A leap of faith. What can we do to curtail intrainstitutional transmission of tuberculosis?

Abstract:

:Large-scale, epidemic transmission of tuberculosis to patients, nonprofessional staff, nurses, and physicians has been documented recently in hospitals, clinics, acquired immunodeficiency syndrome (AIDS) residencies, and correctional facilities. Prominent factors in these outbreaks have included human immunodeficiency virus (HIV) infection and AIDS, delayed diagnosis of tuberculosis, multidrug-resistant strains of tuberculosis that resulted in protracted shedding of mycobacteria, and ventilation patterns in buildings that resulted in the accumulation of infectious particles. Multiple deaths from tuberculosis have resulted. Various strategies, including vaccines, masks, augmented ventilation, air filters, and ultraviolet irradiation have been proposed to control this situation. Although no well-controlled studies exist to document the utility of any of these modalities, ultraviolet germicidal irradiation seems both the best theoretical model and the most practical tactic. Ultraviolet systems should be widely deployed throughout high-risk institutions.

journal_name

Ann Intern Med

authors

Iseman MD

doi

10.7326/0003-4819-117-3-251

subject

Has Abstract

pub_date

1992-08-01 00:00:00

pages

251-3

issue

3

eissn

0003-4819

issn

1539-3704

journal_volume

117

pub_type

杂志文章
  • Low blood pressure in young adults with cystic fibrosis: an effect of chronic salt loss in sweat?

    abstract::Young adults with cystic fibrosis have lower blood pressures than control subjects of similar age and sex. The low blood pressure may be related to the excessive loss of salt in the sweat of these patients. A beneficial effect of the cystic fibrosis gene may be protection against developing hypertension in both the ho...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-82-6-806

    authors: Lieberman J,Rodbard S

    更新日期:1975-06-01 00:00:00

  • Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society.

    abstract:DESCRIPTION:This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,实务指引

    doi:10.7326/0003-4819-155-3-201108020-00008

    authors: Qaseem A,Wilt TJ,Weinberger SE,Hanania NA,Criner G,van der Molen T,Marciniuk DD,Denberg T,Schünemann H,Wedzicha W,MacDonald R,Shekelle P,American College of Physicians.,American College of Chest Physicians.,American Thoracic

    更新日期:2011-08-02 00:00:00

  • ClinicalTrials.gov and Drugs@FDA: A Comparison of Results Reporting for New Drug Approval Trials.

    abstract:BACKGROUND:Pharmaceutical companies and other trial sponsors must submit certain trial results to ClinicalTrials.gov. The validity of these results is unclear. PURPOSE:To validate results posted on ClinicalTrials.gov against publicly available U.S. Food and Drug Administration (FDA) reviews on Drugs@FDA. DATA SOURCES...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/M15-2658

    authors: Schwartz LM,Woloshin S,Zheng E,Tse T,Zarin DA

    更新日期:2016-09-20 00:00:00

  • Minocycline in rheumatoid arthritis. A 48-week, double-blind, placebo-controlled trial. MIRA Trial Group.

    abstract:OBJECTIVE:To assess the safety and efficacy of minocycline in the treatment of rheumatoid arthritis. DESIGN:A double-blind, randomized, multicenter, 48-week trial of oral minocycline (200 mg/d) or placebo. SETTING:6 clinical centers in the United States. PATIENTS:219 adults with active rheumatoid arthritis who had p...

    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:10.7326/0003-4819-122-2-199501150-00001

    authors: Tilley BC,Alarcón GS,Heyse SP,Trentham DE,Neuner R,Kaplan DA,Clegg DO,Leisen JC,Buckley L,Cooper SM,Duncan H,Pillemer SR,Tuttleman M,Fowler SE

    更新日期:1995-01-15 00:00:00

  • Critical pathways as a strategy for improving care: problems and potential.

