General Physical Examine
Overview
A routine physical examination ensures that you stay in good health. A physical can also be a preventive step. It allows you to catch up on vaccinations or detect a serious condition, like cancer or diabetes, before it causes problems. During a routine physical, your doctor can also check vitals, including weight, heart rate, and blood pressure.
概述
例行體檢可確保您保持健康。身體檢 查也可以是預防步驟。它可以讓您在引起問題之前趕上疫苗 接種或檢測嚴重疾病,如癌症或糖尿病。在例行體檢期間,您的醫生還可以檢 查生命體徵,包括體 重、心率和血壓。
What does a physical exam address?
Your doctor will use a physical exam to see how your body is performing. Depending on your personal health history, your doctor may choose to focus on certain areas. If you have a family history of heart disease, for example, you may receive additional blood pressure checks, blood tests, and diabetes and cholesterol screenings.Based on test results,
age, and personal health history, the exam is also an opportunity to discuss future prevention measures with your doctor.
體檢的目的是什麼?
您的醫生將通過體檢來了解您的身體狀況。根據您的個人健康史,您的醫生可能會選擇專注於某些領域。例如,如果您 有心髒病家族史,您可能會接受額外的血壓檢 查、血液檢查以及糖尿病和膽固醇篩 查。 根據測試結果、年齡和個人健康 史,考試也是與您的醫生討論未來預防措施的機會。
What does a physical exam entail?
Updated health history Vital sign checks Visual exam Physical exams
體檢需要什麼?
更新健康史 生命體徵檢查 視覺檢查 體 格檢查
Physical exams: As the physical exam continues, the doctor will use tools to look in your eyes, ears, nose, and throat. They’ll listen to your heart and lungs. This exam also includes:
● touching, or “palpating,” parts of your body (like your abdomen) to feel for abnormalities ● checking skin, hair, and nails
● possibly examining your genitalia and rectum
● testing your motor functions and reflexes
體格檢查: 隨著身體檢查的繼續,醫生將使用工具檢 查您的眼睛、耳朵、鼻子和喉嚨。他們會傾聽你的 心和肺。該考試還包括:
● 觸摸或“觸診”身體的某些部位(如腹部)以感覺異常
● 檢查皮膚、頭髮和指甲
● 可能檢查您的生殖器和直腸
● 測試你的運動功能和反應
Laboratory tests
To complete the physical, your doctor may draw blood for several laboratory tests. These can include a complete blood count and a complete metabolic panel (also called a chemistry panel). The panel tests your blood plasma and can indicate any issues that exist in your kidneys, liver, blood chemistry, and immune system. This helps detect irregularities in your body that might indicate a larger problem. Your doctor may request a diabetes screen and a thyroid screen. If you have an increased risk of heart attack, heart disease, or stroke, they may also request a lipid panel (cholesterol test).
實驗室測試
為了完成身體檢查,您的醫生可能會抽血進行多項實驗室檢 查。這些可以包括全血細胞計數和完整的代謝 組(也稱為化學組)。該小組會測試您的血漿,並可以指出您的腎臟、肝臟、血液化學和免疫系統中存在的任 何問題。這有助於檢測您身體中可能表明存在更大問題的異常情況。您的醫生可能會要求進行糖尿病篩 查
和甲狀腺篩查。如果您患心髒病、心髒病或中風的風險增加,他們可能還會要求進行血脂檢 查(膽固醇測 )
Women:
● Mammogram: In women with low or average risk for breast cancer, a mammogram is recommended every two years between the ages of 50 and 74. Earlier and more frequent testing may be recommended based on your personal history and family history of breast cancer.
● Breast exam: A breast exam can be used to check for abnormal lumps or signs of breast cancer. ● Pap smear: The pap smear is a screening for cervical cancer. Women should begin screening at age 21. After that, subsequent screenings are recommended every three years, as long as the woman has a healthy immune system. After 30 years old, pap smears are recommended once every five years, until the age of 65. After age 65, the majority of women no longer require a pap smear.
● Pelvic exam: This can be done with or without a pap smear. A pelvic exam includes examining the vagina, cervix, and vulva for signs of a sexually transmitted infection (STI) or other conditions.
● Cholesterol test: Most women should begin regular cholesterol checks at age 45. If you have a history of or genetic predisposition to diabetes or heart disease, you may need to begin cholesterol checks as early as age 20.
● Osteoporosis screening: Bone density scans should begin around age 65. They may begin sooner in certain medical conditions.
女性:
● 乳房 X光檢查: 對於乳腺癌風險較低或中等的女性,建議在 50 至 74 歲之間每兩年進行一 次乳房 X 光檢查。根據您的個人乳腺癌病史和家族史,可能會建議更早、更頻繁地進行檢 查。
● 乳房檢查:乳房檢查可用於檢查異常腫塊或乳腺癌的跡象。
● 子宮頸抹片檢查:子宮頸抹片檢查是一種宮頸癌篩查。女性應在 21 歲開始篩查。此後,只 要女性免疫系統健康,建議每三年進行一次後續篩 查。 30 歲後,建議每五年進行一次子宮 頸抹片檢查,直至 65 歲。65 歲後,大多數女性不再需要子宮頸抹片檢 查。
● 骨盆檢查:這可以在有或沒有巴氏塗片的情況下進行。骨盆檢 查包括檢查陰道、子宮頸和 外陰是否有性傳播感染 (STI) 或其他疾病的跡象。
● 膽固醇測試:大多數女性應該在 45 歲時開始定期檢查膽固醇。如果您有糖尿病或心髒病 的病史或遺傳易感性,您可能需要早在 20 歲時開始進行膽固醇檢查。
● 骨質疏鬆症篩查:骨密度掃描應在 65 歲左右開始。在某些醫療條件下可能會更早開始
Men:
● Cholesterol test: Most men are advised to begin regular cholesterol checks at age 35. If you have a history of or genetic predisposition to diabetes or heart disease, you may need to begin cholesterol checks as early as age 20.
