Narrative review: tetanus-a health threat after natural disasters in developing countries.


: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.


Ann Intern Med


Afshar M,Raju M,Ansell D,Bleck TP




Has Abstract


2011-03-01 00:00:00














  • The effect of physician behavior on the collection of data.

    abstract::Determining the patient's major reasons for seeking care is of critical importance in a successful medical encounter. To study the physician's role in soliciting and developing the patient's concerns at the outset of a clinical encounter, 74 office visits were recorded. In only 17 (23%) of the visits was the patient p...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Beckman HB,Frankel RM

    更新日期:1984-11-01 00:00:00

  • Sample size nomograms for interpreting negative clinical studies.

    abstract::In recent years there has been increasing attention to the appropriate interpretation of a clinical study. One special concern has been the difficulty inherent in interpreting studies that were not statistically significant: Was the sample size sufficient to detect a clinically important effect if, in fact, it existed...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Young MJ,Bresnitz EA,Strom BL

    更新日期:1983-08-01 00:00:00

  • Relation of glycemic control to diabetic microvascular complications in diabetes mellitus.

    abstract:OBJECTIVE:To describe the relation between glycated hemoglobin and the incidence or progression, or both, of diabetic microvascular complications in persons with insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). DESIGN:Population-based on cohort study. SETTING:An 11-county area in southern...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Klein R,Klein BE,Moss SE

    更新日期:1996-01-01 00:00:00

  • The myocarditis of systemic lupus erythematosus: association with myositis.

    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


    authors: Borenstein DG,Fye WB,Arnett FC,Stevens MB

    更新日期:1978-11-01 00:00:00

  • Support for physician deception of insurance companies among a sample of Philadelphia residents.

    abstract:BACKGROUND:Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice. OBJECTIVE:To assess public attitudes regarding physician deception of insurance companies. DESIGN:Cross-sectional survey using clinical vignettes. SETTING:Philad...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Alexander GC,Werner RM,Fagerlin A,Ubel PA

    更新日期:2003-03-18 00:00:00

  • Better access to information about clinical trials.

    abstract::Access to information about clinical trials is important to researchers, health care professionals, and patients. Many have argued for the establishment of clinical trials registries, citing their substantial benefits. Although some registries do exist, it has been difficult to create comprehensive, easily accessible ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: McCray AT

    更新日期:2000-10-17 00:00:00

  • Use of an artificial neural network for the diagnosis of myocardial infarction.

    abstract:OBJECTIVE:To validate prospectively the use of an artificial neural network to identify myocardial infarction in patients presenting to an emergency department with anterior chest pain. DESIGN:Prospective, blinded testing. SETTING:Tertiary university teaching center. PATIENTS:A total of 331 consecutive adult patient...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Baxt WG

    更新日期:1991-12-01 00:00:00

  • Efficacy and safety of second-generation antidepressants in the treatment of major depressive disorder.

    abstract:BACKGROUND:Reviews have compared the efficacy and tolerability of newer second-generation antidepressants with those of placebo or older treatments, but comparative evidence for use of second-generation antidepressants to treat major depressive disorder has not been evaluated. PURPOSE:To systematically evaluate compar...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Hansen RA,Gartlehner G,Lohr KN,Gaynes BN,Carey TS

    更新日期:2005-09-20 00:00:00

  • Association of fibrinogen with glycemic control and albumin excretion rate in patients with non-insulin-dependent diabetes mellitus.

    abstract:BACKGROUND:The high prevalence of classic cardiac risk factors in patients with non-insulin-dependent diabetes mellitus does not explain the increased cardiovascular-related morbidity and mortality in these patients. Fibrinogen may have a role in this excess risk. OBJECTIVE:To evaluate the following in patients with n...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Bruno G,Cavallo-Perin P,Bargero G,Borra M,D'Errico N,Pagano G

    更新日期:1996-10-15 00:00:00

  • Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis.

    abstract:BACKGROUND:Nearly 25% of patients hospitalized with heart failure (HF) are readmitted within 30 days. PURPOSE:To assess the efficacy, comparative effectiveness, and harms of transitional care interventions to reduce readmission and mortality rates for adults hospitalized with HF. DATA SOURCES:MEDLINE, Cochrane Librar...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Feltner C,Jones CD,Cené CW,Zheng ZJ,Sueta CA,Coker-Schwimmer EJ,Arvanitis M,Lohr KN,Middleton JC,Jonas DE

    更新日期:2014-06-03 00:00:00

  • Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis: a randomized trial.

    abstract:BACKGROUND:Tumor necrosis factor-alpha is present in arteries in giant cell arteritis. OBJECTIVE:To evaluate the efficacy of infliximab, an anti-tumor necrosis factor-alpha agent, in giant cell arteritis. DESIGN:Randomized, controlled trial. SETTING:22 sites in the United States, the United Kingdom, Belgium, Italy, ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Hoffman GS,Cid MC,Rendt-Zagar KE,Merkel PA,Weyand CM,Stone JH,Salvarani C,Xu W,Visvanathan S,Rahman MU,Infliximab-GCA Study Group.

