Abstract:
:Impairment of penicillin G excretion in renal failure may result in life-threatening, dose-related toxicity. We report a method for achieving a desired mean serum penicillin G concentration in patients with renal failure, with minimal risk of both undertreatment and drug toxicity. The method is based on the linear relation between the total plasma clearance of penicillin G (Cpen) and the endogenous creatinine clearance. The daily maintenance dose of penicillin G (units) is defined by the product, Cpen (ml/min) times desired mean serum penicillin G concentration (mug/ml) times 2300. Application of this method to patients with various degrees of renal impairment by either constant-rate infusion or intermittent infusion gave serum penicillin G concentrations within the desired range in all but 1 of 15 instances. On the basis of these observations, practical guidelines for "comparably massive" penicillin G therapy are suggested.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Bryan CS,Stone WJdoi
10.7326/0003-4819-82-2-189subject
Has Abstractpub_date
1975-02-01 00:00:00pages
189-95issue
2eissn
0003-4819issn
1539-3704journal_volume
82pub_type
杂志文章abstract::Ambulatory education has become an essential part of all internal medicine residencies. To develop excellent ambulatory education programs, we must thoroughly understand the opportunities available in such a setting, and the leaders in internal medicine must be willing to experiment with nontraditional locations and r...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-12-1076
更新日期:1992-06-15 00:00:00
abstract::The availability of vidarabine for the therapy of suspected herpes simplex encephalitis presents a difficult decision for a physician as to whether to do brain biopsy, to treat blindly, or to withhold specific therapy in a patient. The choice is made more difficult because the physician must weigh four likelihoods sim...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-5-641
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of a human immunodeficiency virus (HIV) vaccine given to uninfected volunteers on the interpretation of serodiagnostic HIV test results. DESIGN:Retrospective cohort study. SETTING:5 AIDS Vaccine Evaluation Units funded by the National Institute of Allergy and Infectious Diseases. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-121-8-199410150-00005
更新日期:1994-10-15 00:00:00
abstract::Effective health care is a core determinant of successful aging, and medications are one of the most important therapeutic tools of health care providers. Most older adults use at least one prescription drug. Costs for these drugs are a substantial out-of-pocket expense for Medicare beneficiaries, and low-income older...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-139-5_part_2-200309021-00009
更新日期:2003-09-02 00:00:00
abstract::Several trends in medical education affect our supply of future physicians. The number of new physicians has increased so that each year there is an excess of about 6000 over the number of physicians produced per year a decade ago. Increasing numbers of women and members of minority groups are entering the profession ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-5-806
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND:Advice and exercise are widely recommended for subacute low back pain, but the effectiveness of these interventions is unclear. OBJECTIVE:To investigate the effectiveness of physiotherapist-prescribed exercise, advice, or both for subacute low back pain. DESIGN:Factorial randomized, placebo-controlled tria...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-146-11-200706050-00007
更新日期:2007-06-05 00:00:00
abstract:BACKGROUND:The fecal immunochemical test (FIT) is a common method for colorectal cancer (CRC) screening, yet its acceptability and performance over several rounds of annual testing are largely unknown. OBJECTIVE:To assess FIT performance characteristics over 4 rounds of annual screening. DESIGN:Retrospective cohort s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-0983
更新日期:2016-04-05 00:00:00
abstract::Physical symptoms account for more than half of all outpatient visits, but the specific causes and treatments of many common symptoms are frequently not well established. Because clinical research has primarily targeted specific diseases, symptoms-based research is still an emerging field of scientific inquiry, and op...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-134-9_part_2-200105011-00008
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Estimates of risk for radiation-induced breast cancer from mammography screening have not considered variation in dose exposure or diagnostic work-up after abnormal screening results. OBJECTIVE:To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography scre...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-1241
更新日期:2016-02-16 00:00:00
abstract::During 1973 and 1974, we looked for cases of Colorado tick fever throughout Colorado; 228 cases were identified. Although 90% of the patients reported exposure to ticks before illness, only 52% were aware of an actual tick bite. Typical symptoms of fever, myalgia, and headache were common, but gastrointestinal symptom...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-88-3-303
更新日期:1978-03-01 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:Although few retrospective studies of high altitude have reported that obesity might be associated with the development of acute mountain sickness (AMS), this association has not been studied prospectively. OBJECTIVE:To determine whether obesity is associated with the development of AMS. DESIGN:Obese and n...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-139-4-200308190-00007
更新日期:2003-08-19 00:00:00
abstract:OBJECTIVE:To evaluate the amount of variation in in-hospital mortality and length of intensive care unit (ICU) stay that can be accounted for by clinical data available at ICU admission. DESIGN:Inception cohort study. SETTING:Forty-two ICUs in 40 hospitals, including 26 hospitals that were randomly selected and 14 la...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-118-10-199305150-00001
更新日期:1993-05-15 00:00:00
