Abstract:
OBJECTIVE:To determine the number and distribution of internists in subspecialty training and compare with data collected since 1976; to determine the distribution of activity of subspecialty fellows; and to focus on hematology and oncology. DESIGN:Repeated mail survey with telephone follow-up. PARTICIPANTS:All directors of subspecialty training programs in internal medicine in the United States. RESULTS:The 1988-1989 census identified 7530 fellows in training, 55 more than in 1987-1988. There are 24 more first-year fellows. Reports on the activities of subspecialty fellows show that, overall, 53% of fellows' time is spent in direct patient care, 20% on basic research, 15% on patient-related research, and 12% in teaching. CONCLUSIONS:The number of internists entering subspecialty training has risen at a considerably slower rate in the last 5 years compared with the 5 years before that. The length of subspecialty training has increased significantly since 1976. There has been a shift in subspecialty choice from hematology to oncology and toward joint programs offering both subspecialties.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Lyttle CS,Andersen RM,Neymarc K,Schmidt C,Kohrman CH,Levey GSdoi
10.7326/0003-4819-114-1-36subject
Has Abstractpub_date
1991-01-01 00:00:00pages
36-42issue
1eissn
0003-4819issn
1539-3704journal_volume
114pub_type
杂志文章abstract::Giant cell tumor of bone is a rare, but well-recognized complication of Paget's disease of bone. In contrast, giant cell reparative granuloma (a benign tumor of the jaws occurring primarily in young adults) has never been described in association with Paget's disease. Five patients had giant cell lesions complicating ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-1-35
更新日期:1983-01-01 00:00:00
abstract::Physical symptoms account for more than half of all outpatient visits, but the specific causes and treatments of many common symptoms are frequently not well established. Because clinical research has primarily targeted specific diseases, symptoms-based research is still an emerging field of scientific inquiry, and op...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-134-9_part_2-200105011-00008
更新日期:2001-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effect of massive cocaine intoxication on lung water and ascites accumulation and the effect of beta- and alpha-adrenergic blockade on survival in massive cocaine intoxication in the mouse. DESIGN:The effect of massive cocaine intoxication on lung water, ascitic fluid accumulation, and...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-3-202
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) frequently develop exacerbations, leading to major clinical and health resource use ramifications. OBJECTIVE:To prospectively evaluate the effectiveness of a long-acting inhaled anticholinergic bronchodilator, tiotropium, in reducing COPD exacerbati...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-143-5-200509060-00007
更新日期:2005-09-06 00:00:00
abstract::Low back pain is common, but a herniated intervertebral disk is the cause in only a small percentage of cases. Most symptomatic disk herniations result in clinical manifestations (pain, reflex loss, muscle weakness) that resolve with conservative therapy, and only 5% to 10% of patients require surgery. Sciatica is usu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-112-8-598
更新日期:1990-04-15 00:00:00
abstract::Four hemodialysis patients receiving deferoxamine for metal overload had fatal rhinocerebral rhizopus infections. Serious fungal infections are not commonly seen in patients on dialysis, and none of these patients had the usual risk factors for rhizopus infection. Deferoxamine is being used with increased frequency in...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-5-678
更新日期:1987-11-01 00:00:00
abstract::Medical school graduates are avoiding primary care. The very aspects that once attracted students have been subverted. The breadth of practice that was once appealing has become the breadth of heavy-handed scrutiny, as politicians and business leaders have demanded quality--simplistically defined as dogmatic adherence...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-10-200905190-00011
更新日期:2009-05-19 00:00:00
abstract::A patient with familial Mediterranean fever and amyloidosis who received a cadaver renal transplant 6 1/2 years ago was studied to determine the relation of the serum precursor of secondary amyloid (SAA) to the clinical course and to the deposition of amyloid in the transplant. Amyloid fibrils extracted from the patie...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-1-31
更新日期:1977-07-01 00:00:00
abstract::The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including PIER (Physicians' Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Annals of Internal Medicine editors develop In the Clinic f...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-151-11-200912010-01006
更新日期:2009-12-01 00:00:00
abstract::Nine of 81 members of two families were found to have renal problems. Three patients in one family had renal-retinal dysplasia with probable recessive inheritance. Of the 6 patients in the second family, one received a kidney transplant from his brother who initially had no detectable renal abnormality but later devel...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-2-157
更新日期:1976-02-01 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:STUDY OBJECTIVE:To determine the effectiveness of chemotherapy and adjunctive surgery in managing patients with advanced seminoma. DESIGN:Nonrandomized prospective clinical trial of chemotherapy in a cohort of patients with advanced seminoma. SETTING:Referral cancer hospital. PATIENTS:Consecutive sample of 62 patien...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-4-513
更新日期:1988-04-01 00:00:00
