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6463. Double-blind withdrawal trial of azathioprine as maintenance treatment for Crohn's disease.
作者: D P O'Donoghue.;A M Dawson.;J Powell-Tuck.;R L Bown.;J E Lennard-Jones.
来源: Lancet. 1978年2卷8097期955-7页
51 patients with Crohn's disease who were in good health while taking azathiprine, 2 mg/kg body-weight/day, for at least six months were allocated either to a group in which azathioprine was continued or to one in which a control tablet was substituted. The trial lasted one year unless relapse recurred earlier. The cumulative probability of relapse was nil at six months and 5% (+/-5 S.D.) at a year among those on azathioprine, compared with 25% (+/-9 S.D.) at six months and 41% (+/-11 S.D.) at a year among those in the control group (P less than 0.01). 1 patient in whom azathioprine was continued died of pancytopenia in the fourth month of the trial. Azathioprine is potentially toxic but appears to reduce the relapse-rate in Crohn's disease.
6468. Controlled trial of hyposensitisation to Dermatophagoides pteronyssinus in children with asthma.
Hyposensitisation with Dermatophagoides pteronyssinus tyrosine absorbate in asthmatic children with bronchial sensitivity to D. pteronyssinus was effective in a 12-month double-blind controlled clinical trial. Compared with controls, treated children used a smaller quantity of drugs while maintaining clinical and lung function improvements. In most children who improved there was no change in immediate response to D. pteronyssinus on bronchial provocation test, but the late reaction was lost in half the patients and these showed the greatest improvement in symptoms.
6469. Protective effect of propranolol in threatened myocardial infarction.
Propranolol 0.1 mg/kg intravenously followed by 320 mg orally over 27 h was given to 20 randomly selected patients within 4 h of the onset of suspected myocardial infarction unaccompanied by diagnostic electrocardiographic changes. Patients given propranolol had fewer completed infarcts as assessed by serial electrocardiograms, a lower frequency of serum-creatine-kinase levels above the normal range, and lower peak serum-creatine-kinase levels than 23 control subjects. This evidence suggests that threatened myocardial infarction can in some cases be prevented by early beta-adrenoceptor blockade.
6474. Radiotherapy and hyperbaric oxygen. Report of a Medical Research Council Working Party.
来源: Lancet. 1978年2卷8095期881-4页
The M.R.C. Working Party has coordinated randomised clinical trials to assess hyperbaric oxygen as a sensitiser in radiotherapy. 1669 patients were registered in these studies between 1963 and 1976. Hyperbaric oxygen significantly improved both survival and local tumour control after radiotherapy for head-and-neck tumours and for advanced carcinoma of the cervix. In carcinoma of the bronchus there seemed to be some improvement in survival but this was not statistically singificant. In carcinoma of the bladder hyperbaric oxygen has shown no benefit. Centres already equipped with hyperbaric chambers should continue to use them for those types of tumour shown to benefit. Since hyperbaric oxygen treatment makes great demands on medical and other staff, extension of its use must await comparison with other methods for improving radiotherapy which are now being evaluated.
6476. Controlled study of hypertransfusion during remission induction in childhood acute lymphocytic leukaemia.
In a prospective, controlled trial 26 anaemic, neutropenic children with newly diagnosed acute lymphocytic leukaemia were randomised in pairs to receive either transfusion to a haemoglobin of 10--12 g/dl where clinically indicated (group A) or hypertransfusion to a haemoglobin of 16--18 g/dl (group B). Compared with group A (11 of 13 transfused), group B (all transfused) had a significantly more rapid rise in neutrophils at 7 and 10 days post-transfusion, a lower incidence of infection, and less interruption to chemotherapy. Hypertransfusion restored the myeloid/erythroid ratio to normal in bone-marrow of 5 of 6 children and the proportion of early myeloid precursors was greater than in controls.
6480. Lipid-lowering effect of carnitine in patients with type-IV hyperlipoproteinaemia.
Serum-lipid concentrations were determined in patients with type-IV hyperlipoproteinaemia treated with 900 mg/day oral DL-carnitine chloride. Serum-triglyceride was significantly reduced and concentrations continued to decline as carnitine administration continued. Total and esterified cholesterol concentrations did not change. Intravenous infusion of carnitine produced the same effects. The results suggest that carnitine is of value in the therapy of type-IV hyperliproteinaemia. Increased oxidation of free fatty acids in the tissues seems to account for the effects of carnitine on serum-lipid concentrations.
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