Abstract:
:Pneumococcal disease, which includes pneumococcal pneumonia, meningitis, and bacteremia, is associated with substantial morbidity, mortality, and health care costs in adults. Advanced age, chronic lung or cardiovascular disease, immunosuppressive conditions, and smoking increase the risk for infection. Despite the availability of an effective pneumococcal polysaccharide vaccine (PPSV23), vaccination rates among adults remain suboptimal. This is of immediate concern given the current H1N1 pandemic, since secondary bacterial infection with Streptococcus pneumoniae is common and can contribute to morbidity and mortality. The Centers for Disease Control and Prevention has recently called for increased efforts to vaccinate recommended persons against pneumococcal disease. Long-term trends including the growth of the elderly population and an increase in the number of patients with chronic conditions also underscore the importance of improving pneumococcal vaccination rates. It is important for health care providers, public health officials, and policy makers to recognize the serious health impact of pneumococcal disease in adults and to ensure increased coverage; at present, this is the best way to protect against invasive pneumococcal infection and its consequences.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Rehm SJ,Farley MM,File TM Jr,Hall WJ,Hopkins R,Levine OS,Nichol KL,Nuorti P,Zimmerman RK,Schaffner Wdoi
10.3810/pgm.2009.11.2069subject
Has Abstractpub_date
2009-11-01 00:00:00pages
101-5issue
6eissn
0032-5481issn
1941-9260journal_volume
121pub_type
杂志文章abstract::Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespect...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1433434
更新日期:2018-03-01 00:00:00
abstract::Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes mellitus (T2DM) and is associated with poor clinical outcomes, including an increased risk of all-cause and cardiovascular mortality, as well as adverse economic and social effects. Slowing the development and progression of CKD remains an unme...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2019.1601404
更新日期:2019-05-01 00:00:00
abstract::The prognosis for patients with obsessive-compulsive disorder has improved dramatically in recent years. Primary care physicians, who may be the first healthcare professionals to consult with these patients, can often provide appropriate treatment or therapeutic guidance. Psychiatric consultations and the implementati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.12.807
更新日期:1999-12-01 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:OBJECTIVES:Management of cardiovascular (CV) risk is an essential aspect of diabetes care, and acceptable CV risk is a requirement for antidiabetes medications. Dipeptidyl peptidase-4 (DPP-4) inhibitors effectively reduce glycated hemoglobin, with a low risk of hypoglycemia and weight gain. The purpose of this review i...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2015.1095616
更新日期:2015-01-01 00:00:00
abstract::What clinical circumstances call for aggressive treatment of jaundice in newborns? Is cessation of breast-feeding necessary to help bring down the high bilirubin concentration? When should phototherapy be started--and stopped? The authors address these and other questions in this thorough guide to differential diagnos...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::Many drugs with which to treat reversible obstructive airway disease are available. Beta-adrenergic aerosols are the first line of defense; these are followed, when necessary, by either timed-release theophylline or oral beta-adrenergics. Often, a combination of these drugs must be used to achieve effective relief of ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699911
更新日期:1987-07-01 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::Autonomic neural impulses that accompany discharges during a seizure can cause a variety of cardiac manifestations, including cardiac arrhythmias, sudden death, anginal chest pain, neurogenic pulmonary edema, and symptoms of pheochromocytoma. Either generalized or focal seizures may generate such signs and symptoms. A...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716430
更新日期:1990-11-01 00:00:00
abstract::Preview Although heartburn is the most common symptom of gastroesophageal reflux, many patients with reflux have other, more obscure manifestations. Recognition of all potential signs and symptoms of reflux is important for expeditious management. This article focuses on these atypical presentations and discusses how ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946110
更新日期:1996-04-01 00:00:00
abstract::Oxygen therapy is tremendously valuable for patients with chronic respiratory insufficiency. A physician's prescription is needed to obtain Medicare, Medicaid, or insurance-company reimbursement, and certain guidelines must be followed: Patients are selected if significant hypoxemia is present, appropriate pharmacolog...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700464
更新日期:1988-11-01 00:00:00
abstract::The increased utilization of diagnostic procedures has prompted interest in cost-effective laboratory testing. Clinically useful tests-useful in the sense that the patient benefits-are cost effective. The choice of test(s) is determined by the risks and benefits of proposed management. In practice, the first step in c...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715687
更新日期:1981-02-01 00:00:00
abstract::Obesity is currently a worldwide epidemic, and will likely only increase in prevalence in the coming years. The incidence of the metabolic syndrome (MetS) seems to be paralleling obesity. The MetS is strongly linked to insulin resistance, abdominal obesity, diabetes mellitus, and dyslipidemia. Nonalcoholic fatty liver...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.07.1800
更新日期:2008-07-31 00:00:00
