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【預測COVID-19與死亡風險評估】研究顯示，會影響到COVID-19與死亡的風險因子包含：🌵 體重針對BMI>30者， #隨著BMI的增加，死亡機率也隨之提升🌵 年齡#年齡增加 被認為和死亡風險提升最相關，比起50-59歲者，大於等於八十歲的老年人死亡率提升了20倍以上🌵 性別比起女性， #男性 也被認為和死亡風險增加相關🌵 慢性疾病#糖尿病血糖控制不佳︑#腎功能下降︑#肝臟疾病︑#中風和失智︑#氣喘等，都和死亡風險提升具有相關性💟我可以怎麼做？除了無法改變的年齡及性別以外：🍋 維持理想體重：疫情間控制飲食內容︑保持運動習慣︑規律作息，以維持理想體重，若能趁機減重更好🍋 均衡飲食：均衡攝取六大類食物，維持充足營養🍋 保持運動：以居家運動取代戶外運動，善用彈力帶︑室內跑步機︑YOUTUBE等保持運動，維持每週至少三次，每次至少30分鐘運動並規律作息，避免日夜顛倒和作息異常︑降低免疫力 🍋 回診追蹤：善用視訊看診功能，縮短外出及人與人接觸時間，降低感染風險，使醫療不中斷 🍋 施打疫苗：依規定接種covid-19疫苗，讓身體防護更升級 !資料來源：Stefan, N., Birkenfeld, A.L. & Schulze, M.B. Global pandemics interconnected — obesity, impaired metabolic health and COVID-19. Nat Rev Endocrinol 17, 135–149 (2021).

Q: nat rev 在Facebook 的評價

AZ疫苗注射與血栓栓塞是否AZ的武漢肺炎疫苗增加血液栓塞風險？AZ的新冠肺炎疫苗施打5百萬劑，發現有37個血栓栓塞個案，其中15位是深部靜脈栓塞(DVT)，22位是肺栓塞。以2019年Heit 在 Nature reviews Cardiology 期刊上標題為〈靜脈血栓栓塞的流行病學〉(Epidemiology of venous thromboembolism)的研究指出：靜脈栓塞（包括復發）的發生率約每年每10萬有142到300 以上；深部靜脈栓塞為每年每10萬人91到255名；肺栓塞約每年每10萬人51-75名。對照之下，AZ疫苗發生靜脈血栓栓塞遠比一般流行病學的數據低很多。到目前為止，仍然無法證明注射AZ疫苗與靜脈血栓栓塞有直接因果關係。再者，西方人發生靜脈血栓栓塞的機率遠比亞洲人高出很多。種族差異是個很重要的因素。Klatsky於2000年，針對美國國內的白人，拉丁裔，非裔，及亞裔，作了分析比較。結果顯示，相對風險比較(95%, CI)，白人/非裔為1.1 (0.4-1.4), 拉丁裔/白人為0.7 (0.3-1.5)亞裔/白人為0.2 (1.0-0.5; p=0.002)AZ疫苗雖然對於南非變種病毒雖然效力不好，但與注射後發生靜脈血栓栓塞事件，發生機率極低，到目前(3/17/2021)為止，仍然還無法證明直接的因果關係。資料來源：Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol. 2015;12(8):464-474Klatsky AL, Armstrong MA, Poggi J. Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans. Am J Cardiol. 2000;85(11):1334-1337#AZ疫苗#靜脈血栓栓塞#DVT

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nat rev 在倪曼婷營養師 Facebook 的最讚貼文

