Abstract:
:Why do some people spend most of the night tossing and turning while others drop off as quickly as a cat in the sun? There are many possible explanations for problems with falling and staying asleep and, sometimes, patients actually get a lot more sleep than they think they do. Each type of insomnia has its own set of symptoms, which can be used, along with appropriate diagnostic tools, to help in identification. In this article, Dr. Attarian describes differential diagnosis and summarizes the best treatment approaches to the common causes of insomnia.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Attarian HPdoi
10.3810/pgm.2000.03.935subject
Has Abstractpub_date
2000-03-01 00:00:00pages
127-30, 133-7, 140-2issue
3eissn
0032-5481issn
1941-9260journal_volume
107pub_type
杂志文章,评审abstract::In cases of unusual presentations, such as the three cases described here, gout or gouty arthritis may be misdiagnosed as rheumatoid arthritis, septic arthritis, or other rheumatic conditions and thus inappropriately treated. Microscopic analysis using compensated polarized light and culture of synovial fluid helps di...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.07.20
更新日期:1996-07-01 00:00:00
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::Coronary artery disease (CAD) remains the major cardiovascular health issue in contemporary clinical practice. Treatment options for multivessel CAD include medical therapy, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Here, the authors review the most recent data that compare ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2005.12.1670
更新日期:2005-12-01 00:00:00
abstract::Cecal volvulus is a malrotational abnormality of the intestine that causes obstruction. Diagnosis is difficult and, if delayed, the results may be intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined from physical and laboratory findings. Although not always ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716164
更新日期:1982-08-01 00:00:00
abstract::Nitroglycerin and long-acting nitrates are the pharmacologic mainstays of antianginal therapy, both for acute attacks and for prophylaxis. Propranolol is often effective for prophylaxis in patients incompletely helped by nitrates. A holistic approach is stressed. Appropriate drug use will effect marked improvement in ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714674
更新日期:1977-11-01 00:00:00
abstract::Iron deficiency occurs when the body's iron stores are exhausted. The source of blood loss leading to iron deficiency must be identified in all cases. Anemia of chronic disease generally results from an infectious, inflammatory, or malignant process. However, in some reported cases, no such process could be identified...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701469
更新日期:1992-09-15 00:00:00
abstract::Fluoroquinolone-resistant variants of pandemic clones Spain(23F)-1, Spain(6B)-2, Spain(9V)-3, and Spain(14)-5 have been seen in various regions of the United States and the world, leading to the speculation that fluoroquinolone resistance among US Streptococcus pneumoniae may increase because of clonal spread. Using l...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2008.09.suppl52.283
更新日期:2008-09-01 00:00:00
abstract::Treatment of hypertension in African Americans has special challenges, including a lack of objective trial data on which to base decisions and differing benefits and responses than with other patients. However, adequate control is possible and should be the goal of treating physicians. This article describes current "...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2002.10.1333
更新日期:2002-10-01 00:00:00
abstract::Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used to treat inflammatory pain for decades. More recently, newer NSAIDs were developed to target the inducible isoform of cyclooxygenase (COX), COX-2, with the aim of reducing gastrointestinal toxicity. While the COX-2 selective inhibitors were effective...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1412799
更新日期:2018-01-01 00:00:00
abstract::Head trauma in the elderly is a major source of morbidity and mortality in this population. Prevention of the primary injury is ideal and requires that the primary care physician understands the neurosensory changes of aging. Failing prevention, rapid diagnosis and efficient management of the traumatized patient are o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700292
更新日期:1988-05-15 00:00:00
abstract::Over the past decade, despite the controversies surrounding prostate cancer screening, significant refinements have improved its application. PSA screening, although it has been questioned, appears to confer a mortality benefit and remains the most effective way to identify the possible presence of prostate cancer. Me...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1822067
更新日期:2020-12-01 00:00:00
abstract::A patient's history usually contains key information regarding the type of dizziness and the best way to direct diagnostic workup. In dizziness with a vestibular cause (benign positional vertigo, vestibular neuritis, Meniere's disease, migraine, vertebrobasilar insufficiency), patients often describe their world as sp...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.02.555
更新日期:1999-02-01 00:00:00
