2009年12月29日 星期二

Good News in the Daily Grind

Good News in the Daily Grind

Your Coffee May Have Some Health Perks, but Can Brew Trouble in People With Certain Conditions

(See Correction & Amplification below.)

To judge by recent headlines, coffee could be the latest health-food craze, right up there with broccoli and whole-wheat bread.

But don't think you'll be healthier graduating from a tall to a venti just yet. While there has been a splash of positive news about coffee lately, there may still be grounds for concern.

The Latest Findings on Coffee

[HEALTHCOLjp] Hector Sanchez for The Wall Street Journal
  • Diabetes: Many studies find that coffee—decaf or regular—lowers the risk of developing Type 2 diabetes, but caffeine raises blood sugar in people who already have it.
  • Cancer: Earlier studies implicating coffee in causing cancer have been disproven; may instead lower the risk of colon, mouth, throat and other cancers.
  • Heart disease: Long-term coffee drinking does not appear to raise the risk and may provide some protection.
  • Hypertension: Caffeine raises blood pressure, so sufferers should be wary.
  • Cholesterol: Some coffee—especially decaf—raises LDL, the bad kind of cholesterol.
  • Alzheimer's: Moderate coffee drinking appears to be protective.
  • Osteoporosis: Caffeine lowers bone density, but adding milk can balance out the risk.
  • Pregnancy: Caffeine intake may increase the risk of miscarriage and low birth-weight babies.
  • Sleep: Effects are highly variable, but avoiding coffee after 3 p.m. can avert insomnia.
  • Mood: Moderate caffeine boosts energy and cuts depression, but excess amounts can cause anxiety.

Source: WSJ research

This month alone, an analysis in the Archives of Internal Medicine found that people who drink three to four cups of java a day are 25% less likely to develop Type 2 diabetes than those who drink fewer than two cups. And a study presented at an American Association for Cancer Research meeting found that men who drink at least six cups a day have a 60% lower risk of developing advanced prostate cancer than those who didn't drink any.

Earlier studies also linked coffee consumption with a lower risk of getting colon, mouth, throat, esophageal and endometrial cancers. People who drink coffee are also less likely to have cavities, gallstones, cirrhosis of the liver, Parkinson's disease and Alzheimer's disease, or to commit suicide, studies have found. Last year, researchers at Harvard University and the University of Madrid assessed data on more than 100,000 people over 20 years and concluded that the more coffee they drank, the less likely they were to die during that period from any cause.

But those studies come on the heels of older ones showing that coffee—particularly the caffeine it contains—raises blood pressure, heart rate and levels of homocysteine, an amino acid in blood that is associated with stroke and heart disease. Pregnant women who drink two or more cups of coffee a day have a higher rate of miscarriages and lower birth-weight babies; caffeine has also been linked to benign breast lumps and bone loss in elderly women. And, as many people can attest, coffee can also aggravate anxiety, irritability, heartburn and sleeplessness, which brings its own set of problems, including a higher risk of obesity. Yet it's just that invigorating buzz that other people love and think they can't get through the day without.

Why is there so much confusion about something that's so ubiquitous? After all, some 54% of American adults drink coffee regularly—an estimated 400 million cups per day—and coffee is the second most widely traded commodity in the world, after oil.

News Hub: Evidence of Coffee's Health Benefits


WSJ's health columnist Melinda Beck discusses new evidence that drinking coffee may help prevent diseases such as prostate cancer, Alzheimer's and diabetes.

For starters, the vast majority of coffee studies to date have been observational, in which researchers examine large sets of data over many years, looking for patterns in peoples' habits and their health.

But subjects don't always remember or report accurately on how much they drink. Cup sizes can range from 6 to 32 ounces; caffeine loads can vary from 75 to nearly 300 milligrams. Loading up with sugar, flavored syrup and whipped cream can turn a no-fat, almost no-calorie drink into the equivalent of an ice-cream soda.

Even carefully constructed observational studies that correct for such variables can only find correlations, not prove a cause-and-effect relationship. There may be other, hidden reasons why people who drink a lot of coffee have a lower risk of illness—such as jobs that provide a steady income and access to health care, exercise and healthier food. Conversely, "people who don't feel that healthy may be less likely to drink six cups of coffee a day. ... It's just a possibility," says Jim Lane, a psychophysiologist at Duke University Medical Center who has studied the effects of caffeine for more than 25 years.

Risks Disappear

Indeed, many studies from earlier decades that linked coffee drinking to a higher risk of cancer were apparently detecting related habits instead. Once researchers started adjusting for study subjects who also smoked cigarettes, the additional cancer risk disappeared.

"When I went to medical school, I was told that coffee was harmful. But in the '90s and this decade, it's become clear that if you do these studies correctly, coffee is protective in terms of public health," says Peter R. Martin, a professor of psychiatry and pharmacology at Vanderbilt University and director of the school's Institute for Coffee Studies, founded in 1999 with a grant from coffee-producing countries.

Still, many researchers believe that the only way to draw firm conclusions about something like coffee is through experimental trials in which some subjects are exposed to measured doses and others get a placebo, with other variables tightly controlled. When that's been done, says Duke's Dr. Lane, "the experimental studies and the [observational] studies are in very sharp disagreement about whether caffeine is healthy or not."

Harmful Effects

His own small, controlled studies have shown that caffeine—administered in precise doses in tablet form—raises blood pressure and blood-sugar levels after a meal in people who already have diabetes. Other studies have found that caffeine and stress combined can raise blood pressure even more significantly. "If you are a normally healthy person, that might not have any long-term effect," says Dr. Lane. "But there are some groups of people who are predisposed to get high blood pressure and heart disease and for them, caffeine might be harmful over time."


Epidemiologists counter that such small studies don't mirror real-world conditions, and they can't examine the long-term risk of disease.

The prostate-cancer study, for example, compared the coffee-drinking habits of 50,000 men working in medical professions with their incidence of prostate cancer over 20 years, and also took into account family history of prostate cancer and how frequently they had screenings. Roughly 5,000 of the men developed prostate cancer during that period, including 846 cases of the most advanced and lethal kind. But the more cups of coffee the men drank, the less likely they were to be in that most lethal group. "You can't do a randomized controlled trial on men starting in their 20s and following them until they are old enough to get prostate cancer," says lead investigator Kathryn Wilson, a research fellow in epidemiology at Harvard School of Public Health. "For some of these questions, observational studies are the best we are going to get."

As for diabetes, at least 18 studies have found that drinking three or more cups of coffee a day is linked with a lower risk of developing the disease. The more such findings are repeated, particularly with different populations, the stronger the evidence is.

Beyond Caffeine

In both the prostate and diabetes studies, the health benefits were found for caffeinated as well as decaffeinated coffee, suggesting that some other component in coffee is responsible. Coffee contains traces of hundreds of substances, including potassium, magnesium and vitamin E, as well as chlorogenic acids that are thought to have antioxidant properties.These may protect against cell damage and inflammation that can be precursors to cancer, diabetes, neurological disorders and cardiovascular disease.

One theory gaining credence is that some of those beneficial components may counterbalance some of the harmful effects of caffeine. For example, while caffeine keeps people awake in part by blocking adenosine, a brain chemical that brings on sleep, the chlorogenic acid in coffee keeps adenosine circulating in the brain longer.

