Problem doctors: is there a system-level solution?

abstract：:Physicians treating patients with chronic rheumatoid arthritis spend a considerable amount of time dealing with the psychological and social aspects of the disease. The patients' reaction to the disease can be related to age, experience, personality, and environment at work and at home. Common problems include loss of...

journal_title：Annals of internal medicine

authors： Rogers MP,Liang MH,Partridge AJ

更新日期：1982-03-01 00:00:00

abstract：BACKGROUND:Health care workers are at occupational risk for a vast array of infections that cause substantial illness and occasional deaths. Despite this, few studies have examined the incidence, prevalence, or exposure-associated rates of infection or have considered infection-specific interventions recommended to mai...

journal_title：Annals of internal medicine

authors： Sepkowitz KA

更新日期：1996-11-15 00:00:00

abstract：:Recent reviews have suggested a higher frequency of the lupus anticoagulant or related antiphospholipid antibodies in patients with systemic lupus erythematosus (21% to 65%) than was found in earlier studies (6% to 18%). In our study of 60 consecutive patients, we found the frequency of the lupus anticoagulant by Russ...

journal_title：Annals of internal medicine

authors： Petri M,Rheinschmidt M,Whiting-O'Keefe Q,Hellmann D,Corash L

更新日期：1987-04-01 00:00:00

abstract：PURPOSE:Cost-utility analysis is a type of cost-effectiveness analysis in which health effects are measured in terms of quality-adjusted life-years (QALYs) gained. Such analyses have become popular for examining the health and economic consequences of health and medical interventions, and they have been recommended by ...

journal_title：Annals of internal medicine

authors： Neumann PJ,Stone PW,Chapman RH,Sandberg EA,Bell CM

更新日期：2000-06-20 00:00:00

abstract：BACKGROUND:Longer-term mortality benefit and cost-effectiveness for abdominal aortic aneurysm (AAA) screening are uncertain. OBJECTIVE:To estimate the benefits, in terms of AAA-related and all-cause mortality, and cost-effectiveness of ultrasonography screening for AAA in a group that was invited to screening compared...

journal_title：Annals of internal medicine

authors： Kim LG,P Scott RA,Ashton HA,Thompson SG,Multicentre Aneurysm Screening Study Group.

更新日期：2007-05-15 00:00:00

abstract：OBJECTIVE:To assess internists' familiarity with, confidence in, and attitudes about practice guidelines issued by various organizations. DESIGN:Cross-sectional, self-administered survey. PARTICIPANTS:Questionnaires were mailed to a stratified random sample of 2600 members of the American College of Physicians (ACP) ...

journal_title：Annals of internal medicine

authors： Tunis SR,Hayward RS,Wilson MC,Rubin HR,Bass EB,Johnston M,Steinberg EP

更新日期：1994-06-01 00:00:00

abstract：OBJECTIVE:To estimate relative risk of mortality and median life expectancy for patients with classic hemophilia by a life-table analysis, taking into account deaths that may have occurred in infancy or childhood before the onset of symptoms. DESIGN:Retrospective chart review of clinical series. SETTING:Referral-base...

journal_title：Annals of internal medicine

authors： Jones PK,Ratnoff OD

更新日期：1991-04-15 00:00:00

abstract：:Two patients had recurrent facial edema and peripheral blood eosinophilia. One patient showed a marked increase in the serum level of the eosinophil granule major basic protein. In both patients, skin biopsy samples showed nonspecific mononuclear cell inflammation with few eosinophils. However, immunofluorescence stai...

journal_title：Annals of internal medicine

authors： Songsiridej V,Peters MS,Dor PJ,Ackerman SJ,Gleich GJ,Busse WW

更新日期：1985-10-01 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

authors： Brewer GJ,Hill GM,Prasad AS,Cossack ZT,Rabbani P

更新日期：1983-09-01 00:00:00

abstract：:Between September 1972 and January 1976 an outbreak of dialysis dementia affected 20 patients maintained by long-term hemodialysis. The clinical picture was characterized by an insidious onset of altered behaviour, dementia, speech disturbance, myoclonus, and convulsions. Nineteen patients died, but one patient has su...

