The study was the most recent update on the 2010 report on the Global Burden of Disease, considered the most authoritative work on the causes of ill-health.
“There’s great potential to improve health by avoiding certain risks like smoking and poor diet as well as tackling environmental risks like air pollution," IHME director Dr Christopher Murray told The Guardian. “The challenge for policymakers will be to use what we know to guide prevention efforts and health policies.”
Data from 108 countries from 1990 to 2013 was used in the study, and the number of risk factors in premature deaths was increased from 67 to 79, to provide a broader study.
And unhealthy eating overall, characterised by high consumption of red meat and sugar-sweetened beverages, contributed to more deaths than any other factor - because they contribute towards ischemic heart disease, strokes and diabetes.
The study was the most recent update on the 2010 report on the Global Burden of Disease, considered the most authoritative work on the causes of ill-health.
“There’s great potential to improve health by avoiding certain risks like smoking and poor diet as well as tackling environmental risks like air pollution," IHME director Dr Christopher Murray told The Guardian. “The challenge for policymakers will be to use what we know to guide prevention efforts and health policies.”
Data from 108 countries from 1990 to 2013 was used in the study, and the number of risk factors in premature deaths was increased from 67 to 79, to provide a broader study.
Ischemia, also spelled as ischaemia or ischæmia[a] (/ɪˈskiːmiə/[1][2]), is a restriction in blood supply to tissues,[3] causing a shortage of oxygen and glucose needed for cellular metabolism (to keep tissue alive).[4] Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue. It also means local anemia in a given part of a body sometimes resulting from congestion (such as vasoconstriction,thrombosis or embolism).
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[hide]is·che·mi·a (ĭ-skē'mē-ə)
n.名]《病理》局所貧血，虚血.
A decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels.
[New Latin ischaemia, from Greek iskhaimos, a stopping of the blood : iskhein, to keep back + haima, blood.]
ischemic i·sche'mic adj.短暫性腦缺血發作 腦梗塞的警訊文／陳右緯
案例一：老李正在觀賞精彩的電影頻道，突然發現看不清楚電視螢幕的下半部，他很緊張地揉了眼睛之後，正要叫醒已就寢的太太時，發現又恢復正常了。
案例二：張媽媽和她的手帕交在電話中聊得正起勁，突然說不出話來，拿著電話的右手也無力地垂在沙發邊，等到剛下班的老公發現情況不妙，正要打電話給119時，張媽媽又可以說話了，上肢的力氣也逐漸恢復正常。
◎TIA（transient ischemic attack）短暫性腦缺血發作
前述兩個案例常見於門診及病房，臨床上需要考慮是罹患了「短暫性腦缺血發作」，簡稱TIA。
案例一又可以稱為「短暫性黑矇症」，這是一種特殊形態的腦血管疾病，其特徵是患者發生短暫性的中樞神經功能障礙。這些症狀通常突然出現，但是持續的時間很短暫，由幾分鐘至數小時不等，大多不會超過24小時，這就是為什麼稱為「短暫性腦缺血發作」的緣故。
根據統計，出現「短暫性腦缺血發作」症狀後，3個月內，發生中風的比例達10%，其中大部分發生在前2天。有些病患反覆發作數十次也不會衍生中風，有的則僅發作1至2次後，隨後就發生典型的中風病症。
由於症狀迅速改善，「短暫性腦缺血發作」的治療常較急性腦中風為遲。根據一項以核磁共振檢查此類病人的研究發現，13%的病人已有腦梗塞的跡象。
在英國的一項臨床研究發現，將「短暫性腦缺血發作」病人的轉診治療時間由3天縮短到少於1天，可將3個月內的中風發生率由10.3%大幅減少為2.1%。
早期投予的藥物包括抗血小板劑、降血脂劑等。如果「短暫性腦缺血發作」是由高度狹窄的內頸動脈所造成的，在兩週內施予內頸動脈內膜刮除術，可大幅降低日後發生腦梗塞的風險。
◎正視警訊，儘速就醫方為上策
一旦出現「短暫性腦缺血發作」的病症，通常表示病患的腦血管有較一般人高的危險性發生梗塞。
梗 塞的主因可能是高度狹窄的頸動脈，併有心房顫動的心臟，或是硬化已達到危險程度的腦內動脈。具有下列特徵者有較高的機會造成腦梗塞，包括糖尿病患、年齡大 於60歲、血壓高於140/90毫米汞柱、臨床症狀包括單側無力、語言障礙、持續時間超過10分鐘（尤其超過60分鐘者）。
「短暫性腦缺血發作」的症狀是非常多樣性的，可以是單側肢體無力、感覺異常、語言障礙或單側視力障礙；也可以表現為複視、眩暈、嘔吐、吞嚥困難或步態不穩等。
要提醒大家的是，一定要提高警覺，一旦發生上述的神經症狀，要儘速就醫，不要因為症狀的恢復而掉以輕心。
（本文作者為桃園壢新醫院神經內科主任）
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