Abstract:
:A 65-year-old woman presented to the hospital with weight loss and diarrhea. A diagnosis of thyroid storm was established by the presence of fever, lethargy, tachycardia, heart failure (HF), and abnormal thyroid function tests. An acute coronary syndrome (ACS) was suspected because of anteroseptal ST-segment elevations on electrocardiogram and severe left ventricular (LV) dysfunction with apical dilation on echocardiogram. The ejection fraction (EF) was 25%. Treatment for ACS and HF was begun. Coronary arteriography revealed normal coronaries. Propylthiouracil and corticosteroids were added to treat thyrotoxicosis. On Day 4, repeat echocardiography confirmed an EF of 65% and complete resolution of LV dysfunction and cavity dilation. Reversible LV dysfunction and apical cavity dilation is consistent with Takotsubo cardiomyopathy. While commonly associated with psychological trauma, its association with thyroid storm has only been reported twice before. Knowledge of this possible association is of importance in establishing the diagnosis and instituting a proper treatment plan.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Radhakrishnan A,Granato JEdoi
10.3810/pgm.2009.05.2012subject
Has Abstractpub_date
2009-05-01 00:00:00pages
126-30issue
3eissn
0032-5481issn
1941-9260journal_volume
121pub_type
杂志文章abstract::Most patients with community-acquired pneumonia are treated as outpatients, and choice of therapy is usually empirical because the etiologic agent is unknown. Therapy should include coverage for both typical and atypical organisms. In geographic areas with highly resistant S pneumoniae, one of the newer fluoroquinolon...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.04.668
更新日期:1999-04-01 00:00:00
abstract::In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit. :There ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715824
更新日期:1981-08-01 00:00:00
abstract:AIM:To demonstrate the impact of the parathyroid hormone-related peptide (PTHrP) on the large conductance calcium-activated potassium (BKCa) channels in vascular smooth muscle cells (VSMC) and hyperpolarization of the cell membrane and its dependence on calcium. MATERIALS AND METHODS:VSMC were isolated from rat aorta ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.03.2742
更新日期:2014-03-01 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::Although fairly common, syncope is a frightening symptom that can signal a serious underlying disease. The varying causes present a diagnostic challenge to the examining physician, who needs to assess whether referral for more specialized or invasive study is appropriate. The authors review common cases of syncope and...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701298
更新日期:1992-04-01 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::Remittent isolated palsy of peripheral or of upper cranial nerves in patients with diabetes mellitus is well documented, but paralysis of a lower cranial nerve or an isolated branch of any cranial nerve has not been previously reported. In the case described, temporary paralysis of the left recurrent laryngeal nerve c...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700420
更新日期:1988-09-15 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::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:OBJECTIVE:This study aims to compare the effectiveness of insulin glargine 300 U/mL (Gla-300) with its accompanying patient support program with that of other basal insulin and available patient support programs in patients with type 2 diabetes (T2D) in a real-world setting in terms of achieving HEDIS (Healthcare Effec...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1080/00325481.2016.1241663
更新日期:2016-11-01 00:00:00
abstract::Preview An elevated serum calcium level requires thorough investigation. Is hyperparathyroidism at the root of the abnormality? Malignant disease? Vitamin toxicity? In this article, Dr Kaye discusses clinical evaluation of hypercalcemia and outlines pharmacologic therapy, surgical intervention, and other treatment opt...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945953
更新日期:1995-01-01 00:00:00
abstract::Neonatal circumcision continues to be a controversial subject. The American Academy of Pediatrics has revised its earlier policy, stating that newborn circumcision has potential benefits as well as risks and emphasizing the need to explain these issues to parents considering the procedure so that an informed decision ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701325
更新日期:1992-05-01 00:00:00
abstract::In the fast-paced setting of primary care, it is difficult to detect psychiatric disorders, especially the more subtle disorders, such as minor depression and dysthymia. In cases of dysthymia, in particular, the patients themselves may not even have a sense that anything medically treatable is wrong; they feel as thou...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.11.2003.suppl29.159
更新日期:2003-11-01 00:00:00
abstract::Spirometry is a simple but underutilized test that is particularly well suited for office practice. With it, the physician can distinguish among different types of ventilatory impairment and follow the patient's course. It also permits detection of small-airway disease at an early stage, when measures to prevent devel...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714724
更新日期:1978-01-01 00:00:00
abstract::Measurement of cerebrospinal fluid (CSF) lactate is a useful test when properly applied to the appropriate clinical situation and can offer information other CSF parameters cannot provide. Except for Gram's stain of CSF, lactate level is the most important CSF parameter in the early differentiation of viral (aseptic) ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716403
