《尖端醫療的真相:你安全嗎?》(The Bleeding Edge) 是近期看過最震撼的紀錄片,在 Neflix 上面找得到,目前是爛番茄的滿分。期待明年的奧斯卡,最佳紀錄片會是由《尖端醫療真相》獲得,因為這是任何一位在乎健康的人,都應該被震撼一下的影片(又是個沒鬼的恐怖片)。
以前,關於健康,我只注意到有用藥文化與藥物問題(可以參考同樣是在 Netflix 的《請服藥》Take Your Pills,也是相當值得一看的影片),沒想到,世上還有另一種同樣也是與我們的健康息息相關,同樣也是在醫院(或說在看醫生時)常見的問題——醫療器材與裝置(medical device,包括各類置入性的醫療裝置)。
故事始於幾位女性,大家都是希望有更方便與美好的兩性生活,於是決定要在輸卵管裡放置由拜耳公司生產的 Essure 避孕器(但願台灣沒有人使用)。剛開始,她們都帶著很高的期待,因為這套簡單的避孕裝置,還有醫護人員親身安裝與親自接受試驗,試驗成功之後,還擔任代言人,照常理判斷,Essure 肯定效果奇佳還外加安全無虞。怎知,悲慘的故事就是由此開始。
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《尖端醫療的真相》討論三種體內植入的醫療裝置——Essure 避孕器、手術紗網(surgical mesh)、和鈷鉻合金人工髖關節(chrome-cobalt artificial hips)—— 以及一項手術機器人(Da Vinci 機器手術手臂,典型的「尖端」醫療裝置)。影片中,這些 21 世紀的最新植入式醫療器材,除了使用於一般大眾之外,也有護士的親身安裝與醫生的親身經驗(更換人工髖關節)。
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也就是因為這些專業人士的親身經歷,才能凸顯「FDA、藥廠、和醫護人員」之間,已經失衡的三角關係。就是因為已經失衡而失去監督,才會在這四十多年來(自1976年),逐漸衍生出「藥廠竟然隱瞞醫療裝置的致命危險,還荒謬地騙過醫護人員」的現實。
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影片看到最後,相當令人感傷心痛、不勝唏噓,尤其是眼睜睜看著貪婪藥廠明知產品有問題,卻還貿然上市,大肆行銷,即使東窗事發,還鴨子嘴硬地不承認也不下架。畢竟即使病患回報問題或是提出訴訟,賠償或罰金也只是獲利的九牛一毛,根本不值一提。
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然而,相對於藥商強硬傲慢的態度,那些因為置入性醫療產生副作用而導致婚姻失調、家庭破裂、人生頓挫的受害者,自此身心煎熬的長途抗戰,更像是一場毫不值得又沒有意義的犧牲與悲劇。
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先來看看,為何會使用 Bleeding Edge 這樣的題名。常看 Marvel 或 DC 的朋友,一看到 Bleeding Edge 一詞,頭腦裡馬上閃過的可能會是鋼鐵人(Iron Man)的「血邊裝甲 」,不過,一點也不是,與鋼鐵人無關。
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Bleeding Edge 指的是 bleeding edge technology,意思是有些創新科技因為太新太前衛,若是沒有足夠的實驗、試驗、與時間考驗,在人類對於這項新科技的影響力與副作用仍舊毫無知悉的狀況下,反而可能產生更高的風險與危險。
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一談到創新與科技,一般人馬上都會有劃時代與超越的想像與期待。然而,並非「創新科技」就等於「進步與超越」,有時候這些假設不過只是「幻象」,而非現實,不僅「超越」根本不會實現,更慘的是,還有可能是悲劇的開始。如此,最新科技根本不是尖端(leading edge),而是血流滿地的禍事開端(bleeding edge)。
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覺得電影好重要,不只寫了篇文章紀錄,還在臉書貼了將近全文的1/3 篇。建議有時間的話,可以點入以下文章。不過最好是去看看影片,嚇嚇自己吧。
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半夜兩點發文,會有人看到嗎?
