Abstract:
PURPOSE:To evaluate the use of thyroid function tests to monitor therapy in patients taking levothyroxine. DATA IDENTIFICATION:Studies published between 1966 and January 1990 were identified through computer searches and references of identified studies. STUDY SELECTION:Studies that included a careful description of the patients under study, well-defined interventions, and a meaningful criterion standard were emphasized. DATA EXTRACTION:Data from different studies were combined to estimate the probability of positive and negative test results in well-defined clinical situations. Informal methods of synthesizing evidence were used when combining data from different studies was not justified. RESULTS:The sensitive thyrotropin (TSH) test is the preferred method to monitor therapy because it agrees with physiologic measures of thyroid hormone effect. Among clinically euthyroid patients who take 100 to 150 micrograms/d of levothyroxine, the probability that the sensitive thyrotropin will be undetectable is close to 50%. These patients are most likely to benefit from testing. Patients who take over 250 micrograms/d are almost certain to have undetectable sensitive thyrotropin levels; in these patients, the dose may be lowered without testing. CONCLUSIONS:Adequate long-term studies are needed to determine the role of biochemical testing in monitoring therapy. Current evidence suggests that the sensitive thyrotropin test should be used to monitor therapy. Clinically euthyroid patients taking lower dosages of levothyroxine are most likely to benefit from testing.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Helfand M,Crapo LMdoi
10.7326/0003-4819-113-6-450subject
Has Abstractpub_date
1990-09-15 00:00:00pages
450-4issue
6eissn
0003-4819issn
1539-3704journal_volume
113pub_type
杂志文章,meta分析abstract::Acute severe aortic regurgitation is a relatively unfamiliar, though life-threatening, disease. We review its diverse causes, anatomic faults, and hemodynamic sequelae and set the stage for an understanding of the clinical manifestations in light of their physiologic mechanisms. Clinical information includes the natur...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-87-2-223
更新日期:1977-08-01 00:00:00
abstract::Antibody to native DNA was measured by five techniques: the Crithidia luciliae immunofluorescence (CL-IF) test; filter radioimmunoassays using either untreated human KB DNA, endonuclease-treated KB DNA, or a synthetic polynucleotide (poly dAT); and the Farr immunoprecipitation assay using KB DNA. The specificity and s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-2-186
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:To identify and describe patients with hepatotoxicity possibly caused by flutamide, an antiandrogen drug. DESIGN:Case series of reports, submitted to the Adverse Drug Event Reporting System of the Food and Drug Administration. SETTING:Outpatient clinics and physicians' offices in the United States. PATIENT...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-118-11-199306010-00006
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:To reassess the natural history of polycythemia vera and to obtain reliable estimates of both incidence of thrombosis and survival for use in defining the sample size for therapeutic clinical trials. STUDY DESIGN:Retrospective cohort study of patients with polycythemia who had been followed for 20 years. SE...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-9-199511010-00003
更新日期:1995-11-01 00:00:00
abstract::Sera of 24 patients with an unexplained pneumonia were tested for the presence of antibodies against the Legionnaires' disease bacterium. Fifteen patients had positive serology. The series comprised 12 male and three female patients ranging in age from 17 to 66 years (mean, 51.1 years). All of the patients had a high ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-4-529
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:To determine the effect of a resistance-training program on walking endurance in a healthy, community-dwelling elderly population. DESIGN:12- week randomized, controlled trial comparing a resistance- training group with a nonexercising control group. SETTING:Hospital-affiliated outpatient exercise facility....
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-124-6-199603150-00005
更新日期:1996-03-15 00:00:00
abstract::Twenty-three patients with hyperparathyroidism from six families with the multiple endocrine adenomatosis (MEA) I-syndrome were tested by secretin provocation. In nine cases this led to increases in serum gastrin ranging from 298 to 13 300 pg/ml, whereas the maximum rise in gastrin in the other 14 patients was 32 pg/m...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-719
更新日期:1977-06-01 00:00:00
abstract::Brain death has been discussed extensively for the last 25 years. Most investigators now believe that requiring death of the entire brain as the criterion for brain death in the Uniform Determination of Death Act and the standard clinical tests of brain death outlined in the Report of the Medical Consultants to the Pr...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-6-199309150-00013
更新日期:1993-09-15 00:00:00
abstract:BACKGROUND:Timing of initiation of screening for breast cancer is controversial in the United States. OBJECTIVE:To determine the threshold relative risk (RR) at which the harm-benefit ratio of screening women aged 40 to 49 years equals that of biennial screening for women aged 50 to 74 years. DESIGN:Comparative model...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-156-9-201205010-00002
更新日期:2012-05-01 00:00:00
abstract::This paper describes the role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Inability to compress the common femoral or popliteal vein is usually diagnostic of a first episode of deep venous thrombosis in symptomatic patients (positive predictive value of about ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-129-12-199812150-00009
更新日期:1998-12-15 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::A 20-year follow-up evaluation of young men with fixed and reproducible orthostatic proteinuria showed no evidence of progressive renal disease. Follow-up information was obtained on 43 of the original 64 patients and detailed information was secured on 36. All had normal renal function and only six patients continued...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-4-516
