Medical Update for Psychiatrists最新文献_第7页

New antiepileptic drugs 新型抗癫痫药物

Medical Update for Psychiatrists Pub Date : 1997-09-01 DOI: 10.1016/S1082-7579(97)00059-9

MD Cynthia L. Harden

引用次数: 0

About this issue 关于这个问题

Medical Update for Psychiatrists Pub Date : 1997-09-01 DOI: 10.1016/S1082-7579(97)00077-0

MD Nada L. Stotland

引用次数: 0

Current management of acute pancreatitis 急性胰腺炎的当前管理

Medical Update for Psychiatrists Pub Date : 1997-09-01 DOI: 10.1016/S1082-7579(97)00058-7

MD Janet S. Skarda, MD W. Scott Melvin

{"title":"Current management of acute pancreatitis","authors":"MD Janet S. Skarda, MD W. Scott Melvin","doi":"10.1016/S1082-7579(97)00058-7","DOIUrl":"10.1016/S1082-7579(97)00058-7","url":null,"abstract":"<div><p>Acute pancreatitis is a common clinical entity that presents itself a wide variety of clinical settings. The most common clinical scenario is abdominal pain with or without nausea and vomiting. The symptoms can exist alone or can complicate other disease processes. The diagnosis can be suspected by history and physical exam but is confirmed by laboratory confirmation of an elevated serum amylase concentration. The etiology of pancreatitis is usually attributable to alcohol use or gallstone disease. Other etiologies exist and can include drug reactions, trauma, metabolic derangements or infection. In approximately ten percent of cases the exact etiology is unable to be determined. Initial evaluation mandates delineation of the cause so that intervention will prevent further recurrences. The treatment of pancreatitis remains mainly supportive. Bowel rest and intravenous hydration are the cornerstones of treatment. The use of prophylactic antibiotics are controversial and surgical intervention is necessary only in severe cases of hemorrhagic pancreatitis or to manage the complications such as abscess or pseudocyst formation. The outcome following gallstone pancreatitis is generally favorable with most patients having prompt relief of symptoms and no sequelae. When there is recurrent alcohol abuse or other persistent metabolic disease recurrent acute pancreatitis can develop with a much higher risk of complications or it can progress into chronic pancreatitis. However, with appropriate treatment and intervention the majority of patients with acute pancreatitis do well.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"2 5","pages":"Pages 138-144"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(97)00058-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88879957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Pediatric HIV infection 儿童艾滋病毒感染

Medical Update for Psychiatrists Pub Date : 1997-09-01 DOI: 10.1016/S1082-7579(97)00043-5

MD Susan J. Burke, MD, PhD Maria Jevitz Patterson

引用次数: 0

The abuse and neglect of children II: Recognizing child abuse 虐待和忽视儿童II:认识虐待儿童

Medical Update for Psychiatrists Pub Date : 1997-07-01 DOI: 10.1016/S1082-7579(97)00028-9

S. Woolford, M. Rappley

引用次数: 0

Clinically significant drug interactions with antituberculosis agents 与抗结核药物的临床显著药物相互作用

Medical Update for Psychiatrists Pub Date : 1997-07-01 DOI: 10.1016/S1082-7579(97)00025-3

PharmD Shannon M. Lee , PharmD Mark Bunker

{"title":"Clinically significant drug interactions with antituberculosis agents","authors":"PharmD Shannon M. Lee , PharmD Mark Bunker","doi":"10.1016/S1082-7579(97)00025-3","DOIUrl":"10.1016/S1082-7579(97)00025-3","url":null,"abstract":"<div><p>Tuberculosis (TB) has, until recently, been considered to be primarily of historical importance in the United States, but in the past 10 years the number of reported cases has increased. As a result of mismanaged patients and poor treatment outcomes, a strain of Mycobacterium tuberculosis resistant to both of the most effective antitubercular agents, isoniazid (INH) and rifampin has emerged and necessitates the use of more toxic and less effective drugs for longer periods of time. Compounding the problem is the treatment of HIV/ AIDS patients with TB, which also requires several medications during treatment (1,2). Psychiatric populations are at greater risk for developing TB, and are often treated with multiple medications that have the potential to interact adversely with antitubercular agents. Rifampin is a well-known potent inducer of both cytochrome P450 (CYP) 2C and CYP3A and has the majority of clinically significant drug interactions. INH inhibits the metabolism of many drugs due to a mechanism other than CYP enzyme involvement. Drug interactions involving these and other antitubercular drugs can result in either therapeutic failure or toxicity of antitubercular and/or psychoactive agents. Additionally psychosis has occurred, although rarely, as a direct result of the use of antitubercular treatment in TB patients with no history of psychiatric symptoms (3). Prevention of these drug-induced adverse events as well as education and medication compliance are essential factors in the optimal treatment of psychiatric patients with comorbid TB.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"2 4","pages":"Pages 107-113"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(97)00025-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72552877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Common anorectal disorders 常见肛肠疾病

Medical Update for Psychiatrists Pub Date : 1997-07-01 DOI: 10.1016/S1082-7579(97)00029-0

MD Mark W. Arnold (Associate Professor of Clinical Surgery)