And while caffeine seems to boost adrenaline that primes the body for action, coffee itself may have a calming effect. Even the aroma of coffee beans can help ease stress in rats, researchers at Seoul National University in South Korea showed in a study in the Journal of Agricultural and Food Chemistry last year. Chlorogenic acid also slows the release of glucose into the bloodstream after a meal, which may counteract caffeine's glucose effect.

Benefits Cloaked in 'Mays'

"It's a yin and yang effect," says Vanderbilt's Dr. Martin, an addiction psychiatrist who also notes that former alcoholics who drink coffee are more apt to stay sober than those who don't. Even though these studies are just associations, he says, "they may provide leads for us to better understand some of the most common illnesses that affect mankind as well as developing ways to treat them. But everything is cloaked in 'mays.' "

Most researchers agree that there isn't enough evidence about the benefits of coffee to encourage non-coffee drinkers to acquire the habit. And no one has come close to finding a recommended number of cups per day for optimum health. People's reactions to coffee are highly individual. One small cup can give one person the jitters while others can drink 10 cups and sleep all night.

At the same time, people who love coffee probably don't need to worry that they are harming their health by drinking it -- unless they already have high blood pressure or are pregnant or are having trouble sleeping, in which case it's prudent to cut down.

Even Dr. Lane, who thinks the risks of caffeine outweigh coffee's potential benefits, concedes he drinks several cups a day. "Why do I do it?" he muses. "I ask myself that question ..."

—Email healthjournal@wsj.com.

Correction & Amplification:

Peter R. Martin, a professor at Vanderbilt University School of Medicine and director of the Institute for Coffee Studies there, is an addiction psychiatrist. An earlier version of this column incorrectly stated that he is an addictio

2009年12月17日 星期四


間質性膀胱炎(interstitial cystitis, IC),是一種會造成尿急/頻尿(urgency/frequency
)和/或骨盆腔疼痛(pelvic pain)的臨床症狀症候群。它是膀胱的一種慢性炎性病變 ...
in·ter·sti·tial (ĭn'tər-stĭsh'əl) pronunciation
  1. Relating to, occurring in, or affecting interstices.
  2. Anatomy. Relating to or situated in the small, narrow spaces between tissues or parts of an organ: interstitial cells; interstitial fluid.
interstitially in'ter·sti'tial·ly adv.

2009年12月17日 ... 志賀 葉子さん(しが・ようこ、本名白銀小浪=しろがね・こなみ=歌人)11月12日 午前6時、間質性肺炎のため千葉市の病院で死去、88歳。朝鮮半島生まれ。葬儀は 済ませた。喪主は夫彦太郎(ひこたろう)氏。(2009/12/17-13:03)
一般的認為間質性肺炎(IIP)又稱肺纖維化(IPE)、纖維性肺泡炎(CFA)。本病在國內外還會有其他病名,但是這些病名都是一個繫列的性質相同的病,隻是在病情的進展過程 ...

2009年12月14日 星期一

金屬總含量不得超過50 ppm

消基會抽檢當歸、人蔘、紅棗及枸杞等藥材,發現當歸含有二氧化硫的比例高,人蔘、紅棗及枸杞也有農藥殘留,呼籲民眾使用前先浸泡、烹煮時不加蓋。 衛生署將加強管制中藥製劑的重金屬含量!衛生署中醫藥委員會規劃未來重金屬總含量不得超過50 ppm;如果中藥製劑重金屬含量介 ...

2009年12月8日 星期二


Breakfasts Rich With Grains

Andrew Scrivani for The New York Times

Published: December 7, 2009

Until recently, I’d drifted away from grainy breakfasts, even though breakfast is a great time of day for whole grains — especially if you exercise first thing in the morning, as I do. Then I rediscovered steel-cut oats and homemade granola.

Granola is a breakfast food and snack food consisting of rolled oats, nuts, honey, and sometimes rice,[citation needed] that is usually baked until crispy. During the baking process the mixture is stirred to maintain a loose, breakfast cereal-type consistency. Dried fruits, such as raisins and dates, are sometimes added.

A bowl of granola.

Besides serving as food for breakfast and/or snacks, granola is also often eaten by those who are hiking, camping, or backpacking due to the fact that it is lightweight, high in calories, and easy to store; these properties make it similar to trail mix and muesli.

Granola is often eaten in combination with yogurt, honey, strawberries, bananas, milk, and/or other forms of cereal.[citation needed] It can also serve as a topping for various types of pastries and/or desserts.[1]

2009年11月25日 星期三

Druggings put spotlight on sleeping pill sales

Druggings put spotlight on sleeping pill sales




A recent spate of suspicious deaths linked to sleeping pills has underscored the alarming ease with which the prescription drugs are readily available through illegal channels.

Though the sedative is regulated by law, it can be easily bought at any one of countless sites across the online "black market."

Doctors are also inclined to prescribe sleeping pills without questioning whether patients really need them.

Several recent cases have demonstrated that the widely available drug can just as easily be put to sinister use.

In August, a 41-year-old real estate broker was arrested in Sakai after he allegedly used sleeping pills in juice to drug and sexually assault a woman in her 20s.

Last December, a 68-year-old woman in Yamagata Prefecture allegedly sedated her husband, 65, and 9-year-old granddaughter by putting sleeping pills in their miso soup. She then allegedly attempted to strangle and stab both of them. Her granddaughter died in the attack.

But it was five recent deaths in two high-profile cases that focused intense public scrutiny on the issue.

In October, it was reported that traces of sleeping pills were found in the bodies of two male acquaintances of a 34-year-old Tokyo woman, who has been indicted for fraud in separate cases.

The first, an 80-year-old man, was killed in a fire in Chiba Prefecture in May. The second, a 41-year-old, was found dead in a car in Saitama Prefecture in August.

The substances detected in their bodies matched the sleeping pills the woman had been prescribed at a Tokyo clinic. According to her doctor, the woman asked for three types of sleeping pills, including triazolam.

In November, police sources said traces of sleeping pills found in the bodies of three male acquaintances of a 35-year-old Tottori Prefecture woman, who was arrested on suspicion of fraud, were likely identical.

Sites that illegally sell sleeping pills and other psychotropic drugs abound on the Internet. Triazolam, for instance, is sold for 2,000 yen to 3,000 yen per sheet of 10 pills--much more than when bought at a pharmacy with a prescription.

Though police around the country have been cracking down on illegal trading, it has been a cat-and-mouse game.

In 2007, 92 billion yen worth of hypnotic sedatives and anti-anxiety drugs were shipped to the domestic market by Japanese pharmaceutical companies, a 1.4-fold increase from 10 years before.

Pharmacies are cited as a major source of drugs traded on the Internet. According to the health ministry, criminals frequently steal psychotropic drugs from pharmacies or use fake or photocopied prescriptions to obtain them.

In Obu, Aichi Prefecture, a thief stole 100 triazolam pills from a drug store in August.

In May 2008, a former dentist was given a prison term for illegally obtaining Ritalin, which is methylphenidate hydrochloride, at a drug store in Kawaguchi, Saitama Prefecture.

According to the Japan Pharmaceutical Association, Tokyo and other prefectures have introduced a system by which pharmacies, upon discovering fake prescriptions, notify police or public health centers in an effort to warn other pharmacies.

But sleeping pills are becoming easier to get.

Since April 2008, doctors have been able to prescribe patients up to 30 days' worth of triazolam and 14 other kinds of sleeping pills per visit, up from 14 days.

