abstract：:Lactose intolerance is a common condition that can cause nonspecific gastrointestinal symptoms. A reliable diagnosis cannot be made on the basis of the patient's history. The breath hydrogen test is simple, noninvasive, accurate, and inexpensive and is the diagnostic method of choice. In addition to traditional dietar...

journal_title：Postgraduate medicine

authors： Montes RG,Perman JA

更新日期：1991-06-01 00:00:00

abstract：:Gastroesophageal reflux disease is a very common condition that is usually manifested by heartburn or regurgitation. Reflux esophagitis, caused by mucosal exposure to the backflow of caustic gastric contents, is primarily a result of lower esophageal sphincter dysfunction. Diagnostic workup varies but commonly include...

journal_title：Postgraduate medicine

authors： Sutherland JE

更新日期：1991-05-15 00:00:00

abstract：:Use of "designer drugs" has created a new dilemma for physicians. Generally, it is possible to recognize symptoms and signs of intoxication that fit a specific class of substances, such as amphetamine-like effects for the phenylethylamines and opioid effects for the fentanyl analogues. Designer compounds have crossed ...

journal_title：Postgraduate medicine

authors： Evanko D

更新日期：1991-05-01 00:00:00

abstract：:Treatment of congestive heart failure depends on the cause, precipitating factors, and symptoms of the disease in each patient. Dr Kahn outlines the use of the three main types of pharmacologic agents given for heart failure--diuretics, vasodilators, and digoxin. He describes a stepwise regimen, whereby agents are add...

journal_title：Postgraduate medicine

authors： Kahn JK

更新日期：1991-05-01 00:00:00

abstract：:Bleeding from esophagogastric varices carries a high mortality rate. Active variceal bleeding can usually be temporarily controlled medically with a combination of intravenous vasopressin and nitroglycerin, with balloon tamponade, or with endoscopic sclerotherapy. Because of the high likelihood of recurrence, long-ter...

journal_title：Postgraduate medicine

authors： Marshall JB

更新日期：1991-05-01 00:00:00

abstract：:Febrile convulsions affect about 1 child in 30. Most of these children have a good outcome with no sequelae and do not require prophylactic medication. Differential diagnosis should include meningitis, epilepsy, hypoglycemia, and encephalopathies and other central nervous system disorders. Children with a high risk fo...

journal_title：Postgraduate medicine

authors： Leung AK,Robson WL

更新日期：1991-04-01 00:00:00

abstract：:Although uncommon, hypertensive emergencies require prompt recognition and treatment to reduce very high morbidity and mortality rates. Admission to an intensive care unit for treatment and monitoring is essential for optimal care. A Swan-Ganz catheter is often helpful in management. Intravenous nitroprusside sodium (...

journal_title：Postgraduate medicine

authors： Smith CB,Flower LW,Reinhardt CE

更新日期：1991-04-01 00:00:00

abstract：:Although Charcot's disease and its association with diabetes have been described many times in the literature, it is still often misdiagnosed and incorrectly treated as osteomyelitis, arthritis, or gout. The best safeguard is a high index of suspicion. A warm, swollen foot in a diabetic patient with long-standing neur...

journal_title：Postgraduate medicine

authors： Giurini JM,Chrzan JS,Gibbons GW,Habershaw GM

更新日期：1991-03-01 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

authors： Holmes HS

更新日期：1991-02-15 00:00:00

abstract：:A carefully taken history and thorough physical examination remain the most crucial aspects of diagnosing rheumatic disorders. Non-rheumatologic conditions also need to be kept in mind. Laboratory tests should be looked on as mostly supportive or confirmatory, because many of the tests are relatively nonspecific and m...

journal_title：Postgraduate medicine

authors： Yancey WB Jr,Williams RC Jr

更新日期：1991-02-01 00:00:00

abstract：:Bedside pulmonary artery catheterization has proven to be an important addition to the clinical assessment of critically ill patients. Properly used, the procedure may provide hemodynamic information that is not apparent from physical examination or radiography. It may be safely accomplished through various venous rou...

journal_title：Postgraduate medicine

authors： Zimmerman FH

更新日期：1991-02-01 00:00:00

abstract：:Normalization of serum lipid levels should be initiated as soon as possible in patients with myocardial, cerebrovascular, or peripheral vascular disease. Clinical trials indicate that coronary artery disease and overall mortality rates can be reduced and atherosclerosis stabilized or reversed by lipid-lowering therapy...

