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4562. A double-blind trial of a 16-hour transdermal nicotine patch in smoking cessation.
The use of nicotine chewing gum combined with psychological support improves the success rate in quitting smoking. We studied the safety and efficacy of a transdermal nicotine patch in smoking cessation.
4563. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure.
作者: J N Cohn.;G Johnson.;S Ziesche.;F Cobb.;G Francis.;F Tristani.;R Smith.;W B Dunkman.;H Loeb.;M Wong.
来源: N Engl J Med. 1991年325卷5期303-10页
To define better the efficacy of vasodilator therapy in the treatment of chronic congestive heart failure, we compared the effects of hydralazine and isosorbide dinitrate with those of enalapril in 804 men receiving digoxin and diuretic therapy for heart failure. The patients were randomly assigned in a double-blind manner to receive 20 mg of enalapril daily or 300 mg of hydralazine plus 160 mg of isosorbide dinitrate daily. The latter regimen was identical to that used with a similar patient population in the effective-treatment arm of our previous Vasodilator-Heart Failure Trial.
4564. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure.
作者: .;Salim Yusuf.;Bertram Pitt.;Clarence E Davis.;William B Hood.;Jay N Cohn.
来源: N Engl J Med. 1991年325卷5期293-302页
Patients with congestive heart failure have a high mortality rate and are also hospitalized frequently. We studied the effect of an angiotensin-converting-enzyme inhibitor, enalapril, on mortality and hospitalization in patients with chronic heart failure and ejection fractions less than or equal to 0.35.
4565. Treatment of acute cluster headache with sumatriptan.
Attacks of cluster headache are difficult to treat. Sumatriptan, an agonist of 5-hydroxytryptamine1-like receptors, has proved effective in the treatment of migraine. The clinical similarities between migraine and cluster headache and positive results from an open pilot study in patients with cluster headache indicated that sumatriptan should be evaluated more rigorously in the treatment of this condition.
4566. Treatment of migraine attacks with sumatriptan.
The headache in migraine attacks may be caused by dilatation of certain cranial arteries or arteriovenous anastomoses, by neurogenic dural plasma extravasation, or by both of these mechanisms. Sumatriptan, a novel selective agonist of 5-hydroxytryptamine-like receptors, blocks these phenomena. We investigated its efficacy in migraine.
4568. Sex differences in the management of coronary artery disease. Survival and Ventricular Enlargement Investigators.
作者: R M Steingart.;M Packer.;P Hamm.;M E Coglianese.;B Gersh.;E M Geltman.;J Sollano.;S Katz.;L Moyé.;L L Basta.
来源: N Engl J Med. 1991年325卷4期226-30页
Despite the fact that coronary artery disease is the leading cause of death among women, previous studies have suggested that physicians are less likely to pursue an aggressive approach to coronary artery disease in women than in men. To define this issue further, we compared the care previously received by men and women who were enrolled in a large postinfarction intervention trial.
4569. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer.
作者: J Crawford.;H Ozer.;R Stoller.;D Johnson.;G Lyman.;I Tabbara.;M Kris.;J Grous.;V Picozzi.;G Rausch.
来源: N Engl J Med. 1991年325卷3期164-70页
Neutropenia and infection are major dose-limiting side effects of chemotherapy. Previous studies have suggested that recombinant methionyl granulocyte colony-stimulating factor (G-CSF) can reduce chemotherapy-related neutropenia in patients with cancer. We conducted a randomized clinical trial to test this hypothesis and the clinical implications.
4570. Hyperendemic Streptococcus pyogenes infection despite prophylaxis with penicillin G benzathine.
作者: G C Gray.;J Escamilla.;K C Hyams.;J P Struewing.;E L Kaplan.;A K Tupponce.
来源: N Engl J Med. 1991年325卷2期92-7页
In closely confined populations, in which epidemics of Streptococcus pyogenes infection are common, penicillin G benzathine has long been used prophylactically to reduce morbidity from this pathogen. We report on our investigations of the effectiveness of penicillin G benzathine prophylaxis at a military recruit camp.
4571. Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee.
作者: J D Bradley.;K D Brandt.;B P Katz.;L A Kalasinski.;S I Ryan.
来源: N Engl J Med. 1991年325卷2期87-91页
The optimal short-term, symptomatic therapy for osteoarthritis of the knee has not been fully determined. Accordingly, we compared the efficacy of a nonsteroidal antiinflammatory drug, ibuprofen, given in either an antiinflammatory dose (high dose) or an analgesic dose (low dose), with that of acetaminophen, a pure analgesic.
4574. Cost effectiveness of prophylactic intravenous immune globulin in chronic lymphocytic leukemia.
A recent randomized controlled trial of intravenous immune globulin in patients with chronic lymphocytic leukemia and hypogammaglobulinemia demonstrated a statistically significant reduction in the rate of bacterial infections among patients who received intravenous immune globulin. We used decision-analysis techniques to determine whether prophylactic intravenous immune globulin is likely to result in an overall clinical benefit to patients who receive this treatment and to examine its cost effectiveness.
4575. Intravenous immune globulin for the prevention of bacterial infections in children with symptomatic human immunodeficiency virus infection.
Serious recurrent bacterial infections are a major cause of morbidity and mortality in children infected with the human immunodeficiency virus (HIV). Because intravenous immune globulin has been shown to prevent bacterial infection in patients with primary immunodeficiency and in uncontrolled studies of HIV-infected children, we undertook a multicenter study of its safety and efficacy in children with symptomatic HIV infection.
4576. A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial virus infection.
作者: D W Smith.;L R Frankel.;L H Mathers.;A T Tang.;R L Ariagno.;C G Prober.
来源: N Engl J Med. 1991年325卷1期24-9页
Although the antiviral agent ribavirin improves the course of lower respiratory tract disease in spontaneously breathing infants with respiratory syncytial virus infection, it is not known whether ribavirin can benefit infants with severe respiratory syncytial virus disease who require mechanical ventilation.
4577. Recovery of motor function after spinal-cord injury--a randomized, placebo-controlled trial with GM-1 ganglioside.
Spinal-cord injury is devastating; until recently, there was no medical treatment to improve recovery of the initial neurologic deficit. Studies in animals have shown that monosialotetrahexosylganglioside (GM-1) ganglioside enhances the functional recovery of damaged neurons.
4579. Improvement by acetylcysteine of hemodynamics and oxygen transport in fulminant hepatic failure.
作者: P M Harrison.;J A Wendon.;A E Gimson.;G J Alexander.;R Williams.
来源: N Engl J Med. 1991年324卷26期1852-7页
When administered early after an overdose of acetaminophen, intravenous acetylcysteine prevents hepatic necrosis by replenishing reduced stores of glutathione. How acetylcysteine improves the survival of patients with established liver damage induced by acetaminophen, however, is unknown. This study was undertaken to determine whether the beneficial effect of acetylcysteine under such circumstances could be due to enhancement of oxygen delivery and consumption.
4580. Prophylactic sclerotherapy for esophageal varices in men with alcoholic liver disease. A randomized, single-blind, multicenter clinical trial.
Sclerotherapy is an effective treatment for bleeding esophageal varices in patients with alcoholic liver disease. It has also been suggested that sclerotherapy might be effective in preventing initial episodes of bleeding and improving survival among such patients.
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