Elective Surgery
WEDNESDAY, FEB 16, 2011
What we still don't know about Lasik
As the surgery continues to plague patients like me, the man who approved it for the FDA pushes for a recall
BY ABBY ELLIN
Salon
How are your eyes?
That's all anyone ever wants to know these days: How my eyes are doing after my collision with Lasik almost three years ago. Are they still dry? Do they still hurt when exposed to sunlight? Is my vision still blurred? And what about glasses -- am I still wearing them?
The answer: Yes, yes, yes and yes. Emphatically, resoundingly, blindingly yes. My eyes sting. They burn. I look at neon signs and the colors bleed into a fluorescent Rorschach test. I have difficulty deciphering black lettering on white boards; I have personally helped elevate the stock of Allergan, which manufactures Refresh Plus, the drops that allegedly help dry eye.
Lasik Hong Kong
Clearly, this is all very annoying, but at this point, I'm used to it. It's just one of the things I live with, like PMS and hangnails. And in the grand scheme of things, it's not so bad. According to Market Scope, LLC, an ophthalmic industry research firm, nearly 15 million procedures have been performed in the U.S. over the last decade, with a 95.4 percent patient satisfaction rate. Lasik is also a $1.6 billion industry -- which, as Michael Lewis points out in "The Big Short," was initially created to replace the revenue stream lost to declining cataract surgery reimbursement rates.
Ninety-five percent satisfaction is not awful (although of course it depends on what your definition of "is" is). It's the other 5 percent that worries me. I've interviewed people who've had corneal transplants because of botched Lasik, who've lost their jobs because they can't see -- like Los Angeles Dodger Jay Gibbons, who reportedly stopped playing winter ball in Venezuela because of blurred vision he acquired after Lasik surgery earlier in the season, the L.A. Times reported.
So all in all, I'm pretty lucky. But I think it's fair to say that I'm angry. Not just about my situation, but because this is an industry where it's almost impossible to find a reputable refractive surgeon to speak out on behalf of patients. If you've got a problem, it's your fault. I went to a dry eye specialist in New York City, a guy who wrote a book on the subject. He acknowledged that Lasik causes dry eye and that it's a major surgical side effect.
"Would you ever say that on the record?" I asked.
He shook his head somewhat sheepishly. "We do Lasik here," he explained. Aha! Talk about a smart businessman. He's got the problem and the solution under one roof.
Attorneys also have trouble finding doctors to testify for patients. On June 2, 2009, Todd Krouner, a lawyer in Chappaqua, N.Y., who has won millions of dollars for injured Lasik patients, cross-examined a Dr. Wing Chu in a case involving a patient with post-Lasik ectasia, a bulging of the cornea. Dr. Chu is medical director of the Eye-Bank for Sight Restoration, and an associate clinical professor of ophthalmology at Columbia University, among other appointments. He was hired by the defense to conduct an independent medical examination of the patient. Here's how that conversation went:
Krouner: "Is your version of the Hippocratic oath "first do no harm" translated "first do no harm to any ophthalmologist," is that your interpretation of the Hippocratic oath?"
Chu: "That's a part of it."
Oh. Good to know.
The hero here is a man named Morris Waxler, whom I wrote about last year for Salon. Waxler is a Ph.D. and a former branch chief of the FDA's Center for Devices and Radiological Health from 1995 to 1999. He was, in effect, the man responsible for approving Lasik vision enhancement lasers in 1997. Since that time, he has become rabidly anti-Lasik, publicly admitting that the FDA "screwed up" when it approved it.
Now he's taken his activism a step further. Last month, he filed a petition calling for the FDA to withdraw approval "for all Lasik devices and issue a Public Health Advisory with a voluntary recall of Lasik devices in an effort to stop the epidemic of permanent eye injury caused by lasers and microkeratomes used for Lasik eye surgery."
In his petition, Waxler maintains that the initial approval was based on data that was "dominated by Lasik surgeons working hand-in-glove with Lasik manufacturers. Data recently brought to light exposes this partnership for what it was: a classic example of the fox guarding the henhouse, wherein the primary arbiters of safety and effectiveness of Lasik devices were the device manufacturers and its collaborators." Consequently, he says, the FDA was deprived of knowledge of the full extent of Lasik injuries prior to and during FDA reviews of documents submitted in support of the safety and effectiveness of Lasik devices.
He adds that -- contrary to the FDA's own device-approval standard, which limits adverse events to 1 percent -- published scientific data shows that Lasik devices induce an average adverse event rate of about 22 percent "that persists beyond six months to five or more years."
Lastly, he says, the published data shows that Lasik devices transform healthy corneas into sick corneas that never completely heal; are permanently weakened, vulnerable to trauma and inflammation; cause neuropathic dry eyes; have pathology that progresses annually; are vulnerable to blinding corneal bulging (keratectasia); compromise night vision; have unstable vision corrections that regress; and require eye care that otherwise wouldn't be needed.
This is potent stuff. And it doesn't seem to be the rantings of a bored retiree. "The idea that I had such a hand in getting a product on the market that was messing people's eyes up is disgusting," he says. "My wife said, 'Why are you getting back into that mess? Leave it to other people.' But I couldn't leave it alone. The more I discovered about it, the worse it got. Rereading the applications to the FDA that I once read and reviewed and reviewing the published literature since then -- it's not a pretty picture."
It's not a pretty picture, but it seems to be pervasive among the FDA. According to a recent report in the Archives of Internal Medicine, of the 113 devices that the FDA recalled between 2005 and 2009 for posing serious health risks or even death, more than 70 percent had been approved because they were considered similar to other products on the market. "Our findings reveal critical flaws in the current FDA device review system and its implementation that will require either congressional action or major changes in regulatory policy," the authors wrote.
