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4261. Prevention of corticosteroid osteoporosis. A comparison of calcium, calcitriol, and calcitonin.
作者: P Sambrook.;J Birmingham.;P Kelly.;S Kempler.;T Nguyen.;N Pocock.;J Eisman.
来源: N Engl J Med. 1993年328卷24期1747-52页
Prolonged corticosteroid therapy increases the risk of osteoporosis and fracture. We studied whether corticosteroid-induced osteoporosis could be prevented by treatment with calcium, calcitriol (1,25-dihydroxyvitamin D3), and calcitonin.
4262. A controlled trial of bismuth subsalicylate in infants with acute watery diarrheal disease.
作者: D Figueroa-Quintanilla.;E Salazar-Lindo.;R B Sack.;R León-Barúa.;S Sarabia-Arce.;M Campos-Sánchez.;E Eyzaguirre-Maccan.
来源: N Engl J Med. 1993年328卷23期1653-8页
Bismuth subsalicylate is a common constituent of over-the-counter medications for diarrhea. However, it is uncertain whether bismuth offers any more benefit than standard oral rehydration therapy with early feeding.
4263. Radiotherapy after breast-preserving surgery in women with localized cancer of the breast.
作者: U Veronesi.;A Luini.;M Del Vecchio.;M Greco.;V Galimberti.;M Merson.;F Rilke.;V Sacchini.;R Saccozzi.;T Savio.
来源: N Engl J Med. 1993年328卷22期1587-91页
Conservative surgery and radiotherapy have become well-established treatments for breast cancer, and many trials in progress are attempting to define the most acceptable type of procedure. Between 1987 and 1989 we randomly assigned 567 women with small breast cancers (< 2.5 cm in diameter) to quadrantectomy followed by radiotherapy or to quadrantectomy without radiotherapy. All patients underwent total axillary dissection. The median follow-up period was 39 months (range, 28 to 54).
4264. Lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer.
作者: B Fisher.;J Costantino.;C Redmond.;E Fisher.;R Margolese.;N Dimitrov.;N Wolmark.;D L Wickerham.;M Deutsch.;L Ore.
来源: N Engl J Med. 1993年328卷22期1581-6页
Women with ductal carcinoma in situ have been treated both by lumpectomy and by lumpectomy followed by radiation therapy, but the benefit of combined therapy is uncertain. A group of 818 women with ductal carcinoma in situ were randomly assigned to undergo lumpectomy or lumpectomy followed by breast irradiation (50 Gy). Sufficient tissue was removed that the margins of the resected specimens were histologically tumor-free. The mean duration of follow-up was 43 months (range, 11 to 86). The principal end point of the study was event-free survival, as defined by the presence of no new ipsilateral or contralateral breast cancers, regional or distant metastases, or other cancers and by no deaths from causes other than cancer.
4265. Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS.
作者: W Hughes.;G Leoung.;F Kramer.;S A Bozzette.;S Safrin.;P Frame.;N Clumeck.;H Masur.;D Lancaster.;C Chan.
来源: N Engl J Med. 1993年328卷21期1521-7页
Both trimethoprim-sulfamethoxazole and pentamidine are effective as treatments for Pneumocystis carinii pneumonia, but adverse effects frequently limit their use. Atovaquone (566C80) is a new hydroxynaphthoquinone with activity against P. carinii.
4266. Dapsone-pyrimethamine compared with aerosolized pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV infection. The PRIO Study Group.
作者: P M Girard.;R Landman.;C Gaudebout.;R Olivares.;A G Saimot.;P Jelazko.;C Gaudebout.;A Certain.;F Boué.;E Bouvet.
来源: N Engl J Med. 1993年328卷21期1514-20页
Pneumocystis carinii pneumonia and toxoplasmic encephalitis are frequent life-threatening opportunistic infections in patients with human immunodeficiency virus (HIV) infection. Primary prophylaxis against P. carinii pneumonia is now common, but there are few data on regimens for primary prophylaxis against toxoplasmosis.
4267. Topical tretinoin (retinoic acid) therapy for hyperpigmented lesions caused by inflammation of the skin in black patients.
