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June 12, 2003 Vol. 348 No. 24
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Women with a history of preterm delivery are at high risk for recurrence in subsequent pregnancies, and an effective strategy to reduce this risk has been lacking. In this randomized, placebo-controlled trial, weekly injections of 17 alpha-hydroxyprogesterone caproate reduced the risk of delivery before 37 weeks of gestation by one third among such high-risk women.
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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.
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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.
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.
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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