By 倪曼婷營養師

2021-07-07 19:00:54 有 47 人按讚

【預測COVID-19與死亡風險評估】

研究顯示，
會影響到COVID-19與死亡的風險因子包含：

🌵 體重
針對BMI>30者， #隨著BMI的增加，死亡機率也隨之提升

🌵 年齡
#年齡增加被認為和死亡風險提升最相關，比起50-59歲者，大於等於八十歲的老年人死亡率提升了20倍以上

🌵 性別
比起女性， #男性也被認為和死亡風險增加相關

🌵 慢性疾病

#糖尿病血糖控制不佳︑#腎功能下降︑#肝臟疾病︑#中風和失智︑#氣喘等，都和死亡風險提升具有相關性

💟我可以怎麼做？
除了無法改變的年齡及性別以外：

🍋 維持理想體重：疫情間控制飲食內容︑保持運動習慣︑規律作息，以維持理想體重，若能趁機減重更好

🍋 均衡飲食：均衡攝取六大類食物，維持充足營養

🍋 保持運動：以居家運動取代戶外運動，善用彈力帶︑室內跑步機︑YOUTUBE等保持運動，
維持每週至少三次，每次至少30分鐘運動並規律作息，避免日夜顛倒和作息異常︑降低免疫力

🍋 回診追蹤：善用視訊看診功能，縮短外出及人與人接觸時間，降低感染風險，使醫療不中斷

🍋 施打疫苗：依規定接種covid-19疫苗，讓身體防護更升級 !

資料來源：
Stefan, N., Birkenfeld, A.L. & Schulze, M.B. Global pandemics interconnected — obesity, impaired metabolic health and COVID-19. Nat Rev Endocrinol 17, 135–149 (2021).

Tags: nat rev 隨著BMI的增加年齡增加男性糖尿病血糖控制不佳腎功能下降肝臟疾病中風和失智氣喘等

倪曼婷營養師

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工作接洽/邀稿/演講/諮詢 [email protected] 證照/經歷高考營養師糖尿病衛教營養師腎臟專科營養師彰化營養師公會理事自由時報專欄營養師健康營家專欄營養師華人健康網駐站營養師

nat rev 在林時羽醫師試管嬰兒不孕症生殖醫學 Facebook 的最讚貼文

By 林時羽醫師試管嬰兒不孕症生殖醫學

2021-06-13 16:52:16 有 78 人按讚

❓醫生，我該不該打COVID-19 疫苗❓

最近，台灣疫情持續三級。許多備孕中、懷孕中、哺乳中的朋友紛紛詢問，是否可以接種疫苗？疫苗原本的設計與產出，就是為了緩解疫情、中斷傳遞鏈、保障民眾的健康、維持人類社會文明。因此，「接種疫苗」的策略本身是沒有疑慮的。如今，會有這樣的提問，最主要的原因是，當初各種疫苗臨床試驗都刻意避開備孕中、懷孕中、哺乳中的族群，導致無法有足夠的臨床數據，來說明這些族群施打的安全性。

當醫生給予病人諮詢意見時，必須遵循醫學倫理的準則。即行善原則：在實證、嚴謹、透明和負責的臨床判斷下，醫師提供給病人的臨床處置必須在預期上會帶給病人臨床利益的。同時，也要尊重病人的自主權：也就是，透過提供給病人這些善意的臨床判斷訊息，要能夠讓患者就其病情的臨床處置，做出知情和自願的決定。並且，也應遵循謹慎原則：即當對危險有疑問時，應想辦法預防危險、謹慎行事。