    更新日期:2007-05-01 00:00:00

  • Screening for Urinary Incontinence in Women: A Recommendation From the Women's Preventive Services Initiative.

    abstract:Description:Recommendation on screening for urinary incontinence in women by the Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives. The WPSI's recommendations are intended to guide clinical practice and coverage of services for t...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,实务指引


    authors: O'Reilly N,Nelson HD,Conry JM,Frost J,Gregory KD,Kendig SM,Phipps M,Salganicoff A,Ramos D,Zahn C,Qaseem A,Women's Preventive Services Initiative.

    更新日期:2018-09-04 00:00:00

  • Flecainide-induced ventricular tachycardia and fibrillation in patients treated for atrial fibrillation.

    abstract::Flecainide acetate has a recognized proarrhythmic effect in patients treated for ventricular tachycardia. Three patients developed severe ventricular arrhythmias while taking flecainide for atrial fibrillation. Patient 1 had normal ventricular function and idiopathic atrial fibrillation. Treadmill exercise tests durin...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Falk RH

    更新日期:1989-07-15 00:00:00

  • Update on the methods of the U.S. Preventive Services Task Force: insufficient evidence.

    abstract::The U.S. Preventive Services Task Force (USPSTF) seeks to provide reliable and accurate evidence-based recommendations to primary care clinicians. However, clinicians indicate frustration with the lack of guidance provided by the USPSTF when the evidence is insufficient to make a recommendation. This article describes...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Petitti DB,Teutsch SM,Barton MB,Sawaya GF,Ockene JK,DeWitt T,U.S. Preventive Services Task Force.

    更新日期:2009-02-03 00:00:00

  • Sjögren's syndrome (Sicca syndrome): current issues.

    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


    authors: Moutsopoulos HM,Chused TM,Mann DL,Klippel JH,Fauci AS,Frank MM,Lawley TJ,Hamburger MI

    更新日期:1980-02-01 00:00:00

  • Cardiovascular hospitalizations and mortality among recipients of hematopoietic stem cell transplantation.

    abstract:BACKGROUND:Hematopoietic stem cell transplantation (HSCT) is increasingly used to treat multiple malignant and nonmalignant conditions. The risk for cardiovascular disease after the procedure has not been well-described. OBJECTIVE:To compare rates and hazards of cardiovascular-related hospitalization and death among p...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Chow EJ,Mueller BA,Baker KS,Cushing-Haugen KL,Flowers ME,Martin PJ,Friedman DL,Lee SJ

    更新日期:2011-07-05 00:00:00

  • Percutaneous transluminal angioplasty for renal artery stenosis in a solitary functioning kidney.

    abstract::In five patients with hypertension and marked impairment of renal function due to renal artery stenosis in a solitary functioning kidney, a nonsurgical technique, percutaneous transluminal angioplasty, was used to dilate the stenotic renal artery. Blood pressure improved in all five patients, and renal function improv...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Weinberger MH,Yune HY,Grim CE,Luft FC,Klatte EC,Donohue JP

    更新日期:1979-11-01 00:00:00

  • Physical examination for exclusion of hemodynamically important right ventricular infarction.

    abstract::Fifty-three consecutive patients with inferior myocardial infarction were evaluated prospectively, by physical examination and right heart catheterization within 36 hours of the onset of symptoms, to determine whether physical findings can separate such patients into those with and without associated right ventricular...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Dell'Italia LJ,Starling MR,O'Rourke RA

    更新日期:1983-11-01 00:00:00

  • Amyloid deposition in a renal transplant in familial Mediterranean fever.

    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


    authors: Benson MD,Skinner M,Cohen AS

    更新日期:1977-07-01 00:00:00

  • Care of the Patient Using Cannabis.

