Abstract:
:Of 5379 patients who had received radiation treatment at our institution for benign conditions of the head and neck, 318 developed thyroid cancer 3 to 42 years later. We report follow-up observations (median interval from diagnosis to recurrence or last contact, 10 years; longest interval, 31) for 296 of these patients. Three patients died of thyroid cancer and 40 had recurrences. The rate of recurrence during the 10 years after the detection of thyroid cancer, determined by life-table analysis, was 1.1%/yr. Factors that correlated with the risk of recurrence were tumor size, histologic type, number of lobes involved, vessel invasion, and lymph node metastases. The time from radiation exposure to the discovery of thyroid cancer (latency) and the age at diagnosis both inversely correlated with recurrence. The administration of thyroid hormones reduced the number of recurrences in patients with combined papillary and follicular cancer, but no reductions could be associated with the extent of surgery done or the prophylactic use of radioactive iodine ablation. We conclude that the course of radiation-induced thyroid cancer is the same as that of thyroid cancer found in other settings. We advocate a conservative approach to the treatment of small tumors that have no associated risk for thyroid cancer other than that they developed many years after the patient had been exposed to radiation.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Schneider AB,Recant W,Pinsky SM,Ryo UY,Bekerman C,Shore-Freedman Edoi
10.7326/0003-4819-105-3-405subject
Has Abstractpub_date
1986-09-01 00:00:00pages
405-12issue
3eissn
0003-4819issn
1539-3704journal_volume
105pub_type
杂志文章abstract:STUDY OBJECTIVE:To assess the effects of dopamine, which has an inotropic effect on the myocardium and increases renal and splanchnic blood flow, on diaphragmatic contraction. DESIGN AND PATIENTS:We studied the changes in transdiaphragmatic pressure during electrical bilateral supramaximal stimulation of the phrenic n...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-1-17
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To review the incidence of reversible renal insufficiency in patients with hypertensive nephrosclerosis undergoing antihypertensive therapy. DESIGN:Retrospective analysis of 73 patients in a long-term blood pressure control study that compared the effects of an angiotensin converting enzyme (ACE) inhibitor p...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-115-7-513
更新日期:1991-10-01 00:00:00
abstract::Two patients had recurrent facial edema and peripheral blood eosinophilia. One patient showed a marked increase in the serum level of the eosinophil granule major basic protein. In both patients, skin biopsy samples showed nonspecific mononuclear cell inflammation with few eosinophils. However, immunofluorescence stai...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-4-503
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVE:To determine whether the use of non-potassium-sparing diuretics and beta-blockers is associated with an excess risk for sudden cardiac death in hypertensive patients. DESIGN:Case-control study. SETTING:Rotterdam, the Netherlands. PATIENTS:257 case-patients who had died suddenly while receiving drug therapy...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-7-199510010-00001
更新日期:1995-10-01 00:00:00
abstract::Disseminated candidiasis has become an important infection, particularly in immunocompromised and postoperative patients. Although serologic tests may, in some settings, facilitate a premortem diagnosis, the disease is usually diagnosed by comprehensive clinical evaluation. Detection of the relatively newly recognized...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-89-1-91
更新日期:1978-07-01 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:BACKGROUND:Changes in federal health policy are providing more access to medical care for persons with chronic disease. Providing quality care may require a team approach, which the American College of Physicians calls the "medical home." One new model may involve nurse-managed protocols. PURPOSE:To determine whether ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/M13-2567
更新日期:2014-07-15 00:00:00
abstract::Comprehensive palliative care, as exemplified by many state-of-the-art hospice programs, is the standard of care for the dying. Although palliative care is very effective, physicians, nurses, patients, families, and loved ones regularly face clinically, ethically, legally, and morally challenging decisions throughout ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-6-200003210-00011
更新日期:2000-03-21 00:00:00
abstract:BACKGROUND:Medical students may be at high risk for occupational exposures to blood. OBJECTIVE:To measure the frequency of medical students' exposure to infectious body substances, to identify factors that affect the probability of such exposure, and to suggest targets for the prevention of such exposure. DESIGN:Revi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-1-199901050-00009
更新日期:1999-01-05 00:00:00
abstract::A lack of national health goals has allowed physician manpower policy to be dominated by an expansionist philosophy. Scarce resources have been channeled into the production of specialist physicians trained to provide complex and expensive care for uncommon diseases, using other scare and expensive resources and addin...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-90-2-249
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:To estimate relative risk of mortality and median life expectancy for patients with classic hemophilia by a life-table analysis, taking into account deaths that may have occurred in infancy or childhood before the onset of symptoms. DESIGN:Retrospective chart review of clinical series. SETTING:Referral-base...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
doi:10.7326/0003-4819-114-8-641
更新日期:1991-04-15 00:00:00
abstract::Tax incentives can provide a large financial impetus to change behavior. Current U.S. law establishes a substantial discontinuity in the amount of estate tax that many patients will have to pay in 2010: During this year only, the tax rate drops to zero. This article discusses concerns regarding the sharp change in tax...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-149-11-200812020-00010
更新日期:2008-12-02 00:00:00
