Abstract:
BACKGROUND:Staphylococcus aureus is a common cause of serious infection in patients infected with HIV. OBJECTIVES:To evaluate risk factors for and quantitative effect of S. aureus infection in HIV-infected patients, with special attention to nasal carriage. DESIGN:Prospective, multihospital cohort study. SETTING:Three tertiary care Veterans Affairs Medical Centers. PARTICIPANTS:231 ambulatory HIV-infected patients. RESULTS:Thirty-four percent of patients were nasal carriers of S. aureus. Of these patients, 38% were persistent carriers and 62% were intermittent carriers. Twenty-one episodes of infection occurred in 13 patients: Ten were bacteremias (including 2 cases of endocarditis), 1 was pneumonia, and 10 were cutaneous or subcutaneous infections. Seventeen (85%) of these episodes occurred in patients with CD4 counts less than 100 cells/mm3. Recurrent infections occurred in 3 of 7 patients who survived an initial S. aureus infection. The mortality rate was higher among patients with S. aureus infection than among those without infection (P = 0.03). Factors significantly associated with S. aureus infection were nasal carriage, presence of a vascular catheter, low CD4 count, and neutropenia. Molecular strain typing indicated that for 6 of 7 infected patients, the strain of S. aureus isolated from the infected sites was the same as that previously cultured from the nares. CONCLUSION:Nasal carriage is an important risk factor for S. aureus infection in HIV-infected patients. Controlled studies are indicated to determine whether eradication of nasal carriage in a selected subset of patients (for example, those with a low CD4 cell count) might prevent invasive S. aureus infection in patients with HIV infection.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Nguyen MH,Kauffman CA,Goodman RP,Squier C,Arbeit RD,Singh N,Wagener MM,Yu VLdoi
10.7326/0003-4819-130-3-199902020-00026subject
Has Abstractpub_date
1999-02-02 00:00:00pages
221-5issue
3eissn
0003-4819issn
1539-3704pii
199902020-00008journal_volume
130pub_type
杂志文章abstract::Internal medicine residencies risk becoming obsolete if they are not adjusted to changing patterns of medical practice. Declining length of hospital stay, increased intensity of hospital care, movement of critical management decisions to outpatient settings, increased proportions of admissions for specific diagnostic ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-4-554
更新日期:1986-04-01 00:00:00
abstract::Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture rejec...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-136-5-200203050-00010
更新日期:2002-03-05 00:00:00
abstract:BACKGROUND:Weight loss and increased physical exercise reduce the risk for diabetes in people with impaired glucose tolerance. Randomized trial evidence on the effect of these interventions on people without impaired glucose tolerance is lacking. OBJECTIVE:To examine the influence of a comprehensive intervention progr...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
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abstract:BACKGROUND:With suspected deep venous thrombosis and normal results on proximal vein ultrasonography, a negative d-dimer result may exclude thrombosis and a positive D-dimer result may be an indication for venography. OBJECTIVE:To evaluate and compare the safety of 2 diagnostic strategies for deep venous thrombosis. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-142-7-200504050-00007
更新日期:2005-04-05 00:00:00
abstract:Background:The 2013 cholesterol management guidelines from the American College of Cardiology and American Heart Association (ACC/AHA) recommend lipid screening in all adults older than 20 years to identify those at increased risk for atherosclerotic cardiovascular disease (ASCVD). Statins may be considered for patient...
journal_title:Annals of internal medicine
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更新日期:2017-06-20 00:00:00
abstract:BACKGROUND:Valid measurement of physician performance requires accurate identification of patients for whom a physician is responsible. Among all patients seen by a physician, some will be more strongly connected to their physician than others, but the effect of connectedness on measures of physician performance is not...
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pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-150-5-200903030-00008
更新日期:2009-03-03 00:00:00
abstract:BACKGROUND:Bed alarm systems intended to prevent hospital falls have not been formally evaluated. OBJECTIVE:To investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events. DESIGN:Pair-matched, cluster randomized trial over 18 months. Nursing units were allocated b...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-157-10-201211200-00005
更新日期:2012-11-20 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of levothyroxine and potassium iodide in treating patients with benign solitary cold thyroid nodules. DESIGN:Randomized controlled study. SETTING:Outpatient clinic at a university hospital. PATIENTS:80 patients with solitary solid cold thyroid nodules found to be benign at cy...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-122-1-199501010-00001
更新日期:1995-01-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-8-200010170-00013
更新日期:2000-10-17 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-129-7-199810010-00002
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Health care workers are at occupational risk for a vast array of infections that cause substantial illness and occasional deaths. Despite this, few studies have examined the incidence, prevalence, or exposure-associated rates of infection or have considered infection-specific interventions recommended to mai...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-125-10-199611150-00007
更新日期:1996-11-15 00:00:00
abstract:BACKGROUND:Fibromyalgia is a common chronic pain condition for which patients frequently use acupuncture. OBJECTIVE:To determine whether acupuncture relieves pain in fibromyalgia. DESIGN:Randomized, sham-controlled trial in which participants, data collection staff, and data analysts were blinded to treatment group. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-143-1-200507050-00005
更新日期:2005-07-05 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the tolerance and safety of oral dextran sulfate (UA001), a potent in-vitro inhibitor of human immunodeficiency virus (HIV) in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. DESIGN:Unblinded, dose-escalation 8-week trial. SETTING:An AIDS outpatient cl...