作者: S M Bulengo-Ransby.;C E Griffiths.;C K Kimbrough-Green.;L J Finkel.;T A Hamilton.;C N Ellis.;J J Voorhees.
来源: N Engl J Med. 1993年328卷20期1438-43页
Irregular disfiguring skin hyperpigmentation due to inflammation may develop in black persons. We investigated the treatment of this hyperpigmentation with topical tretinoin (0.1 percent retinoic acid cream). Fifty-four subjects completed a 40-week randomized, double-blind, vehicle-controlled study. Twenty-four subjects applied tretinoin daily to the face, arms, or both areas, and 30 subjects applied vehicle cream. At base line and after 40 weeks of treatment, each subject's post-inflammatory hyperpigmented lesions and normal skin were assessed by clinical and colorimetric evaluations and by analysis of biopsy specimens.
4268. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study.
作者: J S Mandel.;J H Bond.;T R Church.;D C Snover.;G M Bradley.;L M Schuman.;F Ederer.
来源: N Engl J Med. 1993年328卷19期1365-71页
Although tests for occult blood in the feces are widely used to screen for colorectal cancers, there is no conclusive evidence that they reduce mortality from this cause. We evaluated a fecal occult-blood test in a randomized trial and documented its effectiveness.
4269. Blood transfusions and prognosis in colorectal cancer.
作者: O R Busch.;W C Hop.;M A Hoynck van Papendrecht.;R L Marquet.;J Jeekel.
来源: N Engl J Med. 1993年328卷19期1372-6页
Blood transfusions may adversely affect the prognosis of patients treated surgically for cancer, although definite proof of this adverse effect has not been reported.
4270. A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease.
作者: K E Hammermeister.;G K Sethi.;W G Henderson.;C Oprian.;T Kim.;S Rahimtoola.
来源: N Engl J Med. 1993年328卷18期1289-96页
Mechanical heart valves are durable but thrombogenic, and their use requires that the patient receive anticoagulants. In contrast, bioprosthetic valves are less thrombogenic, but they have limited durability because of tissue deterioration.
4271. Treatment of colonic and rectal adenomas with sulindac in familial adenomatous polyposis.
作者: F M Giardiello.;S R Hamilton.;A J Krush.;S Piantadosi.;L M Hylind.;P Celano.;S V Booker.;C R Robinson.;G J Offerhaus.
来源: N Engl J Med. 1993年328卷18期1313-6页
Familial adenomatous polyposis is an autosomal dominant disorder characterized by the formation of hundreds of colorectal adenomas and eventual colorectal cancer. Administration of the nonsteroidal antiinflammatory drug sulindac has been followed by regression of polyps in patients with this disorder, but no controlled trial of this drug in patients who have not had surgery has been reported.
4272. The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia.
作者: D B Hunninghake.;E A Stein.;C A Dujovne.;W S Harris.;E B Feldman.;V T Miller.;J A Tobert.;P M Laskarzewski.;E Quiter.;J Held.
来源: N Engl J Med. 1993年328卷17期1213-9页
A diet low in saturated fat and cholesterol is the standard initial treatment for hypercholesterolemia. However, little quantitative information is available about the efficacy of dietary therapy in clinical practice or about the combined effects of diet and drug therapy.
4273. Effect of early amniotomy on the risk of dystocia in nulliparous women. The Canadian Early Amniotomy Study Group.
Early amniotomy has been advocated as a means of preventing dystocia, but its efficacy has not been studied prospectively. The purpose of this multicenter study was to determine whether routine early amniotomy reduces the risk of dystocia for nulliparous women in spontaneous labor.
4274. Ondansetron compared with dexamethasone and metoclopramide as antiemetics in the chemotherapy of breast cancer with cyclophosphamide, methotrexate, and fluorouracil.
作者: M Levitt.;D Warr.;L Yelle.;H L Rayner.;W S Lofters.;D J Perrault.;K S Wilson.;J Latreille.;M Potvin.;E Warner.
