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2481. Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase III trial 10853. EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group.
作者: J P Julien.;N Bijker.;I S Fentiman.;J L Peterse.;V Delledonne.;P Rouanet.;A Avril.;R Sylvester.;F Mignolet.;H Bartelink.;J A Van Dongen.
来源: Lancet. 2000年355卷9203期528-33页
Ductal carcinoma in situ (DCIS) of the breast is a disorder that has become more common since it may manifest as microcalcifications that can be detected by screening mammography. Since selected women with invasive cancer can be treated safely with breast conservation therapy it is paradoxical that total mastectomy has remained the standard treatment for DCIS. We did a randomised phase III clinical trial to investigate the role of radiotherapy after complete local excision of DCIS.
2482. Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial.
作者: E G Vermeulen.;C D Stehouwer.;J W Twisk.;M van den Berg.;S C de Jong.;A J Mackaay.;C M van Campen.;F C Visser.;C A Jakobs.;E J Bulterjis.;J A Rauwerda.
来源: Lancet. 2000年355卷9203期517-22页
A high plasma homocysteine concentration is associated with increased risk of atherothrombotic disease. We investigated the effects of homocysteine-lowering treatment (folic acid plus vitamin B6) on markers of subclinical atherosclerosis among healthy siblings of patients with premature atherothrombotic disease.
2483. Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial.
作者: M Van Kampen.;W De Weerdt.;H Van Poppel.;D De Ridder.;H Feys.;L Baert.
来源: Lancet. 2000年355卷9198期98-102页
Urinary incontinence is a common long-term complication after radical prostatectomy. Spontaneous recovery of normal urinary control after surgery can take 1-2 years. We aimed to investigate whether there was any beneficial effect of pelvic-floor re-education for patients with urinary incontinence as a result of radical prostatectomy.
2484. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial.
作者: W F Carman.;A G Elder.;L A Wallace.;K McAulay.;A Walker.;G D Murray.;D J Stott.
来源: Lancet. 2000年355卷9198期93-7页
Vaccination of health-care workers has been claimed to prevent nosocomial influenza infection of elderly patients in long-term care. Data are, however, limited on this strategy. We aimed to find out whether vaccination of health-care workers lowers mortality and the frequency of virologically proven influenza in such patients.
2485. Effects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial.
作者: C Thompson.;A L Kinmonth.;L Stevens.;R C Peveler.;A Stevens.;K J Ostler.;R M Pickering.;N G Baker.;A Henson.;J Preece.;D Cooper.;M J Campbell.
来源: Lancet. 2000年355卷9199期185-91页
Depression is a major individual and public-health burden throughout the world and is managed mainly in primary care. The most effective strategy to reduce this burden has been believed to be education of primary-care practitioners. We tested this assumption by assessing the effectiveness of an educational programme based on a clinical-practice guideline in improving the recognition and outcome of primary-care depression.
2486. Laparoscopic or conventional Nissen fundoplication for gastro-oesophageal reflux disease: randomised clinical trial. The Netherlands Antireflux Surgery Study Group.
作者: J E Bais.;J F Bartelsman.;H J Bonjer.;M A Cuesta.;P M Go.;E C Klinkenberg-Knol.;J J van Lanschot.;J H Nadorp.;A J Smout.;Y van der Graaf.;H G Gooszen.
来源: Lancet. 2000年355卷9199期170-4页
For the surgical treatment of gastrooesophageal reflux disease (GORD), laparoscopic Nissen fundoplication has largely replaced the open procedure. Retrospective and prospective non-randomised studies have shown similar results after laparoscopic Nissen fundoplication compared with the open procedure.
2487. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators.
来源: Lancet. 2000年355卷9200期253-9页
Diabetes mellitus is a strong risk factor for cardiovascular and renal disease. We investigated whether the angiotensin-converting-enzyme (ACE) inhibitor ramipril can lower these risks in patients with diabetes.
2488. Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial.
作者: T L Griffiths.;M L Burr.;I A Campbell.;V Lewis-Jenkins.;J Mullins.;K Shiels.;P J Turner-Lawlor.;N Payne.;R G Newcombe.;A A Ionescu.;J Thomas.;J Tunbridge.
来源: Lancet. 2000年355卷9201期362-8页
Pulmonary rehabilitation seems to be an effective intervention in patients with chronic obstructive pulmonary disease. We undertook a randomised controlled trial to assess the effect of outpatient pulmonary rehabilitation on use of health care and patients' wellbeing over 1 year.
2489. Efficacy of artesunate plus pyrimethamine-sulphadoxine for uncomplicated malaria in Gambian children: a double-blind, randomised, controlled trial.
作者: L von Seidlein.;P Milligan.;M Pinder.;K Bojang.;C Anyalebechi.;R Gosling.;R Coleman.;J I Ude.;A Sadiq.;M Duraisingh.;D Warhurst.;A Alloueche.;G Targett.;K McAdam.;B Greenwood.;G Walraven.;P Olliaro.;T Doherty.
来源: Lancet. 2000年355卷9201期352-7页
Resistance to cheap effective antimalarial drugs, especially to pyrimethaminesulphadoxine (Fansidar), is likely to have a striking impact on childhood mortality in sub-Sharan Africa. The use of artesunate (artesunic acid) [corrected] in combination with pyrimethamine-sulphadoxine may delay or prevent resistance. We investigated the efficacy, safety, and tolerability of this combined treatment.
2490. Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery (The Dutch Bypass Oral Anticoagulants or Aspirin Study): a randomised trial.
来源: Lancet. 2000年355卷9201期346-51页
Oral anticoagulants and aspirin are antithrombotic drugs that are commonly used in patients with vascular disease. We investigated whether either of these treatments prevented more effectively than the other bypass complications after infrainguinal bypass surgery.
