2008年8月26日 星期二
2008年8月25日 星期一
只要發揮想像力，什麼事都有可能發生
NOWnews【重點新聞】京奧／倫敦奧運是菲爾普斯最後一站？
拿下生涯14金，菲爾普斯必須開始習慣他的名人生活以及不斷累積的財富，但菲爾普斯並不太在意，他表示，「人有無限潛能，我在過去4年學到的就是，只要發揮想像力，什麼事都有可能發生。我唯一想要的只是開心，而那是最重要的。我不需要什麼事都很完美，我只想開開心心的走完我的職業生涯。」
2008年8月24日 星期日
長期痠痛治不好 恐是憂鬱症
醫定要注意／長期痠痛治不好 恐是憂鬱症-Yahoo!奇摩新聞
您會不會常常有頭痛、肌肉酸痛的症狀，長時間下來都無法根治呢？如果有這種情形的民眾要當心了！您可能是憂鬱症的高危險群。根據調查，憂鬱症的患者中，有七成的病患都會出現頭痛、身體酸疼，但以往常常被認為是一般疾病，反而延誤了憂鬱症的治療時間。
頭痛！頭痛！頭常常疼痛嗎？根據調查，長期有頭痛的毛病，其實是罹患憂鬱症的高危險群。不只頭痛，還包括腰部痛、肌肉酸痛莫名的慢性疼痛，而且台灣有將近7成憂鬱症患者會併發身體疼痛。
精神科醫師李信謙說，疼痛及憂鬱有因果關係，特別憂鬱者缺乏「正腎上腺素」致全身疼痛。
慢性疼痛往往讓人疏忽，錯失發現憂鬱症的黃金時間，但究竟是真酸痛還是真憂鬱，如果已經是憂鬱症的患者，從心情上來區分身體疼痛會造成他們情緒低落，甚至厭世有自殺念頭，在心裡層面也會一直覺得自己的酸痛的毛病比醫師說的還要嚴重，這些都屬於疼痛型的憂鬱症患者。
如果長期陷入心情鬱悶而且身體疼痛，又找不出原因，吃藥也吃不好，精神科醫師李信謙建議，或許要從精神科方面下手，早期發現早期治療。(新聞來源：東森新聞記者賴思豪、林奕勳)
您會不會常常有頭痛、肌肉酸痛的症狀，長時間下來都無法根治呢？如果有這種情形的民眾要當心了！您可能是憂鬱症的高危險群。根據調查，憂鬱症的患者中，有七成的病患都會出現頭痛、身體酸疼，但以往常常被認為是一般疾病，反而延誤了憂鬱症的治療時間。
頭痛！頭痛！頭常常疼痛嗎？根據調查，長期有頭痛的毛病，其實是罹患憂鬱症的高危險群。不只頭痛，還包括腰部痛、肌肉酸痛莫名的慢性疼痛，而且台灣有將近7成憂鬱症患者會併發身體疼痛。
精神科醫師李信謙說，疼痛及憂鬱有因果關係，特別憂鬱者缺乏「正腎上腺素」致全身疼痛。
慢性疼痛往往讓人疏忽，錯失發現憂鬱症的黃金時間，但究竟是真酸痛還是真憂鬱，如果已經是憂鬱症的患者，從心情上來區分身體疼痛會造成他們情緒低落，甚至厭世有自殺念頭，在心裡層面也會一直覺得自己的酸痛的毛病比醫師說的還要嚴重，這些都屬於疼痛型的憂鬱症患者。
如果長期陷入心情鬱悶而且身體疼痛，又找不出原因，吃藥也吃不好，精神科醫師李信謙建議，或許要從精神科方面下手，早期發現早期治療。(新聞來源：東森新聞記者賴思豪、林奕勳)
Chronic neck pain--- stretch & strength?
BMJ Evidence Updates
Abstract
OBJECTIVE: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain. DESIGN: A randomized follow-up study. PARTICIPANTS: One hundred and one patients with chronic non-specific neck pain were randomized in two groups. INTERVENTION: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session. MAIN OUTCOME MEASUREMENTS: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention. RESULTS: No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups (P<0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group.
CONCLUSIONS: No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.
Abstract
OBJECTIVE: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain. DESIGN: A randomized follow-up study. PARTICIPANTS: One hundred and one patients with chronic non-specific neck pain were randomized in two groups. INTERVENTION: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session. MAIN OUTCOME MEASUREMENTS: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention. RESULTS: No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups (P<0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group.
CONCLUSIONS: No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.
