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3801. Lack of effect of walking on labor and delivery.
作者: S L Bloom.;D D McIntire.;M A Kelly.;H L Beimer.;R H Burpo.;M A Garcia.;K J Leveno.
来源: N Engl J Med. 1998年339卷2期76-9页
Walking during labor may reduce patients' discomfort and improve outcomes. We conducted a randomized trial of walking during active labor to determine whether it altered the duration of labor or other maternal or fetal outcomes. Women with uncomplicated pregnancies between 36 and 41 weeks' gestation and in active labor were randomly assigned either to walking or to no walking (usual care). Pedometers were used to quantify walking, and the time spent walking was recorded.
3802. A one-year trial of lamivudine for chronic hepatitis B. Asia Hepatitis Lamivudine Study Group.
作者: C L Lai.;R N Chien.;N W Leung.;T T Chang.;R Guan.;D I Tai.;K Y Ng.;P C Wu.;J C Dent.;J Barber.;S L Stephenson.;D F Gray.
来源: N Engl J Med. 1998年339卷2期61-8页
In preliminary trials, lamivudine, an oral nucleoside analogue, has shown promise for the treatment of chronic hepatitis B. We conducted a one-year, double-blind trial of lamivudine in 358 Chinese patients with chronic hepatitis B. The patients were randomly assigned to receive 25 mg of lamivudine (142 patients), 100 mg of lamivudine (143), or placebo (73) orally once daily. The patients underwent liver biopsies before entering the study and after completing the assigned treatment regimen. The primary end point was a reduction of at least two points in the Knodell necroinflammatory score.
3803. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma.
作者: T P Miller.;S Dahlberg.;J R Cassady.;D J Adelstein.;C M Spier.;T M Grogan.;M LeBlanc.;S Carlin.;E Chase.;R I Fisher.
来源: N Engl J Med. 1998年339卷1期21-6页
Patients with clinically localized, intermediate- or high-grade non-Hodgkin's lymphoma usually receive initial treatment with a doxorubicin-containing regimen such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Pilot studies suggest that eight cycles of CHOP alone or three cycles of CHOP followed by involved-field radiotherapy are effective in such patients.
3804. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol.
作者: M L Stefanick.;S Mackey.;M Sheehan.;N Ellsworth.;W L Haskell.;P D Wood.
来源: N Engl J Med. 1998年339卷1期12-20页
Guidelines established by the National Cholesterol Education Program (NCEP) promote exercise and weight loss for the treatment of abnormal lipoprotein levels. Little is known, however, about the effects of exercise or the NCEP diet, which is moderately low in fat and cholesterol, in persons with lipoprotein levels that place them at high risk for coronary heart disease.
3805. Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography.
作者: R J Adams.;V C McKie.;L Hsu.;B Files.;E Vichinsky.;C Pegelow.;M Abboud.;D Gallagher.;A Kutlar.;F T Nichols.;D R Bonds.;D Brambilla.
来源: N Engl J Med. 1998年339卷1期5-11页
Blood transfusions prevent recurrent stroke in children with sickle cell anemia, but the value of transfusions in preventing a first stroke is unknown. We used transcranial Doppler ultrasonography to identify children with sickle cell anemia who were at high risk for stroke and then randomly assigned them to receive standard care or transfusions to prevent a first stroke.
3806. The effects of self-administering emergency contraception.
Emergency postcoital contraception prevents pregnancy, but it must be prescribed by a doctor and taken within 72 hours of intercourse. It has been proposed that emergency contraception be made available without a prescription. We undertook a study to learn how women might behave if given a supply of emergency contraceptive pills to keep at home.
3807. Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome.
Obese women with the polycystic ovary syndrome are relatively unresponsive to the induction of ovulation by clomiphene. We hypothesized that reducing insulin secretion by administering metformin would increase the ovulatory response to clomiphene.
3808. A comparison of rectal diazepam gel and placebo for acute repetitive seizures.
作者: F E Dreifuss.;N P Rosman.;J C Cloyd.;J M Pellock.;R I Kuzniecky.;W D Lo.;F Matsuo.;G B Sharp.;J A Conry.;D C Bergen.;W E Bell.
来源: N Engl J Med. 1998年338卷26期1869-75页
Acute repetitive seizures are readily recognizable episodes involving increased seizure frequency. Urgent treatment is often required. Rectal diazepam gel is a promising therapy.
3809. Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer.
作者: D M Brizel.;M E Albers.;S R Fisher.;R L Scher.;W J Richtsmeier.;V Hars.;S L George.;A T Huang.;L R Prosnitz.
来源: N Engl J Med. 1998年338卷25期1798-804页
Radiotherapy is often the primary treatment for advanced head and neck cancer, but the rates of locoregional recurrence are high and survival is poor. We investigated whether hyperfractionated irradiation plus concurrent chemotherapy (combined treatment) is superior to hyperfractionated irradiation alone.
3810. Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to an invasive as compared with a conservative management strategy. Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital (VANQWISH) Trial Investigators.
作者: W E Boden.;R A O'Rourke.;M H Crawford.;A S Blaustein.;P C Deedwania.;R G Zoble.;L F Wexler.;R E Kleiger.;C J Pepine.;D R Ferry.;B K Chow.;P W Lavori.
来源: N Engl J Med. 1998年338卷25期1785-92页
Non-Q-wave myocardial infarction is usually managed according to an "invasive" strategy (i.e., one of routine coronary angiography followed by myocardial revascularization).
3811. Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy.
