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4641. The value of immunotherapy with venom in children with allergy to insect stings.
作者: M D Valentine.;K C Schuberth.;A Kagey-Sobotka.;D F Graft.;K A Kwiterovich.;M Szklo.;L M Lichtenstein.
来源: N Engl J Med. 1990年323卷23期1601-3页
The treatment of patients allergic to insect stings with insect-venom injections has been shown to be 97 percent effective in reducing the risk of sting-induced anaphylaxis. However, the frequency of systemic reactions to subsequent stings in unimmunized adults with previous reactions is approximately 60 percent. To determine which factors, in addition to a history of reaction and evidence of venom-specific IgE antibody, predispose patients to future insect-sting reactions, we studied a venom-sensitive group of children who were deemed to be at relatively low risk for severe reactions; 28 percent of them received venom therapy.
4642. The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation.
作者: .;Daniel E Singer.;Robert A Hughes.;Daryl R Gress.;Mary A Sheehan.;Lynn B Oertel.;Sue Ward Maraventano.;Dyan Ryan Blewett.;Bernard Rosner.;J Philip Kistler.
来源: N Engl J Med. 1990年323卷22期1505-11页
Nonrheumatic atrial fibrillation increases the risk of stroke, presumably from atrial thromboemboli. There is uncertainty about the efficacy and risks of long-term warfarin therapy to prevent stroke.
4643. Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask.
作者: L Brochard.;D Isabey.;J Piquet.;P Amaro.;J Mancebo.;A A Messadi.;C Brun-Buisson.;A Rauss.;F Lemaire.;A Harf.
来源: N Engl J Med. 1990年323卷22期1523-30页
Patients with acute exacerbations of chronic obstructive pulmonary disease may require endotracheal intubation with mechanical ventilation. We designed, and here report on the efficacy of, a noninvasive ventilatory-assistance apparatus to provide inspiratory-pressure support by means of a face mask.
4645. A controlled trial of early adjunctive treatment with corticosteroids for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. California Collaborative Treatment Group.
作者: S A Bozzette.;F R Sattler.;J Chiu.;A W Wu.;D Gluckstein.;C Kemper.;A Bartok.;J Niosi.;I Abramson.;J Coffman.
来源: N Engl J Med. 1990年323卷21期1451-7页
Pneumocystis carinii pneumonia remains a common cause of serious morbidity and mortality in patients with the acquired immunodeficiency syndrome (AIDS). The extensive lung injury that accompanies pneumocystis-associated respiratory failure and the reports of clinical benefit from the use of adjunctive corticosteroids provided the rationale for this prospective multicenter trial.
4646. Corticosteroids as adjunctive therapy for severe Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A double-blind, placebo-controlled trial.
作者: S Gagnon.;A M Boota.;M A Fischl.;H Baier.;O W Kirksey.;L La Voie.
来源: N Engl J Med. 1990年323卷21期1444-50页
Preliminary reports suggest that patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia may benefit from the addition of corticosteroid treatment to antibiotic therapy.
4649. A comparison between heparin and low-dose aspirin as adjunctive therapy with tissue plasminogen activator for acute myocardial infarction. Heparin-Aspirin Reperfusion Trial (HART) Investigators.
作者: J Hsia.;W P Hamilton.;N Kleiman.;R Roberts.;B R Chaitman.;A M Ross.
来源: N Engl J Med. 1990年323卷21期1433-7页
We report the results of the Heparin-Aspirin Reperfusion Trial, a collaborative study comparing early intravenous heparin with oral aspirin as adjunctive treatment when recombinant tissue plasminogen activator (rt-PA) is used for coronary thrombolysis during acute myocardial infarction.
4650. Limited efficacy of a Haemophilus influenzae type b conjugate vaccine in Alaska Native infants. The Alaska H. influenzae Vaccine Study Group.
The prevention of invasive Haemophilus influenzae type b disease requires a vaccine that is effective when administered during the first six months of life. The infants of Alaska Natives are at particularly high risk of invasive H. influenzae type b disease.
4651. A randomized, prospective field trial of a conjugate vaccine in the protection of infants and young children against invasive Haemophilus influenzae type b disease.
作者: J Eskola.;H Käyhty.;A K Takala.;H Peltola.;P R Rönnberg.;E Kela.;E Pekkanen.;P H McVerry.;P H Mäkelä.
来源: N Engl J Med. 1990年323卷20期1381-7页
Haemophilus influenzae type b is the leading cause of invasive bacterial disease in young children. The capsular polysaccharide vaccine does not protect children at greatest risk (those under the age of 18 months), but a polysaccharide-protein conjugate vaccine has proved to be more immunogenic in this age group.
4653. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B.