A health ministry official said the government cannot enforce strict regulations in consideration for patients who genuinely need medicine.(IHT/Asahi: November 26,2009)

2009年11月14日 星期六


社会 | 2009.11.13




: 嗯,这很难说,因为我们总会有一些日子感觉自己"状态很糟"。这是我们每个人在日常生活中都能感受到的。但是对抑郁症也有可以用来判断的症状,比如注意力 和专心程度的降低。自我评价、自信心降低,人可能感觉生活没有了意义,有负疚感,可能对未来的前景感到很悲观。也会表现出失眠,睡眠不足,早晨起来会感到 沮丧,可能没有食欲,食欲降低。还有一个基本症状,就是会出现自杀的念头。会想伤害自己,离开现在的生活。这也是疾病带来的,是抑郁的七个基本症状之一。




奥贝尔:如果能够准确的知道这一点,那么就好了。人们相信,在所有的精神科疾病中,都存在某个敏感的压力模式,这是可能引起疾病的脆弱环节。我们每 个人都可能得这样的病。通过研究可以知道,一个主要原因是在生物学的层面上,缺少一种血液中的复合胺,也就是缺少能带来喜悦的荷尔蒙,正常情况下人体内能 自然的合成这种东西。这种荷尔蒙无法合成,或者合成的量不够,就可能导致人陷入消极的阶段,然后大部分情况下是某一个诱发因素,一个不好的情况出现了:与 合作伙伴的冲突、一个亲人的死亡,失去了工作岗位,任何一个事件都可能触发抑郁。


奥 贝尔:治疗肯定有一方面是要补充这种血清素。今天已经有了现代的抗抑郁的药物。人们可以避免神经缝隙对血清素的重新吸收,也就是让内部能产生更多的血清 素。可以通过其他的机制影响血清素,使其含量向积极的方面发展。然后当然是进行心理治疗谈话,什么影响了我,什么成为打击我的因素,我能对我的外部环境做 什么样的改变,调整我的观念,我怎么样去处理压力,我怎样做能够避免这样的压力,我能不能改变外部的条件,还有我能否改变自己来适应这个环境?也就是说, 通过心理教育来对抗疾病也很有作用。


奥 贝尔:我也有这样的看法。男人总是要面临这样的环境,根据传统的习惯,他们是家庭的支柱,他们是外界关注的焦点,他们强壮而精力充沛。我想许多男人也有抑 郁症,但是他们不愿意承认,因为这会让他们不符合这样的形象。许多人借酒来掩饰这一点,这在抑郁症中很常见,人们却完全意识不到这一点,这与社会形势也有 关系。我也曾经说过,抑郁症通常还不被看做是疾病。很难想象当人们坐在候诊室里,一个人说:"我有心肌梗塞,有两根心脏导管在我体内。"然后又来了一个人 说:"我战胜了前列腺癌,我做了手术。"另一个人却说:"我克服了我的抑郁症"或者"我现在已经能控制住我的心理了",这在德国始终都是不可能发生的。心 理疾病基本上还是一个禁忌的话题,我们经历过很多这样的事情,心理学联合会已经进行了很多旨在改变这种羞耻感的活动,因为这是一种被烙上羞耻印记的,受到 歧视的病症。

作者:Daphne Grathwohl / 子江


2009年10月26日 星期一

根除胃幽門螺旋桿菌 可防胃癌

胃癌發生率 有效降低兩成三

2009年9月17日 星期四


〔記者黃建華/高雄報導〕三年前一名鍾姓空姐因長期服用含安非他命的減肥藥而染上毒癮,痛苦不堪而跳 樓輕生,鍾女母親為愛女討公道逮到「禍源」,為免再有人受害,鍾媽媽更以抓黑心減肥藥為職志,昨天又有大型的黑心減肥藥集團栽在鍾媽媽手裡,檢警查扣約五 十萬顆偽藥,逮捕六名嫌犯。

合法掩護非法 代工製藥

警方指 出,扣案偽藥雖不含安毒成份,但標榜純中藥卻摻雜西藥成份,服用後可能造成洗腎等重大後遺症;最讓警方咋舌的是,這批偽藥成本約僅十萬元,竟可賣到一千五 百萬元,利潤高達一百五十倍,無怪乎涉案主嫌均以新型賓士高級轎車代步。全案訊後依詐欺、違反藥商藥事管理法送辦。


偽藥約50萬顆 利潤150倍

警 方說,九十五年間,鍾媽媽的空姐女兒因服用含有安非他命的「黑心減肥藥」染上毒癮,並因戒斷症候群痛苦不堪跳樓尋求解脫。鍾媽媽不甘愛女枉死,向高雄地檢 署檢舉,希望能夠揪出幕後元兇,高雄檢警在九十六年二月間,查獲害死鍾女的黑心減肥藥集團,逮捕張姓製造者,查扣減肥膠囊三十二萬顆。自此鍾媽媽蒐集舉發 黑心減肥藥的腳步不停歇,希望政府剿滅黑心減肥藥的製造者,莫讓悲劇再度發生。

仿老鼠會發貨 6嫌被逮

警 方確認此次黑心減肥偽藥後,立即報請台南地檢署檢察官林仲斌指揮偵辦。調查發現,該偽藥集團以類似「老鼠會」方式行銷發貨,販售點遍及全台,幕後以王姓主 嫌(五十歲)為首,另由旗下胡姓嫌犯(五十八歲)籌備材料,尋找代工藥廠進行偽藥加工,加工成品的偽藥則交由吳姓女大盤商(三十一歲)販售。

專 案小組前天在桃園、台南地區,會同桃縣衛局人員,將王姓主嫌等六人查緝到案,查扣減肥藥粉末、未分裝減肥膠囊、已分裝減肥膠囊、包裝罐、包裝盒、原料處方 單等物,總計這批成品、半成品及原料,約可作成五十萬顆偽藥(一公斤約可加工兩千顆,一盒計八十顆,售兩千五百元),黑市價約一千五百萬元。




不 過,哈佛大學傳染病學教授李普斯奇(Marc Lipsitch)在美國醫藥研究院的研討會上說,根據各國政府統計的染病、住院、死亡等數字,可獲致的結論是:新流感的嚴重性較早先預期的為低,而且和 季節流感的情形相似,屬第一級傳染病,也就是五級當中的最低一級。不過,第一級的傳染病每年在全球造成二十五萬至五十萬人死亡。


2009年8月25日 星期二










2009年8月22日 星期六



衛生署疾病管制局局長郭旭崧也說,為減少抗藥性及副作用問題,目前仍以快速篩檢作為投藥參考;但只要病人已出現類流感症狀,即使快篩呈陰性,或感染者病程 發展迅速、併發肺炎、心肌炎、腦炎等症狀,都可給予克流感藥物。在群聚感染中,只要有一人確認為新流感,其餘接觸者有類流感症狀,也可使用公費藥物。




2009年8月11日 星期二



中時健康╱【中時健康 黃曼瑩/台北報導】 2009-08-11 10:40



台 大醫院遠距照護中心收案除了慢性病患與癌末安寧病患的照護外,並由醫療團隊篩選狹心症、心肌梗塞、心律不整、猝死、中風、經心導管或開心手術等心血管重症 為主要收案考量,因為此類病友曾經歷生死關頭,對於自身的健康照護有較深一層的體會。遠距醫療團隊24小時監控各項生理數據,病友如有疑問,也可以隨時詢 問個案管理師,讓出院病友回家後,還能獲得持續性的照護與諮詢,減少疾病復發或嚴重併發症。

