Abstract:
BACKGROUND:The optimal strategy for diagnosis of deep venous thrombosis (DVT) is less well established for the upper extremities than for the lower extremities. Duplex color ultrasonography can be difficult to perform in the upper extremities because of their anatomy, and contrast venography is often indicated. Moreover, limited data exist on the use of duplex color ultrasonography in this setting. OBJECTIVE:To determine the accuracy of duplex ultrasonography for diagnosis of DVT of the upper extremities. DESIGN:Prospective study of duplex ultrasonography compared with venography. SETTING:A teaching hospital in Amsterdam, the Netherlands. PATIENTS:126 consecutive inpatients and outpatients with suspected DVT of the upper extremities. MEASUREMENTS:Contrast venography was obtained after duplex ultrasonography and was judged independently. A three-step protocol, involving compression ultrasonography, color ultrasonography, and color Doppler ultrasonography, was used. Sensitivity, specificity, and likelihood ratios for ultrasonography as a whole were calculated. The independent value of each step was assessed. RESULTS:Venography and ultrasonography were not feasible in 23 of 126 patients (18%) and 1 of 126 patients (0.8%), respectively. Results of ultrasonography were inconclusive in 3 patients. Venography demonstrated thrombosis in 44 of 99 patients (44%); in 36 patients (36%), thrombosis was related to intravenous catheters or malignant disease. Sensitivity and specificity of duplex ultrasonography were 82% (95% CI, 70% to 93%) and 82% (CI, 72% to 92%), respectively. Venous incompressibility correlated well with thrombosis, whereas only 50% of isolated flow abnormalities proved to be thrombosis-related. CONCLUSIONS:Duplex ultrasonography may be the method of choice for initial diagnosis of patients with suspected thrombosis of the upper extremities. However, in patients with isolated flow abnormalities, contrast venography should be performed.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Baarslag HJ,van Beek EJ,Koopman MM,Reekers JAdoi
10.7326/0003-4819-136-12-200206180-00007subject
Has Abstractpub_date
2002-06-18 00:00:00pages
865-72issue
12eissn
0003-4819issn
1539-3704pii
200206180-00007journal_volume
136pub_type
杂志文章abstract:BACKGROUND:An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE:To identify risk factors for transmission...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-1-199707010-00006
更新日期:1997-07-01 00:00:00
abstract::Increased adrenocorticotropic hormone (ACTH) levels after bilateral adrenalectomy could be secondary to a pituitary tumor, under replacement with cortisol, or an abnormality in the hypothalamic-pituitary-adrenal feedback loop. To distinguish between these possibilities, ACTH levels were measured before and after corti...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-3-277
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abstract:BACKGROUND:Four months of rifampin treatment for latent tuberculosis infection is safer, has superior treatment completion rates, and is as effective as 9 months of isoniazid. However, daily medication costs are higher for a 4-month rifampin regimen than a 9-month isoniazid regimen. OBJECTIVE:To compare health care us...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2020-08-04 00:00:00
abstract:OBJECTIVE:To determine in female tennis and squash players the effect of biological age (that is, the starting age of playing relative to the age at menarche) at which tennis or squash playing was started on the difference in bone mineral content between the playing and non-playing arms. DESIGN:Cross-sectional study. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-1-199507010-00003
更新日期:1995-07-01 00:00:00
abstract:STUDY OBJECTIVE:To define the clinical and hematologic effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on patients with chronic severe neutropenia. DESIGN:Open-label, phase II study of rhGM-CSF. SETTING:Inpatient hematology and surgery clinic at a university medical center. P...
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pub_type: 杂志文章
doi:10.7326/0003-4819-111-11-887
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Menopausal hormone therapy to prevent chronic conditions is currently not recommended because of its adverse effects. PURPOSE:To update evidence about the effectiveness of hormone therapy in reducing risk for chronic conditions and adverse effects, and to examine whether outcomes vary among women in differe...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-157-2-201207170-00466
更新日期:2012-07-17 00:00:00
abstract::Ninety-six patients with life-threatening ventricular arrhythmias refractory to two or more conventional agents were treated with amiodarone and followed for 6 to 40 months (mean, 15 months). Currently, 75 are alive and well. Seven patients died from nonarrhythmic and five from arrhythmic causes. Nonfatal arrhythmias ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-5-577
更新日期:1983-05-01 00:00:00
abstract::The U.S. Preventive Services Task Force (USPSTF) makes recommendations on which preventive services to routinely incorporate into primary care for specific populations. Behavioral counseling interventions are preventive services designed to help persons engage in healthy behaviors and limit unhealthy ones. The USPSTF'...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M13-2128
更新日期:2014-03-18 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-151-4-200908180-00005
更新日期:2009-08-18 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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journal_title:Annals of internal medicine
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更新日期:2005-05-03 00:00:00
abstract::Low back pain is common, but a herniated intervertebral disk is the cause in only a small percentage of cases. Most symptomatic disk herniations result in clinical manifestations (pain, reflex loss, muscle weakness) that resolve with conservative therapy, and only 5% to 10% of patients require surgery. Sciatica is usu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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journal_title:Annals of internal medicine
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pub_type: 杂志文章,随机对照试验
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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abstract:BACKGROUND:Thymectomy is standard therapy fornonthymomatousmyasthenia gravis despite the absence of randomized clinical trials (1). Myasthenia gravis is uncommonly reported in monozygous twins; disease concordance occurs in approximately one third of such identical twin pairs; and treatment for myasthenia gravis, when ...
journal_title:Annals of internal medicine
pub_type: 信件
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更新日期:2011-10-04 00:00:00
abstract:BACKGROUND:Plasma levels of leptin, the recently discovered satiety hormone, are associated with adiposity in humans. OBJECTIVE:To determine whether genetic factors or body fat distribution affect the association between leptin levels and obesity. PARTICIPANTS:23 healthy identical twin pairs (9 male pairs and 14 fema...
journal_title:Annals of internal medicine
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pub_type: 临床试验,杂志文章
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-08-17 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-12-199712150-00005
更新日期:1997-12-15 00:00:00
abstract::We report the case of a 23-year-old woman who developed severe myalgias in association with mild hepatitis B surface antigen-positive hepatitis. Muscle biopsy showed myriads of microvacuoles filled with neutral lipid. Prednisone therapy was associated with complete clearing of all clinical and laboratory abnormalities...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-4-417
更新日期:1977-10-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1979-07-01 00:00:00
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journal_title:Annals of internal medicine
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更新日期:1990-11-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-106-6-886
更新日期:1987-06-01 00:00:00
abstract::Between 1 January 1980 and 18 October 1981, investigators from the Centers for Disease Control collected information on 1407 cases of toxic shock syndrome using a nationwide passive surveillance system. Ninety-two percent of the reported cases were associated with menstruation. Information available on the type of men...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-6-875
更新日期:1982-06-01 00:00:00
abstract::Between June 1980 and September 1981 we evaluated 24 cases of endocarditis from methicillin-resistant Staphylococcus aureus. All of the cases occurred in drug addicts and all were community-acquired. The patients ranged in age from 21 to 59 years and represented an older population than that generally reported for bac...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1982-09-01 00:00:00