作者: G Brown.;J J Albers.;L D Fisher.;S M Schaefer.;J T Lin.;C Kaplan.;X Q Zhao.;B D Bisson.;V F Fitzpatrick.;H T Dodge.
来源: N Engl J Med. 1990年323卷19期1289-98页
The effect of intensive lipid-lowering therapy on coronary atherosclerosis among men at high risk for cardiovascular events was assessed by quantitative arteriography. Of 146 men no more than 62 years of age who had apolipoprotein B levels greater than or equal to 125 mg per deciliter, documented coronary artery disease, and a family history of vascular disease, 120 completed the 2 1/2-year double-blind study, which included arteriography at base line and after treatment. Patients were given dietary counseling and were randomly assigned to one of three treatments: lovastatin (20 mg twice a day) and colestipol (10 g three times a day); niacin (1 g four times a day) and colestipol (10 g three times a day); or conventional therapy with placebo (or colestipol if the low-density lipoprotein [LDL] cholesterol level was elevated).
4654. Prevalence of human immunodeficiency virus type 1 p24 antigen in U.S. blood donors--an assessment of the efficacy of testing in donor screening. The HIV-Antigen Study Group.
作者: H J Alter.;J S Epstein.;S G Swenson.;M J VanRaden.;J W Ward.;R A Kaslow.;J E Menitove.;H G Klein.;S G Sandler.;M H Sayers.
来源: N Engl J Med. 1990年323卷19期1312-7页
We performed a multicenter study in 1989 to determine whether screening whole-blood donors for human immunodeficiency virus type 1 (HIV-1) p24 antigen would improve transfusion safety by identifying carriers of the virus who are seronegative for HIV-1 antibody.
4655. The effect of ursodiol on the efficacy and safety of extracorporeal shock-wave lithotripsy of gallstones. The Dornier National Biliary Lithotripsy Study.
作者: L J Schoenfield.;G Berci.;R L Carnovale.;W Casarella.;P Caslowitz.;D Chumley.;R C Davis.;J Y Gillenwater.;A C Johnson.;R S Jones.
来源: N Engl J Med. 1990年323卷18期1239-45页
In the treatment of gallstones with extracorporeal shock-wave lithotripsy, the bile acid ursodiol is administered to dissolve the gallstone fragments. We designed our study to determine the value of administering this agent.
4657. Pregnancy potential of human oocytes--the effect of cryopreservation.
作者: D Levran.;J Dor.;E Rudak.;L Nebel.;I Ben-Shlomo.;Z Ben-Rafael.;S Mashiach.
来源: N Engl J Med. 1990年323卷17期1153-6页
In vitro fertilization, sometimes involving the cryopreservation of human embryos, has become a routine procedure for the treatment of infertility. Even though there are embryos available for transfer in about 85 percent of the treatment cycles, the rate of pregnancy rarely exceeds 25 percent per cycle. We designed this study to investigate two questions: Does this high rate of failure result from inadequate technique, or does it simply reflect the maximal potential of a cohort of aspirated eggs to produce a pregnancy? And to what extent does cryopreservation affect the capacity for implantation of embryos?
4658. Effect of long-term monitoring of glycosylated hemoglobin levels in insulin-dependent diabetes mellitus.
The value of routine measurements of glycosylated hemoglobin (hemoglobin A1c) in the care of patients with diabetes mellitus is uncertain. We undertook this study to determine whether knowledge of hemoglobin A1c values would result in improved metabolic control in a group of patients with insulin-dependent diabetes mellitus (IDDM).
4659. A pilot study of low-dose zidovudine in human immunodeficiency virus infection.
作者: A C Collier.;S Bozzette.;R W Coombs.;D M Causey.;D A Schoenfeld.;S A Spector.;C B Pettinelli.;G Davies.;D D Richman.;J M Leedom.
来源: N Engl J Med. 1990年323卷15期1015-21页
Zidovudine delays the progression of human immunodeficiency virus (HIV) infection but is associated with hematologic toxicity at high doses. Regimens are needed that preserve or enhance efficacy and reduce toxicity. Acyclovir has been reported to potentiate the effect of zidovudine on HIV in vitro.
4660. A randomized controlled trial of a reduced daily dose of zidovudine in patients with the acquired immunodeficiency syndrome. The AIDS Clinical Trials Group.
作者: M A Fischl.;C B Parker.;C Pettinelli.;M Wulfsohn.;M S Hirsch.;A C Collier.;D Antoniskis.;M Ho.;D D Richman.;E Fuchs.
来源: N Engl J Med. 1990年323卷15期1009-14页
The initially tested dose of zidovudine for the treatment of patients with advanced disease caused by the human immunodeficiency virus type 1 (HIV) was 1500 mg. Although this dose is effective, it is associated with substantial toxicity.
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