藉由遠距醫療的發展,醫療的提供 必須打破區域限制,發展到唾手可得、24小時無間隙的方便性,才是真正高品質的醫療服務,台大醫院的心血管疾病遠距醫療計劃涵蓋海外的生理訊號量測與監 測,目前在大陸的台商也能加入遠距照護醫療網絡,如此讓病友可以在大陸得到跟台北一樣持續性的醫療照護。

2009年7月27日 星期一


德国/欧洲 | 2009.07.25


干咳,发烧,关节疼痛。这些都是患上了H1N1甲型流感出现的症状。当今年4月首次发现了俗称为猪流感的病例后,这种疾病在全球迅速蔓延开来。据世界卫生 组织公布的消息,193个世卫组织成员国中,已有160个国家受到了这种病毒的侵袭。德国也是其中之一。在德国,最近以来受感染的人数急剧增加。但德国卫 生部长强调说,德国已经为预防H1N1甲型流感的大面积蔓延做好了充分准备。

"猪流感病毒失控!患者人数爆增!" 在德国一些街头小报记者的笔下,似乎一场流感大瘟疫正席卷而来。然而根据罗伯特·科赫研究所掌握的信息,实际情况并非如此。该研究所指出,80%的新患者 是近期在度假期间染上了这种疾病的。而更为危险的是,如果德国国内有更多的居民染病,因此首先要防止H1N1病毒在德国国内人群中的交叉感染。罗伯特·科 赫研究所负责人哈克指出,无论是在度假期间,还是在家中,要想降低传染的几率其实并不难。


哈克估计,猪流感在德国暂时还会以目前的速度继续蔓延。罗伯特·科赫研究所现在还在观察猪流感在国外蔓延的情况,比如观察在智利蔓延的情况。现在正 是智利的冬季,因此专家可以研究H1N1甲型流感病毒在寒冷季节中的各种变化,为德国作出预测。迄今在德国出现的大部分病例患病程度都仅仅类似轻度流感, 这和德国储备了大量抗流感药品有直接关系。德国卫生部国务秘书克劳斯·特奥·施罗德说,德国的局面仍在控制范围之内。


然而目前基本稳定的形势随时都会出现大逆转。这是因为猪流感蔓延得地区越大,感染人群越多,感染的途径就会越复杂,病毒的抗药能力也会逐步增强。而 控制猪流感蔓延的最佳的办法是注射疫苗。遗憾的是,目前还没有生产出这种疫苗。德国卫生部国务秘书克劳斯·特奥·施罗德说:"最近几天我们再次同德国的两 家制造商进行了讨论。根据这次讨论的结果,我们可以认为,今年9月底、10月初将制造出首批抗猪流感疫苗来。随后将不断生产并投放到市场。"



哮喘病也是其中的一种。由于受生产时间限制以及群众性接种工作的繁琐,可以预见,这项大面积的接种工作将持续很长时间。德国老百姓目前仍然对战胜 H1N1甲型流感充满了信心。据德国电视二台的一个政治晴雨表节目报道,德国民众中只有18%的人认为,他的健康目前受到了猪流感的威胁。

作者:Benjamin Braden/ 韩明芳


2009年7月13日 星期一

1/3的乳腺癌“并无危害” ?

最后更新时间: 2009年7月10日 格林尼治标准时间11:30更新

通过乳房X线照像筛查乳腺癌在一些欧美国家已得到广泛应用,但近期的一项科学研究显示,如此筛查出的乳腺癌病例中有1/3的其实“并无危害 ”。



美国达特茅斯医学院(Dartmouth Institute for Health Policy)教授吉尔伯特•威尔什(Gilbert Welch)就这一研究结果发表评论说:“这意味着筛查乳腺癌并非像宣传的那样毫无争议”。


不过,英国国民健康医疗系统(NHS)癌症筛查计划负责人茹列塔•帕特尼克(Julietta Patnick)说,乳房X线筛查仍是减少乳腺癌死亡率的有效手段,仅英格兰每年就能挽救1,400人的生命。




英国慈善组织关注乳腺癌(Breast Cancer Care)负责人埃玛•潘纳里(Emma Pennery)说,在能准确界定筛查出的乳腺癌会如何发展前,乳房X线照像筛查仍是尽早发现乳腺癌的有效途径。



2009年6月16日 星期二

Alcohol’s Good for You? Some Scientists Doubt It

Alcohol’s Good for You? Some Scientists Doubt It

Pier Paolo Cito/Associated Press

Published: June 15, 2009

By now, it is a familiar litany. Study after study suggests that alcohol in moderation may promote heart health and even ward off diabetes and dementia. The evidence is so plentiful that some experts consider moderate drinking — about one drink a day for women, about two for men — a central component of a healthy lifestyle.

Readers' Comments

Readers shared their thoughts on this article.

But what if it’s all a big mistake?

For some scientists, the question will not go away. No study, these critics say, has ever proved a causal relationship between moderate drinking and lower risk of death — only that the two often go together. It may be that moderate drinking is just something healthy people tend to do, not something that makes people healthy.

“The moderate drinkers tend to do everything right — they exercise, they don’t smoke, they eat right and they drink moderately,” said Kaye Middleton Fillmore, a retired sociologist from the University of California, San Francisco, who has criticized the research. “It’s very hard to disentangle all of that, and that’s a real problem.”

Some researchers say they are haunted by the mistakes made in studies about hormone replacement therapy, which was widely prescribed for years on the basis of observational studies similar to the kind done on alcohol. Questions have also been raised about the financial relationships that have sprung up between the alcoholic beverage industry and many academic centers, which have accepted industry money to pay for research, train students and promote their findings.

“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.

Even avid supporters of moderate drinking temper their recommendations with warnings about the dangers of alcohol, which has been tied to breast cancer and can lead to accidents even when consumed in small amounts, and is linked with liver disease, cancers, heart damage and strokes when consumed in larger amounts.

“It’s very difficult to form a single-bullet message because one size doesn’t fit all here, and the public health message has to be very conservative,” said Dr. Arthur L. Klatsky, a cardiologist in Oakland, Calif., who wrote a landmark study in the early 1970s finding that members of the Kaiser Permanente health care plan who drank in moderation were less likely to be hospitalized for heart attacks than abstainers. (He has since received research grants financed by an alcohol industry foundation, though he notes that at least one of his studies found that alcohol increased the risk of hypertension.)

“People who would not be able to stop at one to two drinks a day shouldn’t drink, and people with liver disease shouldn’t drink,” Dr. Klatsky said. On the other hand, “the man in his 50s or 60s who has a heart attack and decides to go clean and gives up his glass of wine at night — that person is better off being a moderate drinker.”

Health organizations have phrased their recommendations gingerly. The American Heart Association says people should not start drinking to protect themselves from heart disease. The 2005 United States dietary guidelines say that “alcohol may have beneficial effects when consumed in moderation.”

The association was first made in the early 20th century. In 1924, a Johns Hopkins biologist, Raymond Pearl, published a graph with a U-shaped curve, its tall strands on either side representing the higher death rates of heavy drinkers and nondrinkers; in the middle were moderate drinkers, with the lowest rates. Dozens of other observational studies have replicated the findings, particularly with respect to heart disease.

“With the exception of smoking and lung cancer, this is probably the most established association in the field of nutrition,” said Eric Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health. “There are probably at least 100 studies by now, and the number grows on a monthly basis. That’s what makes it so unique.”