abstract::When many physicians think of managed care, they think first of Kaiser Permanente, the nation's largest HMO. That perception is misguided, according to David M. Lawrence, MD, the chief executive officer and chairman of the boards of the Kaiser Foundation health plan and hospitals. During a phone interview recently, La...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945854
更新日期:1994-05-15 00:00:00
abstract::The important causes of hypoglycemia unrelated to known diabetes are relatively few. Postprandial hypoglycemia is a relatively benign disorder. Fasting hypoglycemia is more serious and may be caused by metabolic disturbances or tumors. Several hereditary disorders cause hypoglycemia in infants and must be diagnosed an...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716369
更新日期:1990-07-01 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::Performing office surgery well is an art. You can accomplish this by being attentive to several factors. These include, but are not limited to, providing an office environment that is pleasant, restful, and happy; using proper lighting, instruments, and suture techniques; using gentle techniques for local infiltration...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698400
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:The mechanism of action of dipeptidyl peptidase-4 inhibitors, such as saxagliptin, makes them suitable for combination therapy in type 2 diabetes mellitus (T2DM). Genetic, cultural, and environmental differences in individuals from different regions of the world may result in differences in treatment respons...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3810/pgm.2011.07.2305
更新日期:2011-07-01 00:00:00
abstract::Bronchiectasis is characterized by permanent, abnormal dilation of the bronchi with chronic inflammation and infection. Bronchiectasis is either caused by or associated with several systemic disorders, and in a significant number of cases, the underlying etiology remains unidentified and is subsequently referred to as...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.09.1912
更新日期:2008-09-01 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::Elderly patients should be evaluated closely before surgery. Problems commonly found in these patients (ie, hypertension, diabetes, and cardiac and pulmonary disease) should be sought with special care and treated before surgery is undertaken. Also, wound healing may be compromised, drug clearance and metabolism impai...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701206
更新日期:1992-02-01 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::Currently, surveillance or risk-oriented follow-up of patients in the individual practice setting may be the most efficacious means of reducing the morbidity and mortality associated with selected types of cancer. Intervention into carcinogenesis or alteration of the natural history of cancer requires a clear understa...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11699112
更新日期:1985-09-01 00:00:00
abstract::Preview New information emerges almost weekly about the relative importance of one factor or another in the development of coronary artery disease. Yet controversies continue over which factor deserves the most emphasis. Dr Elliott presents a broad and, at times, humorous look at research into cardiovascular risk fact...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945892
更新日期:1994-09-01 00:00:00
abstract::When a patient presents with a hard, painless lump in the neck, one should assume that it is a cancer and that it is metastatic from a primary lesion located above the clavicle. A careful physical examination with the appropriate instruments most often will determine the site of the primary lesion. Laryngograms or lat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11714054
更新日期:1975-05-01 00:00:00
abstract::Gastric volvulus is torsion of the stomach, which can compromise the gastric orifices and result in either acute or chronic and intermittent symptoms. We believe that gastric volvulus, especially when partial or intermittent, may be more common than has been previously thought. The condition should be suspected in any...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699576
更新日期:1986-10-01 00:00:00
abstract::Allergy is responsible for many problems in the pediatric age-group. At times the most difficult job for the physician is to determine if the patient is indeed allergic and, if so, to what. Allergy skin testing remains the first choice for diagnostic study. Treatment consists of avoiding the offending allergen if poss...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11716317
更新日期:1984-05-01 00:00:00
abstract::Septic shock is a multisystem disorder that represents the host's response to microbial invasion in its most fulminant form. One of the critical defects is a widespread inability to use available substrate for energy production. Endogenous mediators, particularly the cytokines, appear to play an essential role in this...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704384
更新日期:1989-09-01 00:00:00
abstract::Present evidence suggests that the most important nutritional factor bearing on the risk of development of diabetes mellitus is an excessive caloric intake. Other evidence suggests that both dietary prevention of diabetes and mitigation of hyperglycemia by dietary means can prevent morbidity and mortality from the mic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11712096
更新日期:1976-09-01 00:00:00
abstract::Hypertension is a leading contributor to the burden of cardiovascular disease. The importance of lowering blood pressure (BP) to reduce the risk of cardiovascular events has been demonstrated in numerous clinical trials. Most patients require combination antihypertensive therapy utilizing agents from complementary dru...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.03.1974
更新日期:2009-03-01 00:00:00