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2861. Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis.
作者: D Barnes.;R A Hughes.;R W Morris.;O Wade-Jones.;P Brown.;T Britton.;D A Francis.;G D Perkin.;P Rudge.;M Swash.;H Katifi.;S Farmer.;J Frankel.
来源: Lancet. 1997年349卷9056期902-6页
An intravenous rather than oral course of methylprednisolone is often prescribed for treating acute relapses in multiple sclerosis (MS) despite the lack of evidence to support this route of administration. Our double-blind placebo-controlled randomised trial was designed to compare the efficacy of commonly used intravenous and oral steroid regimens in promoting recovery from acute relapses in MS.
2862. Medical Research Council randomised trial of endometrial resection versus hysterectomy in management of menorrhagia.
The most frequent indication for hysterectomy is menorrhagia, even though the uterus is normal in a large number of patients. Transcervical resection of the endometrium (TCRE) is a less drastic alternative, but success rates have varied and menorrhagia can recur. We have tested the hypothesis that the difference in the proportion of women dissatisfied and requiring further surgery within 3 years of TCRE or hysterectomy would be no more than 15%.
2865. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis.
作者: D P Brandjes.;H R Büller.;H Heijboer.;M V Huisman.;M de Rijk.;H Jagt.;J W ten Cate.
来源: Lancet. 1997年349卷9054期759-62页
Post-thrombotic syndrome varies from mild oedema to incapacitating swelling with pain and ulceration. We investigated the rate of post-thrombotic syndrome after a first episode of deep-vein thrombosis and assessed the preventive effect of direct application of a sized-to-fit graded compression stocking.
2866. Randomised double-blind active-placebo-controlled crossover trial of intravenous fentanyl in neuropathic pain.
The effectiveness of opioid analgesics in non-cancer neuropathic pain is unpredictable and can be disappointing. It is not clear whether opioids, when effective, relieve pain by decreasing pain intensity or pain unpleasantness or by their sedative effect. The aim of this prospective randomised double-blind placebo-controlled crossover trial was to assess relief of pain intensity and pain unpleasantness with intravenous infusions of fentanyl.
2867. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE).
作者: B Pitt.;R Segal.;F A Martinez.;G Meurers.;A J Cowley.;I Thomas.;P C Deedwania.;D E Ney.;D B Snavely.;P I Chang.
来源: Lancet. 1997年349卷9054期747-52页
To determine whether specific angiotensin II receptor blockade with losartan offers safety and efficacy advantages in the treatment of heart failure over angiotensin-converting-enzyme (ACE) inhibition with captopril, the ELITE study compared losartan with captopril in older heart-failure patients.
2868. Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis.
作者: F L van Buchem.;J A Knottnerus.;V J Schrijnemaekers.;M F Peeters.
来源: Lancet. 1997年349卷9053期683-7页
The value of antibiotics in acute rhinosinusitis is uncertain. Although maxillary sinusitis is commonly diagnosed and treated in general practice, no effectiveness studies have been done on unselected primary-care patients. We used a randomised, placebo-controlled design to test the hypothesis that there would be an improvement associated with amoxycillin treatment for acute maxillary sinusitis patients presenting to general practice.
2869. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators.
Survivors of acute myocardial infarction with frequent or repetitive ventricular premature depolarisations (VPDs) have higher mortality 1-2 years after the event than those without VPDs. Although there is no therapy of proven efficacy for such patients, previous studies of amiodarone have been encouraging. CAMIAT was a randomised double-blind placebo-controlled trial designed to assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (> or = 10 VPDs per h or > or = 1 run of ventricular tachycardia).
2870. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators.
作者: D G Julian.;A J Camm.;G Frangin.;M J Janse.;A Munoz.;P J Schwartz.;P Simon.
