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241.
Zeidler HK; Kvien TK; Hannonen P; Wollheim FA; Forre O; Geidel H; Hafstrom I; Kaltwasser JP; Leirisalo-Repo M; Manger B; Laasonen L; Markert ER; Prestele H; Kurki P 《Rheumatology (Oxford, England)》1998,37(8):874-882
OBJECTIVE: This study compared the progression of joint damage in patients
with early active severe rheumatoid arthritis (RA) treated with cyclosporin
or parenteral gold. METHODS: In this open, randomized, multicentre study
with a blinded radiological endpoint, 375 patients who had suffered from
active severe RA for <3 yr were randomized to be treated for 18 months
with low-dose cyclosporin or parenteral gold. The groups were stratified
with regard to corticosteroid use. Primary efficacy variables were numbers
of erosions, erosion score and the Larsen-Dale joint damage score. RESULTS:
Joint damage progressed at similar rates in both treatment arms. In both
groups, patients receiving corticosteroids had less X-ray progression.
Rheumatoid factor positivity, high swollen joint count, high erythrocyte
sedimentation rate and pre-existing X-ray abnormalities predicted
progression of joint damage. Although numbers of serious adverse events
were similar, more gold patients (n = 65) than cyclosporin patients (n =
45) withdrew from study medication because of adverse events. CONCLUSION:
Cyclosporin was comparable to parenteral gold in retarding progression of
joint damage and was better tolerated in terms of adherence to therapy. The
open label design should be kept in mind when assessing this difference.
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242.
Towards developing a diagnostic algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae cervicitis in pregnancy. 总被引:1,自引:5,他引:1 下载免费PDF全文
M R Braddick J O Ndinya-Achola N B Mirza F A Plummer G Irungu S K Sinei P Piot 《Sexually transmitted infections》1990,66(2):62-65
C trachomatis and N gonorrhoeae are major causes of maternal and neonatal morbidity and mortality in developing countries. To identify characteristics predictive of cervical infection, we examined pregnant women attending an antenatal clinic in Nairobi, Kenya. C trachomatis was isolated from 14/178 (8%), and N gonorrhoeae from 17 (10%); cervical infection with either pathogen was present in 28 (16%). Two characteristics were independently predictive of cervical infection by logistic regression analysis; the presence of either endocervical mucopus or induced endocervical bleeding, relative risk 4.2 (95% confidence interval (CI) 2.2 to 8.0) and having more than one sexual partner during pregnancy, relative risk 3.3 (95% CI 1.4 to 7.6). A screening programme for cervical infection which tested women with one or both risk markers would have a sensitivity of 68% (95% CI 51 to 85%) and a positive predictive value of 0.35 (95% CI 0.22 to 0.47). In countries where resources are limited, diagnostic algorithms incorporating clinical signs and behavioural characteristics may be useful in identifying pregnant women at high risk of cervical infection. 相似文献
243.