超級加工食品(Ultra-processed Food)增加糖尿病機會

什麼是超級加工食品(Ultra-processed Food)?

https://www.bbc.co.uk/food/articles/what_is_ultra-processed_food
Ultra-processed foods就是內含你平日在家煮時，不會加入的添加物。例如： colourings, sweeteners and preservatives. 在英國，最常見的ultra-processed食物是：

Industrialised bread (11 %)
Pre-packaged meals (7.7 %)
Breakfast cereals (4.4 %)
Sausages and other reconstituted meat products (3.8 %)

以下的例子說明，同樣的食材，多一點添加物（包括糖）就成了ultra-processed foods：
1. Bread made from wheat flour, water, salt and yeast is processed, but add emulsifiers or colourings and it becomes ultra-processed.

2. Plain oats, corn flakes and shredded wheat are minimally processed, but when the manufacturer adds sugar, flavourings or colourings, they become ultra-processed breakfast cereals.

3. Plain yoghurt is minimally processed, but add sweeteners, preservatives, stabilisers or colourings and it becomes ultra-processed.


Original Investigation
Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort

JAMA Intern Med. Published online December 16, 2019. doi:https://doi.org/10.1001/jamainternmed.2019.5942

- Over 100,000 French adults
- 24-hour dietary recall questionnaires
- median follow-up of 6 years
- 820 participants were diagnosed with T2DM
- The risk of T2DM increased by 13% with each 10% increase in the proportion of diet comprising ultraprocessed foods.

- The authors note that in previous studies, ultraprocessed foods have been linked to increased risks for cancer, cardiovascular disease, and mortality.

結論：減少食物中添加劑，包括糖、色素、香料或是保存劑，才能不變成ultra-processed food，才不會落入T2DM。

PTA 洗腎 通血管

前臂gortex shunt，突然血流停止。發現occlusive thrombus，做POBA，併發rupture，所以放了viabahn stent。(輝pt陳)

PTA 洗腎 通血管

一位洗腎患者，gortex shunt曾放了viabahn stent，突然血流又停掉了，先做POBA。之後若再發生，可以再放viabahn stent。(珠pt文)

電子煙和爆米花工作者肺

新的名詞

Canada May Have Found New Vaping Complication: Popcorn worker’s lung

Life-threatening bronchiolitis related to electronic cigarette use in a Canadian youth

Cite as: CMAJ 2019;191. doi: 10.1503/cmaj.191402; early-released November 21, 2019

爆米花工廠員工之前曾被報導因吸入奶油和香料添加劑加熱氣化後的diacetyl，而引起bronchiolitis obliterans，而稱之popcorn worker's lung，這次vaping也引起相同的病理學現象。

和美國之前報告vaping引起alveolar injury不同，加拿大這次報告是vaping-associated bronchiolitis obliterans。

CT：diffuse centrilobular “tree-in-bud” nodularity with subpleural sparing consistent with bronchiolitis

Histological sections of a transbronchial biopsy：alveoli showed nonspecific acute inflammation and reactive changes

紫色尿袋症候群 (Purple Urine Bag Syndrome)

其實有點藍、綠色的purple urine bag syndrome

尿液培養：pseudomonas aeruginosa

洗腎患者 (弟pt鳳)

PTA 洗腎 通血管

手肘以上外側的cephalic vein已經全塞了 (幸pt春)

PTA 洗腎 通血管

文pt珠
之前放過viabahn stent入gortex shunt，這次突發性人工血管塞住