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4181. Effect of a low-fat diet on the incidence of actinic keratosis.
作者: H S Black.;J A Herd.;L H Goldberg.;J E Wolf.;J I Thornby.;T Rosen.;S Bruce.;J A Tschen.;J P Foreyt.;L W Scott.
来源: N Engl J Med. 1994年330卷18期1272-5页
Actinic keratoses are premalignant lesions and are a sensitive and important manifestation of sun-induced skin damage. Studies in animals have shown that dietary fat influences the incidence of sun-induced skin cancer, but the effect of diet on the incidence of actinic keratosis in humans is not known.
4182. Dose and dose intensity of adjuvant chemotherapy for stage II, node-positive breast carcinoma.
作者: W C Wood.;D R Budman.;A H Korzun.;M R Cooper.;J Younger.;R D Hart.;A Moore.;J A Ellerton.;L Norton.;C R Ferree.
来源: N Engl J Med. 1994年330卷18期1253-9页
Adjuvant chemotherapy is widely used for breast cancer and is known to extend survival. Some clinicians seek a greater survival benefit by increasing the intensity of the dose, whereas others lower it to diminish toxicity.
4183. c-erbB-2 expression and response to adjuvant therapy in women with node-positive early breast cancer.
作者: H B Muss.;A D Thor.;D A Berry.;T Kute.;E T Liu.;F Koerner.;C T Cirrincione.;D R Budman.;W C Wood.;M Barcos.
来源: N Engl J Med. 1994年330卷18期1260-6页
The role of molecular markers in predicting the response to treatment of breast cancer is poorly defined. The Cancer and Leukemia Group B (CALGB) conducted a randomized adjuvant-chemotherapy trial (CALGB 8541) comparing three doses (high, moderate, and low) of cyclophosphamide, doxorubicin, and fluorouracil in 1572 women with node-positive breast cancer. This study (CALGB 8869) was designed to determine whether the DNA index, the S-phase fraction, c-erbB-2 expression, or p53 accumulation could be used as a marker to identify a subgroup of patients more likely than others to benefit from high doses of chemotherapy.
4185. The effect of epoetin beta (recombinant human erythropoietin) on the need for transfusion in very-low-birth-weight infants. European Multicentre Erythropoietin Study Group.
作者: R F Maier.;M Obladen.;P Scigalla.;O Linderkamp.;G Duc.;G Hieronimi.;H L Halliday.;H T Versmold.;G Moriette.;G Jorch.
来源: N Engl J Med. 1994年330卷17期1173-8页
Anemia of prematurity is characterized by low reticulocyte counts and inadequate erythropoietin response, for which many very-low-birth-weight infants receive multiple blood transfusions. We investigated whether early treatment of such infants with recombinant human erythropoietin would reduce their need for transfusions.
4186. A controlled trial of intravenous immune globulin to reduce nosocomial infections in very-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network.
作者: A A Fanaroff.;S B Korones.;L L Wright.;E C Wright.;R L Poland.;C B Bauer.;J E Tyson.;J B Philips.;W Edwards.;J F Lucey.
来源: N Engl J Med. 1994年330卷16期1107-13页
Nosocomial infections are a major cause of morbidity and mortality in premature infants. As a rule, their low serum gamma globulin levels at birth subsequently decline to hypogammaglobulinemic values; hence, prophylactic administration of intravenous immune globulin may reduce the rate of hospital-acquired infections.
4187. Lack of effect of intraarticular corticosteroids for chronic pain in the cervical zygapophyseal joints.
Chronic pain in the cervical zygapophyseal joints is a common problem after a whiplash injury. Treatment with intraarticular injections of corticosteroid preparations has been advocated, but the value of this approach has not been established. We compared the efficacy of a depot injection of a corticosteroid preparation with the efficacy of an injection of a local anesthetic agent in patients with painful cervical zygapophyseal joints.
4188. Preserved endothelium-dependent vasodilatation in patients with essential hypertension.
Previous studies suggest that vascular endothelial function may be impaired in essential hypertension. Although muscarinic agonists dilate blood vessels by releasing an endothelium-derived relaxing factor closely related to nitric oxide, nitroprusside dilates vessels by a mechanism that is independent of the endothelium. The finding of an impaired response to muscarinic agonists but a normal response to nitroprusside in patients with hypertension has suggested that endothelial function is abnormal in hypertension.
4189. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers.
Epidemiologic evidence indicates that diets high in carotenoid-rich fruits and vegetables, as well as high serum levels of vitamin E (alpha-tocopherol) and beta carotene, are associated with a reduced risk of lung cancer.
4190. Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty.
Platelets are believed to play a part in the ischemic complications of coronary angioplasty, such as abrupt closure of the coronary vessel during or soon after the procedure. Accordingly, we evaluated the effect of a chimeric monoclonal-antibody Fab fragment (c7E3 Fab) directed against the platelet glycoprotein IIb/IIIa receptor, in patients undergoing angioplasty who were at high risk for ischemic complications. This receptor is the final common pathway for platelet aggregation.
4191. A randomized trial of acyclovir for 7 days or 21 days with and without prednisolone for treatment of acute herpes zoster.