abstract::Evaluation of a patient presenting with dizziness begins with and largely depends on the patient's history. The diagnosis often can be accurately determined in a primary care setting when a stepwise algorithmic approach is used. The first step is getting a detailed account of precisely what the patient means by "dizzi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::In this review, we focus on current trends in the management of male lower urinary tract symptoms (LUTS), defined here as LUTS, namely, storage, voiding, and post-micturition symptoms presumed secondary to benign prostatic hyperplasia (BPH), and discuss possible novel approaches toward better care. According to result...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1487238
更新日期:2018-06-01 00:00:00
abstract::Metformin is a first-line pharmacological treatment for patients with type 2 diabetes mellitus because of its favorable overall profile, including its glucose-lowering ability, weight-neutral effects, and low risk of hypoglycemia; however, gastrointestinal (GI) intolerance may limit use in some patients. Extended-rele...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.01.2241
更新日期:2011-01-01 00:00:00
abstract::Many aspects of Kawasaki syndrome remain a mystery. The cause of the disease has eluded researchers, and its pathophysiology is a subject of much debate. However, the diagnostic features have been identified: A significant fever for at least 5 days, bilateral nonexudative conjunctivitis, erythema of the palms and sole...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::Solid organ transplantation is now the standard of care for end-stage organ failure, and primary care physicians are frequently involved in the follow-up care of transplant recipients. New-onset diabetes mellitus after solid organ transplantation (NODAT) has emerged as an increasingly important determinant of outcomes...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2008.07.1792
更新日期:2008-07-01 00:00:00
abstract::Deep neck infection has ominous implications if not detected and treated in an early stage. The anatomic relationships of head and neck spaces encourage spread of infection. Immediate hospitalization and constant monitoring of the patient after diagnosis are mandatory. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714389
更新日期:1976-06-01 00:00:00
abstract::Preview How can physicians make appropriate treatment decisions in substance abusers who have serious medical illness, especially when patients may not offer the information needed? Drs Westreich and Rosenthal summarize common physical findings that suggest abuse of specific substances. Recognizing these signs allows ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945984
更新日期:1995-04-01 00:00:00
abstract::The end point in peptic ulcer disease is a crater in the mucosa. The cause of gastric ulcers seems to be the breakdown of defensive factors, which then allows damage from endogenous and/or exogenous aggressive factors. Aggressive factors are more important in duodenal ulcer formation. Treatment options discussed herei...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1993.11701642
更新日期:1993-03-01 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::Healthcare providers usually assess glycemic control in diabetic patients by measuring fasting plasma glucose and preprandial glucose levels, as well as hemoglobin A1c (HbA1c). Evidence now suggests that elevated postprandial glucose concentrations may contribute to suboptimal glycemic control. Several medications and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.12.2001.suppl17.93
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To compare effects of raisin snacks with conventional snacks on glycemia and cardiovascular risk factors. MATERIALS AND METHODS:A 12-week, randomized, controlled trial compared 3-times-a-day consumption of raisins with intake of processed snacks on glycemia and cardiovascular risk factors. Men and women were...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2014.01.2723
更新日期:2014-01-01 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::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::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::Even healthy persons may experience some form of altitude illness when they hike or ski in high mountains. Therefore, it is imperative that those with compromised cardiac or pulmonary function take extra precautions by allowing time for ascent, by recognizing and accepting their limitations, and by descending promptly...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716360
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVES:Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients. METHODS:Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were adm...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2017.1263139
更新日期:2017-01-01 00:00:00
abstract::Patients presenting with typical signs and symptoms of allergic rhinitis may respond to avoidance of allergens and to medications for symptomatic relief. Treatment may include antihistamines, decongestants, cromolyn sodium, and/or topical nasal steroids. Patients whose symptoms are refractory to these therapeutic meas...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699668
更新日期:1987-01-01 00:00:00
abstract::In this era of resource limitations, use of healthcare dollars should be directed to diagnostic and therapeutic programs that can be supported by scientifically valid information. Screening for colorectal cancer has to overcome two limitations before its routine use can be justified. First, the disease is largely a pr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00