Abstract:
BACKGROUND:Neurologic complications of endocarditis can influence diagnosis, therapeutic plans, and prognosis. OBJECTIVE:To describe how early cerebral magnetic resonance imaging (MRI) affects the diagnosis and management of endocarditis in hospitalized adults. DESIGN:Single-center prospective study between June 2005 and October 2008. (ClinicalTrials.gov registration number: NCT00144885) SETTING:Tertiary care university hospital in France. PATIENTS:130 patients with endocarditis. INTERVENTION:Cerebral MRI with angiography performed up to 7 days after admission and before any surgical intervention. MEASUREMENTS:2 experts jointly established the endocarditis diagnostic classification (according to Duke-modified criteria) and therapeutic plans just before and after MRI and then compared them. RESULTS:Endocarditis was initially classified as definite in 77 patients and possible in 50 and was excluded in 3. Sixteen patients (12%) had acute neurologic symptoms. Cerebral lesions were detected by MRI in 106 patients (82% [95% CI, 75% to 89%]), including ischemic lesions in 68, microhemorrhages in 74, and silent aneurysms in 10. Solely on the basis of MRI results and excluding microhemorrhages, diagnostic classification of 17 of 53 (32%) cases of nondefinite endocarditis was upgraded to either definite (14 patients) or possible (3 patients). Endocarditis therapeutic plans were modified for 24 (18%) of the 130 patients, including surgical plan modifications for 18 (14%). Overall, early MRI led to modifications of diagnosis or therapeutic plan in 36 patients (28% [CI, 20% to 36%]). LIMITATION:Investigators did not assess whether the MRI-related changes in diagnosis and therapeutic plans improved patient outcomes or led to unnecessary procedures and increased costs. CONCLUSION:Cerebral lesions were identified by MRI in many patients with endocarditis but no neurologic symptoms. The MRI findings affected both diagnostic classifications and clinical management plans. PRIMARY FUNDING SOURCE:French Ministry of Health.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Duval X,Iung B,Klein I,Brochet E,Thabut G,Arnoult F,Lepage L,Laissy JP,Wolff M,Leport C,IMAGE (Resonance Magnetic Imaging at the Acute Phase of Endocarditis) Study Group.doi
10.7326/0003-4819-152-8-201004200-00006subject
Has Abstractpub_date
2010-04-20 00:00:00pages
497-504, W175issue
8eissn
0003-4819issn
1539-3704pii
152/8/497journal_volume
152pub_type
杂志文章abstract::Folate deficiency is a frequent cause of anemia in alcoholics, but little attention has been paid to its prevention. Folic acid was readily soluble in wines of high ethanol content at concentrations of 10 microgram/ml. Lactobacillus casei folate activity of folic acid added to wines was well maintained during a month'...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-87-5-542
更新日期:1977-11-01 00:00:00
abstract::The prevalence of active tuberculosis and positive tuberculin skin tests was assessed in 132 corticosteroid-treated asthmatics for an evaluation period that represented 620 corticosteroid-years of therapy. There was no evidence of active tuberculosis in any of these patients. Positive intermediate-strength tuberculin ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-3-261
更新日期:1976-03-01 00:00:00
abstract::Severe hypocalcemia secondary to magnesium depletion has been described in numerous patients with gastrointestinal disorders. The development of profound hypomagnesemia in chronic renal disease is a rare finding. We studied three patients with advanced renal failure and magnesium depletion. Severe hypocalcemia also wa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-88-2-206
更新日期:1978-02-01 00:00:00
abstract:DESCRIPTION:Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for testicular cancer. METHODS:The USPSTF performed a targeted literature search for benefits and harms of screening for testicular cancer in asymptomatic males and found no new studies. RECOMMENDA...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/0003-4819-154-7-201104050-00006
更新日期:2011-04-05 00:00:00
abstract:OBJECTIVE:To determine the causes of persistent dizziness in outpatients. DESIGN:Consecutive adult outpatients presenting with a chief complaint of dizziness. SETTING:Four clinics (internal medicine, walk-in, emergency room, and neurology) in a teaching hospital. PATIENTS:Of 185 patients presenting during the 10-mon...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-11-898
更新日期:1992-12-01 00:00:00
abstract::Clinical and epidemiologic characteristics of disease associated with a newly described nonhalophilic Vibrio species, Vibrio mimicus, were identified by studying isolates from 21 patients referred to the Centers for Disease Control between 1977 and 1981. Two isolates were from the ears of patients with otitis who had ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Menopausal hormone therapy to prevent chronic conditions is currently not recommended because of its adverse effects. PURPOSE:To update evidence about the effectiveness of hormone therapy in reducing risk for chronic conditions and adverse effects, and to examine whether outcomes vary among women in differe...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-157-2-201207170-00466
更新日期:2012-07-17 00:00:00
abstract:BACKGROUND:Retail clinics are an increasingly popular source for medical care. Concerns have been raised about the effect of these clinics on the cost, quality, and delivery of preventive care. OBJECTIVE:To compare the care received at retail clinics for 3 acute conditions with that received at other care settings. D...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-151-5-200909010-00006
更新日期:2009-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the effect of weight-bearing exercise training and subsequent detraining on lumbar bone mineral content in postmenopausal women. DESIGN:Non-randomized, controlled, short-term (9 months) trial and long-term (22 months) exercise training and detraining (13 months). SETTING:Section of applied p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-6-824
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Two recent double-blind, randomized, controlled trials (RCTs) showed that oral steroids and nonsteroidal anti-inflammatory drugs have similar analgesic effectiveness for management of gout, but the trials had small sample sizes and other methodological limitations. OBJECTIVE:To compare the effectiveness and...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M14-2070
更新日期:2016-04-05 00:00:00
abstract:DESCRIPTION:Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for abdominal aortic aneurysm (AAA). METHODS:The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) sc...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
