Postgraduate medicine
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Postgraduate medicine · Jul 2008
ReviewContemporary issues in the diagnosis and treatment of obstructive sleep apnea.
Obstructive sleep apnea (OSA) is a common disease associated with significant morbidity and use of health care resources. Therapy with continuous positive airway pressure (CPAP) devices has low risk and a potentially large benefit in treating this disease. ⋯ The use of portable home monitoring devices can greatly increase access to diagnosis and treatment of OSA. However, these devices must be used as part of a comprehensive sleep evaluation program that includes access to board-certified sleep specialists, PSG facilities, and therapists experienced in fitting and troubleshooting CPAP devices.
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Postgraduate medicine · Jul 2008
ReviewClinical manifestations of food allergy: differentiating true allergy from food intolerance.
Food allergy is an abnormal immunologic reaction to food proteins. In this article, we differentiate food allergy from food intolerance and other conditions that may mimic food allergy. We describe clinical presentations of food allergy, outline a practical approach for evaluating patients with suspected food allergy, and discuss recommendations for management.
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How are human papillomavirus (HPV), cervical cancer, and the recently developed HPV vaccines associated with each other? Human papillomavirus is a highly prevalent infection that is easily and unknowingly transmitted because of its asymptomatic nature and long incubation period. Infection requires skin-to-skin contact and is typically sexually transmitted. More than one-half of sexually active women acquire HPV, making it the most prevalent sexually transmitted disease. ⋯ Both vaccines have proven highly effective at preventing infection from their corresponding HPV types. Of importance, neither vaccine is to be used for treatment. Vaccination does not replace routine cervical cancer screening with Pap smears, as the vaccines do not protect against all HPV types.
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Postgraduate medicine · Jun 2006
ReviewWhen chronic kidney disease becomes advanced. Guidelines for care in the emergency department and hospital.
Patients with advanced chronic kidney disease or end-stage renal disease live with a serious condition that often necessitates visits to an emergency department and subsequent hospitalization. Often, physicians in these settings are not trained in nephrology. Emergency department physicians and other nonnephrologists who regularly manage advanced chronic kidney disease and end-stage renal disease need to follow several basic principles to provide excellent care to patients with these conditions.
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Postgraduate medicine · Jun 2006
ReviewEpistaxis packing. Practical pointers for nosebleed control.
Primary care physicians often encounter epistaxis. Its treatment may involve nasal sponge tampons, double-balloon nasal catheters, and anterior gauze with posterior Foley catheters, depending on the location of the bleed. ⋯ Here, Dr. Randall investigates the practical aspects of epistaxis therapy and provides a simplified approach to treatment using three types of packs that work in virtually every situation.