abstract：:No single therapeutic agent has been found to be universally effective for rheumatoid arthritis, so regimens using combinations of drugs have become the rule. Recently, several new agents with unique mechanisms of action have been introduced and found to produce various degrees of clinical benefit. Among these agents ...

journal_title：Postgraduate medicine

authors： Fye KH

更新日期：1999-10-01 00:00:00

abstract：:The Food and Drug Administration's approval of the excimer laser in 1995 heralded the age of laser refractive surgery in the United States. Since then, other advances in refractive surgery have spurred great public interest in and enthusiasm for these procedures. In this article, the authors review the major types of ...

journal_title：Postgraduate medicine

authors： Chaudhry IM,Conti ER,Steinert RF

更新日期：1999-09-01 00:00:00

abstract：:Abdominal aortic aneurysms are believed to result from several factors, one probably being inflammation that leads to dilatation, plaque deposition, and degeneration of the arterial wall. Most of these aneurysms are asymptomatic, but abdominal or back pain, shock, and a pulsatile abdominal mass indicate rupture. Initi...

journal_title：Postgraduate medicine

authors： Gorski Y,Ricotta JJ

更新日期：1999-08-01 00:00:00

abstract：:This paper compares the antifungal activity and efficacy of itraconazole and terbinafine in vitro with their experimental activity and efficacy in vivo in patients with superficial fungal infections (tinea pedis and onychomycosis). Onychomycosis and tinea pedis are often treated with oral antifungals. With the introdu...

journal_title：Postgraduate medicine

authors： De Doncker P,Gupta AK

更新日期：1999-07-01 00:00:00

abstract：:Bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to min...

journal_title：Postgraduate medicine

authors： Mysliwiec V,Pina JS

更新日期：1999-07-01 00:00:00

abstract：:As efforts to improve screening for colon cancer have increased, so has the importance of routine flexible sigmoidoscopy. However, the procedure is still underused, and about half of primary care physicians who recommend it refer their patients to other physicians. Increased use of this valuable screening tool is an i...

journal_title：Postgraduate medicine

authors： Davis PW,Stanfield CB

更新日期：1999-06-01 00:00:00

abstract：:The maximal exercise stress test continues to be an important diagnostic and prognostic tool in the primary care office setting. But are you getting the most accurate information possible? Drs Driggers and Marchant discuss several factors that are crucial to the test's validity--and thus to its usefulness in your clin...

journal_title：Postgraduate medicine

authors： Driggers DA,Marchant D

更新日期：1999-05-01 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

authors： Sonpavde G,Einhorn LH

更新日期：1999-04-01 00:00:00

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

authors： Farber MO

更新日期：1999-04-01 00:00:00

abstract：:Acute compartment syndrome is a surgical emergency. A high index of suspicion is needed in cases of severe contusion, especially if patient complaints seem to outweigh physical findings. Acute surgical fasciotomy is an effective treatment and should be carried out expeditiously if compartment pressures are elevated ov...

journal_title：Postgraduate medicine

authors： Swain R,Ross D

更新日期：1999-03-01 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

authors： Baloh RW

更新日期：1999-02-01 00:00:00

abstract：:A general guideline to successful treatment of headache focuses on a diagnosis that satisfies both physician and patient. Thorough history taking, patient and family education, aggressive approaches, and careful follow-up help patients reach therapeutic goals. Successful long-term therapy for headache enables patients...

journal_title：Postgraduate medicine

authors： Jackson CM

更新日期：1998-11-01 00:00:00

abstract：:In developed countries, prevalence is increasing of malignancy-related secondary lymphedema, usually resulting from lymph node resection or irradiation. Untreated lymphedema usually increases over time, and the physical and psychological sequelae in even mild cases demand appropriate diagnosis and treatment. Patients ...

journal_title：Postgraduate medicine

authors： Tunkel RS,Lachmann E

更新日期：1998-10-01 00:00:00

abstract：:Combination therapy is a cost-effective and rational approach to treatment of severe hypertension and of mild to moderate hypertension that is refractory to monotherapy. The method has several advantages, most notably improved tolerability and enhanced antihypertensive efficacy. Long-term prospective studies are neede...

journal_title：Postgraduate medicine

authors： Houston MC

更新日期：1998-09-01 00:00:00

abstract：:Stroke survivors can be plagued by numerous medical complications, including aspiration pneumonia, heart disease, depression, and venous thromboembolism. Given the impairment already caused by stroke itself, these patients require careful management by a comprehensive rehabilitation team. Dr Harvey discusses common st...

