Medical English | Day24
2014/12/3 医学生

    

     Sinistrad['sinistr?d]

     adv. 向左

     词根sinistr/o-表示向左

     sinistromanual 左利手的,善用左手

     sinistrorse 左旋的

     词组sinistrad writing向左书写

     sinistrad writing automatic向左书写

     Question

     肖锋 翻译和整理

     Asplenic patients are at risk for episodes of rapidly progressive septicemia that are fatal in up to 50% of cases. If fever develops in an asplenic patient, are antibiotics indicated even if there is no obvious source of infection?

     无脾脏患者具有发生急进性败血症的危险,其死亡率高达50%。如果一个无脾患者出现发烧,即使没有明显的感染源,也需要抗生素吗?

     AnswerImmediate administration of anantimicrobial agent is indicated because fever can be the initial manifestation of a fulminant infection and prompt administration of an antiboitic may prevent the development of clinical sepsis.

     由于发烧可能是第一个暴发性感染的迹象,要立即给予抗生素。及时用抗生素可以防止临床败血症的发生(NEJM,2014;371:349)。

     Losmapimod, a novel p38 mitogen-activated protein kinase inhibitor, in non-ST-segment elevation myocardial infarction: a randomised phase 2 trial.

     新型p38促分裂原活化蛋白激酶抑制剂losmapimod用于非ST段抬高型心肌梗死:一项随机Ⅱ期试验

     L Kristin Newby ,Michael S Marber ,Chiara Melloni ,Lea Sarov-Blat ,Laura H Aberle ,Philip E Aylward

     柳叶刀杂志(Lancet)

     2014-06-12

     索引:Lancet.2014 Jun 12;

     中文摘要来源:柳叶刀中文版 王耀霆 译

     BACKGROUND

     p38 MAPK inhibition has potential myocardial protective effects. We assessed losmapimod, a potent oral p38 MAPK inhibitor, in patients with non-ST-segment elevation myocardial infarction (NSTEMI) in a double-blind, randomised, placebo-controlled trial.

     METHODS

     From October, 2009, to November, 2011, NSTEMI patients were assigned oral losmapimod (7·5 mg or 15·0 mg loading dose followed by 7·5 mg twice daily) or matching placebo in a 3:3:2 ratio. Safety outcomes were serious adverse events and alanine aminotransferase (ALT) concentrations over 12 weeks, and cardiac events (death, myocardial infarction, recurrent ischaemia, stroke, and heart failure) at 90 days. Efficacy outcomes were high-sensitivity C-reactive protein (hsCRP) and B-type natriuretic peptide (BNP) concentrations at 72 h and 12 weeks, and troponin I area under the curve (AUC) over 72 h. The losmapimod groups were pooled for analysis. This trial is registered with ClinicalTrials.gov, number NCT00910962.

     FINDINGS

     Of 535 patients enrolled, 526 (98%) received at least one dose of study treatment (losmapimod n=388 and placebo n=138). Safety outcomes did not differ between groups. HsCRP concentrations at 72 h were lower in the losmapimod group than in the placebo group (geometric mean 64·1 nmol/L, 95% CI 53·0-77·6 vs 110·8 nmol/L, 83·1-147·7; p=0·0009) but were similar at 12 weeks. Early geometric mean BNP concentrations were similar at 72 h but significantly lower in the losmapimod group at 12 weeks (37·2 ng/L, 95% CI 32·3-42·9 vs 49·4 ng/L, 38·7-63·0; p=0·04). Mean troponin I AUC values did not differ.

     INTERPRETATION

     p38 MAPK inhibition with oral losmapimod was well tolerated in NSTEMI patients and might improve outcomes after acute coronary syndromes.

     背景:p38促分裂原活化蛋白激酶(MAPK)抑制剂具有潜在的心肌保护效应。Losmapimod是一种重要的口服p38 MAPK抑制剂,作者在一项双盲、随机、安慰剂对照试验中评估了losmapimod对非ST段抬高型心肌梗死(NSTEMI)患者的作用。

     方法:2009年10月至2011年11月,按照3:3:2的比例,NSTEMI患者被随机分配至口服losmapimod组(7.5 mg或15.0 mg负荷剂量后每天2次,每次7.5 mg)或匹配的对照组。安全性结局包括90 d时严重的不良事件、12周后的丙氨酸氨基转移酶浓度及心脏事件(死亡、心肌梗死、复发性局部缺血、卒中及心力衰竭)。有效性结局包括72 h和12周时的高敏感性C反应蛋白(hsCRP)和脑钠肽 (BNP)浓度,以及72 h时肌钙蛋白I曲线下面积(AUC)。汇总losmapimod组进行分析。本试验在ClinicalTrials.gov注册,编号为NCT00910962。

     结果:募集了535例患者,526例(98%)接受了至少一剂的治疗药物(losmapimod组388例,对照组138例)。安全性结局在组间无显著差异。Losmapimod组72 h时的hsCRP浓度低于对照组(几何均数64.1 nmol/L,95%CI 53.0~77.6 vs 110.8 nmol/L,95%CI 83.1~147.7;P=0.000 9),但在12周时两组无显著差异。2组72 h时的BNP浓度相似,但12周时losmapimod组BNP浓度显著降低[几何均数37.2 ng/L(95%CI 32.3~42.9) vs 49.4 ng/L(95%CI 38.7~63.0);P=0.035 9]。肌钙蛋白I AUC均值无变化。

     结论:p38 MAPK抑制剂losmapimod在NSTEMI患者中具有很好的耐受性,也许能够改善急性冠状动脉综合征后的结局。

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