● Prostate cancer screening: In general, using the prostate-specific antigen test and digital rectal exam for prostate cancer screening is not recommended, so talk to your doctor. Screening may be advised for some men starting at age 50. It may start as early as age 40 for those with a strong family history.
● Testicular exam: Your doctor may wish to check each testicle for signs of a problem, including lumps, changes in size, and tenderness.
● Abdominal Aortic Aneurysm screening: This is a one-time screening test done with an ultrasound. It is recommended for all men ages 65-75 who have ever smoked.
男士:
● 膽固醇測試:建議大多數男性在35 歲時開始定期檢查膽固醇。如果您有糖尿病 或心髒病的病史或遺傳易感性,您可能需要早在 20 歲時開始進行膽固醇檢 查。
● 前列腺癌篩查:一般來說,不建議使用前列腺特異性抗原檢測和直腸指檢進行 前列腺癌篩查,因此請諮詢您的醫生。一些從50 歲開始的男性可能會被建議進 行篩查。對於那些有強烈家族史的人來說,它可能早在 40 歲時就開始了。
● 睾丸檢查:您的醫生可能希望檢查每個睾丸是否有問題的跡象,包括腫塊、大小 變化和壓痛。
● 腹主動脈瘤篩查:這是一項使用超聲波進行的一次性篩查測試。建議所有曾吸 煙的65-75 歲男性使用。
Both men and women:
● Colon (colorectal) cancer test: Tests for this cancer usually begin at age 50. It may be sooner based on personal health conditions and family history.
● Lung cancer screening: An annual low-dose CT scan of the lungs is recommended for both men and women ages 55-80 who have smoked for a significant period of time or who are currently smoking. Talk to your doctor to see if your smoking history warrants a lung cancer screen.
● Depression: Many people aren’t aware of possible symptoms of depression because they can be easily attributed to other things. However, a depression screening at each checkup can help your doctor to see if your symptoms are a result of depression. ● Diabetes: If you have a family history or risk factors for diabetes — such as being overweight or having high blood pressure or high cholesterol — you should be screened for diabetes. Your doctor may use the fasting blood sugar test or the A1C test. ● Hepatitis C: All individuals born between 1945 and 1965 are recommended to have a one-time blood test to screen for hepatitis C. ● Vaccinations: All adults continue to need vaccinations throughout their lifetime. Talk to your doctor about which vaccinations are recommended based on your age.
● STI screening: Based on your personal sexual history, regular STI screenings during each routine physical exam may be suggested. This can include HIV and syphilis testing.
● HIV test: Your doctor may recommend taking a one-time HIV test for preventive purposes, or having it done more than once if you regularly have unprotected sex.
● Syphilis test: You may need to take this test if you’re pregnant or at risk for syphilis.
In the blood, PSA is either bound or free (unbound). Bound PSA means that it is attached to other proteins. PSA that is not attached to other proteins is called free PSA because it circulates freely in the blood.
What is a good free PSA percentage?
A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy. Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%.Jan 4, 2021 在血液中,PSA 要么是結合的,要么是游離的(未結合的)。結合的 PSA 意味著它附著在其 他蛋白質上。 未與其他蛋白質結合的 PSA 稱為游離 PSA,因為它在血液中自由循環。
什麼是好的免費 PSA 百分比?
較低的游離 PSA 百分比意味著您患前列腺癌的機率較高,您可能應該進行活檢。 許多醫生建議游離 PSA 百 分比為 10% 或更低的男性進行前列腺活檢,並建議男性在 10% 至 25% 之間考慮進行活檢。 2021 年 1 月 4 日
All About Blood Tests
All About Blood Tests
1. Complete blood count 1. 全血細胞計數
2. Basic metabolic panel
A basic metabolic panel (BMP) usually checks for levels of eight compounds in the blood:
● calcium
● glucose
● sodium
● potassium
● bicarbonate
● chloride
● blood urea nitrogen (BUN)
● creatinine
This test may require you to fast for at least 8 hours before your blood is drawn, depending on the instructions of your doctor and what the test is measuring.
2.基礎代謝面板
基本代謝組 (BMP) 通常檢查血液中八種化合物的水平:
● 鈣
● 葡萄糖
● 鈉
● 鉀
● 碳酸氫鹽
● 氯化物
● 血尿素氮 (BUN)
● 肌酐
該測試可能要求您在抽血前至少禁食 8 小時,具體取決於您的醫生的指示和測試測量的內容。
Two simple tests can help determine your kidney function:
Urine test called ACR (Albumin to Creatinine Ratio): ACR stands for “albumin-to-creatinine ratio.” It tests your urine for albumin, a type of protein. Your body needs protein. But it should be in the blood, not the urine. Having protein in your urine may mean that your kidneys are not filtering your blood well enough. Too much albumin in your urine is an early sign of kidney damage and can be a sign of early kidney disease. If your urine test comes back “positive” for protein, the test should be repeated to confirm the results. Three positive results over three months or more is a sign of kidney disease.
Blood test to estimate your GFR (glomerular filtration rate). GFR is a measure of kidney function and can determine if you have kidney disease and what stage you’re at. To find the GFR, healthcare professionals will test your blood for a waste product called creatinine. Creatinine comes from muscle tissue. When the kidneys are damaged, they have trouble removing creatinine from your blood. Testing for creatinine is only the first step. Next, your creatinine result is used in a math formula to find out your glomerular filtration rate (GFR). Check with your doctor about having a GFR test. Use the new eGFR calculator.
