June 12, 2003
June 12, 2003
Prevention of Preterm Delivery |
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Standard and Increased-Dose BEACOPP Compared with COPP-ABVD for Advanced Hodgkin's Disease Advanced Hodgkin's disease is difficult to control or cure with chemotherapy. This large trial compared three regimens, one of which contained more than the standard doses of cyclophosphamide, etoposide, and doxorubicin. The increased-dose regimen improved five-year survival significantly as compared with the usual chemotherapy regimen. Whereas early Hodgkin's disease is often curable, the later stages of the disease remain a challenge. Recent variations on the theme of combination chemotherapy have improved the situation. This report is representative of these new attempts.
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Involved-Field Radiotherapy for Advanced Hodgkin's Lymphoma Patients with advanced Hodgkin's lymphoma who were in complete remission after chemotherapy were assigned to receive involved-field radiotherapy or no further treatment. After a median follow-up of more than six years, survival was similar in the two groups. This carefully conducted study affirms that involved-field radiotherapy does not provide an additional benefit in patients with advanced Hodgkin's lymphoma who have a complete remission with combination chemotherapy.
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Ambulatory Blood-Pressure Measurements in Patients with Treated Hypertension In this prospective, multicenter study of treated hypertensive patients, ambulatory blood-pressure readings predicted the risk of cardiovascular events during five years of follow-up, even after adjustment for office-based blood-pressure measurements and other cardiovascular risk factors. Twenty-four–hour ambulatory blood-pressure monitoring may be used to improve the stratification of treated hypertensive patients according to cardiovascular risk, although the role of these measures in the care of such patients remains uncertain.
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Preventing Fungal Infections in Chronic Granulomatous Disease In chronic granulomatous disease of childhood, killing of microorganisms is impaired because of defects in the production of hydrogen peroxide. In this controlled study, 39 patients were treated in alternate years with either itraconazole or placebo, once per day. There were seven serious infections during treatment with placebo, and only one during treatment with itraconazole. In this rare disorder of phagocytes, prophylactic use of interferon gamma and antibiotics helps to prevent bacterial infections. A single daily dose of itraconazole can help to prevent serious fungal infections.
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Current Concepts: How Can We Prevent Lyme Disease? More than 75,000 cases of Lyme disease are reported each year in Europe and the United States. Prophylactic treatment after tick bites is only one part of a plan for primary prevention. Other strategies include checking for ticks, use of acaricides, management of vegetation, use of repellents, and techniques to reduce deer and rodent populations. Reducing tick populations can help prevent all tick-borne illnesses.
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Drug Therapy: Aromatase Inhibitors in Breast Cancer Until recently, tamoxifen, a nonsteroidal antiestrogen, was the mainstay of endocrine treatment of breast cancer. However, new aromatase inhibitors that are many times more potent and specific than the first such agent, aminoglutethimide, are changing the management of breast cancer in postmenopausal women. This review discusses the role of aromatase inhibitors such as letrozole, anastrozole, and exemestane in the treatment of breast cancer.
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