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3381. Imaging studies after a first febrile urinary tract infection in young children.
作者: Alejandro Hoberman.;Martin Charron.;Robert W Hickey.;Marc Baskin.;Diana H Kearney.;Ellen R Wald.
来源: N Engl J Med. 2003年348卷3期195-202页
Guidelines from the American Academy of Pediatrics recommend obtaining a voiding cystourethrogram and a renal ultrasonogram for young children after a first urinary tract infection; renal scanning with technetium-99m-labeled dimercaptosuccinic acid has also been endorsed by other authorities. We investigated whether imaging studies altered management or improved outcomes in young children with a first febrile urinary tract infection.
3382. Natalizumab for active Crohn's disease.
作者: Subrata Ghosh.;Eran Goldin.;Fiona H Gordon.;Helmut A Malchow.;Jørgen Rask-Madsen.;Paul Rutgeerts.;Petr Vyhnálek.;Zdena Zádorová.;Tanya Palmer.;Stephen Donoghue.; .
来源: N Engl J Med. 2003年348卷1期24-32页
In chronic inflammatory conditions such as Crohn's disease, the migration of leukocytes from the circulation into the parenchyma and their activation within inflammatory sites are mediated in part by alpha4 integrins.
3383. A controlled trial of natalizumab for relapsing multiple sclerosis.
作者: David H Miller.;Omar A Khan.;William A Sheremata.;Lance D Blumhardt.;George P A Rice.;Michele A Libonati.;Allison J Willmer-Hulme.;Catherine M Dalton.;Katherine A Miszkiel.;Paul W O'Connor.; .
来源: N Engl J Med. 2003年348卷1期15-23页
In patients with multiple sclerosis, inflammatory brain lesions appear to arise from autoimmune responses involving activated lymphocytes and monocytes. The glycoprotein alpha4 integrin is expressed on the surface of these cells and plays a critical part in their adhesion to the vascular endothelium and migration into the parenchyma. Natalizumab is an alpha4 integrin antagonist that reduced the development of brain lesions in experimental models and in a preliminary study of patients with multiple sclerosis.
3384. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients.
作者: James Dean Sandham.;Russell Douglas Hull.;Rollin Frederick Brant.;Linda Knox.;Graham Frederick Pineo.;Christopher J Doig.;Denny P Laporta.;Sidney Viner.;Louise Passerini.;Hugh Devitt.;Ann Kirby.;Michael Jacka.; .
来源: N Engl J Med. 2003年348卷1期5-14页
Some observational studies suggest that the use of pulmonary-artery catheters to guide therapy is associated with increased mortality.
3385. Tetrahydrobiopterin as an alternative treatment for mild phenylketonuria.
作者: Ania C Muntau.;Wulf Röschinger.;Matthias Habich.;Hans Demmelmair.;Björn Hoffmann.;Christian P Sommerhoff.;Adelbert A Roscher.
来源: N Engl J Med. 2002年347卷26期2122-32页
Hyperphenylalaninemia is a common inherited metabolic disease that is due to phenylalanine hydroxylase deficiency, and at least half the affected patients have mild clinical phenotypes. Treatment with a low-phenylalanine diet represents a substantial psychosocial burden, but alternative treatments have not been effective.
3386. Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis.
作者: Francis K L Chan.;Lawrence C T Hung.;Bing Y Suen.;Justin C Y Wu.;Kenneth C Lee.;Vincent K S Leung.;Aric J Hui.;Ka F To.;Wai K Leung.;Vincent W S Wong.;S C Sydney Chung.;Joseph J Y Sung.
来源: N Engl J Med. 2002年347卷26期2104-10页
Current guidelines recommend that patients at risk for ulcer disease who require treatment for arthritis receive nonsteroidal antiinflammatory drugs (NSAIDs) that are selective for cyclooxygenase-2 or the combination of a nonselective NSAID with a proton-pump inhibitor. We assessed whether celecoxib would be similar to diclofenac plus omeprazole in reducing the risk of recurrent ulcer bleeding in patients at high risk for bleeding.
