Abstract:
:Tetanus is an expected complication when disasters strike in developing countries, where tetanus immunization coverage is often low or nonexistent. Collapsing structures and swirling debris inflict numerous crush injuries, fractures, and serious wounds. Clostridium tetani infects wounds contaminated with dirt, feces, or saliva and releases neurotoxins that may cause fatal disease. Clusters of infections have recently occurred after tsunamis and earthquakes in Indonesia, Kashmir, and Haiti. The emergency response to clusters of tetanus infections in developing countries after a natural disaster requires a multidisciplinary approach in the absence of an intensive care unit, readily available resources, and a functioning cold-chain system. It is essential that injured people receive immediate surgical and medical care of contaminated, open wounds with immunization and immunoglobulin therapy. Successful treatment of tetanus depends on prompt diagnosis of clinical tetanus, treatment to ensure neutralization of circulating toxin and elimination of C. tetani infection, control of spasms and convulsions, maintenance of the airway, and management of respiratory failure and autonomic dysfunction.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Afshar M,Raju M,Ansell D,Bleck TPdoi
10.7326/0003-4819-154-5-201103010-00007subject
Has Abstractpub_date
2011-03-01 00:00:00pages
329-35issue
5eissn
0003-4819issn
1539-3704pii
154/5/329journal_volume
154pub_type
杂志文章,评审abstract::Molecular analysis of normal and abnormal human globin genes and their gene products has recently provided information on the precise genetic events that result in hemoglobinopathies. In the case of structurally abnormal hemoglobins, the following mechanisms can be invoked: single nucleotide base substitutions leading...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-91-4-605
更新日期:1979-10-01 00:00:00
abstract::Aspirin breaks the gastric mucosal barrier. We studied the effect of aspirin on this barrier, correlating changes in potential difference and ultrastructure. Mean control potential difference for seven subjects was -48 +/- 1.0 mV. Oral aspirin, 600 mg in 100 ml of saline, reduced potential difference to -39 +/- 1.4 mV...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-3-299
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:No regulations govern placebo composition. The composition of placebos can influence trial outcomes and merits reporting. PURPOSE:To assess how often investigators specify the composition of placebos in randomized, placebo-controlled trials. DATA SOURCES:4 English-language general and internal medicine jou...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-8-201010190-00010
更新日期:2010-10-19 00:00:00
abstract:PURPOSE:To review current management of intractable constipation. DATA SOURCES:Original articles and reviews published in the English-language literature between 1965 and 1993 identified by MEDLINE search. Verbal feedback from attendees after presentation of the document as a clinical symposium at the 14th Internation...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-121-7-199410010-00008
更新日期:1994-10-01 00:00:00
abstract::In two patients with thyroiditis caused by Coccidioides immitis, presented thyroid symptoms and findings were characteristic of subacute thyroiditis. Fine needle aspiration biopsy of the thyroid proved useful in establishing the diagnosis of coccidioidomycosis. This is the first report of coccidioidomycosis presenting...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-3-409
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Data suggest that the effects of coronavirus disease 2019 (COVID-19) differ among U.S. racial/ethnic groups. PURPOSE:To evaluate racial/ethnic disparities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and COVID-19 outcomes, factors contributing to disparities, and intervent...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-6306
更新日期:2020-12-01 00:00:00
abstract::Disorders determined wholly or in part by genetic factors constitute a substantial number of human diseases. This realization has grown during the past 2 decades with the recognition of many specific heritable conditions and the identification of familial risk factors for common disorders. New technologies, such as fe...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
doi:10.7326/0003-4819-104-4-527
更新日期:1986-04-01 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::There has been considerable change in the practice of internal medicine in the past quarter century, including the rise of specialization, increasing time pressure, the hospitalist movement, and the rapidly changing responsibilities of internists in inpatient and outpatient settings. Training programs have not adequat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-144-12-200606200-00010
更新日期:2006-06-20 00:00:00
abstract::An unusual cluster of 11 patients with Pneumocystis carinii pneumonia occurred in a 3-month period at Memorial Hospital, New York. Ten of the 11 patients had lymphoma or leukemia. In 7 patients, corticosteroid therapy was decreased or stopped shortly before pneumocystis pneumonia was diagnosed. The pediatric patients ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-6-722
更新日期:1975-06-01 00:00:00
abstract::Conventional interpretation of clinical trials relies heavily on the classic p value. The p value, however, represents only a false-positive rate, and does not tell the probability that the investigator's hypothesis is correct, given his observations. This more relevant posterior probability can be quantified by an ex...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-3-385
更新日期:1983-03-01 00:00:00
abstract::Five patients with clinically overt myocarditis in the setting of systemic lupus erythematosus were analyzed in terms of associated clinical and serologic features. Myositis and antibodies to nuclear ribonucleoprotein (RNP) were present in all. A retrospective review in 140 consecutive patients with systemic lupus ery...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-5-619
