Gracia Lam
| Preventing Muscle Loss as We Age
Sarcopenia, a decline in skeletal muscle in older people, contributes to loss of independence.
By Jane E. Brody
|
2020年5月19日 星期二
Preventing Muscle Loss as We Age
The Secret to Good Health May Be a Walk in the Park
|
2020年5月14日 星期四
研究發現，自己家裏用傳統方法製造的發酵食品含有廣泛的有益細菌，但商店裏出售的用商業方法生產的發酵食品幾乎不含任何有益菌種。
這是因為商店出售的產品在發酵後需要滅菌消毒，
所以，如果你希望食用發酵食品來改善你的腸道健康，
2020年5月12日 星期二
高血壓事實查核
【錯誤
】網傳「美國已正式規定：65歲以上標準血壓150/90...70歲以上的人高血壓不能低於130，否則極易產生體位低血壓暈倒」？
】網傳「美國已正式規定：65歲以上標準血壓150/90...70歲以上的人高血壓不能低於130，否則極易產生體位低血壓暈倒」？
經查：
一、網傳「美國已正式規定」之血壓標準已過時，目前採取的最新版標準為美國心臟學院和美國心臟學會2017年版的高血壓治療指引JNC8。二、網傳「吳氏計算法」並無科學根據。三、每個人對血壓的承受度不同，收縮壓低於130毫米汞柱，不一定會產生姿勢性低血壓而暈倒。四、血壓高低有不同狀況，不能反映特定疾病。
因此，此傳言為「錯誤」訊息。
背景
內容農場及社群媒體流傳訊息「健康年輕人的血壓是（120/80），老年人的長壽血壓是（140/90）...美國已正式規定：65歲以上標準血壓150/90，80歲以上的正常老人，160甚至170也可以...70歲以上的人高血壓不能低於130，否則極易產生體位低血壓暈倒，高血壓在150～130之間較為安全，寧可高一點，別低。 血糖也是如此，隨年齡的增加適當放寬標準...」
查核
爭議點一、美國是否規定「65歲以上標準血壓150/90，80歲以上的正常老人，160甚至170也可以」？
查核中心查證，傳言所指稱的美國正式規定，並不是美國最新規定，而是美國於2014年的高血壓治療標準，當時訂60歲以上的病人「高血壓治療標準」是 150/90mmHg。
台灣高血壓學會秘書長、台大醫院內科部主治醫師林鴻儒指出，美國心臟學院和美國心臟學會根據2017年統合分析研究的研究證據，已於2017年降低高血壓治療指引JNC8 的治療標準。
林鴻儒說，2017 年統合分析研究指出，年齡大於65歲以上的高血壓患者，將傳統血壓收縮壓控制於140毫米汞柱以下，有益降低心血管疾病發生的風險。因此，於2017年高血壓治療指引JNC8 的治療標準更新為：建議75歲以上病人，可將傳統血壓收縮壓控制於140毫米汞柱以下。
爭議點二、目前最新版的正常血壓標準數值為何？
國泰綜合醫院心血管中心主治醫師王晨旭表示，台灣醫界目前最新版的血壓標準數值，是美國心臟學院和美國心臟學會2017年版的高血壓治療指引，其中「120/80mmHg」為正常血壓的標準，血壓超過「130/80mmHg」即為高血壓。在教育推廣上，正常血壓標準為「120/70mmHg」和超過「130/80mmHg」為高血壓。
爭議點三、網傳「吳氏計算法」是否屬實？
王晨旭表示，2017年4月27日衛福部已針對吳氏計算法釋疑。
衛生福利部國民健康署已澄清：「引用之吳氏計算法查無研究實証基礎，考量其推展性有限，故不建議民眾採行。」
爭議點四、血壓標準會隨年齡有所變化？
林鴻儒表示，收縮壓隨著年紀增加會逐漸升高，接近90歲，收縮壓會逐漸升高至130-140毫米汞柱，而舒張壓在50至55歲會到達最高，約為80毫米汞柱，然後會隨年紀下降。
林鴻儒說，目前認為一般無特殊疾病的民眾，若在診所量測的血壓超過140/90毫米汞柱，以及居家測量的血壓超過135/85毫米汞柱，即會診斷成高血壓，若無治療，罹患高血壓併發症機率會大幅提升。
王晨旭指出，年紀越大，血管動脈硬化程度上升，血壓就會越高。老年人血壓到底可容許到多少，過去可能會說高一點，但現在不一定，能維持正常標準當然是最好。
爭議點四、傳言指稱「70歲以上的人高血壓不能低於130，否則極易產生體位低血壓暈倒」，是否屬實？
衛生福利部彰化醫院心臟內科醫師王彥翔說明，每個人對血壓的承受度不同，因此收縮壓低於130毫米汞柱，不一定會產生姿勢性低血壓而暈倒。
傳言指稱的『體位性低血壓』，應是大陸用語，台灣稱為姿勢性低血壓。
此外，王彥翔建議，高血壓病患在治療時，需和醫師配合，逐步調降血壓，讓身體慢慢適應以降低「突然降壓後而暈倒」的風險。
爭議點五、傳言不同的高、低壓值代表不同的病症，是否屬實？
王晨旭說，血壓高低有很多臨床狀況，甚至有些是心臟瓣膜問題。確診一個高血壓病人需經過定期抽血、超音波甚至心電圖等完整的檢查來判斷，通常不會用用血壓高低值的簡化方式來看，收縮壓和舒張壓的差別如果過大或過小，也可能是其他疾病的問題。
王彥翔也說，血壓的高低跟血管彈性、年紀有關，很難直接用某個數值，就代表某種特定部位有疾病。
結論一、網傳「美國已正式規定」之血壓標準已過時，目前採取的最新版標準為美國心臟學院和美國心臟學會2017年版的高血壓治療指引JNC8。二、網傳「吳氏計算法」並無科學根據。三、每個人對血壓的承受度不同，收縮壓低於130毫米汞柱，不一定會產生姿勢性低血壓而暈倒。四、血壓高低有不同狀況，不能反映特定疾病。
因此，此傳言為「錯誤」訊息。
2020年5月10日 星期日
You may want to ditch that valve face mask: Valve masks are a type of N95 mask that with a one-way valve.