兩個簡單的測試可以幫助確定您的腎功能:
稱為 ACR(白蛋白與肌酐比率)的尿液測試: ACR代表“白蛋白與肌酐比率”。它測試 您尿液中的白蛋白,一種蛋白質。你的身體需要蛋白質。但它應該存在於血液中,而 不是尿液中。尿液中含有蛋白質可能意味著您的腎臟無法充分過濾血液。尿液中白蛋 白過多是腎臟受損的早期徵兆,也可能是早期腎臟疾病的徵兆。如果您的尿液檢測結 果為蛋白質“陽性”,則應重複檢測以確認結果。三個月或更長時間的三個陽性結果是 腎臟疾病的徵兆。
驗血以估計您的 GFR(腎小球濾過率) 。 GFR是衡量腎功能的指標,可以確定您是否 患有腎臟疾病以及您處於哪個階段。為了找到 GFR,醫療保健專業人員將測試您的 血液中是否存在一種叫做肌酐的廢物。肌酐來自肌肉組織。當腎臟受損時,它們無法 從您的血液中去除肌酐。肌酐檢測只是第一步。接下來,您的肌酐結果會用在數學公 式中,以確定您的腎小球濾過率 (GFR)。向您的醫生諮詢有關進行 GFR 測試的信 息。 使用新的 eGFR 計算器。
3. Comprehensive metabolic panel
A comprehensive metabolic panel (CMP) includes all the measurements of a BMP as well as additional proteins and substances related to liver function, such as:
● albumin
● total protein
● alkaline phosphatase (ALP), an enzyme mostly found in the bones and liver that’s involved in several bodily processes
● alanine aminotransferase (ALT), an enzyme found in the liver
● aspartate aminotransferase (AST), an enzyme found in the liver and other tissues within the body ● bilirubin, which is waste resulting from the breakdown of red blood cells that the liver filters out
The same conclusions can be drawn from a CMP as from a BMP for the same substances that a BMP covers. Other abnormal levels can also indicate underlying conditions, such as:
3. 綜合代謝面板
綜合代謝組 (CMP) 包括 BMP 的所有測量值以及與肝功能相關的其他蛋白質和物質,例如:
● 白蛋白
● 總蛋白
● 鹼性磷酸酶 (ALP) ,一種主要存在於骨骼和肝臟中的酶,參與多種身體過程 ● 丙氨酸氨基轉移酶 (ALT) ,一種在肝臟中發現的酶
● 天冬氨酸氨基轉移酶 (AST) ,一種存在於肝臟和體內其他組織中的酶 ● 膽紅素,是肝臟過濾掉的紅細胞分解產生的廢物
對於 BMP 涵蓋的相同物質,可以從 CMP 和從 BMP 中得出相同的結論。其他異常水平也可以指 示潛在狀況,例如:
4. Lipid panel
This test checks levels of two types of cholesterol: high-density lipoprotein (HDL), or “good” cholesterol low-density lipoprotein (LDL), or “bad” cholesterol
HDL is “good” because it removes harmful substances from your blood and helps the liver break them down into waste. LDL is “bad” because it can cause plaque to develop in your arteries, increasing your risk of heart disease. You may need to fast for at least 8 hours before this test.
4. 脂質面板
該測試檢查兩種可信來源的級別膽固醇:
● 高密度脂蛋白 (HDL)或“好”膽固醇
● 低密度脂蛋白 (LDL)或“壞”膽固醇
HDL 是“好”的,因為它可以去除血液中的有害物質,並幫助肝臟將它們分解成廢物。低密度脂蛋白是 “壞的”,因為它會導致 動脈 斑塊形成,增加患心髒病的風險。在此測試之前,您可能需要至少禁食 8 小時。
What are triglycerides
Triglycerides are a type of fat found in your blood. Triglycerides are not a fat you eat. Instead, your body makes triglycerides from what we eat and drink. Measuring the amount of triglycerides in the blood is one way to monitor the risk for heart disease. Fat is an important part of a healthy diet and plays many essential roles in your body. At the same time, higher levels of some fats may lead to a greater risk of developing heart disease. Triglycerides are a type of fat that can increase this risk. Making healthy lifestyle choices is the best way to keep your heart healthy.
Too many triglycerides in the blood can lead to hardening and narrowing of the arteries. This can increase your risk for developing heart disease. This is why it is important to keep triglyceride levels in your blood at a healthy level.
There are different reasons for high triglyceride levels, but these reasons are often related to one another.
Being overweight, especially if you have excess weight around your waist. Eating a high calorie diet that is rich in fat, sugar or sweet foods. Having high blood pressure or diabetes. Triglyceride levels are higher than normal for people with these conditions when they are not managed well. Drinking too much alcohol. The extra calories alcohol provides can turn into fat which increases triglyceride levels.
