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 different subgroups. DATA SOURCES:MEDLINE (January 2002 to November 2011), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the 3rd quarter of 2011), Scopus, and reference lists. STUDY SELECTION:Randomized, placebo-controlled trials of menopausal hormone therapy published in English since 2002 that assessed primary prevention of chronic conditions. DATA EXTRACTION:Investigators extracted data on participants, study design, analysis, follow-up, and results; 2 investigators independently rated study quality by using established criteria. DATA SYNTHESIS:9 fair-quality trials met the inclusion criteria. The Women's Health Initiative reported most of the results, had 11 years of follow-up, and had data most applicable to postmenopausal women in the United States. It showed that estrogen plus progestin therapy reduced fractures (46 fewer per 10 000 woman-years) and increased invasive breast cancer (8 more per 10 000 woman-years), stroke (9 more per 10 000 woman-years), deep venous thrombosis (12 more per 10 000 woman-years), pulmonary embolism (9 more per 10 000 woman-years), lung cancer death (5 more per 10 000 woman-years), gallbladder disease (20 more per 10 000 woman-years), dementia (22 more per 10 000 woman-years), and urinary incontinence (872 more per 10 000 woman-years). Estrogen-only therapy reduced fractures (56 fewer per 10 000 woman-years), invasive breast cancer (8 fewer per 10 000 woman-years), and death (2 fewer per 10 000 woman-years) and increased stroke (11 more per 10 000 woman-years), deep venous thrombosis (7 more per 10 000 woman-years), gallbladder disease (33 more per 10 000 woman-years), and urinary incontinence (1271 more per 10 000 woman-years). Outcomes did not consistently differ by age or comorbid conditions. LIMITATION:Limitations of the trials included low adherence, high attrition, inadequate power to detect risks for some outcomes, and evaluation of few regimens. CONCLUSION:Estrogen plus progestin and estrogen alone decreased risk for fractures but increased risk for stroke, thromboembolic events, gallbladder disease, and urinary incontinence. Estrogen plus progestin increased risk for breast cancer and probable dementia, whereas estrogen alone decreased risk for breast cancer. PRIMARY FUNDING SOURCE:Agency for Healthcare Research and Quality.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Nelson HD,Walker M,Zakher B,Mitchell Jdoi
10.7326/0003-4819-157-2-201207170-00466subject
Has Abstractpub_date
2012-07-17 00:00:00pages
104-13issue
2eissn
0003-4819issn
1539-3704pii
1216773journal_volume
157pub_type
杂志文章,评审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
abstract:OBJECTIVE:To determine whether a cytogenetic response after interferon-alpha therapy in patients with chronic myelogenous leukemia is independently associated with improved survival. DESIGN:Retrospective analysis. PATIENTS:274 patients with a diagnosis of Philadelphia chromosome-positive chronic myelogenous leukemia ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-122-4-199502150-00003
更新日期:1995-02-15 00:00:00
abstract:Background:Frailty assessment may inform surgical risk and prognosis not captured by conventional surgical risk scores. Purpose:To evaluate the evidence for various frailty instruments used to predict mortality, functional status, or major adverse cardiovascular and cerebrovascular events (MACCEs) in older adults unde...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-0652
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Screening programs using conventional cytology have successfully reduced cervical cancer, but newer tests might enhance screening. PURPOSE:To systematically review the evidence on liquid-based cytology (LBC) and high-risk human papillomavirus (HPV) screening for U.S. Preventive Services Task Force use in up...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-10-201111150-00376
更新日期:2011-11-15 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::Relapsing polychondritis, an uncommon, chronic, multisystem disorder characterized by recurrent episodes of inflammation of cartilaginous tissues, can be life-threatening, debilitating, and difficult to diagnose. This review is based on the authors' experience with 36 patients with relapsing polychondritis who were fo...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-129-2-199807150-00011
更新日期:1998-07-15 00:00:00
abstract:BACKGROUND:Although clinicians avoid giving meropenem to patients with penicillin allergy because of potential cross-reactivity, the rate of cross-reactivity between penicillins and meropenem has not been prospectively determined. OBJECTIVE:To assess the tolerability of meropenem in patients with documented penicillin...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-146-4-200702200-00005
更新日期:2007-02-20 00:00:00
abstract::Important historical changes have occurred both in the content of the periodic health examination and in the legitimacy with which this examination has been viewed. These changes reflect fundamental shifts in the objectives of the examination and in the concerns of its advocates, the most prominent of whom have been p...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
doi:10.7326/0003-4819-127-10-199711150-00010
更新日期:1997-11-15 00:00:00
abstract:BACKGROUND:Early prenatal care is vital for improving maternal health outcomes and health behaviors, but medically vulnerable and underserved populations are less likely to begin prenatal care in the first trimester. In 2017, the Health Center Program provided safety-net care to more than 27 million persons, including ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M19-3248
更新日期:2020-12-01 00:00:00
abstract::Several trends in medical education affect our supply of future physicians. The number of new physicians has increased so that each year there is an excess of about 6000 over the number of physicians produced per year a decade ago. Increasing numbers of women and members of minority groups are entering the profession ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-5-806
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND:Growing evidence indicates that peripheral neuropathy (PN) is common even in the absence of diabetes. However, the clinical sequelae of PN have not been quantified in the general population. OBJECTIVE:To assess the associations of PN with all-cause and cardiovascular mortality in the general adult populatio...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-1340
更新日期:2020-12-08 00:00:00
abstract::As the third decade since AIDS was first recognized comes to an end, extraordinary advances have occurred in the understanding, treatment, and prevention of HIV infection and AIDS. As a result of these successes, it is now time to focus on future challenges. Paramount among these is reaching the goal of truly controll...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-154-11-201106070-00345
