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 10-year randomized, double-blind, placebo-controlled trial. SETTING:U.S. female health care professionals in the Women's Health Study. PARTICIPANTS:39,876 initially healthy women age 45 years or older (26,779 gave blood samples that were evaluated for factor V Leiden, G20210A prothrombin, and MTHFR 677C>T polymorphisms). MEASUREMENTS:Documented VTE (deep venous thrombosis or pulmonary embolism) and unprovoked VTE (no recent surgery, trauma, or cancer diagnosis) were prospectively evaluated, secondary end points. INTERVENTION:Aspirin, 100 mg, or placebo on alternate days. RESULTS:Venous thromboembolism occurred in 482 women during follow-up, an incidence higher than that of myocardial infarction and nearly equal to that of stroke. The incidence of VTE (per 1000 person-years) was 1.18 among women randomly assigned to active aspirin, compared with 1.25 among women randomly assigned to placebo (relative hazard, 0.95 [95% CI, 0.79 to 1.13]; rate difference, -0.06 [CI, -0.28 to 0.16]). For unprovoked VTE, the relative hazard was 0.90 (CI, 0.70 to 1.16) and the rate difference was -0.06 (CI, -0.21 to 0.10). Relative hazards associated with aspirin use in higher-risk subgroups were 0.83 (CI, 0.50 to 1.39) among women with either factor V Leiden or the prothrombin mutation and 1.36 (CI, 0.77 to 2.41) among those with a history of VTE. LIMITATION:Venous thromboembolism was a secondary end point in the Women's Health Study. CONCLUSION:These data suggest that long-term, low-dose aspirin treatment has little effect on the prevention of VTE in initially healthy women. ClinicalTrials.gov registration number: NCT00000479.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Glynn RJ,Ridker PM,Goldhaber SZ,Buring JEdoi
10.7326/0003-4819-147-8-200710160-00004subject
Has Abstractpub_date
2007-10-16 00:00:00pages
525-33issue
8eissn
0003-4819issn
1539-3704pii
147/8/525journal_volume
147pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To determine the efficacy of ciprofloxacin therapy in eradicating convalescent fecal excretion of salmonellae after acute salmonellosis. DESIGN:Randomized, placebo-controlled, double-blind trial of ciprofloxacin, with prospective follow-up of nonparticipants. SETTING:An acute care community hospital experie...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-114-3-195
更新日期:1991-02-01 00:00:00
abstract::Comprehensive palliative care, as exemplified by many state-of-the-art hospice programs, is the standard of care for the dying. Although palliative care is very effective, physicians, nurses, patients, families, and loved ones regularly face clinically, ethically, legally, and morally challenging decisions throughout ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-6-200003210-00011
更新日期:2000-03-21 00:00:00
abstract::The study of events in time is fundamental to biomedical research and public health surveillance. Clinicians have an intuitive appreciation for the relevance of time to health and disease, and patients invariably ask questions relating to time for which clinicians need answers. An appreciation of the picture of health...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-1-200001040-00007
更新日期:2000-01-04 00:00:00
abstract::Chronic lymphocytic leukemia developed in four of five siblings, whose father succumbed to the same disease. The pattern of immune deficiency in the leukemic siblings resembled that found in nonfamilial cases of chronic lymphocytic leukemia, and was correlated with the severity of clinical involvement. In three siblin...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-5-554
更新日期:1976-05-01 00:00:00
abstract:OBJECTIVE:To examine the relation of obesity and weight loss to the formation of gallstones according to pertinent clinical and research issues. DATA SOURCES AND EXTRACTION:Original reports obtained through a MEDLINE search from 1966 to 1992 on gallstones plus obesity or reducing diets, supplemented by a manual search...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-10-199311150-00010
更新日期:1993-11-15 00:00:00
abstract:BACKGROUND:Advice and exercise are widely recommended for subacute low back pain, but the effectiveness of these interventions is unclear. OBJECTIVE:To investigate the effectiveness of physiotherapist-prescribed exercise, advice, or both for subacute low back pain. DESIGN:Factorial randomized, placebo-controlled tria...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-146-11-200706050-00007
更新日期:2007-06-05 00:00:00
abstract:OBJECTIVE:To identify the cause of a hypersensitivity pneumonitis and to determine its pathogenesis. DESIGN:Case study. SETTING:Intensive care unit of a referral hospital. PATIENT:A 51-year-old man with chronic bronchitis who developed a hypersensitivity pneumonitis within 1 month after exposure to minocycline, amox...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-6-476
更新日期:1992-09-15 00:00:00
abstract:BACKGROUND:The risk for hypertension after kidney donation remains uncertain. PURPOSE:To see whether normotensive adults who donate a kidney develop higher blood pressure and risk for hypertension compared with nondonor adults acting as control participants. DATA SOURCES:MEDLINE, EMBASE, and Science Citation Index we...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-145-3-200608010-00006
更新日期:2006-08-01 00:00:00
abstract::Transitional care has been defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care in the same location. Transitional care, which primarily concerns the relatively brief time interval that begins with pre...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-141-7-200410050-00009
更新日期:2004-10-05 00:00:00
abstract:BACKGROUND:Depressive disorders are persistent, recurring illnesses that cause great suffering for patients and their families. PURPOSE:To evaluate the benefits and adverse effects of newer pharmacotherapies and herbal treatments for depressive disorders in adults and adolescents. DATA SOURCES:English-language and no...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-132-9-200005020-00011
更新日期:2000-05-02 00:00:00
abstract::Bayesian inference is usually presented as a method for determining how scientific belief should be modified by data. Although Bayesian methodology has been one of the most active areas of statistical development in the past 20 years, medical researchers have been reluctant to embrace what they perceive as a subjectiv...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-12-199906150-00019
更新日期:1999-06-15 00:00:00