作者: J B Nachman.;H N Sather.;M G Sensel.;M E Trigg.;J M Cherlow.;J N Lukens.;L Wolff.;F M Uckun.;P S Gaynon.
来源: N Engl J Med. 1998年338卷23期1663-71页
Children with high-risk acute lymphoblastic leukemia (ALL) who have a slow response to initial chemotherapy (more than 25 percent blasts in the bone marrow on day 7) have a poor outcome despite intensive therapy. We conducted a randomized trial in which such patients were treated with either an augmented intensive regimen of post-induction chemotherapy or a standard regimen of intensive post-induction chemotherapy.
3812. Lack of efficacy of light reduction in preventing retinopathy of prematurity. Light Reduction in Retinopathy of Prematurity (LIGHT-ROP) Cooperative Group.
作者: J D Reynolds.;R J Hardy.;K A Kennedy.;R Spencer.;W A van Heuven.;A R Fielder.
来源: N Engl J Med. 1998年338卷22期1572-6页
Hospital-nursery lighting has been suggested as a factor in causing retinopathy of prematurity. Despite ongoing debate, a causal relation has not been established.
3813. A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina.
Activation of platelets is central to the pathophysiology of unstable angina. We studied whether inhibition of the final common pathway for platelet aggregation with tirofiban, a nonpeptide glycoprotein IIb/IIIa receptor antagonist, would improve clinical outcome in this condition.
3814. Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction.
Antithrombotic therapy improves the prognosis of patients with acute coronary syndromes, yet the syndromes remain a therapeutic challenge. We evaluated tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, in the treatment of unstable angina and non-Q-wave myocardial infarction.
3815. Chlorambucil in indolent chronic lymphocytic leukemia. French Cooperative Group on Chronic Lymphocytic Leukemia.
作者: G Dighiero.;K Maloum.;B Desablens.;B Cazin.;M Navarro.;R Leblay.;M Leporrier.;J Jaubert.;G Lepeu.;B Dreyfus.;J L Binet.;P Travade.
来源: N Engl J Med. 1998年338卷21期1506-14页
To determine whether chlorambucil treatment benefits patients with indolent chronic lymphocytic leukemia (CLL), we conducted two randomized trials in 1535 patients with previously untreated stage A CLL.
3816. The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenzavirus vaccine in children.
作者: R B Belshe.;P M Mendelman.;J Treanor.;J King.;W C Gruber.;P Piedra.;D I Bernstein.;F G Hayden.;K Kotloff.;K Zangwill.;D Iacuzio.;M Wolff.
来源: N Engl J Med. 1998年338卷20期1405-12页
Influenzavirus vaccine is used infrequently in healthy children, even though the rates of influenza in this group are high. We conducted a multicenter, double-blind, placebo-controlled trial of a live attenuated, cold-adapted, trivalent influenzavirus vaccine in children 15 to 71 months old.
3817. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group.
作者: I Goldstein.;T F Lue.;H Padma-Nathan.;R C Rosen.;W D Steers.;P A Wicker.
来源: N Engl J Med. 1998年338卷20期1397-404页
Sildenafil is a potent inhibitor of cyclic guanosine monophosphate hydrolysis [corrected] in the corpus cavernosum and therefore increases the penile response to sexual stimulation. We evaluated the efficacy and safety of sildenafil, administered as needed in two sequential double-blind studies of men with erectile dysfunction of organic, psychogenic, and mixed causes.
3818. Failure of cytarabine in progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection. AIDS Clinical Trials Group 243 Team.
作者: C D Hall.;U Dafni.;D Simpson.;D Clifford.;P E Wetherill.;B Cohen.;J McArthur.;H Hollander.;C Yainnoutsos.;E Major.;L Millar.;J Timpone.
来源: N Engl J Med. 1998年338卷19期1345-51页
Progressive multifocal leukoencephalopathy affects about 4 percent of patients with the acquired immunodeficiency syndrome (AIDS), and survival after the diagnosis of leukoencephalopathy averages only about three months. There have been anecdotal reports of improvement but no controlled trials of therapy with antiretroviral treatment plus intravenous or intrathecal cytarabine.
3819. Recombinant human interleukin-2, recombinant human interferon alfa-2a, or both in metastatic renal-cell carcinoma. Groupe Français d'Immunothérapie.
作者: S Negrier.;B Escudier.;C Lasset.;J Y Douillard.;J Savary.;C Chevreau.;A Ravaud.;A Mercatello.;J Peny.;M Mousseau.;T Philip.;T Tursz.
来源: N Engl J Med. 1998年338卷18期1272-8页
Recombinant human interleukin-2 (aldesleukin) and recombinant human interferon alfa can induce notable tumor regression in a limited number of patients with metastatic renal-cell carcinoma. We conducted a multicenter, randomized trial to determine the effect of each cytokine independently and in combination, and to identify patients who are best suited for this treatment.
3820. Interferon gamma-1b compared with placebo in metastatic renal-cell carcinoma. Canadian Urologic Oncology Group.
作者: M E Gleave.;M Elhilali.;Y Fradet.;I Davis.;P Venner.;F Saad.;L H Klotz.;M J Moore.;V Paton.;A Bajamonde.
来源: N Engl J Med. 1998年338卷18期1265-71页
Most trials of immunomodulators in metastatic renal-cell carcinoma have been uncontrolled and subject to selection bias. The objective of this blinded, placebo-controlled study was to compare overall response rates, time to disease progression, and survival of patients with metastatic renal-cell carcinoma treated with recombinant human interferon gamma-1b or placebo.
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