journal_title：Annals of internal medicine

authors： Dunea G,Mahurkar SD,Mamdani B,Smith EC

更新日期：1978-04-01 00:00:00

abstract：BACKGROUND:Because only limited evidence suggests that elastic stockings prevent the post-thrombotic syndrome in patients with symptomatic deep venous thrombosis (DVT), these stockings are not widely used. OBJECTIVE:To evaluate the efficacy of compression elastic stockings for prevention of the post-thrombotic syndrom...

journal_title：Annals of internal medicine

authors： Prandoni P,Lensing AW,Prins MH,Frulla M,Marchiori A,Bernardi E,Tormene D,Mosena L,Pagnan A,Girolami A

更新日期：2004-08-17 00:00:00

abstract：:The traditional exchange of medical expertise between physicians for patient benefit has been accomplished by referral. Physicians have traditionally decided when and to whom to refer patients. Health care "systems" now dominate medical practice, and their formats can alter spontaneous collegial interaction in referra...

journal_title：Annals of internal medicine

authors： Schaffer WA,Holloman FC Jr

更新日期：1985-10-01 00:00:00

abstract：BACKGROUND:Optimal management of patients who are clinically suspected of having ventilator-associated pneumonia remains open to debate. OBJECTIVE:To evaluate the effect on clinical outcome and antibiotic use of two strategies to diagnose ventilator-associated pneumonia and select initial treatment for this condition....

journal_title：Annals of internal medicine

authors： Fagon JY,Chastre J,Wolff M,Gervais C,Parer-Aubas S,Stéphan F,Similowski T,Mercat A,Diehl JL,Sollet JP,Tenaillon A

更新日期：2000-04-18 00:00:00

abstract：:A patient with a retained bullet developed lead poisoning in association with thyrotoxicosis. The clinical and laboratory data suggest that lead was mobilized from an increased mobile bone pool during the hypermetabolic period with resultant poisoning. The findings give factual support to earlier concepts that lead po...

journal_title：Annals of internal medicine

authors： Cagin CR,Diloy-Puray M,Westerman MP

更新日期：1978-10-01 00:00:00

abstract：Background:High-sensitivity assays for cardiac troponin T (hs-cTnT) are sometimes used to rapidly rule out acute myocardial infarction (AMI). Purpose:To estimate the ability of a single hs-cTnT concentration below the limit of detection (<0.005 µg/L) and a nonischemic electrocardiogram (ECG) to rule out AMI in adults ...

journal_title：Annals of internal medicine

authors： Pickering JW,Than MP,Cullen L,Aldous S,Ter Avest E,Body R,Carlton EW,Collinson P,Dupuy AM,Ekelund U,Eggers KM,Florkowski CM,Freund Y,George P,Goodacre S,Greenslade JH,Jaffe AS,Lord SJ,Mokhtari A,Mueller C,Munro A

更新日期：2017-05-16 00:00:00

abstract：:A severe shortage of organs greatly limits the ability to deliver the miracle of transplantation to people suffering from end-stage organ disease. Contributing to this shortage is a high rate of refusal among families who are asked for permission to remove organs from a recently deceased relative. Mandated choice offe...

journal_title：Annals of internal medicine

authors： Spital A

更新日期：1996-07-01 00:00:00

abstract：:To describe more explicitly the components of competence required of the internist, The American Board of Internal Medicine has analyzed the medical encounter and defined the major variables involved: the abilities required of the internist, the tasks that must be performed to solve a medical problem, the medical illn...

journal_title：Annals of internal medicine

authors：

更新日期：1979-03-01 00:00:00

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

authors： Kenyon TA,Ridzon R,Luskin-Hawk R,Schultz C,Paul WS,Valway SE,Onorato IM,Castro K

更新日期：1997-07-01 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

authors： Des Jarlais DC,Friedman SR,Hopkins W

更新日期：1985-11-01 00:00:00

abstract：BACKGROUND:Studies suggest that vitamin D supplementation may reduce cancer and fracture risks. PURPOSE:To examine the benefits and harms of vitamin D with or without calcium supplementation on clinical outcomes of cancer and fractures in adults. DATA SOURCES:English-language studies identified from MEDLINE and the C...