    abstract::In an era of increasing competition in medical care, critical pathway guidelines have emerged as one of the most popular new initiatives intended to reduce costs while maintaining or even improving the quality of care. Developed primarily for high-volume hospital diagnoses, critical pathways display goals for patients...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-123-12-199512150-00008

    authors: Pearson SD,Goulart-Fisher D,Lee TH

    更新日期:1995-12-15 00:00:00

  • Diagnosis and management of delirium near the end of life.

    abstract::Delirium is a common and distressing symptom that constitutes a significant challenge for end-of-life care. However, reliable techniques are available for the diagnosis of delirium, and effective therapies exist as well. This consensus paper uses a case-based format that begins with an overview of the definition and p...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-135-1-200107030-00011

    authors: Casarett DJ,Inouye SK,American College of Physicians-American Society of Internal Medicine End-of-Life Care Consensus Panel.

    更新日期:2001-07-03 00:00:00

  • The equivalency of two L-thyroxine preparations.

    abstract::Differences in blood levels of thyroid hormones have been reported when patients taking synthetic L-thyroxine were shifted from one manufactured form of the hormone to another. Because recent formulation changes have rendered these earlier data obsolete, we did a crossover study to determine differences in bioavailabi...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-102-6-770

    authors: Hennessey JV,Burman KD,Wartofsky L

    更新日期:1985-06-01 00:00:00

  • Salicylate-induced pulmonary edema. Clinical features and prognosis.

    abstract::To assess the course and prognosis of salicylate-induced pulmonary edema, we reviewed the records of 36 consecutive patients admitted with serum salicylate levels greater than 30 mg/dL. Pulmonary edema developed in eight patients, and pulmonary infiltrates were never seen in 28 patients. Several features distinguished...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-95-4-405

    authors: Heffner JE,Sahn SA

    更新日期:1981-10-01 00:00:00

  • Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women's Preventive Services Initiative.

    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

    authors: Gregory KD,Chelmow D,Nelson HD,Van Niel MS,Conry JA,Garcia F,Kendig SM,O'Reilly N,Qaseem A,Ramos D,Salganicoff A,Son S,Wood JK,Zahn C,Women’s Preventive Services Initiative.

    更新日期:2020-07-07 00:00:00

  • The safety of treadmill exercise stress testing in patients with abdominal aortic aneurysms.

    abstract:BACKGROUND:Exercise stress testing in patients with abdominal aortic aneurysms may cause enlargement or rupture of aneurysms. OBJECTIVE:To evaluate the safety of treadmill exercise stress testing in patients with abdominal aortic aneurysms. DESIGN:Retrospective descriptive study. SETTING:Tertiary care center. PATIE...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-129-8-199810150-00008

    authors: Best PJ,Tajik AJ,Gibbons RJ,Pellikka PA

    更新日期:1998-10-15 00:00:00

  • Meta-analysis in clinical research.

    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

    authors: L'Abbé KA,Detsky AS,O'Rourke K

    更新日期:1987-08-01 00:00:00

  • Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences.

    abstract:BACKGROUND:Benign reductions in neutrophil counts may be more common at certain ages and in certain ethnic groups and may be affected by sex and smoking status. OBJECTIVE:To determine differences in neutrophil counts in the U.S. population according to ethnicity, age, sex, and smoking status. DESIGN:Population-based,...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-146-7-200704030-00004

    authors: Hsieh MM,Everhart JE,Byrd-Holt DD,Tisdale JF,Rodgers GP

    更新日期:2007-04-03 00:00:00

  • Effects of an angiotensin-converting enzyme inhibitor on residual renal function in patients receiving peritoneal dialysis. A randomized, controlled study.

    abstract:BACKGROUND:Residual renal function is an important determinant of mortality and morbidity in patients receiving peritoneal dialysis. However, few studies have evaluated therapeutic approaches for preserving residual renal function after the initiation of dialysis. OBJECTIVE:To test the hypothesis that the angiotensin-...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-139-2-200307150-00010

    authors: Li PK,Chow KM,Wong TY,Leung CB,Szeto CC

    更新日期:2003-07-15 00:00:00

  • Surgical therapy of variant angina associated with nonobstructive coronary disease.

