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4361. Effect of vitamin and mineral supplementation on verbal and non-verbal reasoning of schoolchildren.
作者: I K Crombie.;J Todman.;G McNeill.;C D Florey.;I Menzies.;R A Kennedy.
来源: Lancet. 1990年335卷8692期744-7页
In a randomised controlled trial the effect of vitamin and mineral supplementation for seven months on performance in tests of reasoning was studied in 86 schoolchildren aged 11-13. A small, non-significant difference between the control and supplementation groups was found in a non-verbal test. The net difference in change in scores between the active and placebo groups was 2.4 units (95% CI-1.5 to 6.3). This direction of effect was not consistently seen with three other tests of non-verbal reasoning. Vitamin and mineral supplementation does not improve the performance of schoolchildren in tests of reasoning.
4364. Selective decontamination to reduce gram-negative colonisation and infections after oesophageal resection.
作者: G W Tetteroo.;J H Wagenvoort.;A Castelein.;H W Tilanus.;C Ince.;H A Bruining.
来源: Lancet. 1990年335卷8691期704-7页
181 patients undergoing resection of the oesophagus for carcinoma were randomised to receive selective decontamination (test group) or conventional perioperative antibiotic prophylaxis (controls). 114 patients were finally included in the study: 12 of 56 test patients had 18 infections, whereas 32 of 58 controls acquired 51 infections. Colonisation with aerobic gram-negative microorganisms, and the number of postoperative respiratory tract infections were significantly lower in the test patients. The postoperative therapeutic use of antibiotics was significantly lower in the test group. No endogenous infections were caused by gram-negative bacilli in the test group. Selective decontamination reduces colonisation with gram-negative bacilli and postoperative infections after resection of the oesophagus.
4365. Prenatal deficiency of phosphate, phosphate supplementation, and rickets in very-low-birthweight infants.
A preliminary study showed that placental histology was abnormal for babies who subsequently had rickets. The findings--low plasma phosphate concentration; maximum percentage tubular reabsorption of phosphate; and high urinary calcium loss--are those of renal conservation of phosphate in the presence of phosphate deficiency. In a controlled trial no baby receiving phosphate supplements (50 mg per day) had radiological evidence of rickets whereas bone changes were apparent in 42% of the control group. Prenatal deficiency of phosphate, due to placental insufficiency, can be corrected by phosphate supplementation thereby preventing rickets of prematurity.
4366. Inhibition of HIV progression by dithiocarb. German DTC Study Group.
60 patients with HIV-1 infection in Walter Reed stages 2-4 were randomised to treatment with intravenous or oral dithiocarb (diethyldithiocarbamate, DTC) or placebo for 24 weeks in a paired double-blind design. 55 patients were evaluable at the end of the study: no patient who had received DTC but 6 placebo patients had AIDS, a significant difference. Significantly delayed disease progression was observed in the intravenous DTC group compared with its matching placebo. The benefit in the oral DTC group was not statistically significant. During an 18-month follow-up 3 deaths occurred in the original placebo groups, whereas no patient who had initially received DTC died. A significant delay in progression to AIDS was observed in the DTC groups.
4370. Synergistic effect of prostaglandin E1 and isosorbide dinitrate in peripheral vascular disease.
作者: H Sinzinger.;P Fitscha.;J O'Grady.;F Rauscha.;W Rogatti.;J R Vane.
来源: Lancet. 1990年335卷8690期627-8页
Isosorbide dinitrate, which releases nitric oxide in vivo, and prostaglandin E1 synergised in reducing platelet deposition and increasing platelet survival time in patients with peripheral vascular disease.
4371. Effect of heparin, aspirin, or alteplase in reduction of myocardial ischaemia in refractory unstable angina.
作者: G G Neri Serneri.;G F Gensini.;L Poggesi.;F Trotta.;P A Modesti.;M Boddi.;A Ieri.;M Margheri.;G C Casolo.;M Bini.
来源: Lancet. 1990年335卷8690期615-8页
399 out of 474 inpatients with unstable angina were monitored for 48 h and 97 of these were found to be refractory to conventional antianginal treatments and entered a randomised double-blind study. With the initial protocol heparin infusion or bolus were compared with aspirin; with a modified protocol, heparin infusion, the best of these three treatments, was compared with alteplase. Patients were monitored for 3 days after starting treatment and then observed clinically for 4 more days. On the first days of treatment heparin infusion significantly decreased the frequency of angina (by 84-94%), episodes of silent ischaemia (by 71-77%), and the overall duration of ischaemia (by 81-86%). Heparin bolus and aspirin were not effective. Alteplase caused small (non-significant) reductions on the first day only. Only minor bleeding complications occurred.
4374. Trial of iloprost versus aspirin treatment for critical limb ischaemia of thromboangiitis obliterans. The TAO Study.
152 patients with thromboangiitis obliterans (Buerger's disease) and pain from critical leg ischaemia were randomly allocated to receive iloprost, a chemically stable prostacyclin analogue, or low-dose aspirin, for 28 days in a double-blind trial. On review, 19 patients did not fulfil the stringent entry criteria. Of the other 133 patients, 98 also had leg ulcers. After 21-28 days, 58 (85%) of 68 iloprost-treated patients showed ulcer healing or relief of ischaemic pain, compared with 11 (17%) of 65 in the aspirin-treated group. 43 (63%) on iloprost treatment had complete relief of pain, compared with 18 (28%) on aspirin. Ulcers healed completely in 18 of 52 (35%) who received iloprost compared with 6 of 46 (13%) who received aspirin. 6 months after the start of treatment, the response rate was 45 of 51 (88%) patients treated with iloprost compared with 12 of 44 (21%) patients treated with aspirin.
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