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4401. Treatment of supraventricular tachycardia due to atrioventricular nodal reentry by radiofrequency catheter ablation of slow-pathway conduction.
作者: W M Jackman.;K J Beckman.;J H McClelland.;X Wang.;K J Friday.;C A Roman.;K P Moulton.;N Twidale.;H A Hazlitt.;M I Prior.
来源: N Engl J Med. 1992年327卷5期313-8页
Atrioventricular nodal reentrant tachycardia (AVNRT), the most common form of supraventricular tachycardia, results from conduction through a reentrant circuit comprising fast and slow atrioventricular nodal pathways. Antiarrhythmic-drug therapy is not consistently successful in controlling this rhythm disturbance. Catheter ablation of the fast pathway with radiofrequency current eliminates AVNRT, but it can produce heart block. We hypothesized that catheter ablation of the site of insertion of the slow pathway into the atrium would eliminate AVNRT while leaving normal (fast-pathway) atrioventricular nodal conduction intact.
4402. Treatment of preterm labor with the beta-adrenergic agonist ritodrine.
Beta-adrenergic agonists are commonly used to arrest premature labor. Although treatment of preterm labor with these agents can delay delivery by 24 to 48 hours, the potential risks and benefits to the mother and infant before and after delivery have not been adequately assessed.
4407. Prophylactic intravenous administration of standard immune globulin as compared with core-lipopolysaccharide immune globulin in patients at high risk of postsurgical infection.
作者: .;Alain Cometta.;Jean-Daniel Baumgartner.;Martin L Lee.;Geneviève Hanique.;Michel-Pierre Glauser.
来源: N Engl J Med. 1992年327卷4期234-40页
Infections and their sequelae are a major cause of death among patients admitted to the surgical intensive care unit (ICU). Studies of passive immunotherapy with standard intravenous immune globulin and hyperimmune globulin directed against gram-negative core lipopolysaccharide to prevent gram-negative infections and their serious systemic complications have had equivocal results in such patients.
4408. Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates. The Multicenter Group for the Study of Immune Globulin in Neonates.
作者: C J Baker.;M E Melish.;R T Hall.;D T Casto.;U Vasan.;L B Givner.
来源: N Engl J Med. 1992年327卷4期213-9页
Nosocomial infection is a major risk for premature infants with very low birth weights. One reason for their susceptibility to infection may be antibody deficiency, since there is little transfer of maternal IgG to the fetus before 32 weeks' gestation.
4410. Do the results of randomized clinical trials of cardiovascular drugs influence medical practice? The SAVE Investigators.
作者: G A Lamas.;M A Pfeffer.;P Hamm.;J Wertheimer.;J L Rouleau.;E Braunwald.
来源: N Engl J Med. 1992年327卷4期241-7页
Medical practice patterns change in response to a variety of stimuli, one of which may be the publication of the results of randomized clinical trials. We assessed the temporal association between the publication of clinical trials on myocardial infarction and changes in treatment practices for this disorder.
4411. Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction.
The Cardiac Arrhythmia Suppression Trial (CAST) tested the hypothesis that the suppression of asymptomatic or mildly symptomatic ventricular premature depolarizations in survivors of myocardial infarction would decrease the number of deaths from ventricular arrhythmias and improve overall survival. The second CAST study (CAST-II) tested this hypothesis with a comparison of moricizine and placebo.
4412. Calcium supplementation and increases in bone mineral density in children.
作者: C C Johnston.;J Z Miller.;C W Slemenda.;T K Reister.;S Hui.;J C Christian.;M Peacock.
来源: N Engl J Med. 1992年327卷2期82-7页
Increased dietary intake of calcium during childhood, usually as calcium in milk, is associated with increased bone mass in adulthood; the increase in mass is important in modifying the later risk of fracture. Whether the increase is due to the calcium content of milk, however, is not certain.
4413. High-osmolality and low-osmolality contrast agents.4414. A randomized trial of a program to reduce the use of psychoactive drugs in nursing homes.
作者: J Avorn.;S B Soumerai.;D E Everitt.;D Ross-Degnan.;M H Beers.;D Sherman.;S R Salem-Schatz.;D Fields.
来源: N Engl J Med. 1992年327卷3期168-73页
Although psychoactive medications have substantial side effects in the elderly, these drugs are used frequently in nursing homes. Few interventions have succeeded in changing this situation, and little is known about the clinical effects of such interventions.
4415. Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa. Epidermolysis Bullosa Study Group.
Recessive dystrophic epidermolysis bullosa is an uncommon, severely disabling, heritable disorder characterized by abnormal fragility of the skin. Open trials have suggested that phenytoin is an effective treatment, and this therapy is now widely used.
4416. Reactivation of unstable angina after the discontinuation of heparin.
Heparin is an effective, widely used treatment for unstable angina. Among patients enrolled in a double-blind, randomized, placebo-controlled trial comparing intravenous heparin, aspirin, both treatments, and neither during the acute phase of unstable angina, we encountered patients in whom unstable angina was reactivated after heparin was discontinued.
4417. The effect of high doses of calcium-channel blockers on survival in primary pulmonary hypertension.
Primary pulmonary hypertension is a progressive, fatal disease of unknown cause. Vasodilator drugs have been used as a treatment, but their efficacy is uncertain.
4418. Diagnosis and staging of colonic tumors by conventional abdominal sonography as compared with hydrocolonic sonography.
Ultrasonic examination has become increasingly important in the diagnosis of diseases of the gastrointestinal tract. In neoplastic diseases of the large intestine, however, the diagnostic value of conventional transabdominal sonography is limited. The purpose of this investigation was to determine whether the evaluation and staging of colonic tumors would be improved by the retrograde instillation of water into the colon in a procedure called hydrocolonic sonography.
4419. The use of digoxin-specific Fab fragments for severe digitalis intoxication in children.
Because life-threatening digitalis intoxication is unusual in children, treatment with digoxin-specific-antibody Fab fragments (Fab) has rarely been reported. We describe the efficacy of Fab in the treatment of children with severe digitalis intoxication.
4420. Localization of pancreatic endocrine tumors by endoscopic ultrasonography.
作者: T Rösch.;C J Lightdale.;J F Botet.;G A Boyce.;M V Sivak.;K Yasuda.;N Heyder.;L Palazzo.;H Dancygier.;V Schusdziarra.
来源: N Engl J Med. 1992年326卷26期1721-6页
After a pancreatic endocrine tumor has been diagnosed on the basis of clinical signs and the results of laboratory tests, localization of the tumor by the usual imaging procedures fails in as many as 40 to 60 percent of patients. Endoscopic ultrasonography, a sensitive test for small carcinomas of the pancreas, might also be useful in patients with endocrine tumors of the pancreas that cannot be localized by conventional methods.
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