Abstract:
:The content, role, and purpose of internal medicine, organized as an American specialty 100 years ago, have been marked by ambivalence from the beginning. Nevertheless, molded to a large extent by external events, including the strategic and symbolic importance of surgery in American medicine, the rise of university medical schools, development of other specialties, and, more recently, the demand for primary care and the incentives built into reimbursement schemes and organized health care systems, internal medicine has become a powerful entity in American medicine. Its role in the future is likely to be more influential than in the past, both in policy and substantive areas. Continuing tensions in internal medicine include uncertainties about the relation between generalism and specialism, primary care and subspecialties, and internal medicine and general medicine.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Stevens Rdoi
10.7326/0003-4819-105-4-592subject
Has Abstractpub_date
1986-10-01 00:00:00pages
592-602issue
4eissn
0003-4819issn
1539-3704journal_volume
105pub_type
历史文章,杂志文章abstract:OBJECTIVE:To describe the effects of human immunodeficiency virus (HIV) infection on the serologic manifestations and response to treatment of syphilis in intravenous drug users. DESIGN:Cohort study of intravenous drug users. SETTING:Medical clinic in a hospital-based methadone maintenance treatment program in New Yo...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-118-5-199303010-00005
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Studies suggest that vitamin D supplementation may reduce cancer and fracture risks. PURPOSE:To examine the benefits and harms of vitamin D with or without calcium supplementation on clinical outcomes of cancer and fractures in adults. DATA SOURCES:English-language studies identified from MEDLINE and the C...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-155-12-201112200-00005
更新日期:2011-12-20 00:00:00
abstract::Intravenous drug users are the second largest risk group for the acquired immunodeficiency syndrome (AIDS) and a bridge to two other groups: children and heterosexual partners. In the absence of effective treatment or vaccines, control of the epidemic among drug users will rely on efforts to reduce needle sharing. How...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-5-755
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:Current magnetic resonance techniques generate high signal from venous blood and show thrombi as filling defects. Magnetic resonance direct thrombus imaging (MRDTI) directly visualizes acute thrombus. OBJECTIVE:To determine the accuracy of MRDTI for diagnosis of acute symptomatic deep venous thrombosis (DVT...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-136-2-200201150-00006
更新日期:2002-01-15 00:00:00
abstract::Asthma is characterized by inflammation, reversible airway obstruction, and increased airway responsiveness to various stimuli. It has received wide public attention in recent years because of increasing morbidity and deaths, particularly among black persons. The important role of inflammation in the immunopathogenesi...
journal_title:Annals of internal medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.7326/0003-4819-121-9-199411010-00011
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:Optimal management of patients who are clinically suspected of having ventilator-associated pneumonia remains open to debate. OBJECTIVE:To evaluate the effect on clinical outcome and antibiotic use of two strategies to diagnose ventilator-associated pneumonia and select initial treatment for this condition....
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-132-8-200004180-00004
更新日期:2000-04-18 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
pub_type: 杂志文章
doi:10.7326/M15-0337
更新日期:2015-04-07 00:00:00
abstract:Background:Biosimilars are of growing clinical, regulatory, and commercial importance. Purpose:To summarize evidence about the bioequivalence between biosimilar and reference tumor necrosis factor-α (TNF-α) inhibitors. Data Sources:PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and LILACS from incept...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-0428
更新日期:2016-10-18 00:00:00
abstract::Two cases of patients having calcification within the sella turcica (pituitary stones) have been studied and followed up, one patient for 18 years. A detailed analysis of the radiographic findings and endocrinologic profiles of these two patients is presented. The rarity of bona fide pituitary stones and their benign ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-1-66
更新日期:1975-07-01 00:00:00
abstract::Breast cancer is the major cancer killer of women in the United States. Recent advances in therapy promise more effective control of this illness. The development of hormone receptor analysis permits us to better understand the mechanisms of action of steroid and peptide hormones and increases the likelihood of using ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-784
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:OBJECTIVE:To investigate the relation between the quantity of human immunodeficiency virus type 1 (HIV-1) RNA in plasma and the risk for the acquired immunodeficiency syndrome (AIDS) or a decline in the CD4+ T-cell count after seroconversion. DESIGN:Prospective study. PATIENTS:62 homosexual men with documented HIV-1 ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-122-8-199504150-00003
更新日期:1995-04-15 00:00:00