来源: Lancet. 1997年349卷9053期667-74页
Ventricular arrhythmias are a major cause of death after myocardial infarction, especially in patients with poor left-ventricular function. Previous attempts to identify and suppress arrhythmias with various antiarrhythmic drugs failed to reduce or actually increase mortality. Amiodarone is a powerful antiarrhythmic drug with several potentially beneficial actions, and has shown benefit in several small-scale studies. We postulated that this drug might reduce mortality in patients at high risk of death after myocardial infarction because of impaired ventricular function, irrespective of whether they had ventricular arrhythmias.
2871. Effect of neonatal circumcision on pain response during subsequent routine vaccination.
Preliminary studies suggested that pain experienced by infants in the neonatal period may have long-lasting effects on future infant behaviour. The objectives of this study were to find out whether neonatal circumcision altered pain response at 4-month or 6-month vaccination compared with the response in uncircumcised infants, and whether pretreatment of circumcision pain with lidocaine-prilocaine cream (Emla) affects the subsequent vaccination response.
2872. Randomised placebo-controlled trial of monthly intravenous immunoglobulin therapy in relapsing-remitting multiple sclerosis. Austrian Immunoglobulin in Multiple Sclerosis Study Group.
作者: F Fazekas.;F Deisenhammer.;S Strasser-Fuchs.;G Nahler.;B Mamoli.
来源: Lancet. 1997年349卷9052期589-93页
Multiple sclerosis is an autoimmune disorder characterised by the repeated occurrence of demyelinating lesions within the central nervous system. Uncontrolled studies and experimental evidence suggest beneficial effects of repeated administration of intravenous immunoglobulin (IVIg) by immunomodulating mechanisms and induction or remyelination. We aimed to investigate the efficacy of IVIg in a randomised double-blind multicentre study.
2874. Randomised comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation.
作者: K H Lindner.;B Dirks.;H U Strohmenger.;A W Prengel.;I M Lindner.;K G Lurie.
来源: Lancet. 1997年349卷9051期535-7页
Studies in animals have suggested that intravenous vasopressin is associated with better vital-organ perfusion and resuscitation rates than is epinephrine in the treatment of cardiac arrest. We did a randomised comparison of vasopressin with epinephrine in patients with ventricular fibrillation in out-of-hospital cardiac arrest.
2875. Randomised controlled trial of hydroquinine in muscle cramps.
作者: P H Jansen.;K C Veenhuizen.;A I Wesseling.;T de Boo.;A L Verbeek.
来源: Lancet. 1997年349卷9051期528-32页
Although quinine and hydroquinine are commonly prescribed for muscle cramps, controlled clinical trials of these drugs have reported mixed findings about efficacy. We investigated hydroquinine therapy in otherwise healthy adults who had frequent, ordinary muscle cramps.
2876. Randomised controlled trial of CDP571 antibody to tumour necrosis factor-alpha in Crohn's disease.
作者: W A Stack.;S D Mann.;A J Roy.;P Heath.;M Sopwith.;J Freeman.;G Holmes.;R Long.;A Forbes.;M A Kamm.
来源: Lancet. 1997年349卷9051期521-4页
Tumour necrosis factor-alpha (TNF alpha) is thought to have a central role in the pathogenesis of Crohn's disease. We tested the hypothesis that CDP571, a genetically engineered human antibody to TNF alpha, is effective in modifying disease activity in patients with moderately active Crohn's disease.
2877. Blood-pressure control in the hypertensive population.
In large-scale surveys of individuals with hypertension those whose clinic blood pressure is reduced to 140/90 mm Hg or less have been found to represent only a small fraction of the hypertensive population. We assessed whether these results arise because of a white-coat effect elevating clinic blood pressure.
2880. Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease. Australia/New Zealand Heart Failure Research Collaborative Group.
来源: Lancet. 1997年349卷9049期375-80页
In patients with heart failure, beta-blocker therapy improves left-ventricular function after 3-6 months of treatment, but effects of such treatment on symptoms and exercise performance are inconsistent, and the longer-term effects on death and other serious clinical events remain uncertain. We have investigated these issues in a double-blind, placebo-controlled, randomised trial of the beta-adrenergic blocker carvedilol (which also has alpha 1-blocking properties).
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