更新日期:1978-11-01 00:00:00
abstract::From 1969 to 1974, 19 cases of Serratia marcescens endocarditis were observed in the San Francisco Bay Area. Seventeen patients were intravenous drug users, and Serratia caused 14% of all addict-associated endocarditis in San Francisco. Serratia strains were nonpigmented and had typical antibiotic sensitivities, excep...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-1-29
更新日期:1976-01-01 00:00:00
abstract::Previous epidemiologic studies of staphylococcal infections in newborn infants and surgical patients provide clues to the method of infection in toxic shock syndrome. In newborn infants, staphylococci were shown to be transmitted most often by the hands of nursery personnel to the umbilical stump, which afforded a war...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-6-934
更新日期:1982-06-01 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::Although the efficacy of hepatitis vaccine is well documented, the duration of immunity of healthy adults after vaccination is unknown. We studied 245 hospital employees 3 years after primary vaccination with hepatitis B vaccine to determine the prevalence of immunity indicated by levels of antibody to hepatitis B sur...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-2-185
更新日期:1988-02-01 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::In an effort to prevent cytomegalovirus infection among seronegative patients having marrow transplants, a globulin with high antibody levels against cytomegalovirus was given before and for 11 weeks after transplantation in a randomized trial. Among 36 patients who received no prophylactic granulocyte transfusions, g...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-98-4-442
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:When deep venous thrombosis is suspected, objective testing is required to confirm or refute the diagnosis. OBJECTIVE:To determine whether the combination of a low clinical suspicion and a normal D -dimer result rules out deep venous thrombosis. DESIGN:Prospective cohort study. SETTING:Three tertiary care...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-135-2-200107170-00011
更新日期:2001-07-17 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:BACKGROUND:Many states have laws requiring mammography facilities to tell women with dense breasts and negative results on screening mammography to discuss supplemental screening tests with their providers. The most readily available supplemental screening method is ultrasonography, but little is known about its effect...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M14-0692
更新日期:2015-02-03 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:BACKGROUND:The incidence of esophageal adenocarcinoma is increasing rapidly. Gastroesophageal reflux is a strong risk factor for this disease. The increase in incidence of esophageal adenocarcinoma coincided with the introduction of medications that promote reflux by relaxing the lower esophageal sphincter (LES), such ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-3-200008010-00007
更新日期:2000-08-01 00:00:00
abstract::We performed selective venous catheterization and sampling for ACTH in six patients with ACTH-secreting pituitary adenomas (Cushing's disease) and four patients with occult ectopic ACTH-secreting neoplasms. In five patients with Cushing's disease in whom the inferior petrosal sinus could be catheterized, ACTH levels w...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-5-647
更新日期:1981-05-01 00:00:00
abstract::Nineteen patients with advanced refractory metastatic breast cancer no longer responsive to chemotherapy were treated in the first phase II efficacy trial of recombinant leukocyte A interferon (IFL-rA), a highly purified single molecular species of alpha interferon prepared by recombinant DNA methods. Patients receive...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-98-5-598
更新日期:1983-05-01 00:00:00
abstract:Description:The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update an...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M17-2640
更新日期:2018-03-20 00:00:00
abstract::Clinicians can use data to improve daily clinical practice. This paper offers eight principles for using data to support improvement in busy clinical settings: 1) seek usefulness, not perfection, in the measurement; 2) use a balanced set of process, outcome, and cost measures; 3) keep measurement simple (think big, bu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-6-199803150-00007
更新日期:1998-03-15 00:00:00
abstract::After marketing, drugs should be evaluated for safety and for efficacy. Present national systems are inadequate for both tasks. Safety can be evaluated by means of nonexperimental research, whereas evaluation of efficacy in a variety of settings representing normal medical practice generally requires experiments, rand...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-2-257
更新日期:1979-02-01 00:00:00
abstract:Background:Little is known about whether insurance expansion affects the location and type of emergency department (ED) use. Understanding these changes can inform state-level decisions about the Medicaid expansion under the Patient Protection and Affordable Care Act (ACA). Objective:To investigate the effect of the 2...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M16-0086
更新日期:2017-02-07 00:00:00
abstract:OBJECTIVE:To describe the prevalence of cognitive impairment among elderly primary care patients and to compare diagnostic evaluations and use of health services among patients with and those without cognitive impairment. DESIGN:Prospective cohort study. SETTING:Academic primary care group practice. PATIENTS:3954 pa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-122-6-199503150-00004
更新日期:1995-03-15 00:00:00