Medical English | Day11
2014/11/14 医学生
antidote
['?nt?d?t]
n. [药] 解毒剂；解药；矫正方法
词根anti- 表反对，对立
antipathy 反感
antifeudal 反封建的
词组chemical antidote化学解毒剂；化学性解毒剂
Antidote UK出版者
Sober Antidote醒酒解毒
antidote suggestion政策建议
例句Actually it carries enough poison to kill 26 adult humans within minutes, and there is no antidote.
事实上，它身上带有的毒素能在几分钟内杀死26个成年人，且没有解药。
article.yeeyan.org
Action is the antidote to despair.
行动是绝望的解毒剂。
news.iciba.com
Question来自First-aid Q&A for step 1,ZY翻译
A 24-year-old woman presents to her primary care physician because of depression and insomnia for the past 6 months. The patient states that she feels bad about herself almost all of the time. A review of the patient’s history shows that she has had frequent physician visits with complaints of stomachaches, headaches,and fatigue for the past 2 years. Which of the following characteristics would support a diagnosis of major depressive disorder rather than dysthymic disorder in this patient?
(A) Changes in appetite
(B) Changes in sleep patterns
(C) Depressed mood
(D) Fatigue/lack of energy
(E) Remittance and recurrence
(F) Two-year duration of symptoms
一名24岁女性因为过去六个月的抑郁和失眠来到诊室。患者陈述自我感觉一直不好。回顾病史发现，在过去两年中，她因胃痛，头痛和疲惫频繁来到门诊。以下哪项支持诊断重度抑郁症而不是轻郁症？
A食欲改变
B睡眠模式改变
C抑郁心境
D疲惫，乏力
E反复
F症状持续两年
QuestionThe correct answer is E. Mood disorders are extremely common in primary care offices.Distinguishing between dysthymia and a major depressive episode has clinical implications for this patient. This patient displays somatic symptoms in addition to a depressed mood.Dysthymic disorder requires the presence of two of six symptoms for at least 2 years, including change in appetite, change in sleep patterns,decreased energy, decreased self-esteem,decreased concentration, and increased hopelessness.
Major depressive disorder is diagnosed in patients when they have fi ve of nine symptomsfor at least 2 weeks, including Sleepchanges, loss of Interest (anhedonia), Guilt,Energy loss, Concentration changes, Appetite changes, Psychomotor abnormalities, and Suicidal thoughts (SIG E CAPS). Thus, major depression is more severe, presenting with the onset of a greater number of symptoms; more importantly, however, this constellation of symptoms is episodic in major depression,whereas dysthymia does not remit and recur.
正确答案为E。心境障碍在初级医院很常见。鉴别重度抑郁症和轻郁症有很大临床意义。这位患者除了抑郁心境外，也表现出全身症状。轻郁症要求食欲改变，睡眠模式改变，乏力，自尊感降低，注意力降低，无望感加重这六项中两项持续至少两年。重度抑郁症要求睡眠改变，兴趣缺少，负罪感，乏力，注意力改变，食欲改变，精神运动异常，自杀倾向，九项中有五项持续至少两周。因此，重度抑郁症更为严重，表现出刚开始就有大量症状，而且是连续的，心境恶劣则不同，不会反复出现。
Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study.
提高维生素D水平能否降低高血压风险？
Karani S Vimaleswaran ,Alana Cavadino ,Diane J Berry , ,Rolf Jorde ,Aida Karina Dieffenbach
Lancet Diabetes Endocrinol
2014-06-25
索引：Lancet Diabetes Endocrinol 2014 Jun;
中文摘要来源：医纬达
BACKGROUND
Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk.
METHODS
In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108?173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium.
FINDINGS
In phenotypic analyses (up to n=49?363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (β per 10% increase, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146?581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of -0·10 mm Hg in systolic blood pressure (-0·21 to -0·0001; p=0·0498) and a change of -0·08 mm Hg in diastolic blood pressure (-0·15 to -0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142?255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96-0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of -0·29 mm Hg in diastolic blood pressure (-0·52 to -0·07; p=0·01), a change of -0·37 mm Hg in systolic blood pressure (-0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87-0·97; p=0·002).
INTERPRETATION
Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension. This finding warrants further investigation in an independent, similarly powered study.
背景资料
血浆 25-羟基维生素 D(25[OH]D)浓度低与动脉血压高和高血压风险有关，但这一关联是否存在因果关系还不明确。 我们使用了一种孟德尔随机分配方法，测试 25(OH)D 浓度与血压和高血压风险之间是否存在因果关系。
方法
在该孟德尔随机分配研究中，我们根据影响 25(OH)D 合成的基因变异体或底物可用性(CYP2R1 和 DHCR7)得出了一项等位基因评分(25[OH]D 合成评分)，我们将其用于代表 25(OH)D 浓度。 我们对来自 D-CarDia 协作的 35 项研究、多达 108,173 名个体的数据进行了荟萃分析，以研究该等位基因评分与血压测定值的关系。 我们用之前国际血压联盟(International Consortium on Blood Pressure，ICBP)、基因组流行病学心脏和衰老研究群组(Cohorts for Heart and Aging Research in Genomic Epidemiology，CHARGE)联盟和全球血压遗传学(Global Blood Pressure Genetics，Global BPGen)联盟发布的摘要统计数据对这些分析进行了补充。
研究结果
在表型分析(最多的 n=49,363)中，较高的 25(OH)D 浓度与较低的收缩血压(β每升高 10%，?0·12 mm Hg，95% CI ?0·20 至 ?0·04；p=0·003)和高血压几率下降(比值比 [OR] 0·98，95% CI 0·97—0·99；p=0·0003)有关，但与舒张血压下降无关(β每升高 10%，?0·02 mm Hg，?0·08 至 0·03；p=0·37)。 在我们结合来自 D-CarDia 和 ICBP 数据进行的荟萃分析中(n=146,581，排除重叠研究后)，合成评分的每个 25(OH)D 升高等位基因都与收缩血压 ?0·10 mm Hg 变化(?0·21 至 ?0·0001；p=0·0498)和舒张血压 ?0·08 mm Hg 变化(?0·15 至 ?0·02；p=0·01)有关。 当对 D-CarDia 和高血压联盟数据一起进行荟萃分析时(n=142,255)，该合成评分与高血压几率下降有关(每个等位基因的 OR，0·98，0·96—0·99；p=0·001)。 在工具变量分析中，25(OH)D 基因检测浓度每升高 10% 与舒张血压 ?0·29 mm Hg 变化(?0·52 至 ?0·07；p=0·01)、收缩血压 ?0·37 mm Hg 变化(?0·73 至 0·003；p=0·052)和高血压几率下降 8·1%(OR 0·92，0·87—0·97；p=0·002)有关。
解读
25(OH)D 血浆浓度升高或许能降低高血压风险。 这一发现表明可在一项独立、类似目的的研究中进行进一步研究。
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