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3881. Calcium supplementation to prevent hypertensive disorders of pregnancy.
作者: J M Belizán.;J Villar.;L Gonzalez.;L Campodonico.;E Bergel.
来源: N Engl J Med. 1991年325卷20期1399-405页
Calcium supplementation has been reported to reduce blood pressure in pregnant and nonpregnant women. We undertook this prospective study to determine the effect of calcium supplementation on the incidence of hypertensive disorders of pregnancy (gestational hypertension and preeclampsia) and to determine the value of urinary calcium levels as a predictor of the response.
3884. Interrupted versus continuous chemotherapy in patients with metastatic breast cancer. The Piedmont Oncology Association.
作者: H B Muss.;L D Case.;F Richards.;D R White.;M R Cooper.;J M Cruz.;B L Powell.;C L Spurr.;R L Capizzi.
来源: N Engl J Med. 1991年325卷19期1342-8页
Chemotherapy for metastatic breast cancer is palliative, and the optimal duration of therapy is unknown. We designed a trial to determine whether continuous treatment is superior to stopping treatment after a brief induction period and resuming treatment when the disease progresses.
3885. A randomized trial of intravesical doxorubicin and immunotherapy with bacille Calmette-Guérin for transitional-cell carcinoma of the bladder.
作者: D L Lamm.;B A Blumenstein.;E D Crawford.;J E Montie.;P Scardino.;H B Grossman.;T H Stanisic.;J A Smith.;J Sullivan.;M F Sarosdy.
来源: N Engl J Med. 1991年325卷17期1205-9页
In carcinoma of the bladder, both intravesical chemotherapy and immunotherapy can induce tumor regression and reduce the rate of recurrence, but the relative merits of these two therapies are unclear. We conducted a multi-institutional study to address this question.
3886. Prevention of high-altitude pulmonary edema by nifedipine.
作者: P Bärtsch.;M Maggiorini.;M Ritter.;C Noti.;P Vock.;O Oelz.
来源: N Engl J Med. 1991年325卷18期1284-9页
Exaggerated pulmonary-artery pressure due to hypoxic vasoconstriction is considered an important pathogenetic factor in high-altitude pulmonary edema. We previously found that nifedipine lowered pulmonary-artery pressure and improved exercise performance, gas exchange, and the radiographic manifestations of disease in patients with high-altitude pulmonary edema. We therefore hypothesized that the prophylactic administration of nifedipine would prevent its recurrence.
3887. A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke.
作者: .;Jan van Gijn.;Ale Algra.;Jaap Kappelle.;Peter J Koudstaal.;Anet van Latum.
来源: N Engl J Med. 1991年325卷18期1261-6页
Aspirin is known to improve the outcome of patients who have had a cerebral transient ischemic attack, but the optimal dose of aspirin remains uncertain. Experimental evidence indicates that 30 mg of aspirin daily alters platelet aggregation more favorably than the 300-mg dose currently used in patients after transient ischemic attack or minor ischemic stroke.
3888. Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins.
作者: B W Walsh.;I Schiff.;B Rosner.;L Greenberg.;V Ravnikar.;F M Sacks.
来源: N Engl J Med. 1991年325卷17期1196-204页
Postmenopausal estrogen-replacement therapy may reduce the risk of cardiovascular disease, and this beneficial effect may be mediated in part by favorable changes in plasma lipid levels. However, the effects on plasma lipoprotein levels of postmenopausal estrogens in the low doses currently used have not been precisely quantified, and the mechanism of these effects is unknown.
3889. Prevention of postmenopausal osteoporosis. A comparative study of exercise, calcium supplementation, and hormone-replacement therapy.
作者: R L Prince.;M Smith.;I M Dick.;R I Price.;P G Webb.;N K Henderson.;M M Harris.
来源: N Engl J Med. 1991年325卷17期1189-95页
Osteoporosis among older women is a major public health problem. We studied the effects of three approaches to the prevention of osteoporosis in women with low bone density.
3890. Suppression of thromboxane A2 but not of systemic prostacyclin by controlled-release aspirin.
The antithrombotic efficacy of aspirin is attributed to its inhibition of the enzyme prostaglandin G/H synthase, which is necessary for the formation of thromboxane A2 in platelets. Thromboxane A2 is a potent vasoconstrictor and platelet agonist. However, the formation of prostacyclin by vascular endothelium also requires prostaglandin G/H synthase, and prostacyclin exerts opposite effects on platelet function and vascular tone. We wanted to see whether controlled-release aspirin would affect the formation of thromboxane A2 but not prostacyclin by reducing the aspirin concentration that reaches the posthepatic circulation.
3891. Analgesic effect of intraarticular morphine after arthroscopic knee surgery.
作者: C Stein.;K Comisel.;E Haimerl.;A Yassouridis.;K Lehrberger.;A Herz.;K Peter.
来源: N Engl J Med. 1991年325卷16期1123-6页
Opioids can produce potent antinociceptive effects by interacting with local opioid receptors in inflamed peripheral tissue. In this study we examined the analgesic effects of the intraarticular, as compared with intravenous, administration of morphine after arthroscopic knee surgery.
