

1

eissn

0032-5481

issn

1941-9260

journal_volume

81

pub_type

杂志文章
  • Treating dysthymia and minor depression in primary care.

    abstract::In the fast-paced setting of primary care, it is difficult to detect psychiatric disorders, especially the more subtle disorders, such as minor depression and dysthymia. In cases of dysthymia, in particular, the patients themselves may not even have a sense that anything medically treatable is wrong; they feel as thou...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.3810/pgm.11.2003.suppl29.159

    authors: David AK

    更新日期:2003-11-01 00:00:00

  • HPV and cervical cancer: updates on an established relationship.

    abstract::Despite cervical cancer being considered a preventable disease, it still remains the second most common malignancy in women worldwide, with a higher incidence in underdeveloped countries. Human papillomavirus (HPV) is considered the causative agent of cervical cancer. The major mechanisms through which HPV contributes...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2008.11.1928

    authors: Subramanya D,Grivas PD

    更新日期:2008-11-01 00:00:00

  • The chronic pain syndrome: a physical and psychologic challenge.

    abstract::The chronic pain syndrome differs from chronic pain. The syndrome is a psychologic stress state that can produce physical-type illness, often with musculoskeletal manifestations. It tends to strike the "worried well," by nature hysterical, depressed, hypochondriacal, and dependent. Standard medical, surgical, and psyc...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1981.11715917

    authors: Florence DW

    更新日期:1981-11-01 00:00:00

  • Brain failure in older patients. Uncovering treatable causes of a diminished ability to think.

    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:

    authors: Paist SS 3rd,Martin JR

    更新日期:1996-05-01 00:00:00

  • Adolescent sexual intercourse. Strategies for promoting abstinence in teens.

    abstract::As sex, drugs, and rock 'n' roll have given way to STDs, HIV, and AIDS, adolescent sex has become an increasingly high-risk behavior. Dr Kay strongly believes that primary care physicians can have a prominent role in educating teens and their parents about the consequences of premature sexual activity and in promoting...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Kay LE

    更新日期:1995-06-01 00:00:00

  • Diagnostic cardiac catheterization.

    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

    authors: Walder LA,Schaller FA

    更新日期:1995-03-01 00:00:00

  • Intractable diarrhea of infancy. An alternative treatment strategy.

    abstract::Prolonged diarrhea in an adult is a serious problem; in an infant it is life threatening. Conventional therapy for intractable diarrhea of infancy, which involves use of clear liquids and gradual reintroduction of cow's milk or formula, works in most situations. However, for some infants this type of management exacer...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1983.11698385

    authors: Lebenthal E,Rossi TM

    更新日期:1983-08-01 00:00:00

  • Modulation of the gut microbiota: a focus on treatments for irritable bowel syndrome.

    abstract::Irritable bowel syndrome (IBS), which is characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. IBS is a substantial burden on both patient health-related quality of life and healthcare costs. Several pathophysiologic mechanisms have been postulated...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.2017.1383819

    authors: Harris LA,Baffy N

    更新日期:2017-11-01 00:00:00

  • Severe Pseudomonas aeruginosa infections. Tackling the conundrum of drug resistance.

    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

    authors: Hauser AR,Sriram P

    更新日期:2005-01-01 00:00:00

  • Colorectal carcinoma: overview of management techniques.

    abstract::The fact that the national death rate from carcinoma of the colon and rectum has remained static over the past two decades is strong incentive for future investigation of measures to allow detection in its early and more favorable stage. Although no significant improvements in surgical techniques have afforded improve...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1979.11715249

    authors: Bland KI,Garrison RN,Knutson CO

    更新日期:1979-09-01 00:00:00

  • Life-threatening neck infections. Early diagnosis to forestall crisis.

