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2962. Endarterectomy for moderate symptomatic carotid stenosis: interim results from the MRC European Carotid Surgery Trial.
来源: Lancet. 1996年347卷9015期1591-3页
The objective of this study was to assess whether carotid endarterectomy is an appropriate treatment for patients with recent cerebrovascular events in the territory supplied by a moderately stenosed (30-69%) internal carotid artery. Results have previously been reported for severe (70-99%) and mild (0-29%) stenosis.
2963. Clinical usefulness of serum 1,5-anhydroglucitol in monitoring glycaemic control.
作者: T Yamanouchi.;N Ogata.;T Tagaya.;T Kawasaki.;N Sekino.;H Funato.;L Akaoka.;H Miyashita.
来源: Lancet. 1996年347卷9014期1514-8页
To evaluate prospectively the clinical value of measuring serum concentrations of 1,5-anhydroglucitol (1,5AG) in monitoring glycaemia in patients with newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM), we measured serum 1,5AG in 56 such patients.
2964. Atovaquone and proguanil for Plasmodium falciparum malaria.
The increasing spread of multidrug-resistant Plasmodium falciparum malaria emphasises the urgent need for alternative treatment regimens. The objective of the study was to establish the efficacy of a novel drug combination. We compared a combination of atovaquone and proguanil with amodiaquine in the treatment of acute uncomplicated P falciparum malaria in Lambaréné, Gabon.
2965. Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions.
作者: L Kaiser.;D Lew.;B Hirschel.;R Auckenthaler.;A Morabia.;A Heald.;P Benedict.;F Terrier.;W Wunderli.;L Matter.;D Germann.;J Voegeli.;H Stalder.
来源: Lancet. 1996年347卷9014期1507-10页
Upper-respiratory-tract infection is one of the main causes of overuse of antibiotics. We have found previously that bacteria such as Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae can be isolated from the nasopharyngeal secretions of a substantial proportion of adults with upper-respiratory-tract infections. We have assessed the efficacy of co-amoxiclav in patients with common colds but no clinical signs of sinusitis or other indications for antibiotics.
2966. Comparison of acamprosate and placebo in long-term treatment of alcohol dependence.
作者: A B Whitworth.;F Fischer.;O M Lesch.;A Nimmerrichter.;H Oberbauer.;T Platz.;A Potgieter.;H Walter.;W W Fleischhacker.
来源: Lancet. 1996年347卷9013期1438-42页
About 50% of alcoholic patients relapse within 3 months of treatment. Previous studies have suggested that acamprosate may help to prevent such relapse. The aim of our study was to assess the efficacy and safety of long-term acamprosate treatment in alcohol dependence.
2967. Multicentre prospective randomised trial of fludarabine versus cyclophosphamide, doxorubicin, and prednisone (CAP) for treatment of advanced-stage chronic lymphocytic leukaemia. The French Cooperative Group on CLL.
作者: S Johnson.;A G Smith.;H Löffler.;E Osby.;G Juliusson.;B Emmerich.;P J Wyld.;W Hiddemann.
来源: Lancet. 1996年347卷9013期1432-8页
Fludarabine seems to be a promising treatment for patients with advanced chronic lymphocytic leukaemia (CLL). We compared fludarabine therapy with the combination of cyclophosphamide, doxorubicin, and prednisone (CAP) for treatment of CLL in a randomised, multicentre prospective trial.
2968. Dose-ranging study of riluzole in amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis/Riluzole Study Group II.
Amyotrophic lateral sclerosis (ALS) is a progressive disease with no effective treatment. In an initial study, riluzole decreased mortality and slowed muscle-strength deterioration in ALS patients. We have carried out a double-blind, placebo-controlled, multicentre study to confirm those findings and to assess drug efficacy at different doses.
2970. Identification of the enzyme responsible for oxidative halothane metabolism: implications for prevention of halothane hepatitis.
Fulminant hepatic necrosis ("halothane hepatitis") is an unusual and often fatal complication of halothane anaesthesia. It is mediated by immune sensitisation in susceptible individuals to trifluoroacetylated liver protein neoantigens, formed by oxidative halothane metabolism. The seminal event in halothane hepatitis is hepatic metabolism, yet the enzyme responsible for oxidative halothane metabolism and trifluoroacetylated neoantigen formation remains unidentified. This investigation tested the hypothesis that cytochrome P450 2E1 (CYP2E1) is responsible for human halothane metabolism in vivo.
2971. Randomised, controlled trial of low-dose heparin for prevention of fatal pulmonary embolism in patients with infectious diseases. The Heparin Prophylaxis Study Group.
