Abstract:
:The presenting features of 250 consecutive patients who underwent a ventilation/perfusion lung scan for suspected pulmonary embolus (PE) were analysed. Ninety-six patients had lung scans highly suggestive of PE, with one or more unmatched segmental perfusion defects (scan positive), 86 had low probability scans (scan negative) and 68 an indeterminate scan. Scan positive patients were more likely to have a PaO2 of less than 10.7 kPa, an elevated P(A-a)O2 and an abnormal chest X-ray compared with scan negative patients but these measurements were of poor specificity. Furthermore, scan-positive patients had a higher incidence of lung disease. Localized chest wall tenderness was more common in scan-positive patients, occurring in 9% of patients, but there were no other significant differences in individual symptoms, signs or electrocardiographic findings between scan-positive and scan-negative patients. The diagnosis of PE should not be made on clinical grounds alone and all patients suspected of having a PE should at least undergo isotope lung scanning.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Fennerty AG,Shetty HG,Paton D,Roberts G,Routledge PA,Campbell IAdoi
10.1136/pgmj.66.774.285subject
Has Abstractpub_date
1990-04-01 00:00:00pages
285-9issue
774eissn
0032-5473issn
1469-0756journal_volume
66pub_type
杂志文章abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage. The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly describe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.692.394
更新日期:1983-06-01 00:00:00
abstract::A fatal case of occult foramen magnum meningioma is described which presented with features of cervical myelopathy confirmed by cervical myelogram. Surgical decompression led to initial improvement followed by progressive deterioration and death. Postmortem examination revealed a 4 cm diameter foramen magnum meningiom...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.815.720
更新日期:1993-09-01 00:00:00
abstract::Some antifungal agents have been tested qualitatively in various associations against species of Candida, Cryptococcus and Torulopsis. The method used was the channel test and the results are confirmed by comparison with the serial dilution test in agar. The antagonism in vitro with the combination of amphotericin B i...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.647.683
更新日期:1979-09-01 00:00:00
abstract::Pregnancy is a time of great maternal physiological and metabolic changes. This affects the biochemical and haematological parameters used in the assessment of liver disease, and it is important to appreciate the different reference ranges in pregnancy to facilitate recognition of liver disorders in pregnancy. Due to ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2009.089631
更新日期:2010-03-01 00:00:00
abstract::The majority of second-generation calcium antagonists are dihydropyridines, some of which show vascular selectivity. Several new dihydropyridines have been developed with comparable pharmacodynamic properties to existing calcium antagonists in this class and greatly improved kinetic half-lives. Of these agents, amlodi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::Coeliac disease is exacerbated by wheat gluten. A review of methods for the purification, identification and quantitation of wheat proteins to investigate coeliac disease is presented. Recent developments including amino acid sequencing and expression of wheat protein peptides in E. coli should permit characterization...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.63.743.767
更新日期:1987-09-01 00:00:00
abstract::The results of oesophago-gastro-duodenoscopy (OGD) and radiology in one hundred consecutive elderly patients were reviewed to assess the efficacy, safety and acceptability of endoscopy in this age group. False positive radiological features occurred in two of nine patients with normal endoscopic examinations. The rema...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.630.257
更新日期:1978-04-01 00:00:00
abstract::A case of fatal pseudomembranous enterocolitis associated with ampicillin therapy is described and possible mechanisms for its production discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.620.324
更新日期:1977-06-01 00:00:00
abstract::Four cases of ileo-caecal tuberculosis in Asian immigrants were seen in a 6-month period at The London Hospital. Although rare in Caucasians, this condition is an important cause of gastrointestinal symptoms in this ethnic group. Definitive diagnosis can frequently be made only by histological examination and culture ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.632.410
更新日期:1978-06-01 00:00:00
abstract::Long lists of causes of peripheral neuropathy make peripheral nerve disease a dry and uninspiring subject. A simple scheme based on the answers to just six questions should enable the clinician to recognise characteristic patterns, investigate relevant subgroups appropriately, and identify treatable disorders quickly:...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2011.241612rep
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Essential Skills in the Management of Surgical Cases (ESMSC) is a novel 3-day international undergraduate surgical masterclass. Its current curriculum (Cores integrated for Research-Ci4R) is built on a tetracore, multiclustered architecture combining high-fidelity and low-fidelity simulation-based learning (...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2017-135479
更新日期:2018-05-01 00:00:00
abstract::Paget's disease of bone is a relatively common condition in the UK affecting up to 5% of the population over the age of 55 years with particularly high prevalence in the North West of England. The majority of those affected are asymptomatic. Its precise cause remains unknown, and until recently, choice of treatment of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.856.69
更新日期:1997-02-01 00:00:00
abstract::The effects of nilvadipine on the peripheral circulation in the lower extremities using a duplex system of two-dimensional colour and pulse Doppler ultrasonography were studied in 32 patients with type 2 diabetes mellitus and mild essential hypertension. The patients (19 men and 13 women) were randomly divided into tr...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.71.840.613