3387. Comparison of caspofungin and amphotericin B for invasive candidiasis.
作者: Jorge Mora-Duarte.;Robert Betts.;Coleman Rotstein.;Arnaldo Lopes Colombo.;Luis Thompson-Moya.;Juanita Smietana.;Robert Lupinacci.;Carole Sable.;Nicholas Kartsonis.;John Perfect.; .
来源: N Engl J Med. 2002年347卷25期2020-9页
Caspofungin is an echinocandin agent with fungicidal activity against candida species. We performed a double-blind trial to compare caspofungin with amphotericin B deoxycholate for the primary treatment of invasive candidiasis.
3388. Effect of dialysis dose and membrane flux in maintenance hemodialysis.
作者: Garabed Eknoyan.;Gerald J Beck.;Alfred K Cheung.;John T Daugirdas.;Tom Greene.;John W Kusek.;Michael Allon.;James Bailey.;James A Delmez.;Thomas A Depner.;Johanna T Dwyer.;Andrew S Levey.;Nathan W Levin.;Edgar Milford.;Daniel B Ornt.;Michael V Rocco.;Gerald Schulman.;Steve J Schwab.;Brendan P Teehan.;Robert Toto.; .
来源: N Engl J Med. 2002年347卷25期2010-9页
The effects of the dose of dialysis and the level of flux of the dialyzer membrane on mortality and morbidity among patients undergoing maintenance hemodialysis are uncertain.
3389. Mass treatment to eliminate filariasis in Papua New Guinea.
作者: Moses J Bockarie.;Daniel J Tisch.;Will Kastens.;Neal D E Alexander.;Zachary Dimber.;Florence Bockarie.;Ervin Ibam.;Michael P Alpers.;James W Kazura.
来源: N Engl J Med. 2002年347卷23期1841-8页
The global initiative to eradicate bancroftian filariasis currently relies on mass treatment with four to six annual doses of antifilarial drugs. The goal is to reduce the reservoir of microfilariae in the blood to a level that is insufficient to maintain transmission by the mosquito vector.
3390. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation.
作者: Isabelle C Van Gelder.;Vincent E Hagens.;Hans A Bosker.;J Herre Kingma.;Otto Kamp.;Tsjerk Kingma.;Salah A Said.;Julius I Darmanata.;Alphons J M Timmermans.;Jan G P Tijssen.;Harry J G M Crijns.; .
来源: N Engl J Med. 2002年347卷23期1834-40页
Maintenance of sinus rhythm is the main therapeutic goal in patients with atrial fibrillation. However, recurrences of atrial fibrillation and side effects of antiarrhythmic drugs offset the benefits of sinus rhythm. We hypothesized that ventricular rate control is not inferior to the maintenance of sinus rhythm for the treatment of atrial fibrillation.
3391. A comparison of rate control and rhythm control in patients with atrial fibrillation.
作者: D G Wyse.;A L Waldo.;J P DiMarco.;M J Domanski.;Y Rosenberg.;E B Schron.;J C Kellen.;H L Greene.;M C Mickel.;J E Dalquist.;S D Corley.; .
来源: N Engl J Med. 2002年347卷23期1825-33页
There are two approaches to the treatment of atrial fibrillation: one is cardioversion and treatment with antiarrhythmic drugs to maintain sinus rhythm, and the other is the use of rate-controlling drugs, allowing atrial fibrillation to persist. In both approaches, the use of anticoagulant drugs is recommended.
3392. Oral miltefosine for Indian visceral leishmaniasis.
作者: Shyam Sundar.;T K Jha.;C P Thakur.;Juergen Engel.;Herbert Sindermann.;Christina Fischer.;Klaus Junge.;Anthony Bryceson.;Jonathan Berman.
来源: N Engl J Med. 2002年347卷22期1739-46页
There are 500,000 cases per year of visceral leishmaniasis, which occurs primarily in the Indian subcontinent. Almost all untreated patients die, and all the effective agents have been parenteral. Miltefosine is an oral agent that has been shown in small numbers of patients to have a favorable therapeutic index for Indian visceral leishmaniasis. We performed a clinical trial in India comparing miltefosine with the most effective standard treatment, amphotericin B.