什麼是甘油三酯
甘油三酯是血液中的一種脂肪。甘油三酯不是你吃的脂肪。相反,您的身體會從我們的飲食中產生甘油三 酯。測量血液中甘油三酯的含量是監測心髒病風險的一種方法。
脂肪是健康飲食的重要組成部分,在您的身體中起著許多重要作用。同時,某些脂肪含量較高可能會導致患 心髒病的風險增加。甘油三酯是一種會增加這種風險的脂肪。選擇健康的生活方式是保持心臟健康的最佳 方式。
血液中過多的甘油三酯會導致動脈硬化和變窄。這會增加您患心髒病的風險。這就是為什麼將血液中 的甘油三酯水平保持在健康水平很重要的原因。
高甘油三酯水平有多種原因,但這些原因通常相互關聯。
● 超重,特別是如果你的腰部有多餘的重量。
● 吃富含脂肪、糖或甜食的高熱量飲食。
● 患有高血壓或糖尿病。如果管理不善,患有這些疾病的人的甘油三酯水平會高於正常水平。 ● 飲酒過多。酒精提供的額外卡路里可以轉化為脂肪,從而增加甘油三酯水平。
5. Thyroid panel
A thyroid panel, or thyroid function test, checks how well your thyroid is producing and reacting to certain hormones, such as: Your thyroid is a tiny gland in your neck. It helps regulate bodily functions like your mood, energy level, and overall metabolism.
● Triiodothyronine (T3). Along with T4, this regulates your heart rate and body temperature.
● Thyroxine (T4). Along with T3, this regulates your metabolism and how you grow.
● Thyroid-stimulating hormone (TSH). This helps regulate the levels of hormones your thyroid releases.
● Here are normal results:
● T3: 80–180 nanograms per deciliter of blood (ng/dL)
● T4: 0.8–1.8 ng/dL in adults.
● TSH: 0.5–4 milli-international units per liter of blood (mIU/L)
Abnormal levels of these hormones can indicate numerous conditions, such as:
● low protein levels
● thyroid growth disorders
● abnormal levels of testosterone or estrogen
5.甲狀腺面板
甲狀腺面板或甲狀腺功能測試可檢查您的甲狀腺對某些激素的產生和反應情況,例如:
● 三碘甲狀腺原氨酸(T3) 。與 T4 一起,它可以調節您的心率和體溫。
● 甲狀腺素(T4) 。與 T3 一起,它可以調節您的新陳代謝以及您的成長方式。
● 促甲狀腺激素(TSH) 。這有助於調節甲狀腺釋放的激素水平。 你的甲狀腺是你脖子上的一個小腺體。它有助於調節身體機能 ,如情緒、能量水平和整體新陳代謝。以下是正常結果:
● T3:每分升血液 80–180 納克 (ng/dL)
● T4:成人 0.8–1.8 ng/dL。
● TSH:每升血液 0.5–4 毫國際單位 (mIU/L)
這些激素的異常水平可能表明許多情況,例如:
● 低蛋白質水平
● 甲狀腺生長障礙
● 睾酮或雌激素水平異常
T7 指數是T4 x T3 攝取量除以 100 的乘積。它也稱為游離甲狀腺素指數。
T7=(T4 x T3-攝取)/100
該計算試圖校正甲狀腺素結合蛋白的變化
6. Cardiac biomarkers
Enzymes are proteins that help your body accomplish certain chemical processes, such as breaking down food and clotting blood. They’re used throughout your body for many vital functions.
Common enzymes tested include:
● Creatine kinase (CK). This is an enzyme primarily located in the brain, heart, and skeletal muscle. When muscle damage happens, CK seeps into the blood in growing amounts.
● Creatine kinase-MB (CK-MB). These enzymes are found in your heart. They often increase in your blood after a heart attack or other heart injury.
● Troponin. This is a heart enzyme that can leak into your blood and results from heart injury.
Here are the normal ranges for the enzyme listed above:
● CK: 30–200 U/L
● CK-MB: 0–12 IU/L
● troponin: <1 ng/mL
6. 心臟生物標誌物
酶是幫助您的身體完成某些化學過程的蛋白質,例如分解食物和凝血。它們在您的整個身體中用 於許多重要功能。
● 肌酸激酶 (CK)。這是一種主要存在於大腦、心臟和骨骼肌中的 酶。當肌肉損傷發生時, CK 會越來越多地滲入血液。
● 肌酸激酶-MB (CK-MB)。這些酶存在於您的心臟中。在心髒病發作或其他心臟損傷後,它 們通常會在您的血液中增加。
● 肌鈣蛋白。這是一種心臟 酶,可能會滲入您的血液並由心臟損傷引起。
● CK:30–200 U/L
● CK-MB:0–12 IU/L
● 肌鈣蛋白:<1 ng/mL
7. Sexually transmitted infection tests
Many sexually transmitted infections (STIs) can be diagnosed using a blood sample. These tests are often combined with urine samples or swabs of infected tissue for more accurate diagnoses.
The following STIs can be diagnosed with blood tests:
● chlamydia
● gonorrhea
● herpes
● HIV
● syphilis
Blood tests aren’t always accurate right after contracting an infection. For an HIV infection, for example, you may need to wait at least a month before a blood test can detect the virus.
7. 性傳播感染檢測
許多性傳播感染 (STI) 可以使用血液樣本進行診斷。這些測試通常與尿液樣本或感染組織的拭子結合使用 ,以進行更準確的診斷。
以下性傳播感染可以通過血液檢查進行診斷:
● 衣原體
● 淋病
● 皰疹
● 艾滋病病毒
● 梅毒
感染後驗血並不總是準確的.例如, 對於 HIV 感染,您可能需要至少等待一個月才能通過驗血檢測出病毒。
Key facts
● More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide, the majority of which are asymptomatic.
● Each year there are an estimated 374 million new infections with 1 of 4 STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis.
● More than 500 million people aged 15 to 49 years are estimated to have a genital infection with herpes simplex virus (HSV) .
● HPV infection is associated with 570 000 cases of cervical cancer in 2018, and over 311 000 cervical cancer deaths each year.
● Almost 1 million pregnant women were estimated to be infected with syphilis in 2016, resulting in over 350 000 adverse birth outcomes including 200 000 stillbirths and newborn deaths .