更新日期:1995-10-01 00:00:00
abstract::Intraperitoneal free gas seen radiologically as air under the diaphragm nearly always indicates a perforated abdominal viscus that requires surgical intervention. Rarely, however, the presence of a pneumoperitoneum may not indicate an intra-abdominal perforation and thus may not require laparotomy. Such a situation is...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.863.531
更新日期:1997-09-01 00:00:00
abstract::Major lethal and non-lethal congenital malformations occurring in babies born in Dudley Road Hospital in 1979, 1980 and 1981 were related to the ethnic group of the mother. There was an increased incidence of gastrointestinal malformations in the Indian group and an increased incidence of abnormalities that could be a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.696.657
更新日期:1983-10-01 00:00:00
abstract::Schönlein-Henoch purpura may be complicated by hypoproteinaemia, which in most patients is due to the development of nephrotic syndrome. However, in some proteinuria is insignificant and enteric protein loss has been suggested as the cause. A case with supportive evidence for this is reported. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.655.361
更新日期:1980-05-01 00:00:00
abstract::It is a tragedy that morphine is scarcely available for between 1.3 and 2.5 billion people whilst 3.5 million cancer patients suffer needlessly. In only 10 countries is its consumption rising, in many more only codeine consumption shows an increase, and in many areas even in the Western world prescribing is grossly li...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Two cases of coeliac disease associated with thyroid enlargement are presented. One had a large simple adenomatous goitre which was removed surgically and the other had histological confirmation of lymphadenoma (Hashimoto's disease). ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.616.95
更新日期:1977-02-01 00:00:00
abstract::It has long been accepted that communication is of central importance in healthcare, and a core aspect of clinical competence. Many educational institutions and Royal Colleges now reflect this and consider communication skills a priority in postgraduate examination. The new examination "Practical Assessment of Clinica...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.022129
更新日期:2004-12-01 00:00:00
abstract::Venepuncture is commonly regarded as a trivial procedure allocated to the most junior medical staff. The result of this policy is that junior doctors are required to perform a minimally invasive procedure on consenting patients without any structured venepuncture training or assessment. Consequently, inexperienced doc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.843.23
更新日期:1996-01-01 00:00:00
abstract::Serum potassium concentration was normal (greater than or equal to 3.6 mmol/l) in 29 of 32 patients with the syndrome of inappropriate antidiuretic hormone excess (SIADH) associated with a bronchogenic carcinoma. In 11 of the patients there was no significant change in serum potassium concentration after correction of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.648.721
更新日期:1979-10-01 00:00:00
abstract:BACKGROUND:Enabling healthcare staff to report concerns is critical for improving patient safety. Junior doctors are one of the groups least likely to engage in incident reporting. This matters both for the present and for the future, as many will eventually be in leadership positions. Little is known about junior doct...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-133045
更新日期:2015-05-01 00:00:00
abstract::Proper understanding of the pathological process of a ruptured plaque followed by thrombus formation remains the basis for rational therapy of cardiac ischaemia and myocardial infarction. With the advent of better thrombolytic regimens, improved direct reperfusion via angioplasty and streamlined recognition/admission ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Anaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) is the treatment of choice; however, the recommended dose and route of administration of epinephrine used in the management of anaphylaxis is different from that used in the management ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2007.059097
更新日期:2007-09-01 00:00:00
abstract::A patient with occult pancreatic carcinoma associated with recurrent acute pancreatitis is reported. Endoscopic retrograde cholangiopancreatography after the first attack was normal, the diagnosis being made at repeat examination 10 months later. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.730.765
更新日期:1986-08-01 00:00:00
abstract::We present a 78-year-old woman with clinical acute hypopituitarism in whom pathologic findings showed lymphocytic hypophysitis and retroperitoneal fibrosis. Lymphocytic hypophysitis should be included in the differential diagnosis of hypopituitarism at any age. The association with idiopathic retroperitoneal fibrosis ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.865.732
更新日期:1997-11-01 00:00:00
abstract::Overdosage with cardiac glycosides is well documented, but not usually fatal. A case is described in which cardiac arrest in asystole was associated with a serum digoxin level of 50-4 microgram/1, the highest concentration yet reported after oral administration. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.619.280
更新日期:1977-05-01 00:00:00
abstract::Fifty two cases of tuberculosis of the breast encountered over a 15 year period and accounting for 3% of all breast lesions are reported. The classic presentation was a breast lump with associated sinus in 39%, isolated breast lump in 23%, sinus without lump in 12%, and tender nodularity in 23% of the patients. Associ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.921.422
更新日期:2002-07-01 00:00:00
abstract::A 68 year old man developed cranial diabetes insipidus 3 years after the diagnosis of myelofibrosis, coincident with a marked increase in nucleated cell count. No mass lesion was demonstrable on computed tomographic or magnetic resonance imaging. It is suggested that hypothalamic damage was caused by local infiltratio...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.759.36
更新日期:1989-01-01 00:00:00