While Waxler stops a centimeter short of using the C word (that would be, "conspiracy"), he does wonder why doctors failed to report adverse, or negative, reactions after five or six months. "They didn't report the data," he says. "They said patients wouldn't come back because as far as they could tell patients were doing very well. It's like asking Iran how many nuclear sites they have and them saying, 'We don't have any.' And saying, 'OK, that's fine. We trust you.'"
The refractive surgery community, not surprisingly, is less than pleased with Waxler. The American Society of Cataract and Refractive Surgery stated that while they laud his commitment to Lasik safety (which they share), they "disagree with his science and conclusions."
"The vast preponderance of clinical evidence shows that Lasik is safe and effective -- a conclusion that the FDA has repeatedly re-affirmed in its multiple reviews of up-to-date information," they wrote. "By failing to follow standard scientific protocol, Dr. Waxler does a disservice to all LASIK patients -- including those few who have had serious problems and who deserve to have them clearly understood."
After talking with Waxler, I called, and e-mailed, and called, and e-mailed again, the FDA to no response. Finally, Karen Riley, an FDA spokesperson, shot me an e-mail: "FDA continues to monitor the safety and effectiveness of all devices, including the lasers approved for Lasik," she wrote. "In October of last year we provided a brief update on our role in a three-part study of Lasik that is still in the beginning phases. It is a project that we hope will yield additional insights about this procedure."
It was a nice pat response, but had nothing to do with Waxler's petition. That response came from David S. Buckles, Ph.D., the ombudsman for the CDRH, and was forwarded to me by a Lasik activist:
"I personally appreciate the effort by Dr. Waxler and colleagues to use this approach to raise these issues with the Commissioner's Office because this is an appropriate venue within which to propose changes to the means by which Lasik devices are regulated," Buckles wrote. "While we in CDRH do not have close contact with proceedings in the Commissioner's Office on this particular matter, my understanding is that the petition is under review at the Commissioner's level to determine whether to accept the petition for consideration.
If the petition is accepted for consideration, and subsequently members of CDRH are tasked to participate in the review, then we will have some visibility into the process. However, until that happens, the status of the petition is not within our cognizance."
In other words: Let's wait and see. And wait some more.
Realistically, of course, it's unlikely that Lasik will be banned. Plenty of people have had tremendously wonderful experiences. Even Todd Krouner, the lawyer, says that he "knows and respects too many honest, intelligent, competent Lasik surgeons, who 'eat their own cooking' and have had Lasik themselves," he says. "Still, I believe that the public deserves an honest study, free from the bias and influence of the Lasik industry.
There are bright doctors and trustworthy public health officials who have no financial interest in Lasik, who are certainly qualified to perform a credible study. Without that, I doubt that the public will be able to assess the true risks, benefits and alternatives to Lasik surgery. If doctors cannot agree among themselves about the true incidence of ectasia, or much more common dry eye syndrome, how is a patient ever supposed to make a truly informed decision?"
How indeed? It's a good question, and one I'd like to explore further. But not right now. My eyes hurt.
Abby Ellin is the author of "Teenage Waistland: A Former Fat Kid Weighs in on Living Large, Losing Weight and How Parents Can (and Can't) Help." Her website is AbbyEllin.com. She lives, works, and tries to see in New York City.
2011-02-23
Lasik's blurry vision
Elective Surgery
MONDAY, JAN 25, 2010
salon.com
Lasik's blurry vision
Side effects continue to plague patients like me. Now, as the FDA investigates, one expert admits, "We screwed up"
BY ABBY ELLIN
Lasik
The other day I got a prescription for eyeglasses. This is not newsworthy in itself except for one thing: More than two and a half years ago I had Lasik (laser-assisted in situ keratomileusis), specifically so I could toss away the spectacles I wore for near-sightedness. I knew that eventually I would need reading glasses, but I would, I was assured, be able to see long-distance for a long time.
Problem is, I can't.
Not only is my vision blurred, but as I wrote in a 2008 article for the New York Times, I still see halos, and not the kinds with angels attached. It takes a good 10 minutes for my eyes to adjust to dimly lit rooms.
My eyes are scratchy and as dry as the desert. Yes, before I got the surgery I signed an "informed consent" saying I understood all the possible side effects, but I certainly never knew that they might last indefinitely, and that they would be more than "annoying," as my doctor promised.
But nearly three years later, they are still here. And while I could get an "enhancement" -- that's industry parlance for another surgery to correct errors -- frankly, the only thing I want near my eyes is mascara.
According to the American Society of Cataract and Refractive Surgery, most of the 13.6 million people in the United States who have had Lasik surgery since the first lasers were approved by the FDA in 1998 are pleased with the results. But others have experienced similar, if not worse, problems than I have.
Indeed, the estimated $2.5 billion industry has recently come under fire for its failure to acknowledge potential risks. Last spring, the FDA inspected about 50 Lasik facilities and found that many had no system in place for collecting and transmitting data to the FDA on patients’ reports of post-surgical "adverse events."
And in August, Consumer Reports Health released the results of a survey, which found that 55 percent of Americans who've had laser vision correction surgeries are still wearing glasses or contacts some of the time.
Fifty-three percent experienced at least one side effect within the first four weeks of the surgery; 22 percent of patients experienced them six months after surgery, especially dry eyes, halos, glare and starbursts around lights.
Still, the American Society of Cataract and Refractive Surgery emphasizes that Lasik surgery, which can cost up to $5,000, has a 95.4 percent patient satisfaction rate, based on an analysis of research worldwide from 1996 to 2008, said John Ciccone, a spokesman for the organization. The researchers evaluated 19 studies involving 2,022 patients that specifically addressed patient satisfaction.
"Based on everything we know from the literature, and everything I know from any other elective procedure, Lasik eye surgery is the most successful elective procedure performed," said Dr. Kerry Solomon, a cataract and refractive surgeon in Charleston, S.C., and a co-researcher on the study.
