By Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng
During this new version of A scientific method of drugs, the editor has assembled a panel of prime clinicians and researchers, and reorganized the fabric within the key parts of medication, cardiology, endocrinology, gastroenterology, hematology, neurology, oncology, rheumatology, renal drugs and breathing drugs. This ebook is exclusive -- it displays the adventure of prime specialists on styles of ailment within the Asia-Pacific quarter. There are a number of different comparable books, yet these are through authors from the West and accordingly supply a special viewpoint. The publication additionally contains discussions on genetic illnesses, an infection and antimicrobial resistance to antibiotics, highlighting neighborhood incidences and facts. each one bankruptcy begins with the fundamental recommendations of a specific subject and progressively develops the topic to offer the cutting-edge within the subject. With its concentrate on practices certain to Asia-Pacific, this e-book is a needs to for the scholar, practising clinician and examine scientist attracted to the most recent advancements during this a part of the realm.
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DIAGNOSTIC TESTS IN ACUTE CHEST PAIN The tests serve: 1) to determine the diagnosis; 2) to quickly identify the high risk patients for the fast track, and 3) to delineate patients with little or no risk of having life-threatening conditions. It must be recognized that 8 A Clinical Approach to Medicine although cardiac investigations may be specific when abnormal, lack of sensitivity means that a normal or nonspecific result does not exclude the diagnosis. Electrocardiogram • • • • • Essential first screening test for adults with chest pain, aimed mainly to identify patient with myocardial ischemia.
It is important to make this diagnosis, as it carries a much better prognosis than sustained hypertension, and may arguably not require any treatment at all. Electronic blood pressure monitors are now commonly used. Their ease of use makes them ideal for home self-monitoring and ambulatory blood pressure monitoring. These monitors detect pressure oscillations distal to a deflating cuff — the maximal pressure oscillation corresponds to the mean arterial blood pressure, and the systolic and diastolic blood pressures are empirically derived using algorithms.
As the level of blood pressure is continuously related to the risk of target organ damage, it follows that the target levels of blood pressure in high-risk individuals should be lower than that of low-risk individuals. Table 3 details the recommended target blood pressure levels for some conditions. EVALUATION OF THE HYPERTENSIVE PATIENT There are 4 primary aims in the clinical evaluation of a hypertensive patient: 1) Confirm the diagnosis of hypertension; 2) Establish the etiology of hypertension, and rule out secondary causes of hypertension; 3) Assess for target organ damage; and 4) Identify other coronary risk factors, and determine overall cardiovascular risk.
A Clinical Approach to Medicine by Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng