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推薦頻道:Gimmy a break

2012年2月28日 星期二

新藥和醫療發展更新

新藥(諾華藥廠)Gilenya 口服藥物的回顧檢驗

Health Canada is reviewing a new multiple sclerosis drug that has been linked to 11 deaths.

加拿大衛生局正在檢視和Gilenya代號FTY720 (fingolimod) 口服藥物是否上市,因為此醫藥物目前造成11位MS患者的死亡

There have been no reports of deaths in Canada of people taking the Novartis drug, which is sold under the brand name Gilenya.

Gilenya, also called fingolimod, is taken once a day for people with the relapsing-remitting form of MS.Gilenya, also called fingolimod, is taken once a day for people with the relapsing-remitting form of MS. (Novartis)

Health Canada says that of the deaths outside the country, it's not clear whether the drug itself caused them, or whether other factors played a role.

Both the U.S. Food and Drug Administration and the European Medicines Agency had earlier announced that they were undertaking reviews of Gilenya.

包含美國FDA和歐洲藥品局早先都宣布再次檢視此藥物的情形

Gilenya is used for treatment of relapsing-remitting MS to reduce the frequency of attacks and to delay physical disability; it is generally recommended when other MS treatments have not been effective or cannot be tolerated.

At the time the drug was authorized, it was known that certain types of heart rhythm disturbances can be seen with Gilenya use and the Canadian labelling contains several warnings to this effect.

But Health Canada says it felt the drug's benefits outweighed its risks.

Of the 11 reported deaths, four involved serious heart-related events — three were heart attacks and another a disturbance of the heart rhythm. The seven other deaths are unexplained, including one from the United States involving a person who died within 24 hours of his or her first dose of Gilenya.

11位死亡的案例中有4位和心臟相關 (3位心臟病1位心率不整) 其他7位未明(其中一位第一次服用後24小時內就死亡)

Health Canada says people taking the drug should not discontinue it without consulting their doctor. But anyone on the drug who is feeling symptoms of heart disease — including chest pain, slow or irregular heartbeat, or dizziness — should seek medical care.

The department says doctors should monitor patients on the drug closely. Blood pressure should be checked regularly as the drug is known to increase blood pressure.

看來目前只有Ampyra還較為安全(通用名稱dalfampridine,以前稱為fampridine),是第一個臨床治療是口服和第一個同類接受FDA的批准。其目的是幫助人們與任何類型的MS提高步行速度。該藥物的研製藥廠為 : Biogen Idec

更多閱讀:

美國FDA 批准第一個多發性硬化症的口服新藥

醫療發展更新

Application closes for MS Liberation treatment study in New York

日前有關於加拿大Saskatchewan和美國共同進行靜脈擴張術研究的申請名額已經額滿,加拿大共接到682患者参與實驗研究
For hundreds Multiple Sclerosis patients in Saskatchewan the next few months will be spent waiting.

On Friday, February 24 the deadline closed for the provincially funded MS Liberation Treatment trial in Albany, New York. The government received 682 applications to be part of the trial

Lori Lumax is one of the many people hoping to be chosen for the double-blind study and she is happy to see the government taking a step in the right direction.

“I’m really happy that this is going and there’s more studies coming out all the time so Canada is getting on top of it finally,” Lumax said.

The 46-year-old from Regina was diagnosed in 2003 and most of the time she only feels tired and dizzy. About once a year she has a relapse of symptoms which affect her cognitive functions causing her to lose feeling in her hands and feet and her balance.

Lumax said she is very excited for the study because all of the data will be documented to see if the controversial liberation treatment really works.

“If I’m not chosen for this trial – well, I’ll be looking at other trials coming up,” she said, explaining that she doesn’t want to wait for two years to see if the treatment will be offered here.

Lumax added that she is not willing to go overseas for treatment because she wants to know that there will be after-care in place.

Saskatchewan has one of the highest rates of MS with 3,500 people suffering from the disease. Starting in March the provincial government will send 86 patients to participate in the study in New York.
3月開始將會有86名Ms患者至紐約進行實驗手術研究


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2012年2月21日 星期二

我看 杰若米.林 J.L. update

除了杰若米.林 的故事之外,
請大家可以想想其他運動員的故事

王建民 一個連續兩年拿到19勝卻因為受了傷的投手,再站起來, 更能夠激勵人心
同樣的也要感謝國民對的老闆和教練

郭弘志 一個經歷3次韌帶重建手術的選手, 能夠再站起來, 也是要感謝道奇隊的教練

面對旁人冷漠奇異的眼光, 以及現實冷酷的環境.