The experience of patients like Jeremy Fox, 26, a college student in Rockford, Ill., who got Lasik about four years ago, seem to support this assessment. Getting the procedure, he said, was one of the best decisions he has ever made. While he does experience some starbursts, he said "it’s not bothersome at all."
But the FDA and others are taking note of what they call "quality of life" issues. In October, the FDA, the Defense Department and the National Eye Institute announced in October a three-year effort to assess adverse effects of Lasik.
The effort will involve gauging how many active-duty military patients at the Navy Refractive Surgery Center in San Diego suffered post-surgical eye problems, and a series of national, multi-center clinical trials that will study the impact on quality of life following Lasik surgery in the general population. In addition, the FDA has reopened a public docket to receive comments through Nov. 15.
"We noted that there was little consistent evaluation of the issues," said Mary Long, an FDA spokeswoman, about the reasons for why the study was initiated.
Erik J. Rupard, a doctor and clinical researcher with the U.S. Army, is among those who think such scrutiny is necessary. "Lasik is the Tiger Woods of medical procedures: deeply and demonstrably flawed, but so many people love it that those few of us who speak ill of it are dismissed as cranks and/or loonies," he wrote in an e-mail message. "I saw lots of dry-eye complications in soldiers in Iraq who had undergone the procedure ostensibly because contacts are too unsafe in that dusty environment, and yet the Department of Defense has done no controlled studies to look at the cost -- human and otherwise -- of these post-refractive issues. I am a clinical researcher, and I know that Lasik, a cosmetic procedure, has never been subjected to the pre- or post-marketing scrutiny that we put even lifesaving drugs through."
Surf the Web and you can find dozens of stories from people who have had post-Lasik difficulties: dry-eye, halos, glare. Some complications have resulted in corneal transplants. Over the last few years patient activists have bombarded the FDA with anti-Lasik e-mails, complaints and petitions.
Among them is John Hoge, 39, a businessman in Port Jefferson, N.Y., who suffered from night glare and halos and regrets not choosing the "zero risk option" of corrective lenses. A few years ago he got some experimental contact lenses that have largely taken care of the glare issue. They are expensive, he added, and are not covered by insurance.
While the FDA's recent efforts have given some patient activists a modicum of peace, many do not feel it is enough. "By not inspecting every Lasik facility in this nation, how is the FDA to know if Lasik doctors are compliant?" said Dean Andrew Kantis, 40, a jet salesman in Fort Lauderdale, Fla., who has experienced double vision, starbursts, halos and dry eyes since getting Lasik in 1999, and operates the Web site LifeafterLasik.com.
Some experts believe the FDA should have taken more care when the first lasers were approved in 1998. "We screwed up," said Morris Waxler, a former branch chief of the FDA’s Center for Devices and Radiological Health Office of Science and Technology from 1995 to 1999. "You know how some drugs have a black box warning -- it’s dangerous because of this, this and this -- we could have done something comparable to that. We should have looked at the worst-case impact on patients, rather than just the very good outcomes we saw in the clinical trials."
Larry Pilot, a former associate director for compliance in the FDA’s bureau of medical devices, and currently a lawyer practicing food and drug law in Arlington, Va., agreed. "It appears that information to provide adequate informed consent was not sufficient for all prospective patients about occasions where a bad outcome could result," he said. “The present dissatisfaction rate of 5 percent is very high. Personally and professionally, I am very disappointed in the FDA."
Spokeswoman Long refutes the notion that the FDA was errant. "The FDA has reviewed safety and effectiveness information included in the manufacturer’s applications for approval," she wrote in an e-mail message. "We found them to be safe and effective when used as indicated and will continue to monitor their safety and effectiveness, in addition to taking necessary and appropriate steps to protect the public health."
Timothy A. Ulatowski, director of the FDA’s Office of Compliance at the Center for Devices and Radiological Health, sent out letters to Lasik ambulatory facilities last May reminding them that all risks must be mentioned in every Lasik advertisement online, in print, radio or TV.
"As part of our ongoing review of Lasik and its impact on public health, we continue to look at various aspects of Lasik advertising and how we can better improve public health," said Long.
Still, an informal online search showed dozens of doctors' Web sites that do not mention risks or side effects.
As for the new study, Larry Pilot is not impressed. "The FDA is beginning to do what should have been done 10 years ago," he said. "The bottom line here is that upwards of scores of thousands of human eyes have been irreversibly damaged unnecessarily."
Dr. Solomon disagreed, maintaining that the FDA clinical trials on Lasik lasers were "rigorous" and "well-performed." "I think the FDA did an outstanding job at evaluating the technology," he said. "And the technology and procedure since approval have only gotten better."
As for me, if I had to do it all over again I wouldn't. But hindsight, alas, is 20-20.
Abby Ellin is the author of " Teenage Waistland: A Former Fat Kid Weighs in on Living Large, Losing Weight and How Parents Can (and Can't) Help ." She lives, works, and tries to see in New York City.
Abby Ellin is the author of "Teenage Waistland: A Former Fat Kid Weighs in on Living Large, Losing Weight and How Parents Can (and Can't) Help." Her website is AbbyEllin.com. She lives, works, and tries to see in New York City. More:
MONDAY, JAN 25, 2010
salon.com
Lasik's blurry vision
Side effects continue to plague patients like me. Now, as the FDA investigates, one expert admits, "We screwed up"
BY ABBY ELLIN
Lasik
The other day I got a prescription for eyeglasses. This is not newsworthy in itself except for one thing: More than two and a half years ago I had Lasik (laser-assisted in situ keratomileusis), specifically so I could toss away the spectacles I wore for near-sightedness. I knew that eventually I would need reading glasses, but I would, I was assured, be able to see long-distance for a long time.
