Abstract:
BACKGROUND:Tobacco dependence is a chronic, relapsing condition that may require extended treatment. OBJECTIVE:To assess whether extended-duration transdermal nicotine therapy increases abstinence from tobacco more than standard-duration therapy in adult smokers. DESIGN:Parallel randomized, placebo-controlled trial from September 2004 to February 2008. Participants and all research personnel except the database manager were blinded to randomization. (ClinicalTrials.gov registration number: NCT00364156) SETTING:Academic center. PARTICIPANTS:568 adult smokers. INTERVENTION:In an unstratified small block-randomization scheme, participants were randomly assigned to standard therapy (Nicoderm CQ [GlaxoSmithKline, Research Triangle Park, North Carolina], 21 mg, for 8 weeks and placebo for 16 weeks) or extended therapy (Nicoderm CQ, 21 mg, for 24 weeks). MEASUREMENTS:The primary outcome was biochemically confirmed point-prevalence abstinence at weeks 24 and 52. Secondary outcomes were continuous and prolonged abstinence, lapse and recovery events, cost per additional quitter, and side effects and adherence. RESULTS:At week 24, extended therapy produced higher rates of point-prevalence abstinence (31.6% vs. 20.3%; odds ratio, 1.81 [95% CI, 1.23 to 2.66]; P = 0.002), prolonged abstinence (41.5% vs. 26.9%; odds ratio, 1.97 [CI, 1.38 to 2.82]; P = 0.001), and continuous abstinence (19.2% vs. 12.6%; odds ratio, 1.64 [CI, 1.04 to 2.60]; P = 0.032) versus standard therapy. Extended therapy reduced the risk for lapse (hazard ratio, 0.77 [CI, 0.63 to 0.95]; P = 0.013) and increased the chances of recovery from lapses (hazard ratio, 1.47 [CI, 1.17 to 1.84]; P = 0.001). Time to relapse was slower with extended versus standard therapy (hazard ratio, 0.50 [CI, 0.35 to 0.73]; P < 0.001). At week 52, extended therapy produced higher quit rates for prolonged abstinence only (P = 0.027). No differences in side effects and adverse events between groups were found at the extended-treatment assessment. LIMITATION:The generalizability of the findings may be limited because participants were smokers without medical comorbid conditions who were seeking treatment, and differences in adherence across treatment groups were detected. CONCLUSION:Transdermal nicotine for 24 weeks increased biochemically confirmed point-prevalence abstinence and continuous abstinence at week 24, reduced the risk for smoking lapses, and increased the likelihood of recovery to abstinence after a lapse compared with 8 weeks of transdermal nicotine therapy. PRIMARY FUNDING SOURCE:National Institutes of Health.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Schnoll RA,Patterson F,Wileyto EP,Heitjan DF,Shields AE,Asch DA,Lerman Cdoi
10.7326/0003-4819-152-3-201002020-00005subject
Has Abstractpub_date
2010-02-02 00:00:00pages
144-51issue
3eissn
0003-4819issn
1539-3704pii
152/3/144journal_volume
152pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The National Kidney Foundation has advocated the use of the abbreviated Modification of Diet in Renal Disease (MDRD) equation to estimate glomerular filtration rate (GFR) from serum creatinine measurements in clinical laboratories. However, healthy persons were not included in the development of the MDRD equ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-141-12-200412210-00009
更新日期:2004-12-21 00:00:00
abstract::Severe pulmonary hypertension without pulmonary fibrosis occurred in 10 patients with the CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia), reputedly a benign variant of progressive systemic sclerosis. Time from the initial symptom, Raynaud's phenomenon, to the r...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-4-394
更新日期:1977-04-01 00:00:00
abstract:BACKGROUND:Screening can detect prostate cancer at earlier, asymptomatic stages, when treatments might be more effective. PURPOSE:To update the 2002 and 2008 U.S. Preventive Services Task Force evidence reviews on screening and treatments for prostate cancer. DATA SOURCES:MEDLINE (2002 to July 2011) and the Cochrane ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-11-201112060-00375
更新日期:2011-12-06 00:00:00
abstract::Because the cholesterol-rich very low density (VLD) lipoproteins of subjects with type III hyperlipoproteinemia are distinctively enriched in apolipoprotein E, a radial immunodiffusion assay for apolipoprotein E in whole plasma was developed. Its diagnostic usefulness was tested in randomly selected (n = 174) and hype...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-5-509
更新日期:1977-11-01 00:00:00
abstract::Cataract disrupts the crystalline lens, a transparent, elastic, avascular, biconvex structure composed of a capsule, lens epithelium, and lens fiber cells. Many factors contribute to the progression of lens opacity, but aging is most frequently associated with cataract. As aging-related cataract develops, many biochem...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-102-1-82
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To determine whether the use of non-potassium-sparing diuretics and beta-blockers is associated with an excess risk for sudden cardiac death in hypertensive patients. DESIGN:Case-control study. SETTING:Rotterdam, the Netherlands. PATIENTS:257 case-patients who had died suddenly while receiving drug therapy...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-7-199510010-00001
更新日期:1995-10-01 00:00:00
abstract::Daily change of intravenous (i.v.) infusion administration sets has been recommended by the Center for Disease Control since 1973 to reduce the risk of infusion bacteremia. To evaluate this recommendation, we undertook a prospective, randomized, controlled trial that compared the rates of i.v.-associated bacteremia, i...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-90-5-764
更新日期:1979-05-01 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
pub_type: 杂志文章,meta分析
doi:10.7326/M16-2562
更新日期:2017-05-16 00:00:00
abstract:OBJECTIVE:To describe the diagnostic difficulties, response to therapy, and clinical features of lymphomatoid papulosis and the cumulative frequency of transformation to lymphoma. DESIGN:Case series. SETTING:University hospitals. METHODS:The records of 21 patients with lymphomatoid papulosis who were seen from 1986 ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-122-3-199502010-00009
更新日期:1995-02-01 00:00:00
abstract::Clinical features of 99 patients with staphylococcal infection were reviewed, and sera were tested by solid-phase radioimmunoassay and gel diffusion for staphylococcal antibodies to ascertain whether these variables predict the extent of infection and the need for prolonged therapy. Clinical features, including the pr...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-4-467