作者: M J Wood.;R W Johnson.;M W McKendrick.;J Taylor.;B K Mandal.;J Crooks.
来源: N Engl J Med. 1994年330卷13期896-900页
Acyclovir given for 7 to 10 days is of proved benefit in acute herpes zoster, but studies of its effectiveness in preventing postherpetic neuralgia have had conflicting results. The role of corticosteroids in the treatment of herpes zoster is also controversial.
4192. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group.
作者: S Klahr.;A S Levey.;G J Beck.;A W Caggiula.;L Hunsicker.;J W Kusek.;G Striker.
来源: N Engl J Med. 1994年330卷13期877-84页
Restricting protein intake and controlling hypertension delay the progression of renal disease in animals. We tested these interventions in 840 patients with various chronic renal diseases.
4193. Interferon alfa-2a as compared with conventional chemotherapy for the treatment of chronic myeloid leukemia.
作者: .;Sante Tura.;Michele Baccarani.;Eliana Zuffa.;Domenico Russo.;Renato Fanin.;Alfonso Zaccaria.;Mauro Fiacchini.
来源: N Engl J Med. 1994年330卷12期820-5页
In view of studies showing that interferon alfa was effective treatment for chronic myeloid leukemia and that it prolonged survival, we organized a prospective, controlled comparative study of this treatment.
4194. Transdermal nicotine for active ulcerative colitis.
作者: R D Pullan.;J Rhodes.;S Ganesh.;V Mani.;J S Morris.;G T Williams.;R G Newcombe.;M A Russell.;C Feyerabend.;G A Thomas.
来源: N Engl J Med. 1994年330卷12期811-5页
Ulcerative colitis is largely a disease of nonsmokers. Because anecdotal reports suggest that smoking and nicotine may improve the symptoms of the disease, we examined the effect of nicotine as a supplemental treatment for ulcerative colitis.
4195. Interferon alfa-2a therapy in cryoglobulinemia associated with hepatitis C virus.
作者: R Misiani.;P Bellavita.;D Fenili.;O Vicari.;D Marchesi.;P L Sironi.;P Zilio.;A Vernocchi.;M Massazza.;G Vendramin.
来源: N Engl J Med. 1994年330卷11期751-6页
Essential mixed cryoglobulinemia is frequently associated with hepatitis C virus (HCV) infection. A beneficial effect of interferon alfa therapy has been reported, but we do not know whether the antiviral activity of the drug affects the clinical and biochemical manifestations of disease.
4196. High-dose intravenous methylprednisolone therapy for pain in children and adolescents with sickle cell disease.
The management of episodes of severe pain in patients with sickle cell disease is a difficult clinical problem. We studied 36 children and adolescents with sickle cell disease who had 56 acute episodes of severe pain (44 in 27 patients with sickle cell anemia, 8 in 7 patients with sickle cell-hemoglobin C disease, and 4 in 2 patients with sickle cell-beta (+)-thalassemia). The patients were randomly assigned in double-blind fashion to receive an intravenous infusion of either saline placebo or high-dose methylprednisolone (15 mg per kilogram of body weight, to a maximum of 1000 mg) on their admission to the hospital and again 24 hours later. All the patients received intravenous morphine sulfate until severe pain abated and were then given acetaminophen with codeine.
4197. Evaluation of the quality of life associated with zidovudine treatment in asymptomatic human immunodeficiency virus infection. The AIDS Clinical Trials Group.
作者: W R Lenderking.;R D Gelber.;D J Cotton.;B F Cole.;A Goldhirsch.;P A Volberding.;M A Testa.
来源: N Engl J Med. 1994年330卷11期738-43页
Zidovudine therapy is recommended for asymptomatic patients infected with the human immunodeficiency virus (HIV) who have fewer than 500 CD4+ cells per cubic millimeter. An analysis of the quality of life associated with therapy that integrated both the effects of adverse events and the benefits of delayed disease progression might influence this recommendation.
4198. A comparative trial of didanosine or zalcitabine after treatment with zidovudine in patients with human immunodeficiency virus infection. The Terry Beirn Community Programs for Clinical Research on AIDS.
作者: D I Abrams.;A I Goldman.;C Launer.;J A Korvick.;J D Neaton.;L R Crane.;M Grodesky.;S Wakefield.;K Muth.;S Kornegay.
来源: N Engl J Med. 1994年330卷10期657-62页
Both didanosine and zalcitabine are commonly used to treat patients with human immunodeficiency virus (HIV) infection who cannot tolerate zidovudine treatment or who have had disease progression despite it. The relative efficacy and safety of these second-line therapies are not well defined.
4199. A controlled trial of riluzole in amyotrophic lateral sclerosis. ALS/Riluzole Study Group.
Amyotrophic lateral sclerosis is a progressive motor neuron disease for which there is no adequate treatment. Some research suggests that the excitatory amino acid neurotransmitter glutamate may be involved in the pathogenesis.
4200. Variation in approval by insurance companies of coverage for autologous bone marrow transplantation for breast cancer.
The proper evaluation of new forms of technology depends on the results of clinical trials. However, the treatment of patients in grant-sponsored clinical trials of cancer therapy usually requires that the proposed treatment be approved in advance by an insurance carrier in a process called predetermination.
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