来源: N Engl J Med. 1993年328卷15期1081-4页
Although ondansetron was found to be effective as an antiemetic in numerous clinical trials of highly emetogenic combination-chemotherapy regimens that included cisplatin, its role in milder emetogenic regimens has not been fully defined. To address its use with a widely used but less emetogenic regimen, we performed a double-blind, randomized clinical trial comparing ondansetron with dexamethasone and metoclopramide in patients with breast cancer receiving chemotherapy with cyclophosphamide, methotrexate, and fluorouracil.
4275. Ondansetron plus metopimazine compared with ondansetron alone in patients receiving moderately emetogenic chemotherapy.
作者: J Herrstedt.;T Sigsgaard.;M Boesgaard.;T P Jensen.;P Dombernowsky.
来源: N Engl J Med. 1993年328卷15期1076-80页
The serotonin (5-hydroxytryptamine3) antagonists have improved the treatment of acute chemotherapy-induced nausea and vomiting, but their ability to prevent delayed nausea and vomiting seems less pronounced. The results of a preliminary open trial suggested that the addition of a selective dopamine D2 antagonist could improve the antiemetic efficacy of the serotonin antagonists. In a randomized, double-blind, crossover trial, we compared oral treatment with ondansetron (8 mg twice a day) and the dopamine D2 antagonist metopimazine (30 mg four times a day) with treatment with ondansetron alone for three days in 30 patients who had vomited during the previous cycle of chemotherapy. All the patients received moderately emetogenic chemotherapy.
4276. Hepatitis C virus and cryoglobulinemia. Latial cryoglobulinemia Cooperative Study Group.4277. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma.
作者: R I Fisher.;E R Gaynor.;S Dahlberg.;M M Oken.;T M Grogan.;E M Mize.;J H Glick.;C A Coltman.;T P Miller.
来源: N Engl J Med. 1993年328卷14期1002-6页
CHOP is a first-generation, combination-chemotherapy regimen consisting of cyclophosphamide, doxorubicin, vincristine, and prednisone that has cured approximately 30 percent of patients with advanced stages of intermediate-grade or high-grade non-Hodgkin's lymphoma in national cooperative-group trials. However, studies at single institutions have suggested that 55 to 65 percent of such patients might be cured by third-generation regimens such as ones consisting of low-dose methotrexate with leucovorin rescue, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD); prednisone, doxorubicin, cyclophosphamide, and etoposide, followed by cytarabine, bleomycin, vincristine, and methotrexate with leucovorin rescue (ProMACE-CytaBOM); and methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B).
4278. Single-drug therapy for hypertension in men. A comparison of six antihypertensive agents with placebo. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents.
作者: B J Materson.;D J Reda.;W C Cushman.;B M Massie.;E D Freis.;M S Kochar.;R J Hamburger.;C Fye.;R Lakshman.;J Gottdiener.
来源: N Engl J Med. 1993年328卷13期914-21页
Characteristics such as age and race are often cited as determinants of the response of blood pressure to specific antihypertensive agents, but this clinically important issue has not been examined in sufficiently large trials, involving all standard treatments, to determine the effect of such factors.
4279. Quality of life and antihypertensive therapy in men. A comparison of captopril with enalapril. The Quality-of-Life Hypertension Study Group.
We conducted a multicenter trial comparing two angiotensin-converting-enzyme inhibitors to determine whether effects on quality of life during antihypertensive therapy are uniform within this pharmacologic class of agents, and to relate the effects of the drugs on quality of life to objective adverse events, such as the loss of a job or the death of a spouse.
4280. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup.
作者: S J Winawer.;A G Zauber.;M J O'Brien.;M N Ho.;L Gottlieb.;S S Sternberg.;J D Waye.;J Bond.;M Schapiro.;E T Stewart.
来源: N Engl J Med. 1993年328卷13期901-6页
The identification and removal of adenomatous polyps and post-polypectomy surveillance are considered to be important for the control of colorectal cancer. In current practice, the intervals between colonoscopies after polypectomy are variable, often a year long, and not based on data from randomized clinical trials. We sought to determine whether follow-up colonoscopy at three years would detect important colonic lesions as well as follow-up colonoscopy at both one and three years.
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