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4381. Early zidovudine and survival in HIV infection.4382. A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group.
Valproate is approved for use primarily in patients with absence seizures, but the drug has a broad spectrum of activity against seizures of all types. Partial or secondarily generalized tonic-clonic seizures are often difficult to control adequately with standard treatment, usually carbamazepine or phenytoin.
4383. Central venous catheters and sepsis in patients with quadriplegia.4385. Effects of the early administration of enalapril on mortality in patients with acute myocardial infarction. Results of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II).
作者: K Swedberg.;P Held.;J Kjekshus.;K Rasmussen.;L Rydén.;H Wedel.
来源: N Engl J Med. 1992年327卷10期678-84页
Long-term administration of angiotensin-converting--enzyme (ACE) inhibitors has been shown to improve survival in patients with symptomatic left ventricular failure and to attenuate left ventricular dilatation in patients with myocardial infarction. We studied whether mortality could be reduced during the 6 months after an acute myocardial infarction with use of the ACE inhibitor enalapril.
4386. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions.
It is not known whether the treatment of patients with asymptomatic left ventricular dysfunction reduces mortality and morbidity. We studied the effect of an angiotensin-converting--enzyme inhibitor, enalapril, on total mortality and mortality from cardiovascular causes, the development of heart failure, and hospitalization for heart failure among patients with ejection fractions of 0.35 or less who were not receiving drug treatment for heart failure.
4389. Prophylactic fluconazole and marrow transplantation.
作者: S L Scholten.;M D Nettleman.;E F Sarrazin.
来源: N Engl J Med. 1992年327卷9期644-5; author reply 645页 4392. Methylprednisolone plus chlorambucil as compared with methylprednisolone alone for the treatment of idiopathic membranous nephropathy. The Italian Idiopathic Membranous Nephropathy Treatment Study Group.
Treatment with methylprednisolone and chlorambucil may protect renal function and increase the chance of remission of the nephrotic syndrome in patients with idiopathic membranous nephropathy. To determine whether similar results might be obtained with methylprednisolone alone, we compared the effects of methylprednisolone and chlorambucil with those of methylprednisolone alone in 92 patients with the nephrotic syndrome caused by idiopathic membranous nephropathy. The patients were randomly assigned to receive either alternating one-month courses of methylprednisolone and then chlorambucil for a total of six months (group 1) or methylprednisolone alone for six months at the same cumulative dosage (group 2).
4393. A randomized comparison of transcervical and transabdominal chorionic-villus sampling. The U.S. National Institute of Child Health and Human Development Chorionic-Villus Sampling and Amniocentesis Study Group.
作者: L G Jackson.;J M Zachary.;S E Fowler.;R J Desnick.;M S Golbus.;D H Ledbetter.;M J Mahoney.;E Pergament.;J L Simpson.;S Black.
来源: N Engl J Med. 1992年327卷9期594-8页
Chorionic-villus sampling is done in early pregnancy to obtain fetal cells for the prenatal diagnosis of genetic and chromosomal defects. Transcervical chorionic-villus sampling has been shown to be safe and effective in national trials. Recently, an alternative transabdominal technique has been suggested as potentially easier and safer.
4394. A controlled trial comparing continued zidovudine with didanosine in human immunodeficiency virus infection. The NIAID AIDS Clinical Trials Group.
作者: J O Kahn.;S W Lagakos.;D D Richman.;A Cross.;C Pettinelli.;S H Liou.;M Brown.;P A Volberding.;C S Crumpacker.;G Beall.
来源: N Engl J Med. 1992年327卷9期581-7页
Although zidovudine is effective in patients with human immunodeficiency virus (HIV) infection, its efficacy may decline with prolonged use. Didanosine is another inhibitor of HIV reverse transcriptase. We evaluated the effectiveness of changing anti-HIV treatment from zidovudine to didanosine.
4395. Treatment of metastatic malignant melanoma with dacarbazine plus tamoxifen.
作者: G Cocconi.;M Bella.;F Calabresi.;M Tonato.;R Canaletti.;C Boni.;F Buzzi.;G Ceci.;E Corgna.;P Costa.
来源: N Engl J Med. 1992年327卷8期516-23页
Endocrine factors may affect the clinical course of malignant melanoma and the response to the treatment of this disease. The presence of estrogen receptors in melanomas has been suggested, and occasional responses to antiestrogen therapy have been reported.
4397. A controlled trial of a formalin-inactivated hepatitis A vaccine in healthy children.
作者: A Werzberger.;B Mensch.;B Kuter.;L Brown.;J Lewis.;R Sitrin.;W Miller.;D Shouval.;B Wiens.;G Calandra.
来源: N Engl J Med. 1992年327卷7期453-7页
Although inactivated hepatitis A vaccine is known to be well tolerated and immunogenic in healthy children and adults, its efficacy has yet to be established.
4398. Selective decontamination of the digestive tract.4399. Treatment of supraventricular tachycardia due to atrioventricular nodal reentry by radiofrequency catheter ablation of slow-pathway conduction.
作者: W M Jackman.;K J Beckman.;J H McClelland.;X Wang.;K J Friday.;C A Roman.;K P Moulton.;N Twidale.;H A Hazlitt.;M I Prior.
来源: N Engl J Med. 1992年327卷5期313-8页
Atrioventricular nodal reentrant tachycardia (AVNRT), the most common form of supraventricular tachycardia, results from conduction through a reentrant circuit comprising fast and slow atrioventricular nodal pathways. Antiarrhythmic-drug therapy is not consistently successful in controlling this rhythm disturbance. Catheter ablation of the fast pathway with radiofrequency current eliminates AVNRT, but it can produce heart block. We hypothesized that catheter ablation of the site of insertion of the slow pathway into the atrium would eliminate AVNRT while leaving normal (fast-pathway) atrioventricular nodal conduction intact.
4400. Treatment of preterm labor with the beta-adrenergic agonist ritodrine.
Beta-adrenergic agonists are commonly used to arrest premature labor. Although treatment of preterm labor with these agents can delay delivery by 24 to 48 hours, the potential risks and benefits to the mother and infant before and after delivery have not been adequately assessed.
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