● STIs have direct impact on sexual and reproductive health through stigmatization, infertility, cancers and pregnancy complications and can increase the risk of HIV.
● Drug resistance, especially for gonorrhoea, is a major threat to reducing the burden of STIs worldwide.
關鍵事實
● 全世界每天有超過 100 萬例性傳播感染 (STI) 感染,其中大多數是無症狀的。 ● 每年估計有 3.74 億人新感染 4 種性傳播感染中的一種:衣原體、淋病、梅毒和滴蟲 病。
● 據估計,超過 5 億 15 至 49 歲的人患有單純皰疹病毒 (HSV) 的生殖器感染 。 ● HPV 感染與 2018 年 570 000 例宮頸癌相關,每年有超過 311 000 例宮頸癌死亡。 ● 2016 年估計有近 100 萬孕婦感染梅毒,導致超過 35 萬例不良分娩結局,包括 20 萬 例死產和新生兒死亡 .
● 性傳播感染通過污名化、不孕症、癌症和妊娠並發症直接影響性健康和生殖健康,並 可能增加感染艾滋病毒的風險。
● 耐藥性,尤其是對淋病的耐藥性,是減少全球性傳播感染負擔的主要威脅。
What STDs Cannot be cured?
Of these, 4 are currently curable: syphilis, gonorrhoea, chlamydia and trichomoniasis. The other 4 are incurable viral infections: hepatitis B, herpes simplex virus (HSV), HIV and human papillomavirus (HPV).Aug 22, 2022
Are there more than 30 different STDs?
There are more than 30 different bacteria, viruses and parasites known to be transmitted through sexual contact. Based on WHO latest estimates, approximately 38 million sexually active people aged 15-49 in the Americas have an easily curable STI (Chlamydia, gonorrhea, syphilis and/or trichomoniasis).
What is the most contagious sexually transmitted disease?
HUMAN PAPILLOMAVIRUS (HPV) The human papillomavirus (HPV) is the most common sexually transmitted infection in America. In fact, almost every sexually active person catches it at some point in his or her life.Feb 25, 2015
哪些性病不能治愈?
其中,目前有 4 種可以治愈:梅毒、淋病、衣原體和滴蟲病。其他 4 種是無法治癒 的病毒感染 : 乙型肝炎、單純皰疹病毒 (HSV)、HIV 和人乳頭瘤病毒 (HPV) 。 2022 年 8 月 22 日
有超過 30 種不同的性病嗎?
已知有 30 多種不同的細菌、病毒和寄生蟲可通過性接觸傳播。根據世界衛生組 織的最新估計,美洲約有 3800 萬 15-49 歲的性活躍人群患有易於治癒的性傳播 感染(衣原體、淋病、梅毒和/或滴蟲病)。
傳染性最強的性病是什麼?
人乳頭瘤病毒 (HPV) 人乳頭瘤病毒 (HPV) 是美國最常見的性傳播感染。事實上 ,幾乎每個性活躍的人都會在他或她生命中的某個時刻感染它。 2015 年 2 月 25 日
男女皆宜:
● 結腸(結直腸)癌測試:這種癌症的測試通常從 50 歲開始。根據個人健康狀況和家族史,可能會更早。 ● 肺癌篩查:對於長期吸煙或目前吸煙的 55-80 歲男性和女性,建議每年進行一次肺部低劑量 CT 掃描。與您的醫 生交談,看看您的吸煙史是否需要進行肺癌篩 查。
● 抑鬱症:許多人沒有意識到抑鬱症可能的症狀,因為它們很容易歸因於其他事情。但是,每次檢 查時進行抑鬱症 篩查可以幫助您的醫生了解您的症狀是否是抑鬱症的結果。
● 糖尿病:如果您有糖尿病家族史或風險因素(例如超重或患有高血壓或高膽固醇),您應該接受糖尿病篩 查。您的 醫生可能會使用空腹血糖測試或 A1C 測試。
● 丙型肝炎:建議所有 1945 年至 1965 年間出生的人進行一次性血液檢 查以篩查丙型肝炎。 ● 疫苗接種:所有成年人終生都需要接種疫苗。與您的醫生討論根據您的年齡推薦哪些疫苗接種。 ● STI 篩查:根據您的個人性史,可能會建議在每次例行體檢期間定期進行 STI 篩查。這可能包括 HIV 和梅毒檢 測。
● 艾滋病毒檢測:您的醫生可能會建議您進行一次性艾滋病毒檢測以進行預防,或者如果您經常進行無保護性行 為,則進行多次檢測。
● 梅毒測試:如果您懷孕或有梅毒風險,您可能需要進行此測試。
American Cancer Society Guidelines for the Early Detection of Cancer
美國癌症協會癌症早期檢測指南
https://www.cancer.org/healthy/find-cancer-early/americ an-cancer-society-guidelines-for-the-early-detection-of-c ancer.html
( A ) Breast cancer Screening
● Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so.
● Women age 45 to 54 should get mammograms every year. ● Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
● Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
● All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.
