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3701. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group.
Renal function declines progressively in patients who have diabetic nephropathy, and the decline may be slowed by antihypertensive drugs. The purpose of this study was to determine whether captopril has kidney-protecting properties independent of its effect on blood pressure in diabetic nephropathy.
3702. A comparison of subcutaneous low-molecular-weight heparin with warfarin sodium for prophylaxis against deep-vein thrombosis after hip or knee implantation.
作者: R Hull.;G Raskob.;G Pineo.;D Rosenbloom.;W Evans.;T Mallory.;K Anquist.;F Smith.;G Hughes.;D Green.
来源: N Engl J Med. 1993年329卷19期1370-6页
Deep-vein thrombosis is a potentially life-threatening complication of total hip or knee replacement. There are few data on the effectiveness and safety of warfarin as compared with low-molecular-weight heparin as prophylaxis against this problem.
3703. A comparison of real-time compression ultrasonography with impedance plethysmography for the diagnosis of deep-vein thrombosis in symptomatic outpatients.
作者: H Heijboer.;H R Büller.;A W Lensing.;A G Turpie.;L P Colly.;J W ten Cate.
来源: N Engl J Med. 1993年329卷19期1365-9页
Impedance plethysmography performed serially over a one-week period has been shown to be an effective diagnostic strategy for patients with clinically suspected acute deep-vein thrombosis. Compression ultrasonography has a high sensitivity and specificity for the detection of proximal-vein thrombosis. The clinical value of repeated ultrasonography in the management of symptomatic deep-vein thrombosis is unknown.
3704. A controlled trial of an expansile metal stent for palliation of esophageal obstruction due to inoperable cancer.
Esophageal obstruction due to cancer can produce debilitating dysphagia. Rapid palliation is usually possible with endoscopic placement of a plastic esophageal prosthesis, but this device has a high rate of complications. A new alternative is a metal-mesh stent that collapses to 3 mm in diameter at placement but can then expand up to 16 mm.
3705. Cyclosporine, methotrexate, and prednisone compared with cyclosporine and prednisone for prophylaxis of acute graft-versus-host disease.
作者: N J Chao.;G M Schmidt.;J C Niland.;M D Amylon.;A C Dagis.;G D Long.;A P Nademanee.;R S Negrin.;M R O'Donnell.;P M Parker.
来源: N Engl J Med. 1993年329卷17期1225-30页
Acute graft-versus-host disease (GVHD) following allogeneic bone marrow transplantation remains a serious problem. In a clinical trial, we tested the combination of cyclosporine and prednisone with and without methotrexate for the prevention of GVHD.
3706. Prevention of preeclampsia with low-dose aspirin in healthy, nulliparous pregnant women. The National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units.
作者: B M Sibai.;S N Caritis.;E Thom.;M Klebanoff.;D McNellis.;L Rocco.;R H Paul.;R Romero.;F Witter.;M Rosen.
来源: N Engl J Med. 1993年329卷17期1213-8页
Although low-dose aspirin has been reported to reduce the incidence of preeclampsia among women at high risk for this complication, its efficacy and safety in healthy, nulliparous pregnant women are not known.
3707. Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone.
Benzopyrones can reduce the volume of high-protein edema fluid by stimulating proteolysis. These compounds provide a method for removing excess protein and its consequent edema and reduce its clinical sequelae, such as chronic inflammation and secondary infections.
3708. Reduction of solar keratoses by regular sunscreen use.
The incidence of and mortality from skin cancer are increasing in many countries. In view of the added concern about ozone depletion, many organizations are promoting the regular use of sunscreens to prevent skin cancer, despite the absence of evidence that these products have this effect. Solar (actinic) keratosis is a precursor of squamous-cell carcinoma of the skin.
3709. A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery.
作者: J W Newburger.;R A Jonas.;G Wernovsky.;D Wypij.;P R Hickey.;K C Kuban.;D M Farrell.;G L Holmes.;S L Helmers.;J Constantinou.;E Carrazana.;J K Barlow.;A Z Walsh.;K C Lucius.;J C Share.;D L Wessel.;F L Hanley.;J E Mayer.;A R Costaneda.;J H Ware.
来源: N Engl J Med. 1993年329卷15期1057-64页
Hypothermic circulatory arrest is a widely used support technique during heart surgery in infants, but its effects on neurologic outcome have been controversial. An alternative method, low-flow cardiopulmonary bypass, maintains continuous cerebral circulation but may increase exposure to known pump-related sources of brain injury, such as embolism or inadequate cerebral perfusion.
3710. A short-term clinical evaluation of L-697,661, a non-nucleoside inhibitor of HIV-1 reverse transcriptase. L-697,661 Working Group.
作者: M S Saag.;E A Emini.;O L Laskin.;J Douglas.;W I Lapidus.;W A Schleif.;R J Whitley.;C Hildebrand.;V W Byrnes.;J C Kappes.