Problem is, I can't.
Not only is my vision blurred, but as I wrote in a 2008 article for the New York Times, I still see halos, and not the kinds with angels attached. It takes a good 10 minutes for my eyes to adjust to dimly lit rooms.
My eyes are scratchy and as dry as the desert. Yes, before I got the surgery I signed an "informed consent" saying I understood all the possible side effects, but I certainly never knew that they might last indefinitely, and that they would be more than "annoying," as my doctor promised.
But nearly three years later, they are still here. And while I could get an "enhancement" -- that's industry parlance for another surgery to correct errors -- frankly, the only thing I want near my eyes is mascara.
According to the American Society of Cataract and Refractive Surgery, most of the 13.6 million people in the United States who have had Lasik surgery since the first lasers were approved by the FDA in 1998 are pleased with the results. But others have experienced similar, if not worse, problems than I have.
Indeed, the estimated $2.5 billion industry has recently come under fire for its failure to acknowledge potential risks. Last spring, the FDA inspected about 50 Lasik facilities and found that many had no system in place for collecting and transmitting data to the FDA on patients’ reports of post-surgical "adverse events."
And in August, Consumer Reports Health released the results of a survey, which found that 55 percent of Americans who've had laser vision correction surgeries are still wearing glasses or contacts some of the time.
Fifty-three percent experienced at least one side effect within the first four weeks of the surgery; 22 percent of patients experienced them six months after surgery, especially dry eyes, halos, glare and starbursts around lights.
Still, the American Society of Cataract and Refractive Surgery emphasizes that Lasik surgery, which can cost up to $5,000, has a 95.4 percent patient satisfaction rate, based on an analysis of research worldwide from 1996 to 2008, said John Ciccone, a spokesman for the organization. The researchers evaluated 19 studies involving 2,022 patients that specifically addressed patient satisfaction.
"Based on everything we know from the literature, and everything I know from any other elective procedure, Lasik eye surgery is the most successful elective procedure performed," said Dr. Kerry Solomon, a cataract and refractive surgeon in Charleston, S.C., and a co-researcher on the study.
The experience of patients like Jeremy Fox, 26, a college student in Rockford, Ill., who got Lasik about four years ago, seem to support this assessment. Getting the procedure, he said, was one of the best decisions he has ever made. While he does experience some starbursts, he said "it’s not bothersome at all."
But the FDA and others are taking note of what they call "quality of life" issues. In October, the FDA, the Defense Department and the National Eye Institute announced in October a three-year effort to assess adverse effects of Lasik.
The effort will involve gauging how many active-duty military patients at the Navy Refractive Surgery Center in San Diego suffered post-surgical eye problems, and a series of national, multi-center clinical trials that will study the impact on quality of life following Lasik surgery in the general population. In addition, the FDA has reopened a public docket to receive comments through Nov. 15.
"We noted that there was little consistent evaluation of the issues," said Mary Long, an FDA spokeswoman, about the reasons for why the study was initiated.
Erik J. Rupard, a doctor and clinical researcher with the U.S. Army, is among those who think such scrutiny is necessary. "Lasik is the Tiger Woods of medical procedures: deeply and demonstrably flawed, but so many people love it that those few of us who speak ill of it are dismissed as cranks and/or loonies," he wrote in an e-mail message. "I saw lots of dry-eye complications in soldiers in Iraq who had undergone the procedure ostensibly because contacts are too unsafe in that dusty environment, and yet the Department of Defense has done no controlled studies to look at the cost -- human and otherwise -- of these post-refractive issues. I am a clinical researcher, and I know that Lasik, a cosmetic procedure, has never been subjected to the pre- or post-marketing scrutiny that we put even lifesaving drugs through."
Surf the Web and you can find dozens of stories from people who have had post-Lasik difficulties: dry-eye, halos, glare. Some complications have resulted in corneal transplants. Over the last few years patient activists have bombarded the FDA with anti-Lasik e-mails, complaints and petitions.
Among them is John Hoge, 39, a businessman in Port Jefferson, N.Y., who suffered from night glare and halos and regrets not choosing the "zero risk option" of corrective lenses. A few years ago he got some experimental contact lenses that have largely taken care of the glare issue. They are expensive, he added, and are not covered by insurance.
While the FDA's recent efforts have given some patient activists a modicum of peace, many do not feel it is enough. "By not inspecting every Lasik facility in this nation, how is the FDA to know if Lasik doctors are compliant?" said Dean Andrew Kantis, 40, a jet salesman in Fort Lauderdale, Fla., who has experienced double vision, starbursts, halos and dry eyes since getting Lasik in 1999, and operates the Web site LifeafterLasik.com.
Some experts believe the FDA should have taken more care when the first lasers were approved in 1998. "We screwed up," said Morris Waxler, a former branch chief of the FDA’s Center for Devices and Radiological Health Office of Science and Technology from 1995 to 1999. "You know how some drugs have a black box warning -- it’s dangerous because of this, this and this -- we could have done something comparable to that. We should have looked at the worst-case impact on patients, rather than just the very good outcomes we saw in the clinical trials."
Larry Pilot, a former associate director for compliance in the FDA’s bureau of medical devices, and currently a lawyer practicing food and drug law in Arlington, Va., agreed. "It appears that information to provide adequate informed consent was not sufficient for all prospective patients about occasions where a bad outcome could result," he said. “The present dissatisfaction rate of 5 percent is very high. Personally and professionally, I am very disappointed in the FDA."
Spokeswoman Long refutes the notion that the FDA was errant. "The FDA has reviewed safety and effectiveness information included in the manufacturer’s applications for approval," she wrote in an e-mail message. "We found them to be safe and effective when used as indicated and will continue to monitor their safety and effectiveness, in addition to taking necessary and appropriate steps to protect the public health."
