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3861. A comparison of beclomethasone, salmeterol, and placebo in children with asthma. Canadian Beclomethasone Dipropionate-Salmeterol Xinafoate Study Group.
An inhaled glucocorticoid is currently the medication of choice for long-term control of persistent asthma in children. The role of long-acting beta2-adrenergic-receptor agonists, such as salmeterol, needs to be defined.
3862. Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin T or troponin I.
作者: C W Hamm.;B U Goldmann.;C Heeschen.;G Kreymann.;J Berger.;T Meinertz.
来源: N Engl J Med. 1997年337卷23期1648-53页
Evaluation of patients with acute chest pain in emergency rooms is time-consuming and expensive, and it often results in uncertain diagnoses. We prospectively investigated the usefulness of bedside tests for the detection of cardiac troponin T and troponin I in the evaluation of patients with acute chest pain.
3863. Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women.
作者: P D Delmas.;N H Bjarnason.;B H Mitlak.;A C Ravoux.;A S Shah.;W J Huster.;M Draper.;C Christiansen.
来源: N Engl J Med. 1997年337卷23期1641-7页
Long-term estrogen therapy can reduce the risk of osteoporotic fracture and cardiovascular disease in postmenopausal women. At present, however, these beneficial effects are not separable from undesirable stimulation of breast and endometrial tissues.
3864. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch Trial Investigators.
Patients with coronary heart disease, left ventricular dysfunction, and abnormalities on signal-averaged electrocardiograms have an increased risk sudden death. We evaluated the effect on survival of the prophylactic implantation of cardioverter-defibrillators in such patients at the time of coronary-artery bypass surgery.
3865. Short-term inhibition of parathyroid hormone secretion by a calcium-receptor agonist in patients with primary hyperparathyroidism.
作者: S J Silverberg.;H G Bone.;T B Marriott.;F G Locker.;S Thys-Jacobs.;G Dziem.;S Kaatz.;E L Sanguinetti.;J P Bilezikian.
来源: N Engl J Med. 1997年337卷21期1506-10页
Surgery is the usual therapy for patients with primary hyperparathyroidism. We investigated the ability of a calcimimetic drug that inhibits parathyroid hormone secretion in vitro to decrease serum parathyroid hormone and calcium concentrations in patients with this disorder.
3866. A comparison of low-dose inhaled budesonide plus theophylline and high-dose inhaled budesonide for moderate asthma.
作者: D J Evans.;D A Taylor.;O Zetterstrom.;K F Chung.;B J O'Connor.;P J Barnes.
来源: N Engl J Med. 1997年337卷20期1412-8页
Inhaled glucosteroids and oral theophylline are widely used to treat asthma. We compared the benefits of adding theophylline to inhaled glucosteroid with those of doubling the dose of inhaled glucosteroid in patients with persistent symptoms despite the use of inhaled glucosteroid.
3867. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group.
作者: R A Pauwels.;C G Löfdahl.;D S Postma.;A E Tattersfield.;P O'Byrne.;P J Barnes.;A Ullman.
来源: N Engl J Med. 1997年337卷20期1405-11页
The role of long-acting, inhaled beta2-agonists in treating asthma is uncertain. In a double-blind study, we evaluated the effects of adding inhaled formoterol to both lower and higher doses of the inhaled glucocorticoid budesonide.
3868. A comparison of recombinant hirudin with a low-molecular-weight heparin to prevent thromboembolic complications after total hip replacement.
作者: B I Eriksson.;P Wille-Jørgensen.;P Kälebo.;P Mouret.;N Rosencher.;P Bösch.;M Baur.;S Ekman.;D Bach.;S Lindbratt.;P Close.
来源: N Engl J Med. 1997年337卷19期1329-35页
Patients who undergo total hip replacement have a high risk of thromboembolic complications. Recombinant hirudin (desirudin), a specific inhibitor of thrombin, represents a new development in antithrombotic therapy. We compared the efficacy and safety of desirudin with those of a low-molecular-weight heparin (enoxaparin) for the prevention of thromboembolic complications in patients undergoing primary total hip replacement.
3869. Treatment of children and young adults with early-stage non-Hodgkin's lymphoma.
作者: M P Link.;J J Shuster.;S S Donaldson.;C W Berard.;S B Murphy.
来源: N Engl J Med. 1997年337卷18期1259-66页
Children and young adults with early-stage non-Hodgkin's lymphoma have an excellent prognosis, but treatment is prolonged and is associated with many side effects. We performed two studies to determine whether therapy could be simplified.
3870. A comparison of continuous infusion of alteplase with double-bolus administration for acute myocardial infarction.
Accelerated infusion of alteplase (tissue plasminogen activator) over a period of 90 minutes induces more rapid lysis of coronary-artery thrombi than a 3-hour infusion. With two bolus doses of alteplase, further shortening the duration of administration, complete reperfusion was achieved in more than 85 percent of the patients in initial angiographic studies. We tested the hypothesis that double-bolus alteplase is at least as effective as accelerated infusion.
3871. A comparison of reteplase with alteplase for acute myocardial infarction.
Reteplase (recombinant plasminogen activator), a mutant of alteplase tissue plasminogen activator, has a longer half-life than its parent molecule and produced superior angiographic results in pilot studies of acute myocardial infarction. In this large clinical trial, we compared the efficacy and safety of these two thrombolytic agents.
3872. A comparison of sustained-release bupropion and placebo for smoking cessation.
作者: R D Hurt.;D P Sachs.;E D Glover.;K P Offord.;J A Johnston.;L C Dale.;M A Khayrallah.;D R Schroeder.;P N Glover.;C R Sullivan.;I T Croghan.;P M Sullivan.
