Abstract:
:Platelets play a key role in the initiation of hemostatic mechanisms during vascular injury. When contemplating prescription of antiplatelet agents (APAs) for patients as primary prevention for cardiovascular events, the physician should carefully weigh the potential benefits of cardiovascular risk reduction with the likelihood of harm, related mostly to hemorrhagic complications. The role of APAs in secondary prevention of atherosclerosis and coronary artery disease is well established, however, optimal duration of therapy and intensity of patient treatment are not settled and probably need to be individualized per patient. We describe the data emerging from contemporary trials on the efficacy and safety of the use of oral APAs in various patient subpopulations. We also discuss the advantages and potential roles of new APAs during and following acute coronary syndromes, percutaneous coronary interventions, and symptomatic atherosclerosis. We propose certain strategies and directions for future research to enhance the safety and efficacy prevention by optimizing the beneficial effects of APAs along with other contemporary treatment modalities of primary and secondary prevention.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Acharji S,Lakshmanadoss U,Rudzinski W,Stapleton DD,Kaluski Edoi
10.3810/pgm.2013.09.2694subject
Has Abstractpub_date
2013-09-01 00:00:00pages
19-30issue
5eissn
0032-5481issn
1941-9260journal_volume
125pub_type
杂志文章,评审abstract::Primary prophylaxis is advisable for all patients with moderate-sized or large esophageal varices. After the first episode of bleeding, secondary prophylaxis should be initiated to prevent rebleeding. Multiple treatment modalities are available for each circumstance. Optimal regimens have not yet been established but ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2006.11446045
更新日期:2006-09-01 00:00:00
abstract::Probably nothing in the field of medicine has changed as rapidly over the last decade as antiretroviral (ARV) therapy for HIV infection. New insights into pathogenesis, new tests for measuring virus levels in plasma, and availability of powerful new drugs have combined to transform the care of persons with HIV infecti...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.10.331
更新日期:1997-10-01 00:00:00
abstract::The purpose of this study was to assess the effects of a commercially available weight loss program on weight and glycemic control among obese patients with type 2 diabetes. Participants included 69 patients (49 females, 20 males) with type 2 diabetes who had a mean +/- SD age of 52.2 +/- 9.5 years, a body mass index ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2009.09.2046
更新日期:2009-09-01 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
abstract::When a patient presents with involuntary weight loss, the etiologic considerations can be overwhelming. To plan a cost-effective workup, physicians need to be aware of the most common causes of weight loss and the tests that yield the most pertinent data. Drs Wise and Craig review the clinical studies on unintentional...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-03-01 00:00:00
abstract::Patients with chronic obstructive lung disease (COLD) experience one or more episodes of acute respiratory failure in the late years of their illness. Initial evaluation is aimed at assessing the precipitating factor or factors as well as the severity of the acute episode and the need for intubation and mechanical ven...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699246
更新日期:1986-01-01 00:00:00
abstract::Evidence indicates that preventive healthcare in childhood reduces healthcare costs and enhances health. Physicians can assume a leadership role in promoting children's health by incorporating health promotion measures into their everyday practice, serving as resource persons or leaders in community and school efforts...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699791
更新日期:1987-04-01 00:00:00
abstract::Many patients who present with acute or chronic diarrhea do not have an important organic disease. Most have functional diarrhea. The history, clinical examination, and initial laboratory studies should lead to a provisional diagnosis with respect to organic or functional origin and help define whether the disease aff...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11704504
更新日期:1989-12-01 00:00:00
abstract::Trigger points (TPs) in muscles of the lower torso associated with the spine are an important cause of low back pain. The quadratus lumborum is the muscle most commonly involved, but TPs located there are often overlooked because of inadequate physical examination techniques. TPs in the lower rectus abdominis refer pa...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697757
更新日期:1983-02-01 00:00:00
abstract::Drug-induced jaundice is relatively uncommon but can be a diagnostic puzzle. Because so many pharmaceutical classes and individual agents can produce jaundice, a thorough history of medications taken should be obtained from a patient presenting with jaundice. Jaundice usually resolves when the offending agent is disco...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1988.11700445
更新日期:1988-10-01 00:00:00
abstract::Because some cases of hearing loss demand urgent attention, an approach to patients with hearing loss should be adopted in the primary care setting that allows for systematic institution of an individualized and appropriate treatment plan. Workup is enhanced by categorizing the hearing loss as acute or chronic and con...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:To review glucose-lowering efficacy and changes in renal function associated with sodium-glucose co-transporter 2 (SGLT2) inhibitors among patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). DATA SOURCES:A literature search of MEDLINE and Cochrane databases was performed from 2000...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2019.1549459
更新日期:2019-01-01 00:00:00
abstract::As understanding of the natural history of breast cancer has increased, radical mastectomy has given way to a preference for breast-sparing surgery and greater reliance on radiation therapy and chemotherapy. Probably the most important factor for selection of treatment is consultation with a multidisciplinary team ski...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704444
更新日期:1989-10-01 00:00:00
abstract::Given the present state of the art, any case of apparent pneumonia that is not responding to optimum therapy, or of "viremia" which appears to be progressively deteriorating, should be considered Legionnaires' disease and treated accordingly until proven otherwise. Titers for antibody to the disease in serum obtained ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715346
更新日期:1980-01-01 00:00:00
abstract::This case report describes prolongation of a patient's prothrombin time and partial thromboplastin time possibly due to coadministration of warfarin and an overdose of an acetaminophen-propoxyphene combination analgesic. Patients receive warfarin for many indications, and concomitant use of an analgesic agent is commo...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700233
更新日期:1988-04-01 00:00:00
abstract::In most cases, patients presenting with "the worst headache ever" are found to have a benign condition, notably migraine, toxic vascular headache, or exertion-induced headache. However, ominous causes first must be excluded by appropriate investigation, such as computed tomographic or magnetic resonance imaging scans ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704328
更新日期:1989-07-01 00:00:00
abstract::Benign essential tremor can be distinguished from parkinsonism by its rapid frequency, the involvement of voice and head, and the common finding of a positive family history. Essential tremor is less incapacitating than parkinsonism and less inexorably progressive. Propranolol (Inderal) is the best therapy available a...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11715961
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:Laparoscopic adjustable gastric banding (LAGB) is an established bariatric surgical procedure that produces meaningful weight loss and improvements in patients with type 2 diabetes mellitus (T2DM) and a body mass index (BMI) ≥ 30 kg/m2. This study examined the effect of LAGB on T2DM status in severely obese p...