journal_title：Postgraduate medicine

authors： Blankenhorn DH,Hodis HN

更新日期：1991-01-01 00:00:00

abstract：:The majority of patients can be easily weaned from mechanical ventilation, but a substantial minority pose considerable difficulty. In such cases, the cause of ventilator dependency should be identified and correctable factors should be rectified. An organized plan of management, a team approach, optimal pulmonary and...

journal_title：Postgraduate medicine

authors： Tobin MJ

更新日期：1991-01-01 00:00:00

abstract：:If frostbite is to be treated successfully, direct and indirect effects of injury must be understood. Rapid rewarming helps to preserve tissue by limiting the amount of direct cellular injury. Selective management of blisters helps protect the subdermal plexus, and application of Aloe vera cream (eg, Dermaide Aloe Cre...

journal_title：Postgraduate medicine

authors： McCauley RL,Heggers JP,Robson MC

更新日期：1990-12-01 00:00:00

abstract：:Primary care physicians have a crucial role in recognition of potentially emergent conditions in patients with known or suspected cancer. This task presents a significant challenge because the initial manifestations of these conditions are usually nonspecific. In most cases, therapy is far more effective when diagnosi...

journal_title：Postgraduate medicine

authors： Love N

更新日期：1990-12-01 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

authors： Kantor GR

更新日期：1990-11-01 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

authors： Kothari SS

更新日期：1990-11-01 00:00:00

abstract：:Patients with colon cancer involving regional lymph nodes (stage C disease) have a 5-year survival rate of only 30% to 40%, and the majority die of recurrent disease. Recent trials have shown increased survival rates with postoperative use of fluorouracil plus levamisole. The authors discuss these findings and the imp...

journal_title：Postgraduate medicine

authors： Treat J,Joseph RR

更新日期：1990-10-01 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

authors： Bailey EM,Domenico P,Cunha BA

更新日期：1990-10-01 00:00:00

abstract：:Is the degree of risk involved in providing health care to people infected with human immunodeficiency virus (HIV) acceptable? Every health care worker, even if only for a few anxious minutes, has certainly worried about this risk. Drs Wilson, Williams, and Robinson discuss these concerns and summarize the indications...

journal_title：Postgraduate medicine

authors： Wilson SE,Williams RA,Robinson G

更新日期：1990-09-01 00:00:00

abstract：:Cervical spondylotic myelopathy remains a diagnostic and therapeutic challenge to physicians in a number of specialties. The diagnostic evaluation consists of a comprehensive neurologic and orthopedic examination supplemented by appropriate neurophysiologic and neuroradiologic studies. Currently, magnetic resonance im...

journal_title：Postgraduate medicine

authors： Lehman LB

更新日期：1990-09-01 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

authors： Felicetta JV

更新日期：1990-07-01 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

authors： Houston CS

更新日期：1990-07-01 00:00:00

abstract：:Evidence from epidemiologic, lipid intervention, and coronary angiographic studies demonstrates the importance of high-density lipoprotein cholesterol (HDL-C) in coronary artery disease (CAD) risk. Data from these studies strongly support the measurement of HDL-C in all patients screened for CAD. Patients with low lev...

journal_title：Postgraduate medicine

authors： Lavie CJ,O'Keefe JH,Blonde L,Gau GT

更新日期：1990-05-15 00:00:00

abstract：:Electroconvulsive therapy is controversial and readily arouses the passions of both its supporters and detractors. In this article, Dr Schoen, an internist, discusses various aspects of this 50-year-old technique, including risks, contraindications, and physiologic effects. ...

journal_title：Postgraduate medicine

authors： Schoen RE

更新日期：1990-05-01 00:00:00

abstract：:Coma is a common, life-threatening medical problem encountered by primary care physicians. The principles of emergency management mandate that adequate oxygenation, blood flow, and supplementation with thiamine and glucose be given to the brain before a thorough diagnostic evaluation is undertaken. Knowledge of the us...

journal_title：Postgraduate medicine

authors： Alguire PC

更新日期：1990-05-01 00:00:00

abstract：:Sinusitis may present as an indolent infection, without the classic symptoms and signs commonly expected, and will probably be missed in children who have only cough and persistent rhinorrhea unless this diagnosis is kept in mind. Plain radiography is the most commonly used diagnostic procedure for sinusitis, but comp...