Timothy A. Ulatowski, director of the FDA’s Office of Compliance at the Center for Devices and Radiological Health, sent out letters to Lasik ambulatory facilities last May reminding them that all risks must be mentioned in every Lasik advertisement online, in print, radio or TV.
"As part of our ongoing review of Lasik and its impact on public health, we continue to look at various aspects of Lasik advertising and how we can better improve public health," said Long.
Still, an informal online search showed dozens of doctors' Web sites that do not mention risks or side effects.
As for the new study, Larry Pilot is not impressed. "The FDA is beginning to do what should have been done 10 years ago," he said. "The bottom line here is that upwards of scores of thousands of human eyes have been irreversibly damaged unnecessarily."
Dr. Solomon disagreed, maintaining that the FDA clinical trials on Lasik lasers were "rigorous" and "well-performed." "I think the FDA did an outstanding job at evaluating the technology," he said. "And the technology and procedure since approval have only gotten better."
As for me, if I had to do it all over again I wouldn't. But hindsight, alas, is 20-20.
Abby Ellin is the author of " Teenage Waistland: A Former Fat Kid Weighs in on Living Large, Losing Weight and How Parents Can (and Can't) Help ." She lives, works, and tries to see in New York City.
Abby Ellin is the author of "Teenage Waistland: A Former Fat Kid Weighs in on Living Large, Losing Weight and How Parents Can (and Can't) Help." Her website is AbbyEllin.com. She lives, works, and tries to see in New York City. More:
2011-02-21
Raising Awareness about Electromagnetic Pollution
藤枝國家公園山難 國立台灣大學女學生黃勤文墜崖摔死
甜菊糖的陰謀，你要知
甜菊葉
圓肉、棗子、椰皇 和代糖例如 麥芽糖、甜菊糖、龍舌草蜜
關鍵時刻 20110216 可口可樂秘方+基因改造物祕辛 1/8
Raising Awareness about Electromagnetic Pollution
How your medicines are killing you
Deadly medical errors still common in U.S. hospitals
Is Gluten Bad For You?
Krishna : Myth or History Videos
A beutiful video by Dr Manish Pandit on Sri Krishna, Explaining scientifically about the Krishna's existence in the history of Mankind.
iHerb $5 Discount Off First Order
2011-02-20
How to boost your cancer preventing enzymes
5個品牌的可樂中人造焦糖色素發現明顯的 2-MI 和 4-MI 會令動物致癌
垃圾廢物處理——台灣能，香港為何不能？
137蘇州華工人受害 蘋果認廠毒物正己烷致殘
How Parents Can Ruin their Children's Health
60 Lab Studies Now Confirm Cancer Link to a Vaccine You Probably Had as a Child
How to boost your cancer preventing enzymes
Ten ways public school destroys free thinking (Opinion)
2011-02-19
中原城市領先指數 CCL 13年新高
中原指數13年新高
(明報)2011年2月19日 星期六
【明報專訊】政府去年11月中推出額外印花稅，遏抑樓市炒風後，樓價曾曇花一現回落，但私宅供求失衡再度令樓價很快回升，昨公布的城市大學 與中原地產 合作的中原城市領先指數顯示，截至本月13日，最新報93.41點，對上一周為91.45點，換言之，整體二手樓價一周上升2.14%。樓價升勢正在加速，指數更創1997年11月2日以來新高。中原預測，今年上半年樓價將跨越97年巔峰。
現較97高峰相差一成
下周港府將公布財政預算，各政黨呼籲政府要再出招遏抑樓市，特別是復建居屋（見配稿）。另外，有8家發展昨入標被視為利潤較低、首個規限單位面積（限呎）項目前元朗村用地，反映發展商搶地心切，看好後市。
本港樓價的歷史高峰為1997年10月19日，當時指數報102.93點，現時最新指數仍較當時相差約一成。上述最新指數，主要反映三周前的交易情况（即1月24日至30日的農曆年假前一周）。地產界人士指出，近二三周樓價升勢有可能更急，中原聯席董事黃良昇稱，只要指數每周上升0.5點，20周後指數便可跨越97高峰。
Beauty Products
分區方面，港島、九龍、新界東及新界西區樓價全面上升。港島區指數103.19點，按周上升1.61%，樓價只要再升1.3％，便可以壓倒97年10月26日的104.44點歷史高位。九龍區指數90.29點，按周上升2.34%；新界東區指數報88.11點，按周上升1.98%；新界西區指數報72.69點，按周上升2%。
另方面，昨日截標的前元朗村用地吸引8家發展商入標，反應較市場預期佳，入標包括多家主要發展商如新地、長實 等，恒地方面則稱因為地質問題（項目章程指出有溶洞風險），沒有入標。近年主力興建豪宅的大昌集團 亦罕有入標，大昌執行董事李永修表示﹕「項目位置理想，雖然限呎，但對項目絕無影響」。
限呎元朗村地皮 8發展商入標
有建築師認為，項目雖限呎，但無法限制日後的發售價，相信中標的發展商會在項目設計下工夫，令日後買家可打通單位，突破限呎。他認為，推出限呎項目，作用不大，不過是政府安撫市民的手法。
中原測量師黎堅輝說，雖然該地皮限呎，但地盤大，相信發展商可於整體規劃及用料上升級，令項目有利可圖，料項目日後呎價可達5000至6000元。
(明報)2011年2月19日 星期六
【明報專訊】政府去年11月中推出額外印花稅，遏抑樓市炒風後，樓價曾曇花一現回落，但私宅供求失衡再度令樓價很快回升，昨公布的城市大學 與中原地產 合作的中原城市領先指數顯示，截至本月13日，最新報93.41點，對上一周為91.45點，換言之，整體二手樓價一周上升2.14%。樓價升勢正在加速，指數更創1997年11月2日以來新高。中原預測，今年上半年樓價將跨越97年巔峰。
現較97高峰相差一成
下周港府將公布財政預算，各政黨呼籲政府要再出招遏抑樓市，特別是復建居屋（見配稿）。另外，有8家發展昨入標被視為利潤較低、首個規限單位面積（限呎）項目前元朗村用地，反映發展商搶地心切，看好後市。
本港樓價的歷史高峰為1997年10月19日，當時指數報102.93點，現時最新指數仍較當時相差約一成。上述最新指數，主要反映三周前的交易情况（即1月24日至30日的農曆年假前一周）。地產界人士指出，近二三周樓價升勢有可能更急，中原聯席董事黃良昇稱，只要指數每周上升0.5點，20周後指數便可跨越97高峰。
Beauty Products
