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3241. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock.
作者: J S Hochman.;L A Sleeper.;J G Webb.;T A Sanborn.;H D White.;J D Talley.;C E Buller.;A K Jacobs.;J N Slater.;J Col.;S M McKinlay.;T H LeJemtel.
来源: N Engl J Med. 1999年341卷9期625-34页
The leading cause of death in patients hospitalized for acute myocardial infarction is cardiogenic shock. We conducted a randomized trial to evaluate early revascularization in patients with cardiogenic shock.
3242. A comparison of calcium, vitamin D, or both for nutritional rickets in Nigerian children.
作者: T D Thacher.;P R Fischer.;J M Pettifor.;J O Lawson.;C O Isichei.;J C Reading.;G M Chan.
来源: N Engl J Med. 1999年341卷8期563-8页
Nutritional rickets remains prevalent in many tropical countries despite the fact that such countries have ample sunlight. Some postulate that a deficiency of dietary calcium, rather than vitamin D, is often responsible for rickets after infancy.
3244. Phenobarbital compared with phenytoin for the treatment of neonatal seizures.
作者: M J Painter.;M S Scher.;A D Stein.;S Armatti.;Z Wang.;J C Gardiner.;N Paneth.;B Minnigh.;J Alvin.
来源: N Engl J Med. 1999年341卷7期485-9页
Seizures occur in 1 to 2 percent of neonates admitted to an intensive care unit. The treatment is usually with either phenobarbital or phenytoin, but the efficacy of the two drugs has not been compared directly.
3245. Long-term clinical efficacy of grass-pollen immunotherapy.
作者: S R Durham.;S M Walker.;E M Varga.;M R Jacobson.;F O'Brien.;W Noble.;S J Till.;Q A Hamid.;K T Nouri-Aria.
来源: N Engl J Med. 1999年341卷7期468-75页
Pollen immunotherapy is effective in selected patients with IgE-mediated seasonal allergic rhinitis, although it is questionable whether there is long-term benefit after the discontinuation of treatment.
3246. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group.
作者: H B Rubins.;S J Robins.;D Collins.;C L Fye.;J W Anderson.;M B Elam.;F H Faas.;E Linares.;E J Schaefer.;G Schectman.;T J Wilt.;J Wittes.
来源: N Engl J Med. 1999年341卷6期410-8页
Although it is generally accepted that lowering elevated serum levels of low-density lipoprotein (LDL) cholesterol in patients with coronary heart disease is beneficial, there are few data to guide decisions about therapy for patients whose primary lipid abnormality is a low level of high-density lipoprotein (HDL) cholesterol.
3247. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis.
作者: P Sort.;M Navasa.;V Arroyo.;X Aldeguer.;R Planas.;L Ruiz-del-Arbol.;L Castells.;V Vargas.;G Soriano.;M Guevara.;P Ginès.;J Rodés.
来源: N Engl J Med. 1999年341卷6期403-9页
In patients with cirrhosis and spontaneous bacterial peritonitis, renal function frequently becomes impaired. This impairment is probably related to a reduction in effective arterial blood volume and is associated with a high mortality rate. We conducted a study to determine whether plasma volume expansion with intravenous albumin prevents renal impairment and reduces mortality in these patients.
3248. Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. Pediatric AIDS Clinical Trials Group Study 185 Team.
作者: L M Mofenson.;J S Lambert.;E R Stiehm.;J Bethel.;W A Meyer.;J Whitehouse.;J Moye.;P Reichelderfer.;D R Harris.;M G Fowler.;B J Mathieson.;G J Nemo.
来源: N Engl J Med. 1999年341卷6期385-93页
Maternal, obstetrical, and infant-related factors associated with the risk of perinatal transmission of human immunodeficiency virus type 1 (HIV-1) were identified before the widespread use of zidovudine therapy in pregnant women. The risk factors for transmission when women and infants receive zidovudine are not well characterized.
3249. Complementary clinical benefits of coronary-artery stenting and blockade of platelet glycoprotein IIb/IIIa receptors. Evaluation of Platelet IIb/IIIa Inhibition in Stenting Investigators.
作者: A M Lincoff.;R M Califf.;D J Moliterno.;S G Ellis.;J Ducas.;J H Kramer.;N S Kleiman.;E A Cohen.;J E Booth.;S K Sapp.;C F Cabot.;E J Topol.
来源: N Engl J Med. 1999年341卷5期319-27页
Inhibition of the platelet glycoprotein IIb/IIIa receptor with the monoclonal-antibody fragment abciximab reduces the acute ischemic complications associated with percutaneous coronary revascularization, whereas coronary-stent implantation reduces restenosis. We conducted a trial to determine the efficacy of abciximab and stent implantation in improving long-term outcome.
3250. Oral versus intravenous empirical antimicrobial therapy for fever in patients with granulocytopenia who are receiving cancer chemotherapy. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer.
作者: W V Kern.;A Cometta.;R De Bock.;J Langenaeken.;M Paesmans.;H Gaya.
来源: N Engl J Med. 1999年341卷5期312-8页
Intravenously administered antimicrobial agents have been the standard choice for the empirical management of fever in patients with cancer and granulocytopenia. If orally administered empirical therapy is as effective as intravenous therapy, it would offer advantages such as improved quality of life and lower cost.
3251. A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during cancer chemotherapy.
作者: A Freifeld.;D Marchigiani.;T Walsh.;S Chanock.;L Lewis.;J Hiemenz.;S Hiemenz.;J E Hicks.;V Gill.;S M Steinberg.;P A Pizzo.
来源: N Engl J Med. 1999年341卷5期305-11页
Among patients with fever and neutropenia during chemotherapy for cancer who have a low risk of complications, oral administration of empirical broad-spectrum antibiotics may be an acceptable alternative to intravenous treatment.
