Abstract:
:Prompt and accurate diagnosis of patients presenting with symptoms suggestive of pulmonary arterial hypertension (PAH) is of outmost importance as delays in identifying this clinical entity have detrimental effects on both morbidity and mortality. Initial noninvasive assessment of these patients has traditionally included a number of routine tests of which transthoracic echocardiography (TTE) has been shown to either confirm the presence of structural anomalies of the right ventricle (RV) indicative of PAH or exclude other potential causes of pulmonary hypertension (PH). Consequently, TTE has become a well-validated and readily available imaging tool not only used for this initial screening but also for routine follow-up of PH patients. Since chronic PH is known to unbalance the normal hemodynamic and mechanical homeostatic interaction between the RV and pulmonary circulation; the resulting response is that of an abnormal RV remodeling, clinically translated into progressive RV hypertrophy and dilatation. An enlarged and hypertrophied RV not only would eventually lose effective contractility but also this gradual decline in RV systolic function is the main abnormality in determining adverse clinical outcomes. Therefore, it is of outmost importance that TTE examination be comprehensive but most importantly accurate and reproducible. This review aims to highlight the most important objective measures that can be routinely employed, without added complexity, that will certainly enhance the interpretation and advance our understanding of the hemodynamic and mechanical abnormalities that PH exerts on the RV.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Vargas PE,Lopez-Candales Adoi
10.1080/00325481.2016.1115715subject
Has Abstractpub_date
2016-01-01 00:00:00pages
208-22issue
2eissn
0032-5481issn
1941-9260journal_volume
128pub_type
杂志文章,评审abstract::A 29-year-old man had a febrile illness accompanied by chest pain and tachycardia. The ECG suggested either myocarditis or acute ischemia. Heart muscle enzymes were normal, the peripheral blood count showed absolute and relative lymphocytosis, and an echocardiogram disclosed a small pericardial effusion. After deferve...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700655
更新日期:1989-04-01 00:00:00
abstract::Patients with colon cancer involving regional lymph nodes (stage C disease) have a 5-year survival rate of only 30% to 40%, and the majority die of recurrent disease. Recent trials have shown increased survival rates with postoperative use of fluorouracil plus levamisole. The authors discuss these findings and the imp...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716390
更新日期:1990-10-01 00:00:00
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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::Preview Early diagnosis of sickle cell disease enables physicians to initiate prompt treatment and provide appropriate education and counseling for patients and their families. In this article, Dr Burdick reviews the management of major complications of the disorder, discusses the psychosocial impact, and examines the...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945940
更新日期:1994-12-01 00:00:00
abstract::In a series of 123 children with disorders of defecation, constipation was the main problem in 89 and fecal incontinence in 34. All but three of the latter also had constipation. The principal physical findings were abdominal protuberance with palpable stool in the bowel and the presence of a fecal mass in the rectal ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715223
更新日期:1979-08-01 00:00:00
abstract::Contrary to long-standing mores, what goes on in the person's home is not always sacred. When family relationships break down and family members deal violently with various stresses and problems, intervention is in order. Certain changes in societal attitudes would help prevent the problem. Physicians-alone or working...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716255
更新日期:1982-11-01 00:00:00
abstract::Beta-blockers (beta-blockers) have demonstrated their value across the cardiovascular disease spectrum. Beta-blockers effectively lower blood pressure in patients with hypertension and provide symptomatic or mortality benefits in patients with heart failure and in post-myocardial infarction patients. However, despite ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.01.1951
更新日期:2009-01-01 00:00:00
abstract::Many aspects of Kawasaki syndrome remain a mystery. The cause of the disease has eluded researchers, and its pathophysiology is a subject of much debate. However, the diagnostic features have been identified: A significant fever for at least 5 days, bilateral nonexudative conjunctivitis, erythema of the palms and sole...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::More than half of new mothers may be affected by mood disorders after childbirth. Possible causes and recommended management depend on the type of disorder and its severity. In this article, Dr Knops discusses recognition, prevention, and management of three types of postpartum mood disorders as well as the need for s...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1993.11701624
更新日期:1993-02-15 00:00:00
abstract::The Food and Drug Administration's approval of the excimer laser in 1995 heralded the age of laser refractive surgery in the United States. Since then, other advances in refractive surgery have spurred great public interest in and enthusiasm for these procedures. In this article, the authors review the major types of ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.09.683
更新日期:1999-09-01 00:00:00
