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3841. Treatment of men with paraphilia with a long-acting analogue of gonadotropin-releasing hormone.
Men with deviant sexual behavior, or paraphilia, are usually treated with psychotherapy, antidepressant drugs, progestins, and antiandrogens, but these treatments are often ineffective. Selective inhibition of pituitary-gonadal function with a long-acting agonist analogue of gonadotropin-releasing hormone may abolish the deviant sexual behavior by reducing testosterone secretion.
3842. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group.
作者: H Decousus.;A Leizorovicz.;F Parent.;Y Page.;B Tardy.;P Girard.;S Laporte.;R Faivre.;B Charbonnier.;F G Barral.;Y Huet.;G Simonneau.
来源: N Engl J Med. 1998年338卷7期409-15页
The efficacy and safety of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis is still a matter of debate.
3843. Nutritional benefits of neonatal screening for cystic fibrosis. Wisconsin Cystic Fibrosis Neonatal Screening Study Group.
作者: P M Farrell.;M R Kosorok.;A Laxova.;G Shen.;R E Koscik.;W T Bruns.;M Splaingard.;E H Mischler.
来源: N Engl J Med. 1997年337卷14期963-9页
Many patients with cystic fibrosis are malnourished at the time of diagnosis. Whether newborn screening and early treatment may prevent the development of a nutritional deficiency is not known.
3844. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial.
作者: M Overgaard.;P S Hansen.;J Overgaard.;C Rose.;M Andersson.;F Bach.;M Kjaer.;C C Gadeberg.;H T Mouridsen.;M B Jensen.;K Zedeler.
来源: N Engl J Med. 1997年337卷14期949-55页
Irradiation after mastectomy can reduce locoregional recurrences in women with breast cancer, but whether it prolongs survival remains controversial. We conducted a randomized trial of radiotherapy after mastectomy in high-risk premenopausal women, all of whom also received adjuvant systemic chemotherapy with cyclophosphamide, methotrexate, and fluorouracil (CMF).
3845. Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. Pressure- and Volume-Limited Ventilation Strategy Group.
作者: T E Stewart.;M O Meade.;D J Cook.;J T Granton.;R V Hodder.;S E Lapinsky.;C D Mazer.;R F McLean.;T S Rogovein.;B D Schouten.;T R Todd.;A S Slutsky.
来源: N Engl J Med. 1998年338卷6期355-61页
A strategy of mechanical ventilation that limits airway pressure and tidal volume while permitting hypercapnia has been recommended for patients with the acute respiratory distress syndrome. The goal is to reduce lung injury due to overdistention. However, the efficacy of this approach has not been established.
3846. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome.
作者: M B Amato.;C S Barbas.;D M Medeiros.;R B Magaldi.;G P Schettino.;G Lorenzi-Filho.;R A Kairalla.;D Deheinzelin.;C Munoz.;R Oliveira.;T Y Takagaki.;C R Carvalho.
来源: N Engl J Med. 1998年338卷6期347-54页
In patients with the acute respiratory distress syndrome, massive alveolar collapse and cyclic lung reopening and overdistention during mechanical ventilation may perpetuate alveolar injury. We determined whether a ventilatory strategy designed to minimize such lung injuries could reduce not only pulmonary complications but also mortality at 28 days in patients with the acute respiratory distress syndrome.
3847. The relation of pneumothorax and other air leaks to mortality in the acute respiratory distress syndrome.
作者: J G Weg.;A Anzueto.;R A Balk.;H P Wiedemann.;E N Pattishall.;M A Schork.;L A Wagner.
来源: N Engl J Med. 1998年338卷6期341-6页
In patients with the acute respiratory distress syndrome, pneumothorax and other air leaks - any extrusion of air outside the tracheobronchial tree - have been attributed to high ventilatory pressures or volumes and linked to increased mortality.
3848. Reduction in pulmonary vascular resistance with long-term epoprostenol (prostacyclin) therapy in primary pulmonary hypertension.
Primary (idiopathic) pulmonary hypertension is a progressive, fatal disease. Conventional therapy with anticoagulant and vasodilator drugs may improve symptoms and survival among selected patients, but there is no evidence that the disease can be reversed.
3849. Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. Early Postmenopausal Intervention Cohort Study Group.
作者: D Hosking.;C E Chilvers.;C Christiansen.;P Ravn.;R Wasnich.;P Ross.;M McClung.;A Balske.;D Thompson.;M Daley.;A J Yates.
来源: N Engl J Med. 1998年338卷8期485-92页
Estrogen-replacement therapy prevents osteoporosis in postmenopausal women by inhibiting bone resorption, but the balance between its long-term risks and benefits remains unclear. Whether other antiresorptive therapies can prevent osteoporosis in these women is also not clear.
3850. A comparison of botulinum toxin and saline for the treatment of chronic anal fissure.
作者: G Maria.;E Cassetta.;D Gui.;G Brisinda.;A R Bentivoglio.;A Albanese.
来源: N Engl J Med. 1998年338卷4期217-20页
Chronic anal fissure is a tear in the lower half of the anal canal that is maintained by contraction of the internal anal sphincter. Sphincterotomy, the most widely used treatment, is a surgical procedure that permanently weakens the internal sphincter and may lead to anal deformity and incontinence.
