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2361. Effectiveness of the direct observation component of DOTS for tuberculosis: a randomised controlled trial in Pakistan.
DOTS is the control strategy for tuberculosis promoted by WHO. Pakistan is currently developing its National Tuberculosis Programme, and requires guidance on types of direct observation of treatment appropriate for the local conditions. We did a randomised trial to assess the effectiveness of different packages for tuberculosis treatment under operational conditions in Pakistan.
2362. Effect of pravastatin on frequency of fracture in the LIPID study: secondary analysis of a randomised controlled trial. Long-term Intervention with Pravastatin in Ischaemic Disease.
作者: I R Reid.;W Hague.;J Emberson.;J Baker.;A Tonkin.;D Hunt.;S MacMahon.;N Sharpe.
来源: Lancet. 2001年357卷9255期509-12页
Statins inhibit the same biochemical pathway as aminobisphosphonates, therefore these cholesterol-lowering agents may have a beneficial effect on osteoporosis. This possibility has been supported by the finding that some statins also stimulate bone formation, and by observational studies suggesting that patients using statins have higher bone densities and lower fracture rates than controls. To assess whether statins have clinically significant effects on bone, we studied the frequency of fractures in a large randomised controlled trial of these agents.
2363. Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomised trial.
作者: R Hurskainen.;J Teperi.;P Rissanen.;A M Aalto.;S Grenman.;A Kivelä.;E Kujansuu.;S Vuorma.;M Yliskoski.;J Paavonen.
来源: Lancet. 2001年357卷9252期273-7页
Heavy menstrual blood loss is a common reason for women to seek medical care. The levonorgestrel-releasing intrauterine system (IUS) is an effective medical treatment for menorrhagia. We report a randomised comparison of this approach with hysterectomy in terms of the quality of life of women with menorrhagia and cost-effectiveness.
2364. Comparison of formoterol and terbutaline for as-needed treatment of asthma: a randomised trial.
作者: A E Tattersfield.;C G Löfdahl.;D S Postma.;A Eivindson.;A G Schreurs.;A Rasidakis.;T Ekström.
来源: Lancet. 2001年357卷9252期257-61页
Asthma guidelines recommend that long-acting inhaled beta-agonists should be used as maintenance therapy for patients with asthma inadequately controlled on an inhaled corticosteroid. We studied the safety and efficacy of the long-acting beta-agonist formoterol compared with terbutaline, each taken as needed, in patients with moderate to severe asthma.
2365. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial.
作者: J Y Reginster.;R Deroisy.;L C Rovati.;R L Lee.;E Lejeune.;O Bruyere.;G Giacovelli.;Y Henrotin.;J E Dacre.;C Gossett.
来源: Lancet. 2001年357卷9252期251-6页
Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms.
2366. Prevention of hepatocellular carcinoma in patients with chronic active hepatitis C and cirrhosis.
作者: S Nishiguchi.;S Shiomi.;S Nakatani.;T Takeda.;K Fukuda.;A Tamori.;D Habu.;T Tanaka.
来源: Lancet. 2001年357卷9251期196-7页
In a prospective randomised controlled study, 90 patients with chronic active hepatitis C and compensated cirrhosis were assigned symptomatic treatment or interferon alfa (IFN-alpha). We report data on decompensation, detection of hepatocellular carcinoma, and mortality rates. IFN-alpha gave a sustained response in only a small proportion of patients, but worsening of compensated cirrhosis was prevented and development of hepatocellular carcinoma was inhibited, increasing the survival rate. The risk ratio of IFN-alpha versus symptomatic treatment decreased by 0.250 for progression to Child-Pugh grade B, 0.256 for detection of hepatocellular carcinoma, and 0.135 for a fatal outcome.
2367. How medical students learn spatial anatomy.
Despite its importance in clinical tasks, spatial learning is poorly understood. We did a randomised, single-blind study on 146 medical students to assess the effectiveness of student-controlled multiple views on the spatial learning process. High spatial ability of the student, and self-directed examination of an object from multiple different perspectives improves spatial learning.
