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4302. Inhaled nitric oxide for the adult respiratory distress syndrome.
作者: R Rossaint.;K J Falke.;F López.;K Slama.;U Pison.;W M Zapol.
来源: N Engl J Med. 1993年328卷6期399-405页
The adult respiratory distress syndrome is characterized by pulmonary hypertension and right-to-left shunting of venous blood. We investigated whether inhaling nitric oxide gas would cause selective vasodilation of ventilated lung regions, thereby reducing pulmonary hypertension and improving gas exchange.
4303. Electrophysiologically guided antiarrhythmic therapy versus beta-blocker therapy in patients with ventricular tachyarrhythmias.4304. Effect of ranitidine and amoxicillin plus metronidazole on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer.
作者: E Hentschel.;G Brandstätter.;B Dragosics.;A M Hirschl.;H Nemec.;K Schütze.;M Taufer.;H Wurzer.
来源: N Engl J Med. 1993年328卷5期308-12页
Persistent infection with Helicobacter pylori is associated with the recurrence of duodenal ulcer. Whether the efficacy of bismuth therapy in reducing the rate of recurrence of duodenal ulcer is due to its antimicrobial effects on H. pylori or to a direct protective action on the mucosa is still a matter of debate.
4305. Rapid serologic testing with immune-complex-dissociated HIV p24 antigen for early detection of HIV infection in neonates. Southern California Pediatric AIDS Consortium.
作者: S A Miles.;E Balden.;L Magpantay.;L Wei.;A Leiblein.;D Hofheinz.;G Toedter.;E R Stiehm.;Y Bryson.
来源: N Engl J Med. 1993年328卷5期297-302页
Serologic detection of human immunodeficiency virus (HIV) infection in neonates is complicated by the presence of immune complexes, consisting of passively transferred maternal antibodies and HIV antigens. A new, rapid assay has been designed to disrupt these immune complexes in order to permit the detection of a specific HIV antigen. We evaluated the efficacy of this assay in detecting HIV infection in neonates.
4307. A prospective, randomized study of cochlear implants. The Department of Veterans Affairs Cochlear Implant Study Group.
Cochlear implants restore some degree of hearing in patients with severe hearing impairment, but the efficacy of different implants has not been compared. We conducted a prospective trial to compare several cochlear implants.
4308. Early treatment of acute biliary pancreatitis by endoscopic papillotomy.
Most patients with acute biliary pancreatitis have stones in the biliary tract or ampulla of Vater. Because these stones may be passed spontaneously soon after a patient is admitted to the hospital, the importance of early operative removal is not known. We tested the hypothesis that endoscopic papillotomy within 24 hours of admission decreased the incidence of complications in patients with acute biliary pancreatitis.
4309. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. The Veterans Affairs Cooperative Study Group.
作者: R W Hobson.;D G Weiss.;W S Fields.;J Goldstone.;W S Moore.;J B Towne.;C B Wright.
来源: N Engl J Med. 1993年328卷4期221-7页
The efficacy of carotid endarterectomy in patients with asymptomatic carotid stenosis has not been confirmed in randomized clinical trials, despite the widespread use of operative intervention in such patients.
4311. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease.
In 1987 we began a multicenter controlled clinical trial of deprenyl (a monoamine oxidase inhibitor) and tocopherol (a component of vitamin E that traps free radicals) in the treatment of early Parkinson's disease. We randomly assigned 800 patients to one of four treatments: placebo, active tocopherol and deprenyl placebo, active deprenyl and tocopherol placebo, or both active drugs. The primary end point was the onset of disability prompting the clinical decision to begin administering levodopa. An interim analysis showed that deprenyl was beneficial (N Engl J Med 1989;321:1364-71). We report the results of tocopherol treatment after a mean (+/- SD) follow-up of 14 +/- 6 months, as well as the follow-up results for deprenyl.
4312. A preliminary study of diltiazem in the prevention of coronary artery disease in heart-transplant recipients.
作者: J S Schroeder.;S Z Gao.;E L Alderman.;S A Hunt.;I Johnstone.;D B Boothroyd.;V Wiederhold.;E B Stinson.
来源: N Engl J Med. 1993年328卷3期164-70页
Accelerated coronary artery disease is a major cause of late morbidity and mortality among heart-transplant recipients. Because calcium-channel blockers can suppress diet-induced atherosclerosis in laboratory animals, we assessed the efficacy of diltiazem in preventing coronary artery disease in transplanted hearts.
