Abstract:
STUDY OBJECTIVE:To determine the usefulness of the continuous intravenous dexamethasone suppression test in the differential diagnosis of patients with the Cushing syndrome. DESIGN:Comparison of the results of this test with those of other tests in the study population and with data from the literature. SETTING:Referral-based endocrine division in a university hospital. PATIENTS:One hundred and twenty-one patients with the Cushing syndrome were evaluated: corticotropin (ACTH)-secreting pituitary tumors, 90 cases; adrenal adenoma, 13; adrenal carcinoma, 9; ectopic ACTH-secreting tumors, 6; corticotropin-releasing-hormone (CRH)-secreting tumors, 2; and autonomous bilateral micronodular adrenal hyperplasia, 1. The continuous intravenous dexamethasone suppression test was done in 101 patients. MEASUREMENTS AND MAIN RESULTS:Dexamethasone (1 mg/h) was administered intravenously for 7 hours. A cortisol decrease of at least 190 nmol/L was defined as a positive response. In identification of patients with ACTH-secreting pituitary adenomas, this test had a sensitivity of 100% (95% CI, 95% to 100%), a specificity of 90% (CI, 70% to 99%), and a diagnostic accuracy of 98% (CI, 93% to 100%). Only two patients had false test results. They both had CRH-secreting tumors. Cortisol secretion was also shown to be sensitive for feedback control in other tests, however. CONCLUSION:The continuous intravenous dexamethasone suppression test has better diagnostic accuracy than other tests that are currently used in the differential diagnosis of the Cushing syndrome, and this test is very convenient. The only false test results were found in patients with CRH-secreting tumors.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Biemond P,de Jong FH,Lamberts SWdoi
10.7326/0003-4819-112-10-738subject
Has Abstractpub_date
1990-05-15 00:00:00pages
738-42issue
10eissn
0003-4819issn
1539-3704journal_volume
112pub_type
杂志文章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::Deaths and injuries related to firearms constitute a major public health problem in the United States. In response to firearm violence and other firearm-related injuries and deaths, an interdisciplinary, interprofessional group of leaders of 8 national health professional organizations and the American Bar Association...
journal_title:Annals of internal medicine
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doi:10.7326/M15-0337
更新日期:2015-04-07 00:00:00
abstract::Approximately 3000 people in Bennington, Vermont, 19% of the population, had a diarrheal illness during the first and second weeks of June 1978. Persons affected reported abdominal cramps (86%), diarrhea (82%), malaise (73%), and headache (47%). The mean duration of illness was 4.6 days. The illness was associated wit...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-3-292
更新日期:1982-03-01 00:00:00
abstract:PURPOSE:To integrate information from the various disciplines that contribute to the understanding of the cause and prevention of sudden cardiac death: identification of new approaches from applied clinical epidemiology; identification and control of transient risk factors; and evaluation of the results of intervention...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-12-199312150-00006
更新日期:1993-12-15 00:00:00
abstract::Four hundred sixty patients and staff from 15 U.S. dialysis centers were surveyed by the immune adherence hemagglutination technique for antibody to hepatitis A antigen (anti-HA). The age-standardized anti-HA prevalence was 42.9% in patients and 42.1% in staff. These rates are almost identical to those of socioeconomi...
journal_title:Annals of internal medicine
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abstract::Research on assessing or managing medication adherence applies approaches from observational, interventional, and implementation science that spans many disciplines and demands coherent conceptualization, valid methods, appropriate analyses, and complete and accurate reporting. To ensure such reporting, the European S...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章
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更新日期:2018-07-03 00:00:00
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
doi:10.7326/0003-4819-111-8-650
更新日期:1989-10-15 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of housestaff physician reporting as a method for identifying adverse events on a medical service and to compare the physician reporting mechanism with a retrospective record review mechanism. SETTING:Medical service of an urban, university-affiliated teaching hospital. DESIGN:Co...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-119-5-199309010-00004
更新日期:1993-09-01 00:00:00
abstract::The U.S. Food and Drug Administration (FDA) Amendments Act of 2007 mandated that the FDA develop a system for using automated health care data to identify risks of marketed drugs and other medical products. The Observational Medical Outcomes Partnership is a public-private partnership among the FDA, academia, data own...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-9-201011020-00010
更新日期:2010-11-02 00:00:00
abstract::The approximately 1.2 million inmates in U.S. correctional institutions have a high prevalence of communicable diseases, such as human immunodeficiency virus (HIV) infection, tuberculosis, hepatitis B virus infection, and gonorrhea. Before their incarceration, most inmates had limited access to health care, which, tog...
