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6085. Trial of dipyridamole-aspirin in recurring venous thrombosis.
38 patients (26 men) with recurring venous thromboembolism (RVTE) were enrolled in a prospective double-blind, placebo-controlled trial of dipyridamole (DPY), 100 mg a day, and aspirin (ASA), 1200 mg a day. Platelet survival (51Cr labelling of autologous platelets) was measured every 6 months for 18 months. 19 patients were randomised to treatment with DPY and ASA, and 1 had new venous thrombosis (after 15 months of treatment); 19 received placebo and 7 had new venous thrombosis (4--16 months later (chi 2 = 5.70; p< 0.05). DPY-ASA increased platelet survival whereas placebo treatment did not. The results suggest that in patients with RVTE and abnormal platelet survival time DPY in combination with ASA decreases the frequency of new venous thrombosis. Peptic ulcers developed in 2 patients treated with DPY-ASA.
6087. The Northwick Park electroconvulsive therapy trial.
作者: E C Johnstone.;J F Deakin.;P Lawler.;C D Frith.;M Stevens.;K McPherson.;T J Crow.
来源: Lancet. 1980年2卷8208-8209期1317-20页
70 patients with endogenous depression, defined by strict criteria, who fulfilled the Newcastle indications for electroconvulsive therapy (ECT) were randomly allocated either to a course of eight simulated ECTs or to a course of eight real ECTs. The improvement in terms of psychiatrists' ratings in the group of patients given real ECT was significantly greater (p < 0.01) than that in those given simulated ECT, but the difference between the two groups was small in relation to the considerable improvement of both groups over the 4-week treatment period. No differences were found between the two groups at one-month and six-month follow-up. The therapeutic benefits of electrically induced convulsions in depression were of lesser magnitude and were more transient than has sometimes been claimed. In the real-ECT group memory was impaired during treatment but memory tests revealed no difference between the groups at six-month follow-up.
6090. Does a change in the composition of human milk affect sucking patterns and milk intake?
Human breast milk of high and low fat content was fed to twenty-four babies aged 4-9 days from bottles. Changes in fat content parallel to those found during the course of a breast-feed (i.e., switching the baby from low-fat breast milk to high-fat breast milk) did not alter either milk intake rate or sucking patterns.
6091. Aminoacid therapy of alcoholic hepatitis.
35 consecutive patients with alcoholic hepatitis were randomly allocated to control (18 patients) and study (17 patients) groups. All patients were offered a 3000 kcal 100 g protein diet and were studied for 28 days. The study group received 70-85 g of intravenous aminoacids daily in the form of 'Aminosyn' or 'Travasol'. Both groups had similar clinical and biochemical features at the time of randomisation. Ascites and encephalopathy tended to improve more in the study group. Serum concentrations of bilirubin (p < 0.01) and albumin (p < 0.025) improved in the study but not in the control group. 4 patients died in the control group, but none died in the study group. Intravenous therapy with aminoacid for 4 weeks seemed to be associated with lower mortality rate (p < 0.02) and improved serum bilirubin and albumin concentrations in patients with alcoholic hepatitis.
6092. Controlled trial of Pseudomonas immunoglobulin and vaccine in burn patients.
In a controlled trial burn patients at risk of Pseudomonas aeruginosa septicaemia were passively immunised with an immunoglobulin prepared from plasma from healthy human volunteers vaccinated with a polyvalent pseudomonas vaccine; passively immunised and vaccinated; or only vaccinated. In children the mortality was lowest in those passively immunised (0%, 0/18); it was 21% (9/42) in controls. In adults the mortality rate of those receiving immunoglobulin or vaccine was 10% (3/30) or 8.3% (5/60), respectively, compared with 36% (22/61) in controls. Combined vaccine and immunoglobulin treatment gave rather less protection (mortality 13.6%, 3/22) than vaccine alone. Pseudomonas infection of burns was less common in patients who received immunoglobulin than in vaccinated or control patients.
6096. Hepatitis B vaccine: immune responses in haemodialysis patients.
Antibody to hepatitis B surface antigen (anti-HBs) developed within six months in 80% of haemodialysis patients given either two or three 40 micrograms doses of hepatitis B vaccine. A total of 89% had anti-HBs after a booster dose given six months later. Anti-HBs titres were higher in patients who received three initial doses than in those who received only two doses, but the proportion of anti-HBs-positive patients was the same in the two groups. Male patients became anti-HBs positive less often than females and their antibody titres were lower.
6099. Safety and patient acceptability of intravenous immune globulin in 10% maltose.
作者: H D Ochs.;R H Buckley.;B Pirofsky.;S H Fischer.;R H Rousell.;C J Anderson.;R J Wedgwood.
来源: Lancet. 1980年2卷8205期1158-9页
The safety and patient acceptance of two preparations of modified (reduced and alkylated) immune globulin for intravenous use were evaluated; one preparation was formulated as a 5% solution in 10% maltose (IGIV-maltose), the other did not contain maltose (IGIV). In this double-blind trial each of 29 immunodeficient patients received three consecutive monthly infusions (100 or 150 mg/kg immune globulin) of one preparation before being crossed over to the other. Only 3 of 29 patients had adverse reactions when on IGIV-maltose, compared with 22 who had side-effects during infusions of IGIV (p < 0.001). Adverse reactions were recorded during 3 of 87 IGIV-maltose infusions and during 51 infusions with the maltose-free IGIV (p < 0.001). 27 patients expressed preference for IGIV-maltose. IGIV-maltose seems safe and will permit rapid infusion of large doses of immune globulin, thus improving the management of patients with antibody deficiency diseases.
6100. Prevention of spinal osteoporosis in oophorectomised women.
100 women who had taken part in a prospective controlled trial of oestrogen therapy for prevention of post-oophorectomy bone loss were reviewed after a median follow-up period of nine years. A significant reduction in height occurred among the placebo-treated group, but not in the group treated with mestranol (mean 23 x 3 micrograms/day). The placebo-treated group had a higher spine score, lower central vertebral height, and larger wedge-angle than the oestrogen group. Within each group none of these spinal morphometric changes correlated with changes in mineral content of metacarpal or radial bones as measured by photon absorptiometry or X-ray densitometry, although both peripheral and central measurements showed highly significant differences between groups. Oestrogen treatment, therefore, prevents against central, as well as peripheral, bone loss, and reduces the incidence of vertebral compression.
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