Fatal pulmonary embolism and other thromboembolic complications are common in hospital inpatients. However, there is little evidence on the routine use of pharmacological thromboprophylaxis in non-surgical patients. We assessed the efficacy and safety of low-dose heparin in the prevention of hospital-acquired, clinically relevant, fatal pulmonary embolism in patients with infectious diseases.
2972. Impact of adjuvant therapy on quality of life in women with node-positive operable breast cancer. International Breast Cancer Study Group.
作者: C Hürny.;J Bernhard.;A S Coates.;M Castiglione-Gertsch.;H F Peterson.;R D Gelber.;J F Forbes.;C M Rudenstam.;E Simoncini.;D Crivellari.;A Goldhirsch.;H J Senn.
来源: Lancet. 1996年347卷9011期1279-84页
Adjuvant therapy for early breast cancer is effective but may be toxic. Our aim was to investigate the impact of the presence, timing, and duration of adjuvant chemotherapy on patients' perceptions of their quality of life (QL).
2973. Randomised controlled trial of single-dose antibiotic prophylaxis in surgical treatment of closed fractures: the Dutch Trauma Trial.
The efficacy of prophylactic antibiotics in fracture surgery remains controversial for lack of well-documented prospective studies. We report here the findings of the Dutch Trauma Trial, a prospective, randomised, double-blind, placebo-controlled study of antibiotic prophylaxis in the primary operative treatment of limb fractures. Ceftriaxone was chosen because of its pharmacokinetic profile, including high serum levels, high tissue penetration, and long elimination half-life, makes it suitable for single-dose prophylaxis.
2975. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. The Surgical Cooperative Group.
作者: A Cuschieri.;P Fayers.;J Fielding.;J Craven.;J Bancewicz.;V Joypaul.;P Cook.
来源: Lancet. 1996年347卷9007期995-9页
In Japan the surgical approach to treatment of potentially curable gastric cancer, including extended lymphadenectomy, seems in retrospective surveys to give better results than the less radical procedures favoured in Western countries. There has, however, been no evidence from randomised trials that extended lymphadenectomy (D2 gastric resection) confers a survival advantage. This question was addressed in a trial involving thirty-two surgeons in Europe.
2976. Randomised, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy.
作者: A W Majeed.;G Troy.;J P Nicholl.;A Smythe.;M W Reed.;C J Stoddard.;J Peacock.;A G Johnson.
来源: Lancet. 1996年347卷9007期989-94页
We report a prospective randomised comparison between laparoscopic and small-incision cholecystectomy in 200 patients which was designed to eliminate bias for or against either technique.
2977. Results of a breast-cancer-surgery trial compared with observational data from routine practice.
作者: E Marubini.;L Mariani.;B Salvadori.;U Veronesi.;R Saccozzi.;M Merson.;R Zucali.;F Rilke.
来源: Lancet. 1996年347卷9007期1000-3页
The strength of randomised controlled trials (RCTs) is that they allow investigators to draw reliable inferences about treatment differences; physicians can then make a choice between different options. Their weakness is that they are conducted on a set of patients who cannot be regarded as a random sample from the population that will be treated outside the trial. Observational data collected in a prospective clinical database may provide more realistic estimates.
2978. Transdermal oestrogen for treatment of severe postnatal depression.
Postnatal depression can have long-term adverse consequences for the mother, for the marital relationship, and for the infant's psychological development. Such depressions can be severe and resistant to both support and counselling and to therapy with antidepressant drugs. We investigated the antidepressant efficacy of oestrogen given transdermally.
2979. Randomised trial of endoscopic sphincterotomy with gallbladder left in situ versus open surgery for common bileduct calculi in high-risk patients.
作者: E M Targarona.;R M Ayuso.;J M Bordas.;E Ros.;I Pros.;J Martínez.;J Terés.;M Trías.
来源: Lancet. 1996年347卷9006期926-9页
Morbidity and mortality after surgical treatment of bileduct stones increase with age and associated diseases. A proposed alternative therapy is endoscopic sphincterotomy (ES) with the gallbladder left in situ, and we elected to compare this option with standard open surgery in high-risk patients.
2980. Randomised, double-blind, placebo-controlled study of fluoxetine in chronic fatigue syndrome.
作者: J H Vercoulen.;C M Swanink.;F G Zitman.;S G Vreden.;M P Hoofs.;J F Fennis.;J M Galama.;J W van der Meer.;G Bleijenberg.
来源: Lancet. 1996年347卷9005期858-61页
No somatic treatment has been found to be effective for chronic fatigue syndrome (CFS). Antidepressant therapy is commonly used. Fluoxetine is recommended in preference to tricyclic agents because it has fewer sedative and autonomic nervous system effects. However, there have been no randomised, placebo-controlled, double-blind studies showing the effectiveness of antidepressant therapy in CFS. We have carried out such a study to assess the effect of fluoxetine in depressed and non-depressed CFS patients.
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