Medical English | Day10
2014/11/12 医学生

    

    

     melanin

     ['mel?n?n]

     n. 黑色素

     词根melan/o- 黑色

     melanocytes 生黑色素细胞

     melanosis 黑变病；[皮肤] 黑素沉着病

     词组melanin granule黑素颗粒

     melanin index黑素指数；进行黑素指数；行黑素指数；黑色素指数

     melanin pigment黑色素

     melanin cell色素细胞

     Inhibiting Melanin抑制黑色素

     Weakens Melanin淡化皮肤黑色素

     Melanin Content黑色素含量

     例句The pigment in the upper layer of skin(epidermis) that gives your skin its normal color is called melanin.

     在浅层皮肤(表皮)中有种色素能让你的皮肤保持其正常的颜色，称为黑色素。

     article.yeeyan.org

    

     Question肖锋 翻译和整理In the presence of WPW, what does the delta wave indicate on an EKG?预激综合症心电图上的Delta波意味着什么？

     AnswerThe delta wave reflects the segment of ventricular myocardium that depolarizes earlier than anticipated because AV accessory conduction is faster than AV node conduction.Delta波反映由于比房室结传导更快的房室旁路传导而出现的部分心室肌提前去极化(预激)(Am J EM, Vol. 27, pg.880)。

    

     Pregnancy Incidence and Outcomes Among Women Receiving Preexposure Prophylaxis for HIV Prevention: A Randomized Clinical Trial.

     PrEP疗法或不能消除HIV对怀孕的影响

     Nelly R Mugo ,Ting Hong ,Connie Celum ,Deborah Donnell ,Elizabeth A Bukusi ,Grace John-Stewart

     美国医学会杂志(JAMA)

     2014-07-23

     索引：JAMA 2014 Jul;312(4):362-371

     中文摘要来源：Medsci.cn

     Importance

     Antiretroviral preexposure prophylaxis (PrEP), using tenofovir disoproxil fumarate (TDF) and combination emtricitabine/tenofovir disoproxil fumarate (FTC+TDF), is efficacious for prevention of human immunodeficiency virus (HIV) acquisition. PrEP could reduce periconception HIV risk, but the effect on pregnancy outcomes is not well defined.

     Objective

     To assess pregnancy incidence and outcomes among women using PrEP during the periconception period.

     Design, Setting, and Participants

     Randomized trial among 1785 HIV-serodiscordant heterosexual couples (the Partners PrEP Study) in which the female partner was HIV uninfected that demonstrated that PrEP was efficacious for HIV prevention, conducted between July 2008 and June 2013 at 9 sites in Kenya and Uganda.

     Interventions

     Daily oral TDF (n?=?598), combination FTC+TDF (n?=?566), or placebo (n?=?621) through July 2011, when PrEP demonstrated efficacy for HIV prevention. Thereafter, participants continued receiving active PrEP without placebo. Pregnancy testing occurred monthly and study medication was discontinued when pregnancy was detected.

     Main Outcomes and Measures

     Pregnancy incidence, birth outcomes (live births, pregnancy loss, preterm birth, congenital anomalies), and infant growth.

     Results

     A total of 431 pregnancies occurred. Pregnancy incidence was 10.0 per 100person-years among women assigned placebo, 11.9 among those assigned TDF(incidence difference, 1.9; 95% CI, -1.1 to 4.9 [P?=?.22 vs placebo]), and 8.8among those assigned FTC+TDF (incidence difference, -1.3; 95% CI, -4.1 to 1.5[P?=?.39 vs placebo]). Before discontinuation of the placebo treatment group inJuly 2011, the occurrence of pregnancy loss (96 of 288 pregnancies) was 42.5%for women receiving FTC+TDF compared with 32.3% for those receiving placebo(difference for FTC+TDF vs placebo, 10.2%; 95% CI, -5.3% to 25.7%; P?=?.16) andwas 27.7% for those receiving TDF alone (difference vs placebo, -4.6%; 95% CI,-18.1% to 8.9%; P?=?.46). After July 2011, the frequency of pregnancy loss (52of 143 pregnancies) was 37.5% for FTC+TDF and 36.7% for TDF alone (difference,0.8%; 95% CI, -16.8% to 18.5%; P?=?.92). Occurrence of preterm birth,congenital anomalies, and growth throughout the first year of life did notdiffer significantly for infants born to women who received PrEP vs placebo.

