Abstract:
BACKGROUND:Indinavir, a protease inhibitor widely used to treat patients with HIV infection, has been associated with nephrolithiasis. Distinctive urinary crystals and a spectrum of urologic disorders were noted in patients receiving indinavir. OBJECTIVE:To determine the composition of urinary crystals and the frequency of asymptomatic crystalluria and urinary tract symptoms in patients receiving indinavir. PATIENTS:Patients with HIV infection who were enrolled in studies conducted at the National Institutes of Health. MEASUREMENTS:Microscopic urinalysis, high-performance liquid chromatography (HPLC) and mass spectrometry of urinary crystals and stones, and clinical evaluation of patients with urologic symptoms. RESULTS:Of 240 patients receiving indinavir, 142 provided urine specimens for analysis. Twenty-nine (20%) had crystals consisting of plate-like rectangles and fan-shaped or starburst forms. Mass spectrometry and HPLC confirmed that these crystals were composed of indinavir. Of 40 patients who were not receiving indinavir, none had similar crystals (P < 0.001). Nineteen of the 240 patients receiving indinavir (8%) developed urologic symptoms. Of these, 7 (3%) had nephrolithiasis and the other 12 (5%) had previously undescribed syndromes: crystalluria associated with dysuria and crystalluria associated with back or flank pain. Four of the patients with the latter syndrome had radiographic evidence of intrarenal sludging. CONCLUSIONS:Indinavir forms characteristic crystals in the urine. This crystalluria may be associated with dysuria and urinary frequency, with flank or back pain associated with intrarenal sludging, and with the classic syndrome of renal colic.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Kopp JB,Miller KD,Mican JA,Feuerstein IM,Vaughan E,Baker C,Pannell LK,Falloon Jdoi
10.7326/0003-4819-127-2-199707150-00004subject
Has Abstractpub_date
1997-07-15 00:00:00pages
119-25issue
2eissn
0003-4819issn
1539-3704journal_volume
127pub_type
杂志文章abstract::The insulin-like growth factor (IGF) family of peptides, binding proteins, and receptors are ubiquitous and important for normal human growth and development. Modern techniques including specific radioimmunoassays, radioreceptor assays and recombinant DNA technology have improved our understanding of the role of IGFs ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-10-854
更新日期:1992-05-15 00:00:00
abstract:OBJECTIVE:To provide a rational strategy for the evaluation and long-term management of epilepsy. DATA SOURCES:Articles written between 1964 and 1993, obtained from a MEDLINE search on epilepsy-related topics as well as from the author's personal files, major reference books on antiepileptic drugs, and references iden...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-120-5-199403010-00010
更新日期:1994-03-01 00:00:00
abstract::The experience of serving as an expert witness can add considerably to a physician's knowledge of medicine and the forces that affect the profession. Each case compels the physician to examine carefully all the clinical data. The physician must assess the quality of care given and render an opinion that is consistent ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-100-1-139
更新日期:1984-01-01 00:00:00
abstract::The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during whi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-7-200904070-00115
更新日期:2009-04-07 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::Physicians treating patients with chronic rheumatoid arthritis spend a considerable amount of time dealing with the psychological and social aspects of the disease. The patients' reaction to the disease can be related to age, experience, personality, and environment at work and at home. Common problems include loss of...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-3-344
更新日期:1982-03-01 00:00:00
abstract:DESCRIPTION:Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for testicular cancer. METHODS:The USPSTF performed a targeted literature search for benefits and harms of screening for testicular cancer in asymptomatic males and found no new studies. RECOMMENDA...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/0003-4819-154-7-201104050-00006
更新日期:2011-04-05 00:00:00
abstract::In alternative medicine, the main question regarding placebo has been whether a given therapy has more than a placebo effect. Just as mainstream medicine ignores the clinical significance of its own placebo effect, the placebo effect of unconventional medicine is disregarded except for polemics. This essay looks at th...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-136-11-200206040-00011
更新日期:2002-06-04 00:00:00
abstract::Fifteen patients with chronic type B hepatitis were treated with corticosteroids in a randomized, double-blind, placebo-controlled trial lasting 28 days. Ten patients received prednisolone, 60 mg/d for 2 weeks, then 30 mg/d for another 2 weeks; 5 patients received placebo. Serum aminotransferase levels decreased signi...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-104-1-12
更新日期:1986-01-01 00:00:00
abstract::The following principles of appropriate antibiotic use for adults with acute pharyngitis apply to immunocompetent adults without complicated comorbid conditions, such as chronic lung or heart disease, and history of rheumatic fever. They do not apply during known outbreaks of group A streptococcus.1. Group A beta-hemo...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章,实务指引
doi:10.7326/0003-4819-134-6-200103200-00019
更新日期:2001-03-20 00:00:00
abstract:OBJECTIVE:To describe the course of rheumatoid arthritis over 5 years in adults and to evaluate the effect of parenterally administered gold salts on that course. DESIGN:A prospective observational study of adults with rheumatoid arthritis. Data derived from annual interviews with patients from 1983 to 1988 and from p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-114-6-437
更新日期:1991-03-15 00:00:00
abstract:Background:The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and ...