更新日期:1990-10-01 00:00:00
abstract::Pruritus scroti is a common clinical disorder that is caused by various inflammatory disorders, infections, infestations, and neoplasms. Laboratory evaluation, including bacterial and fungal cultures, microscopic examination, skin biopsies, and measurement of blood glucose levels, is useful in establishing the diagnos...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716424
更新日期:1990-11-01 00:00:00
abstract::Primary care physicians have an important role in diagnosing and treating eye disorders--including dacryocystitis, blepharitis, and conjunctivitis--and in determining when ophthalmologic referral is needed. Fundus examination for diagnosis of glaucoma and diabetic eye complications should be a part of the routine exam...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Primary care physicians play a pivotal role in the early identification of patients with COPD. Early diagnosis, along with aggressive intervention, is the only way that the increasing morbidity and mortality of COPD can be reversed. Any patient with a history of smoking should undergo evaluation for the possibility of...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2002.06.1225
更新日期:2002-06-01 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::Regular aerobic exercise has significant cardiovascular benefits, including a reduction in incidence of and mortality from coronary artery disease--probably because of positive effects on blood lipid levels and blood pressure. Aerobic exercise can also be an important adjunct to a weight-loss program. Many persons who...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700983
更新日期:1991-07-01 00:00:00
abstract::Primary care physicians play an important role in the outpatient evaluation of proteinuria, a common finding in everyday medical practice. Therefore, it is important to recognize which symptoms and signs signal the need for further evaluation. A simple urine dipstick test usually is the first step, but factors leading...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.04.201
更新日期:1997-04-01 00:00:00
abstract::As one patient put it after hearing his treatment options for a stage I testicular tumor, "If you're gonna have cancer, this is about as easy a road as you get." With recognition of the importance of orchiectomy, development of the nerve-sparing lymph node dissection procedure, and availability of modern chemotherapy ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.04.699
更新日期:1999-04-01 00:00:00
abstract::Oat cell carcinoma is the one variety of primary lung cancer which is sufficiently responsive to a variety of drugs and drug combinations that a very high rate of response and significant prolongation of survival can be consistently achieved. The question of whether anyone has been "cured" by drug treatment awaits mor...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714758
更新日期:1978-02-01 00:00:00
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 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.09.2694
更新日期:2013-09-01 00:00:00
abstract::The balloon-tipped thermodilution catheter (BTTC) is an expensive, labor-intensive technology that has moderate risks. The sensitivity and specificity of the three principal tests that it can perform have not yet been well defined for different patient groups. The BTTC allows the acquisition of mixed venous blood, fro...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699383
更新日期:1986-05-01 00:00:00
abstract::The goal of screening for colorectal cancer is to find early, asymptomatic cancers and adenomatous polyps that are 1 cm or more in diameter or that are villous or tubulovillous histologically. A study using fecal occult blood testing with rehydration and no sigmoidoscopy found that deaths from colorectal cancer can be...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract::Successful joint and soft-tissue aspiration and injection rely on the physician's understanding of the indications, contraindications, and general techniques involved in these procedures. The procedures are generally well tolerated and can be used to treat many painful musculoskeletal and soft-tissue conditions. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.01.834
更新日期:2001-01-01 00:00:00
abstract::Although leprosy is increasing in incidence in the United States, it is confined almost entirely to immigrants from developing countries and their close contacts. While the clinical disease has not changed, leprosy has diffused more widely throughout the United States as a result of migration. Primary care physicians ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698955
更新日期:1985-04-01 00:00:00
abstract::Objective: Abnormal pro-inflammatory regulation of the immune system might contribute to the pathogenesis of hyperglycemia during pregnancy. We examined the correlations of neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR) with disease severity and assessed their predictive values. Methods: This re...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1764235
更新日期:2020-11-01 00:00:00
abstract::Varicose veins are a common problem that still presents a major challenge to the physician and the patient. Complete surgical removal of the malfunctioning veins has proved to be the most effective management for significant varicosities, although several nonsurgical methods are available for mild cases or those not s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715178
更新日期:1979-06-01 00:00:00