於是乎，世界上不同的政府、不同的專業醫學會，依據醫學倫理的認知與控制疫情的著眼點，對於這三類族群是否施打疫苗，也有不盡相同的指引。

🎈美國疾病管理局(CDC)宣布：如果被建議接種COVID-19 疫苗的民眾，恰巧又懷孕，可以接種。若有問題，與醫師討論。
🎈美國婦產科醫學會：懷孕中、哺乳中的民眾，如果在優先接種名單中，可以接種COVID-19 疫苗。
🎈母嬰醫學會(SMFM)：懷孕中、哺乳中的民眾，如果合乎接種COVID-19 疫苗的條件，應予施打。
🎈美國生殖醫學會(ASRM)：接受不孕症治療或懷孕中的病人，應該被鼓勵接種疫苗。但是，在諮詢時，仍應考量醫學倫理的原則，即自主權原則、行善原則、不傷害原則。
🎈加拿大婦產科醫學會(SOGC)：對懷孕中或哺乳中的民眾，如果不接種COVID-19疫苗的危險機率超過接種的危險機率的話，就應該接種。
🎈奧地利：懷孕或哺乳中的婦女不應該接種COVID-19疫苗。但是其配偶應該接種。
🎈法國：懷孕中的婦女不建議接種，因為安全的資訊仍不足夠。
🎈德國：因為資訊仍嫌不足，懷孕中或哺乳中的婦女必須經過利與弊的評估後，才給予建議。
🎈英國：先前看法，孕婦不應該接種(as of December 30, 2020)。現在的看法，如果孕婦屬於高危險群，應該與醫師討論，考量是否接種。
🎈紐西蘭：孕婦應該延後接種。
🎈以色列：備孕中、懷孕中、哺乳中的婦女應該接種COVID-19疫苗。
🎈日本：因為疫苗的安全資訊不足，孕婦不建議施打。
🎈世界衛生組織 (WHO)：如果是孕婦並且是高危險族群，與醫師討論後，決定是否接種COVID-19疫苗。

✅ 歐洲生殖醫學會 (ESHRE) 與時俱進，於這個月(June 2021) 更新了指引。對於疫苗的施打，從較謹慎，變成較寬鬆，的建議。大家可以參考我以下的 slides。

[參考文獻]：
1. Adhikari EH and Spong CY. COVID-19 Vaccination in Pregnant and Lactating Women. JAMA 2021: 325; 1039-1040.
2. Beharier O, Plitman Mayo R, Raz T, Nahum Sacks K, Schreiber L, Suissa-Cohen Y, Chen R, Gomez-Tolub R, Hadar E, Gabbay-Benziv R, et al. Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine. J Clin Invest 2021.
3. Chervenak FA, McCullough LB, Bornstein E, Johnson L, Katz A, McLeod-Sordjan R, Nimaroff M, Rochelson BL, Tekbali A, Warman A, et al. Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. Am J Obstet Gynecol 2021: 224; 470-478.
4. Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, O'Brien P, Morris E, Draycott T, Thangaratinam S, et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob Health 2021: 9; e759-e772.
5. Collier AY, McMahan K, Yu J, Tostanoski LH, Aguayo R, Ansel J, Chandrashekar A, Patel S, Apraku Bondzie E, Sellers D, et al. Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women. JAMA 2021.
6. Cosma S, Carosso AR, Corcione S, Cusato J, Borella F, Antonucci M, Marozio L, Revelli A, Preti M, Ghisetti V, et al. Longitudinal analysis of antibody response following SARS-CoV-2 infection in pregnancy: From the first trimester to delivery. J Reprod Immunol 2021: 144; 103285.
7. Davanzo R, Agosti M, Cetin I, Chiantera A, Corsello G, Ramenghi LA, Staiano A, Tavio M, Villani A, Viora E, et al. Breastfeeding and COVID-19 vaccination: position statement of the Italian scientific societies. Ital J Pediatr 2021: 47; 45.
8. Male V. Are COVID-19 vaccines safe in pregnancy? Nat Rev Immunol 2021: 21; 200-201.
9. Shimabukuro TT, Kim SY, Myers TR, Moro PL, Oduyebo T, Panagiotakopoulos L, Marquez PL, Olson CK, Liu R, Chang KT, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med 2021.
10. Stafford IA, Parchem JG, and Sibai BM. The coronavirus disease 2019 vaccine in pregnancy: risks, benefits, and recommendations. Am J Obstet Gynecol 2021: 224; 484-495.
11. ESHRE : COVID-19 vaccination and assisted reproduction – update June 2021