(A) 乳腺癌
● 如果願意, 40 至 44 歲的女性應該可以選擇開始每年進行一次乳房 X 光檢查(乳房 X 光檢查)的乳腺癌篩查。
● 45 至 54 歲的女性應每年進行乳房 X 光檢查。
● 55 歲及以上的女性應每 2 年進行一次乳房 X 光檢查,或者可以繼續每 年進行一次篩查。
● 只要女性身體健康並且預計能活 10 年或更長時間,就應該繼續進行篩 查。
● 所有女性都應該熟悉與乳腺癌篩查相關的已知益處、局限性和潛在危 害。
(B) Colon and rectal cancer and polyps
For people at average risk for colorectal cancer, the American Cancer Society recommends starting regular screening at age 45. This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). Talk to your health care provider about which tests might be good options for you, and to your insurance provider about your coverage. No matter which test you choose, the most important thing is to get screened. If you’re in good health, you should continue regular screening through age 75. For people ages 76 through 85, talk with your health care provider about whether continuing to get screened is right for you. When deciding, take into account your own preferences, overall health, and past screening history. People over 85 should no longer get colorectal cancer screening. If you choose to be screened with a test other than colonoscopy, any abnormal test result needs to be followed up with a colonoscopy.
( B ) 結腸癌和直腸癌和息肉
對於結腸直腸癌的平均風險人群,美國癌症協會建議在45 歲時開始定期篩查。這可以 通過在人的糞便中尋找癌症跡象的敏感測試(基於糞便的測試)或通過檢查結腸和直 腸的檢查(視覺檢查)來完成。與您的醫療保健提供者討論哪些測試可能是您的好選擇 ,並與您的保險提供者討論您的承保範圍。無論您選擇哪種測試,最重要的是接受篩 查。 如果您身體健康,您應該在75 歲之前繼續進行定期篩查。 對於76 至 85 歲的人, 請與您的醫療保健提供者討論繼續接受篩查是否適合您。在決定時,請考慮您自己的 偏好、整體健康狀況和過去的篩查歷史。 85 歲以上的人不應再接受結直腸癌篩查。 如果您選擇接受結腸鏡檢查以外的檢查,則任何異常檢查結果都需要進行結腸鏡檢 查。
( C ) Cervical cancer
● Cervical cancer screening should start at age 25. People under age 25 should not be tested because cervical cancer is rare in this age group.
● People between the ages of 25 and 65 should get a primary HPV (human papillomavirus) test* done every 5 years. If a primary HPV test is not available, a co-test (an HPV test with a Pap test) every 5 years or a Pap test every 3 years are still good options. (*A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration has approved certain tests to be primary HPV tests.)
● People over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Those with a history of a serious cervical pre-cancer should continue to be tested for at least 25 years after that diagnosis, even if testing goes past age 65.
● People whose cervix has been removed by surgery for reasons not related to cervical cancer or serious pre-cancer should not be tested.
● People who have been vaccinated against HPV should still follow the screening recommendations for their age groups.
( C ) 宮頸癌
● 宮頸癌篩查 應該從 25 歲開始。25 歲以下的人不應該接受檢查,因為宮頸癌在這個年齡組 中很少見。
● 25 至 65 歲的人應每 5 年進行一次初級 HPV(人乳頭瘤病毒)檢測*。如果無法進行主要 HPV 檢測,則每 5 年進行一次聯合檢測( HPV 檢測和巴氏試驗)或每 3 年進行一次巴氏試 驗仍然是不錯的選擇。 (*初級 HPV 測試是一種自行進行的 HPV 測試,用於篩查。美國食 品和藥物管理局已批准某些測試為初級 HPV 測試。)
● 65 歲以上且在過去 10 年中定期進行宮頸癌檢測且結果正常的人不應接受宮頸癌檢測。一 旦停止測試,就不應再次開始。那些有嚴重宮頸癌前病變病史的人應在診斷後繼續進行至 少 25 年的檢測,即使檢測已超過 65 歲。
● 因與宮頸癌或嚴重癌前病變無關的原因 通過手術切除宮頸的人不應接受檢測。 ● 接種過 HPV 疫苗的人仍應遵循針對其年齡組的篩 查建議。
Human papillomavirus (HPV) subtypes and their relationships with cervical smear results in cervical cancer screening: a community-based study from the central Anatolia region of Turkey
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947064/
There are more than 40 sexually transmitted types of HPV that infect the skin and mucous membranes. In infected individuals, the immune system normally eliminates the virus within two years, but in some individuals, persistent HPV infection causes cervical cancer and genital warts [9]. HPVs are divided into three groups as low, potentially high, and high-risk types. HPV6, HPV11, HPV40, HPV42, HPV43, HPV44, HPV54, HPV61, HPV70, HPV72, HPV81, and CP6108 are low risk; HPV26, HPV53, and HPV66 are potentially high risk, and HPV16, HPV18, HPV31, HPV33, HPV35, HPV39, HPV45, HPV51, HPV52, HPV56, HPV58, HPV59, HPV68, HPV73, and HPV82 are high-risk types .
人乳頭瘤病毒 (HPV) 亞型及其與宮頸塗片的關係導致宮頸癌篩查:來自 土耳其中部安納托利亞地區的社區研究
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947064/
有40 多種性傳播類型的 HPV 會感染皮膚和粘膜。在受感染的個體中,免疫系統通常會在兩 年內消除病毒,但在某些個體中,持續的 HPV 感染會導致宮頸癌和生殖器疣 [ 9 ]。 HPV 分為三組,即 低危型、潛在高危型和高危型。 HPV6、HPV11、HPV40、HPV42、HPV43、HPV44、HPV54、HPV61、 HPV70、HPV72、HPV81和CP6108為低風險; HPV26、HPV53、HPV66為潛在高危型, HPV16、
HPV18、HPV31、HPV33、HPV35、HPV39、HPV45、HPV51、HPV52、HPV56、HPV58、HPV59、 HPV68、HPV73、HPV82為高危型。
CDC 建議 11 至 12 歲的兒童每隔 6 至 12 個月接種兩劑 HPV 疫苗。
● 第一劑通常建議在 11-12 歲時使用。疫苗接種可在 9 歲時開始。
● 如果第一劑是在 15歲生日之前接種的,則只需接種兩劑。
在 15 至 26 歲之後開始該系列的青少年和年輕人需要三劑 HPV 疫苗。
● 9 至 14 歲的兒童在間隔不到 5 個月的時間內接種了兩劑 HPV 疫苗,將需要接種第三劑。 ● 還建議 9 至 26 歲免疫系統較弱的人服用三劑。
不建議 26 歲以上的所有人接種疫苗。
● 一些尚未接種疫苗的27 至 45 歲的成年人可能會在與他們的醫生討論他們感染新 HPV 的風險以及接種疫苗對他們可能帶來的好處後決定接種 HPV 疫苗。
● 這個年齡段的 HPV 疫苗接種提供的益處較少,因為這個年齡段的更多人已經接觸過 HPV。
CDC recommends that 11- to 12-year-olds receive two doses of HPV vaccine 6 to 12 months apart.