You may want to ditch that valve face mask: The pros and cons
Valve masks are a type of N95 mask that with a one-way valve.
By
Dr. Nancy A. Anoruo
10 May 2020, 00:23
6 min read
01:5105:15
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What is an N95 mask?ABC News looks at how America reacted to the rising coronavirus death toll and unprecedented unemployment numbers in April.
The novel coronavirus pandemic brought society a new definition of normal which now includes wearing face masks. While the benefits of masks are clear, widespread use unearthed a host of drawbacks: face irritation, difficulty breathing, moisture buildup and the dreaded foggy glasses.
MORE: Facial hair and N95 masks: What you need to know
One type of mask called a "valve mask" helps solve some of these problems, but is now under fire for not protecting the public as it should -- drawing into question whether they should be used at all.
N95 masks, masks that protect against at least 95% of very small (0.3 micron) particles, became the gold standard for mask protection during the pandemic.
FILE PHOTO: A nurse wears a N95 respiratory mask during a training session, April 28, 2009, in Oakland, Calif.FILE PHOTO: A nurse wears a N95 respiratory mask during a training session, April 28, 2009, in Oakland, Calif.Justin Sullivan/Getty Images, FIle
Valve masks are a type of N95 mask that have a one-way valve allowing exhaled air to pass through a small round or square filter disc attached to the front. Some commercially available cloth masks also feature a valve
Valve masks have several benefits. In addition to protecting the wearer if fitted correctly, they allow easier exhalation than traditional masks, prevent humidity and and reduce uncomfortable heat and carbon dioxide buildup inside the mask.
Even though valve masks adequately protect the wearer, they fall short because of the valve design which only filters air breathed in, but not breathed out.
The purpose of the Centers for Disease Control and Prevention's universal masking guidelines is to prevent viral transmission from infected individuals to people around them. Exhaled air passes unfiltered into the environment, taking potential coronavirus droplets with it and defeating the mask's one important purpose -- protecting those around you.
"We want to protect you from me. And so, this valved N95 [mask] really doesn't function appropriately in this COVID environment-- either in the health care setting, or in the community," said William Schaffner, MD, professor of preventive medicine and infectious disease at Vanderbilt University Medical Center.
Some states have drawn a hard line against their use. California's Bay Area counties banned their use as part of their universal mask order that went into effect April 17. Violation of the order is punishable as a misdemeanor under the California Health and Safety Code, and can result in a fine up to $1,000, imprisonment up to 90 days or both.
MORE: From scarves to HEPA filters, what kind of face covering is your best bet against coronavirus?
While valve masks outwardly appear like a technological step up from a homemade cloth or a standard surgical mask, an old fashioned cloth or surgical mask is actually superior for the COVID-19 pandemic.
FILE PHOTO: A woman demonstrates how to use the N95 respiratory mask, April 28, 2009, in Oakland, Calif.FILE PHOTO: A woman demonstrates how to use the N95 respiratory mask, April 28, 2009, in Oakland, Calif.Justin Sullivan/Getty Images
"Cloth and surgical masks would clearly rank superior ... the N95 valve mask doesn't protect everyone around me. Of course, the major reason the CDC began to recommend the universal use of masks in the community was because of asymptomatic infection and wishing to reduce the transmission from the person who is infected to others," Schaffner said,
And what about those who insist standard masks are just too uncomfortable?
Schaffner advised they 'get with the program.'
"Sorry about that… if you're wearing masks just to protect yourself that's different than the program that we're thinking of -- the goal that we're trying to implement."
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