Postgraduate medicine
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Postgraduate medicine · Jan 2005
The expert consensus guideline series. Treatment of dementia and its behavioral disturbances. Introduction: methods, commentary, and summary.
New treatment options for dementia and its behavioral disturbances have become available since publication of The Expert Consensus Guidelines on the Treatment of Agitation in Older Persons with Dementia in 1998. While only 2 cholinesterase inhibitors, donepezil and tacrine, were available in 1998, 3 new cognitive-enhancing agents have been introduced since that time as well as several new atypical antipsychotics and antidepressants. However, there are still limited data from controlled studies to guide clinicians in choosing among these agents and sequencing and combining treatments. We therefore conducted a new survey study of expert opinion on the treatment of cognitive impairment and behavioral disturbances associated with dementia. ⋯ The experts reached high levels of consensus on key steps in treating dementia and associated behavioral disturbances. Within the limits of expert opinion and with the expectation that new research data will take precedence, these guidelines may provide direction for clinicians offering care to patients with dementia.
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Postgraduate medicine · Oct 2004
Review Comparative StudyThe promise of atypical antipsychotics: fewer side effects mean enhanced compliance and improved functioning.
Five new antipsychotic drugs introduced in the United States in the last decade offer physicians the ability to treat patients with schizophrenia and bipolar mania without the adverse effects of the first-generation antipsychotics. In this article, the authors discuss the advantages and side effects of these agents and present a guide to help physicians choose the optimal drug in the most favorable formulation for each patient.
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Postgraduate medicine · Sep 2004
ReviewOpioids for chronic noncancer pain. Tailoring therapy to fit the patient and the pain.
Opioids are powerful medications with a history that includes use for pain relief and, at times, addiction. This history of therapy versus drug abuse continues to cloud their prescription today, despite reports of effective treatment for the chronic pain that certain diseases can bring. Here, Drs Antoin and Beasley review the use of opioid agents in medicine, highlight the importance of proper patient selection and education in their use, and convey how opioids can be a viable option today for successful therapy for chronic noncancer pain.
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Postgraduate medicine · Sep 2004
ReviewThree common neuralgias. How to manage trigeminal, occipital, and postherpetic pain.
The pain experienced by patients with trigeminal, occipital, or postherpetic neuralgia is often severe, chronic, and difficult to treat. In this article, Drs Ashkenazi and Levin outline the pathologic mechanisms of pain in these common neuralgias and discuss individually tailored pharmacologic and surgical approaches to their treatment.
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Postgraduate medicine · Jul 2004
ReviewDiabetic retinopathy. Control of systemic factors preserves vision.
Diabetic retinopathy, a retinal microangiopathy, is the leading cause of blindness for persons aged 20 to 65 years in the United States. Routine screening and early treatment are cost-effective and have been shown to help preserve sight. ⋯ This article, the first of two on retinal vascular disease, provides a review of nonproliferative and proliferative diabetic retinopathy. The second article, which will appear in an upcoming issue of POSTGRADUATE MEDICINE, discusses retinal vascular disease in hypertension.