     Conclusions and Relevance

     Among HIV-serodiscordant heterosexual African couples, differences in pregnancy incidence, birth outcomes, and infant growth were not statistically different for women receiving PrEP with TDF alone or combination FTC+TDF compared with Among HIV-serodiscordant heterosexual African couples, differences in pregnancy incidence, birth outcomes, and infant growth were not statistically different for women receiving PrEP with TDF alone or combination FTC+TDF compared with placebo at conception. Given that PrEP was discontinued when pregnancy was detected and that CIs for the birth outcomes were wide, definitive statements about the safety of PrEP in the periconception period cannot be made. These results should be discussed with HIV-uninfected women receiving PrEP who are considering becoming pregnant.

     据7月23/30日发表在《美国医学会杂志》上的一则研究披露，在非洲的异性恋伴侣中，当男方HIV阳性而女方为阴性时，与那些接受安慰剂的女性相比，接受抗逆转录病毒的接触前预防 (PrEP) 疗法没有在怀孕发生率、出生结局及婴儿生长方面带来显著的差异。文章的作者指出，这些发现没有提出一个有关在怀孕之前PrEP疗法安全性的确切结论。这一期杂志将提前出版，以与国际艾滋病大会时间一致。

     以每日口服富马酸替诺福韦酯(TDF)及共同配制的恩曲他滨/富马酸替诺福韦酯(FTC+ TDF)进行的接触前抗逆转录病毒预防治疗已被证明在不同人群中可有效防止感染人类免疫缺陷病毒(HIV)。根据文章的背景资料，PrEP将是有HIV感染风险妇女——包括那些HIV血清学不一致的伴侣(如他们中只有一人感染了HIV)——的较安全受孕策略的一个重要成分，但其对怀孕结果的影响并不明确。

     华盛顿大学西雅图分校的Nelly R. Mugo, M.B.Ch.B., M.P.H.及其同事对伴侣PrEP研究(Partners PrEP Study)开展了进一步的追踪；该研究是一个随机的、有安慰剂作为对照的试验；它是在2008年7月至2013年6月间在HIV血清学不一致伴侣中开展的用PrEP预防HIV的试验。在这一分析中——它包括了在肯尼亚和乌干达的1785对伴侣，研究人员对在围孕期使用PrEP的妇女中的怀孕发生率及后果进行了评估。这些女性被随机指派每日口服TDF (n = 598)、 FTC+TDF 组合(n = 566)或安慰剂 (n = 621)直至2011年7月，那时PrEP被证明对HIV的预防有效。此后，试验的参与者在不用安慰剂的情况下继续接受积极的PrEP。

     共出现了431起怀孕。研究人员发现，怀孕发生率没有因研究组的不同而有显著差异，而且在接受PrEP的妇女和那些接受安慰剂的妇女与发生流产之间没有统计学上的显著关联，即在接受FTC+TDF的妇女中的百分比为42.5%，在那些接受安慰剂的人中为32.3%，而在那些仅接受TDF的人中则为27.7%。在2011年7月(那时停掉了安慰剂组)之后，FTC+TDF组的流产频率为37.5%而仅用TDF组则为36.7%。

     对那些接受PrEP vs 安慰剂的妇女所生的婴儿而言，其早产发生率、先天异常、肾功能及在出生后整个第一年中的生长方面都没有显著的差异。

     文章的作者写道，对某些结果而言——它们包括流产、早产、先天异常及婴儿死亡等，可信区间是宽的(提示结果中有不确定性且需要有更多的数据)，并包括同时有零效应及可能有害，因此，无法做出有关PrEP在围孕期安全性的明确陈述。

     应该将这些结果与考虑怀孕的接受PrEP的无感染HIV妇女进行讨论。

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