Abstract:
OBJECTIVE:To describe the course of rheumatoid arthritis over 5 years in adults and to evaluate the effect of parenterally administered gold salts on that course. DESIGN:A prospective observational study of adults with rheumatoid arthritis. Data derived from annual interviews with patients from 1983 to 1988 and from physician surveys in 1983 and 1987. SETTING:Rheumatology practices in the community. PATIENTS:The study began in 1982 with 822 adults who had rheumatoid arthritis and were under the care of rheumatologists. INTERVENTIONS:Those selected by rheumatologists in the management of their patients. MEASUREMENTS:Information describing sociodemographic and clinical characteristics, course, and therapy was collected from patients and verified by physician reports. Functional status, measured by the Health Assessment Questionnaire, and the number of painful joints were used as outcome variables. Outcome variables were adjusted for age, sex, disease duration, baseline values of the outcome variable, and the use of four disease-remittive agents other than gold. MAIN RESULTS:Multivariate repeated-measures analysis of variance showed no change in the course of rheumatoid arthritis over 5 years. The use of parenteral gold for at least 2 consecutive years at the start of the observation period produced, on average, no change in the course over 5 years in the two outcome variables. CONCLUSION:In our study of a community-based population of adults with rheumatoid arthritis who were under the care of community rheumatologists, we found that there was, on average, no statistically significant change in function or number of painful joints between 1983 and 1988. Patients receiving parenteral gold therapy for at least 2 consecutive years did not show a statistically significant difference in outcome when compared with those not receiving such therapy.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Epstein WV,Henke CJ,Yelin EH,Katz PPdoi
10.7326/0003-4819-114-6-437subject
Has Abstractpub_date
1991-03-15 00:00:00pages
437-44issue
6eissn
0003-4819issn
1539-3704journal_volume
114pub_type
杂志文章abstract::The data from population-based, randomized trials of the mammographic screening of women aged 40 to 49 years are limited by retrospective subgroup analysis, low statistical power, and the use of older mammographic techniques. Nonetheless, meta-analysis involving the most recently reported data from all similarly desig...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-7-199504010-00010
更新日期:1995-04-01 00:00:00
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
更新日期:2001-07-03 00:00:00
abstract:BACKGROUND:Hyperuricemia is associated with risk for cardiovascular disease and death. However, the role of uric acid independent of established risk factors is uncertain. OBJECTIVE:To examine the relation of serum uric acid level to incident coronary heart disease, death from cardiovascular disease, and death from al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-131-1-199907060-00003
更新日期:1999-07-06 00:00:00
abstract:OBJECTIVE:To provide a rational strategy for the evaluation and long-term management of epilepsy. DATA SOURCES:Articles written between 1964 and 1993, obtained from a MEDLINE search on epilepsy-related topics as well as from the author's personal files, major reference books on antiepileptic drugs, and references iden...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-120-5-199403010-00010
更新日期:1994-03-01 00:00:00
abstract::Given the low mortality and morbidity of the severe acute respiratory syndrome (SARS) compared with other public health scourges, is the attention devoted to it misdirected? The SARS experience has provided at least 4 enduring lessons. First, by providing a test of the capacity of each part of the public health system...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-139-7-200310070-00011
更新日期:2003-10-07 00:00:00
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:
更新日期:1980-01-01 00:00:00
abstract::Plasma lipid and lipoprotein-cholesterol levels were measured in 10 insulin-dependent (Type I) diabetics taking their usual dose of conventionally administered insulin during 6 months of a continuous subcutaneous insulin infusion delivered with a small, portable, battery-powered pump. With this insulin delivery system...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-4-426
更新日期:1981-10-01 00:00:00
abstract::Disorders determined wholly or in part by genetic factors constitute a substantial number of human diseases. This realization has grown during the past 2 decades with the recognition of many specific heritable conditions and the identification of familial risk factors for common disorders. New technologies, such as fe...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
doi:10.7326/0003-4819-104-4-527
更新日期:1986-04-01 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
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
pub_type: 杂志文章
doi:10.7326/0003-4819-90-3-402
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Travelers' diarrhea causes substantial morbidity and postinfectious irritable bowel syndrome. OBJECTIVE:To evaluate nonabsorbable rifaximin for prevention of travelers' diarrhea. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Guadalajara, Mexico. PARTICIPANTS:U.S. students. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-10-200505170-00005
更新日期:2005-05-17 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::We examined the survival time and costs of therapy for patients with end-stage renal disease. A computer simulation model of the current system was constructed to estimate the cost-effectiveness of home and center hemodialysis and live related as well as cadaver donor renal transplantation. Analysis of the simulation ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-243