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https://sosreader.com/n/sci_fi_mov…/5b6db6f8fd89780001a07de8
同時也有1部Youtube影片,追蹤數超過2,210的網紅DJ Macky Suson,也在其Youtube影片中提到,I have done my Botox and Fillers Injection at ClearSK Aesthetics and it’s time for my final verdict. Do I recommend them? Was it worth it? Please chec...
fda medical device 在 Focus Taiwan Facebook 八卦
Taiwanese nationals will be allowed to bring in or mail from abroad a medical oximeter for personal use, the Taiwan Food and Drug Administration (FDA) announced Monday, in response to strong demand for the device.
https://focustaiwan.tw/society/202106280016
fda medical device 在 眼科陳慶隆醫師-視網膜的大小事 Facebook 八卦
術後可調整度數及散光的人工水晶體 RxSight,正式被美國FDA通過,如果未來能在台灣上市,將是眼科醫師與患者的一大福音!
美國食品藥物管理局(FDA)昨(22)日批准了RxSight的光調節水晶體(light adjustable lens)和光傳遞設備(light delivery device, LDD),這是第一個可以在白內障手術後,對人工水晶體(intraocular lens, IOL)進行小幅度調整的醫療器械系統,幫助患者不戴眼鏡也能擁有良好視力。
白內障通常是由於年紀增長,水晶體變硬或混濁,影響患者視力。也有些是由於外傷性、併發性(如青光眼)、代謝性(如糖尿病)等引起的白內障。
解決療法之一便是進行人工水晶體置換手術,然而許多患者會有些微屈光不正,需要使用眼鏡或隱形眼鏡矯正。
為了替患者解決人工水晶體不當聚焦的問題,RxSight 建構獨特材料IOL,在手術後17至21天,對LDD發出的紫外線進行反應。根據所需調整量,患者在1到2周內接受3或4次光照治療,每次約40-150秒。
白內障手術開始到光療結束,患者必須配戴特殊眼鏡防護紫外線,保護新水晶體免受紫外線照射影響。
FDA批准是基於針對此產品所做的試驗成果,該研究隨機性地在17個研究地點挑選600名患有散光的患者,比較了光調節水晶體與現有的單焦點水晶體。
使用光調節水晶體的患者接受輕度LDD治療,術後6個月的裸眼視力(uncorrected visual acuity, UCVA)達到20/20或更高,是接受單焦點水晶體患者的兩倍。與使用傳統IOL相比,患者平均遠距離裸眼視力在視力表上可多看清楚一行。
75%的患者散光也有所減少,91.8%使用光調節水晶體的患者也達到目標驗光球鏡度數(manifest refraction spherical equivalent)0.5D以內的結果,這與近期LASIK研究中所見屈光準確性相似。
FDA醫療器械暨輻射健康中心(Center for Devices and Radiological Health)眼科和耳鼻喉科部門主任Malvina Eydelman表示,到今天為止,白內障手術常見的屈光不正問題,都還得透過眼鏡矯正。不過這個系統為部分患者提供了一個新的選擇,使醫生在初次手術後,可進行多次,可在辦公室內操作的步驟,對植入的水晶體做些調整,提高不戴眼鏡的視力。
RxSight執行長Eric Weinberg指出,我們很高興全球首個手術後可調式IOL成功到達另一個里程碑,這對期待屈光人工水晶體技術再度突破的患者、外科醫生和驗光師來說,是一個相當令人振奮的機會。我們很感謝所有參與這項工作的人員,包括協助研究的臨床工作人員,以及準備審查監管報告的雙方(RxSight和FDA)工作人員。
感謝 David 提供中文翻譯。
資料來源:
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm586405.htm
The U.S. Food and Drug Administration today approved the RxSight Inc. Light Adjustable Lens and Light Delivery Device, the first medical device system that can make small adjustments to the artificial lens’ power after cataract surgery so that the patient will have better vision when not using glasses.
