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2401. Effect of suplatast tosilate, a Th2 cytokine inhibitor, on steroid-dependent asthma: a double-blind randomised study. Tokyo Joshi-Idai Asthma Research Group.
作者: J Tamaoki.;M Kondo.;N Sakai.;K Aoshiba.;E Tagaya.;J Nakata.;K Isono.;A Nagai.
来源: Lancet. 2000年356卷9226期273-8页
Th2 cytokines play an important part in the pathogenesis of asthma. Our aim was to study the effect of suplatast tosilate, a selective Th2 cytokine inhibitor, on asthma control and asthma exacerbations during reduction of inhaled corticosteroid dose in patients with steroid-dependent asthma.
2402. Effects of transdermal nicotine on cognitive performance in Down's syndrome.
Down's syndrome involves age-dependent neuropathological and neurochemical changes similar to Alzheimer's disease, with cholinergic deficits being the most consistent. There is currently no proven treatment for Down's syndrome. We investigated the effect of nicotine-agonistic stimulation with 5 mg transdermal patches, compared with placebo, on cognitive performance in five adults with the disorder. Improvements possibly related to attention and information processing were seen for Down's syndrome patients compared with healthy controls. Our preliminary findings are encouraging, although not generalizable because of small numbers.
2403. Treatment of acute otitis media with an antiadhesive oligosaccharide: a randomised, double-blind, placebo-controlled trial.
作者: P Ukkonen.;K Varis.;M Jernfors.;E Herva.;J Jokinen.;E Ruokokoski.;D Zopf.;T Kilpi.
来源: Lancet. 2000年356卷9239期1398-402页
Antiadhesive compounds are promising candidates for prevention or treatment of infections. We have investigated the efficacy of such an agent, 3'-sialyllacto-N-neotetraose (NE-1530), given intranasally for prophylaxis of acute otitis media and for effect on nasopharyngeal carriage of bacteria.
2404. Tailored fluorouracil, epirubicin, and cyclophosphamide compared with marrow-supported high-dose chemotherapy as adjuvant treatment for high-risk breast cancer: a randomised trial. Scandinavian Breast Group 9401 study.
作者: J Bergh.;T Wiklund.;B Erikstein.;E Lidbrink.;H Lindman.;P Malmström.;P Kellokumpu-Lehtinen.;N O Bengtsson.;G Söderlund.;G Anker.;E Wist.;S Ottosson.;E Salminen.;P Ljungman.;H Holte.;J Nilsson.;C Blomqvist.;N Wilking.
来源: Lancet. 2000年356卷9239期1384-91页
Chemotherapy drug distribution varies greatly among individual patients. Therefore, we developed an individualised fluorouracil, epirubicin, cyclophosphamide (FEC) regimen to improve outcomes in patients with high-risk early breast cancer. We then did a randomised trial to compare this individually tailored FEC regimen with conventional adjuvant chemotherapy followed by consolidation with high-dose chemotherapy with stem-cell support.
2405. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group.
作者: M E Hannah.;W J Hannah.;S A Hewson.;E D Hodnett.;S Saigal.;A R Willan.
来源: Lancet. 2000年356卷9239期1375-83页
For 3-4% of pregnancies, the fetus will be in the breech presentation at term. For most of these women, the approach to delivery is controversial. We did a randomised trial to compare a policy of planned caesarean section with a policy of planned vaginal birth for selected breech-presentation pregnancies.
2406. Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: a randomised trial. rBPI21 Meningococcal Sepsis Study Group.
作者: M Levin.;P A Quint.;B Goldstein.;P Barton.;J S Bradley.;S D Shemie.;T Yeh.;S S Kim.;D P Cafaro.;P J Scannon.;B P Giroir.
来源: Lancet. 2000年356卷9234期961-7页
Endotoxin is a primary trigger of the inflammatory processes that lead to shock, multiorgan failure, and purpura fulminans in meningococcal sepsis. Bactericidal/permeability-increasing protein (BPI) is a natural protein, stored within the neutrophil granules, that binds to and neutralises the effects of endotoxin in vitro, in laboratory animals, and in humans. To establish whether a recombinant 21-kDa modified fragment of human BPI (rBPI21), containing the active antimicrobial and endotoxin-neutralising moiety, would decrease death and long-term disability from meningococcal sepsis, we did a randomised, double-blind, placebo-controlled trial of rBPI21 in children with severe meningococcal sepsis.
2407. Alternative strategies for stroke care: a prospective randomised controlled trial.
Organised specialist care for stroke improves outcome, but the merits of different methods of organisation are in doubt. This study compares the efficacy of stroke unit with stroke team or domiciliary care.
2408. A palliative-care intervention and death at home: a cluster randomised trial.
作者: M S Jordhøy.;P Fayers.;T Saltnes.;M Ahlner-Elmqvist.;M Jannert.;S Kaasa.
来源: Lancet. 2000年356卷9233期888-93页
The Palliative Medicine Unit at University Hospital of Trondheim, Norway, started an intervention programme that aims to enable patients to spend more time at home and die there if they prefer. Close cooperation was needed with the community health-care professionals, who acted as the principal formal caregivers, and a multidisciplinary consultant team coordinated the care. We did a cluster randomised trial to assess the intervention's effectiveness compared with conventional care
2409. Contribution of central sensitisation to the development of non-cardiac chest pain.
Non-cardiac chest pain mimics angina pectoris but generally originates from the oesophagus. Visceral hypersensitivity may contribute, but its neurophysiological basis is unclear. We investigated whether central sensitisation, an activity-dependent amplification of sensory transfer in the central nervous system, underlies visceral pain hypersensitivity and non-cardiac chest pain.
