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4241. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections.
Recurrent urinary tract infections are a problem for many postmenopausal women. Estrogen replacement restores atrophic mucosa, lowers vaginal pH, and may prevent urinary tract infections.
4242. A two-year trial of oleic and erucic acids ("Lorenzo's oil") as treatment for adrenomyeloneuropathy.
作者: P Aubourg.;C Adamsbaum.;M C Lavallard-Rousseau.;F Rocchiccioli.;N Cartier.;I Jambaqué.;C Jakobezak.;A Lemaitre.;F Boureau.;C Wolf.
来源: N Engl J Med. 1993年329卷11期745-52页
Adrenomyeloneuropathy is an X-linked recessive disorder characterized by myelopathy, peripheral neuropathy, and cerebral demyelination, which develop in association with the accumulation of very-long-chain fatty acids. The administration of oleic and erucic acids inhibits the synthesis of very-long-chain fatty acids. Recently such dietary treatment has been widely publicized as a possible cure for this disease.
4243. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.
The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was designed to compare new, aggressive thrombolytic strategies with standard thrombolytic regimens in the treatment of acute myocardial infarction. Our hypothesis was that newer thrombolytic strategies that produce earlier and sustained reperfusion would improve survival.
4244. A comparison of aspirin with placebo in patients treated with warfarin after heart-valve replacement.
作者: A G Turpie.;M Gent.;A Laupacis.;Y Latour.;J Gunstensen.;F Basile.;M Klimek.;J Hirsh.
来源: N Engl J Med. 1993年329卷8期524-9页
Despite the use of warfarin, major systemic embolism remains an important complication in patients with heart-valve replacement. Although the addition of antiplatelet agents has the potential to reduce this complication, their efficacy and safety when given in combination with warfarin are uncertain.
4245. A randomized study of outpatient treatment with ceftriaxone for selected febrile children with sickle cell disease.
作者: J A Wilimas.;P M Flynn.;S Harris.;S W Day.;R Smith.;P J Chesney.;J H Rodman.;J M Eguiguren.;D L Fairclough.;W C Wang.
来源: N Engl J Med. 1993年329卷7期472-6页
Because of their susceptibility to pneumococcal sepsis, children with sickle cell disease and fever are usually hospitalized for antibiotic therapy. Outpatient treatment may be a safe and less expensive alternative for selected patients.
4246. A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators.
The relative efficacies of various antiarrhythmic drugs in the treatment of ventricular tachyarrhythmias are not well known. This study examined the effectiveness of imipramine, mexiletine, pirmenol, procainamide, propafenone, quinidine, and sotalol in patients with ventricular tachyarrhythmias who were enrolled in the Electrophysiologic Study versus Electrocardiographic Monitoring trial.
4247. A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators.
Invasive electrophysiologic study and noninvasive Holter monitoring (in conjunction with exercise testing) have both been used to evaluate the efficacy of antiarrhythmic drugs in patients with sustained ventricular tachycardia and in survivors of cardiac arrest. We directly compared these two approaches to the prediction of drug efficacy.
4248. Radioimmunotherapy of B-cell lymphoma with [131I]anti-B1 (anti-CD20) antibody.
作者: M S Kaminski.;K R Zasadny.;I R Francis.;A W Milik.;C W Ross.;S D Moon.;S M Crawford.;J M Burgess.;N A Petry.;G M Butchko.
来源: N Engl J Med. 1993年329卷7期459-65页
Many patients with non-Hodgkin's lymphomas are not cured by current therapies, and new approaches to treatment are needed. As part of an ongoing phase 1 study, we examined the effect of radioimmunotherapy with 131I-labeled B-cell-specific anti-CD20 monoclonal antibody in 10 patients with CD20-positive B-cell lymphomas in whom primary chemotherapy had failed.
4249. Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer.
作者: J T Johnson.;G A Ferretti.;W J Nethery.;I H Valdez.;P C Fox.;D Ng.;C C Muscoplat.;S C Gallagher.
来源: N Engl J Med. 1993年329卷6期390-5页
We evaluated pilocarpine hydrochloride for the treatment of radiation-induced xerostomia, a common complication of irradiation of the head and neck. A prospective, randomized, double-blind, placebo-controlled trial was undertaken to test the safety and efficacy of pilocarpine, particularly in reversing the decrease in the production of saliva and other manifestations of xerostomia. Patients received either placebo or pilocarpine (5 mg or 10 mg orally three times a day) for 12 weeks and were evaluated at base line and every 4 weeks.
4250. Prehospital thrombolytic therapy in patients with suspected acute myocardial infarction.
The efficacy of thrombolytic therapy for acute myocardial infarction depends partly on how soon after the onset of symptoms it is administered. We therefore studied the efficacy and safety of thrombolytic therapy administered before hospital admission and thrombolytic therapy administered after admission in patients with suspected myocardial infarction.