journal_title:Postgraduate medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3810/pgm.2012.11.2590
更新日期:2012-11-01 00:00:00
abstract::As efforts to improve screening for colon cancer have increased, so has the importance of routine flexible sigmoidoscopy. However, the procedure is still underused, and about half of primary care physicians who recommend it refer their patients to other physicians. Increased use of this valuable screening tool is an i...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.06.622
更新日期:1999-06-01 00:00:00
abstract::Early recognition and treatment of immunologically mediated diseases of the lung are vital to prevent irreparable damage. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis are often confused but should not be difficult to distinguish. The former is nonatopic and is marked by chills, fever, ches...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714331
更新日期:1976-04-01 00:00:00
abstract::Nearly every healthcare reform plan introduced in Congress this year addresses medical malpractice. Although the tort reform goals in the plans may be similar, the methods of achieving them differ substantially. To highlight the areas that need to be resolved, we set up a dialogue between a physician and a plaintiff's...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945900
更新日期:1994-10-01 00:00:00
abstract::Even modest alcohol ingestion can increase the risk of steatosis, and long-term, excessive consumption can lead to alcoholic hepatitis and eventually cirrhosis. Most patients with clinically significant alcoholic liver disease have histologic findings typical of all three conditions. The only clearly beneficial treatm...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.04.462
更新日期:1998-04-01 00:00:00
abstract::Bedside pulmonary artery catheterization has proven to be an important addition to the clinical assessment of critically ill patients. Properly used, the procedure may provide hemodynamic information that is not apparent from physical examination or radiography. It may be safely accomplished through various venous rou...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700825
更新日期:1991-02-01 00:00:00
abstract::With the US population aging steadily, herpes zoster represents a growing contributor to diminished quality of life. Dermatologic manifestations appear as immunity declines with age but rarely pose a significant threat, except in instances when ocular structures are involved. Pain is of more concern, because it usuall...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.06.1114
更新日期:2000-06-01 00:00:00
abstract::Drug acquisition cost is an important component in the analysis of economic and clinical outcomes in the treatment of respiratory tract infections (RTIs). However, bacterial resistance has emerged as a crucial variable that must also be considered. Drug-resistant infections result in more expensive drug therapy, longe...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.09.2002.suppl19.100
更新日期:2002-09-01 00:00:00
abstract:INTRODUCTION:Over the past 2 decades, there has been a significant increase in the number of incidentally found small renal cortical neoplasms (RCNs). As more RCNs are being discovered in the elderly and infirmed patient populations, there has been a growing interest in the role of active surveillance (AS). Active surv...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.01.2251
更新日期:2011-01-01 00:00:00
abstract::Head trauma in the elderly is a major source of morbidity and mortality in this population. Prevention of the primary injury is ideal and requires that the primary care physician understands the neurosensory changes of aging. Failing prevention, rapid diagnosis and efficient management of the traumatized patient are o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700292
更新日期:1988-05-15 00:00:00
abstract::The urine of less than 3% of healthy persons shows more than three red cells per high-power field, which is about the limit of sensitivity of test strips for occult blood. Even minimal hematuria may herald serious problems and must be investigated. Common causes include infection, urethritis, and urethrotrigonitis (25...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699979
更新日期:1987-09-15 00:00:00
abstract::Granulomatous inflammation of the peritoneal surfaces resulting from exposure to cornstarch granules from surgical gloves produces a syndrome of abdominal pair, adynamic ileus, fever, peritonitis, variable white blood cell count, and inflammatory ascites. Symptoms develop three to four weeks after a routine abdominal ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11716541
更新日期:1976-01-01 00:00:00
abstract::Asthma is treated by avoiding the precipitants of symptoms, by a trial of hyposensitization (immunotherapy) if the precipitant cannot be avoided, and principally by pharmacologic therapy. Acute attacks have been most widely treated with epinephrine, but adrenergic aerosol bronchodilators and aminophylline are being us...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714330
更新日期:1976-04-01 00:00:00