abstract::Hearing loss is highly prevalent and may significantly affect how we age. Although the population is aging, relatively few adults receive treatment for hearing loss. Internists are a critical partner to audiologists and otolaryngologists in caring for the adult population with hearing loss. This review provides a prim...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC202012010
更新日期:2020-12-01 00:00:00
abstract::Axial, dual spin-echo magnetic resonance (MR) images, taken at the level of the pulmonary arteries and gated to the cardiac cycle, were qualitatively and quantitatively evaluated in nine patients with primary pulmonary arterial hypertension and six controls. In controls and patients, intravascular signal intensity was...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-3-317
更新日期:1985-09-01 00:00:00
abstract::Diabetes mellitus is classified into two major categories: type I, which is insulin dependent, and type II, which is not. Insulin resistance in type II diabetes may be related to impaired receptor binding in some forms of the disorder. In the past, diabetes in pregnant women resulted in high rates of maternal and infa...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-96-5-635
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Plasma levels of leptin, the recently discovered satiety hormone, are associated with adiposity in humans. OBJECTIVE:To determine whether genetic factors or body fat distribution affect the association between leptin levels and obesity. PARTICIPANTS:23 healthy identical twin pairs (9 male pairs and 14 fema...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-1-199701010-00004
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To evaluate whether a brief course of treatment with gallium nitrate can reduce biochemical parameters of accelerated bone turnover in patients with advanced Paget disease. DESIGN:Unblinded trial, decreasing dose schedules of gallium nitrate. SETTING:University hospital with primary orthopedic and metabolic...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-11-847
更新日期:1990-12-01 00:00:00
abstract::In addition to gonorrhea and syphilis, both of which may develop primarily at anorectal or pharyngeal sites, a number of conditions, including Neisseria meningitidis urethritis, nonspecific urethritis, anorectal herpes, condyloma acuminatum, amebiasis, giardiasis, shigellosis, typhoid fever, enterobiasis, and hepatiti...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-92-6-805
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Although clinicians avoid giving meropenem to patients with penicillin allergy because of potential cross-reactivity, the rate of cross-reactivity between penicillins and meropenem has not been prospectively determined. OBJECTIVE:To assess the tolerability of meropenem in patients with documented penicillin...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-146-4-200702200-00005
更新日期:2007-02-20 00:00:00
abstract:Background:Little is known about how physician time is allocated in ambulatory care. Objective:To describe how physician time is spent in ambulatory practice. Design:Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours). Setting:U.S. ambulatory care in 4 ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M16-0961
更新日期:2016-12-06 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
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-125-1-199607010-00010
更新日期:1996-07-01 00:00:00
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
更新日期:2003-07-15 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::Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavio...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-1330
更新日期:2016-01-19 00:00:00
abstract:OBJECTIVE:To determine whether oral acyclovir reduces the incidence of recurrent herpes labialis in otherwise healthy patients with proven frequently recurrent disease. DESIGN:Randomized, double-blind, placebo-controlled, crossover trial. SETTING:Outpatient facility of the Clinical Center, National Institutes of Heal...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-118-4-199302150-00004
更新日期:1993-02-15 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:BACKGROUND:Recently, liver transplantation has been used to treat patients with familial amyloid polyneuropathy (FAP). OBJECTIVE:To describe the clinical course of patients with FAP who received partial-liver transplantation from living donors. DESIGN:Case series. SETTING:University hospital in Matsumoto, Japan. PA...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-131-8-199910190-00008
更新日期:1999-10-19 00:00:00
abstract::The four main conceptual paradigms of basic biomedical research are that the explication of mechanisms is a primary goal of science; that scientific data must be "hard"; that formulation of hypotheses and counter-hypotheses is a principal creative challenge; and that experiments are the main mechanism for using scient...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-99-3-393
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVE:To appraise the measurement properties of the Canadian Cardiovascular Society (CCS) classification of stable angina pectoris. DATA SOURCES:Relevant articles were identified through a MEDLINE search (1976 to November 1991). Bibliographies of retrieved articles were also reviewed. STUDY SELECTION:Studies chos...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-8-677
更新日期:1992-10-15 00:00:00
abstract:PURPOSE:To integrate information from the various disciplines that contribute to the understanding of the cause and prevention of sudden cardiac death: identification of new approaches from applied clinical epidemiology; identification and control of transient risk factors; and evaluation of the results of intervention...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-12-199312150-00006
更新日期:1993-12-15 00:00:00