{"title":"Common anorectal disorders","authors":"MD Mark W. Arnold (Associate Professor of Clinical Surgery)","doi":"10.1016/S1082-7579(97)00029-0","DOIUrl":"10.1016/S1082-7579(97)00029-0","url":null,"abstract":"<div><p>Anorectal disorders are extremely common and are often manifest in the psychiatric patient population. While most conditions are self-limited, there are a variety of problems, from hemorrhoids to infection and venereal disease, that demand diagnosis and treatment. The patient is often unaware of the true nature of the problem and frequently attributes his or her symptoms to “hemorrhoids.”</p><p>The distal rectum and anal canal are the location of most of the pathology discussed below. Examination consists of inspection of the perianal area, digital examination, and instrumentation with anoscopy and sigmoidoscopy. Most conditions are readily apparent. The examiner must always keep in mind that many common symptoms of anal rectal disorders such as bleeding, pain, and discharge, can be signs of malignancy.</p><p>Conditions to be discussed include hemorrhoids, fissure in ano, fistulas, abscesses, pruritus ani, pilonidal sinus, condylomata acuminatum, and other venereal infections. This list includes the most common disorders with which the general physician will be confronted. Discussion will be directed toward identification and appropriate therapy.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"2 4","pages":"Pages 99-103"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(97)00029-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72861726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The abuse and neglect of children II: Recognizing child abuse 虐待和忽视儿童II:认识虐待儿童

Medical Update for Psychiatrists Pub Date : 1997-07-01 DOI: 10.1016/S1082-7579(97)00028-9

MD Susan J. Woolford, MD Marsha D. Rappley

{"title":"The abuse and neglect of children II: Recognizing child abuse","authors":"MD Susan J. Woolford, MD Marsha D. Rappley","doi":"10.1016/S1082-7579(97)00028-9","DOIUrl":"https://doi.org/10.1016/S1082-7579(97)00028-9","url":null,"abstract":"<div><p>Child abuse is a highly significant problem for children and their families. Almost three million reports of child abuse were filed in 1992; 65% of these were substantiated. This is the second in a series of three articles regarding abuse. The first, \"The Abuse and Neglect of Children,\" published in the last edition of Medical Update for Psychiatrists, describes the epidemiology of abuse, characteristics of high-risk victims and perpetrators, and important issues regarding the reporting of abuse and interacting with families. This second article focuses on recognising child abuse. The hallmark of intentional, abusive injury to a child is a discrepant history, unreasonable given the age of the child and the nature of the wound or circumstances surrounding the injury. Specific injuries such as fractures, bruises, burns, and blunt trauma may have characteristic patterns suggesting abuse. Neglect is the failure of the care-giver to provide for adequate child care in health, education, supervision, and physical needs of the child. Munchausen by proxy is the diagnosis given to deceptive action taken by a parent to simulate illness in a child, that is detrimental to the child and for which secondary gain is derived by the parent in the medical process. Sexual abuse will be the subject of the third and last article, which is to follow in the next issue of Medical Update for Psychiatrists. An awareness of the classic features of child abuse will help the physician recognize abuse, and thus may protect a child from further abuse and provide a family with badly needed services.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"2 4","pages":"Pages 90-93"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(97)00028-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91764461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

About this issue 关于这个问题

Medical Update for Psychiatrists Pub Date : 1997-07-01 DOI: 10.1016/S1082-7579(97)00042-3

MD Nada L. Stotland

引用次数: 0

Mental stress and the cardiovascular system part I: Cardiovascular response to acute mental stress in normal subjects 精神压力与心血管系统第一部分:正常人急性精神压力下的心血管反应

Medical Update for Psychiatrists Pub Date : 1997-07-01 DOI: 10.1016/S1082-7579(97)00026-5

MD W.Victor R. Vieweg, PhD Linda M. Dougherty, MD Christopher S. Nicholson

{"title":"Mental stress and the cardiovascular system part I: Cardiovascular response to acute mental stress in normal subjects","authors":"MD W.Victor R. Vieweg, PhD Linda M. Dougherty, MD Christopher S. Nicholson","doi":"10.1016/S1082-7579(97)00026-5","DOIUrl":"10.1016/S1082-7579(97)00026-5","url":null,"abstract":"<div><p>In normal subjects, acute mental stress may alter baseline cardiovascular parameters. During this stimulation, blood pressure and heart rate commonly increase. Changes in peripheral vascular resistance are variable. Parameter responses during acute mental stress may be incorporated in the model of isotonic (dynamic or volume) exercise with increased blood pressure and decreased peripheral vascular resistance or in the model of isometric (static or pressure) exercise with increased blood pressure and increased peripheral vascular resistance. Sustained isotonic exercise such as jogging or swimming is generally considered healthful. In contrast, sustained isometric exercise such as weight lifting or snow shoveling is generally not considered healthful. Measuring peripheral vascular resistance may be important in distinguishing between healthful and unhealthful activities. In normal subjects, acute mental stress may also alter heart rate, double product (blood pressure × heart rate), cardiac output, stroke volume, forearm blood flow, left ventricular ejection fraction, and cardiac microcirculation.</p><p>Studies in normal subjects have identified relationships between hostility and increased arousal, and blood pressure and heart rate increases. Failure to measure peripheral vascular resistance in these studies confounds full interpretation of the findings.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"2 4","pages":"Pages 94-98"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(97)00026-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73079930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8