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 Carolina hospitals. RESULTS:Pleural effusions occurred in 59 patients for an overall incidence of 27%. The mean age of the patients was 35 +/- 2 years (SE) and the male to female ratio was 5:1. The cause was infectious in 39 (66%) patients, noninfectious in 18 (31%), and unknown in 2 (3%). Pleural effusions were caused by bacterial pneumonia in 18 (31%) patients, Pneumocystis carinii pneumonia in 9 (15%), Mycobacterium tuberculosis in 5 (8%), septic embolism in 2 (3%), Nocardia asteroides in 2 (3%), cryptococcus neoformans in 2 (3%), and Mycobacterium arium intracellulare in 1 (2%). Among noninfectious causes (n = 18), hypoalbuminemia was the cause in 11 patients (19%), cardiac failure in 3 (5%), and atelectasis, Kaposi sarcoma, uremic pleurisy, and adult respiratory distress syndrome in 1 (2%) each. Patients with AIDS who had pleural effusions had significantly lower serum albumin levels and had lower CD4 counts than did those without pleural effusions (P < 0.001). CONCLUSIONS:Pleural effusions are common in hospitalized patients with AIDS. Bacterial pneumonia is the most common cause for pleural effusion in AIDS. Large effusions are associated with Kaposi sarcoma and tuberculosis. Hypoalbuminemia is a common cause of noninfectious pleural effusions.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Joseph J,Strange C,Sahn SAdoi
10.7326/0003-4819-118-11-199306010-00005subject
Has Abstractpub_date
1993-06-01 00:00:00pages
856-9issue
11eissn
0003-4819issn
1539-3704journal_volume
118pub_type
杂志文章abstract:BACKGROUND:Neurologic complications of endocarditis can influence diagnosis, therapeutic plans, and prognosis. OBJECTIVE:To describe how early cerebral magnetic resonance imaging (MRI) affects the diagnosis and management of endocarditis in hospitalized adults. DESIGN:Single-center prospective study between June 2005...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-152-8-201004200-00006
更新日期:2010-04-20 00:00:00
abstract::Elevated serum digoxin concentrations and clinical toxicity have been reported in patients receiving quinidine. The present study was undertaken to ascertain whether a similar interaction occurs between quinidine and another cardiac glycoside, digitoxin, and if so to evaluate the pharmacokinetic basis in five healthy ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-1-35
更新日期:1981-01-01 00:00:00
abstract::Concierge medical practices, which advertise expanded access to care and individualized attention, collect charges both from insurance companies and directly from their patients. Some bill hundreds of dollars for one-time "executive" physicals, whereas others have patients pay annual retainer fees. Yet, virtually no d...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-152-6-201003160-00009
更新日期:2010-03-16 00:00:00
abstract:BACKGROUND:An effective national biosurveillance system expedites outbreak recognition and facilitates response coordination at the federal, state, and local levels. The BioSense system, used at the Centers for Disease Control and Prevention, incorporates chief complaints but not data from the whole encounter note into...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-156-1-201201030-00003
更新日期:2012-01-03 00:00:00
abstract:DESCRIPTION:Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on counseling and interventions to prevent tobacco use and tobacco-related disease in adults, including pregnant women. METHODS:The USPSTF reviewed the evidence on interventions for tobacco smoking cessation that are relevant to...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M15-2023
更新日期:2015-10-20 00:00:00
abstract::The mechanisms of flushing reactions are pharmacologically and physiologically heterogeneous. Flushing may result from agents acting directly on the vascular smooth muscle or may be mediated by vasomotor nerves. Vasomotor nerves may lead to flushing as a result of events at both peripheral and central sites. In suscep...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-95-4-468
更新日期:1981-10-01 00:00:00
abstract::Implantable cardioverter defibrillators are life-saving devices for many patients with cardiac disease. Recipients of these devices, nevertheless, often suffer from progressive comorbid and cardiac conditions. Therefore, physicians should anticipate situations in which the defibrillator is no longer desired by the pat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-142-8-200504190-00012
更新日期:2005-04-19 00:00:00