abstract:STUDY OBJECTIVE:To determine the clinical variables affecting outcome after balloon aortic valvuloplasty. DESIGN:Longitudinal follow-up of consecutive case series. PATIENTS:Consecutive sample of 36 patients with severe calcific aortic stenosis, and without active infection or left ventricular mural thrombus. INTERVE...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-110-6-421
更新日期:1989-03-15 00:00:00
abstract:PURPOSE:To examine studies of normal colon and colorectal cancer for evidence that the location of the primary tumor proximal or distal to the splenic flexure of the colon may determine distinct genetic categories of this disease. DATA IDENTIFICATION:Studies were identified through a manual search of journals, through...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-113-10-779
更新日期:1990-11-15 00:00:00
abstract:Description:The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update an...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M17-2640
更新日期:2018-03-20 00:00:00
abstract::Amantadine HCl administration has resulted in accelerated resolution of influenza A illness. Prolonged abnormalities in pulmonary function have been described in uncomplicated influenza A. To study the effect of amantadine on these changes, we evaluated young adults with documented natural influenza A with clear chest...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-85-2-177
更新日期:1976-08-01 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::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:BACKGROUND:Preventive therapy is an important element of syphilis control efforts. No currently recommended, single-dose alternatives to penicillin G benzathine are available for treatment of incubating syphilis. OBJECTIVE:To evaluate the use of a single 1.0-g dose of azithromycin for treatment of persons recently exp...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-131-6-199909210-00007
更新日期:1999-09-21 00:00:00
abstract::Hearing loss is highly prevalent and may significantly affect how we age. Although the population is aging, relatively few adults receive treatment for hearing loss. Internists are a critical partner to audiologists and otolaryngologists in caring for the adult population with hearing loss. This review provides a prim...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC202012010
更新日期:2020-12-01 00:00:00
abstract::HemoQuant, an assay based on heme-derived porphyrin, quantifies both total fecal hemoglobin ant that fraction already converted to porphyrin by gut flora (the intestinal converted fraction). Recovery by HemoQuant of blood added to stools exceeded 99% and was not affected by ascorbic acid, iron, or other additives. Hem...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-101-3-297
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Patients with reduced left ventricular function and ventricular enlargement after myocardial infarction are at significantly greater risk for congestive heart failure and death. Nevertheless, recovery of ventricular function occurs in a significant proportion of patients after myocardial infarction, and mode...
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:10.7326/0003-4819-134-6-200103200-00009
更新日期:2001-03-20 00:00:00
abstract::Since 1969, medications have been provided to patients at the Johns Hopkins Hospital using a computer system that controls the entire medication process from entry of physician's order to hourly drug distribution. Special envelopes containing patient and dosage information are computer generated for each dose to be ad...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-3-342
更新日期:1975-09-01 00:00:00
abstract::Three patients with advanced Graves' ophthalmopathy were treated with cyclophosphamide. All had proptosis and diplopia. One patient had disabling iatrogenic Cushing's syndrome from steroid treatment of the ophthalmopathy and had undergone bilateral orbital decompression before cyclophosphamide therapy; steroids could ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-6-921
更新日期:1979-06-01 00:00:00
abstract:BACKGROUND:Benign reductions in neutrophil counts may be more common at certain ages and in certain ethnic groups and may be affected by sex and smoking status. OBJECTIVE:To determine differences in neutrophil counts in the U.S. population according to ethnicity, age, sex, and smoking status. DESIGN:Population-based,...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-146-7-200704030-00004
更新日期:2007-04-03 00:00:00
abstract::A discrete evoking factor or presumed pathophysiologic mechanism is not recognized in the majority of patients with chronic urticaria or angioedema. Two cases are reported in which chronic urticaria was the main manifestation of an immune cutaneous vasculitis associated with hypocomplementemia attributable to classic ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-5-534
更新日期:1977-05-01 00:00:00
abstract::Thirty-five consecutive patients with progressive systemic sclerosis were prospectively evaluated for evidence of Sjögren's syndrome. Six of the 35 (17%) were judged to have the disorder. This is a higher prevalence than in most reports, but much lower than that recently reportedly by Alarcón-Segovia and associates (7...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-5-535
更新日期:1977-11-01 00:00:00
abstract::Cystic fibrosis was diagnosed after age 13 in 25 patients. All had an elevated sweat chloride and either a sibling with cystic fibrosis or typical pulmonary infection or digestive symptoms caused by exocrine pancreatic deficiency. Fourteen had long-standing pulmonary or digestive symptoms. In contrast, four of eight p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-2-188
更新日期:1977-08-01 00:00:00
abstract:UNLABELLED:Chinese translation BACKGROUND:Black persons are more likely than white persons to be diagnosed with colorectal cancer and to die from it. The extent to which genetic or biological factors versus disparities in screening rates explain this variance remains controversial. OBJECTIVE:To define the prevalence ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-159-1-201307020-00004
更新日期:2013-07-02 00:00:00
abstract::Recent data indicate that the lymphadenopathy-associated virus (LAV) is morphologically similar to animal lentiviruses, such as equine infectious anemia and visna viruses. This finding, together with the cross-reactivity of the core proteins of LAV with those of the equine infectious anemia virus and a similarity in g...
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