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3521. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group.
作者: M Packer.;M R Bristow.;J N Cohn.;W S Colucci.;M B Fowler.;E M Gilbert.;N H Shusterman.
来源: N Engl J Med. 1996年334卷21期1349-55页
Controlled clinical trials have shown that beta-blockers can produce hemodynamic and symptomatic improvement in chronic heart failure, but the effect of these drugs on survival has not been determined.
3522. Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications.
作者: J R O'Dell.;C E Haire.;N Erikson.;W Drymalski.;W Palmer.;P J Eckhoff.;V Garwood.;P Maloley.;L W Klassen.;S Wees.;H Klein.;G F Moore.
来源: N Engl J Med. 1996年334卷20期1287-91页
Rheumatoid arthritis is a common disease that causes substantial morbidity and mortality. The responses of patients with rheumatoid arthritis to treatment with a single so-called disease-modifying drug, such as methotrexate, are often suboptimal. Despite limited data, many patients are treated with combinations of these drugs.
3523. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group.
Mild perioperative hypothermia, which is common during major surgery, may promote surgical-wound infection by triggering thermoregulatory vasoconstriction, which decreases subcutaneous oxygen tension. Reduced levels of oxygen in tissue impair oxidative killing by neutrophils and decrease the strength of the healing wound by reducing the deposition of collagen. Hypothermia also directly impairs immune function. We tested the hypothesis that hypothermia both increases susceptibility to surgical-wound infection and lengthens hospitalization.
3524. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease.
作者: G S Omenn.;G E Goodman.;M D Thornquist.;J Balmes.;M R Cullen.;A Glass.;J P Keogh.;F L Meyskens.;B Valanis.;J H Williams.;S Barnhart.;S Hammar.
来源: N Engl J Med. 1996年334卷18期1150-5页
Lung cancer and cardiovascular disease are major causes of death in the United States. It has been proposed that carotenoids and retinoids are agents that may prevent these disorders.
3525. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease.
作者: C H Hennekens.;J E Buring.;J E Manson.;M Stampfer.;B Rosner.;N R Cook.;C Belanger.;F LaMotte.;J M Gaziano.;P M Ridker.;W Willett.;R Peto.
来源: N Engl J Med. 1996年334卷18期1145-9页
Observational studies suggest that people who consume more fruits and vegetables containing beta carotene have somewhat lower risks of cancer and cardiovascular disease, and earlier basic research suggested plausible mechanisms. Because large randomized trials of long duration were necessary to test this hypothesis directly, we conducted a trial of beta carotene supplementation.
3526. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents.
作者: A Schömig.;F J Neumann.;A Kastrati.;H Schühlen.;R Blasini.;M Hadamitzky.;H Walter.;E M Zitzmann-Roth.;G Richardt.;E Alt.;C Schmitt.;K Ulm.
来源: N Engl J Med. 1996年334卷17期1084-9页
The clinical benefit of coronary-artery stenting performed in conjunction with coronary angioplasty is limited by the risk of thrombotic occlusion of the stent as well as hemorrhagic and vascular complications of intensive anticoagulation. We compared antiplatelet therapy with conventional anticoagulant therapy with respect to clinical outcomes 30 days after coronary-artery stenting.
3527. Treatment of human immunodeficiency virus infection with saquinavir, zidovudine, and zalcitabine. AIDS Clinical Trials Group.
作者: A C Collier.;R W Coombs.;D A Schoenfeld.;R L Bassett.;J Timpone.;A Baruch.;M Jones.;K Facey.;C Whitacre.;V J McAuliffe.;H M Friedman.;T C Merigan.;R C Reichman.;C Hooper.;L Corey.
来源: N Engl J Med. 1996年334卷16期1011-7页
In patients with human immunodeficiency virus (HIV) infection, combined treatment with several agents may increase the effectiveness of antiviral therapy. We studied the safety and efficacy of saquinavir, an HIV-protease inhibitor, given with one or two nucleoside antiretroviral agents, as compared with the safety and efficacy of a combination of two nucleosides alone.
3528. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. TERMPROM Study Group.
作者: M E Hannah.;A Ohlsson.;D Farine.;S A Hewson.;E D Hodnett.;T L Myhr.;E E Wang.;J A Weston.;A R Willan.
来源: N Engl J Med. 1996年334卷16期1005-10页
As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. It is not known whether inducing labor will reduce this risk or whether one method of induction is better then another.
3529. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group.
作者: G Maschio.;D Alberti.;G Janin.;F Locatelli.;J F Mann.;M Motolese.;C Ponticelli.;E Ritz.;P Zucchelli.
来源: N Engl J Med. 1996年334卷15期939-45页
Drugs that inhibit angiotensin-converting enzyme slow the progression of renal insufficiency in patients with diabetic neuropathy. Whether these drugs have a similar action in patients with other renal diseases is not known. We conducted a study to determine the effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of renal insufficiency in patients with various underlying renal diseases.
3530. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. The Alprostadil Study Group.
Erectile dysfunction is a common medical problem affecting many men. Although several intracavernosal therapies are available, their efficacy and safety have not been studied systematically.
3531. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. The Tasman Study Group.
