Abstract:
OBJECTIVE:To determine the necessity of posteroanterior chest roentgenography for the identification of pneumothorax and other complications after thoracentesis. DESIGN:Prospective cohort study. SETTING:Tertiary care teaching hospital. PATIENTS:67 men and 43 women (mean age +/- SD, 62.4 +/- 13.2 years). Exclusion criteria included age younger than 18 years, concurrent pleural biopsy, ultrasound guidance, and use of mechanical ventilation. MEASUREMENTS:174 thoracenteses done between March 1991 and June 1993. RESULTS:2 hemothoraces (1.2%) occurred, and 8 patients had a total of 9 pneumothoraces (5.2%). The roentgenograms obtained immediately after the procedures identified 8 pneumothoraces; the other pneumothorax was seen incidentally on a delayed roentgenogram obtained 3 days later. Pneumothorax was suspected in 5 of the 8 cases, and tube thoracostomy was done in 4 of these 5 cases. Patients with unsuspected pneumothorax identified on the roentgenogram obtained immediately after the procedure did not receive treatment for their pneumothoraces. Univariate analysis showed that the variables that correlated significantly with pneumothorax were aspiration of air during the procedure (relative risk ratio, 12.3; 95% CI, 3.7 to 41.4), number of passes with the thoracentesis needle (relative risk ratio, 6.1; CI, 1.6 to 23.3), history of thoracic radiation therapy (relative risk ratio, 10.5; CI, 2.5 to 44.4), and operator suspicion of pneumothorax (relative risk ratio, 25.9; CI, 8.6 to 78.5). CONCLUSION:Among hospitalized patients with pleural effusions, we identified subgroup of patients in whom the risk for pneumothorax is low enough (approximately 1%) with sufficiently minimal clinical consequences to justify the avoidance of about 60% of chest roentgenograms obtained after thoracentesis. These patients are clinically stable, have not previously received chest irradiation, had only one pass at thoracentesis attempted without the aspiration of any air, and give no other indication of pneumothorax.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Doyle JJ,Hnatiuk OW,Torrington KG,Slade AR,Howard RSdoi
10.7326/0003-4819-124-9-199605010-00005subject
Has Abstractpub_date
1996-05-01 00:00:00pages
816-20issue
9eissn
0003-4819issn
1539-3704journal_volume
124pub_type
杂志文章abstract:BACKGROUND:AL amyloidosis is a fatal disease resulting from tissue deposition of amyloid fibrils derived from monoclonal immunoglobulin light chains. Treatment with oral chemotherapy is minimally effective. OBJECTIVE:To test survival and organ response in a large sample of patients treated with high-dose intravenous m...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-140-2-200401200-00008
更新日期:2004-01-20 00:00:00
abstract:OBJECTIVE:To determine, through structured methodologic review of published articles, the effectiveness of short-course (< or = 2 weeks) antibiotic therapy for catheter-related Staphylococcus aureus bacteremia. DATA SOURCES:English-language publications on catheter-related S. aureus bacteremia identified using MEDLINE...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-119-4-199308150-00010
更新日期:1993-08-15 00:00:00
abstract::The pursuit of the ideal tumor marker has generated many tests for use in the diagnosis and management of cancer, several of which are now widely available. Tumor markers have five potential uses in patient care: They can be used for screening, for diagnosis, for establishing prognosis, for monitoring treatment, and f...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-115-8-623
更新日期:1991-10-15 00:00:00
abstract::Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture rejec...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-136-5-200203050-00010
更新日期:2002-03-05 00:00:00
abstract:BACKGROUND:Several studies show an inverse association between self-reported physical activity and type 2 diabetes. It is not known whether physical activity or cardiorespiratory fitness is associated with the onset of objectively determined impaired fasting glucose and type 2 diabetes. OBJECTIVE:To determine whether ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-2-199901190-00002
更新日期:1999-01-19 00:00:00
abstract:SOURCE CITATION:Baldetti L, Melillo F, Moroni F, et al. Meta-analysis comparing P2Y12 inhibitors in acute coronary syndrome. Am J Cardiol. 2020;125;1815-22. 32305225. ...
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pub_type: 评论,杂志文章
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更新日期:2020-09-15 00:00:00
abstract:Background:The safety and effectiveness of dual therapy (direct oral anticoagulant [DOAC] plus P2Y12 inhibitor) versus triple therapy (vitamin K antagonist plus aspirin and P2Y12 inhibitor) in patients with nonvalvular atrial fibrillation (AF) after percutaneous coronary intervention (PCI) is unclear. Purpose:To exami...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/M19-3763
更新日期:2020-04-07 00:00:00
abstract:Description:The purpose of this guidance statement is to guide clinicians on colorectal cancer screening in average-risk adults. Methods:This guidance statement is derived from a critical appraisal of guidelines on screening for colorectal cancer in average-risk adults and the evidence presented in these guidelines. N...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2019-11-05 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:SOURCE CITATION:Mahady SE, Margolis KL, Chan A, et al. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut. 2020. [Epub ahead of print.] 32747412. ...
journal_title:Annals of internal medicine
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更新日期:2021-01-01 00:00:00
abstract:SOURCE CITATION:Cao B, Wang Y, Wen D, et al. A trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19. N Engl J Med. 2020;382:1787-99. 32187464. ...
