Postgraduate medicine
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Postgraduate medicine · Jul 1984
Case ReportsInsomnia and its treatment. When are hypnotics justified?
Symptomatic treatment of transient insomnias is advisable, for without treatment these sleep disorders may become persistent. The drugs of choice are the benzodiazepine hypnotics, which have minimal side effects when used for short periods in properly selected patients. ⋯ Transient insomnias must be differentiated from persistent insomnias, which are more resistant to treatment. Hypnotic agents not only are more likely to be ineffective against persistent insomnias but also have greater potential for exacerbating a sleep-related breathing disorder, producing a drug-dependent insomnia, or contributing to drug misuse.
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Postgraduate medicine · Jun 1984
Urinary tract infection during pregnancy. Asymptomatic bacteriuria, acute cystitis, and acute pyelonephritis.
Urinary tract infection is one of the most common medical complications of pregnancy, occurring in roughly 10% of all pregnancies. The clinical entities most commonly seen are bacteriuria, acute cystitis, and acute pyelonephritis. ⋯ Patients with untreated or inadequately treated asymptomatic bacteriuria are at high risk for development of acute pyelonephritis, a serious febrile illness that can lead to major maternal and fetal complications. Patients with acute pyelonephritis should be hospitalized and treated aggressively.
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Postgraduate medicine · Mar 1984
Epiglottitis in the adult. Recognizing and treating the acute case.
Acute epiglottitis in adults is probably commoner than is generally appreciated. Although upper airway obstruction can occur, the course most often is benign. ⋯ Treatment consists of maintenance of a patent airway and use of humidified oxygen and antibiotics (ampicillin and chloramphenicol [Chloromycetin] ). The role of corticosteroids in treatment of epiglottitis is still controversial.