Postgraduate medicine
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Postgraduate medicine · Jun 2004
ReviewBehavioral problems in dementia. Strategies for pharmacologic and nonpharmacologic management.
Behavioral disturbances in Alzheimer's disease and related disorders are common throughout all stages of these dementing illnesses. They are a major source of caregiver distress and can lead to premature institutionalization of the patient if not properly addressed. ⋯ In this article, Dr Smith outlines ways to manage behavioral problems in dementia with pharmacologic as well as nonpharmacologic approaches. Throughout, she emphasizes that proper treatment of problem behaviors in this vulnerable population requires the education and patience of caregivers and physicians alike.
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Postgraduate medicine · Jul 2003
ReviewWest Nile virus infection. What you need to know about this emerging threat.
The most important aspects to remember about West Nile virus infection are summed up in the following points: West Nile virus is transmitted by bites from infected Culex species mosquitoes. Most infections do not result in serious illness. ⋯ No effective antiviral treatment is available. Avoiding contact with mosquitoes is the key preventive measure.
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Autoimmune hepatitis is a chronic inflammatory liver disease that responds well to prednisone alone or in combination with azathioprine. Combination therapy is preferred initially because of the lower rate of corticosteroid-induced adverse effects. Specific criteria for diagnosis include a wide range of biochemical, histologic, and immunologic features that define the disease. ⋯ Sustained histologic remission is achievable in the majority of patients, although many patients require low-dose maintenance therapy. Drug therapy may be beneficial in patients with cirrhosis when considerable inflammation is noted on biopsy. Orthotopic liver transplantation should be considered for patients with decompensated cirrhosis due to autoimmune hepatitis or those with severe hepatitis in whom initial therapy is not successful.