3892. A controlled trial of corticosteroid injections into facet joints for chronic low back pain.
作者: S Carette.;S Marcoux.;R Truchon.;C Grondin.;J Gagnon.;Y Allard.;M Latulippe.
来源: N Engl J Med. 1991年325卷14期1002-7页
Chronic low back pain is a common problem with many treatments, few of which have been rigorously evaluated. This randomized, placebo-controlled trial was designed to evaluate the efficacy of injections of corticosteroid into facet joints to treat chronic low back pain.
3893. Paracentesis with intravenous infusion of albumin as compared with peritoneovenous shunting in cirrhosis with refractory ascites.
作者: P Ginès.;V Arroyo.;V Vargas.;R Planas.;F Casafont.;J Panés.;M Hoyos.;L Viladomiu.;A Rimola.;R Morillas.
来源: N Engl J Med. 1991年325卷12期829-35页
There is no satisfactory treatment for refractory ascites in patients with cirrhosis. Both peritoneovenous shunts and paracentesis have been used, but there is uncertainty about their relative merits.
3894. A randomized trial of treatment options for alcohol-abusing workers.
作者: D C Walsh.;R W Hingson.;D M Merrigan.;S M Levenson.;L A Cupples.;T Heeren.;G A Coffman.;C A Becker.;T A Barker.;S K Hamilton.
来源: N Engl J Med. 1991年325卷11期775-82页
Employee-assistance programs sponsored by companies or labor unions identify workers who abuse alcohol and refer them for care, often to inpatient rehabilitation programs. Yet the effectiveness of inpatient treatment, as compared with a variety of less intensive alternatives, has repeatedly been called into question. In this study, anchored in the work site, we compared the effectiveness of mandatory in-hospital treatment with that of required attendance at the meetings of a self-help group and a choice of treatment options.
3895. Perioperative total parenteral nutrition in surgical patients.
We undertook this study to test the hypothesis that perioperative total parenteral nutrition (TPN) decreases the incidence of serious complications after major abdominal or thoracic surgical procedures in malnourished patients.
3897. A controlled trial comparing foscarnet with vidarabine for acyclovir-resistant mucocutaneous herpes simplex in the acquired immunodeficiency syndrome. The AIDS Clinical Trials Group.
作者: S Safrin.;C Crumpacker.;P Chatis.;R Davis.;R Hafner.;J Rush.;H A Kessler.;B Landry.;J Mills.
来源: N Engl J Med. 1991年325卷8期551-5页
Most strains of herpes simplex virus that are resistant to acyclovir are susceptible in vitro to both foscarnet and vidarabine. We conducted a randomized trial to compare foscarnet with vidarabine in 14 patients with the acquired immunodeficiency syndrome (AIDS) and mucocutaneous herpetic lesions that had been unresponsive to intravenous therapy with acyclovir for a minimum of 10 days. The patients were randomly assigned to receive either foscarnet (40 mg per kilogram of body weight intravenously every 8 hours) or vidarabine (15 mg per kilogram per day intravenously) for 10 to 42 days. In the isolates of herpes simplex virus we documented in vitro resistance to acyclovir and susceptibility to foscarnet and vidarabine.
3898. The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women.
The National Cholesterol Education Program (NCEP) recommends a low-saturated-fat, low-cholesterol diet, with weight loss if indicated, to correct elevated plasma cholesterol levels. Weight loss accomplished by simple caloric restriction or increased exercise typically increases the level of high-density lipoprotein (HDL) cholesterol. Little is known about the effects on plasma lipoproteins of a hypocaloric NCEP diet with or without exercise in overweight people.
3899. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis.
作者: .;H J M Barnett.;D W Taylor.;R B Haynes.;D L Sackett.;S J Peerless.;G G Ferguson.;A J Fox.;R N Rankin.;V C Hachinski.;D O Wiebers.;M Eliasziw.
来源: N Engl J Med. 1991年325卷7期445-53页
Without strong evidence of benefit, the use of carotid endarterectomy for prophylaxis against stroke rose dramatically until the mid-1980s, then declined. Our investigation sought to determine whether carotid endarterectomy reduces the risk of stroke among patients with a recent adverse cerebrovascular event and ipsilateral carotid stenosis.
3900. Comparison of plasma exchange with plasma infusion in the treatment of thrombotic thrombocytopenic purpura. Canadian Apheresis Study Group.
作者: G A Rock.;K H Shumak.;N A Buskard.;V S Blanchette.;J G Kelton.;R C Nair.;R A Spasoff.
来源: N Engl J Med. 1991年325卷6期393-7页
Thrombotic thrombocytopenic purpura is an uncommon disease with a high mortality rate even with current treatment. The cause of the syndrome and its optimal treatment are unknown. Although both plasma exchange and plasma infusion have been useful treatments, it is not clear which is superior. In this report we describe a prospective randomized trial comparing plasma exchange with plasma infusion for the treatment of thrombotic thrombocytopenic purpura.
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