還有很多沒沒無聞, 或罕見疾病的小小英雄們, 他們也都能夠經歷人生最嚴苛的環境, 活出自己的生活.

你們就是身邊的杰若米!

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我看 杰若米.林 J.L.

從麥可喬丹(M.J.)退休後 直到杰若米.林 (J.L)出現後. 才重新喚醒曾經存在學生時代的血液.
也再度回想起2009年某一天我的心情
看到杰若米,就讓我想到研究所的一位朋友,
他也是籃球愛好者,我們以前常常聚在一起打球.

媒體大幅報導著這樣一個灰姑娘還有他背後所不為人知的故事.
在極端惡劣的環境中,到底該如何來面對,才是這個故事要告訴我們的.
雖然,不是每個人的際遇都能夠像杰若米一樣,遇到尼克隊的教練.



看著許多訪談,其中最讓我印象深刻的是:

不要讓旁人影響你,無須理會旁人對自己的言語或眼光
這一點尤其重要, 因為你是你, 旁人不是你. 旁人怎麼看你都不重要, 你不是為其他人而活.

家人有著共同的信念,緊密的結合,能夠相互支持和鼓勵.

信仰很重要,它是支持你繼續的一部分.


當他成為眾人目光焦點的時候, 才是真正考驗的開始,
隨之而來的將會是NBA最嚴酷的試鍊(骯髒的犯規...etc).
還有週遭給予的壓力(失去自我的隱私和生活),
甚至是名和利的誘惑


另外附上其他人一些對杰若米的體悟,瞧瞧囉.

名字縮寫也是J.L. 的我與有榮焉. May the force be with you, Jeremy.

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2012年2月6日 星期一

有沒有不經由手術就能夠讓靜脈狹窄的問題不再惡化的方式?

大家新年快樂,好久不見,祝大家龍年攏健康。

這篇篇名很長,也是我想要去找到的答案

或許有,但也許不是一朝見效。我想,國際上已經有很多的研究證據指出,中樞靜脈循環不全會造成肢障或是加重MS的症狀。而氣球擴張術也已經證實了是一項足夠安全而且是解決最快的方式。
我們是多麼幸運,能夠有這樣突破性的進展,來幫助我們。

遺憾的是:可能會再窄回來。
支架,是一個能夠延長窄化時間的方式,也毋庸置疑。
但,能夠延長多久呢?

記得之前,北榮的胡醫師在他的臨床檢驗當中發現了用力呼氣能夠增加內頸靜脈內些許的血流量。
不久之前,在我住所附近的醫院中也有一位神經內科醫師:蘇醫師,在知道了我的過去的病史和義大利桑伯尼醫師的論文之後,並不會對這一個新的理論排斥或表示否定的看法。
反而,他教我一個呼吸的方式,(他用科學的角度來說明)讓我覺得有機會去打通轉折處可能阻塞的問題。

蘇:你以前是不是常閉氣?
我:游泳的時候
蘇:最好不要常常閉氣,而且不要吸飽氣之後閉氣,因為吸飽氣之後閉氣會造成胸腔的壓力增大,相對於腦部的血液可能會流不下來。而吐氣要吐到盡,盡可能的把所有的氣都吐出來,讓胸腔變小,造成胸腔的壓力變低,腦部的血液可能會因為壓力差而往下流。記得,吐盡氣後,閉氣再將腹部挺出,讓橫隔膜下降,讓肺部空間變大,造成胸腔壓力變小(類真空狀態)。造成壓力差,有機會讓腦血液往下流,你試試看。

在說完之後,我就立刻做了一次,我的感覺是:
在吐盡氣後,閉氣,腹部挺出之後沒多久(約5-8秒),麻麻的感覺由頭頂慢慢的往下,經過我的咽喉,到胸腔。
當下,很興奮,雖然我不知道麻的感覺是不是代表著血流,但是,很特別。

但是,不是每一次都有相同的感覺,也許是我阻塞的太過嚴重了吧。

這是一個很神奇的經驗,分享給大家,讓大家也試試看。
我後來發現,吸氣的時候,會有由胸腔往頭頂上麻的感覺,你們也可以試試看。

附上圖,讓大家試試看

註:請參考我網誌2011/7/23的文章

頸靜脈之自我擴張IJV Self-expasion

Keep breathing!
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