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 SOURCES:MEDLINE (1966 to November 2007) and other selected databases were searched for English-language studies. STUDY SELECTION:For the efficacy analysis, investigators selected studies that reported the rate of or risk for fractures. For the adverse event analysis, they selected studies that reported the relationship between an agent and cardiovascular, thromboembolic, or upper gastrointestinal events; malignant conditions; and osteonecrosis. DATA EXTRACTION:Using a standardized protocol, investigators abstracted data on fractures and adverse events, agents and comparators, study design, and variables of methodological quality. DATA SYNTHESIS:Good evidence suggests that alendronate, etidronate, ibandronate, risedronate, zoledronic acid, estrogen, parathyroid hormone (1-34), and raloxifene prevent vertebral fractures more than placebo; the evidence for calcitonin was fair. Good evidence suggests that alendronate, risedronate, and estrogen prevent hip fractures more than placebo; the evidence for zoledronic acid was fair. The effects of vitamin D varied with dose, analogue, and study population for both vertebral and hip fractures. Raloxifene, estrogen, and estrogen-progestin increased the risk for thromboembolic events, and etidronate increased the risk for esophageal ulcerations and gastrointestinal perforations, ulcerations, and bleeding. LIMITATION:Few studies have directly compared different agents or classes of agents used to treat osteoporosis. CONCLUSION:Although good evidence suggests that many agents are effective in preventing osteoporotic fractures, the data are insufficient to determine the relative efficacy or safety of these agents.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
MacLean C,Newberry S,Maglione M,McMahon M,Ranganath V,Suttorp M,Mojica W,Timmer M,Alexander A,McNamara M,Desai SB,Zhou A,Chen S,Carter J,Tringale C,Valentine D,Johnsen B,Grossman Jdoi
10.7326/0003-4819-148-3-200802050-00198subject
Has Abstractpub_date
2008-02-05 00:00:00pages
197-213issue
3eissn
0003-4819issn
1539-3704pii
0000605-200802050-00198journal_volume
148pub_type
杂志文章,meta分析abstract:PURPOSE:To review the radiofrequency ablation method, describe the technique, and discuss the indications, results, and limitations of its use in patients with cardiac tachyarrhythmias. DATA SOURCES:Peer-reviewed reports in the literature by clinical investigators who use radiofrequency catheter ablation as identified...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-121-6-199409150-00010
更新日期:1994-09-15 00:00:00
abstract::Medical professional codes have long prohibited physician involvement in assisting a patient's suicide. However, despite ethical and legal prohibitions, calls for the liberalization of this ban have grown in recent years. The medical profession should articulate its views on the arguments for and against changes in pu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-135-3-200108070-00015
更新日期:2001-08-07 00:00:00
abstract::Anxiety commonly accompanies serious illness. However, in some patients anxiety is the primary manifestation of illness. Diagnostic criteria for these "primary" anxiety disorders have been redefined in the most recent revision of the American Psychiatric Association's Diagnostic and Statistical Manual. We discuss thes...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-100-4-558
更新日期:1984-04-01 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:Background:Biosimilars are of growing clinical, regulatory, and commercial importance. Purpose:To summarize evidence about the bioequivalence between biosimilar and reference tumor necrosis factor-α (TNF-α) inhibitors. Data Sources:PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and LILACS from incept...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-0428
更新日期:2016-10-18 00:00:00
abstract::HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-5-606
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial I...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-145-8-200610170-00007
更新日期:2006-10-17 00:00:00
abstract::Increasingly, interventions aimed at improving care are likely to use such technologies as machine learning and artificial intelligence. However, health care has been relatively late to adopt them. This article provides clinical examples in which machine learning and artificial intelligence are already in use in healt...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M19-0872
更新日期:2020-06-02 00:00:00
abstract::In 1978 the Institute of Medicine issued "A Manpower Policy for Health Care," the report of a study of major issues bearing on the availability of an adequate number of physicians for provision of primary care and on potential strategies for an appropriate manpower policy. The report was analyzed by committees of the ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-6-843
更新日期:1980-06-01 00:00:00
abstract::The insulin-like growth factor (IGF) family of peptides, binding proteins, and receptors are ubiquitous and important for normal human growth and development. Modern techniques including specific radioimmunoassays, radioreceptor assays and recombinant DNA technology have improved our understanding of the role of IGFs ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-10-854
更新日期:1992-05-15 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::Research participants require ongoing protection of the kind already established in law and regulation. However, "special scrutiny" for certain types of research is also needed. Three criteria for special scrutiny are 1) research that involves initial experiences of translating new scientific advances into humans, esp...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-140-3-200402030-00013
更新日期:2004-02-03 00:00:00
abstract:BACKGROUND:Mucositis can be a serious complication of cancer treatment. Palifermin reduces mucositis when given in multiple doses to patients undergoing hematopoietic stem-cell transplantation. OBJECTIVE:To evaluate the efficacy of palifermin given as a single dose before each cycle in patients receiving multicycle ch...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-153-6-201009210-00003