abstract::We evaluated the usefulness of computed tomography (CT) brain scanning in alcoholic patients with withdrawal seizures (n = 151) and other neurologic problems (n = 87) and compared the findings of a detailed neurologic examination to the results of CT scanning. In patients with seizures, nearly 50% of CT scans were nor...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-4-519
更新日期:1981-04-01 00:00:00
abstract::The exocrine pancreas secretes into the gut on demand more than 20 proteins that are indispensable for digestion. In-vivo autodigestion is prevented by an array of natural safeguards. In acute pancreatitis, inappropriate intrapancreatic activation and release of pancreatic hydrolases occur, but the pathogenetic mechan...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-103-1-86
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Pharmacologic thromboprophylaxis reduces the risk for venous thromboembolism after total hip replacement (THR) or total knee replacement (TKR). New oral anticoagulants (NOACs), including direct thrombin inhibitors and factor Xa inhibitors, are emerging options for thromboprophylaxis after these procedures. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-159-4-201308200-00008
更新日期:2013-08-20 00:00:00
abstract::Previous epidemiologic studies of staphylococcal infections in newborn infants and surgical patients provide clues to the method of infection in toxic shock syndrome. In newborn infants, staphylococci were shown to be transmitted most often by the hands of nursery personnel to the umbilical stump, which afforded a war...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-6-934
更新日期:1982-06-01 00:00:00
abstract:BACKGROUND:Hyperuricemia is associated with risk for cardiovascular disease and death. However, the role of uric acid independent of established risk factors is uncertain. OBJECTIVE:To examine the relation of serum uric acid level to incident coronary heart disease, death from cardiovascular disease, and death from al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-131-1-199907060-00003
更新日期:1999-07-06 00:00:00
abstract::To re-evaluate the relationship between Crohn's disease and sarcoidosis, we compared the numbers and types of cells recovered by bronchoalveolar lavage from normal volunteers and patients with Crohn's disease, with other forms of inflammatory bowel disease, and with sarcoidosis. Patients with Crohn's disease, but not ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-1-17
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) is avoided in most patients with implanted cardiac devices because of safety concerns. OBJECTIVE:To define the safety of a protocol for MRI at the commonly used magnetic strength of 1.5 T in patients with implanted cardiac devices. DESIGN:Prospective nonrandomized trial. (C...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-155-7-201110040-00004
更新日期:2011-10-04 00:00:00
abstract:OBJECTIVE:To determine whether antimicrobial therapy for Helicobacter pylori infection accelerates the healing of duodenal ulcers. DESIGN:Single-blind, randomized, controlled trial. SETTING:Veterans Affairs hospital. PARTICIPANTS:One hundred and five patients with endoscopically verified duodenal ulcers. INTERVENTI...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-115-4-266
更新日期:1991-08-15 00:00:00
abstract:STUDY OBJECTIVE:To assess the long-term benefit and side effects of danazol therapy, and to delineate factors influencing the responses in patients with autoimmune thrombocytopenia. DESIGN:Before and after trial. SETTING:Referral-based hematology clinics and the University of Miami teaching hospitals. PATIENTS:Data ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-9-723
更新日期:1989-11-01 00:00:00
abstract::Early defibrillation is the most important determinant of survival for victims of cardiac arrest due to ventricular fibrillation. The automated external defibrillator (AED) was developed as the result of the American Heart Association's Public Access Defibrillation initiative. The goal of this initiative is to place A...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-135-11-200112040-00011
更新日期:2001-12-04 00:00:00
abstract:BACKGROUND:With suspected deep venous thrombosis and normal results on proximal vein ultrasonography, a negative d-dimer result may exclude thrombosis and a positive D-dimer result may be an indication for venography. OBJECTIVE:To evaluate and compare the safety of 2 diagnostic strategies for deep venous thrombosis. ...