更新日期:1982-10-01 00:00:00
abstract::Doxorubicin (Adriamycin) was administered by continuous infusion to reduce peak plasma levels and thus lessen cardiac toxicity. Cardiotoxicity was monitored by noninvasive methods, and endomyocardial biopsy specimens were studied by electronmicroscopy. Cardiotoxicity was compared in 21 patients receiving doxorubicin i...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-2-133
更新日期:1982-02-01 00:00:00
abstract::During the National Cooperative Gallstone Study, therapy with chenodiol, 750 or 375 mg/d, for 2 years resulted in confirmed, complete gallstone dissolution in 14% and 5% of patients, respectively, and partial dissolution (greater than 50%) in 27% and 18%. The present study was done to determine the frequency with whic...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-100-3-382
更新日期:1984-03-01 00:00:00
abstract:PURPOSE:To assess the data that support the use of coronary angiography and angioplasty after acute myocardial infarction, that identify the risks of these procedures, and that analyze their use and costs. DATA SOURCES:English-language articles published between 1970 and June 1995 identified through a search of the ME...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-126-7-199704010-00007
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To determine whether concurrent treatment with acetaminophen and zidovudine impairs clearance of zidovudine, thereby increasing the risk for zidovudine-induced hematologic toxicity. DESIGN:Dose escalation, drug interaction study. SETTING:University clinical research center. PATIENTS:Patients with the acqui...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-114-11-937
更新日期:1991-06-01 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:Background:Zika virus has spread rapidly in the Americas and has been imported into many nonendemic countries by travelers. Objective:To describe clinical manifestations and epidemiology of Zika virus disease in travelers exposed in the Americas. Design:Descriptive, using GeoSentinel records. Setting:63 travel and t...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M16-1842
更新日期:2017-01-17 00:00:00
abstract:BACKGROUND:Although the efficacy of adjuvant chemotherapy in prolonging survival for women with breast cancer has been well documented, limited population-based information is available on the actual use of chemotherapy. OBJECTIVE:To examine the relationship between age and chemotherapy use. DESIGN:Cohort study. SET...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-2-200301210-00009
更新日期:2003-01-21 00:00:00
abstract::Adult salicylate intoxication has been considered to be easily recognized and assciated with low morbidity and mortality. In the present study of 73 consecutive adults hospitalized with salicylate intoxication, 27% of patients were undiagnosed for as long as 72 h after admission. The initial physical findings and labo...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-6-745
更新日期:1976-12-01 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::Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of popu...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-140-1-200401060-00009
更新日期:2004-01-06 00:00:00
abstract:SOURCE CITATION:Ye Z, Rochwerg B, Wang Y, et al. Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline. CMAJ. 2020;192:E536-45. 32350002. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/ACPJ202007210-004
更新日期:2020-07-21 00:00:00
abstract:BACKGROUND:Alleviating the problems faced by dying persons and their families has drawn substantial public attention, but little is known about the experience of dying. OBJECTIVE:To characterize the experience of dying from the perspective of surrogate decision makers, usually close family members (89%). DESIGN:Prosp...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-126-2-199701150-00001
更新日期:1997-01-15 00:00:00
abstract::This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for family and intimate partner violence, based on the USPSTF's examination of evidence specific to family and intimate partner violence, and updates the 1996 recommendations on this topic. In 1996, the USPSTF found...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章,实务指引
doi:10.7326/0003-4819-140-5-200403020-00014
更新日期:2004-03-02 00:00:00
abstract::An investigation of patient care in four hospitals compared levels of resource use between 1964 and 1974 for patients with a primary diagnosis of pneumonia. Results showed a decreased length of stay in all hospitals. Unique patterns of increases and decreases existed in each hospital for the changing use of diagnostic...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-5-648
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:Screening women for Chlamydia trachomatis in family planning clinics is associated with a reduced incidence of chlamydial sequelae. However, the question of whom to screen to maintain efficient use of resources remains controversial. OBJECTIVE:To assess the cost-effectiveness of chlamydial screening done ac...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-4-199802150-00005
更新日期:1998-02-15 00:00:00
abstract:BACKGROUND:Extended-duration low-molecular-weight heparin has been shown to prevent venous thromboembolism (VTE) in high-risk surgical patients. OBJECTIVE:To evaluate the efficacy and safety of extended-duration enoxaparin thromboprophylaxis in acutely ill medical patients. DESIGN:Randomized, parallel, placebo-contro...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-153-1-201007060-00004
更新日期:2010-07-06 00:00:00
abstract::Transmission of the human immunodeficiency virus (HIV) was studied in a group of patients with cancer who received transfusion of blood components harvested from a single, asymptomatic, seropositive donor. Of ten living recipients, nine had antibodies to the virus in fresh or cryopreserved sera at a median of 384 days...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-105-4-519
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Previous research has supported screening for gonorrhea and chlamydia in asymptomatic, sexually active women (including pregnant women) who are younger than 25 years or at increased risk but not in other patient populations. PURPOSE:To update the 2005 and 2007 systematic reviews for the U.S. Preventive Serv...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M14-1022
更新日期:2014-12-16 00:00:00