女人,别与酒精做朋友

男女有别长期的研究和观察发现,酒对女性的危害要大于男性.男性长期酗酒出现酒精中毒症大约需要10～15年,而女性只要5～10年.这是因为女性体内雌激素的分泌能妨碍乙醛脱氢酶的作用,而乙醛脱氢酶正是人体内分解酒精的代谢产物乙醛,减少其毒性的重要物质.所以女性饮酒后,体内乙醛含量很容易增加,酒精的毒性作用也更强.     

按病种收费应慎重推行

有关部门试图通过推行按病种收费这一收费方式改革,来解决看病贵这一顽症.本文通过对这一收费方式的分析,总结出按病种收费不仅不能解决看病贵,而且还会引发一些新的矛盾和问题,建议有关部门应慎重推行.     

Iodine should be routinely added to complementary foods

Iodine deficiency has major health consequences for the fetus and infant. Most individuals can tolerate fairly high intakes of iodine without problems. The Western Hemisphere has made great progress towards correcting its iodine deficiency, but pockets of deficiency remain and fragile monitoring systems endanger sustainability. Because the consequences of iodine deficiency are severe and the risks of excess treatment with modest supplements are minimal, we recommend the regular addition of 90 microg of iodine daily to complementary foods for children and 150 micro g for pregnant or lactating women, accompanied by effective monitoring of urinary iodine concentration in the population.     

Cervical screening: why young women should be encouraged to be screened

BACKGROUND: The English National Health Service Cervical Screening Programme (NHSCSP) recommendation not to offer cervical screening to women aged 20-24 years is considered in the context of national rates of cervical intraepithelial neoplasia grade 3 (CIN3) and invasive cervical carcinoma, falling screening coverage in young women, detection of screen-detected invasive cancers and risks of excisional treatment of CIN. METHODS: Registrations of invasive and in situ cervical carcinoma were obtained from the Office for National Statistics, data on screening coverage and cytology results from the NHSCSP website and data on screen-detected cancers from an audit at Guy's & St Thomas' NHS Foundation Trust (GSTFT). RESULTS: Before and after the introduction of organised screening in England, CIN3 was primarily detected in women aged 20-39 years. Increasing rates of CIN3 were recorded in women aged 20-24 years during the last decade (3000-4000 cases per year) despite falling screening coverage. The peak incidence of invasive cancer in screening age groups is now 35-39 years. At GSTFT in 1999-2006, 24 of 32 cancers (75%) in women aged 20-34 years were screen-detected and that percentage declined in subsequent 15-year age bands (p < or =0.0001). DISCUSSION AND CONCLUSIONS: Delaying the age for screening eligibility carries a risk of CIN becoming more extensive, and therefore more difficult to excise, as well as a risk of progression. The NHSCSP should reconsider its decision and encourage young women to be screened, not excluding those aged 20-24 years. Facilities for taking the tests should be made more convenient. Women should be informed that low-grade CIN is potentially reversible and may safely be monitored. Cervical screening also provides an opportunity for education on healthy lifestyles and safer sex while treatment should be reserved for high-grade CIN.     

脑力劳动严防五种病

低头并发征脑力劳动者的一种职业病。表现为出汗、颈肩与上臂有间歇性麻木感,医学上为低头并发征。预防方法:每隔半小时抬头、伸脖,做扩胸运     

To be and to have a critical friend in medical teaching

Background  In order to stimulate reflection and continuous professional development, a model of critical friends evaluating each other was introduced in medical education.
Objective  To investigate whether the critical friend concept can serve as a pragmatic model for evaluation of medical teachers and as a fruitful tool for enhancing self-knowledge and professional development among medical educators.
Methods  Three pairs of critical friends were formed, consisting of experienced medical teachers ( n  = 6) at the Karolinska Institutet. Each teacher was assigned to give 1 lecture and 1 seminar in his or her specific research or clinical field. The critical friend evaluated the performance in class, acting as an observer using a pre-formed protocol. The evaluation was communicated to the teacher during a 45-minute session within 48 hours after the teaching session. Each of the 6 teachers was criticised and gave criticism within the pair configurance. The outcome of the process was evaluated by an experimenter, not participating in the process, who performed a semistructured interview with each of the 6 teachers.
Results  Each teacher had a different way of reflecting on teaching after the project than before and made changes in his or her way of teaching. We also noted that being a critical friend may be even more effective than having one. The majority of the feedback provided was positive and valuable.
Conclusion  To be and to have a critical friend is worth the extra workload. Therefore, the critical friend concept should be made part of regular teaching practice .     

