Abstract:
:Community-acquired pneumonia is still a significant cause of morbidity and mortality and is often misdiagnosed and inappropriately treated. Although it can be caused by a wide variety of micro-organisms, the pneumococcus, atypicals, such as Mycoplasma pneumoniae and Chlamydophila pneumoniae, Staphylococcus aureus and certain Gram-negative rods are the usual pathogens encountered. The site-of-care decision is critical in determining the site and type of care as well as the extent of diagnostic workup. Antimicrobial therapy should be started as soon as possible particularly in those requiring admission to hospital, but typically the physician does not know with any degree of certainty the identity of the etiologic pathogen. A number of national guidelines have been published to help the physician with this choice. The initial drug(s) can be modified if necessary if the pathogen and its antimicrobial susceptibility pattern becomes known. Adjunctive therapy such as pressors and fluid replacement are of value and macrolides appear to help as well, likely secondary to their immunomodulatory effects. Recent data also suggest a role for steroids.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Mandell LAdoi
10.1080/00325481.2015.1074030subject
Has Abstractpub_date
2015-08-01 00:00:00pages
607-15issue
6eissn
0032-5481issn
1941-9260journal_volume
127pub_type
杂志文章,评审abstract:OBJECTIVES:Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients. METHODS:Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were adm...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2017.1263139
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:Our aim was to investigate the association of liver fibrosis and necroinflammation with HS in untreated young patients with chronic hepatitis B (CHB). MATERIALS AND METHODS:A retrospective study was conducted in a military hospital in Turkey. A total of 254 subjects with CHB were included in this study. The...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1221733
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Binge eating disorder (BED) is now a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). However, post-DSM-5 patient profiles and viewpoints on BED diagnosis and treatment remain unclear. This study used a focus group methodology to examine demographic and cl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.09.2800
更新日期:2014-09-01 00:00:00
abstract::Recent increases in obesity, diabetes, and hypertension, along with the aging of the US population, are driving a dramatic rise in the prevalence of chronic kidney disease (CKD). Despite this increase, the majority of Americans with early-stage CKD remain unaware of their disease. Primary care physicians are at the fo...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.09.2473
更新日期:2011-09-01 00:00:00
abstract::Fear of the needle is a real issue with some patients and may be an obstacle to inducing anesthesia before minor surgical procedures are performed. Adults may express this fear verbally or, out of embarrassment, even avoid coming to the physician's office. Children may become intensely anxious and hysterical. In this ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700843
更新日期:1991-02-15 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::Ovulatory dysfunctional uterine bleeding (DUB), a disease prevalent in the latter half of the reproductive years, is diagnosed when organic causes for bleeding have been excluded by clinical, laboratory, and surgical diagnostic means. Disordered prostaglandin metabolism within the endometrium explains most cases of DU...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698855
更新日期:1985-01-01 00:00:00
abstract::As one patient put it after hearing his treatment options for a stage I testicular tumor, "If you're gonna have cancer, this is about as easy a road as you get." With recognition of the importance of orchiectomy, development of the nerve-sparing lymph node dissection procedure, and availability of modern chemotherapy ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.04.699
更新日期:1999-04-01 00:00:00
abstract::Alzheimer's disease has been found to be genetically transmitted. Structural changes in the disease include loss of neurons, specifically cholinergic and perhaps noradrenergic neurons. Functional connections among neurons are also lost. No cause has yet been determined, but slow viruses, autoimmune processes, and alum...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698359
更新日期:1983-04-01 00:00:00
abstract::Hemorrhoids are a common source of anorectal symptoms, which are determined by their size. A helpful measure in small hemorrhoids is a high-fiber diet; in moderate lesions, ligature therapy is effective. Surgery should be reserved for large hemorrhoids. Anal fissures, probably caused by trauma to the anal canal during...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::No single therapeutic agent has been found to be universally effective for rheumatoid arthritis, so regimens using combinations of drugs have become the rule. Recently, several new agents with unique mechanisms of action have been introduced and found to produce various degrees of clinical benefit. Among these agents ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.10.1.703
更新日期:1999-10-01 00:00:00
abstract::Objectives: To understand the role of ophthalmoscopic examination (dilated retina examination and widefield fundus photography) in the diagnosis and management of nosocomial acquisition of Mycobacterium chimaera following open heart surgery with cardiopulmonary bypass utilizing a heater-cooler unit, an entity that is ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2019.1697545
更新日期:2020-03-01 00:00:00
abstract::Varicose veins are a common problem that still presents a major challenge to the physician and the patient. Complete surgical removal of the malfunctioning veins has proved to be the most effective management for significant varicosities, although several nonsurgical methods are available for mild cases or those not s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715178
