Abstract:
OBJECTIVE:To describe how the results of bone densitometry affect women's decisions about measures to prevent fractures and to determine whether labeling women as having below-normal bone density has adverse effects. DESIGN:Mail survey of a random sample of women. SETTING:Four community hospitals in the San Francisco Bay area. PATIENTS:A total of 261 women (response rate, 81.3%) who had undergone bone densitometry. MEASUREMENTS:Bone densitometry and self-report of changes in attitude and behaviors. RESULTS:Fifty-three percent of the women reported that their first bone density measurements were below normal, and 44% said that they were diagnosed as having osteoporosis on the basis of their test results. Women who reported that their bone density measurements were below normal were much more likely than women with normal results to begin some type of measure to prevent fractures (94% compared with 56%; P less than 0.01), to start hormone therapy (38% compared with 8%; P less than 0.01), and to take precautions to avoid falling (50% compared with 9%; P less than 0.01). Women reporting low bone density, however, also became more fearful of falling (38% compared with 2%; P less than 0.01) and limited their activities to avoid falling (24% compared with 2%; P less than 0.01). CONCLUSIONS:The results of bone densitometry substantially influence women's decisions about beginning estrogen replacement therapy and other preventive measures for osteoporotic fractures. The potential effects of labeling a woman as having below-normal bone density need to be considered before densitometry is widely used for unselective screening of women.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Rubin SM,Cummings SRdoi
10.7326/0003-4819-116-12-990subject
Has Abstractpub_date
1992-06-15 00:00:00pages
990-5issue
12 Pt 1eissn
0003-4819issn
1539-3704journal_volume
116pub_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:BACKGROUND:Hematopoietic stem cell transplantation (HSCT) is increasingly used to treat multiple malignant and nonmalignant conditions. The risk for cardiovascular disease after the procedure has not been well-described. OBJECTIVE:To compare rates and hazards of cardiovascular-related hospitalization and death among p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-155-1-201107050-00004
更新日期:2011-07-05 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:OBJECTIVE:To assess the use of L-tryptophan by patients with eosinophilic fasciitis and compare this with its use by patients with progressive systemic sclerosis (scleroderma). DESIGN:Retrospective and prospective analysis. Six patients with eosinophilic fasciitis were identified retrospectively and two prospectively....
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-112-10-758
更新日期:1990-05-15 00:00:00
abstract::We discuss here some of the last decade's diagnostic and therapeutic advances in the treatment of lung cancer, as well as current and future research objectives. Roentgenographs from selected patients illustrate the natural history of lung cancer. We present perspectives concerning selection from the growing diagnosti...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-1-93
更新日期:1975-07-01 00:00:00
abstract::Recent studies have indicated that outcomes in patients with atrial fibrillation who are managed with rate control and anticoagulation are similar to those in patients who have maintenance of sinus rhythm. These studies did not include important groups of patients with atrial fibrillation in whom antiarrhythmic therap...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2004-11-02 00:00:00
abstract:Background:Central line-associated bloodstream infection (CLABSI) remains prevalent in hospitals in the United States. Objective:To evaluate the impact of a multimodal intervention in hospitals with elevated rates of health care-associated infection. Design:Pre-post observational evaluation of a prospective, national...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M18-3533
更新日期:2019-10-01 00:00:00
abstract::The syndrome of bulimia is a common disorder and can be associated with serious psychological and physical morbidity. Unfortunately, many patients are reluctant to discuss their symptoms with their physicians and few clues can be found on physical examination to aid in the diagnosis. Possible physical signs include ul...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-107-1-71
更新日期:1987-07-01 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
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doi:10.7326/0003-4819-151-12-200912150-00156
更新日期:2009-12-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-145-9-200611070-00009
更新日期:2006-11-07 00:00:00
abstract::The usefulness of HbA, as a monitor of metabolic control was studied in 15 diabetic outpatients during periods of stable, deteriorating, and improving control. Mean fasting concentrations of HbA, and plasma glucose during a 3-month period of stable control were 12.6% +/- 0.8% and 120 +/- 8 mg/dL, respectively. One wee...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-3-357
更新日期:1980-03-01 00:00:00
abstract::Intravenous drug users are the second largest risk group for the acquired immunodeficiency syndrome (AIDS) and a bridge to two other groups: children and heterosexual partners. In the absence of effective treatment or vaccines, control of the epidemic among drug users will rely on efforts to reduce needle sharing. How...