女孩,别避讳看妇科

长期以来,有些家长对孩子患妇科病总是迷惑不解,甚至错误地认为女孩子得了妇科病是不光彩的事情,更不愿意带孩子到妇科去看病。其实,到妇科看病时,家长只要将女孩的病史、症状等告诉医生,医生会根据病情进行各种必要的检查、化验。医生对女孩一般不做阴道检查,只做肛门检查,更不会损伤处女膜。如果病情复杂,或病变部位需要做阴道检查,也会事先征得家长的同意。有些疾病,如先天性处女膜闭锁,若不及时做处女膜切开,不但不能及时解除急性腹痛,有     

Nondaily smokers should be asked and advised to quit

BACKGROUND: Nondaily smokers are a growing subpopulation of smokers. Current cessation guidelines were developed for daily smokers, and how clinicians might help nondaily smokers is not clear. METHODS: Analyzing the 2000 National Health Interview Survey in 2004, we compared characteristics of nondaily smokers with never smokers and daily smokers. We used multivariate logistic regression to compare predictors of wanting to quit in 6 months between nondaily and daily smokers. RESULTS: About one in five current smokers was a nondaily smoker. Nondaily smokers reported better health than daily smokers, but had some health status indicators suggesting worse health than never smokers. Nondaily smokers were more likely to want to quit (odds ratio [OR]=1.31, 95% confidence interval [CI]=1.10-1.56) than daily smokers, but were less likely to report a physician having asked about tobacco use (41% vs 50%, p<0.0001) or advised quitting (31% vs 41%, p<0.0001). In both nondaily and daily smokers, physician advice (nondaily OR=1.50, 95% CI=1.03-2.2; daily OR=1.58, 95% CI=1.32-1.89), and the belief that secondhand smoke harms others (nondaily OR=1.48, 95% CI=1.04-2.1; daily OR=1.80, 95% CI=1.56-2.1), predicted wanting to quit. Higher-educated nondaily smokers were less likely to want to quit (OR=0.54, 95% CI=0.32-0.91), unlike in daily smokers (OR=1.48, 95% CI=1.15-1.89). Latino nondaily smokers were less likely (OR=0.43, 95% CI=0.30-0.64) than whites, and African-American daily smokers were more likely (OR=1.27, 95% CI=1.04-1.55) than whites, to want to quit. CONCLUSIONS: While daily smokers may seem a higher cessation priority, nondaily smokers may be more likely to quit with brief interventions. Cessation messages should address health risks of any smoking, ethnic differences, smoke-free messages, and situational triggers.     

Folic acid should not be added automatically to bread

The Health Council of the Netherlands recommends fortifying bread with folic acid to ensure that women have a basic level of folic acid intake around the time of conception in order to prevent neonatal neural tube defects. This advice should not be followed because Dutch children who already have adequate intake may easily be overdosed. Sixteen million people will be subjected to lifelong folic acid intake to prevent neural tube defects in 30 of the 200,000 babies born each year. A long-term investment in education and care targeting immigrant women is a much more effective and efficient alternative.     

仍应重视葡萄胎的有关研究

由于计划生育和生育观念的变迁,育龄妇女中各种流产和葡萄胎发生率已大为降低.当今典型的葡萄胎明显减少.常以不典型症状出现,临床诊断不易,常造成误诊、漏诊或延误诊断.另一方面由于该病经历了长期(尤其近几年)的研究,诊治效果良好,似有"疑无路,走到头或难深入"的假象,国际上妊娠滋养细胞疾病的专题会议减少和/或会议规模不大,常常仅作为妇科肿瘤会议中的一小分支讨论,目前文献中涉及该问题也少,国际专家重点研究葡萄胎者也寥寥无几,所以重视程度逐年下降.尤其是一些年轻医师对该疾病也较生疏,若葡萄胎的正确处理受到影响,也势必对妊娠滋养细胞肿瘤的防治不利,故仍不容忽视对葡萄胎的研究.