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/M16-1536
更新日期:2017-06-20 00:00:00
abstract:SOURCE CITATION:Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes: a systematic review and network meta-analysis. Ann Intern Med. 2020;173:278-86. 32598218. ...
journal_title:Annals of internal medicine
pub_type: 评论,杂志文章
doi:10.7326/ACPJ202011170-053
更新日期:2020-11-17 00:00:00
abstract::Sixty-eight patients clinically suspected of having (33), or at high risk for (35), deep venous thrombosis were studied with contrast venography, radiofibrinogen leg scanning, and impedance plethysmography as well as ventilation and perfusion lung scans. Thrombosis limited to the veins in the calf of the leg (unilater...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-4-439
更新日期:1981-04-01 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:OBJECTIVE:To explore how frequently physicians lose medical malpractice cases despite providing standard care and to assess whether severity of patient injury influences the frequency of plaintiff payment. DESIGN:Retrospective cohort study. SETTING:Physicians from the state of New Jersey insured by one insurance comp...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-9-780
更新日期:1992-11-01 00:00:00
abstract::Bulimarexia, an eating disorder that is characterized by binge eating followed by self-induced vomiting or abuse of cathartic or diuretic drugs, has been defined as both a sequela of anorexia nervosa and a distinct eating disorder. In this review the presentation, prevalence, and complications of the various eating di...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-6-800
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the relation between skeletal muscle disease (myopathy) and degenerative changes in cardiac muscle (cardiomyopathy) in patients with chronic alcoholism. DESIGN:A cross-sectional study. SETTING:University medical center. PARTICIPANTS:Group A included 24 patients with chronic alcoholism who had d...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-120-7-199404010-00001
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Diagnosis of pulmonary embolism requires clinical probability assessment. Implicit assessment is accurate but is not standardized, and current prediction rules have shortcomings. OBJECTIVE:To construct a simple score based entirely on clinical variables and independent from physicians' implicit judgment. D...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-144-3-200602070-00004
更新日期:2006-02-07 00:00:00
abstract::This issue provides a clinical overview of sickle cell disease focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. No...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-5-201109060-01003
更新日期:2011-09-06 00:00:00
abstract:BACKGROUND:Hypertension often persists after adrenalectomy for primary aldosteronism. OBJECTIVE:To determine factors associated with resolution of hypertension after adrenalectomy for primary aldosteronism. DESIGN:Retrospective cohort study. SETTING:Tertiary care referral center in Rochester, Minnesota. PATIENTS:Al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-135-4-200108210-00010
更新日期:2001-08-21 00:00:00
abstract::Between June 1980 and September 1981 we evaluated 24 cases of endocarditis from methicillin-resistant Staphylococcus aureus. All of the cases occurred in drug addicts and all were community-acquired. The patients ranged in age from 21 to 59 years and represented an older population than that generally reported for bac...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-3-330
更新日期:1982-09-01 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::The relationship between oral contraceptives and death from thromboembolism shown by studies of vital statistics, and the contribution of cigarette smoking to these deaths are reviewed. In 1968 a British study showed that a slight increase in deaths from thromboembolism had occurred in young women, proportional to th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:
更新日期:1970-09-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy of ciprofloxacin therapy in eradicating convalescent fecal excretion of salmonellae after acute salmonellosis. DESIGN:Randomized, placebo-controlled, double-blind trial of ciprofloxacin, with prospective follow-up of nonparticipants. SETTING:An acute care community hospital experie...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-114-3-195
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:The news media are often criticized for exaggerated coverage of weak science. Press releases, a source of information for many journalists, might be a source of those exaggerations. OBJECTIVE:To characterize research press releases from academic medical centers. DESIGN:Content analysis. SETTING:Press rele...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-9-200905050-00007
更新日期:2009-05-05 00:00:00
abstract::Studies of circulating T- and B-lymphocyte rosettes were done in 20 healthy controls and 29 patients with pulmonary tuberculosis, including 18 receiving rifampin chemotherapy. Eight of the 18 patients in the rifampin group (44%) had significant suppression of their T-cell rosettes as compared with patients with tuberc...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-4-484
更新日期:1975-04-01 00:00:00
abstract:PURPOSE:To review the electropharmacology, clinical applications, side effects, and hemodynamic profile of intravenous amiodarone. DATA SOURCES:The MEDLINE database was searched for English-language material, including reports of clinical trials and in vivo studies, review articles, and abstracts presented at national...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-127-4-199708150-00007
更新日期:1997-08-15 00:00:00
abstract::Three patients with polymyositis had elevated serum levels of creatine kinase MB isoenzyme. The presence of this isoenzyme is used extensively to diagnose myocardial infarction, but the isoenzyme is also found in sera of patients with primary muscular and neuromuscular disorders. We studied cardiac function in two of ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-3-341
更新日期:1981-03-01 00:00:00
abstract::The Hospital Readmissions Reduction Program (HRRP) has penalized hospitals with higher 30-day readmission rates more than $3 billion to date. Clinicians and policy experts have raised concerns that the 30-day readmission measure used in this program provides an incomplete picture of performance because it does not cap...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-3486
更新日期:2021-01-01 00:00:00