4251. Low leukocyte counts with blast cells in cerebrospinal fluid of children with newly diagnosed acute lymphoblastic leukemia.
作者: H H Mahmoud.;G K Rivera.;M L Hancock.;R A Krance.;L E Kun.;F G Behm.;R C Ribeiro.;J T Sandlund.;W M Crist.;C H Pui.
来源: N Engl J Med. 1993年329卷5期314-9页
Treatment of the central nervous system is crucial to the successful treatment of acute lymphoblastic leukemia in children. The intensity and timing of the therapy are based on the presence or predicted risk of central nervous system leukemia as assessed according to criteria that remain controversial.
4252. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus.
A cause-and-effect relation between blood glucose concentrations and microvascular complications in patients with insulin-dependent diabetes mellitus has not been established.
4253. Zidovudine in persons with asymptomatic HIV infection and CD4+ cell counts greater than 400 per cubic millimeter. The European-Australian Collaborative Group.
作者: D A Cooper.;J M Gatell.;S Kroon.;N Clumeck.;J Millard.;F D Goebel.;J N Bruun.;G Stingl.;R L Melville.;J González-Lahoz.
来源: N Engl J Med. 1993年329卷5期297-303页
Zidovudine therapy is of benefit in the treatment of symptomatic and asymptomatic human immunodeficiency virus (HIV) infection in persons with CD4+ cell counts of less than 500 per cubic millimeter. The efficacy, safety, and duration of benefit of zidovudine in those with 500 or more CD4+ cells per cubic millimeter are uncertain.
4254. A comparison of directional atherectomy with balloon angioplasty for lesions of the left anterior descending coronary artery.
作者: A G Adelman.;E A Cohen.;B P Kimball.;R Bonan.;D R Ricci.;J G Webb.;L Laramee.;G Barbeau.;M Traboulsi.;B N Corbett.
来源: N Engl J Med. 1993年329卷4期228-33页
Restenosis is a major limitation of coronary angioplasty. Directional coronary atherectomy was developed with the expectation that it would provide better results than angioplasty, including a lower rate of restenosis. We undertook a randomized, multicenter trial to compare the rates of restenosis for atherectomy and angioplasty when used to treat lesions of the proximal left anterior descending coronary artery.
4255. A comparison of directional atherectomy with coronary angioplasty in patients with coronary artery disease. The CAVEAT Study Group.
作者: E J Topol.;F Leya.;C A Pinkerton.;P L Whitlow.;B Hofling.;C A Simonton.;R R Masden.;P W Serruys.;M B Leon.;D O Williams.
来源: N Engl J Med. 1993年329卷4期221-7页
Directional coronary atherectomy is a new technique of coronary revascularization by which atherosclerotic plaque is excised and retrieved from target lesions. With respect to the rate of restenosis and clinical outcomes, it is not known how this procedure compares with balloon angioplasty, which relies on dilation of the plaque and vessel wall. We compared the rate of restenosis after angioplasty with that after atherectomy.
4256. Effects of vesnarinone on morbidity and mortality in patients with heart failure. Vesnarinone Study Group.
作者: A M Feldman.;M R Bristow.;W W Parmley.;P E Carson.;C J Pepine.;E M Gilbert.;J E Strobeck.;G H Hendrix.;E R Powers.;R P Bain.
来源: N Engl J Med. 1993年329卷3期149-55页
Inotropic therapy, other than with digitalis glycosides, has had limited success in patients with chronic congestive heart failure. We investigated whether vesnarinone, a new positive inotropic agent, reduces morbidity and mortality and improves the quality of life of patients with symptomatic heart failure.
4257. Preventing bronchoconstriction in exercise-induced asthma with inhaled heparin.
We have previously reported that inhaled heparin prevents allergic bronchoconstriction in sheep and inhibits the anti-IgE-mediated release of histamine from mast cells in vitro. Since the release of such mediators has been implicated in exercise-induced asthma, we investigated whether inhaled heparin could also attenuate the bronchoconstrictor response in this disease.
4258. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures.
作者: N P Rosman.;T Colton.;J Labazzo.;P L Gilbert.;N B Gardella.;E M Kaye.;C Van Bennekom.;M R Winter.
来源: N Engl J Med. 1993年329卷2期79-84页
Phenobarbital, once widely prescribed to prevent febrile seizures, is now in disfavor because of its side effects and lack of efficacy. Diazepam, administered only during episodes of fever, may be a safe, effective agent to prevent the recurrence of febrile seizures.
4259. Mortality rates and risk factors for coronary disease in black as compared with white men and women.
作者: J E Keil.;S E Sutherland.;R G Knapp.;D T Lackland.;P C Gazes.;H A Tyroler.
来源: N Engl J Med. 1993年329卷2期73-8页
Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white populations. In this investigation, we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks.
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