journal_title:Annals of internal medicine
pub_type: 评论,杂志文章
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更新日期:2020-06-16 00:00:00
abstract::Neuroblastoma, the second commonest solid tumor in children, is a neoplasm of the peripheral autonomic nervous system that usually occurs before children are 6 years old. Therapy of localized tumor (clinical stage I and II) and of a special form of metastatic tumor (clinical stage IV-S) is usually successful, but trea...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-97-6-873
更新日期:1982-12-01 00:00:00
abstract:OBJECTIVE:To determine the role of B19 parvovirus in red cell aplasia of patients infected with human immunodeficiency virus type 1 (HIV-1). DESIGN:Uncontrolled clinical trial, with assay of serum, peripheral blood cells, and bone marrow for virus using DNA hybridization and immunocytochemistry techniques; these assay...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-12-926
更新日期:1990-12-15 00:00:00
abstract:BACKGROUND:Severe aplastic anemia is a life-threatening bone marrow failure disorder. High-dose cyclophosphamide therapy followed by allogeneic bone marrow transplantation cures the disease. However, it requires a suitable donor and carries the risk for graft-versus-host disease. A small pilot study demonstrated that h...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-135-7-200110020-00006
更新日期:2001-10-02 00:00:00
abstract:STUDY OBJECTIVE:To determine if the combination of ganciclovir and intravenous cytomegalovirus immunoglobulin is effective in patients with cytomegalovirus pneumonia after bone marrow transplant. DESIGN:Consecutive entry trial with treatment for a minimum of 14 days. PATIENTS:Consecutive sample of 25 patients with bo...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-10-783
更新日期:1988-11-15 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:BACKGROUND:Prospective data defining the clinical course in idiopathic pulmonary fibrosis (IPF) are sparse. OBJECTIVE:To analyze the clinical course of patients with mild to moderate IPF. DESIGN:Analysis of data from the placebo group of a randomized, controlled trial evaluating interferon-gamma1b. SETTING:Academic ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-12_part_1-200506210-00005
更新日期:2005-06-21 00:00:00
abstract::Our review focuses on low density lipoprotein (LD lipoprotein) and very low density lipoprotein (VLD lipoprotein) in their roles as transporters of cholesterol and triglyceride and as factors contributing to premature arteriovascular disease. We describe the clinical manifestations of the common, primary hyperlipoprot...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-85-4-497
更新日期:1976-10-01 00:00:00
abstract:PURPOSE:To review current management of intractable constipation. DATA SOURCES:Original articles and reviews published in the English-language literature between 1965 and 1993 identified by MEDLINE search. Verbal feedback from attendees after presentation of the document as a clinical symposium at the 14th Internation...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-121-7-199410010-00008
更新日期:1994-10-01 00:00:00
abstract::A patient with bladder carcinoma metastatic to lung and brain died of pneumonia. Autopsy examination showed a confluent bronchopneumonia with several small abscesses and acute pyelonephritis with abscess formation. Legionella pneumophila, serogroup 4, was isolated in pure culture from lung tissue postmortem and was al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-6-835
更新日期:1980-12-01 00:00:00
abstract::Antibiotic-associated diarrhea and colitis were well established soon after antibiotics became available. Early work implicated Staphylococcus aureus, but in 1978 Clostridium difficile became the established pathogen in the vast majority of cases. In the first 5 years (1978 through 1983), the most common cause was cli...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2006-11-21 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2002-07-02 00:00:00
abstract::Position statements opposing legalization of physician-assisted suicide by organizations such as the American College of Physicians-American Society of Internal Medicine rightly emphasize that palliative care should be the standard of care for the dying, and that the inadequacies that exist in its delivery should be r...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2003-02-04 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of continuous intravenous infusion of prostacyclin (epoprostenol) in primary pulmonary hypertension. DESIGN:Randomized trial with 8-week treatment periods and nonrandomized treatment for up to 18 months. SETTING:Four referral centers. PATIENTS:Sequential sample of 24 patient...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1990-04-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease (CVD) is the leading cause of death in the United States. PURPOSE:To update a systematic review about the benefits of aspirin for the primary prevention of cardiovascular events in adults aged 40 years or older and to evaluate effect modification in subpopulations. DATA SOURCES:MEDLI...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2016-06-21 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
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更新日期:2011-10-04 00:00:00
abstract:BACKGROUND:Antioxidant vitamins are thought to play a role in atherosclerosis. Supplementation of these nutrients has been explored as a means of reducing cardiovascular morbidity and mortality. PURPOSE:To assess the evidence of the effectiveness of vitamin supplementation, specifically vitamins A, C, and E; beta-caro...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The choice of antiplatelet therapy after acute coronary syndrome (ACS) is complicated: Ticagrelor and prasugrel are novel alternatives to clopidogrel, patients with some genotypes may not respond to clopidogrel, and low-cost generic formulations of clopidogrel are available. OBJECTIVE:To determine the most ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2014-02-18 00:00:00
abstract::One hundred ninety-eight patients with chronic myelogenous leukemia received marrow transplants after intensive chemotherapy and total body irradiation. Multivariate analysis showed disease status at time of transplantation to be the most powerful predictor of survival. The probability of long-term survival for alloge...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-2-155
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:The vast scientific literature on smoking and health contains few large studies with direct estimates of long-term mortality by smoking habits. Data have been lacking, particularly for women. OBJECTIVE:To study smoking and deaths and causes of death in women and men of middle age (40 to 70 years of age). D...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2006-03-21 00:00:00