journal_title：Annals of internal medicine

authors： Chung M,Lee J,Terasawa T,Lau J,Trikalinos TA

更新日期：2011-12-20 00:00:00

abstract：STUDY OBJECTIVE:To determine the sensitivity of herpes simplex virus isolates to acyclovir and the importance of resistant isolates in hospitalized patients. DESIGN:Retrospective incidence cohort study. SETTING:All herpes simplex virus isolates cultured over 1 year from patients followed at a tertiary care center. P...

journal_title：Annals of internal medicine

authors： Englund JA,Zimmerman ME,Swierkosz EM,Goodman JL,Scholl DR,Balfour HH Jr

更新日期：1990-03-15 00:00:00

abstract：BACKGROUND:Combining endoscopic therapy and beta-blockers may improve outcomes in patients with cirrhosis and bleeding esophageal varices. PURPOSE:To assess whether a combination of endoscopic and drug therapy prevents overall and variceal rebleeding and improves survival better than either therapy alone. DATA SOURCE...

journal_title：Annals of internal medicine

authors： Gonzalez R,Zamora J,Gomez-Camarero J,Molinero LM,Bañares R,Albillos A

更新日期：2008-07-15 00:00:00

abstract：BACKGROUND:Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist. OBJECTIVE:To identify process quality indicators that are essential to high-quality, home-based primary care. DESIGN:An expert development panel reviewed established and new qu...

journal_title：Annals of internal medicine

authors： Smith KL,Soriano TA,Boal J

更新日期：2007-02-06 00:00:00

abstract：:The prevalence of sleep apnea was studied in 46 middle- and older-aged men with "essential hypertension." Thirty-four age- and weight-similar normotensive men were also studied. Fourteen hypertensive men and three controls had sleep apnea syndrome, as defined as greater than ten apneas per hour of sleep. Hypertensive ...

journal_title：Annals of internal medicine

authors： Fletcher EC,DeBehnke RD,Lovoi MS,Gorin AB

更新日期：1985-08-01 00:00:00

abstract：PURPOSE:It is currently unknown whether intensive insulin treatment of diabetes decreases the risk for cardiovascular complications by lowering glucose levels or increases the risk by postulated direct atherogenic effects. This article reviews published data from two long-term, randomized clinical trials that compared ...

journal_title：Annals of internal medicine

authors： Genuth S

更新日期：1996-01-01 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

authors： Chachoua A,Dieterich D,Krasinski K,Greene J,Laubenstein L,Wernz J,Buhles W,Koretz S

更新日期：1987-08-01 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

authors： Stevens R

更新日期：1986-10-01 00:00:00

abstract：:The cause of stroke in young patients frequently cannot be established. Eleven consecutive patients, age 50 and younger, had clinical evidence of cerebral embolization. Results of physical, radiographic, electrocardiographic, and two-dimensional echocardiographic examinations were normal in all patients. During normal...

journal_title：Annals of internal medicine

authors： Harvey JR,Teague SM,Anderson JL,Voyles WF,Thadani U

更新日期：1986-11-01 00:00:00

abstract：:Antinuclear antibodies are present in most patients receiving procainamide. To ascertain whether IgG antiguanosine antibodies are associated with the development of the symptoms of systemic lupus erythematosus, we compared the levels of these antibodies in the sera of 65 patients receiving procainamide: 18 with procai...

journal_title：Annals of internal medicine

authors： Weisbart RH,Yee WS,Colburn KK,Whang SH,Heng MK,Boucek RJ

更新日期：1986-03-01 00:00:00

abstract：BACKGROUND:Previous studies suggest that patients hospitalized with acute myocardial infarction (MI) in December have poor outcomes, and some studies have hypothesized that the cause may be the infrequent use of evidence-based therapies during the December holiday season. OBJECTIVE:To compare the care and outcomes of ...

journal_title：Annals of internal medicine

authors： Meine TJ,Patel MR,DePuy V,Curtis LH,Rao SV,Gersh BJ,Schulman KA,Jollis JG

更新日期：2005-10-04 00:00:00