journal_title：Postgraduate medicine

authors： Herrera AM,deShazo RD

更新日期：1990-04-01 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

authors： Skelton WP,Skelton NK

更新日期：1990-03-01 00:00:00

abstract：:An understanding of the causes and course of acute allergic contact dermatitis aids in recognition of this common problem. The most frequent cause is the Rhus group (poison ivy, oak, and sumac), and a large percentage of the US population is sensitized to this group of allergens. With severe cases, prompt administrati...

journal_title：Postgraduate medicine

authors： Wooldridge WE

更新日期：1990-03-01 00:00:00

abstract：:Decubitus ulcers can develop in any chronically ill patient who is immobilized. Elderly patients and patients with spinal cord injury are at particularly high risk. Prevention is best achieved by identification of susceptible patients, alleviation of causative and predisposing factors, and early detection of ischemic ...

journal_title：Postgraduate medicine

authors： Shenaq SM,Dinh TA

更新日期：1990-03-01 00:00:00

abstract：:On the basis of currently available information, the following recommendations can be made for treating osteoporosis. Women with no contraindications should maintain a total calcium intake of 1,000 mg daily before menopause and 1,500 mg daily after menopause. Calcium supplementation should be considered adjunct treatm...

journal_title：Postgraduate medicine

authors： Trachtenbarg DE

更新日期：1990-03-01 00:00:00

abstract：:Rocky Mountain spotted fever, caused by a rickettsial organism transmitted by the bite of a tick, can be confused with many more common diseases. Diagnosis is made more challenging by the fact that treatment is most efficacious if begun before the second week of illness. Tetracycline and doxycycline are the most succe...

journal_title：Postgraduate medicine

authors： Fischer JJ

更新日期：1990-03-01 00:00:00

abstract：:Not since the early 1950s has the number of new cases of syphilis been as high as it is now. The infectious agent, Treponema pallidum, is extremely difficult to culture in vitro and almost impossible to see by conventional light microscopy. A nonspecific antibody test is used for screening and a specific treponemal an...

journal_title：Postgraduate medicine

authors： Farnes SW,Setness PA

更新日期：1990-02-15 00:00:00

abstract：:Because of the broad range of physiologic problems and the many potential sources of complications, liver transplantation patients require contributions from virtually the complete spectrum of medical science. The evolving specialty of liver transplantation has eagerly assimilated advances in surgical techniques, anes...

journal_title：Postgraduate medicine

authors： Williams JW,Sabesin SM

更新日期：1990-02-01 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

authors： Landreneau RJ

更新日期：1990-01-01 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

authors： Mandel S

更新日期：1990-01-01 00:00:00

abstract：:Many patients who present with acute or chronic diarrhea do not have an important organic disease. Most have functional diarrhea. The history, clinical examination, and initial laboratory studies should lead to a provisional diagnosis with respect to organic or functional origin and help define whether the disease aff...

journal_title：Postgraduate medicine

authors： Bruckstein AH

更新日期：1989-12-01 00:00:00

abstract：:The tools and methods of epidemiology, particularly the clinical trial, help guide the clinical practice of medicine. Dr Gorelick reviews the results of major clinical trials for prevention of transient cerebral ischemia and atherothrombotic stroke and assesses the effect of these findings on treatment. ...

journal_title：Postgraduate medicine

authors： Gorelick PB

更新日期：1989-12-01 00:00:00

abstract：:In addition to prolonged glucocorticoid therapy (not discussed here), at least five other conditions cause Cushing's syndrome. They are excessive corticotropin secretion by the pituitary gland (which results in Cushing's disease), ectopic production of corticotropin by malignant nonpituitary tumors, benign adrenal ade...

journal_title：Postgraduate medicine

authors： Felicetta JV

更新日期：1989-12-01 00:00:00

abstract：:High blood pressure is unquestionably a risk factor for premature morbidity and mortality, especially from coronary artery disease and stroke. Risk of clinical manifestations of coronary artery disease increases dramatically if other risk factors, such as a history of cigarette smoking, hypercholesterolemia, left vent...

journal_title：Postgraduate medicine

authors： Borhani NO

更新日期：1989-11-01 00:00:00