2410. Family support for stroke: a randomised controlled trial.
Attention is currently focused on family care of stroke survivors, but the effectiveness of support services is unclear. We did a single-blind, randomised, controlled trial to assess the impact of family support on stroke patients and their carers.
2411. Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial.
作者: T Takayama.;T Sekine.;M Makuuchi.;S Yamasaki.;T Kosuge.;J Yamamoto.;K Shimada.;M Sakamoto.;S Hirohashi.;Y Ohashi.;T Kakizoe.
来源: Lancet. 2000年356卷9232期802-7页
Postsurgical recurrence of hepatocellular carcinoma (HCC) is frequent and fatal. Adoptive immunotherapy is active against HCC. We assessed whether postoperative immunotherapy could lower the frequency of recurrence.
2412. Anthelminthic treatment and haemoglobin concentrations during pregnancy.
A longitudinal study was conducted in Sierra Leone to measure the impact of a single dose anthelminthic (400 mg albendazole) and daily iron-folate supplements (36 g iron and 5 mg folate) on haemoglobin (HG) concentration during pregnancy. After controlling for baseline Hb concentration and season, anthelmintic treatment reduced the decline in haemoglobin concentration between the first and third trimesters by 6.6 g/L (p=0.0034) relative to the control. The corresponding value for iron-folate supplements was 13.7 g/L(p<0.0001) [corrected]. These findings indicate that anthelminthic treatment should be included in strategies to control maternal anaemia in Sierra Leone.
2413. Doxycycline and rifampicin for mild scrub-typhus infections in northern Thailand: a randomised trial.
作者: G Watt.;P Kantipong.;K Jongsakul.;P Watcharapichat.;D Phulsuksombati.;D Strickman.
来源: Lancet. 2000年356卷9235期1057-61页
Some strains of scrub typhus in northern Thailand are poorly responsive to standard antirickettsial drugs. We therefore did a masked, randomised trial to compare rifampicin with standard doxycycline therapy for patients with scrub typhus.
2414. Helicobacter pylori test-and-eradicate versus prompt endoscopy for management of dyspeptic patients: a randomised trial.
作者: A T Lassen.;F M Pedersen.;P Bytzer.;O B Schaffalitzky de Muckadell.
来源: Lancet. 2000年356卷9228期455-60页
Strategies based on screening for Helicobacter pylori to manage dyspeptic patients in primary care have been proposed, but the clinical consequences are unclear. We did a randomised trial to assess the efficacy and safety of a test-and-eradicate strategy compared with prompt endoscopy in the management of patients with dyspepsia.
2415. Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial.
作者: P J Mease.;B S Goffe.;J Metz.;A VanderStoep.;B Finck.;D J Burge.
来源: Lancet. 2000年356卷9227期385-90页
Etanercept, a tumour-necrosis-factor inhibitor, has shown efficacy in the treatment of rheumatoid arthritis. Psoriatic arthritis and psoriasis are disease states in which tumour necrosis factor, a proinflammatory cytokine, is present in increased concentrations in joints and in the skin. Therefore, psoriatic arthritis and psoriasis may be appropriate therapeutic targets for etanercept.
2416. Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT).
作者: M J Brown.;C R Palmer.;A Castaigne.;P W de Leeuw.;G Mancia.;T Rosenthal.;L M Ruilope.
来源: Lancet. 2000年356卷9227期366-72页
The efficacy of antihypertensive drugs newer than diuretics and beta-blockers has not been established. We compared the effects of the calcium-channel blocker nifedipine once daily with the diuretic combination co-amilozide on cardiovascular mortality and morbidity in high-risk patients with hypertension.
2417. Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study.
作者: L Hansson.;T Hedner.;P Lund-Johansen.;S E Kjeldsen.;L H Lindholm.;J O Syvertsen.;J Lanke.;U de Faire.;B Dahlöf.;B E Karlberg.
来源: Lancet. 2000年356卷9227期359-65页
Calcium antagonists are a first-line treatment for hypertension. The effectiveness of diltiazem, a non-dihydropyridine calcium antagonist, in reducing cardiovascular morbidity or mortality is unclear. We compared the effects of diltiazem with that of diuretics, beta-blockers, or both on cardiovascular morbidity and mortality in hypertensive patients.
2418. Comparison of vasopeptidase inhibitor, omapatrilat, and lisinopril on exercise tolerance and morbidity in patients with heart failure: IMPRESS randomised trial.
作者: J L Rouleau.;M A Pfeffer.;D J Stewart.;D Isaac.;F Sestier.;E K Kerut.;C B Porter.;G Proulx.;C Qian.;A J Block.
来源: Lancet. 2000年356卷9230期615-20页
We aimed to assess in patients with congestive heart failure whether dual inhibition of neutral endopeptidase and angiotensin-converting enzyme (ACE) with the vasopeptidase inhibitor omapatrilat is better than ACE inhibition alone with lisinopril on functional capacity and clinical outcome.
2420. Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania.
作者: M Sweat.;S Gregorich.;G Sangiwa.;C Furlonge.;D Balmer.;C Kamenga.;O Grinstead.;T Coates.
来源: Lancet. 2000年356卷9224期113-21页
Access to HIV-1 voluntary counselling and testing (VCT) is severely limited in less-developed countries. We undertook a multisite trial of HIV-1 VCT to assess its impact, cost, and cost-effectiveness in less-developed country settings.
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