Abstract:
:The hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors of statin action are very effective and safe drugs, and they are widely used for the treatment of hyperlipidemia and the prevention of primary and secondary cardiovascular diseases (CVDs). However, recent meta-analyses of previous studies done with statins have shown that these drugs could induce new onset diabetes mellitus (NODM), especially in subjects prone to diabetes: obese, females, older age, Asian descent, and those with pre-diabetes or the metabolic syndrome. Several meta-analyses of randomized, controlled trials with statins and population-based studies of subjects taking statins have shown different incidence of NODM ranging from 28% in the JUPITER study to 43% in the UK clinical practice cohort. The exact cause of statin-induced NODM is not clearly known and several pathophysiologic mechanisms have been proposed, which include modification of the lipoprotein particle size, inhibition of HMG-CoA reductase, decreased expression of GLUT 4, and decreased adiponectin and ubiquinone levels, including others, which all lead to either increase in insulin resistance or decrease in insulin secretion. Based on the current evidence, the use of statins should not be withheld from subjects at high cardiovascular risk, even if they are prone to NODM, because their benefits outweigh their risks. However, in persons prone to the development of NODM, vigilance is required and periodic measurements of plasma glucose or HbA1c should be performed. If NODM develops, statin treatment should not be stopped, but a switch to administration of a more favorable statin, administration of statin on alternate days, or reduction of the dose should be considered, or antidiabetic therapy added.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Chrysant SGdoi
10.1080/00325481.2017.1292107subject
Has Abstractpub_date
2017-05-01 00:00:00pages
430-435issue
4eissn
0032-5481issn
1941-9260journal_volume
129pub_type
杂志文章,评审abstract::All patients with chronic stable angina presumed to be due to coronary artery disease should undergo exercise stress testing early in evaluation for evidence of high-risk coronary disease. If the exercise stress test shows early positive findings, patients should undergo cardiac catheterization to exclude left main co...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699599
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the pharmacokinetics of lisdexamfetamine dimesylate (LDX), a long-acting prodrug stimulant, and mixed amphetamine salts extended-release (MAS XR), alone or with omeprazole, a proton pump inhibitor (PPI). METHODS:This open-label, randomized, 4-period crossover study enrolled healthy adults (18-45 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2009.09.2048
更新日期:2009-09-01 00:00:00
abstract::Our review describes potential weight-altering effects of psychotropic medications (antipsychotics, antidepressants, anti-anxiety medications, mood stabilizers, sedative-hypnotics, medications for attention-deficit/hyperactivity disorder, and other psychotropic medications) and offers guidance on switching a medicatio...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.09.2706
更新日期:2013-09-01 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::This paper compares the antifungal activity and efficacy of itraconazole and terbinafine in vitro with their experimental activity and efficacy in vivo in patients with superficial fungal infections (tinea pedis and onychomycosis). Onychomycosis and tinea pedis are often treated with oral antifungals. With the introdu...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1999-07-01 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::Preview How can physicians make appropriate treatment decisions in substance abusers who have serious medical illness, especially when patients may not offer the information needed? Drs Westreich and Rosenthal summarize common physical findings that suggest abuse of specific substances. Recognizing these signs allows ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945984
更新日期:1995-04-01 00:00:00
abstract::With prostate cancer being diagnosed and treated in more than 300,000 men each year, the pool of long-term survivors is dramatically increasing. Because these patients are usually elderly, they are often receiving follow-up care for unrelated problems in a primary care setting. This offers the physician an excellent o...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.09.73
更新日期:1996-09-01 00:00:00
abstract::Rocky Mountain spotted fever, caused by a rickettsial organism transmitted by the bite of a tick, can be confused with many more common diseases. Diagnosis is made more challenging by the fact that treatment is most efficacious if begun before the second week of illness. Tetracycline and doxycycline are the most succe...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704599
更新日期:1990-03-01 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::The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contri...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.07.2684
更新日期:2013-07-01 00:00:00
abstract::Many controversies, only a few of which have been discussed here, are now raging in the field of resuscitation. Much is expected to change in the next five to ten years. The American Heart Association is now considering changes for its new advanced cardiac life support course, which should be ready this year. The cour...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699404
更新日期:1986-05-15 00:00:00
