Abstract:
BACKGROUND:Urine tests for Chlamydia trachomatis permit expansion of screening beyond traditional clinic environments. Prevention of infection in teenagers is a high priority. OBJECTIVE:To define the prevalence of C. trachomatis among teenagers by using the ligase chain reaction assay on urine specimens and to evaluate leukocyte esterase testing of urine specimens as an indicator of infection. DESIGN:Cross-sectional study. SETTING:An adolescent clinic, a juvenile detention facility, seven school-based clinics, and three community-based youth organizations in Seattle, Washington. PARTICIPANTS:10,118 sexually active teenagers and young adults. MEASUREMENTS:Chlamydia trachomatis infection detected in urine specimens by ligase chain reaction assay and leukocyturia detected by leukocyte esterase testing. RESULTS:The prevalence of chlamydial infection among female participants was 8.6% and declined with increasing age; among male participants, it was 5.4% and increased with increasing age. In female participants, independent predictors of infection were being 17 years of age or younger (odds ratio [OR], 1.49), having had two or more sex partners in the previous 2 months (OR, 1.61), and having genitourinary symptoms (OR, 1.46). In male participants, independent predictors were being of nonwhite race or ethnicity (OR, 2.00 to 3.08), having had two or more sex partners in the previous 2 months (OR, 1.57), and having used a condom during the most recent sexual encounter (OR, 0.67). For identifying infection in male participants, the sensitivity of leukocyte esterase testing was 58.9%, the specificity was 94.9%, the positive predictive value was 38.4%, and the negative predictive value was 97.7%. CONCLUSIONS:Chlamydial infection is common in teenagers and young adults in community settings. The urine ligase chain reaction assay will permit widespread screening for C. trachomatis, but leukocyte esterase testing had low sensitivity for selecting persons for screening with this assay. Indicators of chlamydial infection differed substantially in male and female participants.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Marrazzo JM,White CL,Krekeler B,Celum CL,Lafferty WE,Stamm WE,Handsfield HHdoi
10.7326/0003-4819-127-9-199711010-00004subject
Has Abstractpub_date
1997-11-01 00:00:00pages
796-803issue
9eissn
0003-4819issn
1539-3704journal_volume
127pub_type
杂志文章abstract::The 1950s witnessed prodigious growth in our knowledge of the chemical nature of the gene, the mechanisms by which the information inherent in its sequence of nucleotide units was conveyed to the cell's machinery for synthesizing proteins, and the mode of operation of that machinery. Watson and Crick raised the curtai...
journal_title:Annals of internal medicine
pub_type: 评论,历史文章,杂志文章
doi:10.7326/0003-4819-138-7-200304010-00016
更新日期:2003-04-01 00:00:00
abstract::The diagnosis of gout depends on showing urate crystals in synovial effusions or, with less certainty, recognizing a characteristic clinical presentation. The management of gout has four phases: control of inflammation, diagnostic evaluation, education of the patient, and treatment for the hyperuricemia. Sound logical...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-5-812
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:A daily injection of low-molecular-weight heparin (LMWH) is often prescribed to women with unexplained recurrent pregnancy loss (RPL), although evidence suggesting a benefit is questionable. OBJECTIVE:To determine whether LMWH increases ongoing pregnancy and live-birth rates in women with unexplained RPL. ...
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/M14-2062
更新日期:2015-05-05 00:00:00
abstract:BACKGROUND:The number of very elderly persons who are candidates for implantation of a permanent pacemaker is increasing, but the effect of cardiac pacing on long-term survival and functional variables has not been determined. OBJECTIVE:To determine long-term survival after implantation of a permanent pacemaker in oct...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-125-6-199609150-00008
更新日期:1996-09-15 00:00:00
abstract:OBJECTIVE:To develop criteria for interpreting results of the metyrapone test for the differential diagnosis of the adrenocorticotropin (ACTH)-dependent Cushing syndrome and to compare its diagnostic accuracy with that of the high-dose dexamethasone suppression test. DESIGN:Retrospective cohort study. SETTING:Inpatie...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-121-5-199409010-00002
更新日期:1994-09-01 00:00:00
abstract::Adult salicylate intoxication has been considered to be easily recognized and assciated with low morbidity and mortality. In the present study of 73 consecutive adults hospitalized with salicylate intoxication, 27% of patients were undiagnosed for as long as 72 h after admission. The initial physical findings and labo...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-6-745
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:To determine the effect of the presence of a patent foramen ovale on the right-to-left shunt in patients with respiratory failure who receive positive end-expiratory pressure (PEEP). DESIGN:Convenience sample with randomized application of PEEP. SETTING:General intensive care unit of a university teaching h...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-119-9-199311010-00004
更新日期:1993-11-01 00:00:00
abstract::Acute bronchitis is an acute cough illness in otherwise healthy adults that usually lasts 1 to 3 weeks. This review describes the pathophysiology of the condition and provides a practical approach to the evaluation and treatment of adults with uncomplicated acute bronchitis. Practical points to be made are:1. Respirat...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-133-12-200012190-00014
更新日期:2000-12-19 00:00:00
abstract:BACKGROUND:Although viral rebound follows cessation of suppressive antiretroviral therapy in chronic HIV infection, a viremic clinical syndrome has not been described. OBJECTIVE:To describe a retroviral syndrome associated with cessation of effective antiretroviral therapy in chronic HIV infection. DESIGN:Case report...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-6-200009190-00010