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:10.7326/0003-4819-142-7-200504050-00007
更新日期:2005-04-05 00:00:00
abstract::Although many manifestations of giant cell arteries are increasingly recognized, little attention has been paid to respiratory symptoms associated with this disorder. We report the cases of 16 patients with giant cell arteritis who had prominent symptoms related to the respiratory tract including cough, sore throat, a...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-101-5-594
更新日期:1984-11-01 00:00:00
abstract::Diabetes mellitus is classified into two major categories: type I, which is insulin dependent, and type II, which is not. Insulin resistance in type II diabetes may be related to impaired receptor binding in some forms of the disorder. In the past, diabetes in pregnant women resulted in high rates of maternal and infa...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-96-5-635
更新日期:1982-05-01 00:00:00
abstract::The Federated Council for Internal Medicine (FCIM) comprises the American Board of Internal Medicine, American College of Physicians, American Society of Internal Medicine, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, and the Society of General Internal Medicine. The Co...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章
doi:10.7326/0003-4819-117-9-778
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Warfarin reduces the risk for ischemic stroke in patients with atrial fibrillation (AF) but increases the risk for hemorrhage. Dabigatran is a fixed-dose, oral direct thrombin inhibitor with similar or reduced rates of ischemic stroke and intracranial hemorrhage in patients with AF compared with those of war...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-154-1-201101040-00289
更新日期:2011-01-04 00:00:00
abstract:BACKGROUND:Many dispensing errors made in hospital pharmacies can harm patients. Some hospitals are investing in bar code technology to reduce these errors, but data about its efficacy are limited. OBJECTIVE:To evaluate whether implementation of bar code technology reduced dispensing errors and potential adverse drug ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-145-6-200609190-00006
更新日期:2006-09-19 00:00:00
abstract:BACKGROUND:Bed alarm systems intended to prevent hospital falls have not been formally evaluated. OBJECTIVE:To investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events. DESIGN:Pair-matched, cluster randomized trial over 18 months. Nursing units were allocated b...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-157-10-201211200-00005
更新日期:2012-11-20 00:00:00
abstract::Under the current system of disability determination and workers' compensation for occupational lung disease, disabled workers or their survivors can reasonably count on being compensated. However, by rejecting established scientific truth in order to pay workers' compensation in circumstances where disability or deat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-6-908
更新日期:1982-12-01 00:00:00
abstract::Rising health care expenditures have led to numerous cost-control proposals. An examination of the ethical questions surrounding the role that physicians play in the control of health care costs suggests that unilateral rationing decisions by individual physicians at the bedside are morally unacceptable. Such decision...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-11-920
更新日期:1992-06-01 00:00:00
abstract::Conventional interpretation of clinical trials relies heavily on the classic p value. The p value, however, represents only a false-positive rate, and does not tell the probability that the investigator's hypothesis is correct, given his observations. This more relevant posterior probability can be quantified by an ex...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-3-385
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:Few treatments exist for coronavirus disease 2019 (COVID-19). PURPOSE:To evaluate the effectiveness and harms of remdesivir for COVID-19. DATA SOURCES:Several databases, tables of contents of journals, and U.S. Food and Drug Administration and company websites were searched from 1 January through 31 August...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-5752
更新日期:2020-10-05 00:00:00
abstract::Imaging under loading stress is hypothesized to improve the diagnostic value of magnetic resonancel imaging (MRI) for musculoskeletal conditions. This article reviews 57 studies about MRI under physiologic loading stress performed in an upright or sitting position or under axial loading by using a compression device. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-9-201111010-00009
更新日期:2011-11-01 00:00:00
abstract::To reduce health care costs, some third-party payers have enlisted primary care physicians as gatekeepers to medical care. In gatekeeper systems, primary care physicians must approve all care provided to their patients. This approval is a condition of payment for the service, with the usual exception of true emergenci...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-102-4-537
更新日期:1985-04-01 00:00:00