作者: M M Koopman.;P Prandoni.;F Piovella.;P A Ockelford.;D P Brandjes.;J van der Meer.;A S Gallus.;G Simonneau.;C H Chesterman.;M H Prins.
来源: N Engl J Med. 1996年334卷11期682-7页
An intravenous course of standard (unfractionated) heparin with the dose adjusted to prolong the activated partial-thromboplastin time to a desired length is the standard initial in-hospital treatment for patients with deep-vein thrombosis, but fixed-dose subcutaneous low-molecular-weight heparin appears to be as effective and safe. Because the latter treatment can be given on an outpatient basis, we compared the two treatments in symptomatic outpatients with proximal-vein thrombosis but no signs of pulmonary embolism.
3532. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis.
作者: M Levine.;M Gent.;J Hirsh.;J Leclerc.;D Anderson.;J Weitz.;J Ginsberg.;A G Turpie.;C Demers.;M Kovacs.
来源: N Engl J Med. 1996年334卷11期677-81页
Patients with acute proximal deep-vein thrombosis are usually treated first in the hospital with intravenous standard (unfractionated) heparin. However, the longer plasma half-life, better bioavailability after subcutaneous administration, and more predictable anticoagulant response of low-molecular-weight heparins make them attractive for possible home use. We compared these two approaches.
3534. Recombinant erythropoietin for the treatment of anemia in inflammatory bowel disease.
作者: S Schreiber.;S Howaldt.;M Schnoor.;S Nikolaus.;J Bauditz.;C Gasché.;H Lochs.;A Raedler.
来源: N Engl J Med. 1996年334卷10期619-23页
Some patients with inflammatory bowel disease have anemia that is refractory to treatment with iron and vitamins. We examined whether administering iron and recombinant erythropoietin could raise hemoglobin levels in such patients.
3535. Ragweed immunotherapy in adult asthma.
作者: P S Creticos.;C E Reed.;P S Norman.;J Khoury.;N F Adkinson.;C R Buncher.;W W Busse.;R K Bush.;J Gadde.;J T Li.
来源: N Engl J Med. 1996年334卷8期501-6页
Although allergen immunotherapy is effective for allergic rhinitis, its role in treating asthma is unclear.
3536. Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. Myeloma Aredia Study Group.
作者: J R Berenson.;A Lichtenstein.;L Porter.;M A Dimopoulos.;R Bordoni.;S George.;A Lipton.;A Keller.;O Ballester.;M J Kovacs.;H A Blacklock.;R Bell.;J Simeone.;D J Reitsma.;M Heffernan.;J Seaman.;R D Knight.
来源: N Engl J Med. 1996年334卷8期488-93页
Skeletal complications are a major clinical manifestation of multiple myeloma. These complications are caused by soluble factors that stimulate osteoclasts to resorb bone. Bisphosphonates such as pamidronate inhibit osteoclastic activity and reduce bone resorption.
3537. A controlled trial of a two-component acellular, a five-component acellular, and a whole-cell pertussis vaccine.
作者: L Gustafsson.;H O Hallander.;P Olin.;E Reizenstein.;J Storsaeter.
来源: N Engl J Med. 1996年334卷6期349-55页
Because of concern about safety and efficacy, no pertussis vaccine has been included in the vaccination program in Sweden since 1979. To provide data that might permit the reintroduction of a pertussis vaccine, we conducted a placebo-controlled trial of two acellular and one whole-cell pertussis vaccines.
3538. A controlled trial of two acellular vaccines and one whole-cell vaccine against pertussis. Progetto Pertosse Working Group.
作者: D Greco.;S Salmaso.;P Mastrantonio.;M Giuliano.;A E Tozzi.;A Anemona.;M L Ciofi degli Atti.;A Giammanco.;P Panei.;W C Blackwelder.;D L Klein.;S G Wassilak.
来源: N Engl J Med. 1996年334卷6期341-8页
Concern about both safety and efficacy has made the use of whole-cell pertussis vaccines controversial. In some European countries, including Italy, the rate of vaccination against pertussis is low.
3539. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension.
作者: R J Barst.;L J Rubin.;W A Long.;M D McGoon.;S Rich.;D B Badesch.;B M Groves.;V F Tapson.;R C Bourge.;B H Brundage.;S K Koerner.;D Langleben.;C A Keller.;S Murali.;B F Uretsky.;L M Clayton.;M M Jöbsis.;S D Blackburn.;D Shortino.;J W Crow.; .
来源: N Engl J Med. 1996年334卷5期296-301页
Primary pulmonary hypertension is a progressive disease for which no treatment has been shown in a prospective, randomized trial to improve survival.
3540. Lack of effect of thyroxine in patients with Graves' hyperthyroidism who are treated with an antithyroid drug.
Antithyroid drugs are effective in patients with hyperthyroidism due to Graves' disease, but the rate of recurrence after treatment is high. In a recent Japanese study, adjunctive treatment with thyroxine (T4) was associated with a recurrence rate 20 times lower than that among patients who received only an antithyroid drug. If these results are confirmed, combined therapy with an antithyroid drug and T4 might become the treatment of choice for all patients with Graves' hyperthyroidism.
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