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2281. Extent of ST-segment deviation in a single electrocardiogram lead 90 min after thrombolysis as a predictor of medium-term mortality in acute myocardial infarction.
In evolving myocardial infarction, assessment of the sum of early resolution of ST-segment elevation (sumSTR) has become an established method to predict outcome. We have found previously that mortality is predicted more accurately by the existing ST-segment deviation in the single electrocardiograph (ECG) lead with maximum deviation (maxSTE) 90 min after start of thrombolysis. This report compares the power to predict medium-term mortality by these two approaches.
2282. Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study.
作者: A T van Oosterom.;I Judson.;J Verweij.;S Stroobants.;E Donato di Paola.;S Dimitrijevic.;M Martens.;A Webb.;R Sciot.;M Van Glabbeke.;S Silberman.;O S Nielsen.; .
来源: Lancet. 2001年358卷9291期1421-3页
Gastrointestinal stromal tumours (GISTs) are rare tumours of the gastrointestinal tract characterised by cell-surface expression of the tyrosine kinase KIT (CD117). No effective systemic treatment is available. Imatinib (STI571) inhibits a similar tyrosine kinase, BCR-ABL, leading to responses in chronic myeloid leukaemia, and has also been shown to inhibit KIT. We did a phase I study to identify the dose-limiting toxic effects of imatinib in patients with advanced soft tissue sarcomas including GISTs.
2283. Comparison of hypertonic saline and alternate-day or daily recombinant human deoxyribonuclease in children with cystic fibrosis: a randomised trial.
作者: R Suri.;C Metcalfe.;B Lees.;R Grieve.;M Flather.;C Normand.;S Thompson.;A Bush.;C Wallis.
来源: Lancet. 2001年358卷9290期1316-21页
Daily recombinant human deoxyribonuclease (rhDNase) is an established but expensive treatment in cystic fibrosis. Alternate-day treatment, if equally effective, would reduce the drug cost. Hypertonic saline improved lung function to the same degree as rhDNase in short-term studies. We compared the effectiveness of daily rhDNase, hypertonic saline, and alternate-day rhDNase in children with cystic fibrosis.
2285. Selective seratonin 1F (5-HT(1F)) receptor agonist LY334370 for acute migraine: a randomised controlled trial.
作者: D J Goldstein.;K I Roon.;W W Offen.;N M Ramadan.;L A Phebus.;K W Johnson.;J M Schaus.;M D Ferrari.
来源: Lancet. 2001年358卷9289期1230-4页
Triptans (5-HT(1B/1D) receptor agonists) are effective drugs for acute migraine, but the side-effect of coronary vasoconstriction restricts their use in patients who are at risk of coronary artery disease. We have studied the efficacy of LY334370, a selective serotonin 1F (5-HT(1F)) receptor agonist with preclinical efficacy and no vasoconstriction, for migraine relief.
2286. Gain in bone mineral mass in prepubertal girls 3.5 years after discontinuation of calcium supplementation: a follow-up study.
Calcium supplementation during childhood and adolescence increases bone-mass accrual. Whether or not this benefit persists after discontinuation of supplementation is not known. We previously showed a favourable effect of milk-extracted calcium phosphate incorporated in various foods on accumulation of bone mineral mass in 8-year-old girls. We now report the results of a follow-up study undertaken more than 3 years after the end of calcium supplementation.
2287. Effects of the dual endothelin-receptor antagonist bosentan in patients with pulmonary hypertension: a randomised placebo-controlled study.
作者: R N Channick.;G Simonneau.;O Sitbon.;I M Robbins.;A Frost.;V F Tapson.;D B Badesch.;S Roux.;M Rainisio.;F Bodin.;L J Rubin.
来源: Lancet. 2001年358卷9288期1119-23页
Endothelin 1, a powerful endogenous vasoconstrictor and mitogen, might be a cause of pulmonary hypertension. We describe the efficacy and safety of bosentan, a dual endothelin-receptor antagonist that can be taken orally, in patients with severe pulmonary hypertension.
2288. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack.
Blood pressure is a determinant of the risk of stroke among both hypertensive and non-hypertensive individuals with cerebrovascular disease. However, there is uncertainty about the efficacy and safety of blood-pressure-lowering treatments for many such patients. The perindopril protection against recurrent stroke study (PROGRESS) was designed to determine the effects of a blood-pressure-lowering regimen in hypertensive and non-hypertensive patients with a history of stroke or transient ischaemic attack.
2289. Guided self-management and patient-directed follow-up of ulcerative colitis: a randomised trial.
Ulcerative colitis is managed mainly in secondary care by regular outpatient reviews done by specialist clinicians. Alternatives would be to discharge patients to primary care or to provide open-access clinics, but neither of these options reduce patients' dependency on doctors or allow patients' involvement in disease management. We did a randomised controlled trial to assess an alternative to traditional outpatient care.
2290. Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial.
作者: G H Mickisch.;A Garin.;H van Poppel.;L de Prijck.;R Sylvester.; .
