法乐氏四联症(Tetralogy of Fallot)是一种复杂性紫绀型先天性心脏畸形,占先心病12%,较为常见,但亲兄妹3人均患本病实属罕见。兰医一院胸心外科分别于1987年和1988年为存活的患相同先天性法乐氏四联症的亲兄妹2人进行了根治手术,均获...法乐氏四联症(Tetralogy of Fallot)是一种复杂性紫绀型先天性心脏畸形,占先心病12%,较为常见,但亲兄妹3人均患本病实属罕见。兰医一院胸心外科分别于1987年和1988年为存活的患相同先天性法乐氏四联症的亲兄妹2人进行了根治手术,均获治愈,随访2~2.5年,完全正常。患者的父母是姑表亲之近亲婚配,经系统检查均无心脏疾患,智力正常,身体健康;其母亲在该兄妹的怀孕期。展开更多
Objective: The purpose of this studywas to estimate the efficacy of valacyclovir suppressive therapy in pregnantwomen with recurrent genital herpes. Study design: At 36 weeks’ gestation, herpes simplex virus (HSV)- 2...Objective: The purpose of this studywas to estimate the efficacy of valacyclovir suppressive therapy in pregnantwomen with recurrent genital herpes. Study design: At 36 weeks’ gestation, herpes simplex virus (HSV)- 2 seropositive women were randomized to receive oral valacyclovir 500 mg or placebo twice daily until delivery. Genital tract and neonatal specimens were collected weekly for HSV culture and qualitative polymerase chain reaction (PCR) assay to detect viral DNA from the time of randomization to delivery. Both maternal and neonatal toxicity measures were obtained. Results: The 112 enrolled women (57 valacyclovir, 55 placebo) had similar HSV recurrence risks, including mean number of active HSV recurrences before randomization during the index pregnancy (1.1 ± 1.9 vs 1.5 ± 2.1, P = .308) and days between randomization and delivery (20.3 ± 10.2 vs 22.0 ± 8.9, P = .344). The number of women with clinical HSV recurrences between the time of randomization and delivery was significantly lower in the valacyclovir versus placebo group (10.5% vs 27.3% ; P = .023, RR 0.4, 95% CI 0.2- 0.9). Shedding of HSV within 7 days of delivery was similar in the valacyclovir and placebo group (10.4% vs 12.0% , P = .804; RR 0.9, 95% CI 0.3- 2.7), as was the number of women with clinical HSV lesions at delivery (5.3% vs 14.6% , P = .121; RR 0.4, 95% CI 0.1- 1.3). No neonates had symptomatic congenital HSV infection before discharge or up to 2 weeks’ postpartum, and no clinical or laboratory safety concerns were identified. Conclusion: Administration of valacyclovir beginning at 36 weeks’ gestation to women with a history of recurrent genital HSV reduced the number of women with subsequent clinical HSV recurrences.展开更多
文摘法乐氏四联症(Tetralogy of Fallot)是一种复杂性紫绀型先天性心脏畸形,占先心病12%,较为常见,但亲兄妹3人均患本病实属罕见。兰医一院胸心外科分别于1987年和1988年为存活的患相同先天性法乐氏四联症的亲兄妹2人进行了根治手术,均获治愈,随访2~2.5年,完全正常。患者的父母是姑表亲之近亲婚配,经系统检查均无心脏疾患,智力正常,身体健康;其母亲在该兄妹的怀孕期。
文摘Objective: The purpose of this studywas to estimate the efficacy of valacyclovir suppressive therapy in pregnantwomen with recurrent genital herpes. Study design: At 36 weeks’ gestation, herpes simplex virus (HSV)- 2 seropositive women were randomized to receive oral valacyclovir 500 mg or placebo twice daily until delivery. Genital tract and neonatal specimens were collected weekly for HSV culture and qualitative polymerase chain reaction (PCR) assay to detect viral DNA from the time of randomization to delivery. Both maternal and neonatal toxicity measures were obtained. Results: The 112 enrolled women (57 valacyclovir, 55 placebo) had similar HSV recurrence risks, including mean number of active HSV recurrences before randomization during the index pregnancy (1.1 ± 1.9 vs 1.5 ± 2.1, P = .308) and days between randomization and delivery (20.3 ± 10.2 vs 22.0 ± 8.9, P = .344). The number of women with clinical HSV recurrences between the time of randomization and delivery was significantly lower in the valacyclovir versus placebo group (10.5% vs 27.3% ; P = .023, RR 0.4, 95% CI 0.2- 0.9). Shedding of HSV within 7 days of delivery was similar in the valacyclovir and placebo group (10.4% vs 12.0% , P = .804; RR 0.9, 95% CI 0.3- 2.7), as was the number of women with clinical HSV lesions at delivery (5.3% vs 14.6% , P = .121; RR 0.4, 95% CI 0.1- 1.3). No neonates had symptomatic congenital HSV infection before discharge or up to 2 weeks’ postpartum, and no clinical or laboratory safety concerns were identified. Conclusion: Administration of valacyclovir beginning at 36 weeks’ gestation to women with a history of recurrent genital HSV reduced the number of women with subsequent clinical HSV recurrences.