    abstract::Infections of the neck become life-threatening with airway or systemic involvement. The first step in successful management is early recognition by the initial examiner. Patient evaluation includes a thorough history and physical examination, laboratory studies, and if the patient's condition is stable, roentgenograph...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1984.11698815

    authors: Beck HJ,McCaffrey TV

    更新日期:1984-12-01 00:00:00

  • Recognizing glaucoma. A guide for the primary care physician. .

    abstract::Glaucoma is a group of diseases leading to characteristic cupping and damage of the optic nerve head associated with progressive visual loss. The exact mechanism of damage is unknown, but current research is pointing toward a multifactorial disease process, in which elevated intraocular pressure is just one of the fac...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Chaudhry I,Wong S

    更新日期:1996-05-01 00:00:00

  • Oral trauma. Emergency care of lacerations, fractures, and burns.

    abstract::Emergency physicians are usually the first to see patients with injuries to oral and facial tissues. Because many of these patients may have life-threatening neurologic injuries, secondary oral and perioral problems may be overlooked initially. These injuries, however, have a profound potential for causing lifelong di...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1989.11700566

    authors: Comer RW,Fitchie JG,Caughman WF,Zwemer JD

    更新日期:1989-02-01 00:00:00

  • Gastrointestinal foreign bodies. When to remove them, when to watch and wait.

    abstract::By being aware of which patients are at high risk for ingestion or insertion of foreign bodies, physicians can be on the lookout for objects in the gastrointestinal tract and ready to institute initial care. Esophageal foreign bodies and other objects that increase the chance of perforation or obstruction may require ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1992.11701481

    authors: Clarkston WK

    更新日期:1992-10-01 00:00:00

  • Dysphagia. A practical approach to diagnosis.

    abstract::Our diagnostic approach to a patient with dysphagia begins with detailed history taking and physical examination. On the basis of findings, a radiographic and/or endoscopic study of the esophagus is done. We usually have barium-swallow radiography done initially, and if the radiographs are equivocal, upper gastrointes...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1992.11701537

    authors: Yang RD,Valenzuela JE

    更新日期:1992-11-15 00:00:00

  • Norwegian-type scabies mimicking contact dermatitis in an immunosuppressed patient.

    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

    authors: Wolf R,Wolf D,Viskoper RJ,Sandbank M

    更新日期:1985-07-01 00:00:00

  • Dyspareunia of vulvo-vaginal origin. Causes and management.

    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 ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1983.11697774

    authors: Huffman JW

    更新日期:1983-02-01 00:00:00

  • Dermatoses: common in blacks.

    abstract::Some skin disorders are more common in blacks than in whites or are so rare in whites as to be almost peculiar to blacks. Pigmentary abnormalities, either dark or light spots, often occur in association with inflammatory skin diseases. Curvature of the hair follicle is thought to be at the root of two other painful co...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1977.11712223

    authors: Kenney JA Jr

    更新日期:1977-06-01 00:00:00

  • Evaluation of patients with syncope. Separating the 'wheat' from the 'chaff'.

    abstract::Although fairly common, syncope is a frightening symptom that can signal a serious underlying disease. The varying causes present a diagnostic challenge to the examining physician, who needs to assess whether referral for more specialized or invasive study is appropriate. The authors review common cases of syncope and...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1992.11701298

    authors: Hopson JR,Kienzle MG

    更新日期:1992-04-01 00:00:00

  • Hereditary hemochromatosis.

    abstract::Preview Hereditary hemochromatosis, once believed to be rare, is now known to affect 1 in 250 to 300 people of northern European descent. Untreated, the disorder can have serious complications, but for patients in whom it is discovered and treated early, the prognosis is good. In this guide to diagnosis and management...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1994.11945914

    authors: Olynyk JK,Bacon BR

    更新日期:1994-11-01 00:00:00

  • Accuracy and clinical utility of a point-of-care HbA1c testing device.