2491. Comparison of sibrafiban with aspirin for prevention of cardiovascular events after acute coronary syndromes: a randomised trial. The SYMPHONY Investigators. Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-acute Coronary Syndromes.
来源: Lancet. 2000年355卷9201期337-45页
Aspirin lowers risks of death and myocardial infarction in patients with acute coronary syndromes. Intravenous glycoprotein IIb/IIIa receptor antagonists further reduce the rates of ischaemic events in these patients, but the efficacy of long-term oral glycoprotein IIb/IIIa receptor blockade has not been established. We tested whether the oral glycoprotein IIb/IIIa receptor antagonist sibrafiban would prevent more cardiovascular events than aspirin, when given within 7 days of, and sustained for 90 days after, an acute coronary syndrome event.
2492. 15-month efficacy of maternal oral zidovudine to decrease vertical transmission of HIV-1 in breastfed African children. DITRAME ANRS 049 Study Group.
来源: Lancet. 1999年354卷9195期2050-1页
In a randomised, double-blind comparison of a maternal short regimen of oral zidovudine with placebo in West Africa the 15-month efficacy of zidovudine in preventing mother-to-child transmission of HIV-1 infection was estimated at 30% (95% CI -2 to 52).
2493. Treatment of hypertension with ascorbic acid.
作者: S J Duffy.;N Gokce.;M Holbrook.;A Huang.;B Frei.;J F Keaney.;J A Vita.
来源: Lancet. 1999年354卷9195期2048-9页
In a randomised, double-blind, placebo-controlled study we showed that treatment of hypertensive patients with ascorbic acid lowers blood pressure. Further studies of ascorbic acid to treat hypertension, with clinical endpoints, are warranted.
2494. Low-dose oral contraceptives and acquired resistance to activated protein C: a randomised cross-over study.
作者: J Rosing.;S Middeldorp.;J Curvers.;M Christella.;L G Thomassen.;G A Nicolaes.;J C Meijers.;B N Bouma.;H R Büller.;M H Prins.;G Tans.
来源: Lancet. 1999年354卷9195期2036-40页
We have reported previously that, compared with use of second-generation oral contraceptives, the use of third-generation oral contraceptives is associated with increased resistance to the anticoagulant action of activated protein C (APC). Owing to the cross-sectional design of that study, these observations may have been subject to unknown bias or uncontrolled effects of the menstrual cycle. We aimed to overcome these sources of bias by doing a cycle-controlled randomised cross-over trial.
2495. Effects of video information on precolonoscopy anxiety and knowledge: a randomised trial.
The provision of information before medical or surgical procedures should improve knowledge and allay anxiety about the pending procedure. This trial aimed to assess the value of an information video in this process.
2496. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial.
The pathogenesis of reflex sympathetic dystrophy (RSD) is not clear, nor is there a definitive treatment for this syndrome. The morbidity, costs in health care, and loss of work time justify the search for a means to prevent post-traumatic dystrophy. Although the role of toxic oxygen radicals has not yet been clarified, we investigated vitamin C (ascorbic acid) as a prophylactic antioxidant drug.
2497. Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa blockade in patients undergoing coronary stenting: results from a multicentre randomised trial. EPISTENT Investigators. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting.
作者: E J Topol.;D B Mark.;A M Lincoff.;E Cohen.;J Burton.;N Kleiman.;D Talley.;S Sapp.;J Booth.;C F Cabot.;K M Anderson.;R M Califf.
来源: Lancet. 1999年354卷9195期2019-24页
We assessed in a randomised trial the long-term outcomes for potent adjunctive antiplatelet therapy given at the time of coronary stenting.
2498. Efficacy and safety of long-chain polyunsaturated fatty acid supplementation of infant-formula milk: a randomised trial.
作者: A Lucas.;M Stafford.;R Morley.;R Abbott.;T Stephenson.;U MacFadyen.;A Elias-Jones.;H Clements.
来源: Lancet. 1999年354卷9194期1948-54页
We tested whether addition of n-3 and n-6 long-chain polyunsaturated fatty acids (LCPUFA) to infant-formula milk during the first 6 months promotes long-term cognitive and motor development, without adverse consequences.
2499. Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group.
作者: R Maini.;E W St Clair.;F Breedveld.;D Furst.;J Kalden.;M Weisman.;J Smolen.;P Emery.;G Harriman.;M Feldmann.;P Lipsky.
来源: Lancet. 1999年354卷9194期1932-9页
Not all patients with rheumatoid arthritis can tolerate or respond to methotrexate, a standard treatment for this disease. There is evidence that antitumour necrosis factor alpha (TNFalpha) is efficacious in relief of signs and symptoms. We therefore investigated whether infliximab, a chimeric human-mouse anti-TNFalpha monoclonal antibody would provide additional clinical benefit to patients who had active rheumatoid arthritis despite receiving methotrexate.
2500. Intrauterine insemination or in-vitro fertilisation in idiopathic subfertility and male subfertility: a randomised trial and cost-effectiveness analysis.
作者: A J Goverde.;J McDonnell.;J P Vermeiden.;R Schats.;F F Rutten.;J Schoemaker.
来源: Lancet. 2000年355卷9197期13-8页
Couples affected by idiopathic subfertility or male subfertility have an estimated spontaneous conception rate of about 2% per cycle. Although various infertility treatments are available, counselling of a couple in their choice of treatment is difficult because of the lack of consistent data from good-quality comparative studies. We compared the results of treatment with intrauterine insemination (IUI) with those of in-vitro fertilisation (IVF), and did a cost-effectiveness analysis.
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