2368. Bone-targeted therapy for advanced androgen-independent carcinoma of the prostate: a randomised phase II trial.
作者: S M Tu.;R E Millikan.;B Mengistu.;E S Delpassand.;R J Amato.;L C Pagliaro.;D Daliani.;C N Papandreou.;T L Smith.;J Kim.;D A Podoloff.;C J Logothetis.
来源: Lancet. 2001年357卷9253期336-41页
Prostate carcinoma is linked to osteoblastic metastasis. We therefore investigated the value of bone-targeted consolidation therapy in selected patients with advanced androgen-independent carcinoma of the prostate.
2369. Efficacy of inhaled human insulin in type 1 diabetes mellitus: a randomised proof-of-concept study.
作者: J S Skyler.;W T Cefalu.;I A Kourides.;W H Landschulz.;C C Balagtas.;S L Cheng.;R A Gelfand.
来源: Lancet. 2001年357卷9253期331-5页
Effective glycaemic control in type 1 diabetes mellitus usually requires two or more insulin injections daily. Inhaled intrapulmonary delivery of insulin offers a potential new way to deliver meal-related insulin, eliminating the need for preprandial injections.
2370. Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Collaborative Group of the Primary Prevention Project.
In addition to the treatment of specific cardiovascular risk factors, intervention which interferes with the general mechanisms of atherosclerosis could further reduce the incidence of cardiovascular events. We aimed to investigate in general practice the efficacy of antiplatelets and antioxidants in primary prevention of cardiovascular events in people with one or more major cardiovascular risk factors.
2371. Inhaled nitric oxide in neonates with persistent pulmonary hypertension.
作者: W Tworetzky.;J Bristow.;P Moore.;M M Brook.;M R Segal.;R C Brasch.;S Hawgood.;J R Fineman.
来源: Lancet. 2001年357卷9250期118-20页
To investigate the oxygenation and haemodynamic dose response to inhaled nitric oxide in neonates with persistent pulmonary hypertension (PPHN), we gave seven neonates nitric oxide and measured directly pulmonary arterial pressure. Inhaled nitric oxide produced peak improvement in oxygenation at 5 parts per million (ppm) whereas peak improvement in the pulmonary-to-systemic arterial pressure ratio did not occur until a nitric oxide dose of 20 ppm, which suggests that an Initial dose of 20 ppm is optimum for the treatment of PPHN.
2372. Effects of recombinant human interleukin-12 on eosinophils, airway hyper-responsiveness, and the late asthmatic response.
作者: S A Bryan.;B J O'Connor.;S Matti.;M J Leckie.;V Kanabar.;J Khan.;S J Warrington.;L Renzetti.;A Rames.;J A Bock.;M J Boyce.;T T Hansel.;S T Holgate.;P J Barnes.
来源: Lancet. 2000年356卷9248期2149-53页
Interleukin-12 (IL-12) is a macrophage-derived cytokine that modulates T lymphocyte responses and has the capacity to suppress allergic and eosinophilic inflammation.
2373. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response.
作者: M J Leckie.;A ten Brinke.;J Khan.;Z Diamant.;B J O'Connor.;C M Walls.;A K Mathur.;H C Cowley.;K F Chung.;R Djukanovic.;T T Hansel.;S T Holgate.;P J Sterk.;P J Barnes.
来源: Lancet. 2000年356卷9248期2144-8页
Interleukin-5 (IL-5) is essential for the formation of eosinophils, which are thought to have a major role in the pathogenesis of asthma and other allergic diseases. We aimed to assess the effects of monoclonal antibody to IL-5 on blood and sputum eosinophils, airway hyper-responsiveness, and the late asthmatic reaction to inhaled allergen in patients with mild asthma.
2374. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group.