    abstract:BACKGROUND:Point-of-care testing (POCT) is widely used to measure blood glucose levels in people with diabetes, although its use in measuring glycated hemoglobin (HbA1c) levels is less common, perhaps due to perceived performance issues and access to the technology. METHODS:Forty blood samples were analyzed in duplica...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.3810/pgm.2013.05.2664

    authors: Knaebel J,Irvin BR,Xie CZ

    更新日期:2013-05-01 00:00:00

  • Adjunctive aripiprazole, olanzapine, or quetiapine for major depressive disorder: an analysis of number needed to treat, number needed to harm, and likelihood to be helped or harmed.

    abstract:OBJECTIVE:To describe the efficacy and safety of adjunctive aripiprazole, olanzapine, and quetiapine for major depressive disorder. DATA SOURCES:Published registration study reports, supplemented by clinical trial synopses as disclosed by manufacturers and product labeling. STUDY SELECTION:All available reports of st...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2010.07.2174

    authors: Citrome L

    更新日期:2010-07-01 00:00:00

  • Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS.

    abstract:BACKGROUND:Symptoms of irritable bowel syndrome (IBS) can have a profound impact on emotional health and quality of life, and current treatments are sometimes unsatisfactory for patients facing this lifelong disease. Probiotics, which can normalize gastrointestinal microflora, may alleviate symptoms of IBS. OBJECTIVE:...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.3810/pgm.2009.03.1984

    authors: Hun L

    更新日期:2009-03-01 00:00:00

  • Outpatient management of inflammatory bowel disease. Let's keep it as simple as possible.

    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

    authors: Butt JH

    更新日期:1992-11-01 00:00:00

  • Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States.

    abstract:OBJECTIVE:To evaluate healthcare resource utilization (HCRU) by osteoarthritis (OA) pain severity. METHODS:Cross-sectional surveys of US physicians and their patients were conducted between February and May 2017. Using the Numeric Rating Scale, patients were classified by self-reported pain intensity in the last week ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.2020.1841988

    authors: Nalamachu S,Robinson RL,Viktrup L,Cappelleri JC,Bushmakin AG,Tive L,Mellor J,Hatchell N,Jackson J

    更新日期:2021-01-01 00:00:00

  • Helping patients who say they cannot sleep. Practical ways to evaluate and treat insomnia.

    abstract::Why do some people spend most of the night tossing and turning while others drop off as quickly as a cat in the sun? There are many possible explanations for problems with falling and staying asleep and, sometimes, patients actually get a lot more sleep than they think they do. Each type of insomnia has its own set of...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2000.03.935

    authors: Attarian HP

    更新日期:2000-03-01 00:00:00

  • Otitis media reassessed.

    abstract::Preview Management of otitis media in children is a controversial matter: The basic questions of why, in whom, and how it should be treated are undergoing continual reassessment. In this article, Drs Shapiro and Bluestone provide answers to these and other questions, such as Why is treatment of acute otitis media just...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1995.11945992

    authors: Shapiro AM,Bluestone CD

    更新日期:1995-05-01 00:00:00

  • Alpha 1-blocker combination therapy for hypertension.

    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

    authors: Houston MC

    更新日期:1998-09-01 00:00:00

  • Hyperbaric oxygen therapy. Promoting healing in difficult cases.

    abstract::Inhalation of pressurized 100% oxygen is a helpful adjunctive treatment for certain patients, because the increased oxygen carried by the blood to the tissue enhances new growth of microcirculation and, thus, healing. Patients with tissue breakdown after radiation therapy, refractory osteomyelitis, gas gangrene, soft-...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1986.11699267

    authors: Cohn GH

    更新日期:1986-02-01 00:00:00

  • Peripheral neuropathy in patients with chronic renal failure. A treatable source of discomfort and disability.

    abstract::Uremic polyneuropathy occurs in about half of patients undergoing dialysis and is characterized by axonal degeneration with secondary segmental demyelination. Hemodialysis or peritoneal dialysis halts the progress of polyneuropathy but usually does not bring improvement. However, improvement invariably occurs with suc...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.1997.10.344

    authors: Pirzada NA,Morgenlander JC

    更新日期:1997-10-01 00:00:00