更新日期:1978-10-01 00:00:00
abstract:BACKGROUND:AL amyloidosis is a fatal disease resulting from tissue deposition of amyloid fibrils derived from monoclonal immunoglobulin light chains. Treatment with oral chemotherapy is minimally effective. OBJECTIVE:To test survival and organ response in a large sample of patients treated with high-dose intravenous m...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-140-2-200401200-00008
更新日期:2004-01-20 00:00:00
abstract:DESCRIPTION:Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for bladder cancer. METHODS:The USPSTF performed a targeted literature search for new evidence on the benefits and harms of screening, the accuracy of primary care-feasible screening tests, and the benefit...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/0003-4819-155-4-201108160-00008
更新日期:2011-08-16 00:00:00
abstract::Reversible cerebral vasoconstriction syndromes (RCVS) comprise a group of diverse conditions, all characterized by reversible multifocal narrowing of the cerebral arteries heralded by sudden (thunderclap), severe headaches with or without associated neurologic deficits. Reversible cerebral vasoconstriction syndromes a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-146-1-200701020-00007
更新日期:2007-01-02 00:00:00
abstract::The relationship between oral contraceptives and death from thromboembolism shown by studies of vital statistics, and the contribution of cigarette smoking to these deaths are reviewed. In 1968 a British study showed that a slight increase in deaths from thromboembolism had occurred in young women, proportional to th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:
更新日期:1970-09-01 00:00:00
abstract::The past 2 decades have seen a revolution in legal access to cannabis, driven largely by activists and business interests. As a result, the population of cannabis users nationwide-especially daily users-has grown significantly. An estimated 4.5-7 million persons in the United States now meet criteria for cannabis use ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC202011030
更新日期:2020-11-03 00:00:00
abstract:Description:The purpose of this guidance statement is to guide clinicians on colorectal cancer screening in average-risk adults. Methods:This guidance statement is derived from a critical appraisal of guidelines on screening for colorectal cancer in average-risk adults and the evidence presented in these guidelines. N...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M19-0642
更新日期:2019-11-05 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::Under the current system of disability determination and workers' compensation for occupational lung disease, disabled workers or their survivors can reasonably count on being compensated. However, by rejecting established scientific truth in order to pay workers' compensation in circumstances where disability or deat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-6-908
更新日期:1982-12-01 00:00:00
abstract:Background:High-risk human papillomavirus (hrHPV) testing to triage women with minor cervical lesions generates many referrals. Purpose:To evaluate the accuracy of genotyping for HPV types 16 and 18 and its utility as a second triage step after hrHPV testing in women with minor cervical lesions. Data Sources:Searches...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M15-2735
更新日期:2017-01-17 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:Injection insulin therapy is not readily accepted by patients and many health care providers; therefore, less invasive options for insulin therapy are desirable. PURPOSE:To examine the efficacy, safety, and patient acceptability of inhaled insulin therapy in nonpregnant adults with diabetes mellitus. DATA ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-145-9-200611070-00009
更新日期:2006-11-07 00:00:00
abstract:DESCRIPTION:New recommendation from the U.S. Preventive Services Task Force (USPSTF) on the use of nontraditional, or novel, risk factors in assessing the coronary heart disease (CHD) risk of asymptomatic persons. METHODS:Systematic reviews were conducted of literature since 1996 on 9 proposed nontraditional markers o...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/0003-4819-151-7-200910060-00008
更新日期:2009-10-06 00:00:00
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 p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-114-6-437
更新日期:1991-03-15 00:00:00
abstract::Traditional educational methods change clinical practice only with considerable effort and difficulty. In particular, the teaching of critical appraisal in the setting of journal clubs does not increase the amount of medical research read by trainees. Experiential learning theory, corroborated by the success of proble...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-11-199706010-00006
更新日期:1997-06-01 00:00:00
abstract:DESCRIPTION:Although approximately 85 million units of red blood cells (RBCs) are transfused annually worldwide, transfusion practices vary widely. The AABB (formerly, the American Association of Blood Banks) developed this guideline to provide clinical recommendations about hemoglobin concentration thresholds and othe...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引,评审
doi:10.7326/0003-4819-157-1-201206190-00429
更新日期:2012-07-03 00:00:00
abstract:BACKGROUND:New tests, such as magnetic resonance imaging (MRI) and electron-beam computed tomography (CT), are being developed for the diagnosis of coronary artery disease. OBJECTIVE:To determine the conditions that a new test must meet to be a cost-effective alternative to established imaging tests. DESIGN:Decision ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-131-9-199911020-00008
更新日期:1999-11-02 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:BACKGROUND:Risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to close contacts of infected persons has not been well estimated. OBJECTIVE:To evaluate the risk for transmission of SARS-CoV-2 to close contacts in different settings. DESIGN:Prospective cohort study. SETTING:Close con...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-2671
更新日期:2020-12-01 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:Understanding the risk factors for ventilator-associated pneumonia can help to assess prognosis and devise and test preventive strategies. OBJECTIVE:To examine the baseline and time-dependent risk factors for ventilator-associated pneumonia and to determine the conditional probability and cumulative risk ov...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-129-6-199809150-00002
更新日期:1998-09-15 00:00:00