Abstract:
:Nonalcoholic fatty liver disease (NAFLD) is quickly emerging as a global epidemic in parallel with the rise in obesity and the Metabolic Syndrome. NAFLD, once seen simply as a passive consequence of the Metabolic Syndrome (MetS), has been found to interact with other features of MetS to exacerbate insulin resistance, diabetes, and cardiovascular disease. NAFLD is also becoming the top indication for liver transplant and an important risk factor for hepatocellular carcinoma. Treatment of this disorder is limited mainly to lifestyle modifications to promote weight loss along with consideration for off-label use of certain medications, but recent progression in clinical trials means more effective treatments are on the horizon. Therefore, the primary care provider must be prepared to recognize and determine the severity of this disorder in order to optimize management. In this review, we will discuss risk factors for NAFLD, workup and differential, and finally, offer recommendations on screening.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Jensen T,Wieland A,Cree-Green M,Nadeau K,Sullivan Sdoi
10.1080/00325481.2019.1546532subject
Has Abstractpub_date
2019-01-01 00:00:00pages
19-30issue
1eissn
0032-5481issn
1941-9260journal_volume
131pub_type
杂志文章,评审abstract::Although Charcot's disease and its association with diabetes have been described many times in the literature, it is still often misdiagnosed and incorrectly treated as osteomyelitis, arthritis, or gout. The best safeguard is a high index of suspicion. A warm, swollen foot in a diabetic patient with long-standing neur...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700869
更新日期:1991-03-01 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::Acute compartment syndrome is a surgical emergency. A high index of suspicion is needed in cases of severe contusion, especially if patient complaints seem to outweigh physical findings. Acute surgical fasciotomy is an effective treatment and should be carried out expeditiously if compartment pressures are elevated ov...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.03.599
更新日期:1999-03-01 00:00:00
abstract::There are three key goals in current management of the diabetic pregnancy. Normal diabetes control before conception and during the first trimester in an attempt to reduce the incidence of congenital abnormalities. This implies that all diabetic women of childbearing age should have counseling before pregnancy. Routin...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698879
更新日期:1985-02-01 00:00:00
abstract::While there is evidence for cardiac arrhythmias associated with macrolide and fluoroquinolone antibiotics, there is still debate among health care providers as to whether this risk of arrhythmia is overstated. A joint panel of the US Food and Drug Administration suggested that macrolide and fluoroquinolone labels need...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2017.1362938
更新日期:2017-09-01 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::The goals of therapy for congestive heart failure (CHF) are to improve quality of life and to prolong it. Improvement in patients with CHF can only be realized, however, if a multidisciplinary healthcare team can provide effective management in both the inpatient and outpatient settings. Inhibition of compensatory mec...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.01.143
更新日期:1997-01-01 00:00:00
abstract::Healthcare providers usually assess glycemic control in diabetic patients by measuring fasting plasma glucose and preprandial glucose levels, as well as hemoglobin A1c (HbA1c). Evidence now suggests that elevated postprandial glucose concentrations may contribute to suboptimal glycemic control. Several medications and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.12.2001.suppl17.93
更新日期:2001-12-01 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::The best treatment for adenocarcinoma of the prostate depends on the patient's age, general medical condition, life expectancy, and willingness to accept such side effects as impotence. Radical prostatectomy or full-dose radiation therapy are usually curative when cancer is confined to the gland. The technique of pros...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1988.11700490
更新日期:1988-11-15 00:00:00
abstract::The cutaneous manifestations of systemic diseases are diverse. In some cases, they are the first signs of an underlying disorder, such as Cowden's disease, dermatomyositis, and Lyme disease. Sister Mary Joseph's nodule (metastatic involvement of the umbilicus) is an ominous sign of internal malignant disease. Drug-ind...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::Parents of a child who is diagnosed as defective face a crisis for which they are usually unprepared. They need an opportunity to work through their intense feelings. In addition, they need specific information about how to be of use to their child. Self-help groups composed of parents of children with a similar handi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715093
更新日期:1979-03-01 00:00:00
abstract::Current therapeutic options make office management of the patient with uncomplicated left-sided ulcerative colitis or mild to moderate Crohn's disease quite feasible for the primary care physician. On the horizon are additional drugs that will enhance the physician's ability to treat patients with inflammatory bowel d...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700202
更新日期:1988-03-01 00:00:00
abstract::Syndromes of delusional misidentification consist of disordered familiarity and have been reported in diverse diagnoses, including Parkinson's disease. Although the most common delusional misidentification is Capgras syndrome, in which the sufferer believes a familiar person has been replaced by an identical imposter,...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1411161
更新日期:2018-03-01 00:00:00
abstract::Drug-induced illness is common in any clinical practice. The consequences of failure or delay in diagnosis--persistent or recurring illness, unnecessary diagnostic evaluation, inappropriate treatment, and future jeopardy from the drug--can be avoided by early recognition. Using descriptions of cases from his practice,...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715344
更新日期:1980-01-01 00:00:00
abstract::Iron deficiency occurs when the body's iron stores are exhausted. The source of blood loss leading to iron deficiency must be identified in all cases. Anemia of chronic disease generally results from an infectious, inflammatory, or malignant process. However, in some reported cases, no such process could be identified...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701469
更新日期:1992-09-15 00:00:00
abstract::Introduction: Adolescents and young adults are the primary reservoirs and transmitters of meningococci. In the US, meningococcal serogroup B (MenB) disease predominates over A, C, W, and Y; ACIP-recommended MenACWY and MenB vaccines are available. We investigated invasive meningococcal disease (IMD) burden and vaccina...