更新日期:1979-06-01 00:00:00
abstract::The association of depression and erectile dysfunction (ED) has been firmly established, but it may be difficult to distinguish between cause and effect--whether ED causes the depression or the depression causes ED--in an individual patient. In most patients who have major depression, successful reversal of the depres...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.5.15.2000.suppl5.29
更新日期:2000-05-01 00:00:00
abstract::Colonic cancer remains a major cause of death because diagnosis is usually delayed. Improved methods for earlier detection will maximize the patient's chances for survival. At present, surgery offers the greatest possibility of cure, but even in those instances where less than definitive resection is possible, there i...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11714014
更新日期:1975-04-01 00:00:00
abstract::The present staging methods for non-small-cell lung cancer provide little more than epidemiologic assessment of prognosis for grossly defined groups of patients. Except in extreme instances, physicians can tell patients very little about their prognosis or the need for supplemental therapy. More effective and less tox...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704526
更新日期:1990-01-01 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::The diagnostic survey of the infertile couple usually takes about three months. After semen analysis, the husband is referred for general and urologic examination. The wife is given a general physical and pelvic examination and returns during the next two months for ovulation studies. Tubal patency tests are also perf...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714654
更新日期:1977-10-01 00:00:00
abstract::Two distinct subpopulations in the pediatric age-group are particularly at risk for poisoning, and the substances likely to be ingested by each group differ. The method of critical care given here incorporates consideration of specific types of poisoning into an overall plan of general diagnostic and therapeutic measu...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716152
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease is frequently present in patients with type 2 diabetes mellitus (T2DM). New therapeutic options in this patient subpopulation are needed. OBJECTIVES:Assess the effect of renal impairment on the pharmacokinetics (PK), efficacy, and safety of albiglutide in single- and multiple-dose stu...
journal_title:Postgraduate medicine
pub_type: 临床试验,杂志文章
doi:10.3810/pgm.2014.05.2754
更新日期:2014-05-01 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:OBJECTIVES:There is evidence that increasing severity of hypertriglyceridemia increases the risk of acute pancreatitis. There is a debate about superiority of treatment methods and previous works have specifically called for direct comparison between IV insulin and apheresis techniques. Identify patient characteristics...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2018.1470439
更新日期:2018-06-01 00:00:00
abstract::Broncholithiasis, a disease that is probably much more common than has been reported, is most often associated with pulmonary infections, for example, tuberculosis and histoplasmosis. Stones originate from calcified peribronchial lymph nodes that erode into the tracheobronchial tree, but lithoptysis occurs infrequentl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700166
更新日期:1988-02-15 00:00:00
abstract::Careful attention to the practical aspects of oral anticoagulant therapy can improve patient compliance and lessen the risk of bleeding complications. A variety of risk factors for bleeding associated with oral anticoagulant therapy have been defined and should be assessed before initiating therapy. Recent investigati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 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:BACKGROUND:Asian Americans exhibit a high prevalence of chronic hepatitis B (CHB) compared with the general population in the United States. However, there are specific barriers to appropriate health care in the Asian American population, and CHB awareness is low. The aim of this study was to examine CHB awareness amon...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.09.2213
更新日期:2010-09-01 00:00:00
abstract::Systolic dysfunction of the heart represents a state of "prerenal" azotemia, in which the excess of total body salt and water is redistributed to venous and interstitial fluid compartments. This results in a diminished effective circulating blood volume and thereby decreases tissue perfusion. The kidneys perceive the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 00:00:00
abstract::Stroke survivors can be plagued by numerous medical complications, including aspiration pneumonia, heart disease, depression, and venous thromboembolism. Given the impairment already caused by stroke itself, these patients require careful management by a comprehensive rehabilitation team. Dr Harvey discusses common st...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.08.552
更新日期:1998-08-01 00:00:00
abstract::Patients with protracted depression respond well to long-term maintenance antidepressant therapy. A precise diagnosis is a prerequisite to therapeutic decisions. Diagnosis may be missed and treatment inadequate if symptoms are attributed solely to aging or to life's circumstances. Proper dosage is determined by the pa...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700579
更新日期:1989-02-01 00:00:00
abstract::Legg-Calvé-Perthes disease affects children, mostly boys, in the age range of 3 to 12 years. Severity and duration are quite variable. Catterall's classification of disease according to degree of femoral head involvement is of real prognostic value. Other factors of prognostic importance are loss of motion, metaphysea...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714449
更新日期:1976-10-01 00:00:00