journal_title:Annals of internal medicine
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doi:10.7326/0003-4819-103-5-755
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease (CVD) is the leading cause of death in the United States. PURPOSE:To update a systematic review about the benefits of aspirin for the primary prevention of cardiovascular events in adults aged 40 years or older and to evaluate effect modification in subpopulations. DATA SOURCES:MEDLI...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M15-2113
更新日期:2016-06-21 00:00:00
abstract::Physician performance failures are not rare and pose substantial threats to patient welfare and safety. Few hospitals respond to such failures promptly or effectively. Failure to ensure the quality and safety of the performance of colleagues is a breach of medicine's fiduciary responsibility to the public. A major rea...
journal_title:Annals of internal medicine
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更新日期:2006-01-17 00:00:00
abstract:BACKGROUND:Despite extensive literature, the diagnostic role of d-dimer for deep venous thrombosis (DVT) or pulmonary embolism (PE) remains unclear, reflecting multiple d-dimer assays and concerns about differing sensitivities and variability. PURPOSE:To systematically review trials that assessed sensitivity, specific...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-140-8-200404200-00005
更新日期:2004-04-20 00:00:00
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journal_title:Annals of internal medicine
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doi:10.7326/0003-4819-149-5-200809020-00005
更新日期:2008-09-02 00:00:00
abstract::Forceful new demands for accountability in medicine are arising from many interested parties. To maintain professional standards, physicians need to establish which demands are desirable and which are not. We adopt a model of stratified accountability that includes three major components: the accountable parties, the ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-124-2-199601150-00008
更新日期:1996-01-15 00:00:00
abstract:BACKGROUND:Resistance to activated protein C due to the factor V R506Q (Leiden) mutation is the most common clotting abnormality in patients with venous thromboembolism. OBJECTIVE:To evaluate the risk for venous thromboembolism associated with the factor V Leiden mutation or with resistance to activated protein C in t...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-8-199904200-00004
更新日期:1999-04-20 00:00:00
abstract:BACKGROUND:Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. OBJECTIVE:To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-147-6-200709180-00006
更新日期:2007-09-18 00:00:00
abstract:BACKGROUND:Indinavir, a protease inhibitor widely used to treat patients with HIV infection, has been associated with nephrolithiasis. Distinctive urinary crystals and a spectrum of urologic disorders were noted in patients receiving indinavir. OBJECTIVE:To determine the composition of urinary crystals and the frequen...
journal_title:Annals of internal medicine
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更新日期:1997-07-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2007-01-02 00:00:00
abstract::Much of what is formally taught in medicine is about the knowledge, skills, and behaviors required of a physician, including how to express compassion and respect for patients at the bedside. What is learned, however, includes not only admirable qualities but also behaviors and qualities that are inconsistent with eth...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M17-2058
更新日期:2018-04-03 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-119-4-199308150-00010
更新日期:1993-08-15 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::Two cases of patients having calcification within the sella turcica (pituitary stones) have been studied and followed up, one patient for 18 years. A detailed analysis of the radiographic findings and endocrinologic profiles of these two patients is presented. The rarity of bona fide pituitary stones and their benign ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-1-66
更新日期:1975-07-01 00:00:00
abstract:OBJECTIVE:To determine the effect of the presence of a patent foramen ovale on the right-to-left shunt in patients with respiratory failure who receive positive end-expiratory pressure (PEEP). DESIGN:Convenience sample with randomized application of PEEP. SETTING:General intensive care unit of a university teaching h...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-119-9-199311010-00004
更新日期:1993-11-01 00:00:00
abstract::The Hospital Readmissions Reduction Program (HRRP) has penalized hospitals with higher 30-day readmission rates more than $3 billion to date. Clinicians and policy experts have raised concerns that the 30-day readmission measure used in this program provides an incomplete picture of performance because it does not cap...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-3486
更新日期:2021-01-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-124-9-199605010-00005
更新日期:1996-05-01 00:00:00
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 rel...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-2-189
更新日期:1975-02-01 00:00:00
abstract::Wilson's disease is an inherited disorder of copper accumulation that is fatal if untreated. Because penicillamine, the established treatment, is toxic in a substantial number of patients, we studied the efficacy of zinc treatment. We induced a negative or neutral copper balance in five out of five patients with Wilso...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-3-314
更新日期:1983-09-01 00:00:00