The first dose is routinely recommended at ages 11–12 years old. The vaccination can be started at age 9 years. Only two doses are needed if the first dose was given before 15th birthday.
Teens and young adults who start the series later, at ages 15 through 26 years, need three doses of HPV vaccine. Children aged 9 through 14 years who have received two doses of HPV vaccine less than 5 months apart will need a third dose.
Three doses are also recommended for people aged 9 through 26 years who have weakened immune systems.
Vaccination is not recommended for everyone older than age 26 years.
Some adults age 27 through 45 years who are not already vaccinated may decide to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination for them. HPV vaccination in this age range provides less benefit, because more people in this age range have already been exposed to HPV.
( D ) Endometrial cancer
The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected vaginal bleeding or spotting to their doctors. Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with a health care provider about your history.
( D ) 子宮內膜癌
美國癌症協會建議,在絕經期,應告知所有女性子宮內膜癌的風險和症狀。女性應向醫生報 告任何意外的陰道出血或發現。 一些女性——由於她們的病史——可能需要考慮每年進行 一次子宮內膜活檢。請與醫療保健提供者談談您的病史。
( E ) Lung cancer The most recent version of the American Cancer Society
(ACS) lung cancer screening guideline [from 2018] is being taken down while we review new scientific evidence to be included in the next update. While this important update is being completed, the ACS advises that health care providers, and people at increased risk for lung cancer, follow the recently updated recommendations for annual lung cancer screening from the US Preventive Services Task Force (USPSTF), the American Academy of Family Physicians (AAFP), or the American College of Chest Physicians. These organizations recommend yearly lung cancer screening with LDCT scans for people who:
● Are 50 to 80 years old and in fairly good health,
and
● Currently smoke or have quit in the past 15 years,
and
● Have at least a 20 pack-year smoking history. (This is the number of packs of cigarettes per day multiplied by the number of years smoked. For example, someone who smoked 2 packs a day for 10 years [2 x 10 = 20] has 20 pack-years of smoking, as does a person who smoked 1 pack a day for 20 years [1 x 20 = 20].)
( E ) 肺癌 最新版本的美國癌症協會 (ACS) 肺癌篩查指南 [自 2018 年起]
正在被刪除,同時我們將審 查新的科學證據以包含在下一次更新中。在完成這一重要更新的同時 ,ACS 建議醫療保健提供者和肺癌風險增加的人遵循美國預防服務工作組 (USPSTF)、美國科學 院院士最近更新的年度肺癌篩 查建議。家庭醫師 (AAFP),或美國胸科醫師學會。這些組織建議每 年對以下人群進行 LDCT 肺癌篩查:
● 年齡在 50 至 80 歲之間,身體狀況良好,
和
● 目前吸煙或在過去 15 年內戒菸,
和
● 至少有 20 包年的吸煙史。 (這是每天吸煙的包數乘以吸煙的年數。例如,每天吸煙 2 包, 持續 10 年的人 [2 x 10 = 20] 有 20 包年的吸煙量,一個人也是如此。每天抽 1 包煙 20 年 的人 [1 x 20 = 20]。)
( F ) Prostate cancer
The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. We believe that men should not be tested without first learning about what we know and don’t know about the risks and possible benefits of testing and treatment. Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them. If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with a health care provider starting at age 45. If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.
( F ) 前列腺癌
美國癌症協會建議男性與醫療保健提供者就是否接受前列腺癌檢測做出明智的決 定。研究尚未證明檢測的潛在好處大於檢測和治療的危害。我們認為,在沒有 首先了解我們所知道和不知道的測試和治療的風險和可能的好處之前,不應 該對男性進行測試。從 50 歲開始,男性應該與醫療保健提供者討論測試的利
弊,以便他們決定測試是否是他們的正確選擇。如果您是非裔美國人或有一 個在 65 歲之前患有前列腺癌的父親或兄弟,您應該從 45 歲開始與醫療保健 提供者進行此談話。如果您決定接受檢測,您應該與或沒有直腸檢查。您接受 檢測的頻率取決於您的 PSA 水平。
There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer .A percent-free PSA above 25% is considered normal. Some doctors recommend that if you have a percent-free PSA of 18% or less you should have a prostate biopsy. Other doctors recommend having a biopsy if the percent-free PSA is around 12% or less.