journal_title:Annals of internal medicine
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doi:10.7326/0003-4819-118-2-199301150-00010
更新日期:1993-01-15 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::A prospective pretreatment staging evaluation was done on 49 consecutive patients with mycosis fungoides or the Sézary syndrome to study patterns of disease spread and prognostic factors. Routine staging procedures included complete blood count, blood chemistries, chest roentgenogram, lymphangiogram, radionuclide scan...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-2-223
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND:Dietary and lifestyle modification efforts are the primary treatments for people who are obese or overweight. The effect of dietary counseling on long-term weight change is unclear. PURPOSE:To perform a meta-analysis of the effect of dietary counseling compared with usual care on body mass index (BMI) over ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-147-1-200707030-00007
更新日期:2007-07-03 00:00:00
abstract:BACKGROUND:The established International Prognostic Index for lymphomas has not included patients with systemic AIDS-related non-Hodgkin lymphoma. OBJECTIVE:To establish the most appropriate prognostic index for use in patients with systemic AIDS-related non-Hodgkin lymphoma. DESIGN:A prospective study involving univ...
journal_title:Annals of internal medicine
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更新日期:2005-08-16 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
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更新日期:1998-09-15 00:00:00
abstract:STUDY OBJECTIVE:To determine the effect of a nurse-managed intervention for smoking cessation in patients who have had a myocardial infarction. DESIGN:Randomized, with a 6-month treatment period and a 6-month follow-up. SETTING:Kaiser Foundation hospitals in Redwood City, Santa Clara, Hayward, and San Jose, Californi...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-113-2-118
更新日期:1990-07-15 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
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更新日期:2020-11-03 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-124-9-199605010-00005
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Telaprevir (TVR) plus peginterferon-α2a (PEG-IFN-α2a) and ribavirin substantially increases treatment efficacy for genotype 1 chronic hepatitis C virus (HCV) infection versus PEG-IFN-α2a-ribavirin alone. Its safety and efficacy in patients with HCV and HIV-1 are unknown. OBJECTIVE:To assess the safety and e...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-07-16 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-141-5-200409070-00101
更新日期:2004-09-07 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-10-199311150-00010
更新日期:1993-11-15 00:00:00
abstract:BACKGROUND:Few recent data are available on risk factors for perioperative supraventricular arrhythmia (SVA) after noncardiac surgery or on the effect of SVA on clinical outcomes. OBJECTIVE:To determine the incidence, clinical correlates, and effect on length of stay of perioperative SVA in patients having major nonca...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-129-4-199808150-00003
更新日期:1998-08-15 00:00:00
abstract::Sudden cardiac death remains a leading cause of death in the United States, accounting for more than 350,000 deaths each year, and the survival rate of victims remains low. Most survivors face a significant risk for recurrence. The typical substrate is chronic--abnormal myocardium with fibrosis (often from previous my...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-114-6-499
更新日期:1991-03-15 00:00:00
abstract:STUDY OBJECTIVE:To define the clinical and hematologic effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on patients with chronic severe neutropenia. DESIGN:Open-label, phase II study of rhGM-CSF. SETTING:Inpatient hematology and surgery clinic at a university medical center. P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-11-887
更新日期:1989-12-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-5-689
更新日期:1985-11-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-5-641
更新日期:1980-05-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M18-0425
更新日期:2019-05-07 00:00:00
abstract::9-(1,3-dihydroxy-2-propoxymethyl) guanine (ganciclovir) was used to treat 41 patients (median age, 37 years) with the acquired immunodeficiency syndrome and cytomegalovirus gastrointestinal infection. Sites of infection were the colon in 31, the esophagus in 5, the rectum in 4, and the small bowel in 1. Patients recei...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-2-133
更新日期:1987-08-01 00:00:00
abstract::Sixty-eight patients clinically suspected of having (33), or at high risk for (35), deep venous thrombosis were studied with contrast venography, radiofibrinogen leg scanning, and impedance plethysmography as well as ventilation and perfusion lung scans. Thrombosis limited to the veins in the calf of the leg (unilater...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-4-439
更新日期:1981-04-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, cause, and characteristics of pleural effusions in hospitalized patients with the acquired immunodeficiency syndrome (AIDS). DESIGN:Retrospective. PARTICIPANTS:A total of 222 patients with AIDS hospitalized between January 1986 and January 1992 at the Medical University of South ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-118-11-199306010-00005
更新日期:1993-06-01 00:00:00