3252. Neostigmine for the treatment of acute colonic pseudo-obstruction.
Acute colonic pseudo-obstruction -- that is, massive dilation of the colon without mechanical obstruction -- may develop after surgery or severe illness. Although it may resolve with conservative therapy, colonoscopic decompression is sometimes needed to prevent ischemia and perforation of the bowel. Uncontrolled studies have suggested that neostigmine, may be an effective treatment.
3253. Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease. Atorvastatin versus Revascularization Treatment Investigators.
作者: B Pitt.;D Waters.;W V Brown.;A J van Boven.;L Schwartz.;L M Title.;D Eisenberg.;L Shurzinske.;L S McCormick.
来源: N Engl J Med. 1999年341卷2期70-6页
Percutaneous coronary revascularization is widely used in improving symptoms and exercise performance in patients with ischemic heart disease and stable angina pectoris. In this study, we compared percutaneous coronary revascularization with lipid-lowering treatment for reducing the incidence of ischemic events.
3254. A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure.
作者: G Brisinda.;G Maria.;A R Bentivoglio.;E Cassetta.;D Gui.;A Albanese.
来源: N Engl J Med. 1999年341卷2期65-9页
Lateral internal sphincterotomy, the most common treatment for chronic anal fissure, may cause permanent injury to the anal sphincter, which can lead to fecal incontinence. We compared two nonsurgical treatments that avert the risk of fecal incontinence. We randomly assigned 50 adults with symptomatic chronic posterior anal fissures to receive treatment with either a total of 20 U of botulinum toxin injected into the internal anal sphincter on each side of the anterior midline or 0.2 percent nitroglycerin ointment applied twice daily for six weeks.
3255. Vitamin A supplementation for extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network.
作者: J E Tyson.;L L Wright.;W Oh.;K A Kennedy.;L Mele.;R A Ehrenkranz.;B J Stoll.;J A Lemons.;D K Stevenson.;C R Bauer.;S B Korones.;A A Fanaroff.
来源: N Engl J Med. 1999年340卷25期1962-8页
Vitamin A supplementation may reduce the risk of chronic lung disease and sepsis in extremely-low-birth-weight infants. The results of our pilot study suggested that a dose of 5000 IU administered intramuscularly three times per week for four weeks was more effective than the lower doses given in past trials.
3256. Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking. European Respiratory Society Study on Chronic Obstructive Pulmonary Disease.
作者: R A Pauwels.;C G Löfdahl.;L A Laitinen.;J P Schouten.;D S Postma.;N B Pride.;S V Ohlsson.
来源: N Engl J Med. 1999年340卷25期1948-53页
Although patients with chronic obstructive pulmonary disease (COPD) should stop smoking, some do not. In a double-blind, placebo-controlled study, we evaluated the effect of the inhaled glucocorticoid budesonide in patients with mild COPD who continued smoking. After a six-month run-in period, we randomly assigned 1277 subjects (mean age, 52 years; mean forced expiratory volume in one second [FEV1], 77 percent of the predicted value; 73 percent men) to twice-daily treatment with 400 microg of budesonide or placebo, inhaled from a dry-powder inhaler, for three years.
3257. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. Department of Veterans Affairs Cooperative Study Group.
作者: D E Niewoehner.;M L Erbland.;R H Deupree.;D Collins.;N J Gross.;R W Light.;P Anderson.;N A Morgan.
来源: N Engl J Med. 1999年340卷25期1941-7页
Although their clinical efficacy is unclear and they may cause serious adverse effects, systemic glucocorticoids are a standard treatment for patients hospitalized with exacerbations of chronic obstructive pulmonary disease (COPD). We conducted a double-blind, randomized trial of systemic glucocorticoids (given for two or eight weeks) or placebo in addition to other therapies, for exacerbations of COPD. Most other care was standardized over the six-month period of follow-up. The primary end point was treatment failure, defined as death from any cause or the need for intubation and mechanical ventilation, readmission to the hospital for COPD, or intensification of drug therapy.
3258. Effects of different forms of dietary hydrogenated fats on serum lipoprotein cholesterol levels.
Metabolic studies suggest that fatty acids containing at least one double bond in the trans configuration, which are found in hydrogenated fat, have a detrimental effect on serum lipoprotein cholesterol levels as compared with unsaturated fatty acids containing double bonds only in the cis configuration. We compared the effects of diets with a broad range of trans fatty acids on serum lipoprotein cholesterol levels.
3259. Prevention of implantable-defibrillator shocks by treatment with sotalol. d,l-Sotalol Implantable Cardioverter-Defibrillator Study Group.
作者: A Pacifico.;S H Hohnloser.;J H Williams.;B Tao.;S Saksena.;P D Henry.;E N Prystowsky.
来源: N Engl J Med. 1999年340卷24期1855-62页
Patients with implantable cardioverter-defibrillators often receive adjunctive antiarrhythmic therapy to prevent frequent shocks. We tested the efficacy and safety of sotalol, a beta-blocker with class III antiarrhythmic effects, for this purpose.
3260. Facilitating transthoracic cardioversion of atrial fibrillation with ibutilide pretreatment.
作者: H Oral.;J J Souza.;G F Michaud.;B P Knight.;R Goyal.;S A Strickberger.;F Morady.
来源: N Engl J Med. 1999年340卷24期1849-54页
Atrial fibrillation cannot always be converted to sinus rhythm by transthoracic electrical cardioversion. We examined the effect of ibutilide, a class III antiarrhythmic agent, on the energy requirement for atrial defibrillation and assessed the value of this agent in facilitating cardioversion in patients with atrial fibrillation that is resistant to conventional transthoracic cardioversion.
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