美国国家公共电台 NPR Vitamin Treatment For Sepsis Is Put To The Test

 

STEVE INSKEEP, HOST:

Sepsis is a medical condition caused by an overwhelming immune response to an infection. It is a major killer¹ in both the United States and the rest of the world. Could a cheap combination of vitamins help conquer it? Several studies are underway right now to answer that question. NPR's Richard Harris reports about the push to get an answer quickly.

RICHARD HARRIS, BYLINE³: Forty-four-year-old Dorian Pelfrey was desperately⁴ ill. He arrived at the Emory University Hospital in Atlanta in mid-October, urgently needing a liver transplant. Shortly after he arrived in the intensive care unit, he had a severe reaction to an internal infection, sepsis. His wife, Shauna, says his blood pressure plummeted⁵ and his heartbeat was out of whack⁶.

SHAUNA PELFREY: He went from doing OK to just doing really bad in very little time.

HARRIS: So you must have been worried.

S. PELFREY: Yes, very, especially with trying to keep him well enough to make it to a liver transplant.

HARRIS: The doctor caring for him told Shauna that the hospital was running a clinical trial to test out an experimental treatment for sepsis. It involves IV vitamin C and another vitamin, thiamine, and a steroid. Half the volunteers would end up with the experimental treatment; the other half would get simply fluids. Everyone would get all the usual intensive medical care to treat sepsis, as well.

S. PELFREY: And I decided⁷ to enter him into the trial.

HARRIS: How'd that go?

S. PELFREY: It was a long four days of lots of medicine, lots of care from a lot of different doctors, a lot of different areas of medicine. And then he did become well enough to receive a liver transplant.

HARRIS: The Pelfreys have no idea whether he got the experimental treatment or the placebo⁸. Regardless, Dorian's health has slowly been improving since his bout² with sepsis and his liver transplant. His throat is sore because of a breathing tube, so he can't talk, but he's following our conversation from his hospital bed.

You're doing okay?

He nods.

I hope you have a speedy recovery.

DORIAN PELFREY: Thank you.

HARRIS: He replies, with an almost imperceptible thank you. He is one of at least 200 people, perhaps as many as 500, who will participate in this clinical trial. It came about after a doctor in Virginia reported remarkable⁹ success with this combination of vitamins and steroids. Dr. Jonathan Sevransky, a critical care doctor at Emory, is a driving force behind the study.

JONATHAN SEVRANSKY: Hundreds of thousands of people die in the U.S. every year, and millions of people die in the world of this. So when somebody comes out with a potential treatment that is cheap and relatively¹⁰ easily available, it's something that you want to think about.

HARRIS: Sevransky went from thinking about it to doing it after a foundation in Atlanta approached the medical center doctors asking if they could figure out if this treatment was the real deal.

SEVRANSKY: One of the things they were very interested in doing was getting an answer quickly.

HARRIS: To accomplish that, Sevransky and colleagues at Emory, Johns Hopkins and Vanderbilt organized a clinical trial that could involve as many as 40 hospitals around the country. Now, studies with critically ill patients are challenging, in part because it's an emergency situation and doctors have to move fast. One frustrating¹¹ consequence of that, Sevransky says, is that critical care is based more on tradition than carefully conducted studies.

SEVRANSKY: Back in the Dark Ages, when I was in training, almost a hundred percent of what we did was based on experience. Now probably 25 percent of what we do is based on data, and 75 percent is based on experience. And it would be awfully¹² nice (laughter) to raise that 25 percent much higher.

HARRIS: That's part of his motivation for doing this study, which, after all, will contribute to scientific knowledge, whether the treatment is a great success, a dud or something in between. Sevransky finds that gratifying.

SEVRANSKY: And it's enjoyable to work with a team of people. You know, research is really - it's like a team sport.

HARRIS: The team include those who designed the study to make sure it provides meaningful results, those who make sure it's done ethically¹³, another team to analyze¹⁴ the data and people like Dr. Kate Nugent, whose job is to make it happen day to day.

KATE NUGENT: This is some of our demo kits¹⁶.

HARRIS: She reaches into the small box and pulls out vials of what may or may not be thiamine and steroids and a bottle holding about a cup of liquid that, in a real kit¹⁵, might or might not be vitamin C.

NUGENT: So the full kit contains this with a kit number that's associated with it. The vitamin C needs to be stored in a refrigerator, and the thiamine and steroids can be stored at room temperature.

HARRIS: A key part of her job has been to gin up awareness¹⁷ and enthusiasm among the doctors who staff the various intensive care units and emergency rooms at Emory.

NUGENT: And then after patients started to get enrolling¹⁸, it was kind of like a ball rolling down the hill at that point in time, and people are very excited about it.

HARRIS: To date, the trial has enrolled¹⁹ more than 70 patients. And the clock is ticking.

CRAIG COOPERSMITH: Getting a clinical trial done within one year, which is our goal, is actually lightning fast.

HARRIS: Dr. Craig Coopersmith at Emory says once 200 patients have been enrolled in the study, an independent group of researchers will take a peek²⁰ at the data to see if there's a big difference between the patients who got the vitamins versus²¹ those who got the placebo.

COOPERSMITH: If there's a huge effect, the trial gets stopped prior to the 500 patients.

HARRIS: A huge effect would be like what the doctor in Virginia has reported in his hospital. But Coopersmith says it's much more likely that if there is an effect, it will be smaller. So the study involving 500 patients is designed to pick up a 10 percent improvement in outcomes from sepsis.

COOPERSMITH: Ten percent would be massively important. Mortality from sepsis is higher than any other condition in the hospital.

