The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Coronary-artery revascularization before elective major vascular surgery.
The benefit of coronary-artery revascularization before elective major vascular surgery is unclear. ⋯ Coronary-artery revascularization before elective vascular surgery does not significantly alter the long-term outcome. On the basis of these data, a strategy of coronary-artery revascularization before elective vascular surgery among patients with stable cardiac symptoms cannot be recommended.
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Randomized Controlled Trial Clinical Trial
A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer.
The likelihood of distant recurrence in patients with breast cancer who have no involved lymph nodes and estrogen-receptor-positive tumors is poorly defined by clinical and histopathological measures. ⋯ The recurrence score has been validated as quantifying the likelihood of distant recurrence in tamoxifen-treated patients with node-negative, estrogen-receptor-positive breast cancer.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Palifermin for oral mucositis after intensive therapy for hematologic cancers.
Oral mucositis is a complication of intensive chemotherapy and radiotherapy with no effective treatment. We tested the ability of palifermin (recombinant human keratinocyte growth factor) to decrease oral mucosal injury induced by cytotoxic therapy. ⋯ Palifermin reduced the duration and severity of oral mucositis after intensive chemotherapy and radiotherapy for hematologic cancers.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Levodopa and the progression of Parkinson's disease.
Despite the known benefit of levodopa in reducing the symptoms of Parkinson's disease, concern has been expressed that its use might hasten neurodegeneration. This study assessed the effect of levodopa on the rate of progression of Parkinson's disease. ⋯ The clinical data suggest that levodopa either slows the progression of Parkinson's disease or has a prolonged effect on the symptoms of the disease. In contrast, the neuroimaging data suggest either that levodopa accelerates the loss of nigrostriatal dopamine nerve terminals or that its pharmacologic effects modify the dopamine transporter. The potential long-term effects of levodopa on Parkinson's disease remain uncertain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Rivastigmine for dementia associated with Parkinson's disease.
Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease. We investigated the effects of the dual cholinesterase inhibitor rivastigmine in such patients. ⋯ In this placebo-controlled study, rivastigmine was associated with moderate improvements in dementia associated with Parkinson's disease but also with higher rates of nausea, vomiting, and tremor.