abstract::Preview Although the early symptoms of Parkinson's disease can be ameliorated, the illness is relentlessly progressive. Studies have therefore been conducted in hopes of finding therapy to delay its disabling course. In this article, Dr Ahlskog examines recent proposals and their application in cases of early and adva...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945830
更新日期:1994-05-01 00:00:00
abstract::The primary care physician can often delineate the cause of chest pain in a patient under 21 years of age after a thoughtful, careful, and thorough history and physical examination. Occasionally, an ECG and a chest x-ray film may be helpful. Noncardiac causes for the chest pain should be explored, and if found, the ch...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697888
更新日期:1983-06-01 00:00:00
abstract::In the Western world, diabetes is the biggest cause of peripheral neuropathy, usually distal symmetric polyneuropathy but some times another polyneuropathy or a focal neuropathy. In addition, hypothyroidism and acromegaly can cause carpal tunnel syndrome and other sensory complaints. A complete blood cell count, nerve...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.09.318
更新日期:1997-09-01 00:00:00
abstract::Present evidence suggests that the most important nutritional factor bearing on the risk of development of diabetes mellitus is an excessive caloric intake. Other evidence suggests that both dietary prevention of diabetes and mitigation of hyperglycemia by dietary means can prevent morbidity and mortality from the mic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11712096
更新日期:1976-09-01 00:00:00
abstract::Neonatal circumcision continues to be a controversial subject. The American Academy of Pediatrics has revised its earlier policy, stating that newborn circumcision has potential benefits as well as risks and emphasizing the need to explain these issues to parents considering the procedure so that an informed decision ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701325
更新日期:1992-05-01 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::The role of reflux in the development of esophagitis, stricture, and Barrett's esophagus is well recognized. However, reflux is not an infrequent cause of atypical chest pain, chronic pulmonary disorders, and pharyngeal and laryngeal changes. Increased insight into the pathogenesis of reflux and the relationship betwe...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 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::Hair analysis has important uses in screening for metal intoxication and exposure to environmental pollutants, as well as applications in forensic medicine. In addition, hair analysis has been hailed as the new "in" tool for diagnosis of nutritional deficiencies and chronic diseases, but data to support these applicat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716248
更新日期:1982-11-01 00:00:00
abstract::Proximal gastric vagotomy without drainage is widely accepted in Great Britain and Europe but in the United States has been done mainly in university centers. The operation denervates the acid-secreting parietal cell mass of the stomach, preserving vagal innervation to the gastric antrum and extragastric abdominal vis...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714810
更新日期:1978-04-01 00:00:00
abstract::Many men experience sexual function disorders, the most common of which are PE and ED. However, they may hesitate to seek treatment because of the perceived embarrassment associated with discussing their symptoms with a physician. The introduction of PDE-5 inhibitors for the treatment of ED has resulted in increased a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.04.1761
更新日期:2008-04-01 00:00:00
abstract::More than 70 medications have been implicated as a cause of drug-induced lupus. The condition most commonly manifests with arthralgias and fever. The most important laboratory feature is an elevated antinuclear antibody titer, which often corresponds to the presence of antihistone antibodies. Fortunately, the course o...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.09.83
更新日期:1996-09-01 00:00:00
abstract::This article on microcytic anemia is the first of several on laboratory investigation of anemia. Microcytic anemia, characterized by a mean corpuscular volume of less than 80 cu mu, is usually due to iron deficiency or chronic disease but may signify thalassemia minor. Exact identification of the cause is important, s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715037
更新日期:1979-01-01 00:00:00
abstract::Biochemical monitoring is generally advised for drugs that are potentially toxic, have a narrow therapeutic range, or are prescribed for life-threatening disease. Monitoring should not be attempted until the serum concentration reaches a plateau, or steady state, and sampling must be timed carefully. Besides incorrect...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715801
更新日期:1981-07-01 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::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::In 90% of children, otitis media with effusion resolves within 3 months. When it persists longer, it is considered chronic. Initial treatment of chronic otitis media with effusion is repeated courses of antibiotics, and a short course of steroids may be appropriate. Use of antihistamines and decongestants has not been...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::Theophylline has long been a cornerstone of bronchodilator therapy for asthma and chronic obstructive lung disease, but until recently its use carried the risk of serious, even fatal, toxicity. With recent advances in understanding of this drug's pharmacologic properties and pharmacokinetic characteristics, serious to...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698651
更新日期:1984-06-01 00:00:00