abstract:BACKGROUND:Soon, half of all physicians may be married to other physicians (that is, in dual-doctor families). Little is known about how marriage to another physician affects physicians themselves. OBJECTIVE:To learn how physicians in dual-doctor families differ from other physicians in their professional and family l...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-4-199902160-00017
更新日期:1999-02-16 00:00:00
abstract:Background:Delirium is common in hospitalized patients and is associated with worse outcomes. Antipsychotics are commonly used; however, the associated benefits and harms are unclear. Purpose:To conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Data Sources:P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M19-1860
更新日期:2019-10-01 00:00:00
abstract::The latest guidelines from the American College of Cardiology and American Heart Association, released in fall 2013, provide a long-anticipated update to the recommendations of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-1739
更新日期:2016-12-06 00:00:00
abstract:BACKGROUND:Apolipoprotein E (apoE) genotypes play critical roles in lipid metabolism and are believed to influence risk for coronary heart disease (CHD). Despite many population studies, however, the impact of apoE polymorphism on risk for CHD remains uncertain. PURPOSE:To qualitatively and quantitatively assess the e...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-141-2-200407200-00013
更新日期:2004-07-20 00:00:00
abstract::Meta-analysis is the process of combining study results that can be used to draw conclusions about therapeutic effectiveness or to plan new studies. We review important design and statistical issues of this process. The design issues include protocol development, objectives, literature search, publication bias, measur...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-107-2-224
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:HIV-infected patients with sustained immunologic improvement from antiretroviral therapy may be able to discontinue chemoprophylaxis against Pneumocystis carinii pneumonia (PCP). OBJECTIVE:To compare PCP incidence in HIV-infected patients who had sustained CD4+ lymphocyte counts greater than 200 cells/mm3 a...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-3-200002010-00005
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. OBJECTIVE:To assess whether APM impr...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/M15-0899
更新日期:2016-04-05 00:00:00
abstract::An investigation of patient care in four hospitals compared levels of resource use between 1964 and 1974 for patients with a primary diagnosis of pneumonia. Results showed a decreased length of stay in all hospitals. Unique patterns of increases and decreases existed in each hospital for the changing use of diagnostic...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-5-648
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:The pandemic potential of influenza A (H5N1) virus is a prominent public health concern of the 21st century. OBJECTIVE:To estimate the effectiveness and cost-effectiveness of alternative pandemic (H5N1) mitigation and response strategies. DESIGN:Compartmental epidemic model in conjunction with a Markov mod...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-151-12-200912150-00156
更新日期:2009-12-15 00:00:00
abstract:OBJECTIVE:To study the relation between housestaff coverage schedules and the occurrence of preventable adverse events. DESIGN:Case-control study. SETTING:Urban teaching hospital. PATIENTS:All 3146 patients admitted to the medical service during a 4-month period. MEASUREMENTS:A previously tested confidential self-r...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-121-11-199412010-00008
更新日期:1994-12-01 00:00:00
abstract::The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during whi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-7-200904070-00115
更新日期:2009-04-07 00:00:00
abstract:BACKGROUND:Impressive decreases in cardiovascular mortality have been achieved through risk factor reduction and clinical intervention, yet cardiovascular disease remains a leading cause of death nationally. OBJECTIVE:To estimate up-to-date preventable fractions of cardiovascular mortality associated with elimination ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M14-1753
更新日期:2015-08-18 00:00:00
abstract::Under the current system of disability determination and workers' compensation for occupational lung disease, disabled workers or their survivors can reasonably count on being compensated. However, by rejecting established scientific truth in order to pay workers' compensation in circumstances where disability or deat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-6-908
更新日期:1982-12-01 00:00:00
abstract::We examined the survival time and costs of therapy for patients with end-stage renal disease. A computer simulation model of the current system was constructed to estimate the cost-effectiveness of home and center hemodialysis and live related as well as cadaver donor renal transplantation. Analysis of the simulation ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-243
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To determine which procedures nephrologists do in practice, where they learned the procedures, and how much training they recommend to achieve and maintain clinical competence in each. DESIGN:Mailed survey. PARTICIPANTS:A random sample of 700 members of the American College of Physicians who were identified...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-5-392
更新日期:1990-09-01 00:00:00
abstract::We have seen two patients whose hepatitis was due to the administration of aprindine, a new antiarrhythmic agent. In both patients evidence of hepatitis appeared within 3 weeks of initiating aprindine therapy and resolved rapidly when the drug was withdrawn. The reintroduction of aprindine in one patient was associate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-3-359
更新日期:1978-09-01 00:00:00
abstract::9-(1,3-dihydroxy-2-propoxymethyl) guanine (ganciclovir) was used to treat 41 patients (median age, 37 years) with the acquired immunodeficiency syndrome and cytomegalovirus gastrointestinal infection. Sites of infection were the colon in 31, the esophagus in 5, the rectum in 4, and the small bowel in 1. Patients recei...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-2-133
更新日期:1987-08-01 00:00:00