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林時羽醫師の合好之旅 – 向不孕告別
http://www.xn--kjvo3a634c.com/
#試管嬰兒 #胚胎植入 #療程 #林時羽 #醫師 #SuccessIVF #防疫 #疫情 #三級 #COVID19 #疫苗

Tags: nat rev 試管嬰兒胚胎植入療程林時羽醫師 SuccessIVF 防疫疫情三級 COVID19 疫苗

林時羽醫師試管嬰兒不孕症生殖醫學

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現任: TFC 台北婦產科診所生殖中心副院長學歷: 澳洲 Monash大學醫學院生殖醫學博士、中山醫學大學醫學系林時羽醫師の合好之旅– 向不孕告別 http://www.林時羽.com

nat rev 在 Facebook 的精選貼文

2021-03-17 17:16:05 有 379 人按讚

AZ疫苗注射與血栓栓塞

是否AZ的武漢肺炎疫苗增加血液栓塞風險？

AZ的新冠肺炎疫苗施打5百萬劑，發現有37個血栓栓塞個案，其中15位是深部靜脈栓塞(DVT)，22位是肺栓塞。

以2019年Heit 在 Nature reviews Cardiology 期刊上標題為〈靜脈血栓栓塞的流行病學〉(Epidemiology of venous thromboembolism)的研究指出：
靜脈栓塞（包括復發）的發生率約每年每10萬有142到300 以上；
深部靜脈栓塞為每年每10萬人91到255名；
肺栓塞約每年每10萬人51-75名。

對照之下，AZ疫苗發生靜脈血栓栓塞遠比一般流行病學的數據低很多。到目前為止，仍然無法證明注射AZ疫苗與靜脈血栓栓塞有直接因果關係。

再者，西方人發生靜脈血栓栓塞的機率遠比亞洲人高出很多。種族差異是個很重要的因素。

Klatsky於2000年，針對美國國內的白人，拉丁裔，非裔，及亞裔，作了分析比較。結果顯示，相對風險比較(95%, CI)，
白人/非裔為1.1 (0.4-1.4),
拉丁裔/白人為0.7 (0.3-1.5)
亞裔/白人為0.2 (1.0-0.5; p=0.002)

AZ疫苗雖然對於南非變種病毒雖然效力不好，但與注射後發生靜脈血栓栓塞事件，發生機率極低，到目前(3/17/2021)為止，仍然還無法證明直接的因果關係。

資料來源：
Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol. 2015;12(8):464-474
Klatsky AL, Armstrong MA, Poggi J. Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans. Am J Cardiol. 2000;85(11):1334-1337

#AZ疫苗
#靜脈血栓栓塞
#DVT

Tags: nat rev AZ疫苗靜脈血栓栓塞 DVT

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nat rev 在 Taiwan Bar Youtube 的最佳解答

By Taiwan Bar

2021-03-07 20:00:12 有 1,859,004 人看過有 31,709 人喜歡

#歡迎光臨臺灣吧 #人類世界的八大秘密 #性教育
你知道嗎？
「G點不是一個點」！
「處女膜本來就是破的」！
還有還有「女生竟然也會勃起」！

你希望讓陰道健康又性福嗎？
還是你正為陰道發炎而煩惱呢？

女性身體，到底還有什麼秘密
是我們不知道的？
人類世界陰道的八大秘密，一起來揭秘！

想要支持臺灣吧持續製作內容？
🍺 快加入臺灣吧「灣吧好捧油」：https://lihi1.com/CizZn
--
00:24 秘密一：welcome my 縫
01:49 秘密二：陰道裡面沒感覺？
02:43 秘密三：女生也會勃起？
03:27 秘密四：G點到底在哪裡
04:29 秘密五：處女膜本來就是破的！
05:39 秘密六：法國人騎小馬洗陰部
06:37 秘密七：愛吃甜食讓陰道發炎？
（分泌物異常？要如何找醫生？看文章，顧好私密處健康！）
➡️ https://bella.pse.is/3dj773
07:35 秘密八：健康作業要畫自己的陰部