更新日期:2010-09-21 00:00:00
abstract:BACKGROUND:Although few retrospective studies of high altitude have reported that obesity might be associated with the development of acute mountain sickness (AMS), this association has not been studied prospectively. OBJECTIVE:To determine whether obesity is associated with the development of AMS. DESIGN:Obese and n...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-139-4-200308190-00007
更新日期:2003-08-19 00:00:00
abstract::The term functional somatic syndrome has been applied to several related syndromes characterized more by symptoms, suffering, and disability than by consistently demonstrable tissue abnormality. These syndromes include multiple chemical sensitivity, the sick building syndrome, repetition stress injury, the side effect...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-130-11-199906010-00016
更新日期:1999-06-01 00:00:00
abstract::The irritable bowel syndrome is a common chronic disorder having a broad clinical spectrum of severity. Although only a small proportion of those afflicted seek medical help for their symptoms, a subset have severe and intractable symptoms. A positive diagnosis should be established from the history and physical exami...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-12-1009
更新日期:1992-06-15 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::Individual differences in metabolism of the sulfonamides may predispose patients to idiosyncratic reactions. Sulfonamides are metabolized by N-acetylation (mediated by a genetically polymorphic enzyme) and oxidation to potentially toxic metabolites. We examined 6 patients who had severe reactions to sulfonamides and c...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-105-2-179
更新日期:1986-08-01 00:00:00
abstract::The classification of acute leukemia has almost invariably been based on the morphologic diagnosis into two broad categories: acute lymphocytic and acute myeloid leukemia. Despite the wide range of morphologic variation in both groups, strict criteria to define the subgroups have only recently been proposed. The conve...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-87-6-740
更新日期:1977-12-01 00:00:00
abstract:OBJECTIVE:To determine the rate of use of prophylaxis for venous thromboembolism in high-risk hospital patients. DESIGN:A retrospective medical record review. SETTING:A community-wide study in 16 short-stay hospitals in central Massachusetts. PATIENTS:A total of 2017 patients with multiple risk factors for venous th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-591
更新日期:1991-10-15 00:00:00
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
更新日期:1995-12-15 00:00:00
abstract::Systematic reviewers increasingly must decide whether and how to incorporate existing systematic reviews into complex systematic reviews that are commissioned to support clinical guideline development or for other health policy uses. To date, however, this issue has been largely unexamined. Reviewers seeking to incorp...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-148-10-200805200-00010
更新日期:2008-05-20 00:00:00
abstract::Much time and effort are spent on designing primary research studies. Similar care must be given to planning systematic reviews. The review should be based on an important, well-focused question that is relevant to patient care. By formulating the question properly, the criteria that primary studies must meet to be in...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-127-5-199709010-00008
更新日期:1997-09-01 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
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-125-10-199611150-00007
更新日期:1996-11-15 00:00:00
abstract::A patient with bladder carcinoma metastatic to lung and brain died of pneumonia. Autopsy examination showed a confluent bronchopneumonia with several small abscesses and acute pyelonephritis with abscess formation. Legionella pneumophila, serogroup 4, was isolated in pure culture from lung tissue postmortem and was al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-6-835
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Previous meta-analyses demonstrated that high-dose glucocorticoids were not beneficial in sepsis. Recently, lower-dose glucocorticoids have been studied. PURPOSE:To compare recent trials of glucocorticoids for sepsis with previous glucocorticoid trials. DATA SOURCES:Systematic MEDLINE search for studies pu...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-141-1-200407060-00014
更新日期:2004-07-06 00:00:00
abstract:BACKGROUND:The sequelae during the first two decades after acute hepatitis C virus (HCV) infection have been well studied, but the outcome thereafter is unknown. OBJECTIVE:To conduct an extended study of the natural history of HCV infection by using archived serum specimens originally collected between 1948 and 1954. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-2-200001180-00003
更新日期:2000-01-18 00:00:00
abstract::The 1950s witnessed prodigious growth in our knowledge of the chemical nature of the gene, the mechanisms by which the information inherent in its sequence of nucleotide units was conveyed to the cell's machinery for synthesizing proteins, and the mode of operation of that machinery. Watson and Crick raised the curtai...
journal_title:Annals of internal medicine
pub_type: 评论,历史文章,杂志文章
doi:10.7326/0003-4819-138-7-200304010-00016
更新日期:2003-04-01 00:00:00
abstract::This paper outlines the clinical, serologic, and immunogenetic differences and similarities of Sjögren's syndrome alone (primary) and Sjögren's syndrome associated with rheumatoid arthritis and systemic lupus erythematosus (secondary). The immunoregulation in Sjögren's syndrome is discussed and the incidence of immune...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-212
更新日期:1980-02-01 00:00:00
abstract::Between 1978 and 1985, the number of active internists in the United States increased from 64,000 to 91,000, and by 1998 the number will have increased to 141,000. This growth represents an increase of 121% for a 20-year period, during which time the population of the United States is expected to increase only 19%. Th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-1-93
更新日期:1987-07-01 00:00:00