分區方面，港島、九龍、新界東及新界西區樓價全面上升。港島區指數103.19點，按周上升1.61%，樓價只要再升1.3％，便可以壓倒97年10月26日的104.44點歷史高位。九龍區指數90.29點，按周上升2.34%；新界東區指數報88.11點，按周上升1.98%；新界西區指數報72.69點，按周上升2%。
另方面，昨日截標的前元朗村用地吸引8家發展商入標，反應較市場預期佳，入標包括多家主要發展商如新地、長實 等，恒地方面則稱因為地質問題（項目章程指出有溶洞風險），沒有入標。近年主力興建豪宅的大昌集團 亦罕有入標，大昌執行董事李永修表示﹕「項目位置理想，雖然限呎，但對項目絕無影響」。
限呎元朗村地皮 8發展商入標
有建築師認為，項目雖限呎，但無法限制日後的發售價，相信中標的發展商會在項目設計下工夫，令日後買家可打通單位，突破限呎。他認為，推出限呎項目，作用不大，不過是政府安撫市民的手法。
中原測量師黎堅輝說，雖然該地皮限呎，但地盤大，相信發展商可於整體規劃及用料上升級，令項目有利可圖，料項目日後呎價可達5000至6000元。
2011-02-18
Standard Chartered Hong Kong Marathon 2011
Standard Chartered Hong Kong Marathon 2011
http://www.hkmarathon.com
Running
Leading Results:
MEN -
1. Nelson Kirwa ROTICH, KEN 2:16.00 (US$) 34,000
2. Julius Kiplimo MAISEI, KEN 2:16.06 15,000
3. Tesfaye Girma BEKELE, ETH 2:16.31 6,500
4. Robert Kiplagat KOSEKEI, KEN 2:16.53 3,600
5. Hammou MOUDOUJI, MAR 2:16.55 1,800
6. Julius Kiprono MUTAI, KEN 2:17.04 1,600
WOMEN -
1. Janet Jelegat RONO, KEN 2:33:42 34,000
2. Samira RAIF, MAR 2:33:51 15,000
3. Bifa Yeshimabet TADESSE, ETH 2:34:14 6,500
4. Negash Hadush LETAY, ETH 2:35:35 3,600
5. CHENG Wenrong, CHN 2:35:49 1,800
6. Rose CHESHIRE, KEN 2:38:06 --
Marathon runners urged to watch step on health
Elizabeth Law
Thursday, February 17, 2011
The Standard
The record 65,000 runners participating in Sunday's Hong Kong Standard Chartered Marathon are advised to put personal health and safety above all else.
The alert comes after dozens of runners collapsed during last year's event, with 55 hospitalized. Most of them suffered from heatstroke, or had breathing difficulties because of air pollution.
Accident and emergency doctors said those most at risk are the inexperienced who don't know how far to push themselves.
Participants are urged to take precautions against the cold to avoid hypothermia, and to watch for slippery roads if running in the rain.
According to the observatory, while there will be sunny intervals, the day will begin with patches of rain all over the territory, with temperatures ranging from 13 to 17 degrees Celsius.
The Auxiliary Medical Services will provide support, with more than 400 personnel spread over 20 first-aid posts.
The annual event features three separate runs, including the 42-kilometer full marathon and 21km half marathon.
AMS doctor Chan Man-chung said risks are greater at the 10km mark and the finish.
The 10km mark is where most runners who are not fully prepared start experiencing leg cramps.
As for the finish, runners tend to go all out when sprinting towards the line, and very often collapse from exhaustion, Chan said.
The marathons start in Tsim Sha Tsui, then wind through Kowloon and the New Territories before reaching through Hong Kong Island to end in Victoria Park.
The less strenuous 10km challenge starts at the Eastern Island Corridor and also finishes in Victoria Park.
To facilitate the marathon, several roads in Hong Kong, Kowloon and the New Territories will be closed, with more than 130 bus services disrupted.
The MTR will begin services from 3.25am to allow runners to get to the starting point.
Members of the public can go onto www.td.com.hk for details of the affected roads, as well as the alternative transport services available.
Standard Chartered hk marathon 2011 2010 2009 2008 2007 photo result
hong kong chartered marathon charter marathon
http://www.hkmarathon.com
Running
Leading Results:
MEN -
1. Nelson Kirwa ROTICH, KEN 2:16.00 (US$) 34,000
2. Julius Kiplimo MAISEI, KEN 2:16.06 15,000
3. Tesfaye Girma BEKELE, ETH 2:16.31 6,500
4. Robert Kiplagat KOSEKEI, KEN 2:16.53 3,600
5. Hammou MOUDOUJI, MAR 2:16.55 1,800
6. Julius Kiprono MUTAI, KEN 2:17.04 1,600
WOMEN -
1. Janet Jelegat RONO, KEN 2:33:42 34,000
2. Samira RAIF, MAR 2:33:51 15,000
3. Bifa Yeshimabet TADESSE, ETH 2:34:14 6,500
4. Negash Hadush LETAY, ETH 2:35:35 3,600
5. CHENG Wenrong, CHN 2:35:49 1,800
6. Rose CHESHIRE, KEN 2:38:06 --
Marathon runners urged to watch step on health
Elizabeth Law
Thursday, February 17, 2011
The Standard
The record 65,000 runners participating in Sunday's Hong Kong Standard Chartered Marathon are advised to put personal health and safety above all else.