来源: N Engl J Med. 1997年337卷17期1195-202页
Trials of antidepressant medications for smoking cessation have had mixed results. We conducted a double-blind, placebo-controlled trial of a sustained-release form of bupropion for smoking cessation. We excluded smokers with current depression, but not those with a history of major depression. The 615 subjects were randomly assigned to receive placebo or bupropion at a dose of 100, 150, or 300 mg per day for seven weeks. The target quitting date (or "target quit date") was one week after the beginning of treatment. Brief counseling was provided at base line, weekly during treatment, and at 8, 12, 26, and 52 weeks. Self-reported abstinence was confirmed by a carbon monoxide concentration in expired air of 10 ppm or less.
3873. Efficacy of the rhesus rotavirus-based quadrivalent vaccine in infants and young children in Venezuela.
作者: I Pérez-Schael.;M J Guntiñas.;M Pérez.;V Pagone.;A M Rojas.;R González.;W Cunto.;Y Hoshino.;A Z Kapikian.
来源: N Engl J Med. 1997年337卷17期1181-7页
Rotaviruses are the principal known etiologic agents of severe diarrhea among infants and young children worldwide. Although a rhesus rotavirus-based quadrivalent vaccine is highly effective in preventing severe diarrhea in developed countries, in developing countries its efficacy has been less impressive. We thus conducted a catchment study in Venezuela to assess the efficacy of the vaccine against dehydrating diarrhea.
3874. The effect of enforcing tobacco-sales laws on adolescents' access to tobacco and smoking behavior.
作者: N A Rigotti.;J R DiFranza.;Y Chang.;T Tisdale.;B Kemp.;D E Singer.
来源: N Engl J Med. 1997年337卷15期1044-51页
Enforcing laws banning tobacco sales to minors is widely advocated as a way to reduce young people's access to tobacco and tobacco use. Whether this approach is successful is not known.
3875. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. Crohn's Disease cA2 Study Group.
作者: S R Targan.;S B Hanauer.;S J van Deventer.;L Mayer.;D H Present.;T Braakman.;K L DeWoody.;T F Schaible.;P J Rutgeerts.
来源: N Engl J Med. 1997年337卷15期1029-35页
Studies in animals and an open-label trial have suggested a role for antibodies to tumor necrosis factor alpha, specifically chimeric monoclonal antibody cA2, in the treatment of Crohn's disease.
3876. All-trans-retinoic acid in acute promyelocytic leukemia.
作者: M S Tallman.;J W Andersen.;C A Schiffer.;F R Appelbaum.;J H Feusner.;A Ogden.;L Shepherd.;C Willman.;C D Bloomfield.;J M Rowe.;P H Wiernik.
来源: N Engl J Med. 1997年337卷15期1021-8页
All-trans-retinoic acid induces complete remission in acute promyelocytic leukemia. However, it is not clear whether induction therapy with all-trans-retinoic acid is superior to chemotherapy alone or whether maintenance treatment with all-trans-retinoic acid improves outcome.
3877. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer.
作者: J Ragaz.;S M Jackson.;N Le.;I H Plenderleith.;J J Spinelli.;V E Basco.;K S Wilson.;M A Knowling.;C M Coppin.;M Paradis.;A J Coldman.;I A Olivotto.
来源: N Engl J Med. 1997年337卷14期956-62页
Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to decline in the 1980s because it failed to improve overall survival. We prospectively tested the efficacy of combining radiotherapy with chemotherapy.
3878. Comparison of administration of recombinant human thyrotropin with withdrawal of thyroid hormone for radioactive iodine scanning in patients with thyroid carcinoma.
作者: P W Ladenson.;L E Braverman.;E L Mazzaferri.;F Brucker-Davis.;D S Cooper.;J R Garber.;F E Wondisford.;T F Davies.;L J DeGroot.;G H Daniels.;D S Ross.;B D Weintraub.
来源: N Engl J Med. 1997年337卷13期888-96页
To detect recurrent disease in patients who have had differentiated thyroid cancer, periodic withdrawal of thyroid hormone therapy may be required to raise serum thyrotropin concentrations to stimulate thyroid tissue so that radioiodine (iodine-131) scanning can be performed. However, withdrawal of thyroid hormone therapy causes hypothyroidism. Administration of recombinant human thyrotropin stimulates thyroid tissue without requiring the discontinuation of thyroid hormone therapy.
3879. Percutaneous drainage compared with surgery for hepatic hydatid cysts.
作者: M S Khuroo.;N A Wani.;G Javid.;B A Khan.;G N Yattoo.;A H Shah.;S G Jeelani.
来源: N Engl J Med. 1997年337卷13期881-7页
In recent years percutaneous drainage has been used successfully to treat the hepatic hydatid cysts of echinococcal disease. We performed a controlled trial to compare the safety and efficacy of percutaneous drainage with those of surgical cystectomy, the traditional treatment.
3880. Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenzavirus infections. GG167 Influenza Study Group.
作者: F G Hayden.;A D Osterhaus.;J J Treanor.;D M Fleming.;F Y Aoki.;K G Nicholson.;A M Bohnen.;H M Hirst.;O Keene.;K Wightman.
来源: N Engl J Med. 1997年337卷13期874-80页
The sialic acid analogue zanamivir (GG167) is a selective inhibitor of influenza A and B virus neuraminidases. These viral enzymes are essential for the release of virus from infected cells, and they may also reduce the inactivation of virus by respiratory secretions. When administered experimentally directly to the respiratory tract, zanamivir has potent antiviral effects. We assessed the therapeutic activity of zanamivir in adults with acute influenza.
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