Abstract:
:Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia, yet because AF can often be intermittent or lacking in overt symptoms, its prevalence is underestimated, and it may be diagnosed only incidentally. Because AF is a potent ischemic stroke risk factor and stroke rates are similar for paroxysmal, persistent, and permanent AF, all AF types require prompt management. This involves identifying and treating underlying causative factors, then implementing a "rate-control" or "rhythm-control" strategy. Regardless of approach, concomitant antithrombotic therapy for stroke risk reduction is recommended. Antithrombotic agent choice (acetylsalicylic acid or warfarin) depends on level of stroke risk; this review covers both the CHADS2 and CHA2DS2-VASc risk stratification schemes. Warfarin provides effective ischemic stroke prophylaxis but has numerous drawbacks, including a narrow therapeutic range, unpredictable pharmacokinetics, slow on-/offset of action, and multiple food and drug interactions. New oral anticoagulants that lack many of these drawbacks are in development. Here we review these drugs for stroke prevention in AF.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Saliba Wdoi
10.3810/pgm.2011.03.2260subject
Has Abstractpub_date
2011-03-01 00:00:00pages
27-35issue
2eissn
0032-5481issn
1941-9260journal_volume
123pub_type
杂志文章,评审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::Patients with chronic pelvic pain are challenging, from both diagnostic and therapeutic viewpoints. At the pain clinic at the Medical College of Georgia School of Medicine, Augusta, we have discovered over the past 3 years that psychiatric disease is probably underrecognized in these patients and that physicians are o...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::Physicians need to be aware that women and mothers are capable of sexually abusing children and need to watch for signs that a mother may be at risk for perpetrating abuse or that a child may have been abused. Posttraumatic stress disorder, attention-deficit hyperactivity disorder, secondary enuresis and encopresis, n...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract::Lyme disease can be difficult to recognize because not all patients have erythema migrans or other classic symptoms. Therefore, laboratory testing has become an important aid to clinical diagnosis. But the story doesn't end there-serologic testing presents another set of problems and concerns. Drs. Still and Ryan expl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.1997.07.260
更新日期:1997-07-01 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::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: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::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::Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Recent major publications, such as the Action to Control Cardiovascular Risk in Diabetes trial, the Advance in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation tria...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.11.2501
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are common functional bowel disorders. Patients with IBS-C or CIC often present with ≥ 1 comorbidity that coincides with either of these conditions. These comorbidities may make underappreciated contributions to the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.03.2640
更新日期:2013-03-01 00:00:00
abstract::With the recent availability of human insulin, we have entered a new era in therapy for diabetes mellitus. Human insulin is not a cure for diabetes; however, no disadvantages are known to be associated with its use at present. Human insulin costs less than the other purified insulins, and because of its potential adva...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1986.11699459
更新日期:1986-07-01 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::Narcotic maintenance may be needed to relieve chronic pain in ambulatory patients who fail to respond to other pain therapies. Oral, long-acting narcotics are preferred, and nonnarcotic pain therapies can be administered simultaneously to reduce the narcotic dosage. To legally undertake narcotic maintenance, the physi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698315
更新日期:1983-01-01 00:00:00
abstract::Pulmonary artery hypertension (PAH) refers to several subgroups of disease in which the mean pulmonary artery pressure (mPAP) is elevated to more than 25 mm Hg, pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg, and an elevated pulmonary vascular resistance (PVR) > 3 Wood units as confirmed by right heart catheterizati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1188664
更新日期:2016-06-01 00:00:00
abstract::Male factors play a role in up to half of subfertile couples, contrary to the myth that male factors rarely play a role. In this article, Dr Sandlow counters this and other myths about male infertility and suggests that primary care physicians can increase a couple's chance of conceiving by evaluating for male as well...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.02.902
更新日期:2000-02-01 00:00:00
abstract::In acutely injured patients, recognition of profound shock may be difficult initially. Ensuring adequate oxygenation, restoring intravascular volume, and controlling ongoing blood loss are key principles of treatment in these patients. Additionally, an appreciation for and recognition of the possible adverse consequen...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-03-01 00:00:00
abstract::Minor burns are common but require early and appropriate care to avoid infection and scarring. Damage can be arrested by immersing the burn in cold water as soon as possible. The goals of care are then to remove dead tissue and protect viable tissue during healing. Very superficial burns require only application of an...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700548
更新日期:1989-01-01 00:00:00
abstract::Patients with nonpsychotic mental health and emotional problems are commonly seen by primary care physicians. The objective of this study was to expand the Provisional Diagnostic Instrument-4 (PDI-4) to include a short self-report screen for 5 common anxiety-related diagnoses: panic attack (PA), social phobia (SP), ob...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2011.09.2463
更新日期:2011-09-01 00:00:00
abstract::The work of psychotherapists who have a cognitive-behavioral orientation and are trained in time-limited, focused psychotherapy has proved to be beneficial in the setting of a comprehensive medical and health maintenance organization. Group interventions that deal with relaxation, social skills, depression, agoraphobi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698601
更新日期:1984-02-15 00:00:00
abstract::Infectious diseases in the institutionalized elderly are emerging as 1 of the major issues challenging physicians treating adult patients. The most common syndromes encountered are nursing home-acquired pneumonia, urinary tract infections, and skin and soft tissue infections. As a complicating factor, immunocompromise...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.02.2001.suppl12.68
更新日期:2001-02-01 00:00:00
abstract::Common variable immunodeficiency (CVID) is readily considered in patients presenting with recurrent sino-pulmonary infections, however this disease has a broad range of clinical manifestations and diagnosis can be delayed by several years. We present the case of a 44-year-old postpartum female who presented with nause...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1199250
更新日期:2016-08-01 00:00:00
abstract::Genetic syndromes that convey a significant risk of breast cancer are responsible for a small but significant percentage of these cancers. However, the vast majority of breast cancers occur in women with no family history of the disease. Nongenetic risk factors include age, previous breast disease, breast tissue densi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2004.10.1595
更新日期:2004-10-01 00:00:00
abstract::Preview The effects of waning ovarian function start before menstruation stops, and they can be medically important. What changes should women expect, and what preventive health measures can they take? When is oral contraceptive therapy appropriate? How can irregular bleeding and decreased vaginal lubrication best be ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945822
更新日期:1994-04-01 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::Prolonged diarrhea in an adult is a serious problem; in an infant it is life threatening. Conventional therapy for intractable diarrhea of infancy, which involves use of clear liquids and gradual reintroduction of cow's milk or formula, works in most situations. However, for some infants this type of management exacer...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698385
更新日期:1983-08-01 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::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: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:OBJECTIVES:The clinical significance of hyperplastic polyp-like histologic changes in random biopsy samples ('serrated epithelial change' or SEC) from patients with inflammatory bowel disease (IBD) remains uncertain, with some studies suggesting an increased risk of dysplasia and even carcinoma. Controlled studies are ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1802138
更新日期:2021-01-01 00:00:00
abstract::While more remains to be learned about the natural history of deep vein thrombosis and pulmonary embolism, better information is now available on which to base decisions about diagnosis and treatment. Several retrospective and prospective studies have placed the value of lung scanning, venography, and pulmonary angiog...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699336
更新日期:1986-03-01 00:00:00