更新日期:2011-06-07 00:00:00
abstract:STUDY OBJECTIVE:To determine the relative importance of adiposity and fat distribution to cardiovascular risk profile. DESIGN:A cross-sectional study. SETTING:Clinical research center funded by the National Institutes of Health. PATIENTS:Convenience sample of 33 healthy premenopausal women with a wide range of body ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-11-867
更新日期:1989-06-01 00:00:00
abstract::Impairment of penicillin G excretion in renal failure may result in life-threatening, dose-related toxicity. We report a method for achieving a desired mean serum penicillin G concentration in patients with renal failure, with minimal risk of both undertreatment and drug toxicity. The method is based on the linear rel...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-2-189
更新日期:1975-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effect of massive cocaine intoxication on lung water and ascites accumulation and the effect of beta- and alpha-adrenergic blockade on survival in massive cocaine intoxication in the mouse. DESIGN:The effect of massive cocaine intoxication on lung water, ascitic fluid accumulation, and...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-3-202
更新日期:1989-02-01 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:PURPOSE:To review prospective epidemiologic studies and randomized trials regarding the role of antioxidant vitamins (vitamins E and C and beta-carotene) in the prevention of cardiovascular disease, with emphasis on differences in results obtained by these two types of studies. DATA SOURCES:Computerized and manual sea...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-123-11-199512010-00009
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To determine the rate of use of prophylaxis for venous thromboembolism in high-risk hospital patients. DESIGN:A retrospective medical record review. SETTING:A community-wide study in 16 short-stay hospitals in central Massachusetts. PATIENTS:A total of 2017 patients with multiple risk factors for venous th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-591
更新日期:1991-10-15 00:00:00
abstract:BACKGROUND:An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE:To identify risk factors for transmission...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-1-199707010-00006
更新日期:1997-07-01 00:00:00
abstract::The 1950s witnessed prodigious growth in our knowledge of the chemical nature of the gene, the mechanisms by which the information inherent in its sequence of nucleotide units was conveyed to the cell's machinery for synthesizing proteins, and the mode of operation of that machinery. Watson and Crick raised the curtai...
journal_title:Annals of internal medicine
pub_type: 评论,历史文章,杂志文章
doi:10.7326/0003-4819-138-7-200304010-00016
更新日期:2003-04-01 00:00:00
abstract::To determine the relative sensitivity and specificity of noninvasive methods for detecting aortic insufficiency, we compared the accuracy of auscultation, echocardiography, and pulsed Doppler echocardiography in detecting aortic insufficiency in 106 patients in whom the presence or absence of the lesion was shown by s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-5-599
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:To measure changes in spinal and femoral neck bone mineral densities in patients treated for Graves thyrotoxicosis. DESIGN:Cohort study. SETTING:Tertiary care center. PATIENTS:Fifteen women with active Graves thyrotoxicosis. Six patients were premenopausal and nine were postmenopausal. All patients had evi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-1-199401010-00002
更新日期:1994-01-01 00:00:00
abstract::Rapid growth in the use and complexity of Holter monitoring technologies has resulted in the diverse recorders and analysis devices that are compared in this review. Holter recording modes include continuous recording, which makes all electrocardiographic (ECG) data available for analysis; patient-activated recording,...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-102-1-73
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:No effective oral therapy exists for early coronavirus disease 2019 (COVID-19). OBJECTIVE:To investigate whether hydroxychloroquine could reduce COVID-19 severity in adult outpatients. DESIGN:Randomized, double-blind, placebo-controlled trial conducted from 22 March through 20 May 2020. (ClinicalTrials.gov...
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/M20-4207
更新日期:2020-10-20 00:00:00
abstract:BACKGROUND:The paucity of public health messages that directly address communities of color might contribute to racial and ethnic disparities in knowledge and behavior related to coronavirus disease 2019 (COVID-19). OBJECTIVE:To determine whether physician-delivered prevention messages affect knowledge and information...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-6141
更新日期:2020-12-21 00:00:00
abstract:OBJECTIVE:To develop criteria for interpreting results of the metyrapone test for the differential diagnosis of the adrenocorticotropin (ACTH)-dependent Cushing syndrome and to compare its diagnostic accuracy with that of the high-dose dexamethasone suppression test. DESIGN:Retrospective cohort study. SETTING:Inpatie...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-121-5-199409010-00002
更新日期:1994-09-01 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::Considerable evidence links elevated blood cholesterol levels to the development of atherosclerosis. The National Cholesterol Education Program (NCEP) has recently published revised guidelines for detecting and treating hypercholesterolemia in adults. Included in these guidelines is the recommendation that all adults ...
journal_title:Annals of internal medicine
pub_type: 评论,杂志文章,评审
doi:10.7326/0003-4819-124-5-199603010-00008
更新日期:1996-03-01 00:00:00
abstract::The training of physicians for the delivery of primary care is becoming a national priority. The period of residency training is viewed by many as the focal point for educational change to meet this demand. The Residency Program in Social Medicine at Montefiore Hospital and Medical Center was begun in 1970 and offers ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-3-359
更新日期:1977-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of the addition of ifosfamide to cisplatin plus etoposide (VIP), or vinblastine (VeIP), in patients with recurrent germ cell tumors. DESIGN:Nonrandomized, prospective phase II trial. SETTING:Tertiary referral university hospital. PATIENTS:Fifty-six of fifty-eight entered pat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-7-540
更新日期:1988-10-01 00:00:00