    abstract::Patients with variant angina refractory to medical therapy pose a difficult management problem. We report two patients with variant angina who had focal spasm in coronary arteries with fixed obstructions of less than 20% of the luminal diameter. Ischemic episodes were accompanied by malignant ventricular arrhythmias a...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-94-6-771

    authors: Sussman EJ,Goldberg S,Poll DS,MacVaugh H 3rd,Simson MB,Silber SA,Kastor JA

    更新日期:1981-06-01 00:00:00

  • Weight training improves walking endurance in healthy elderly persons.

    abstract:OBJECTIVE:To determine the effect of a resistance-training program on walking endurance in a healthy, community-dwelling elderly population. DESIGN:12- week randomized, controlled trial comparing a resistance- training group with a nonexercising control group. SETTING:Hospital-affiliated outpatient exercise facility....

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-124-6-199603150-00005

    authors: Ades PA,Ballor DL,Ashikaga T,Utton JL,Nair KS

    更新日期:1996-03-15 00:00:00

  • Crystalluria and urinary tract abnormalities associated with indinavir.

    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

    pub_type: 杂志文章

    doi:10.7326/0003-4819-127-2-199707150-00004

    authors: Kopp JB,Miller KD,Mican JA,Feuerstein IM,Vaughan E,Baker C,Pannell LK,Falloon J

    更新日期:1997-07-15 00:00:00

  • Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients.

    abstract:BACKGROUND:Understanding the risk factors for ventilator-associated pneumonia can help to assess prognosis and devise and test preventive strategies. OBJECTIVE:To examine the baseline and time-dependent risk factors for ventilator-associated pneumonia and to determine the conditional probability and cumulative risk ov...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-129-6-199809150-00002

    authors: Cook DJ,Walter SD,Cook RJ,Griffith LE,Guyatt GH,Leasa D,Jaeschke RZ,Brun-Buisson C

    更新日期:1998-09-15 00:00:00

  • Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial.

    abstract:BACKGROUND:Despite convincing evidence that lowering blood pressure decreases cardiovascular morbidity and mortality, the hypertension burden remains high and control rates are poor in developing countries. OBJECTIVE:To assess the effectiveness of 2 community-based interventions on blood pressure in hypertensive adult...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.7326/0003-4819-151-9-200911030-00004

    authors: Jafar TH,Hatcher J,Poulter N,Islam M,Hashmi S,Qadri Z,Bux R,Khan A,Jafary FH,Hameed A,Khan A,Badruddin SH,Chaturvedi N,Hypertension Research Group.

    更新日期:2009-11-03 00:00:00

  • Hearing loss in the Sjögren syndrome.

    abstract:BACKGROUND:Ear involvement is not unusual in autoimmune diseases, but few data on this problem in the Sjögren syndrome are available. OBJECTIVES:To determine whether the incidence of hearing loss is increased in patients with the Sjögren syndrome and to determine what factors might be involved in the pathogenesis of S...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-126-6-199703150-00005

    authors: Tumiati B,Casoli P,Parmeggiani A

    更新日期:1997-03-15 00:00:00

  • Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study.

    abstract:Background:Older adults with acute myocardial infarction (AMI) have higher prevalence of functional impairments, including deficits in cognition, strength, and sensory domains, than their younger counterparts. Objective:To develop and evaluate the prognostic utility of a risk model for 6-month post-AMI mortality in ol...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/M19-0974

    authors: Dodson JA,Hajduk AM,Geda M,Krumholz HM,Murphy TE,Tsang S,Tinetti ME,Nanna MG,McNamara R,Gill TM,Chaudhry SI

    更新日期:2020-01-07 00:00:00

  • Deconstructing the placebo effect and finding the meaning response.

    abstract::We provide a new perspective with which to understand what for a half century has been known as the "placebo effect." We argue that, as currently used, the concept includes much that has nothing to do with placebos, confusing the most interesting and important aspects of the phenomenon. We propose a new way to underst...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-136-6-200203190-00011

    authors: Moerman DE,Jonas WB

    更新日期:2002-03-19 00:00:00

  • Reporting the recruitment process in clinical trials: who are these patients and how did they get there?

    abstract:BACKGROUND:A common criticism of randomized, controlled trials (RCTs) is that the enrollment process may be highly selective and those who enroll may not represent persons in the general population. The recruitment process reported in published RCTs has not been systematically evaluated. OBJECTIVE:To determine whether...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-137-1-200207020-00007

    authors: Gross CP,Mallory R,Heiat A,Krumholz HM

    更新日期:2002-07-02 00:00:00

  • Discussing hidden bias in observational studies.

