Abstract:
:Discovery of the factor V Leiden and prothrombin G20210A mutations has greatly increased the percentage of patients in whom venous thrombosis can be attributed to hereditary thrombophilia. The first step in the diagnostic approach to all patients with venous thrombosis consists of a careful history and physical examination combined with routine laboratory testing to characterize the severity of the thrombotic condition and determine the presence of any of the acquired causes of hypercoagulability. The second step is to consider screening for the causes of hereditary and acquired thrombophilia in selected subsets of patients. The selection of patients for testing, the choice of tests to perform, and the timing of the testing are important and challenging issues to consider. Routine testing would be warranted if the identification of abnormalities led to an alteration in the type or duration of initial anticoagulant therapy or the use of long-term prophylactic anticoagulation. The available data, however, do not yet indicate that most patients with defined thrombophilic states should be managed any differently than patients without identifiable abnormalities. On the basis of relative prevalences of the various thrombophilias, patients can be classified as "strongly" or "weakly" thrombophilic depending on their thrombotic histories. Management considerations and guidelines are offered for patients who are found to have one or more defined abnormalities, hereditary or otherwise. The future identification of additional laboratory abnormalities predisposing patients to thrombosis, coupled with prospective clinical trials, should enable us to better identify patients at high risk for recurrence who will benefit from prolonged anticoagulant prophylaxis.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Bauer KAdoi
10.7326/0003-4819-135-5-200109040-00013subject
Has Abstractpub_date
2001-09-04 00:00:00pages
367-73issue
5eissn
0003-4819issn
1539-3704pii
200109040-00013journal_volume
135pub_type
杂志文章,评审abstract:BACKGROUND:Because psychological approaches are likely to produce sustained benefits without the risk for tolerance or adverse effects associated with pharmacologic approaches, cognitive behavioral therapy for insomnia (CBT-i) is now commonly recommended as first-line treatment for chronic insomnia. PURPOSE:To determi...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M14-2841
更新日期:2015-08-04 00:00:00
abstract:BACKGROUND:Severe aplastic anemia is a life-threatening bone marrow failure disorder. High-dose cyclophosphamide therapy followed by allogeneic bone marrow transplantation cures the disease. However, it requires a suitable donor and carries the risk for graft-versus-host disease. A small pilot study demonstrated that h...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-135-7-200110020-00006
更新日期:2001-10-02 00:00:00
abstract::Adult T-cell leukemia associated with human T-cell leukemia virus type I (HTLV-I) is characterized by a clonal expansion of a CD4-positive subset of T lymphocytes that constitutively express high numbers of interleukin-2 receptors and that frequently infiltrate the skin; osteolytic bone lesions, and hypercalcemia. Usi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-4-274
更新日期:1988-08-15 00:00:00
abstract::Approximately 3000 people in Bennington, Vermont, 19% of the population, had a diarrheal illness during the first and second weeks of June 1978. Persons affected reported abdominal cramps (86%), diarrhea (82%), malaise (73%), and headache (47%). The mean duration of illness was 4.6 days. The illness was associated wit...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-3-292
更新日期:1982-03-01 00:00:00
abstract:PURPOSE:To review the available data on the treatment of chronic stable angina and formulate a rational approach to the use of pharmacologic therapy, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass graft surgery (CABG). DATA SOURCES:A MEDLINE search of English-language literature publ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-128-3-199802010-00008
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Short-term aspirin therapy can lower the risk for venous thromboembolism (VTE) in high-risk patients, but whether the long-term use of low-dose aspirin reduces risk in healthy adults is uncertain. OBJECTIVE:To test the efficacy of long-term aspirin therapy for preventing VTE. DESIGN:Secondary analysis of a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-147-8-200710160-00004
更新日期:2007-10-16 00:00:00
abstract:BACKGROUND:Radiation therapy is one of many treatment options for patients with prostate cancer. PURPOSE:To update findings on the clinical and biochemical outcomes of radiation therapies for localized prostate cancer. DATA SOURCES:MEDLINE (2007 through March 2011) and the Cochrane Central Register of Controlled Tria...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-3-201108020-00347
更新日期:2011-08-02 00:00:00
abstract:BACKGROUND:The incidence of esophageal adenocarcinoma is increasing rapidly. Gastroesophageal reflux is a strong risk factor for this disease. The increase in incidence of esophageal adenocarcinoma coincided with the introduction of medications that promote reflux by relaxing the lower esophageal sphincter (LES), such ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-3-200008010-00007
更新日期:2000-08-01 00:00:00
abstract::We report a case of combined idiopathic immune neutropenia and immune thrombocytopenia (thromboneutropenia). Therapy with prednisone was ineffective. Treatment with vincristine raised the patient's platelet count but did not increase the neutrophil count. Splenectomy led to a prompt complete remission. Using radioimmu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-5-704
更新日期:1980-11-01 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:BACKGROUND:Mesenchymal stem cells can differentiate into endothelial cells and participate in angiogenesis in adults. In experimental models of acute myocardial infarction, mesenchymal stem cells led to the recovery of cardiac function through the formation of a new vascular network. OBJECTIVE:To describe treatment wi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-10-201011160-00007
更新日期:2010-11-16 00:00:00
abstract:DESCRIPTION:The Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives, developed a recommendation on screening for anxiety in adolescent and adult women to improve detection; achieve earlier diagnosis and treatment; and improve healt...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M20-0580
更新日期:2020-07-07 00:00:00