journal_title：Postgraduate medicine

authors： Harvey RL

更新日期：1998-08-01 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

authors： Ruckenstein MJ

更新日期：1998-06-01 00:00:00

abstract：:Cataracts are the most common treatable form of reduced vision in older adults. Although the incidence of cataracts is high after age 65, careful history taking and clinical examination are essential to establish the diagnosis. Cataract surgery is medically indicated when the view to the retina is obscured or lens-ind...

journal_title：Postgraduate medicine

authors： Trudo EW,Stark WJ

更新日期：1998-05-01 00:00:00

abstract：:Even modest alcohol ingestion can increase the risk of steatosis, and long-term, excessive consumption can lead to alcoholic hepatitis and eventually cirrhosis. Most patients with clinically significant alcoholic liver disease have histologic findings typical of all three conditions. The only clearly beneficial treatm...

journal_title：Postgraduate medicine

authors： Hill DB,Kugelmas M

更新日期：1998-04-01 00:00:00

abstract：:Eradication of H pylori and cure of peptic ulcer disease are possible if effective regimens are used correctly. Treatment markedly improves clinical outcomes and significantly decreases cost of care. As primary care physicians take a larger role in management of these infections, they need to understand the importance...

journal_title：Postgraduate medicine

authors： Laine L,Fendrick AM

更新日期：1998-03-01 00:00:00

abstract：:Asthma is a common and eminently treatable disease. Most asthma patients are initially seen by primary care physicians, who are likely to have a significant part in management. Research has provided physicians with a better understanding of the pathophysiologic basis of asthma and new antiasthma agents. Guidelines hav...

journal_title：Postgraduate medicine

authors： Keenan JM

更新日期：1998-03-01 00:00:00

abstract：:Treating rheumatoid arthritis can be very satisfying when patients participate fully in designing and implementing their therapeutic strategy. However, the strategy's success depends on early intervention and disease modification. Many patients do well when education, rest, diet, exercise, and drug therapy are incorpo...

journal_title：Postgraduate medicine

authors： Gremillion RB,van Vollenhoven RF

更新日期：1998-02-01 00:00:00

abstract：:Hand eczema continues to bedevil both patients and physicians. While appropriate and judicious intervention minimizes aggravation, discomfort, and inconvenience, recurrences are frequent. Treatment with corticosteroids is often effective for irritant dermatitis. Efforts to avoid the irritant, protect the hands, and us...

journal_title：Postgraduate medicine

authors： Landow K

更新日期：1998-01-01 00:00:00

abstract：:Psychotic disorders usually develop by middle age, but initial onset can be later in life. Delusions, hallucinations, and other psychotic symptoms may accompany medical conditions, mood disorders, and Alzheimer's disease, thereby confusing the diagnosis. In this review, Dr Harris describes some of the more common psyc...

journal_title：Postgraduate medicine

authors： Harris MJ

更新日期：1997-12-01 00:00:00

abstract：:Breast pain is a common, often distressing problem among women. After significant disease is ruled out, most patients respond to simple reassurance. Others, however, require treatment because symptoms interfere with their lifestyle. The authors offer practical suggestions for tailoring treatment for these patients acc...

journal_title：Postgraduate medicine

authors： Steinbrunn BS,Zera RT,Rodriguez JL

更新日期：1997-11-01 00:00:00

abstract：:Uremic polyneuropathy occurs in about half of patients undergoing dialysis and is characterized by axonal degeneration with secondary segmental demyelination. Hemodialysis or peritoneal dialysis halts the progress of polyneuropathy but usually does not bring improvement. However, improvement invariably occurs with suc...

journal_title：Postgraduate medicine

authors： Pirzada NA,Morgenlander JC

更新日期：1997-10-01 00:00:00

abstract：:Probably nothing in the field of medicine has changed as rapidly over the last decade as antiretroviral (ARV) therapy for HIV infection. New insights into pathogenesis, new tests for measuring virus levels in plasma, and availability of powerful new drugs have combined to transform the care of persons with HIV infecti...

journal_title：Postgraduate medicine

authors： Henry K,Stiffman M,Feldman J

更新日期：1997-10-01 00:00:00

abstract：:Looking back at the long history of cancer, we can still relate to that POSTGRADUATE MEDICINE editorial written 50 years ago: "None of the basic problems of cancer has been solved. The death rate is constantly mounting. Small wonder that many doctors face cancer with a pessimism bordering on resignation." The temptati...