Cataracts are a common eye condition where the natural lens becomes clouded, impairing a patient’s vision. Following cataract surgery, during which the natural lens of the eye that has become cloudy is removed and replaced with an artificial lens (intraocular lens, or IOL), many patients have some minor residual refractive error requiring use of glasses or contact lenses. Refractive error, which is caused when the artificial lens does not focus properly, causes blurred vision.
“Until now, refractive errors that are common following cataract surgery could only be corrected with glasses, contact lenses or refractive surgery,” said Malvina Eydelman, M.D., director of the Division of Ophthalmic, and Ear, Nose and Throat at the FDA’s Center for Devices and Radiological Health. “This system provides a new option for certain patients that allows the physician to make small adjustments to the implanted lens during several in-office procedures after the initial surgery to improve visual acuity without glasses.”
The RxSight IOL is made of a unique material that reacts to UV light, which is delivered by the Light Delivery Device, 17-21 days after surgery. Patients receive three or four light treatments over a period of 1-2 weeks, each lasting about 40-150 seconds, depending upon the amount of adjustment needed. The patient must wear special eyeglasses for UV protection from the time of the cataract surgery to the end of the light treatments to protect the new lens from UV light in the environment.
A clinical study of 600 patients was conducted to evaluate the safety and effectiveness of the RxSight Light Adjustable Lens and Light Delivery Device. Six months after the procedure, patients on average saw an improvement of about one additional line down the vision chart, for distance vision without glasses, compared to a conventional IOL. Six months after surgery, 75 percent also had a reduction in astigmatism.
The device is intended for patients who have astigmatism (in the cornea) before surgery and who do not have macular diseases.
The device should not be used in patients taking systemic medication that may increase sensitivity to UV light such as tetracycline, doxycycline, psoralens, amiodarone, phenothiazines, chloroquine, hydrochlorothiazide, hypercin, ketoprofen, piroxicam, lomefloxacin and methoxsalen. Treatment in patients taking such medications may lead to irreversible eye damage. The device is also contraindicated in cases where patients have a history of ocular herpes simplex virus.
The FDA approved the Vision Light Adjustable Lens and the Light Delivery Device to RxSight Inc.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency is also responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
fda medical device 在 DJ Macky Suson Youtube 的評價
I have done my Botox and Fillers Injection at ClearSK Aesthetics and it’s time for my final verdict.
Do I recommend them? Was it worth it?
Please check out this video.
You can also watch the entire consultation and procedure here:
https://youtu.be/UaSY12wxKhQ
Tag a friend who is looking for botox and fillers injection recommendations.
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Botox is a protein made from botulinum toxin that the bacterium Clostridium botulinum produces. This is the same toxin that causes botulism.
Botox is a toxin, but when people use it correctly and in small doses, it has a number of medical and cosmetic uses.
Botox injections are probably best known for reducing skin wrinkles. Botox can also help treat crossed eyes, eyelid spasms, excessive sweating, and some bladder disorders.
In this article, we will explain how Botox works, its uses, possible risks, and side effects.
Source: https://www.medicalnewstoday.com/articles/158647
Dermal fillers, also known as injectable implants, soft tissue fillers, or wrinkle fillers are medical device implants approved by the Food and Drug Administration (FDA) for use in helping to create a smoother and/or fuller appearance in the face, including nasolabial folds, cheeks and lips and for increasing the volume of the back of the hand.
Source: https://www.fda.gov/medical-devices/cosmetic-devices/dermal-fillers-soft-tissue-fillers#:~:text=Dermal%20fillers%2C%20also%20known%20as,lips%20and%20for%20increasing%20the
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fda medical device 在 An Introduction to FDA's Regulation of Medical Devices 的八卦
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