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To measure changes in spinal and femoral neck bone mineral densities in patients treated for Graves thyrotoxicosis. DESIGN:Cohort study. SETTING:Tertiary care center. PATIENTS:Fifteen women with active Graves thyrotoxicosis. Six patients were premenopausal and nine were postmenopausal. All patients had evi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-1-199401010-00002
更新日期:1994-01-01 00:00:00
abstract:PURPOSE:To compare the efficacy, safety, and cost-effectiveness of low-molecular-weight heparin with standard heparin for the prevention of deep vein thrombosis after total hip arthroplasty. DATA IDENTIFICATION:Studies were identified by MEDLINE search and review of bibliographies of retrieved articles. Hospital resou...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-119-11-199312010-00008
更新日期:1993-12-01 00:00:00
abstract::The latest guidelines from the American College of Cardiology and American Heart Association, released in fall 2013, provide a long-anticipated update to the recommendations of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-1739
更新日期:2016-12-06 00:00:00
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
更新日期:2002-07-02 00:00:00
abstract::A platelet transfusion from a blood group O donor, immunized 1 month before with Pneumovax, caused a hemolytic reaction in a blood group A recipient. Forty-five of 59 group O donors (76%) and all of nine group B donors immunized with Pneumovax had a fourfold or higher anti-A response. Half of the anti-A antibody in hi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-5-580
更新日期:1982-05-01 00:00:00
abstract::A controlled clinical trial compared three-drug and four-drug combination chemotherapy in 109 patients with advanced small-cell anaplastic carcinoma of the lung. The combination of vincristine, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), cyclophosphamide, and methotrexate was significantly superior to the com...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-89-2-177
更新日期:1978-08-01 00:00:00
abstract::Essential trace elements such as zinc, iron, and copper participate in various enzyme reactions directly related to the regulation of blood pressure and indirectly related to generation of oxidative metabolic energy, alterations in blood lipid levels, and alterations in taste acuity. The toxicological action of severa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-5-823
更新日期:1983-05-01 00:00:00
abstract::To reduce health care costs, some third-party payers have enlisted primary care physicians as gatekeepers to medical care. In gatekeeper systems, primary care physicians must approve all care provided to their patients. This approval is a condition of payment for the service, with the usual exception of true emergenci...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-102-4-537
更新日期:1985-04-01 00:00:00
abstract::Deaths and injuries from firearms are significant public health problems, and clinicians are in a unique position to identify risk among their patients and discuss the importance of safe firearm practices. Although clinicians may be ill-prepared to engage in such discussions, an adequate body of evidence is available ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/AITC201906040
更新日期:2019-06-04 00:00:00
abstract:BACKGROUND:Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported. OBJECTIVE:To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A. DESIGN:Retrospective chart review. SETTING:15 acute care...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-128-2-199801150-00006
更新日期:1998-01-15 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: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
pub_type: 杂志文章
doi:10.7326/0003-4819-76-3-112-6-416
更新日期:1990-03-15 00:00:00
abstract::Medically unexplained functional or somatization symptoms are somatic disorders that are not adequately explained by physical disease processes. The way in which these disorders have been understood and managed has varied over the history of medicine. However, only in the past 100 years has the "mental" explanation pr...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-134-9_part_2-200105011-00018
更新日期:2001-05-01 00:00:00
abstract::The causes, therapy for, and consequences of hypernatremia in elderly patients are not well understood. We found that in 15,187 consecutive hospital admissions, 162 (1.1%) patients who were at least 60 years of age had serum sodium levels that measured greater than 148 meq/L. Of that 162, 57% had become hypernatremic ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-2-309
更新日期:1987-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of cisplatin-based combination chemotherapy in patients with advanced ovarian germ-cell tumors. DESIGN:Nonrandom prospective trial with endpoints of tumor response, results of repeat surgical exploration, progression-free interval, and survival. SETTING:Cooperative university-...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-111-1-22
更新日期:1989-07-01 00:00:00
abstract::Pemphigus is an autoimmune intraepidermal bullous disease involving the skin and mucous membranes. There are four clinically recognized variants of this disease. The histopathologic hallmark is acantholysis, which is disruption of normal cell-to-cell adhesion. Patients produce an IgG antibody directed against an antig...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-92-3-396
更新日期:1980-03-01 00:00:00
abstract::Glomerular-fixed antibody was eluted from the kidney of a 17-year-old patient who died 2 weeks after the onset of acute poststreptococcal glomerulonephritis. Elevated titers of antibodies to streptococcal enzymes were found in the serum but not in the glomerular eluate. Streptococcal M protein and anti-M protein react...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-4-478
更新日期:1980-04-01 00:00:00