Drug Reactions—A Major Cause of Death

　　Adverse drug reactions may cause the deaths of over 100, 000 US hospital patients each year, making them a leading cause of death nationwide, according to a report in the Journal of the America Medical Association.

　　“The incidence of serious and fatal adverse drug reactions（ADRs）in US hospitals was found to be extremely high,” say researchers at the University of Toronto in Ontario, Canada.

　　They carried on an analysis of 39 ADR-related studies at US hospitals over the past 30 years and defined an ADR as “any harmful, unintended, and undesired effect of a drug which occurs at doses used in humans for prevention, diagnosis, or therapy. ”

　　An average 6.7% of all hospitalized patients experience an ADR every year, according to the researchers. They estimate that “in 1994, overall 2, 216, 000 hospitalized patients had serious ADRs, and 106, 000 had fatal ADRs.” This means that ADRs may rank as the fourth single largest cause of death in America.

　　And these incidence figures are probably conservative, the researchers add, since their ADR, definition did not include outcomes linked to problems in drug administration, overdoses, drug abuse, and therapeutic failures.

　　The control of ADRs also means spending more money. One US study estimated the overall cost of treating ADRs at up to $4 billion per year.

　　Dr. David Bates of Brigham and Women's Hospital in Boston, Massachusetts, believes that healthcare workers need to pay more attention to the problem, especially since many ADRs are easily preventable. “When a patient develops and allergy or sensitivity, it is often not recorded,” Bates notes, “and patients receive drugs to which they have known allergies or sensitivities with disturbing frequency.” He believes computerized surveillance systems—still works-in-progress at many of the nation's hospitals—should help cut down the frequency of these types of errors.

　　1. Researchers at the University of Toronto believe that
　　A. ADRs have caused medical problems, though they seldom lead to death.
　　B. ADRs have very often caused patients to die in Canada.
　　C. ADRs have caused many deaths in America over the past 30 years.
　　D. it is easy to prevent ADRs from happening.

　　2. The investigators say that
　　A. 67 patients out of 100 in every America hospital die from ADRs each year.
　　B. 67 patients out of 100 in every American hospital experience an ADR each year.
　　C. 6. 7% of all hospitalized patients in American experience ADRs each year on average.
　　D. 6. 7% of all hospitalized patients in Canada experience ADRs each year on average.

　　3. An American research estimates that the total sum of money spent in treating ADRs each year is as much as
　　A. $ 40, 000, 000, 000.
　　B. $ 4, 000, 000, 000.
　　C. $ 400, 000, 000.
　　D. $ 40, 000, 000.

　　4. The Canadian investigators think that
　　A. the ADR incidence figures from their research are surely very exact.
　　B. the ADR incidence figures from their research are probably too high.
　　C. the ADR incidence figures from their research are perhaps too low.
　　D. None of the above is true.

　　5. According to Dr. David Bates, hospitals in America
　　A. are not paying enough attention to possibilities of ADR happenings.
　　B. have never tried to use computers to prevent ADRs from happening.
　　C. do not use those drugs which will cause side effects to their patients.
　　D. know that many ADRs are easily preventable.

Silent and Deadly

　　Transient ischemic attacks（TIAS）, or mini-strokes, result from temporary interruptions of blood flow to the brain.  Unlike full strokes, they present symptoms lasting anywhere from a few seconds to 24 hours.  Rarely do they cause permanent neurological damage, but they are often precursors of a major stroke.

　　“Our message is quite clear,” says Dr. Robert Adams, professor of neurology at the Medical College of Georgia in August. “TIAS，while less severe than strokes in the short term, are quite dangerous and need a quick diagnosis and treatment as well as appropriate follow-up to prevent future injury.”

　　Unfortunately, mini-strokes are greatly under diagnosed. A study conducted for the National Stroke Association indicates that 2.5% of all adults aged 18 or older（about 4.9 million people in the U. S. ）have experienced a confirmed TI A. An additional 1.2 million Americans over the age of 45, the study showed, have most likely suffered a mini-stroke without realizing it. These findings suggest that if the public knew how to spot the symptoms of stroke, especially mini-strokes, and sought prompt medical treatment, thousands of lives could be saved and major disability could be avoided.

　　The problem is that the symptoms of a mini-stroke are often subtle and passing. Nonetheless, there are signs you can look out for:
　　*Numbness or weakness in the face, arm or leg, especially on one side of the body.
　　*Trouble seeing in one or both eyes.
　　*Confusion and difficulty speaking or understanding.
　　*Difficulty walking, dizziness or loss of coordination.
　　*Severe headache with no known cause.