HARRIS: A 10 percent mortality decrease would save tens of thousands of lives in the U.S. every year, he says. In fact, sepsis is such a major killer, there's actually a second large study, out of Harvard, asking the same question about the vitamin treatment. The two together will either tell doctors that there's a remarkable new treatment for a deadly disease or that it was another good idea that just simply didn't pan out.

Richard Harris, NPR News.

(SOUNDBITE OF TRISTAN DE LIEGE'S "SHE CHANGES")

1 killer   

n.杀人者，杀人犯，杀手，屠杀者

参考例句：

• Heart attacks have become Britain's No.1 killer disease.心脏病已成为英国的头号致命疾病。
• The bulk of the evidence points to him as her killer.大量证据证明是他杀死她的。

2 bout   

n.侵袭，发作；一次(阵，回)；拳击等比赛

参考例句：

• I was suffering with a bout of nerves.我感到一阵紧张。
• That bout of pneumonia enfeebled her.那次肺炎的发作使她虚弱了。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 desperately   

adv.极度渴望地，绝望地，孤注一掷地

参考例句：

• He was desperately seeking a way to see her again.他正拼命想办法再见她一面。
• He longed desperately to be back at home.他非常渴望回家。

5 plummeted   

v.垂直落下，骤然跌落( plummet的过去式和过去分词 )

参考例句：

• Share prices plummeted to an all-time low. 股票价格暴跌到历史最低点。
• A plane plummeted to earth. 一架飞机一头栽向地面。 来自《简明英汉词典》

6 whack   

v.敲击，重打，瓜分；n.重击，重打，尝试，一份

参考例句：

• After years of dieting,Carol's metabolism was completely out of whack.经过数年的节食，卡罗尔的新陈代谢完全紊乱了。
• He gave me a whack on the back to wake me up.他为把我弄醒，在我背上猛拍一下。

7 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

8 placebo   

n.安慰剂；宽慰话

参考例句：

• The placebo has been found to work with a lot of different cases.人们已发现安慰剂能在很多不同的病例中发挥作用。
• The placebo effect refers to all the observable behaviors caused by placebo.安慰剂效应是指由安慰剂所引起的可观察的行为。

9 remarkable   

adj.显著的，异常的，非凡的，值得注意的

参考例句：

• She has made remarkable headway in her writing skills.她在写作技巧方面有了长足进步。
• These cars are remarkable for the quietness of their engines.这些汽车因发动机没有噪音而不同凡响。

10 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

11 frustrating   

adj.产生挫折的，使人沮丧的，令人泄气的v.使不成功( frustrate的现在分词 )；挫败；使受挫折；令人沮丧

参考例句：

• It's frustrating to have to wait so long. 要等这么长时间，真令人懊恼。
• It was a demeaning and ultimately frustrating experience. 那是一次有失颜面并且令人沮丧至极的经历。 来自《简明英汉词典》

12 awfully   

adv.可怕地，非常地，极端地

参考例句：

• Agriculture was awfully neglected in the past.过去农业遭到严重忽视。
• I've been feeling awfully bad about it.对这我一直感到很难受。

13 ethically   

adv.在伦理上，道德上

参考例句：

• Ethically , we have nothing to be ashamed about . 从伦理上说，我们没有什么好羞愧的。
• Describe the appropriate action to take in an ethically ambiguous situation. 描述适当行为采取在一个道德地模棱两可的情况。

14 analyze   

vt.分析，解析 (=analyse)

参考例句：

• We should analyze the cause and effect of this event.我们应该分析这场事变的因果。
• The teacher tried to analyze the cause of our failure.老师设法分析我们失败的原因。

15 kit   

n.用具包，成套工具；随身携带物

参考例句：

• The kit consisted of about twenty cosmetic items.整套工具包括大约20种化妆用品。
• The captain wants to inspect your kit.船长想检查你的行装。

16 kits   

衣物和装备( kit的名词复数 )； 成套用品； 配套元件

参考例句：

• Keep your kits closed and locked when not in use. 不用的话把你的装备都锁好放好。
• Gifts Articles, Toy and Games, Wooden Toys, Puzzles, Craft Kits. 采购产品礼品，玩具和游戏，木制的玩具，智力玩具，手艺装备。

17 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。

18 enrolling   

v.招收( enrol的现在分词 )；吸收；入学；加入；[亦作enrol]( enroll的现在分词 )；登记，招收，使入伍（或入会、入学等），参加，成为成员；记入名册；卷起，包起

参考例句：

• They lashed out at the university enrolling system. 他们猛烈抨击大学的招生制度。 来自辞典例句
• You're enrolling in a country club, Billy. 你是注册加入乡村俱乐部了，比利。 来自辞典例句

19 enrolled   

adj.入学登记了的v.[亦作enrol]( enroll的过去式和过去分词 )；登记，招收，使入伍（或入会、入学等），参加，成为成员；记入名册；卷起，包起

参考例句：

• They have been studying hard from the moment they enrolled. 从入学时起，他们就一直努力学习。 来自《简明英汉词典》
• He enrolled with an employment agency for a teaching position. 他在职业介绍所登了记以谋求一个教师的职位。 来自《简明英汉词典》

20 peek   

vi.偷看，窥视；n.偷偷的一看，一瞥

参考例句：

• Larry takes a peek out of the window.赖瑞往窗外偷看了一下。
• Cover your eyes and don't peek.捂上眼睛，别偷看。

21 versus   

prep.以…为对手，对；与…相比之下

参考例句：

• The big match tonight is England versus Spain.今晚的大赛是英格兰对西班牙。
• The most exciting game was Harvard versus Yale.最富紧张刺激的球赛是哈佛队对耶鲁队。