Abstract:
:Inflammatory bowel disease (IBD) is difficult to diagnose, and differentiating between ulcerative colitis (UC) and Crohn's disease (CD) can be challenging. Overlapping symptoms of UC and CD often delay diagnosis, despite availability of endoscopic, radiologic, and histologic tools. This delay in diagnosis is quite common in clinical practice, which may also delay initiation of appropriate treatment. Abnormal immune responses found in IBD have led to the use of serum biomarkers (eg, anti-Saccharomyces cerevisiae antibody [ASCA], perinuclear antineutrophil cytoplasmic antibody [pANCA], antibodies to flagellin [anti-CBir1]) to improve diagnostic confidence in IBD. These biomarkers are beginning to be used to stratify patients with UC and CD according to disease phenotype and risk of complications. Associations between quantity and quality of immune reactivity and severe disease phenotypes are increasingly evident. This suggests that serologic panels of multiple IBD biomarkers can be used to identify the relative risk of progression to complicated disease behaviors, and that this information may ultimately impact therapeutic decisions. This review discusses the diagnostic process and challenges in IBD, with emphasis on the role that serologic markers may play in addressing these challenges.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Arai Rdoi
10.3810/pgm.2010.07.2184subject
Has Abstractpub_date
2010-07-01 00:00:00pages
177-85issue
4eissn
0032-5481issn
1941-9260journal_volume
122pub_type
杂志文章,评审abstract:BACKGROUND:Point-of-care testing (POCT) is widely used to measure blood glucose levels in people with diabetes, although its use in measuring glycated hemoglobin (HbA1c) levels is less common, perhaps due to perceived performance issues and access to the technology. METHODS:Forty blood samples were analyzed in duplica...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2013.05.2664
更新日期:2013-05-01 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::The cutaneous manifestations of systemic diseases are diverse. In some cases, they are the first signs of an underlying disorder, such as Cowden's disease, dermatomyositis, and Lyme disease. Sister Mary Joseph's nodule (metastatic involvement of the umbilicus) is an ominous sign of internal malignant disease. Drug-ind...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::In most cases, the cause of facial paralysis can be determined on the basis of the clinical evaluation, and expensive diagnostic tests can be avoided. Because Bell's palsy is not always the cause, physicians need to be able to identify critical findings on history and physical examination that indicate an alternative ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.06.522
更新日期:1998-06-01 00:00:00
abstract::The spectrum of interaction between drugs and the kidney is broad. Most drugs are excreted at least partially by the kidney, and renal function affects drug bioavailability, volume of drug distribution, and drug metabolism and rate of drug elimination. Drug therapy not only is potentially hazardous in patients with re...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714978
更新日期:1978-11-01 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::Acute exacerbations of chronic obstructive pulmonary disease occur often. Severity should be established by signs and symptoms and by reference to baseline pulmonary function test results when necessary. If the exacerbation is mild to moderate, treatment should include antibiotics, theophylline, beta agonists, and muc...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701168
更新日期:1992-01-01 00:00:00
abstract::In clinical practice, atrial fibrillation (AF) is the most commonly encountered arrhythmia. With the aging of the US population, the number of patients with AF that physicians encounter will increase. Atrial fibrillation management involves a combination of rate- and rhythm-control strategies with thromboprophylaxis, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.11.2491
更新日期:2011-11-01 00:00:00
abstract::In the evaluation of male and female infertility the history, family history, physical examination, and endocrine and gonadal functional evaluations are the most informative measures. The cause of the infertility is never found in some 17.5% of couples and in almost one fourth of males. In over one third of cases male...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715204
更新日期:1979-07-01 00:00:00
abstract::Preview Although headaches in elderly patients are usually benign, they are common and some can be life-threatening. Precise diagnosis is imperative for optimum pain management and early detection of underlying organic disorders. Dr Ruoff discusses the primary types of benign headache, current diagnostic criteria, and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945773
更新日期:1993-12-01 00:00:00
abstract::Penile lesions are a discomfiting affliction demanding skillful diagnosis and management by the primary care physician. This article discusses and illustrates 14 common types, delineating characteristics, course, and treatment. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715853
更新日期:1981-09-01 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: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::In addition to sinus and dental abnormalities and stress, several different neurologic conditions can cause facial pain. These include various neuroalgias (trigeminal, vagoglosso-pharyngeal, cranial), carotodynia, and optic neuritis. Pain characteristics and results of specific neurologic tests establish the diagnosis...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704523