abstract::In observational studies or nonrandomized experiments, treated and control groups may differ in their outcomes even if the treatment has no effect; this may happen if the groups were not comparable before the start of treatment. The groups may fail to be comparable in either of two ways: They may differ with respect t...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-115-11-901
更新日期:1991-12-01 00:00:00
abstract::The content, role, and purpose of internal medicine, organized as an American specialty 100 years ago, have been marked by ambivalence from the beginning. Nevertheless, molded to a large extent by external events, including the strategic and symbolic importance of surgery in American medicine, the rise of university m...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
doi:10.7326/0003-4819-105-4-592
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Primary prevention of Alzheimer disease and other types of dementia (all-cause dementia) is an important public health goal. Evidence to date is insufficient to recommend any lifestyle change to prevent or delay the onset of dementia. OBJECTIVE:To assess the association between objectively measured midlife ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-158-3-201302050-00005
更新日期:2013-02-05 00:00:00
abstract:BACKGROUND:Alleviating the problems faced by dying persons and their families has drawn substantial public attention, but little is known about the experience of dying. OBJECTIVE:To characterize the experience of dying from the perspective of surrogate decision makers, usually close family members (89%). DESIGN:Prosp...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-126-2-199701150-00001
更新日期:1997-01-15 00:00:00
abstract::Amantadine HCl administration has resulted in accelerated resolution of influenza A illness. Prolonged abnormalities in pulmonary function have been described in uncomplicated influenza A. To study the effect of amantadine on these changes, we evaluated young adults with documented natural influenza A with clear chest...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-85-2-177
更新日期:1976-08-01 00:00:00
abstract::The U.S. Food and Drug Administration (FDA) Amendments Act of 2007 mandated that the FDA develop a system for using automated health care data to identify risks of marketed drugs and other medical products. The Observational Medical Outcomes Partnership is a public-private partnership among the FDA, academia, data own...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-9-201011020-00010
更新日期:2010-11-02 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::The safety of using inhaled beclomethasone dipropionate for the treatment of severe asthma during pregnancy was evaluated during 45 pregnancies in 40 women. Despite chronic administration of theophylline and, in some women, ephedrine, the asthma was so severe that corticosteroids were essential to prevent emergency ro...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-4-478
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Two recent double-blind, randomized, controlled trials (RCTs) showed that oral steroids and nonsteroidal anti-inflammatory drugs have similar analgesic effectiveness for management of gout, but the trials had small sample sizes and other methodological limitations. OBJECTIVE:To compare the effectiveness and...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M14-2070
更新日期:2016-04-05 00:00:00
abstract::Vasodilator drugs were initially administered to patients with primary pulmonary hypertension based on the unproven hypothesis that pulmonary vasoconstriction played an important role in the pathogenesis of the disease. There were early reports of hemodynamic and clinical improvement after treatment with various vasod...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-103-2-258
更新日期:1985-08-01 00:00:00
abstract::Poststreptococcal acute glomerulonephritis is prototypic of the immunologic glomerulonephritides. It most commonly follows streptococcal infection of the pharynx or skin. The diagnosis is usually not difficult when a nephritic clinical presentation (with such manifestations as hematuria, edema, and hypertension) is as...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-91-1-76
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:Ulcerative colitis is predominantly a disease of nonsmokers. Transdermal nicotine may help control clinical manifestations of this condition. OBJECTIVE:To determine the efficacy of transdermal nicotine for controlling clinical disease activity in active ulcerative colitis. DESIGN:Randomized, double-blind, ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-126-5-199703010-00004
更新日期:1997-03-01 00:00:00
abstract::Therapy of pulmonary hypertension is limited by the low potency and adverse effects of current pulmonary vasodilators. The hemodynamic effects of nitroglycerin in human pulmonary hypertension are not known. We administered nitroglycerin to nine patients with chronic pulmonary hypertension. Nitroglycerin increased card...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-1-9
更新日期:1983-07-01 00:00:00
abstract:SOURCE CITATION:Mahady SE, Margolis KL, Chan A, et al. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut. 2020. [Epub ahead of print.] 32747412. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/ACPJ202101190-004
更新日期:2021-01-01 00:00:00
abstract::Advances have recently been made in understanding the pharmacokinetics of theophylline. To correlate the new knowledge of theophylline pharmacokinetics with the drug's current status in therapy, we have critically reviewed the relevant investigations of the last 5 years. We consider data on its presumed mechanisms of ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-101-1-63
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Dietary and lifestyle modification efforts are the primary treatments for people who are obese or overweight. The effect of dietary counseling on long-term weight change is unclear. PURPOSE:To perform a meta-analysis of the effect of dietary counseling compared with usual care on body mass index (BMI) over ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-147-1-200707030-00007
更新日期:2007-07-03 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:The frequency and severity of post-thrombotic sequelae after spontaneous axillary-subclavian venous thrombosis remain poorly known. OBJECTIVE:To determine the late sequelae of conventionally treated spontaneous axillary-subclavian venous thrombosis. DESIGN:Cross-sectional study. SETTING:University departm...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-131-7-199910050-00006
更新日期:1999-10-05 00:00:00