更新日期:2000-09-19 00:00:00
abstract:BACKGROUND:Screening mammography is recommended for women 50 to 69 years of age because of its proven efficacy and reasonable cost-effectiveness. Extending screening recommendations to include women 40 to 49 years of age remains controversial. OBJECTIVE:To compare the cost-effectiveness of screening mammography in wom...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-11-199712010-00001
更新日期:1997-12-01 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:Little evidence exists to support the theory that small-bore nasogastric tubes prevent gastroesophageal reflux and microaspiration in intubated patients. OBJECTIVE:To determine whether gastroesophageal reflux and microaspiration in intubated patients can be reduced by the use of a small-bore nasogastric tub...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-130-12-199906150-00007
更新日期:1999-06-15 00:00:00
abstract:BACKGROUND:No regulations govern placebo composition. The composition of placebos can influence trial outcomes and merits reporting. PURPOSE:To assess how often investigators specify the composition of placebos in randomized, placebo-controlled trials. DATA SOURCES:4 English-language general and internal medicine jou...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-8-201010190-00010
更新日期:2010-10-19 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:BACKGROUND:Dietary and lifestyle modification efforts are the primary treatments for people who are obese or overweight. The effect of dietary counseling on long-term weight change is unclear. PURPOSE:To perform a meta-analysis of the effect of dietary counseling compared with usual care on body mass index (BMI) over ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-147-1-200707030-00007
更新日期:2007-07-03 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:OBJECTIVE:To determine risk factors for community-acquired and nosocomial group B streptococcal disease in adults. DESIGN:Case-control study. SETTING:3 metropolitan areas in the United States with an aggregate population of 6.6 million persons. PATIENTS:219 nonpregnant adults with invasive group B streptococcal infe...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-6-199509150-00003
更新日期:1995-09-15 00:00:00
abstract::In observational studies or nonrandomized experiments, treated and control groups may differ in their outcomes even if the treatment has no effect; this may happen if the groups were not comparable before the start of treatment. The groups may fail to be comparable in either of two ways: They may differ with respect t...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-115-11-901
更新日期:1991-12-01 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::Research on assessing or managing medication adherence applies approaches from observational, interventional, and implementation science that spans many disciplines and demands coherent conceptualization, valid methods, appropriate analyses, and complete and accurate reporting. To ensure such reporting, the European S...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章
doi:10.7326/M18-0543
更新日期:2018-07-03 00:00:00
abstract:BACKGROUND:A survey of general internist members of the American College of Physicians (ACP) in 1986 found that they did a large number and variety of procedures in their practices. Since then, changes in the practice of medicine, regulatory requirements, and availability of subspecialists may have affected the number ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-146-5-200703060-00007
更新日期:2007-03-06 00:00:00
abstract:OBJECTIVE:To reassess the natural history of polycythemia vera and to obtain reliable estimates of both incidence of thrombosis and survival for use in defining the sample size for therapeutic clinical trials. STUDY DESIGN:Retrospective cohort study of patients with polycythemia who had been followed for 20 years. SE...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-9-199511010-00003
更新日期:1995-11-01 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:Ear involvement is not unusual in autoimmune diseases, but few data on this problem in the Sjögren syndrome are available. OBJECTIVES:To determine whether the incidence of hearing loss is increased in patients with the Sjögren syndrome and to determine what factors might be involved in the pathogenesis of S...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-6-199703150-00005
更新日期:1997-03-15 00:00:00
abstract::The U.S. Food and Drug Administration (FDA) Amendments Act of 2007 mandated that the FDA develop a system for using automated health care data to identify risks of marketed drugs and other medical products. The Observational Medical Outcomes Partnership is a public-private partnership among the FDA, academia, data own...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-9-201011020-00010
更新日期:2010-11-02 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:BACKGROUND:Combining endoscopic therapy and beta-blockers may improve outcomes in patients with cirrhosis and bleeding esophageal varices. PURPOSE:To assess whether a combination of endoscopic and drug therapy prevents overall and variceal rebleeding and improves survival better than either therapy alone. DATA SOURCE...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-149-2-200807150-00007
更新日期:2008-07-15 00:00:00
abstract:BACKGROUND:The high prevalence of classic cardiac risk factors in patients with non-insulin-dependent diabetes mellitus does not explain the increased cardiovascular-related morbidity and mortality in these patients. Fibrinogen may have a role in this excess risk. OBJECTIVE:To evaluate the following in patients with n...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-125-8-199610150-00005
更新日期:1996-10-15 00:00:00
abstract:BACKGROUND:An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE:To identify risk factors for transmission...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-1-199707010-00006
更新日期:1997-07-01 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