更新日期:1990-01-01 00:00:00
abstract::The skin is a window of internal malignancies and other diseases. The cutaneous signs of internal malignancy can be divided into four major groups: (1) hypersensitivity or toxic reactions, (2) infections, (3) metabolic disorders, and (4) tumors. A diagnosis of the many signs of systemic malignancy is made by inspectio...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699299
更新日期:1986-02-15 00:00:00
abstract::In public whirlpools, low disinfectant levels and inadequate monitoring are clearly a public health concern. Implementing guidelines published by the Centers for Disease Control seems to be the most reasonable approach to preventing dermatitis in persons who use these facilities. Physicians should be on the alert for ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701042
更新日期:1991-09-01 00:00:00
abstract::Sjögren's syndrome is a chronic, systemic, autoimmune inflammatory disorder characterized by lymphocytic infiltration of exocrine glands, most notably the salivary and lacrimal glands. It results in loss of functional epithelium, diminished exocrine function, and gradual onset of dryness of the eyes, mouth, and other ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2004.09.1587
更新日期:2004-09-01 00:00:00
abstract::Management of patients with diabetes mellitus and chronic kidney disease (CKD) is a challenging task because multiple factors in each condition may impact the other. Glycemic control offers significant benefits in the prevention of diabetic kidney disease (DKD), but other associated morbidities are also important to a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.05.2002
更新日期:2009-05-01 00:00:00
abstract::Myasthenia gravis most commonly affects the ocular muscles. Abnormal fatigability of the involved muscle groups is the most remarkable feature of the physical examination. Recent studies have demonstrated that a thymus-derived antibody plays a role in the pathogenesis of myasthenia gravis, which is now thought to be a...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715218
更新日期:1979-08-01 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
abstract::Preview Although specific vitamin deficiency syndromes are relatively rare in the United States, primary care physicians may encounter them in elderly patients and persons who consume minimal diets. Knowledge of such deficiencies is crucial in the evaluation of these patients. The authors discuss manifestations of def...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704615
更新日期:1990-03-01 00:00:00
abstract::Although statin therapy has revolutionized management of coronary heart disease (CHD), the lowering of low-density lipoprotein cholesterol (LDL-C) levels is not the whole story. Increased plasma concentrations of high-density lipoprotein cholesterol (HDL-C) have a cardioprotective effect that is just as important for ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2005.04.1610
更新日期:2005-04-01 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::Preview In most patients with stable angina pectoris, symptoms can be controlled successfully with drug therapy. Revascularization procedures should be reserved for those at high risk for cardiac events and those who do not respond to optimal therapy with any of the three classes of antianginal agents. In this article...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946093
更新日期:1995-12-01 00:00:00
abstract::With use of the International Normalized Ratio (INR), physicians can accurately assess the intensity of anticoagulation in treatment programs and trials. Bleeding is the major complication of oral anticoagulant therapy, and its incidence can be lessened, with no loss of efficacy, by using less intense therapy (INR, 2 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::Hepatitis C virus (HCV) is responsible for most cases of non-A non-B hepatitis and is primarily spread by a parenteral route, although familial, sexual, and maternal transmission may occur rarely. Second-generation assays and the polymerase chain reaction facilitate detection of HCV infection. The association between ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::Urinalysis and urine chemistries are most helpful in determining whether acute renal failure is due to a prerenal, renal, or postrenal cause. A plain film of the abdomen should be obtained, with ultrasound or computed tomography also being done if obstruction is suspected. When prerenal and postrenal causes have been ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716292
更新日期:1982-12-01 00:00:00
abstract::To aid in making care of HIV-infected patients part of your office routine, Dr Coodley presents here a checklist that combines the various clinical aspects of initial management. Covering the steps from the history to plans for follow-up, this article should allay anxiety and promote confidence in your entire staff by...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1993.11701640
更新日期:1993-03-01 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::Hyponatremia (serum sodium <135 mEq/L) is a common electrolyte disorder in community or hospitalized patients. Serum sodium levels should be corrected at a proper rate in patients with hyponatremia, since overcorrection of serum sodium levels is related to devastating neurologic consequences, such as the osmotic demye...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1186488
更新日期:2016-06-01 00:00:00