3393. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus.
作者: Jan B F Hulscher.;Johanna W van Sandick.;Angela G E M de Boer.;Bas P L Wijnhoven.;Jan G P Tijssen.;Paul Fockens.;Peep F M Stalmeier.;Fiebo J W ten Kate.;Herman van Dekken.;Huug Obertop.;Hugo W Tilanus.;J Jan B van Lanschot.
来源: N Engl J Med. 2002年347卷21期1662-9页
Controversy exists about the best surgical treatment for esophageal carcinoma.
3394. Glycoprotein-D-adjuvant vaccine to prevent genital herpes.
作者: Lawrence R Stanberry.;Spotswood L Spruance.;Anthony L Cunningham.;David I Bernstein.;Adrian Mindel.;Stephen Sacks.;Stephen Tyring.;Fred Y Aoki.;Moncef Slaoui.;Martine Denis.;Pierre Vandepapeliere.;Gary Dubin.; .
来源: N Engl J Med. 2002年347卷21期1652-61页
An effective prophylactic vaccine would help control the spread of genital herpes.
3395. A controlled trial of a human papillomavirus type 16 vaccine.
作者: Laura A Koutsky.;Kevin A Ault.;Cosette M Wheeler.;Darron R Brown.;Eliav Barr.;Frances B Alvarez.;Lisa M Chiacchierini.;Kathrin U Jansen.; .
来源: N Engl J Med. 2002年347卷21期1645-51页
Approximately 20 percent of adults become infected with human papillomavirus type 16 (HPV-16). Although most infections are benign, some progress to anogenital cancer. A vaccine that reduces the incidence of HPV-16 infection may provide important public health benefits.
3396. Antimicrobial treatment in diabetic women with asymptomatic bacteriuria.
作者: Godfrey K M Harding.;George G Zhanel.;Lindsay E Nicolle.;Mary Cheang.; .
来源: N Engl J Med. 2002年347卷20期1576-83页
Asymptomatic bacteriuria is common among women with diabetes, and the treatment of such infections has been recommended to prevent complications related to symptomatic urinary tract infection.
3397. Dexamethasone in adults with bacterial meningitis.
Mortality and morbidity rates are high among adults with acute bacterial meningitis, especially those with pneumococcal meningitis. In studies of bacterial meningitis in animals, adjuvant treatment with corticosteroids has beneficial effects.
3398. Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis.
作者: Ana R Sousa.;Abhi Parikh.;Glenis Scadding.;Christopher J Corrigan.;Tak H Lee.
来源: N Engl J Med. 2002年347卷19期1493-9页
Patients with asthma who have aspirin sensitivity have greater cysteinyl leukotriene production and greater airway hyperresponsiveness to the effects of inhaled cysteinyl leukotrienes than their aspirin-tolerant counterparts. We hypothesized that the latter effect reflects elevated expression of the cysteinyl leukotriene receptor CysLT1 on inflammatory cells in the target organ and that its expression is down-regulated by aspirin desensitization.
3399. Effects of the amount and intensity of exercise on plasma lipoproteins.
作者: William E Kraus.;Joseph A Houmard.;Brian D Duscha.;Kenneth J Knetzger.;Michelle B Wharton.;Jennifer S McCartney.;Connie W Bales.;Sarah Henes.;Gregory P Samsa.;James D Otvos.;Krishnaji R Kulkarni.;Cris A Slentz.
来源: N Engl J Med. 2002年347卷19期1483-92页
Increased physical activity is related to reduced risk of cardiovascular disease, possibly because it leads to improvement in the lipoprotein profile. However, the amount of exercise training required for optimal benefit is unknown. In a prospective, randomized study, we investigated the effects of the amount and intensity of exercise on lipoproteins.
3400. Sex-based differences in the effect of digoxin for the treatment of heart failure.
The Digitalis Investigation Group trial reported that treatment with digoxin did not decrease overall mortality among patients with heart failure and depressed left ventricular systolic function, although it did reduce hospitalizations slightly. Even though the epidemiologic features, causes, and prognosis of heart failure vary between men and women, sex-based differences in the effect of digoxin were not evaluated.
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