journal_title:Postgraduate medicine
pub_type: 社论
doi:10.1080/00325481.2019.1671667
更新日期:2019-11-01 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::Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has quickly spread all over the globe from China. Pleural involvement is not common; around 5-10% of patients can develop pleural effusion and little is known about the involvement of pleural str...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1838817
更新日期:2020-10-27 00:00:00
abstract::Self-assessment case studies illustrating prudent selection of antimicrobial agents in septic shock following urinary catheterization, bacteremia and skin lesions in an immunocompromised patient, and endocarditis in a patient with a prosthetic heart valve. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714791
更新日期:1978-03-01 00:00:00
abstract::Treatment of primary breast cancer with excision of the tumor plus radiation is now an accepted alternative to mastectomy in women who desire breast preservation and have a suitable clinical presentation. Tumor size and location should be carefully considered before applying treatment with this method, the primary con...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1986.11699425
更新日期:1986-06-01 00:00:00
abstract::The skin is a window of internal malignancies and other diseases. The cutaneous signs of internal malignancy can be divided into four major groups: (1) hypersensitivity or toxic reactions, (2) infections, (3) metabolic disorders, and (4) tumors. A diagnosis of the many signs of systemic malignancy is made by inspectio...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699299
更新日期:1986-02-15 00:00:00
abstract::Hepatitis C virus (HCV) is responsible for most cases of non-A non-B hepatitis and is primarily spread by a parenteral route, although familial, sexual, and maternal transmission may occur rarely. Second-generation assays and the polymerase chain reaction facilitate detection of HCV infection. The association between ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::Preview The success of calcium channel antagonists in controlling hypertension, angina pectoris, and arrhythmias is well known. In recent years, second-generation agents have been introduced that are also effective against migraine headaches and Raynaud's phenomenon and appear to improve atherosclerosis and congestive...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945790
更新日期:1994-01-01 00:00:00
abstract::Motor fluctuations and dyskinesia often develop in patients with Parkinson's disease after 3 to 5 years of levodopa therapy. Dosage adjustments, addition of a second medication to the drug regimen, and dietary modifications may help maximize response to symptomatic therapy. Given the dramatic variability of symptoms a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-01-01 00:00:00
abstract::Is the degree of risk involved in providing health care to people infected with human immunodeficiency virus (HIV) acceptable? Every health care worker, even if only for a few anxious minutes, has certainly worried about this risk. Drs Wilson, Williams, and Robinson discuss these concerns and summarize the indications...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704737
更新日期:1990-09-01 00:00:00
abstract::The fact that atopic dermatitis is such a common medical problem underlies the need for better understanding of the basic disease processes and the development of new therapeutic approaches. Infection is now recognized as an important exacerbating factor, and the role of inflammatory and immunologic mediators is recei...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698671
更新日期:1984-07-01 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::Symptomatic treatment of transient insomnias is advisable, for without treatment these sleep disorders may become persistent. The drugs of choice are the benzodiazepine hypnotics, which have minimal side effects when used for short periods in properly selected patients. The three such drugs currently available in the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698665
更新日期:1984-07-01 00:00:00
abstract::Physicians must be alert to the possibility of abuse within the family and home. They should be well prepared to help victims begin the transition to a safer environment. An awareness of the prevalence of abuse and a high index of suspicion are the most effective clinical tools for assisting victims of domestic violen...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.07.11
更新日期:1996-07-01 00:00:00