abstract::Thirty-nine cases of Legionnaires' disease in a 16-month period were identified in visitors to and residents of Bloomington, Indiana. Thirty-five patients had spent at least one night at the Indiana Memorial Union in the 2 weeks before becoming ill. Five of 32 sporadic cases nationwide between 1 January and 31 March 1...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-4-587
更新日期:1979-04-01 00:00:00
abstract::Hyperamylasemia, which has been reported in patients with the eating disorders anorexia nervosa and bulimia, generally has been thought to result from pancreatitis. To evaluate the mechanisms of hyperamylasemia, we measured amylase, lipase, and isoamylase activity in 17 consecutive patients admitted to the eating diso...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-106-1-50
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Lack of confidence in postpolypectomy surveillance guidelines may be a factor in the observed low adherence rates among providers. OBJECTIVE:To assess the 2006 postpolypectomy colonoscopy surveillance guidelines, which recommend 3-year follow-up colonoscopy for individuals with high-risk adenomas (defined a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-148-6-200803180-00004
更新日期:2008-03-18 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:BACKGROUND:Despite extensive literature, the diagnostic role of d-dimer for deep venous thrombosis (DVT) or pulmonary embolism (PE) remains unclear, reflecting multiple d-dimer assays and concerns about differing sensitivities and variability. PURPOSE:To systematically review trials that assessed sensitivity, specific...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-140-8-200404200-00005
更新日期:2004-04-20 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:Background:Triplex vaccine was developed to enhance cytomegalovirus (CMV)-specific T cells and prevent CMV reactivation early after hematopoietic stem cell transplant (HCT). Objective:To determine the safety and efficacy of Triplex. Design:First-in-patient, phase 2 trial. (ClinicalTrials.gov: NCT02506933). Setting:3...
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/M19-2511
更新日期:2020-03-03 00:00:00
abstract:BACKGROUND:Valid measurement of physician performance requires accurate identification of patients for whom a physician is responsible. Among all patients seen by a physician, some will be more strongly connected to their physician than others, but the effect of connectedness on measures of physician performance is not...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-150-5-200903030-00008
更新日期:2009-03-03 00:00:00
abstract:BACKGROUND:In previous open-label noncomparative clinical trials, both fluconazole and itraconazole were effective therapy for progressive forms of coccidioidomycosis. OBJECTIVE:To determine whether fluconazole or itraconazole is superior for treatment of nonmeningeal progressive coccidioidal infections. DESIGN:Rando...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-133-9-200011070-00009
更新日期:2000-11-07 00:00:00
abstract::Abdominal aortic aneurysms (AAAs) occur in 1 of 20 older men, remain asymptomatic for many years, and, if left untreated, cause death from rupture in about one third of patients. Ultrasonography is a suitable screening test for AAA, and elective repair can prevent rupture. Although these features suggest a promising t...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-139-6-200309160-00016
更新日期:2003-09-16 00:00:00
abstract:BACKGROUND:Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial I...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-145-8-200610170-00007
更新日期:2006-10-17 00:00:00
abstract:Background:As cardiovascular risk increases in China, interest in strategies to mitigate it is growing. However, national information about the prevalence and treatment of high cardiovascular disease (CVD) risk is limited. Objective:To assess the prevalence and treatment of high CVD risk as well as variations in risk ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M18-1932
更新日期:2019-03-05 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::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:BACKGROUND:Questions remain about the importance of smoking and smoking cessation after incident myocardial infarction. OBJECTIVE:To assess the association between smoking status and risk for recurrent coronary events. DESIGN:Retrospective, population-based, inception cohort study. SETTING:Health maintenance organiz...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-137-6-200209170-00009
更新日期:2002-09-17 00:00:00
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
doi:10.7326/0003-4819-146-9-200705010-00004
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Because only limited evidence suggests that elastic stockings prevent the post-thrombotic syndrome in patients with symptomatic deep venous thrombosis (DVT), these stockings are not widely used. OBJECTIVE:To evaluate the efficacy of compression elastic stockings for prevention of the post-thrombotic syndrom...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-141-4-200408170-00004
更新日期:2004-08-17 00:00:00
abstract:PURPOSE:To review the current knowledge about breast cancer in black women--including epidemiology, risk factors, screening practices, pathology, clinical manifestations, treatment, and outcome--with emphasis on issues that might explain why the survival rate in this population of women is lower than that in white wome...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-124-10-199605150-00007
更新日期:1996-05-15 00:00:00