Postgraduate medicine
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Postgraduate medicine · Feb 1984
Bedside evaluation in cardiac emergencies. Criteria for rapid diagnosis.
Because timely diagnosis and treatment are essential in cardiac emergencies, every physician who provides primary critical care should master the art of cardiovascular examination. In particular, this requires patience and skill at auscultation, as subtle differences in murmurs, for example, often differentiate two conditions. With a tentative diagnosis, the physician can then choose only the necessary confirmatory tests.
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Postgraduate medicine · Nov 1983
Endocrine emergencies. Adrenal crisis, myxedema coma, and thyroid storm.
Each of the endocrine emergencies discussed here--adrenal crisis, myxedema coma, and thyroid storm--represents decompensation of a long-standing endocrine disorder and is precipitated in most cases by some stressful event. Each necessitates immediate, aggressive therapy. ⋯ Although some risks may be inherent in this approach, they are minimal compared with the risks of delaying therapy until laboratory confirmation can be obtained. Immediate therapy consists of specific measures to correct the hormone deficit or excess; the precipitating cause should then be sought and treated.
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Asbestos exposure is causally related to the development of asbestosis, bronchogenic carcinoma, malignant mesothelioma, and nonmalignant pleural disorders. Clinical and roentgenographic manifestations of asbestosis mimic other diffuse fibrotic lung diseases. However, a concomitant finding of pleural plaques strongly suggests the diagnosis. ⋯ Nonmalignant pleural disorders may not cause any symptoms but should alert the physician to other concurrent or potential asbestos-related diseases. To diagnose asbestos-related diseases, physicians should bear in mind the long latent period and should take a careful, comprehensive occupational and environmental history. Cigarette smoking markedly increases the risk for development of bronchogenic carcinoma in asbestos workers and increases the mortality due to asbestosis.