Alcohol is believed to reduce coronary disease because it has been found to increase the “good” HDL cholesterol and have anticlotting effects. Other benefits have been suggested, too. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers. A report from the Framingham Offspring Study found that moderate drinkers had greater mineral density in their hipbones than nondrinkers. Researchers have reported that light drinkers are less likely than abstainers to develop diabetes, and that those with Type 2 diabetes who drink lightly are less likely to develop coronary heart disease.

But the studies comparing moderate drinkers with abstainers have come under fire in recent years. Critics ask: Who are these abstainers? Why do they avoid alcohol? Is there something that makes them more susceptible to heart disease?

Some researchers suspect the abstainer group may include “sick quitters,” people who stopped drinking because they already had heart disease. People also tend to cut down on drinking as they age, which would make the average abstainer older — and presumably more susceptible to disease — than the average light drinker.

In 2006, shortly after Dr. Fillmore and her colleagues published a critical analysis saying a vast majority of the alcohol studies they reviewed were flawed, Dr. R. Curtis Ellison, a Boston University physician who has championed the benefits of alcohol, hosted a conference on the subject. A summary of the conference, published a year later, said scientists had reached a “consensus” that moderate drinking “has been shown to have predominantly beneficial effects on health.”

The meeting, like much of Dr. Ellison’s work, was partly financed by industry grants. And the summary was written by him and Marjana Martinic, a senior vice president for the International Center for Alcohol Policies, a nonprofit group supported by the industry. The center paid for tens of thousands of copies of the summary, which were included as free inserts in two medical journals, The American Journal of Medicine and The American Journal of Cardiology.

In an interview, Dr. Ellison said his relationship with the industry did not influence his work, adding, “No one would look at our critiques if we didn’t present a balanced view.”

Dr. Fillmore and the co-authors of her analysis posted an online commentary saying the summary had glossed over some of the deep divisions that polarized the debate at the conference. “We also dispute Ellison and Martinic’s conclusions that more frequent drinking is the strongest predictor of health benefits,” they wrote.

(Dr. Fillmore has received support from the Alcohol Education and Rehabilitation Foundation of Australia, a nonprofit group that works to prevent alcohol and substance abuse.)

Dr. Ellison said Dr. Fillmore’s analysis ignored newer studies that corrected the methodological errors of earlier work. “She threw out the baby with the bathwater,” he said.

Meanwhile, two central questions remain unresolved: whether abstainers and moderate drinkers are fundamentally different and, if so, whether it is those differences that make them live longer, rather than their alcohol consumption.

Dr. Naimi of the C.D.C., who did a study looking at the characteristics of moderate drinkers and abstainers, says the two groups are so different that they simply cannot be compared. Moderate drinkers are healthier, wealthier and more educated, and they get better health care, even though they are more likely to smoke. They are even more likely to have all of their teeth, a marker of well-being.

“Moderate drinkers tend to be socially advantaged in ways that have nothing to do with their drinking,” Dr. Naimi said. “These two groups are apples and oranges.” And simply advising the nondrinkers to drink won’t change that, he said.

Some scientists say the time has come to do a large, long-term randomized controlled clinical trial, like the ones for new drugs. One approach might be to recruit a large group of abstainers who would be randomly assigned either to get a daily dose of alcohol or not, and then closely followed for several years; another might be to recruit people who are at risk for coronary disease.

But even the experts who believe in the health benefits of alcohol say this is an implausible idea. Large randomized trials are expensive, and they might lack credibility unless they were financed by the government, which is unlikely to take on the controversy. And there are practical and ethical problems in giving alcohol to abstainers without making them aware of it and without contributing to accidents.

Still, some small clinical trials are already under way to see whether diabetics can reduce their risk of heart disease by consuming alcohol. In Boston, researchers at Beth Israel Deaconess Medical Center are recruiting volunteers 55 and over who are at risk for heart disease and randomly assigning them to either drink plain lemonade or lemonade spiked with tasteless grain alcohol, while scientists track their cholesterol levels and scan their arteries.

In Israel, researchers gave people with Type 2 diabetes either wine or nonalcoholic beer, finding that the wine drinkers had significant drops in blood sugar, though only after fasting; the Israeli scientists are now working with an international team to begin a larger two-year trial.

“The last thing we want to do as researchers and physicians is expose people to something that might harm them, and it’s that fear that has prevented us from doing a trial,” said Dr. Sei Lee of the University of California, San Francisco, who recently proposed a large trial on alcohol and health.

“But this is a really important question,” he continued. “Because here we have a readily available and widely used substance that may actually have a significant health benefit — but we just don’t know enough to make recommendations.”

2009年6月1日 星期一

Rooting Out The Facts On An Immune Booster: astragalus黃耆



科 學研究發現黃耆能夠改善免疫系統﹐但這些研究基本上都是亞洲進行的﹐西方國家的相關研究很少。馬薩諸塞州劍橋的天然標準研究協會(Natural Standard Research Collaboration)評估了黃耆提高免疫能力的證據﹐並按照從A到F的評分標準給黃耆打分為C。這個協會是一家評估天然療法的科學家組織。天然標 準協會的創始人之一、波士頓馬薩諸塞州總醫院的主治藥劑師烏爾布里奇(Catherine Ulbricht)說﹐C的評分意味著沒有明確的或存在衝突性的科學信息﹐還沒有定論。


研 究報告的共同作者之一、俄勒岡州波特蘭美國自然醫學院(National College of Natural Medicine)的免疫學家茨維奇(Heather Zwickey)說﹐顯然黃耆確實能夠刺激人的免疫系統。但她又說﹐這不一定就意味著黃耆能夠提高人體抵御疾病的能力。茨維奇是美國自然醫學院旗下非盈利 性機構赫夫戈特研究院(Helfgott Research Institute)的研究主管。她介紹說﹐免疫細胞通常針對的都是非常具體的病原體﹐因此整體提升免疫活性並不一定就能帶來特定的益處﹐比方說提高防禦 甲型H1N1流感的能力。

黃耆價格不貴﹐可以從很多製藥商處買到。紐約製藥商Telomerase Activation Sciences Inc.銷售的一種藥濃縮提煉出了黃耆的一種有效成分。這家公司說﹐研究顯示﹐它得到加州企業Geron Corp.授權後生產的藥劑TA-65可以促進免疫系統。該公司認為﹐這種藥的功效原理是刺激一種能夠延長端粒的酵素﹐端粒是染色體尾端的序列。TA Sciences說﹐當端粒太短的時候﹐細胞就不能再分裂了﹔研究顯示﹐TA-65能夠幫助延長免疫細胞的端粒。TA-65目前被用於一種包含多種檢測的 綜合性治療﹐6個月的治療費用為6,725美元。TA Sciences表示﹐這些檢測可以幫助公司積累數據﹐向客戶顯示治療正在提高他們的健康狀況。


Laura Johannes

2009年 06月 02日 10:36
Rooting Out The Facts On An Immune Booster

A Chinese herb called astragalus can boost your immune system and help you fend off infections, from the common cold to swine flu, according companies that sell it. Scientists say astragalus boosts the immune system, but it isn't known if that translates to any health benefit.

The root of a perennial called astragalus has long been used in Chinese medicine to boost the body's defenses, often with other herbs. In the U.S., it is available in teas, tinctures and as a dietary supplement.