abstract::Thymomas may be discovered during routine evaluation, through reported symptoms, or increasingly, during evaluation for myasthenia gravis. Histologic details of these tumors have little bearing on prognosis or evaluation of malignant potential. Malignancy is determined by evidence of invasion through the tumor capsule...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699321
更新日期:1986-03-01 00:00:00
abstract::Acute urinary retention often is secondary to obstruction of the bladder or distal genitourinary system, which may be induced by any of a number of medical or surgical conditions. Treatment varies according to the cause. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11715998
更新日期:1982-02-01 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::Suicide is a major public health problem in the United States. Psychiatric disorders that feature or lead to suicidal ideation may be overlooked in the primary care setting because patients are reluctant to broach the subject. In this article, Dr Hamilton describes how physicians can open a dialogue with patients so t...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.11.1289
更新日期:2000-11-01 00:00:00
abstract::Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used to treat inflammatory pain for decades. More recently, newer NSAIDs were developed to target the inducible isoform of cyclooxygenase (COX), COX-2, with the aim of reducing gastrointestinal toxicity. While the COX-2 selective inhibitors were effective...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1412799
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:There is a need to identify safe and effective opioid-sparing multimodal alternative treatment strategies and approaches, including topical analgesics, for opioid-experienced chronic pain patients to mitigate the risk of addiction, misuse, and abuse of opioids. METHODS:This subset analysis from a prospective...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2018.1414551
更新日期:2018-01-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2009.05.2012
更新日期:2009-05-01 00:00:00
abstract::Objectives: The commonest types of peripheral neuropathy in the context of Coeliac Disease (CD) and gluten sensitivity (GS) are length-dependent symmetrical sensorimotor neuropathies and sensory ganglionopathies. In patients with such neuropathy, (gluten neuropathy), peripheral neuropathic pain is prevalent suggesting...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2019.1650609
更新日期:2019-09-01 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::In recent years bone marrow transplantation has become increasingly feasible for treating adult acute leukemia unresponsive to chemotherapy. However, the technique is not without significant intrinsic morbidity. The mouth is a singularly sensitive reflector of the cytotoxic, infectious, and hemorrhagic complications a...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715304
更新日期:1979-11-01 00:00:00
abstract::Many drugs with which to treat reversible obstructive airway disease are available. Beta-adrenergic aerosols are the first line of defense; these are followed, when necessary, by either timed-release theophylline or oral beta-adrenergics. Often, a combination of these drugs must be used to achieve effective relief of ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699911
更新日期:1987-07-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715543
更新日期:1980-09-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
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更新日期:1989-07-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698430
更新日期:1983-09-01 00:00:00
abstract::Epileptiform seizures occurred in a 34-year-old woman who was receiving amitriptyline and lithium carbonate therapy for treatment of endogenous depression. While receiving amitriptyline maintenance therapy, she was given lithium on two separate occasions, and despite serum levels of lithium in the therapeutic range, g...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715252
更新日期:1979-09-01 00:00:00
abstract::A patient's history usually contains key information regarding the type of dizziness and the best way to direct diagnostic workup. In dizziness with a vestibular cause (benign positional vertigo, vestibular neuritis, Meniere's disease, migraine, vertebrobasilar insufficiency), patients often describe their world as sp...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.02.555
更新日期:1999-02-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVES:Multilevel noncontiguous thoracic and lumbar spinal tuberculosis (MNST) is a relatively rare entity. The objective of this retrospective study was to investigate whether a technique involving a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumenta...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2019.1552824
更新日期:2019-01-01 00:00:00
abstract::The prevalence of chronic kidney disease (CKD) has increased markedly over past decades due to the aging of the worldwide population. Despite the progress in the prevention and treatment, the cardiovascular (CV) morbidity and mortality remain high among patients with CKD. Although CKD is a progressive and irreversible...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1481714
更新日期:2018-06-01 00:00:00
abstract::Many medical conditions that clearly have a strong genetic component are not transmitted in a straightforward dominant, recessive, or X-linked pattern. Recent progress in understanding other modes of inheritance, such as imprinting, trinucleotide repeat expansion, mitochondrial inheritance, and mosaicism, has allowed ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.09.1.1210
更新日期:2000-09-01 00:00:00