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 Medjournal_title
Postgraduate medicineauthors
Marin GAsubject
Has Abstractpub_date
1987-01-01 00:00:00pages
178-82, 187-8issue
1eissn
0032-5481issn
1941-9260journal_volume
81pub_type
杂志文章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
更新日期:2003-11-01 00:00:00
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
更新日期:2008-11-01 00:00:00
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
更新日期:1981-11-01 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::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:
更新日期:1995-06-01 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::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
更新日期:1983-08-01 00:00:00
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
更新日期:2017-11-01 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::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
更新日期:1979-09-01 00:00:00
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
更新日期:1984-12-01 00:00:00
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:
更新日期:1996-05-01 00:00:00
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
更新日期:1989-02-01 00:00:00
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
更新日期:1992-10-01 00:00:00
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
更新日期:1992-11-15 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::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
更新日期:1983-02-01 00:00:00
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
更新日期:1977-06-01 00:00:00
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
更新日期:1992-04-01 00:00:00
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
更新日期:1994-11-01 00:00:00
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
更新日期:2013-05-01 00:00:00
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
更新日期:2010-07-01 00:00:00
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
更新日期:2009-03-01 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: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
更新日期:2021-01-01 00:00:00
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
更新日期:2000-03-01 00:00:00
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
更新日期:1995-05-01 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::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
更新日期:1986-02-01 00:00:00
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
更新日期:1997-10-01 00:00:00