来源: Lancet. 2001年358卷9286期966-70页
Surgery is the main treatment for localised renal cell carcinoma, but use of radical nephrectomy for metastatic disease is highly controversial. We aimed to establish whether radical nephrectomy done before interferon-alfa-based immunotherapy improved time to progression and overall survival (primary endpoints) compared with interferon alfa alone.
2291. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial.
作者: M P Manns.;J G McHutchison.;S C Gordon.;V K Rustgi.;M Shiffman.;R Reindollar.;Z D Goodman.;K Koury.;M Ling.;J K Albrecht.
来源: Lancet. 2001年358卷9286期958-65页
A sustained virological response (SVR) rate of 41% has been achieved with interferon alfa-2b plus ribavirin therapy of chronic hepatitis C. In this randomised trial, peginterferon alfa-2b plus ribavirin was compared with interferon alfa-2b plus ribavirin.
2292. Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): a randomised trial.
Since previous randomised treatment trials in coronary disease have focused on patients younger than 75 years of age, their findings might not apply to the elderly population in whom the cardiac risk profile, risk of intervention, and comorbidities are increased. We aimed to assess quality of life and outcome of elderly patients with coronary disease after medical or revascularisation therapy.
2293. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial.
Wound infection after clean surgery is an expensive and often underestimated cause of patient morbidity, and the benefits of using prophylactic antibiotics have not been proven. Warming patients during colorectal surgery has been shown to reduce infection rates. We aimed to assess whether warming patients before short duration, clean surgery would have the same effect.
2294. Effect of long-term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma: a randomised trial.
作者: N Cascinelli.;F Belli.;R M MacKie.;M Santinami.;R Bufalino.;A Morabito.
来源: Lancet. 2001年358卷9285期866-9页
Less than half of patients with melanoma that has spread to local draining regional lymph nodes (stage III melanoma) live with no disease for 5 years or longer after surgery. We aimed to see whether interferon alpha-2a increased survival prospects in these patients.
2295. Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double-blind study.
Functional disability is generally caused by hemiplegia after stroke. Physiotherapy used to be the only way of improving motor function in such patients. However, administration of amphetamines in addition to exercise improves motor recovery in animals, probably by increasing the concentration of norepinephrine in the central nervous system. Our aim was to ascertain whether levodopa could enhance the efficacy of physiotherapy after hemiplegia.
2296. Mycophenolate mofetil monotherapy in liver transplantation.
Chronic renal failure is a major cause of morbidity and mortality after orthotopic liver transplantation. We did a randomised controlled trial of mycophenolate mofetil monotherapy in liver transplant patients who developed renal failure associated with calcineurin-inhibitor (ciclosporin or tacrolimus) immunosuppressive therapy. Although renal failure improved when the calcineurin-inhibitor dose was reduced and ultimately stopped, the trial was stopped when three of five patients on monotherapy developed organ rejection requiring a second transplantation.
2297. Replacement of calcineurin inhibitors with mycophenolate mofetil in liver-transplant patients with renal dysfunction: a randomised controlled study.
作者: H J Schlitt.;A Barkmann.;K H Böker.;H H Schmidt.;N Emmanouilidis.;J Rosenau.;M J Bahr.;G Tusch.;M P Manns.;B Nashan.;J Klempnauer.
来源: Lancet. 2001年357卷9256期587-91页
Renal dysfunction is a major complication of long-term immunosuppressive therapy with calcineurin inhibitors (CNI) in liver-transplant recipients. We undertook a randomised study to assess the safety and efficacy of CNI withdrawal and replacement by mycophenolate mofetil.
2298. Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group.
作者: J P Collet.;M Vanasse.;P Marois.;M Amar.;J Goldberg.;J Lambert.;M Lassonde.;P Hardy.;J Fortin.;S D Tremblay.;D Montgomery.;J Lacroix.;A Robinson.;A Majnemer.
来源: Lancet. 2001年357卷9256期582-6页
The use of hyperbaric oxygen for children with cerebral palsy has spread worldwide, despite little scientific evidence of efficacy. We did a randomised trial to assess the efficacy and side-effects of this form of therapy in children with cerebral palsy.
2299. Effect of aggressive versus conventional lipid lowering on atherosclerosis progression in familial hypercholesterolaemia (ASAP): a prospective, randomised, double-blind trial.
作者: T J Smilde.;S van Wissen.;H Wollersheim.;M D Trip.;J J Kastelein.;A F Stalenhoef.
来源: Lancet. 2001年357卷9256期577-81页
High LDL-cholesterol is a risk factor for atherosclerosis. We aimed to determine whether aggressive cholesterol lowering with statins was more effective than conventional statin treatment in this disease. We investigated the effect of high-dose atorvastatin on carotid atherosclerosis progression.
2300. Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial.
作者: P M Bath.;E Lindenstrom.;G Boysen.;P De Deyn.;P Friis.;D Leys.;R Marttila.;J Olsson.;D O'Neill.;J Orgogozo.;B Ringelstein.;J van der Sande.;A G Turpie.
来源: Lancet. 2001年358卷9283期702-10页
Low-molecular-weight heparins and heparinoids are superior to unfractionated heparin in the prevention and treatment of venous thromboembolism, but their safety and efficacy in acute ischaemic stroke are inadequately defined.
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