◤ 感謝本集乾爸乾媽，一起認識他們 ◢
🙋‍♀️ 婦科疾病困擾？TFC臺北婦產科診所生殖中心
https://www.tfcivf.com/
🩸 還在猶豫嗎？加入棉條的世界（凱娜棉條，月經一姐凡妮莎）
https://lovekira.one/taiwanbar
--
資料來源：
⛏ 秘密一：
1. 陰道的大小：Human Reproduction, Volume 21, Issue 6, June 2006, Pages 1618–1622

⛏ 秘密二：
1. 生理用品使用比例：Kantar Insights Division 凱度洞察台灣/ LifePoints
2. 陰道內的神經：Female Genital Anatomy, Boston University School of Medicine, 2002 November 26
3. 美國衛生棉條使用比例：Tampon use in young women, J Pediatr Adolesc Gynecol. 1998 Aug;11(3)
4. 美國女性衛生調查：Variation in Feminine Hygiene Practices ‐ as a Function of Age, Journal of Obstetric, Gynecologic, & Neonatal Nursing, 2006 July 28

⛏ 秘密四：
1. G點是什麼：Beyond the G-spot: clitourethrovaginal complex anatomy in female orgasm, Nat Rev Urol. 2014 Sep;11(9):531-8

⛏ 秘密五：
1. 陰道冠結構：Hymen: facts and conceptions, theHealth 2012; 3(4): 109-115
2. 處女情結：Honor Killings and the Construction of Gender in Arab Societies, Am. J. Comp. L.,2010
3. 陰道冠正名：Vaginal corona Myths surrounding virginity – your questions answered, RFSU

⛏ 秘密六：
1. 坐浴盆的歷史：The Bidet's Revival, the Atlantic, MARCH 18, 2018
2. 臺灣的披衣菌感染情況：不孕症的共犯─披衣菌，臺北市立聯合醫院
3. 披衣菌是美國感染最多的性病：Chlamydia - CDC Fact Sheet

⛏ 秘密七：
1. 高糖份造成陰道炎：Determination of factors affecting relapse of vaginitis among reproductive-aged women: An experimental study, Electron Physician. 2017 Jan; 9(1): 3499–3507
2. 益生菌減緩陰道炎：Efficacy of Lactobacillus Rhamnosus GR-1 and of Lactobacillus Reuteri RC-14 in the treatment and prevention of vaginoses and bacterial vaginitis relapses, Minerva Ginecol
. 2008 Oct;60(5):369-76.
Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study, American Journal of Obstetrics and Gynecology, VOLUME 203, ISSUE 2, P120.E1-120.E6, AUGUST 01, 2010
口服益生菌用於反覆性黴菌陰道炎輔助治療臨床實證探討，家庭醫學與基層醫療第三十五卷第三期
--
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歡迎光臨臺灣吧人類世界的八大秘密性教育臺灣吧黑啤

Taiwan Bar

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臺灣吧 - 致力於讓臺灣成為亞洲數位內容的燈塔歡迎光臨臺灣吧！我們是一間新媒體公司，致力於發展內容與品牌。您可以免費觀賞所有作品，也請以分享與購買商品支持我們。網路商城：http://bit.ly/TaiwanBarShop 官方網站：http://taiwanbar.cc 臉書專頁：http://goo.gl/nLQPZQ instagram: https://www.instagram.com/taiwan_bar/ 合作信箱：[email protected] 客服信箱：[email protected] 徵才信箱：[email protected] 共同創辦人：謝政豪、張佳家、林辰、蕭宇辰 - - - - - - - - Taiwan Bar for products and more info official website: http://taiwanbar.cc Facebook: http://goo.gl/nLQPZQ instagram: https://www.instagram.com/taiwan_bar/ for licensing, sponsorship & other business opportunities: official mailbox: [email protected]

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