Postgraduate medicine
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Postgraduate medicine · May 1999
ReviewHypertensive crisis. How to tell if it's an emergency or an urgency.
Hypertensive crisis occurs when critically elevated blood pressure is accompanied by diastolic pressure greater than 120 to 130 mm Hg. The presence of acute or ongoing end-organ damage constitutes a hypertensive emergency, which requires reduction of blood pressure within minutes to hours to avoid catastrophic outcomes. ⋯ Although hypertensive crises are relatively rare, most primary care physicians will eventually encounter them. Thus, for optimal patient outcomes, it is important to be aware of appropriate treatment options as well as the impact of potential complications on management.
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Postgraduate medicine · Apr 1999
ReviewSick euthyroid syndrome. What to do when thyroid function tests are abnormal in critically ill patients.
Abnormal thyroid hormone concentrations are common in patients with serious nonthyroidal illnesses. Early evidence suggests that thyroid hormone levels may predict the prognosis for some patients. Abnormal thyroid function is usually reversible, but thyroid function tests should be repeated when the nonthyroidal illness is resolved. Whether active intervention using thyroid hormone supplements is beneficial or not remains controversial and requires future large-scale investigation.
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Postgraduate medicine · Apr 1999
ReviewImaging studies for acute low back pain. When and when not to order them.
Acute low back pain is generally a self-limited condition, and most patients recover within a few weeks without the need for imaging studies. However, physicians need to be on the lookout for red flags that point to more serious conditions, such as infection or malignancy, which require imaging. In this article, the authors identify these warning signs and discuss the appropriate use of imaging studies for a variety of symptoms and conditions.
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Postgraduate medicine · Apr 1999
ReviewManaging the unstable patient. The first 10 minutes often set the course.
Some patients die shortly after the onset of an acute illness, despite the best of care. However, a well-led well-organized approach during the first 10 minutes of care can greatly improve the chances of survival and minimize subsequent morbidity. Early treatment should emphasize proper airway management, adequate intravenous access, and a thoughtful approach to the use of medications.