Scientific studies, mostly in Asia, have found the herb boosts the immune system in humans, but Western studies are scant. Natural Standard Research Collaboration, a Cambridge, Mass., scientist-owned group that evaluates natural therapies, reviewed the evidence for the immune-boosting properties of astragalus and gave it a 'C' on a scale from A to F. 'A grade of C means unclear or conflicting scientific information,' says Catherine Ulbricht, senior attending pharmacist at Massachusetts General Hospital in Boston and a co-founder of Natural Standard. 'The jury is still out.'

One of the few Western studies on the immune-boosting properties of astragalus was published in 2007, using 16 human subjects. Within 24 hours, biological markers in the group that took an astragalus tincture showed the activity of white blood cells, a key part of the body's defenses against invaders, rose significantly compared with a group on a placebo.

'Certainly it does work to stimulate your immune system,' says study co-author Heather Zwickey, an immunologist at National College of Natural Medicine in Portland, Ore. But that doesn't necessarily translate into a better resistance to disease, says Dr. Zwickey, who is director of research at the college's nonprofit Helfgott Research Institute. Immune cells often target very specific pathogens, so a general boost in immune activity doesn't necessarily translate into a specific benefit, such as a better ability to fight off swine flu, she says.

The herb is inexpensive and available from a variety of makers. A concentrated version that isolates one of its component ingredients is sold by Telomerase Activation Sciences Inc. of New York. The company's formulation, called TA-65 and licensed from Geron Corp., of Menlo Park, Calif., has been shown in unpublished work to boost the immune system, says TA Sciences. The company believes its supplement works by stimulating an enzyme that lengthens telomeres, sequences at the ends of chromosomes. When telomeres get too short, cells can no longer divide; research suggests TA-65 may help lengthen telomeres on immune cells, the company says. The herb is sold as part of a package that involves extensive testing; cost is $6,725 for six months. The testing helps the company accumulate data and show clients that it is improving their health, TA Sciences says.

Astragalus isn't recommended for people with autoimmune diseases such as lupus or multiple sclerosis, where activating the immune system could be harmful. Anyone allergic to peas is likely also to be allergic to astragalus, adds Dr. Ulbricht. Like other herbs, check with your doctor before using it with other medicines.

tobacco products

WHO pushes for graphic warnings on tobacco products

The World Health Organization (WHO) has urged governments to require that all tobacco packages include pictorial warnings to show the sickness and suffering caused by tobacco use.

The WHO will mark its No Tobacco Day with events across the globe and the kickoff to a new campaign promoting the use of pictorial warnings on tobacco products. "Show the truth, picture warnings save lives," is the message and theme of this year's No Tobacco Day.

When the WHO says the truth, it means bleeding brains, blackened gums and bulging neck tumors. A healthy lung on the left with a diseased lung on the right with the warning Bildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Warnings on British cigarette packages may include disturbing images like this one

"Although some people question the need for such pictures, the evidence is absolutely clear that they convince people to quit," said Douglas Bettcher, the head of the WHO's Tobacco Free Initiative.

"Disgust, fear, sadness or worry" triggered by the graphic images can effectively discourage smoking.

Bettcher said the images are the most effective way to communicate the risks of smoking to those who are unaware of the dangers as well as to those who try to block such worries from their mind when they smoke.

According to the WHO, such warning images are already used in more than 20 countries, including Britain, Belgium, Iran, Peru and Malaysia, although nine out of ten people live in countries that do not require their use.

Smoking a global issue

The WHO Framework Convention on Tobacco Control obliges its 160 signatory countries to require health warnings on packaging, which describe the harmful effects of tobacco use. The convention does not make it mandatory for warnings to also include pictures.

People pass over a no smoking sign in the Madrid undergroundBildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Many EU countries have passed laws banning smoking in public places

In addition to compelling warnings, the WHO campaigns to cut tobacco use internationally by eliminating smoking in public buildings, imposing high taxes on tobacco products and banning tobacco marketing and sponsorships.

Today, 80 percent of the world's smokers live in developing countries, a number that has risen in recent years due to increased marketing and production in those countries.

Different events are taking place across Europe to promote a tobacco free world. In Bosnia-Herzegovina ,there will be a performance by the Sarajevo Drum Orchestra, information and advice booths as well as games in the main square in Sarajevo.

In Italy, there will be a conference on Italian health policies, the prevention and treatment of tobacco-related illnesses and the promotion of a smoke-free culture.

In the Czech Republic, a group of about 80 people will climb Snezka, the country's highest mountain and a symbol of clean air.

Editor: Greg Benzow

2009年5月23日 星期六

W.H.O. to Rewrite Rules for Declaring a Pandemic

W.H.O. to Rewrite Rules for Declaring a Pandemic

Yuriko Nakao/Reuters

In Tokyo, schoolchildren visited the upper house of Parliament on Friday. According to data from the World Health Organization, Japan has had 294 confirmed cases of swine flu, but no deaths.

Published: May 22, 2009

Bowing to pressure, the World Health Organization announced Friday that it would rewrite its rules for alerting the world to new diseases, meaning the swine flu circling the globe will probably never be declared a full-fledged pandemic.

Dr. Keiji Fukuda, the deputy director general making the W.H.O. announcement, said that he could not predict exactly what the new rules would be but that criteria would include a “substantial risk of harm to people,” not just the geographic spread of a relatively benign virus.

The six-point system was created in 2005 when the threat was H5N1 avian flu, which has a fatality rate of about 60 percent. But the system does not take into account a virus’s lethality, and in the current outbreak, some countries have complained that the warning system created panic and pressure for border closings, even though the strain was less deadly.

Asked if the W.H.O. could damage its credibility by changing the rules in mid-outbreak, Dr. Fukuda said: “There’s nothing like reality for telling you whether something is working or not. Rigidly adhering to something that is not working would not be very helpful.”

Speaking in Geneva, Dr. Fukuda added, “We’re trying to walk a fine line between not raising panic and not being complacent.”

The W.H.O., starting in April, quickly raised its alert level to 4 and then 5 as the virus spread in North America. But even as the virus infected people in Britain, Spain and Japan, the agency did not go to Level 6, which signifies spread to a new continent. Dr. Fukuda argued that there was still no proof of “community spread,” meaning beyond travelers, schools and contacts. Some experts were skeptical.

While acquiescing, he noted that experts hashed out these issues in 2005. Geographic spread is easy to detect, but severity is highly subjective. Death rates are impossible to calculate before many people are infected; if they turn out to be high, precious time has been lost. Viruses can mutate, becoming more lethal, and even a less lethal strain can kill many people in poor nations with young, malnourished and AIDS-infected populations.

Separately, federal health officials said a study of flu genes released Friday showed that the virus could have been circulating undetected in pigs for years, and called for better surveillance.

The study, published online by Science magazine, was a collaboration between virologists from the Centers for Disease Control and Prevention and the W.H.O., along with others from Mexico, Britain, the Netherlands and the health departments of several American states and New York City.

After sequencing virus genes from 76 Americans and Mexicans and comparing them to known human and pig sequences, the study found no identical matches but concluded that the virus could be in pigs anywhere in the world, said Dr. Nancy Cox, chief of the federal agency’s flu division.

The closest match, surprisingly, was found in Thailand in 2005 — a pig with both North American and Eurasian flu genes.

Since the outbreak began, virologists have wondered how Eurasian genes got into a North American pig. Live pigs are moved through the Americas fairly easily, but rarely are legally moved across oceans, because they carry diseases. Even a single breeding boar must be tested and quarantined.

Now that the mixed genes have been found in Asia, it is possible that they came from a North American pig that was taken there. There is little flu surveillance of pigs in much of the world, and even in the United States it is “not very systematic,” Dr. Cox said.