journal_title：Postgraduate medicine

authors： Harpham WS,Hoel D

更新日期：1997-09-01 00:00:00

abstract：:In the Western world, diabetes is the biggest cause of peripheral neuropathy, usually distal symmetric polyneuropathy but some times another polyneuropathy or a focal neuropathy. In addition, hypothyroidism and acromegaly can cause carpal tunnel syndrome and other sensory complaints. A complete blood cell count, nerve...

journal_title：Postgraduate medicine

authors： Perkins AT,Morgenlander JC

更新日期：1997-09-01 00:00:00

abstract：:Lyme disease can be difficult to recognize because not all patients have erythema migrans or other classic symptoms. Therefore, laboratory testing has become an important aid to clinical diagnosis. But the story doesn't end there-serologic testing presents another set of problems and concerns. Drs. Still and Ryan expl...

journal_title：Postgraduate medicine

authors： Still MM,Ryan ME

更新日期：1997-07-01 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

authors： Koretz RL

更新日期：1997-07-01 00:00:00

abstract：:Scleroderma, psoriasis, lichen planus, and other skin disorders may signal a more serious internal disease. Physicians who recognize such clues can initiate early treatment while disease is in its early stages. The authors of this article describe several of the more common dermatologic conditions linked to systemic d...

journal_title：Postgraduate medicine

authors： Kirsner RS,Federman DG

更新日期：1997-06-01 00:00:00

abstract：:Runny noses, sneezing, nasal congestion, and other nuisance symptoms are part and parcel of primary care practice. But how can you quickly discern which symptoms are related to common colds and which stem from allergic rhinitis? Careful history taking usually provides clues, but allergy testing may be needed when trig...

journal_title：Postgraduate medicine

authors： Ferguson BJ

更新日期：1997-05-01 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

authors： Ali H

更新日期：1997-04-01 00:00:00

abstract：:Recognition and appropriate treatment of IBS can be challenging. A rational approach to management focuses on a positive diagnosis based on the characteristic pattern of symptoms and the exclusion of organic disorders. Dietary modification and pharmacologic therapy may be useful for relieving symptoms. Patient educati...

journal_title：Postgraduate medicine

authors： Harris MS

更新日期：1997-03-01 00:00:00

abstract：:The goals of therapy for congestive heart failure (CHF) are to improve quality of life and to prolong it. Improvement in patients with CHF can only be realized, however, if a multidisciplinary healthcare team can provide effective management in both the inpatient and outpatient settings. Inhibition of compensatory mec...

journal_title：Postgraduate medicine

authors： Sorrentino MJ

更新日期：1997-01-01 00:00:00

abstract：:Nephrolithiasis is caused by several biochemical mechanisms, identification of which allows specific therapy that may prevent recurrences. In patients with their first kidney stone, careful evaluation is needed to identify those at highest risk for recurrence. Extensive evaluation of this subgroup should lead to prope...

journal_title：Postgraduate medicine

authors： Trivedi BK

更新日期：1996-12-01 00:00:00

abstract：:Although the link between cigarette smoking and its cardiovascular effects is well established, the mechanisms through which smoking raises blood pressure remain to be clarified. Possible mechanisms include nicotine-induced peripheral and central sympathetic nervous system stimulation, persisting levels of nicotine in...

journal_title：Postgraduate medicine

authors： Kochar MS,Bindra RS

更新日期：1996-11-01 00:00:00

abstract：:Prompt, thorough evaluation is needed when patients present with symptoms of renal colic, acute urinary retention, prostatitis, pyelonephritis, and other urologic emergencies. Primary care physicians have an important role in initial workup and treatment. Once the diagnosis is determined, urologic consultation may be ...

journal_title：Postgraduate medicine

authors： Samm BJ,Dmochowski RR

更新日期：1996-10-01 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

authors： Rich MW

更新日期：1996-09-01 00:00:00

abstract：:With prostate cancer being diagnosed and treated in more than 300,000 men each year, the pool of long-term survivors is dramatically increasing. Because these patients are usually elderly, they are often receiving follow-up care for unrelated problems in a primary care setting. This offers the physician an excellent o...

journal_title：Postgraduate medicine

authors： Freedman A,Hahn G,Love N

更新日期：1996-09-01 00:00:00