    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


    authors: Williams AR,Hill KP

    更新日期:2020-11-03 00:00:00

  • Vitamin-D-resistant osteomalacia in hemodialysis patients lacking secondary hyperparathyroidism.

    abstract::We describe a sporadic, vitamin-D-resistant osteomalacic syndrome in 19 patients undergoing hemodialysis. The syndrome was found in less than 1.5% of patients from referring dialysis centers. All 19 patients had multiple fractures, severe myopathy, and many developed spontaneous hypercalcemia. Severe osteomalacia with...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Hodsman AB,Sherrard DJ,Wong EG,Brickman AS,Lee DB,Alfrey AC,Singer FR,Norman AW,Coburn JW

    更新日期:1981-05-01 00:00:00

  • Indications for pulmonary function testing.

    abstract:STUDY OBJECTIVE:To critically assess original studies evaluating the role of preoperative pulmonary function testing in predicting postoperative outcomes. DESIGN:MEDLINE search of English-language articles from 1966 to 1987 using the following medical subjects headings respiratory function tests, lung, lung diseases, ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,meta分析


    authors: Zibrak JD,O'Donnell CR,Marton K

    更新日期:1990-05-15 00:00:00

  • Current and future concepts of lung cancer.

    abstract::We discuss here some of the last decade's diagnostic and therapeutic advances in the treatment of lung cancer, as well as current and future research objectives. Roentgenographs from selected patients illustrate the natural history of lung cancer. We present perspectives concerning selection from the growing diagnosti...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Benfield JR,Julliard GJ,Pilch YH,Rigler LG,Selecky P

    更新日期:1975-07-01 00:00:00

  • Peripheral nerves regenerated in familial amyloid polyneuropathy after liver transplantation.

    abstract:BACKGROUND:Liver transplantation holds promise as a treatment for familial amyloid polyneuropathy. OBJECTIVE:To determine whether peripheral nerves regenerate in patients with familial amyloid polyneuropathy after liver transplantation. DESIGN:Case report. SETTING:University hospital in Matsumoto, Japan. PATIENT:A ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Ikeda S,Takei Y,Yanagisawa N,Matsunami H,Hashikura Y,Ikegami T,Kawasaki S

    更新日期:1997-10-15 00:00:00

  • In the clinic. Plantar fasciitis.

    abstract::This issue provides a clinical overview of plantar fasciitis focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. Non-...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审


    authors: Young C

    更新日期:2012-01-03 00:00:00

  • A tuberculostearic acid assay in the diagnosis of sputum smear-negative pulmonary tuberculosis. A prospective study of bronchoscopic aspirate and lavage specimens.

    abstract:OBJECTIVE:To determine whether the detection of tuberculostearic acid (TBSA) in bronchial aspirate and bronchoalveolar lavage specimens is useful for the rapid diagnosis of active pulmonary tuberculosis in patients suspected of having the disease. SETTING:A pulmonary clinic in a teaching hospital. PATIENTS:Forty pati...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Pang JA,Chan HS,Chan CY,Cheung SW,French GL

    更新日期:1989-10-15 00:00:00

  • Hospital ventilation and risk for tuberculous infection in canadian health care workers. Canadian Collaborative Group in Nosocomial Transmission of TB.

    abstract:BACKGROUND:The risk for and determinants of transmission of tuberculosis in hospitals caring for moderate numbers of patients with tuberculosis remain uncertain. OBJECTIVE:To study the association of tuberculin conversion among health care workers with ventilation of patient care areas. DESIGN:Cross-sectional observa...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章


    authors: Menzies D,Fanning A,Yuan L,FitzGerald JM

    更新日期:2000-11-21 00:00:00

  • Prostate cancer screening: what we know and what we need to know.

    abstract:OBJECTIVE:To critically evaluate the evidence for recommending the screening of asymptomatic men for prostate cancer with a blood test to detect a prostate-specific antigen (PSA). DATA SOURCES:Relevant articles on screening for prostate cancer were identified from MEDLINE searches, from the authors' files, and from th...

    journal_title:Annals of internal medicine

    pub_type: 历史文章,杂志文章


    authors: Kramer BS,Brown ML,Prorok PC,Potosky AL,Gohagan JK

    更新日期:1993-11-01 00:00:00

  • Chemoprevention of breast cancer: a summary of the evidence for the U.S. Preventive Services Task Force.

    abstract:PURPOSE:Chemoprevention offers promise as a strategy for reducing morbidity and mortality from breast cancer in women. This review examined the evidence for the effectiveness of chemoprevention in women without a history of breast cancer. DATA SOURCES:MEDLINE (1966 to December 2001). STUDY SELECTION:English-language,...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审


    authors: Kinsinger LS,Harris R,Woolf SH,Sox HC,Lohr KN

    更新日期:2002-07-02 00:00:00

  • Ultrasonographic screening before hospital discharge for deep venous thrombosis after arthroplasty: the post-arthroplasty screening study. A randomized, controlled trial.

    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


    authors: Robinson KS,Anderson DR,Gross M,Petrie D,Leighton R,Stanish W,Alexander D,Mitchell M,Flemming B,Gent M

    更新日期:1997-09-15 00:00:00