3851. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome.
作者: P J Schmidt.;L K Nieman.;M A Danaceau.;L F Adams.;D R Rubinow.
来源: N Engl J Med. 1998年338卷4期209-16页
The symptoms of women with premenstrual syndrome improve in response to suppression of ovarian function, although these women have no evidence of ovarian dysfunction. We undertook a study to determine the role of estrogen and progesterone in this syndrome.
3852. Interleukin-2-receptor blockade with daclizumab to prevent acute rejection in renal transplantation. Daclizumab Triple Therapy Study Group.
作者: F Vincenti.;R Kirkman.;S Light.;G Bumgardner.;M Pescovitz.;P Halloran.;J Neylan.;A Wilkinson.;H Ekberg.;R Gaston.;L Backman.;J Burdick.
来源: N Engl J Med. 1998年338卷3期161-5页
Monoclonal antibodies that block the high-affinity interleukin-2 receptor expressed on alloantigen-reactive T lymphocytes may cause selective immunosuppression. Daclizumab is a genetically engineered human IgG1 monoclonal antibody that binds specifically to the alpha chain of the interleukin-2 receptor and may thus reduce the risk of rejection after renal transplantation.
3853. The role of a common variant of the cholesteryl ester transfer protein gene in the progression of coronary atherosclerosis. The Regression Growth Evaluation Statin Study Group.
作者: J A Kuivenhoven.;J W Jukema.;A H Zwinderman.;P de Knijff.;R McPherson.;A V Bruschke.;K I Lie.;J J Kastelein.
来源: N Engl J Med. 1998年338卷2期86-93页
The high-density lipoprotein (HDL) cholesterol concentration is inversely related to the risk of coronary artery disease. The cholesteryl ester transfer protein (CETP) has a central role in the metabolism of this lipoprotein and may therefore alter the susceptibility to atherosclerosis.
3854. Relation between therapy for hyperthyroidism and the course of Graves' ophthalmopathy.
作者: L Bartalena.;C Marcocci.;F Bogazzi.;L Manetti.;M L Tanda.;E Dell'Unto.;G Bruno-Bossio.;M Nardi.;M P Bartolomei.;A Lepri.;G Rossi.;E Martino.;A Pinchera.
来源: N Engl J Med. 1998年338卷2期73-8页
The chief clinical characteristics of Graves' disease are hyperthyroidism and ophthalmopathy. The relation between the two and the effect of treatment for hyperthyroidism on ophthalmopathy are unclear.
3855. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions.
We conducted a multi-institutional, randomized, blinded trial to determine whether the use of platelets from which leukocytes had been removed by a filter or that had been treated with ultraviolet B irradiation would prevent the formation of antiplatelet alloantibodies and refractoriness to platelet transfusions.
3856. Monitoring women at risk for preterm labor.
作者: D C Dyson.;K H Danbe.;J A Bamber.;Y M Crites.;D R Field.;J A Maier.;L A Newman.;D A Ray.;D L Walton.;M A Armstrong.
来源: N Engl J Med. 1998年338卷1期15-9页
Preterm birth is a major cause of perinatal morbidity and mortality. Whether the rate of preterm birth can be reduced by frequent contact between nurses and pregnant women or home monitoring of uterine activity is not known.
3857. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias.
Patients who survive life-threatening ventricular arrhythmias are at risk for recurrent arrhythmias. They can be treated with either an implantable cardioverter-defibrillator or antiarrhythmic drugs, but the relative efficacy of these two treatment strategies is unknown.
3858. Absence of toxicity of oats in patients with dermatitis herpetiformis.
作者: C M Hardman.;J J Garioch.;J N Leonard.;H J Thomas.;M M Walker.;J E Lortan.;A Lister.;L Fry.
来源: N Engl J Med. 1997年337卷26期1884-7页
People with gluten sensitivity should avoid foods containing wheat, rye, and barley, but there has been debate about whether they should avoid oats. Although patients with celiac disease have recently been shown to tolerate oats, less is known about the effects of oats on patients with dermatitis herpetiformis.
3859. The threshold for prophylactic platelet transfusions in adults with acute myeloid leukemia. Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto.
作者: P Rebulla.;G Finazzi.;F Marangoni.;G Avvisati.;L Gugliotta.;G Tognoni.;T Barbui.;F Mandelli.;G Sirchia.
来源: N Engl J Med. 1997年337卷26期1870-5页
Prophylactic platelet transfusions are usually administered to patients receiving myelotoxic chemotherapy when their platelet count falls below 20,000 per cubic millimeter. Some observations suggest that lower platelet counts can be appropriate in patients in stable condition, but the safety of lower thresholds is uncertain.
3860. Lamotrigine for generalized seizures associated with the Lennox-Gastaut syndrome. Lamictal Lennox-Gastaut Study Group.
作者: J Motte.;E Trevathan.;J F Arvidsson.;M N Barrera.;E L Mullens.;P Manasco.
来源: N Engl J Med. 1997年337卷25期1807-12页
The Lennox-Gastaut syndrome, a severe form of epilepsy that usually begins in early childhood, is difficult to treat. Dose-related drug toxicity is common.
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