The alert comes after dozens of runners collapsed during last year's event, with 55 hospitalized. Most of them suffered from heatstroke, or had breathing difficulties because of air pollution.
Accident and emergency doctors said those most at risk are the inexperienced who don't know how far to push themselves.
Participants are urged to take precautions against the cold to avoid hypothermia, and to watch for slippery roads if running in the rain.
According to the observatory, while there will be sunny intervals, the day will begin with patches of rain all over the territory, with temperatures ranging from 13 to 17 degrees Celsius.
The Auxiliary Medical Services will provide support, with more than 400 personnel spread over 20 first-aid posts.
The annual event features three separate runs, including the 42-kilometer full marathon and 21km half marathon.
AMS doctor Chan Man-chung said risks are greater at the 10km mark and the finish.
The 10km mark is where most runners who are not fully prepared start experiencing leg cramps.
As for the finish, runners tend to go all out when sprinting towards the line, and very often collapse from exhaustion, Chan said.
The marathons start in Tsim Sha Tsui, then wind through Kowloon and the New Territories before reaching through Hong Kong Island to end in Victoria Park.
The less strenuous 10km challenge starts at the Eastern Island Corridor and also finishes in Victoria Park.
To facilitate the marathon, several roads in Hong Kong, Kowloon and the New Territories will be closed, with more than 130 bus services disrupted.
The MTR will begin services from 3.25am to allow runners to get to the starting point.
Members of the public can go onto www.td.com.hk for details of the affected roads, as well as the alternative transport services available.
Standard Chartered hk marathon 2011 2010 2009 2008 2007 photo result
hong kong chartered marathon charter marathon
2011-02-17
Rackspace - Off-Site Hosting is Good for E-Commerce Businesses
Why Off-Site Hosting is Good for E-Commerce Businesses
FEBRUARY 15, 2011
By Brian Anthony Hernandez,
Business News Daily Staff Writer
Rackspace Hosting
To save time and money, businesses across the world are relying on companies that host information technology (IT) to store their e-mails, data, websites and applications on off-site servers.
These hosting companies eliminate the need for businesses to purchase, manage and maintain pricey – and often complicated – computing infrastructures.
Christopher Rajiah, Rackspace Hosting’s vice president of North American channel sales, said hosting is increasingly playing an important role, particularly for e-commerce businesses. Rajiah spoke with BusinessNewsDaily about the latest hosting trends, reasons businesses shouldn’t be afraid of hosting services and Rackspace’s similarities to a certain superhero.
BusinessNewsDaily: What trends are you seeing in the e-commerce and technology industries? Any major concerns?
Christopher Rajiah: We are seeing e-commerce platforms and cloud computing solutions work together and more in sync than ever before.
What’s driving this trend is really the need for speed and compute resources to run a successful e-commerce platform. As data traffic increases, the availability of these resources dwindles.
In the cloud, e-commerce organizations can scale resources as they need them, on demand, meaning when there’s a peak in service or shopping —such as Cyber Monday — e-commerce companies utilizing cloud computing can quickly spin up servers in the cloud to handle additional requests and spin them down when the need is gone.
One major concern for e-commerce companies is downtime. Sometimes it happens, but for organizations that fail to properly plan their hosting needs, it can happen a lot. And in e-commerce, that inability to process transactions means lost revenue for every minute that goes by. By adjusting the computing resources on the fly and using a hosting solution that provides advanced monitoring and support to fix problems when they occur, e-commerce companies can be assured that their transactions won't be compromised by a lack of resources.
BND: Why should businesses consider hosting services?
C.R.: By working with a hosting provider, businesses can get an increase their scalability and lower their costs and the need for lost of internal on-staff experts.
Whether they choose to host their e-mail, data, website or applications — like the ones that process online payment transactions — businesses can tap into additional resources when they need it without having to buy more physical servers or hire internal IT support to run them.
Businesses should consider hosting because it provides a wealth of benefits, including both saved money and time, as well as support from experts who know exactly how to effectively manage these environments.
This helps organizations focus on their business, instead of on the IT infrastructure that powers it.
BND: If Rackspace were a superhero, which one would it be and why?
C.R.: Definitely Superman. Rackspace employees – called Rackers – are the everyday heroes who come to the rescue of clients day in and day out whenever they need help. They act with super speed in response to fixing problems and answering questions, they have super-strong knowledge in their fields and the vision to see what customers need before they need it.
FEBRUARY 15, 2011
By Brian Anthony Hernandez,
Business News Daily Staff Writer
Rackspace Hosting
To save time and money, businesses across the world are relying on companies that host information technology (IT) to store their e-mails, data, websites and applications on off-site servers.
These hosting companies eliminate the need for businesses to purchase, manage and maintain pricey – and often complicated – computing infrastructures.
Christopher Rajiah, Rackspace Hosting’s vice president of North American channel sales, said hosting is increasingly playing an important role, particularly for e-commerce businesses. Rajiah spoke with BusinessNewsDaily about the latest hosting trends, reasons businesses shouldn’t be afraid of hosting services and Rackspace’s similarities to a certain superhero.
BusinessNewsDaily: What trends are you seeing in the e-commerce and technology industries? Any major concerns?
Christopher Rajiah: We are seeing e-commerce platforms and cloud computing solutions work together and more in sync than ever before.
What’s driving this trend is really the need for speed and compute resources to run a successful e-commerce platform. As data traffic increases, the availability of these resources dwindles.