2008年8月2日 星期六
Motor cortex stimulation for chronic pain: systematic review and meta-analysis of the literature
BMJ Evidence Updates
Abstract
OBJECTIVE: To conduct a systematic review and meta-analysis to quantify the efficacy of invasive and noninvasive brain stimulation for the treatment of chronic pain. METHODS: MEDLINE and other databases were searched as data sources. Reference lists and conference abstracts were examined for further relevant articles. We included studies that evaluated the effects of invasive and noninvasive brain stimulation of motor cortex on chronic pain using the visual analogue scale. Eleven studies using noninvasive brain stimulation and 22 studies using invasive brain stimulation met our inclusion criteria. The results showed that weighted responder rate was 72.6% (95% CI, 67.7-77.4) for the invasive stimulation studies and 45.3% (95% CI, 39.2-51.4) for the noninvasive stimulation studies. This difference was significant. For the noninvasive stimulation studies, the random effects model revealed that the number of responders in the active group was significantly higher as compared with sham stimulation group (risk ratio of 2.64) (95% CI, 1.63-4.30).
CONCLUSIONS: This meta-analysis shows that two different techniques of brain stimulation of motor cortex--invasive and noninvasive--can exert a significant effect on pain in patients with chronic pain. We discuss potential reasons that invasive brain stimulation showed a larger effect in this meta-analysis. Our findings encourage continuation of research in this area and highlight the need for well-designed clinical trials to define the role of brain stimulation in pain management.
Abstract
OBJECTIVE: To conduct a systematic review and meta-analysis to quantify the efficacy of invasive and noninvasive brain stimulation for the treatment of chronic pain. METHODS: MEDLINE and other databases were searched as data sources. Reference lists and conference abstracts were examined for further relevant articles. We included studies that evaluated the effects of invasive and noninvasive brain stimulation of motor cortex on chronic pain using the visual analogue scale. Eleven studies using noninvasive brain stimulation and 22 studies using invasive brain stimulation met our inclusion criteria. The results showed that weighted responder rate was 72.6% (95% CI, 67.7-77.4) for the invasive stimulation studies and 45.3% (95% CI, 39.2-51.4) for the noninvasive stimulation studies. This difference was significant. For the noninvasive stimulation studies, the random effects model revealed that the number of responders in the active group was significantly higher as compared with sham stimulation group (risk ratio of 2.64) (95% CI, 1.63-4.30).
CONCLUSIONS: This meta-analysis shows that two different techniques of brain stimulation of motor cortex--invasive and noninvasive--can exert a significant effect on pain in patients with chronic pain. We discuss potential reasons that invasive brain stimulation showed a larger effect in this meta-analysis. Our findings encourage continuation of research in this area and highlight the need for well-designed clinical trials to define the role of brain stimulation in pain management.
Exercise for fibromyalgia: a systematic review
BMJ Evidence Updates
Exercise for fibromyalgia: a systematic review
Abstract
OBJECTIVE: Fibromyalgia (FM) is a syndrome expressed by chronic widespread pain often associated with reduced physical function. Exercise is a common recommendation in management of FM. We evaluated the effects of exercise training on global well-being, selected signs and symptoms, and physical function in individuals with FM. METHODS: We searched Medline, Embase, CINAHL, SportDiscus, PubMed, PEDro, and the Cochrane Central Register for Controlled Trials to July 2005 and included randomized trials evaluating cardiorespiratory endurance, muscle strength, and flexibility. Methodological quality was assessed using the van Tulder and Jadad instruments. Training protocols were evaluated using American College of Sports Medicine (ACSM) guidelines. Clinical heterogeneity limited metaanalysis to 6 aerobic and 2 strength studies. RESULTS: There were 2276 subjects across the 34 studies; 1264 subjects were assigned to exercise interventions. Metaanalysis of 6 studies provided moderate-quality evidence that aerobic-only exercise training at ACSM-recommended intensity levels has positive effects on global well-being (SMD 0.49, 95% CI 0.23-0.75) and physical function (SMD 0.66, 95% CI 0.41-0.92) and possibly on pain (SMD 0.65, 95% CI -0.09 to 1.39) and tender points (SMD 0.23, 95% CI -0.18 to 0.65). Strength and flexibility remain underevaluated; however, strength training may have a positive effect on FM symptoms.
CONCLUSION: Aerobic-only training has beneficial effects on physical function and some FM symptoms. Strength-only training may improve FM symptoms, but requires further study. Large, high-quality studies of exercise-only interventions that provide detailed information on exercise prescription and adherence are needed.
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