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更新日期:2014-08-19 00:00:00
abstract:BACKGROUND:The clinical significance of asymptomatic deep venous thrombosis that develops after joint arthroplasty and the value of screening tests to detect thrombi are uncertain. OBJECTIVES:To determine 1) the rate of symptomatic deep venous thrombosis or pulmonary embolism occurring after hospitalization for joint ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-127-6-199709150-00004
更新日期:1997-09-15 00:00:00
abstract::The clinical implications of newly acquired left bundle-branch block (LBBB) were examined prospectively in the Framingham Study population. During 18 years of observation 55 people developed LBBB. The mean age at the onset of LBBB was 62; LBBB occurred largely in people with antecedent hypertension, cardiac enlargemen...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-90-3-303
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Bhutan implemented a national program for human papillomavirus (HPV) vaccination in 2010 involving girls aged 12 to 18 years and achieving nearly 90% coverage. OBJECTIVE:To estimate HPV vaccine effectiveness in a city in Bhutan. DESIGN:2 cross-sectional surveys, 2011-2012 and 2018. SETTING:2 hospitals in ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-2849
更新日期:2020-12-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the clinical and epidemiologic features of Vibrio vulnificus infections. DESIGN:Case series based on notifiable disease report forms and patient medical records. SETTING:Cases reported to the Florida Department of Health and Rehabilitative Services from 1981 to 1987. PATIENTS:Sixty-two pa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-4-318
更新日期:1988-08-15 00:00:00
abstract::During the early 1990s, the U.S. government addressed the issue of providing universal health care to all its citizens. Although this issue has not been completely resolved, centralization of electronic data and sharing of health care information among insurers and providers have been pursued. The emergence of electro...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-127-8_part_2-199710151-00050
更新日期:1997-10-15 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::Hepatitis is a significant complication of the treatment of hemophilia A with factor VIII concentrates. Chronic liver disease in these patients is infrequently documented in the literature. The results of percutaneous liver biopsy, under the coverage of glycine-precipitated factor VIII, in six patients with hemophilia...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-703
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:Indinavir, a protease inhibitor widely used to treat patients with HIV infection, has been associated with nephrolithiasis. Distinctive urinary crystals and a spectrum of urologic disorders were noted in patients receiving indinavir. OBJECTIVE:To determine the composition of urinary crystals and the frequen...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-2-199707150-00004
更新日期:1997-07-15 00:00:00
abstract::Bulimarexia, an eating disorder that is characterized by binge eating followed by self-induced vomiting or abuse of cathartic or diuretic drugs, has been defined as both a sequela of anorexia nervosa and a distinct eating disorder. In this review the presentation, prevalence, and complications of the various eating di...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-6-800
更新日期:1983-12-01 00:00:00
abstract::Abdominal aortic aneurysms (AAAs) occur in 1 of 20 older men, remain asymptomatic for many years, and, if left untreated, cause death from rupture in about one third of patients. Ultrasonography is a suitable screening test for AAA, and elective repair can prevent rupture. Although these features suggest a promising t...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-139-6-200309160-00016
更新日期:2003-09-16 00:00:00
abstract::Antinuclear antibodies are present in most patients receiving procainamide. To ascertain whether IgG antiguanosine antibodies are associated with the development of the symptoms of systemic lupus erythematosus, we compared the levels of these antibodies in the sera of 65 patients receiving procainamide: 18 with procai...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-3-310
更新日期:1986-03-01 00:00:00
abstract:Background:The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and ...
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/M16-1536
更新日期:2017-06-20 00:00:00
abstract:OBJECTIVE:To determine whether self-assessment of purified protein derivative of tuberculin (PPD) skin test reactions, done using a simple two-choice approach, is an effective screening method for tuberculosis. DESIGN:Double-blind comparison between self-assessments and trained professional readings of PPD skin test r...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-125-4-199608150-00004
更新日期:1996-08-15 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::Breast cancer is the major cancer killer of women in the United States. Recent advances in therapy promise more effective control of this illness. The development of hormone receptor analysis permits us to better understand the mechanisms of action of steroid and peptide hormones and increases the likelihood of using ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-784
更新日期:1977-06-01 00:00:00
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:PURPOSE:To review clinical scenarios in which nonelectrophysiologist physicians may interact with patients who have implantable defibrillators. DATA SOURCES:Peer-reviewed original articles and reviews addressing aspects of implantable defibrillator therapy that are relevant to the clinician. DATA SYNTHESIS:The capaci...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-10-199505150-00007
更新日期:1995-05-15 00:00:00
abstract:BACKGROUND:Many constituents of fruits and vegetables may reduce the risk for coronary heart disease, but data on the relationship between fruit and vegetable consumption and risk for coronary heart disease are sparse. OBJECTIVE:To evaluate the association of fruit and vegetable consumption with risk for coronary hear...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-134-12-200106190-00010
更新日期:2001-06-19 00:00:00
abstract:OBJECTIVE:To assess the efficacy and toxicity of moricizine in treating patients with serious ventricular arrhythmias and inducible sustained ventricular tachycardia. DESIGN:Uncontrolled clinical trial. SETTING:The intensive care and telemetry units of Northwestern Memorial Hospital, St. Francis Hospital and Medical ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-5-375
更新日期:1992-03-01 00:00:00