Canadian pig farmers are required to report flu; Americans are not. Early this month, the United States Agriculture Department’s chief veterinarian said it sequenced only 500 samples a year from 100 million pigs.

In 2006, facing the avian flu threat, the United States chicken industry began voluntarily testing 1.6 million chickens a year.

Dr. Paul Sundberg, head of science for the National Pork Board, said it was planning more tests, especially on pigs in contact with people at fairs or livestock exhibits.

Henry L. Niman, who runs a Web site tracking flu mutations, complained that many swine sequences are posted by American universities and in Mexico only on private databases. “Those sequences would be very useful for figuring out how the H1N1 emerged,” he said.

The flu could also be in an intermediate host, said Dr. Cox, as the 2002 SARS virus passed from bats to humans through palm civets. But she said scientists “don’t have a hypothesis for alternative hosts.” Not enough is known about how many species carry flu, Dr. Cox said. For example, virologists were surprised to learn in 2004 that bird flu could kill zoo tigers and house cats.

Dr. Fukuda also said the new virus has been confirmed in 42 countries and had killed 86 people. About half of those hospitalized are young and healthy with no underlying conditions, he said. In the United States, such conditions are more common among the 300 now hospitalized.

Denise Grady contributed reporting.

2009年4月25日 星期六




含 水楊酸的痱滋藥膏「保治靈」,可能令兒童患上致命的雷爾氏綜合症,衛生署一直沒有規管。昨日,香港執業藥劑協會揭發,本港市面尚有二十四種藥物含水楊酸, 包括常用的「ORA-SED GEL」,毋須醫生處方,市民隨時可在藥房購買。協會呼籲政府加強規管有關藥物,規定購買時需要醫生處方,以及有藥劑師在場監督,保障市民的健康安全。本 報記者 曾愷欣

日前,英國政府呼籲十六歲以下兒童勿用「保治靈」,本港衛生署則認為暫時無需停 售。不過,本港執業藥劑師協會表示,除「保治靈」外,本港尚有二十四種衛生署註冊的痱滋唇瘡藥膏含水楊酸。協會主席鄭綺雯說,含有水楊酸的藥膏毋須醫生處 方,隨時可在市面上購買,雖然產品有標示含水楊酸成分,勸喻對水楊酸有過敏反應的人勿用,但包裝上並無列明對十六歲或以下的兒童的風險。


水 楊酸可令兒童患上致命的雷爾氏綜合症,損害腦部、肝臟功能和出現腎衰竭,嚴重可致命,衛生署卻一直沒有進行規管。鄭綺雯說,二十五種含水楊酸的藥物,佔市 面同類產品一半;她認為衛生署需修改法例加強規管,列為醫生處方藥物,以及藥劑師監管下才可出售,加強把關作用,並要求生產商註明對兒童的風險。她表示, 不含水楊酸藥物同具保護作用,呼籲家長慎重選擇。

衛生署回應表示,藥物註冊局於下周一開會,研 究是否要加強規管含有水楊酸的藥物。「保治靈」生產商稱,將會視乎衛生署的會議結果,決定是否在包裝補加警告字句;而英國政府只是列出理論上的風險,根據 藥物測試,依照正確的藥物說明使用,不會有危險。「ORA-SED GEL」生產商則沒有回應。



據 悉,衛生署在恆常抽查發現「皮特靈」的抗真菌含量標示為百分之一,但實際只有百分之零點零六,指令進行回收。樂信藥廠於一星期內提交報告,證明符合標示, 衛生署現在跟進報告資料,暫緩回收行動。鄭綺雯批評衛生署的做法不當,並擔心劑量有偏差會影響藥效,要求衛生署交代受影響的批號,以及進行全面回收,保障 市民的健康安全。



2009年4月23日 星期四


2009年 04月 23日 14:31



普通美國人每天的食鹽消耗量約為3,400毫克﹐遠遠高於美國膳食指南(U.S. Dietary Guidelines)建議的2,300毫克﹐同時也是人體所需水平的15倍。

Associated Press



紐 約市衛生專員托馬斯•弗里登(Thomas Frieden)表示﹐高血壓是僅次於吸煙之後的可預防疾病和死亡的主要原因。弗里登敦促全美包裝食品製造商和餐廳在未來10年內逐漸將食鹽用量減少 50%。美國疾病控制和預防中心(The Centers for Disease Control and Prevention﹐簡稱CDC)估計﹐採取這項措施﹐不僅每年可以挽救15萬人的生命﹐而且可以減少100億美元的醫療支出。

大約5000萬美國人都患有高血壓(即血壓水平長時間至少為140/90 mm/Hg)。另有2000萬人接近高血壓(即血壓水平為120/80至139/ 89)。相比白種人﹐高血壓在非裔美國人當中更加普遍﹐而隨著年齡的增大﹐將近90%的美國人最終都會患上高血壓。



食品製造商協會(Grocery Manufacturers Association)表示﹐近年來﹐該協會的許多會員已經開始逐漸減少食品含鹽量﹐並陸續推出低鹽食品。但是﹐它同時表示﹐任何政府措施都需要增強對消費者的教育以及以科學研究為佐證。

少 數批評人士認為﹐目前並沒有足夠證據顯示大幅降低食鹽用量是必要之舉。位於紐約州布朗克斯的阿爾波特愛因斯坦醫學院(Albert Einstein College of Medicine)的藥品和公共衛生教授麥克爾•阿爾德曼(Michael Alderman)表示﹐並沒有充分的科學研究顯示普遍降低食鹽攝取量可以拯救生命﹐這樣做可能反而會帶來意想不到的後果。阿爾德曼博士表示﹐在某些情況 下﹐降低食鹽攝取量可能引發腎臟問題﹐或者促進胰島素抗體的生成。阿爾德曼博士目前還擔任行業團體鹽學會(Salt Institute)的志願顧問。

CDC 心臟病和中風預防中心主任達爾文•拉巴特(Darwin Labarthe)對此持不同意見。他表示﹐學術界普遍認為降低食鹽攝取量有助於減少心臟病和中風的風險﹐少有證據顯示它會引起任何不良的副作用。美國心 臟協會(American Heart Association)、美國醫學會(American Medical Association)以及世界衛生組織(World Health Organization)都在提倡降低食鹽攝取量。





Melinda Beck

(編者按﹕本文作者Melinda Beck是《華爾街日報》健康養生專欄“Health Journal”的專欄作家)

2009年4月21日 星期二






[編輯] 名稱

  • 「攝護」一詞最早出現於日本1805年出版的《醫範提綱》一書。
  • 「攝護腺」一詞最早出現於日本1826年出版的《重訂解體新書》一書。
  • 英文Prostate Gland一詞在19世紀傳入中國。合信(Benjamin Hobson)所著的《全體新論》(1845-1850年))、《西醫略論》(1857年)中使用了「膀胱蒂」一詞。
  • 根據學者張大慶的研究,中文「前列腺」一詞最早出現在1918年,發表于「醫學名詞審查會第三次開會記錄」中。
  • 日本解剖學會1929年1941年設立了兩次用語改訂委員會,會議成果於1949年發表在《解剖學用語》(序文為1944年) 中,「攝護腺」因其漢字難寫難認,其日語名稱改為「前位腺」,後又確定為「前立腺」。