Low-dose dopamine is commonly administered to critically ill patients in the belief that it reduces the risk of renal failure by increasing renal blood flow. However, these effects have not been established in a large randomised controlled trial, and use of dopamine remains controversial. We have done a multicentre, randomised, double-blind, placebo-controlled study of low-dose dopamine in patients with at least two criteria for the systemic inflammatory response syndrome and clinical evidence of early renal dysfunction (oliguria or increase in serum creatinine concentration).
2375. Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary oedema: a randomised trial.
作者: J Masip.;A J Betbesé.;J Páez.;F Vecilla.;R Cañizares.;J Padró.;M A Paz.;J de Otero.;J Ballús.
来源: Lancet. 2000年356卷9248期2126-32页
Non-invasive pressure support ventilation (NIPSV) is an effective treatment for acute respiratory failure in patients with chronic obstructive pulmonary disease. We assessed the efficacy of this therapy in acute cardiogenic pulmonary oedema in a randomised comparison with conventional oxygen therapy.
2376. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance.
作者: W P James.;A Astrup.;N Finer.;J Hilsted.;P Kopelman.;S Rössner.;W H Saris.;L F Van Gaal.
来源: Lancet. 2000年356卷9248期2119-25页
Sibutramine is a tertiary amine that has been shown to induce dose-dependent weight loss and to enhance the effects of a low-calorie diet for up to a year. We did a randomised, double-blind trial to assess the usefulness of sibutramine in maintaining substantial weight loss over 2 years.
2377. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial.
作者: C L Loprinzi.;J W Kugler.;J A Sloan.;J A Mailliard.;B I LaVasseur.;D L Barton.;P J Novotny.;S R Dakhil.;K Rodger.;T A Rummans.;B J Christensen.
来源: Lancet. 2000年356卷9247期2059-63页
Hot flashes can be troublesome, especially when hormonal therapy is contraindicated. Preliminary data have suggested that newer antidepressants, such as venlafaxine, can diminish hot flashes. We undertook a double-blind, placebo-controlled, randomised trial to assess the efficacy of venlafaxine in women with a history of breast cancer or reluctance to take hormonal treatment because of fear of breast cancer.
2378. Effect of dofetilide in patients with recent myocardial infarction and left-ventricular dysfunction: a randomised trial.
作者: L Køber.;P E Bloch Thomsen.;M Møller.;C Torp-Pedersen.;J Carlsen.;E Sandøe.;K Egstrup.;E Agner.;J Videbaek.;B Marchant.;A J Camm.; .
来源: Lancet. 2000年356卷9247期2052-8页
Arrhythmias cause much morbidity and mortality after myocardial infarction, but in previous trials, antiarrhythmic drug therapy has not been convincingly effective. Dofetilide, a new class III agent, was investigated for effects on all-cause mortality and morbidity in patients with left-ventricular dysfunction after myocardial infarction.
2379. Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trial.
The platelet glycoprotein IIb/IIIa inhibitors, although effective in reducing ischaemic complications of percutaneous coronary intervention, are used in few coronary stent implantation procedures. ESPRIT (Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy) is a randomised, placebo-controlled trial to assess whether a novel, double-bolus dose of eptifibatide could improve outcomes of patients undergoing coronary stenting.
2380. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study.
作者: I McKeith.;T Del Ser.;P Spano.;M Emre.;K Wesnes.;R Anand.;A Cicin-Sain.;R Ferrara.;R Spiegel.
来源: Lancet. 2000年356卷9247期2031-6页
Dementia with Lewy bodies is a common form of dementia in the elderly, characterised clinically by fluctuating cognitive impairment, attention deficits, visual hallucinations, parkinsonism, and other neuropsychiatric features. Neuroleptic medication can provoke severe sensitivity reactions in patients with dementia of this type. Many deficits in cholinergic neurotransmission are seen in the brain of patients with Lewy-body dementia; therefore, drugs enhancing central cholinergic function represent a rationally-based therapeutic approach to this disorder. Rivastigmine, a cholinesterase inhibitor, was tested in a group of clinically characterised patients with Lewy-body dementia.
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