Abstract:
:A total of 187 heart failure patients aged 65-92 years, with pretreatment serum creatinine levels below 200 mumol/l, were monitored for more than 12 months on angiotensin-converting enzyme (ACE) inhibitor therapy. Optimal ACE inhibitor dosage was found in 27% of patients, while a significant deterioration in renal function, characterised by > 20% increase in serum creatinine to > 200 mumol/l, occurred in 25 patients. This was most closely attributable to ACE inhibitor treatment per se (implying co-existence of bilateral renal artery stenosis) in only four cases, including one in whom renal deterioration was reproducible on inadvertent rechallenge. In the other 21, renal deterioration was attributable to diuretic-related blood volume depletion (two cases), nonsteroidal anti-inflammatory drugs (two cases), obstructive uropathy (two cases), preterminal renal shutdown (two cases), and the interaction between diuretic and ACE inhibitor dosage (including long-acting vs short-acting drugs) (13 cases). This study could serve as the basis for future comparisons of ACE-inhibitor-related renal deterioration when the entry requirement is optimal ACE inhibitor dosage.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Jolobe OMdoi
10.1136/pgmj.75.883.275subject
Has Abstractpub_date
1999-05-01 00:00:00pages
275-7issue
883eissn
0032-5473issn
1469-0756journal_volume
75pub_type
杂志文章abstract:BACKGROUND:Enabling healthcare staff to report concerns is critical for improving patient safety. Junior doctors are one of the groups least likely to engage in incident reporting. This matters both for the present and for the future, as many will eventually be in leadership positions. Little is known about junior doct...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-133045
更新日期:2015-05-01 00:00:00
abstract::The prognosis of patients with metastatic adrenal cortical carcinoma is poor, and their disabling symptoms are usually unresponsive to conventional therapy. A patient with Cushing's syndrome secondary to a secretory adrenal cortical carcinoma was treated with octreotide, endocrine therapy and chemotherapy having faile...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.834.229
更新日期:1995-04-01 00:00:00
abstract:PURPOSE:To determine the association between professors' self-perception of mentoring skills and their academic performance. DESIGN:Two hundred and fifteen professors from Imperial College London, the first Academic Health Science Centre (AHSC) in the UK, were surveyed. The instrument adopted was the Mentorship Skills...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133542
更新日期:2016-10-01 00:00:00
abstract::A 63 year old man who suffered from syringomyelia related to post-meningitic spinal arachnoiditis caused by Candida tropicalis is reported. The clinical syndrome of syringomyelia developed gradually and a definite diagnosis was delayed for more than 10 years. The patient has partially recovered after surgical treatmen...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.790.767
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervou...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134475
更新日期:2017-07-01 00:00:00
abstract::Twenty-four hour intragastric acidity was measured in nine volunteer subjects in a single-blind placebo-controlled cross-over study comparing the effects of famotidine with ranitidine. The volunteer subjects received famotidine (40 mg at night), famotidine (20 mg at night), ranitidine (300 mg at night) or placebo in a...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-01-01 00:00:00
abstract::We present a 78-year-old woman with clinical acute hypopituitarism in whom pathologic findings showed lymphocytic hypophysitis and retroperitoneal fibrosis. Lymphocytic hypophysitis should be included in the differential diagnosis of hypopituitarism at any age. The association with idiopathic retroperitoneal fibrosis ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.865.732
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:To identify the consultation activities of clinical ethics committees (CECs) in the UK and the views of CEC chairpersons regarding such activities. METHODS:An anonymous, password-protected online questionnaire was sent by e-mail to 70 CEC chairpersons. The questionnaire contained 14 items. RESULTS:Of the 70...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2008.075879
更新日期:2009-09-01 00:00:00
abstract::A case is presented of a young competitive body-builder who abused anabolic steroid drugs and developed profound symptomatic hypogonadotrophic hypogonadism. With the help of prescribed testosterone (Sustanon) he stopped taking anabolic drugs, and later stopped Sustanon also. Hypogonadism returned, but was successfully...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.74.867.45
更新日期:1998-01-01 00:00:00
abstract::Hospital referral is indicated as an emergency for breast infections not settling with oral antibiotics. Referrals to a breast clinic over a period of 6 months were assessed for prior antibiotic prescription. A total of 1078 patients were seen during this period. 91 (8%) patients had been prescribed antibiotics, 71% o...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2006.049296
更新日期:2006-11-01 00:00:00
abstract::The gross and microscopic features of an unusual case of neurocutaneous melanosis are described. This is an example of the rare association between a primary central nervous system malignant melanoma and a giant congenital melanocytic naevus of 'bathing trunk' distribution. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.764.387
更新日期:1989-06-01 00:00:00
abstract::The protean neurological manifestations of human immunodeficiency virus (HIV) infection are reviewed. Both the central nervous system and peripheral nervous system may be affected and many of the complications may occur in individuals with acquired immunodeficiency syndrome (AIDS)-related complex, or who are seroposit...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.64.749.180
更新日期:1988-03-01 00:00:00
abstract::This report describes the case history of a middle-aged lady who presented with symptoms and signs over one year leading to a diagnosis of multiple sclerosis. During one of her relapses, she developed trismus--an association that has not been described before in multiple sclerosis. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.780.853
更新日期:1990-10-01 00:00:00
