降鉀粉(Kalimate)和大腸壞死(Colonic Necrosis)

在常常高血鉀的洗腎患者，平常是可能服用降鉀粉的。雖然醫師都會警告患者有腸子壞死的副作用，但是因為不常發生，大家可能就不以為意。這期的台腎有這樣病例鮮明的大腸鏡照片，和病理切片，值得大家一看。腸子壞死的可能機轉和resin crystal引起腸子發炎反應有關。

Acta Nephrologica 31(1): 31-36, 2017
Case Report
Calcium Polystyrene Sulfonate (Kalimate)-Related Colonic Necrosis in a Uremic Patient
Lyu-Fan Li1, Bo-Ruei Huang2, Shih-hung Huang3, Chwei-Shiun Yang1,4
1Division of Nephrology, Department of Medicine, Cathay General Hospital, Taipei, Taiwan
2Department of Medicine, Cathay General Hospital, Taipei, Taiwan
3Department of Pathology, Cathay General Hospital, Taipei, Taiwan
4Department of Medicine, Taipei Medical University, Taipei, Taiwan

患者喜歡健美的醫師嗎？

When Your Doctor Is Fitter Than You Are

By LAUREN C. HOWEJULY 13, 2017

https://nyti.ms/2vgkF6S

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“I enjoy working out at the gym,” declares one profile. “To keep myself fit, I like to hike, bike and
exercise,” says another.

這不是交友網站上的個人介紹，而是醫師網站上的自我介紹。

很有趣的文章，若是患者遇到一位比自己健美的醫師，會有什麼事發生？

最近一篇Journal of Personality and Social Psychology研究（內文未附連結）發現肥胖的患者會去選「不強調自己身材多健美或是多喜好運動的醫師」，甚至會刻意去避開，因為肥胖的患者覺得，這類的醫師可能會看不起患者。

This research documents that promoting that you practice what you preach can backfire.

Instead, it should realize that doctors who don’t advertise healthy lifestyles may appear more approachable to some patients, while super-fit physicians may want to display compassion and understanding toward patients who do not find exercise appealing, or do not conform to stereotypical portraits of health.

醫師們不要過度去強調健康的生活型態，對患者而言，也許是較沒有壓力的。

（註：那做醫美醫師的廣告，男的帥女的美，是怎麼一回事？）

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Lauren C. Howe is a social psychologist from Stanford University who studies trust in experts.

日本的長壽專家醫師 (Shigeaki Hinohara)

Dr. Shigeaki Hinohara, Longevity Expert, Dies at (or Lives to) 105

By SAM ROBERTSJULY 25, 2017

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The New York Times
https://nyti.ms/2tXDBGz


Dr. Shigeaki Hinohara, right, with Emperor Akihito in 2006 in Tokyo. Dr. Hinohara’s advice helped make Japan the world leader in longevity. CreditToshifumi Kitamura/Agence France-Presse — Getty Images

Dr. Shigeaki Hinohara，5大建議1) 避免暴飲暴食 2) 避免過早退休 3) 每年健康檢查 4) 爬樓梯 5) Having Fun。他是讓日本人成為世界上最長壽人種之一的推手，自己活了105歲。真正體現了聖經路加福音上說的「Physician, heal thyself」

也許有些人想要提早退休，可以看看這篇文章，想要長壽的人也可以看看他是怎麼辦到的。

He imposed few inviolable health rules, though he did recommend some basic guidelines: Avoid obesity, take the stairs (he did, two steps at a time) and carry your own packages and luggage. Remember that doctors cannot cure everything. Don’t underestimate the beneficial effects of music and the company of animals; both can be therapeutic. Don’t ever retire, but if you must, do so a lot later than age 65. And prevail over pain simply by enjoying yourself.

查詢Physician, heal thyself這句話時，意外得到
The phrase alludes to the readiness and ability of physicians to heal sickness in others while sometimes not being able or willing to heal themselves. This suggests something of 'the cobbler always wears the worst shoes', that is, cobblers are too poor and busy to attend to their own footwear.
(修鞋的皮匠常常自己都穿破舊的鞋子)

醫師要照顧好病人的健康前，先要照顧好自己，身體力行「Physician, heal thyself」