abstract:Background:Patients desire information about health care costs because they are increasingly responsible for these costs. Public Web sites that offer cost information could inform provider-patient discussions of costs at the point of care. Objective:To evaluate tools to facilitate the use of publicly available cost in...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M18-2223
更新日期:2019-05-07 00:00:00
abstract:STUDY OBJECTIVE:To test the hypothesis that work as a respiratory therapist is associated with an increased risk of developing asthma. DESIGN:Cross-sectional questionnaire study comparing respiratory therapists with controls (physical therapists and radiologic technologists). Subsequent validation of reported asthma w...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-10-767
更新日期:1989-05-15 00:00:00
abstract:BACKGROUND:Mesenchymal stem cells can differentiate into endothelial cells and participate in angiogenesis in adults. In experimental models of acute myocardial infarction, mesenchymal stem cells led to the recovery of cardiac function through the formation of a new vascular network. OBJECTIVE:To describe treatment wi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-10-201011160-00007
更新日期:2010-11-16 00:00:00
abstract:BACKGROUND:Persons with abdominal aortic aneurysm are more likely to have a higher prevalence of risk factors for and clinical manifestations of cardiovascular disease. It is unknown whether these factors explain the high mortality rate associated with abdominal aortic aneurysm. OBJECTIVE:To describe the risk for mort...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-134-3-200102060-00008
更新日期:2001-02-06 00:00:00
abstract:BACKGROUND:It is unclear whether patients understand that percutaneous coronary intervention (PCI) reduces only chronic stable angina and not myocardial infarction (MI) or associated mortality. OBJECTIVE:To compare cardiologists' and patients' beliefs about PCI. DESIGN:Survey. SETTING:Academic center. PARTICIPANTS:...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-5-201009070-00005
更新日期:2010-09-07 00:00:00
abstract::This issue provides a clinical overview of Clostridium difficile infection focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In th...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-153-7-201010050-01004
更新日期:2010-10-05 00:00:00
abstract::With the renewed interest in esophageal motility disorders, diffuse esophageal spasm is being diagnosed more frequently. In many clinical settings, however, the term is used as a synonym for noncardiac chest pain. Our review of the literature and broad clinical experience in studying the motility patterns of healthy s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-100-2-242
更新日期:1984-02-01 00:00:00
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
更新日期:1987-08-01 00:00:00
abstract::Identical male twins had alveolar cell carcinoma with nearly synchronous onset and similar histopathologic features, both metastatic to the brain. The hypothesis is advanced that there are genes shared by these twins that determine not only the susceptibility of pulmonary cells to malignant transformation but also the...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-4-447
更新日期:1977-10-01 00:00:00
abstract::Antibiotic-associated diarrhea and colitis were well established soon after antibiotics became available. Early work implicated Staphylococcus aureus, but in 1978 Clostridium difficile became the established pathogen in the vast majority of cases. In the first 5 years (1978 through 1983), the most common cause was cli...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-145-10-200611210-00008
更新日期:2006-11-21 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
pub_type: 杂志文章
doi:10.7326/0003-4819-103-4-600
更新日期:1985-10-01 00:00:00
abstract:Background:Difficulties with daily functioning are common in middle-aged adults. However, little is known about the epidemiology or clinical course of these problems, including the extent to which they share common features with functional impairment in older adults. Objective:To determine the epidemiology and clinica...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M17-0496
更新日期:2017-12-05 00:00:00
abstract::Tissues from guinea pigs inoculated intraperitoneally with the Legionnaires' disease (LD) bacterium were studied with light, immunofluorescent, and electron microscopy. The principal gross lesion was diffuse peritonitis of varying severity. Microscopically, the peritonitis of covered by a mixed inflammatory infiltrate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-4-671
更新日期:1979-04-01 00:00:00
abstract:BACKGROUND:Initiation of antiretroviral therapy (ART) during tuberculosis (TB) treatment remains challenging. PURPOSE:To assess evidence from randomized, controlled trials of the timing of ART initiation in HIV-infected adults with newly diagnosed pulmonary TB. DATA SOURCES:PubMed, EMBASE, Cochrane Central Register o...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M14-2979
更新日期:2015-07-07 00:00:00
abstract:OBJECTIVE:To determine whether the detection of tuberculostearic acid (TBSA) in bronchial aspirate and bronchoalveolar lavage specimens is useful for the rapid diagnosis of active pulmonary tuberculosis in patients suspected of having the disease. SETTING:A pulmonary clinic in a teaching hospital. PATIENTS:Forty pati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-8-650
更新日期:1989-10-15 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:BACKGROUND:Although several agents are available to treat osteoporosis, the relative efficacy and toxicity of these agents when used to prevent fractures has not been well described. PURPOSE:To compare the benefits in fracture reduction and the harms from adverse events of various therapies for osteoporosis. DATA SOU...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-148-3-200802050-00198
更新日期:2008-02-05 00:00:00
abstract::Adult T-cell leukemia associated with human T-cell leukemia virus type I (HTLV-I) is characterized by a clonal expansion of a CD4-positive subset of T lymphocytes that constitutively express high numbers of interleukin-2 receptors and that frequently infiltrate the skin; osteolytic bone lesions, and hypercalcemia. Usi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-4-274
更新日期:1988-08-15 00:00:00
abstract::We diagnosed Waldenström's macroglobulinemia in a father and three offspring. Clinical and subclinical autoimmune disorders occurred excessively in the family. The HLA haplotype A2, B8, DRw3 was detected in all patients with Waldenström's macroglobulinemia and all but one family member with autoimmune manifestations. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-6-830
更新日期:1980-12-01 00:00:00