血液中的 PSA 沒有特定的正常或異常水平。過去,4.0 ng/mL 及更低的 PSA 水平被 認為是正常的。然而,一些 PSA 水平低於 4.0 ng/mL 的人患有前列腺癌,而許多 PSA 水平在 4 至 10 ng/mL 之間的人則沒有前列腺癌 高於 25% 的游離 PSA 百分比 被認為是正常的。一些醫生建議,如果您的游離 PSA 百分比為 18% 或更低,您應該 進行前列腺活檢。如果游離 PSA 百分比約為 12% 或更低,其他醫生建議進行活檢。
US, CT, MRI
ULTRASOUND
Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging method that uses high-frequency sound waves to produce images of structures within your body. The images can provide valuable information for diagnosing and treating a variety of diseases and conditions.
Ultrasound is used for many reasons, including to:
● View the uterus and ovaries during pregnancy and monitor the developing baby's health ● Diagnose gallbladder disease
● Evaluate blood flow
● Guide a needle for biopsy or tumor treatment
● Examine a breast lump
● Check your thyroid gland
● Detect genital and prostate problems
● Assess joint inflammation (synovitis)
● Evaluate metabolic bone disease
診斷超聲
也稱為超聲檢查或診斷醫學超聲檢查,是一種使用高頻聲波 產生體內結構圖像的成像方法。這些圖像可以 為診斷和治療各種疾病和病症提供有價 值的信息。
使用超聲波的原因有很多,包括:
● 在懷孕期間查看子宮和卵巢並監測發育中的嬰兒的健康狀況
● 診斷膽囊疾病
● 評估血流
● 引導針進行活檢或腫瘤治療
● 檢查乳房腫塊
● 檢查你的甲狀腺
● 檢測生殖器和前列腺問題
● 評估關節炎症(滑膜炎)
● 評估代謝性骨病
CT, CAT
A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. CT scan images provide more-detailed information than plain X-rays do.
A CT scan has many uses, but it's particularly well-suited to quickly examine people who may have internal injuries from car accidents or other types of trauma. A CT scan can be used to visualize nearly all parts of the body and is used to diagnose disease or injury as well as to plan medical, surgical or radiation treatment.
CT, CAT
計算機斷層掃描 (CT) 掃描結合了從您身體周圍不同角度拍攝 的一系列 X 射線圖像,並使用計算機處理來創建您體內骨骼、 血管和軟組織的橫截面圖像(切片)。 CT 掃描圖像提供比 通 X 射線更詳細的信息。
CT 掃描有很多用途,但它特別適合快㏿檢查可能因車禍或其他 類型外傷而內傷的人,CT 掃描可用於可視化身體的幾乎所有部 位,用於診斷疾病或損傷以及計劃醫療、手術或放射治療。
5,000 mrem per year
Consequently, to protect health and safety, the U.S. Nuclear Regulatory Commission (NRC) has established standards that allow exposures of up to 5,000 mrem per year for those who work with and around radioactive material, and 100 mrem per year for members of the public (in addition to the radiation we receive from …
每年 5,000 mrem
因此,為了保護健康和安全,美國核管理委員會 (NRC) 制定了標準,允許從事放射性 物質工作和在放射性物質周圍工作的人員每年暴露高達 5,000 mrem,公眾成員每年 暴露高達 100 mrem (除了我們從...接收到的輻射
1 mSv = 0.1 rem; 1 rem = 10 mSv
How much radiation is safe in a lifetime?
5,000mrem (50 mSv )-(Since 1957) Occupational limit per year for adult radiation workers, including soldiers exposed to radiation. It is "as low as reasonably achievable; however, not to exceed 5,000 millirems." It is recommended that lifetime cumulative exposure is not to exceed the age multiplied by 1,000 millirems.Jan 5, 1994
一生接受多少輻射是安全的?
5,000mrem (50mSv )自 1957 年起)成年輻射工作者(包括暴露於輻射的 士兵)每年的職業限制。它是“合理可實現的最低值;但是,不超過 5,000 毫雷姆。”建議終生累積暴露量不超過年齡乘以 1,000 毫雷姆。 1994 年 1 月 5 日
Radiation Doses for Common CT Scans
Common types of CT scans and the amount of radiation you would absorb from them include:
● Belly and pelvis: 10 mSv, equal to about 3 years of background radiation
● Colonography: 6 mSv, equal to about 2 years of background radiation
● Head: 2 mSv, equal to about 8 months of background radiation
● Spine: 6 mSv, equal to about 2 years of background radiation
● Chest: 7 mSv, equal to about 2 years of background radiation
● Lung cancer screening: 1.5 mSv, equal to about 6 months of background radiation
● Coronary angiography (CTA): 12 mSv, equal to about 4 years of background radiation ● Cardiac (for calcium scoring): 3 mSv, equal to about 1 year of background radiation ● Belly and pelvis: 20 mSv, equal to about 7 years of background radiation
● Head: 4 mSv, equal to about 16 months of background radiation
常見 CT 掃描的輻射劑量
常見的 CT 掃描類型以及您從中吸收的輻射量包括:
● 腹部和骨盆:10 mSv,相當於大約 3 年的背景輻射
● 結腸造影:6 mSv,相當於大約 2 年的背景輻射
● 頭部:2 mSv,相當於大約 8 個月的背景輻射
● 脊椎:6 mSv,相當於大約 2 年的背景輻射
● 胸部:7 mSv,相當於大約 2 年的背景輻射
● 肺癌篩查:1.5 mSv,相當於大約 6 個月的背景輻射
● 冠狀動脈造影 (CTA):12 mSv,相當於大約 4 年的背景輻射
● 心臟(用於鈣評分):3 mSv,相當於大約 1 年的背景輻射
● 腹部和骨盆:20 mSv,相當於大約 7 年的背景輻射
● 頭部:4 mSv,相當於大約 16 個月的背景輻射
Radiation Dose in X-Ray and CT Exams https://www.radiologyinfo.org/en/info/safety-xray