4313. Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer.
作者: G P Browman.;G Wong.;I Hodson.;J Sathya.;R Russell.;L McAlpine.;P Skingley.;M N Levine.
来源: N Engl J Med. 1993年328卷3期159-63页
Smoking is a risk factor for several cancers and may also limit the efficacy of treatment. In this study, we evaluated the influence of cigarette smoking during radiation therapy on the efficacy of treatment in patients with head and neck cancer.
4314. A short-term trial of butyrate to stimulate fetal-globin-gene expression in the beta-globin disorders.
作者: S P Perrine.;G D Ginder.;D V Faller.;G H Dover.;T Ikuta.;H E Witkowska.;S P Cai.;E P Vichinsky.;N F Olivieri.
来源: N Engl J Med. 1993年328卷2期81-6页
Fetal-globin (gamma-globin) chains inhibit the polymerization of hemoglobin S (sickle hemoglobin) and can functionally substitute for the beta-globin chains that are defective or absent in patients with the beta-thalassemias. Identifying safe mechanisms to stimulate fetal-hemoglobin production is therefore of great interest. Previous studies have shown that administering butyrate selectively stimulates the promoter of the human fetal-globin gene and leads to increases in gamma-globin--gene expression in the developing fetus, cultured cells, and animal models.
4315. Comparison of low-dose isotretinoin with beta carotene to prevent oral carcinogenesis.
作者: S M Lippman.;J G Batsakis.;B B Toth.;R S Weber.;J J Lee.;J W Martin.;G L Hays.;H Goepfert.;W K Hong.
来源: N Engl J Med. 1993年328卷1期15-20页
High-dose isotretinoin therapy has been determined to be an effective treatment for leukoplakia. However, a high rate of relapses and toxic reactions led us to conduct a trial of a much lower dose of isotretinoin in the hope of maintaining a response and limiting toxicity.
4316. Efficacy of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome).
The Lennox-Gastaut syndrome is a childhood disorder characterized by multiple types of seizures, mental retardation, characteristic electroencephalographic abnormalities, and resistance to standard antiepileptic drugs. Felbamate is an investigational antiepileptic drug with a preclinical profile that suggests it would be effective in patients with multiple types of seizures. In controlled clinical trials, felbamate was superior to placebo in reducing the frequency of refractory partial-onset seizures.
4317. A controlled trial of antimicrobial prophylaxis for Lyme disease after deer-tick bites.
作者: E D Shapiro.;M A Gerber.;N B Holabird.;A T Berg.;H M Feder.;G L Bell.;P N Rys.;D H Persing.
来源: N Engl J Med. 1992年327卷25期1769-73页
Borrelia burgdorferi, which causes Lyme disease, is transmitted by deer ticks (lxodes dammini) in the northeastern and midwestern United States. Although deer-tick bites are common in areas in which the disease is endemic, there is uncertainty about how to manage the care of persons who are bitten.
4319. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021.
作者: W D Hardy.;J Feinberg.;D M Finkelstein.;M E Power.;W He.;C Kaczka.;P T Frame.;M Holmes.;H Waskin.;R J Fass.
来源: N Engl J Med. 1992年327卷26期1842-8页
Pneumocystis carinii pneumonia (PCP) continues to be the most common index diagnosis in the acquired immunodeficiency syndrome (AIDS), but it is not clear which of several available agents is the most effective in preventing a recurrence of PCP.
4320. A controlled trial of aerosolized pentamidine or trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus infection. The Dutch AIDS Treatment Group.
作者: M M Schneider.;A I Hoepelman.;J K Eeftinck Schattenkerk.;T L Nielsen.;Y van der Graaf.;J P Frissen.;I M van der Ende.;A F Kolsters.;J C Borleffs.
来源: N Engl J Med. 1992年327卷26期1836-41页
Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) is recommended for patients with human immunodeficiency virus (HIV) infection if their CD4 cell counts are below 200 per cubic millimeter (0.2 x 10(9) per liter). Either aerosolized pentamidine or trimethoprim-sulfamethoxazole (co-trimoxazole) is commonly prescribed for prophylaxis, but the relative efficacy and toxicity of these agents are unknown.
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