    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

    authors: Rosenbaum PR

    更新日期:1991-12-01 00:00:00

  • Recurrent coronary vasoconstriction caused by intranasal cocaine: possible role for metabolites.

    abstract:OBJECTIVE:To define the temporal characteristics of cocaine-induced coronary vasoconstriction in humans and to assess the relation between cocaine-induced coronary vasoconstriction and the blood concentration of cocaine and its main metabolites. DESIGN:Randomized, double-blind, controlled clinical trial. SETTING:Card...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-116-7-556

    authors: Brogan WC 3rd,Lange RA,Glamann DB,Hillis LD

    更新日期:1992-04-01 00:00:00

  • Ethical decisions in the care of a patient terminally ill with metastatic cancer.

    abstract::A case of a patient with metastatic cancer raises the issues of patient refusal of treatment, euthanasia, and unintended side effects of therapy. For each management dilemma, there are relevant ethical and legal considerations, justifications, and conclusions. In addition, psychological and social influences on the de...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:

    authors: Lo B,Jonsen AR

    更新日期:1980-01-01 00:00:00

  • Role of platelets in tumor cell metastases.

    abstract::Platelets may have a role in the development of animal tumor metastases. Ultrastructural studies in vivo have shown arrested tumor emboli surrounded by platelets. Several tumor cell lines induce thrombocytopenia in vivo. Certain tumor cells aggregate platelets in vitro. Correlations exist between the ability of some t...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-95-5-636

    authors: Karpatkin S,Pearlstein E

    更新日期:1981-11-01 00:00:00

  • Incompetent patients with limited care in the absence of family consent. A study of socioeconomic and clinical variables.

    abstract::To understand the factors that distinguish terminally ill, incompetent patients who are given do-not-resuscitate status by physicians against the wishes of the patient's family, I reviewed the charts of 20 such patients (cases) seen in consultation by the ethics committee at the Massachusetts General Hospital over 10 ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-109-10-819

    authors: Brennan TA

    更新日期:1988-11-15 00:00:00

  • Should This Patient Receive Aspirin?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    abstract::Aspirin exerts antiplatelet effects through irreversible inhibition of cyclooxygenase-1, whereas its anticancer effects may be due to inhibition of cyclooxygenase-2 and other pathways. In 2009, the U.S. Preventive Services Task Force endorsed aspirin for primary prevention of cardiovascular disease. However, aspirin's...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/M17-2162

    authors: Burns RB,Graham K,Sawhney MS,Reynolds EE

    更新日期:2017-12-05 00:00:00

  • 12-month outcomes of community engagement versus technical assistance to implement depression collaborative care: a partnered, cluster, randomized, comparative effectiveness trial.

    abstract:BACKGROUND:Depression collaborative care implementation using community engagement and planning (CEP) across programs improves 6-month client outcomes in minority communities, compared with technical assistance to individual programs (resources for services [RS]). However, 12-month outcomes are unknown. OBJECTIVE:To c...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.7326/M13-3011

    authors: Chung B,Ong M,Ettner SL,Jones F,Gilmore J,McCreary M,Sherbourne C,Ngo V,Koegel P,Tang L,Dixon E,Miranda J,Belin TR,Wells KB

    更新日期:2014-11-18 00:00:00

  • Meta-analysis: the effect of dietary counseling for weight loss.

    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

    authors: Dansinger ML,Tatsioni A,Wong JB,Chung M,Balk EM

    更新日期:2007-07-03 00:00:00