[編輯] 概述









[編輯] 前列腺體積




[編輯] 參見


2009年4月10日 星期五


年63歲的作家琳達•巴克林(Linda Hale Bucklin)看見自己所在的社區新開了一家“健腦俱樂部”﹐當場辦了張卡。現在﹐她每週去那裡三次﹐通過電腦學習一個“視覺處理”課程﹐她覺得這個課程幫助她更快地找到汽車鑰匙﹐並提高了自己的網球技巧。


她 加入的是活力大腦(Vibrant Brains)健腦俱樂部(Vibrant Brains)﹔據老闆講﹐從2007年12月起﹐俱樂部已吸引了約200名會員。會員每月支付60美元﹐就可以使用由20個電腦工作站構成的設施﹐電腦 上安裝了“腦部鍛煉”軟件﹐包括一個據說可以鍛煉大腦的“神經操”程序。琳達說﹐她迷上了一個藝術品拍賣游戲﹐這款游戲先展示十幾張將要拍賣的莫奈 (Monets sic)名畫﹐“然後插入其他一些莫奈的畫﹐讓你分出哪些是要拍賣的。”她說﹐“我大學兼修藝術史﹐但仍覺得這個游戲很難。”


大 多數“健腦俱樂部”的基礎配備是一個計算機房﹐在電腦上安裝一些公司開發的相關軟件﹐如Posit Science Corp.、CogniFit Ltd.,、Lumos Labs Inc.和Happy Neuron Inc.公司等。和去普通健身房練舉重和普拉提(Pilates)的人一樣﹐一些體驗這種新型健腦方式的用戶說﹐他們更喜歡有私人教練的陪伴。除了基本的 認知訓練外﹐腦部保健還包括精神健康評估和放鬆練習等項目。

佛羅里達州博卡拉頓市的新興企業Sparks of Genius公司面向老年人提供“科學的健腦運動”。在南加州﹐十幾所Nifty after Fifty健身俱樂部正在把傳統健身項目與坐在電腦前的腦部保健項目結合起來﹐聲稱在健身後進行健腦最為有效。Spa運營商Canyon Ranch公司位於亞利桑納州土桑市﹐它在其馬薩諸塞州Lenox市的健身俱樂部推出一系列健腦項目﹐包括腦部營養課﹐遺傳學保健和認知訓練等。

腦 部鍛煉也正在健身房外流行開來。芝加哥有一家“健腦店”(Marbles: The Brain Store)﹐提供各種改善腦部健康的課程。康涅狄格州哈特福德市一家非盈利組織“新英格蘭認知中心”(The New England Cognitive Center)正在培訓健腦教練﹐目的是將其健腦項目Brain G.Y.M.M.項目推廣到全國的社區中心。據專門調查腦部鍛煉軟件市場的SharpBrains Inc.公司的創始人之一阿爾瓦羅•弗爾南德斯(Alvaro Fernandez)說﹐過去三年來﹐已有700多個退休社區引進了電腦化的腦部保健中心。

“這個領域在2008年有了爆炸性的增長。” 弗爾南德斯說。他預計2008年消費者在腦部保健方面支出超過了8,000萬美元。“這個行業既有訓練工具又有教練﹐成長前景比很多人預想的要真實得多。”

Photo: vibrantBrains
腦 部保健行業的建立基礎是一個相對較新的科學發現﹕腦可塑性﹐即在人的一生中﹐感官刺激會促進腦部神經的相互聯繫﹐從而重新煥發活力。《美國醫學會雜 誌》(Journal of the American Medical Association)於2006年發表了一項研究結果﹐對2,832老年人進行的一項臨床試驗表明﹐“認知訓練”--如識別一組字母或單詞有何規律 --有助於改善記憶力和提高推理能力。

最近一項對487名65歲以上的老年人進行的研究發現﹐在八週時間內通過腦部鍛煉軟件進行40小時 訓練的人在記憶力和注意力方面有顯著改進。該研究成果計劃在2009年4月出版的《美國老年醫學會雜誌》(Journal of the American Geriatrics Society)上發表。

這份研究報告說﹐“腦部保健”仍是一個模糊的概念。一些科學家只是把 健腦視為商人想從大眾對老年痴呆症的恐懼感中謀利的最新手段。據估計﹐全美已有530萬人患上“阿爾茨海默症”(Alzheimer)。阿爾茨海默病症協 會(Alzheimer's Association)預測﹐隨著嬰兒潮一代開始步入老年﹐到2010年﹐美國每年將出現50萬人老年痴呆症患者﹐這一趨勢將持續數十年。


“ 認知訓練可能有好處﹐會讓一些人反應更靈敏﹐但現在還幾乎沒有任何證據可以證明﹐人為控制的認知訓練療程可以減少阿爾茨海默症的發病率﹐或能影響人的日常 生理機能。”邁阿密大學米勒醫學院(University of Miami's Miller School of Medicine)的精神病學教授戴維•羅文斯坦恩(David Loewenstein)說道。

但老年痴呆症恐懼人群和那些已進入老年痴獃症早期的患者不會坐等研究成果出爐。任天堂公司(Nintendo Co.)表示﹐自2006年以來﹐公司開發的電子游戲《頭腦時代》(Brain Age)已經在美國賣出550萬份以上﹐從而極大提高了人們對腦部鍛煉的認知度。

雖 然許多腦部鍛煉中心主要面向嬰兒潮一代﹐但這個人群的父母們也在加入進來。2008年﹐以前曾是演員經紀人的伊娃•斯萊恩(Eva Slane,)成為佛羅里達州薩拉索塔市一家健腦俱樂部Neurobics Club的會員。“我想儘可能讓自己保持敏銳﹐”她說。80歲的斯萊恩現在最喜歡玩的健腦設備是達金健腦系統(Dakim BrainFitness System)﹐那是一個觸摸屏電腦﹐上面有很多20世紀50年代前的電影和音樂片段﹐還配上畫外音﹐可以像玩游戲一樣操縱它們。

82歲的馬歇爾•凱恩(Marshall Kahn)是加州富勒頓市的一名家庭醫生﹐他說自己在Nifty after Fifty健腦俱樂部做的那些腦部鍛煉讓他精神振奮﹐甚至打算重新開始當起兼職醫生給病人看病。他說﹐做了那些腦部練習後﹐我發現自己的狀態還不錯。

41 歲的麗莎.斯庫納曼(Lisa Schoonerman)是活力大腦健腦俱樂部的創始人之一﹐她說自己在得知母親患上額顳痴呆症(一種記憶往往會快速消失的老年痴呆症)後開始留意要開一 家健腦俱樂部。她的合伙人簡•茲維克(Jan Zivic) 11年前因車禍陷入昏迷﹐大腦記憶嚴重受損﹐在康復治療中嘗試了一些早期的腦部鍛煉游戲。兩人不約而同地將目光投向健腦這個點子上﹐即科學家所稱的強化“ 認知儲備”。該理論認為﹐人們接受更多的腦部刺激有助於擴大腦容量﹐擴張腦神經通道﹐在腦部受傷或老年痴呆症開始切斷腦神經聯繫時﹐對腦部起到保護作用。


63 歲的俱樂部會員蓋洛•摩爾(Gail Moore)說自己很難搞定那些健腦游戲﹐從來都享受不到“贏”的快感。“我很討厭那個名叫‘園藝大師’的游戲﹐每片樹葉看上去都一模一樣﹐我老是猜不出 來。但我一直告訴自己﹐做這個游戲的意義不在於得到高分﹐而在於做游戲本身。”

Kelly Greene