来源: N Engl J Med. 1993年329卷15期1065-72页
The non-nucleoside reverse transcriptase inhibitors are novel antiretroviral agents with selective activity in vitro against human immunodeficiency virus type 1 (HIV-1). They act through direct inhibition of reverse transcriptase and are not incorporated into DNA.
3711. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.
作者: .;D M Nathan.;S Genuth.;J Lachin.;P Cleary.;O Crofford.;M Davis.;L Rand.;C Siebert.
来源: N Engl J Med. 1993年329卷14期977-86页
Long-term microvascular and neurologic complications cause major morbidity and mortality in patients with insulin-dependent diabetes mellitus (IDDM). We examined whether intensive treatment with the goal of maintaining blood glucose concentrations close to the normal range could decrease the frequency and severity of these complications.
3712. Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group.
作者: B G Ewigman.;J P Crane.;F D Frigoletto.;M L LeFevre.;R P Bain.;D McNellis.
来源: N Engl J Med. 1993年329卷12期821-7页
Many clinicians advocate routine ultrasound screening during pregnancy to detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities, and errors in the estimation of gestational age. However, it is not known whether the detection of these conditions through screening leads to interventions that improve perinatal outcome.
3713. Two controlled trials of rifabutin prophylaxis against Mycobacterium avium complex infection in AIDS.
作者: S D Nightingale.;D W Cameron.;F M Gordin.;P M Sullam.;D L Cohn.;R E Chaisson.;L J Eron.;P D Sparti.;B Bihari.;D L Kaufman.
来源: N Engl J Med. 1993年329卷12期828-33页
Disseminated Mycobacterium avium complex infection eventually develops in most patients with the acquired immunodeficiency syndrome (AIDS). This infection results in substantial morbidity and reduces survival by about six months.
3714. Effect of dietary fish oil on renal function and rejection in cyclosporine-treated recipients of renal transplants.
作者: J J van der Heide.;H J Bilo.;J M Donker.;J M Wilmink.;A M Tegzess.
来源: N Engl J Med. 1993年329卷11期769-73页
Dietary fish oil exerts effects on renal hemodynamics and the immune response that may benefit renal-transplant recipients treated with cyclosporine. To evaluate this possibility, we studied the effect of fish oil on renal function, blood pressure, and the incidence of acute rejection episodes in cyclosporine-treated recipients of renal transplants.
3715. A preliminary study of cardiopulmonary resuscitation by circumferential compression of the chest with use of a pneumatic vest.
作者: H R Halperin.;J E Tsitlik.;M Gelfand.;M L Weisfeldt.;K G Gruben.;H R Levin.;B K Rayburn.;N C Chandra.;C J Scott.;B J Kreps.
来源: N Engl J Med. 1993年329卷11期762-8页
More than 300,000 people die each year of cardiac arrest. Studies have shown that raising vascular pressures during cardiopulmonary resuscitation (CPR) can improve survival and that vascular pressures can be raised by increasing intrathoracic pressure.
3716. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections.
Recurrent urinary tract infections are a problem for many postmenopausal women. Estrogen replacement restores atrophic mucosa, lowers vaginal pH, and may prevent urinary tract infections.
3717. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.
The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was designed to compare new, aggressive thrombolytic strategies with standard thrombolytic regimens in the treatment of acute myocardial infarction. Our hypothesis was that newer thrombolytic strategies that produce earlier and sustained reperfusion would improve survival.
3718. A comparison of aspirin with placebo in patients treated with warfarin after heart-valve replacement.
作者: A G Turpie.;M Gent.;A Laupacis.;Y Latour.;J Gunstensen.;F Basile.;M Klimek.;J Hirsh.
来源: N Engl J Med. 1993年329卷8期524-9页
Despite the use of warfarin, major systemic embolism remains an important complication in patients with heart-valve replacement. Although the addition of antiplatelet agents has the potential to reduce this complication, their efficacy and safety when given in combination with warfarin are uncertain.
3719. A randomized study of outpatient treatment with ceftriaxone for selected febrile children with sickle cell disease.
作者: J A Wilimas.;P M Flynn.;S Harris.;S W Day.;R Smith.;P J Chesney.;J H Rodman.;J M Eguiguren.;D L Fairclough.;W C Wang.
来源: N Engl J Med. 1993年329卷7期472-6页
Because of their susceptibility to pneumococcal sepsis, children with sickle cell disease and fever are usually hospitalized for antibiotic therapy. Outpatient treatment may be a safe and less expensive alternative for selected patients.
3720. A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators.
The relative efficacies of various antiarrhythmic drugs in the treatment of ventricular tachyarrhythmias are not well known. This study examined the effectiveness of imipramine, mexiletine, pirmenol, procainamide, propafenone, quinidine, and sotalol in patients with ventricular tachyarrhythmias who were enrolled in the Electrophysiologic Study versus Electrocardiographic Monitoring trial.
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