journal_title:Annals of internal medicine
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更新日期:1989-02-01 00:00:00
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journal_title:Annals of internal medicine
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doi:10.7326/0003-4819-144-4-200602210-00006
更新日期:2006-02-21 00:00:00
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doi:10.7326/0003-4819-148-7-200804010-00012
更新日期:2008-04-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M17-3011
更新日期:2018-07-03 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-6-199903160-00016
更新日期:1999-03-16 00:00:00
abstract:BACKGROUND:Prospective data defining the clinical course in idiopathic pulmonary fibrosis (IPF) are sparse. OBJECTIVE:To analyze the clinical course of patients with mild to moderate IPF. DESIGN:Analysis of data from the placebo group of a randomized, controlled trial evaluating interferon-gamma1b. SETTING:Academic ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-12_part_1-200506210-00005
更新日期:2005-06-21 00:00:00
abstract::We retrospectively reviewed the therapeutic efficacy of antithyroid drugs for Graves disease. Sixty-nine patients were divided into three categories according to their response: 28 (40.6%) were unable to achieve a remission; 6 (8.7%) achieved a remission and subsequently had a relapse; and 35 (50.7%) were able to sust...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1987-10-01 00:00:00
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journal_title:Annals of internal medicine
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-10-854
更新日期:1992-05-15 00:00:00
abstract::Sixty-nine out of a kindred of 100 members covering five generations were examined and studied, and 34 were hypercalcemic. Sixteen subjects were believed, on the basis of laboratory and clinical observations, to have primary hyperparathyroidism. Eight patients were subjected to exhaustive study to identify polyendocri...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-1-36
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Vaccines are one of the greatest achievements in public health. Prevalence and clinical significance of emerging postapproval, vaccine-related safety issues have not been systematically studied. OBJECTIVE:To explore postmarketing safety modifications in U.S. Food and Drug Administration (FDA)-approved vacci...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-2726
更新日期:2020-09-15 00:00:00
abstract::The relation between blood pressure before stroke and survival after the event, was examined in the Manitoba study cohort of 3983 men. The last recorded blood pressure before the first stroke and the change in blood pressure from a measurement 5 years earlier were used. Increasing magnitude of systolic blood pressure ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-1-15
更新日期:1978-07-01 00:00:00
abstract:STUDY OBJECTIVE:To assess respiratory muscle fatigue in acute respiratory failure in patients with chronic obstructive pulmonary disease and evaluate its influence on weaning patients from mechanical ventilation. DESIGN AND PATIENTS:We studied the time course of tracheal occlusion pressure (P0.1) and high-to-low ratio...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-6-800
更新日期:1988-06-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-8-201010190-00010
更新日期:2010-10-19 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-5-812
更新日期:1979-05-01 00:00:00
abstract::Sera of 24 patients with an unexplained pneumonia were tested for the presence of antibodies against the Legionnaires' disease bacterium. Fifteen patients had positive serology. The series comprised 12 male and three female patients ranging in age from 17 to 66 years (mean, 51.1 years). All of the patients had a high ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-4-529
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:To determine the rate of use of prophylaxis for venous thromboembolism in high-risk hospital patients. DESIGN:A retrospective medical record review. SETTING:A community-wide study in 16 short-stay hospitals in central Massachusetts. PATIENTS:A total of 2017 patients with multiple risk factors for venous th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-591
更新日期:1991-10-15 00:00:00
abstract:BACKGROUND:Initiation of antiretroviral therapy (ART) during tuberculosis (TB) treatment remains challenging. PURPOSE:To assess evidence from randomized, controlled trials of the timing of ART initiation in HIV-infected adults with newly diagnosed pulmonary TB. DATA SOURCES:PubMed, EMBASE, Cochrane Central Register o...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M14-2979
更新日期:2015-07-07 00:00:00