　　Along with these symptoms, researchers have identified some key indicators that increase your chances of having a full-blown stroke after a TIA: if you're over 60, have experienced symptoms lasting longer than 10 minutes, feel weak and have a history of diabetes.

　　As with many diseases, you can help yourself by changing your lifestyle. The first things you should do are quit smoking, limit your intake of alcohol to no more than a drink or two a day and increase your physical activity. Even those who suffer from high blood pressure or diabetes can improve their odds—and minimize complications if they do have a stroke—by keeping their illness under control.

　　If you experience any of the symptoms, your first call should be to your doctor. It could be the call that saves your life.

　　1. Which of the following is NOT true of mini-strokes?
　　A. The cause of them remains unidentified.
　　B. They seldom cause permanent neurological damage.
　　C. They symptoms of them are often passing.
　　D. They are not unrelated to major strokes.

　　2. To prevent mini-strokes from turning into major strokes, it is important to
　　A. save thousands of lives.
　　B. avoid major disability.
　　C. seek prompt medical treatment.
　　D. prevent future injury.

　　3. The passage indicates that the symptoms of mini-strokes
　　A. are always easy to spot.
　　B. are frequently hard to recognize.
　　C. usually last a couple of days.
　　D. can by no means be avoided.

　　4. All of the following may be signs of mini-strokes EXCEPT for
　　A. trouble seeing in one eye.
　　B. numbness in the face.
　　C. loss of coordination.
　　D. severe headache caused by external injury.

　　5. It can be inferred from the passage that mini-strokes are
　　A. more dangerous than major strokes.
　　B. silent and deadly.
　　C. difficult to cure.
　　D. sure to lead to major strokes.

In-line Skating and Injuries

　　Increasing number of children are taking up in-line skating, and it is those new skaters who are most at risk for injuries, according to a statement from an American research institute.

　　Some 17. 7 million people younger than age 18 participated in the sport in the US in 1996, a 24% increase over the previous year.

　　Also in 1996 in-line skating injuries sent 76, 000 skaters under the age of 21 to the emergency room. Inexperienced skaters accounted for 14% of all injuries requiring treatment.

　　The most common reasons for injuries were losing one's balance due to road debris, being unable to stop, out-of-control speeding, or falls while doing a trick.

　　One third of skating injuries are to the wrist, and two thirds of wrist injuries are fractures. Wearing wrist guards could reduce the number of these injuries by an estimated 87%，according to the AAP.

　　Likewise, elbow pads could reduce elbow injuries by 82%, and knee pads could reduce the number of knee injuries by 32%, advise the experts.

　　Helmet used by young skaters is required by law in New York and Oregon, and the research institute also recommends that young skaters wear a bicycle helmet or a similar approved sports helmet.

　　The age at which children are ready to use in-line skates depends upon a number of conditions, including the child's foot size and body strength, general athletic ability and muscle coordination, and the ability to judge traffic and pay attention to the condition of the skating surface ahead, the experts advise.

　　The most dangerous skating practice, called “truck-surfing”，involves skating while holding onto a moving vehicle. Few skaters have fatal injuries, but 31 of 36 deaths reported since 1992 involved being knocked down by motor vehicle, according to data from the US Consumer Product Safety Commission.

　　1. How many people took part in in-line skating in the US in 1995?
　　A. About 17. 7 million.
　　B. More than 17. 7 million.
　　C. Fewer than 17. 7 million.
　　D. Exactly 17. 7 million.

　　2. Which of the following is NOT mentioned as the most common reason for injuries?
　　A. Skating with wrist and elbow wounds.
　　B. Losing one's balance due to road debris.
　　C. Being unable to stop due to high speed.
　　D. Falling down when doing a trick.

　　3. What are the things experts might NOT advise youngsters to wear?
　　A. Wrist guards.
　　B. Elbow and knee pads.
　　C. Helmets of some kind.
　　D. Boots and thick clothes.

　　4. “Truck-surfing” means
　　A. skating inside a truck while it is moving.
　　B. skating while holding onto a moving truck.
　　C. skating at a speed faster than a truck.
　　D. skating at the end of a moving truck.

　　5. According to the last paragraph, bumping with a motor vehicle took up of the deaths reported since 1992.
　　A. over 80%
　　B. below 80%
　　C. about 31%
　　D. about 36%