abstract::Verrucous carcinoma is a rare skin malignancy of squamous cell origin. It is characterised by negligible cellular atypia and a low mitotic rate. These are reflected in slow locally invasive behaviour and very infrequent metastatic spread. The tumour is also recognised in oral and anogenital sites. Cutaneous lesions pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.889.674
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::Common bile duct perforation causing biliary peritonitis is an unusual entity and a pancreatic calculus causing this perforation is all the more rare, and to our knowledge has not been reported previously. Such an unusual presentation of chronic calcific pancreatitis is herein reported. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.804.837
更新日期:1992-10-01 00:00:00
abstract::Pregnancy is a time of great maternal physiological and metabolic changes. This affects the biochemical and haematological parameters used in the assessment of liver disease, and it is important to appreciate the different reference ranges in pregnancy to facilitate recognition of liver disorders in pregnancy. Due to ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2009.089631
更新日期:2010-03-01 00:00:00
abstract::Herpes simplex encephalitis may be underdiagnosed in Britain. We report eight patients treated at one hospital over three years. Fever, impaired consciousness or focal neurological signs were seen in all patients at presentation but herpes simplex encephalitis was rarely considered as the initial diagnosis. The electr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.746.1037
更新日期:1987-12-01 00:00:00
abstract::Testis cancer is an increasing problem, especially in northern European male populations. However, survival has improved dramatically over one generation. Environmental factors may have a role in the aetiology with high oestrogen concentrations implicated. Testis cancer is subdivided between seminoma and non-seminoma....
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2007.057992
更新日期:2007-10-01 00:00:00
abstract::The 1994 NACT Wyeth-Ayerst Travelling Fellowship provided the opportunity to compare the education and welfare of pre-registration house officers in the UK with their nearest counterpart in the US residency system. Investment in all aspects of learning was impressive, as was the retention of the central role of the pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.835.273
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Primary percutaneous coronary intervention (PPCI) programmes vary in admission criteria from open referral to acceptance of electrocardiogram (ECG) protocol positive patients only. Rigid criteria may result in some patients with acutely occluded coronary arteries not receiving timely reperfusion therapy. OB...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-130818
更新日期:2013-07-01 00:00:00
abstract::Various tumours, in particular lymphomas, have been reported in association with azathioprine treatment, both after renal transplantation and in other conditions. A case is reported here of acute myeloid leukaemia associated with azathioprine therapy for rheumatoid arthritis, and this is now the third case reported in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.617.173
更新日期:1977-03-01 00:00:00
abstract::We describe two cases of digoxin toxicity presenting with clinical and electroencephalographic evidence of encephalopathy without other features of digoxin toxicity. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.848.367
更新日期:1996-06-01 00:00:00
abstract::High flow arteriogenic priapism is uncommon and usually occurs after trauma to the genitoperineal area. The onset of prolonged erection can be delayed and is often relatively pain free. Arteriography in this case illustrated the causative bilateral arteriocavernosal fistulae and pseudoaneurysms. Treatment consisted of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.77.905.193
更新日期:2001-03-01 00:00:00
abstract::This paper discusses the relationship between panic and other symptoms of anxiety disorders. The approach to classification of these disorders described in the Diagnostic and Statistical Manual of Mental Disorders (Third Edition) of the American Psychiatric Association is outlined. It is concluded that there are subst...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Despite the remarkable advances in cardiovascular therapeutics over the past four decades, little impact has been made on either the incidence or mortality rate of congestive heart failure and it remains a major clinical and public health problem. Recent practice audits have suggested that proven efficacious therapies...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.858.194
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To assess parent preferences for utilisation of a parent-focused, telephone-based coaching service, or 'FITLINE,' to prevent or manage childhood obesity. METHODS:A cross-sectional survey of parents of children aged 2-12 years was conducted at a paediatric practice in Greater Boston, Massachusetts, USA, betwe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132928
更新日期:2015-04-01 00:00:00
abstract::Hypersensitivity reactions to chemotherapy drugs pose significant difficulties in management, especially when no suitable alternative is available or acceptable and delay in continuation of treatment may be life-threatening. Such reactions may be IgE- or non-IgE-mediated and have varied manifestations. Timely recognit...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2014-132686
更新日期:2015-03-01 00:00:00
abstract::Serum thyrotrophin has been measured before and after the intravenous administration of 200 micrograms of thyrotrophin-releasing hormone in 91 white subjects (33 stable diabetic patients and 58 healthy controls), none of whom had any clinical evidence of thyroid or pituitary dysfunction. Seven of the diabetic subjects...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.728.445
更新日期:1986-06-01 00:00:00
abstract::Learning curves graphically represent the relationship between learning effort and learning outcome. Learning curves are increasingly used in research, the design of randomised controlled trials, the assessment of competency, healthcare education and training programme design. In this review we have outlined the princ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2018-135880
更新日期:2018-09-01 00:00:00