In the cloud, e-commerce organizations can scale resources as they need them, on demand, meaning when there’s a peak in service or shopping —such as Cyber Monday — e-commerce companies utilizing cloud computing can quickly spin up servers in the cloud to handle additional requests and spin them down when the need is gone.
One major concern for e-commerce companies is downtime. Sometimes it happens, but for organizations that fail to properly plan their hosting needs, it can happen a lot. And in e-commerce, that inability to process transactions means lost revenue for every minute that goes by. By adjusting the computing resources on the fly and using a hosting solution that provides advanced monitoring and support to fix problems when they occur, e-commerce companies can be assured that their transactions won't be compromised by a lack of resources.
BND: Why should businesses consider hosting services?
C.R.: By working with a hosting provider, businesses can get an increase their scalability and lower their costs and the need for lost of internal on-staff experts.
Whether they choose to host their e-mail, data, website or applications — like the ones that process online payment transactions — businesses can tap into additional resources when they need it without having to buy more physical servers or hire internal IT support to run them.
Businesses should consider hosting because it provides a wealth of benefits, including both saved money and time, as well as support from experts who know exactly how to effectively manage these environments.
This helps organizations focus on their business, instead of on the IT infrastructure that powers it.
BND: If Rackspace were a superhero, which one would it be and why?
C.R.: Definitely Superman. Rackspace employees – called Rackers – are the everyday heroes who come to the rescue of clients day in and day out whenever they need help. They act with super speed in response to fixing problems and answering questions, they have super-strong knowledge in their fields and the vision to see what customers need before they need it.
CBS 女戰地特派員記者 Lara Logan 慘遭埃及暴民性侵
CBS 女記者 慘遭埃及暴民性侵
2011/02/16
陳禹安
（法新社紐約15日電） 美國哥倫比亞廣播公司（CBS）今天說，該台首席海外特派員蘿根（Lara Logan）在埃及報導總統穆巴拉克（Hosni Mubarak）垮台時，遭暴民「殘忍」性侵。
哥倫比亞廣播公司發表聲明：「當時群眾歡慶（穆巴拉克下台），她與她的團隊及保鑣遭危險分子包圍。超過200位暴民突然發狂。」
Chadwicks
「在暴民推擠下，她與團隊走散。她被暴民包圍，並不斷遭到殘忍性侵與毆打，直到後來，才被一群女子與約20名埃及士兵救出。」
美國哥倫比亞廣播公司表示，這起事件發生於11日開羅市中心解放廣場（Tahrir Square），也就是穆巴拉克下台當天。
事發後隔天，蘿根即飛往美國。聲明中表示：「她目前在醫院靜養。」
出生於南非的蘿根，因曾報導伊拉克及阿富汗戰爭，成為美國最家喻戶曉的戰地特派員。她在2006年成為哥倫比亞廣播公司首席海外特派員。（譯者：中央社陳禹安）
2011/02/16
陳禹安
（法新社紐約15日電） 美國哥倫比亞廣播公司（CBS）今天說，該台首席海外特派員蘿根（Lara Logan）在埃及報導總統穆巴拉克（Hosni Mubarak）垮台時，遭暴民「殘忍」性侵。
哥倫比亞廣播公司發表聲明：「當時群眾歡慶（穆巴拉克下台），她與她的團隊及保鑣遭危險分子包圍。超過200位暴民突然發狂。」
Chadwicks
「在暴民推擠下，她與團隊走散。她被暴民包圍，並不斷遭到殘忍性侵與毆打，直到後來，才被一群女子與約20名埃及士兵救出。」
美國哥倫比亞廣播公司表示，這起事件發生於11日開羅市中心解放廣場（Tahrir Square），也就是穆巴拉克下台當天。
事發後隔天，蘿根即飛往美國。聲明中表示：「她目前在醫院靜養。」
出生於南非的蘿根，因曾報導伊拉克及阿富汗戰爭，成為美國最家喻戶曉的戰地特派員。她在2006年成為哥倫比亞廣播公司首席海外特派員。（譯者：中央社陳禹安）
6 Foods That Weaken Bones
農業部令查皮革奶 舊皮具榨蛋白質 可致癌足奪命
6 Foods That Weaken Bones
Hemp Milk
6 Steps for Saving a Wet Cell Phone
《不能說的真相》-EP001-基因改造食物
2010-12-02
《不能說的真相》- EP011 – 素食的真相
2011-02-10
2011-02-15
中國 10％食米鎘超標 毒米多吃腳軟腿部出現無力疼痛
中國 10％食米鎘超標 毒米多吃腳軟腿部出現無力疼痛
中國大量生產摻入塑膠原料的假米
《不能說的真相》-EP003-氣象武器 HAARP
TSA refusal to release body scanner safety reports has many crying foul
Jean-Michel Cousteau's Ocean Futures Society recently named Reef Safe SunCare by Beach Buff as the ideal sunscreen for both humans and ocean creatures.
2011-02-13
Discover the health benefits of bananas
旺角街頭種高粱
Vaccine Safety Dangerous Side Effects Danger Risks Not Safe Children Reaction Concerned Parents Immunization http://easss.com/health/vaccine
Sunscreen causes rickets - new wave of cases in England
Ricketts is a childhood bone-softening disease produced by deficiency of vitamin D, which the body produces upon exposure to sunlight.
Discover the health benefits of bananas
Sports: Being Aron Ralston
In 2003, Aron Ralston amputated his arm after he was trapped by a boulder in a Utah canyon. Six years later, he still struggles with the meaning of his survival.
The most important metatarsal in history: Fossil shows man walked tall 3 million years ago
By DAVID DERBYSHIRE
11th February 2011
iPhone Hack Reveals Password In Just 6 Minutes (VIDEO)
The Huffington Post Amy Lee
2/10/11
2011-02-12
Pineapple is more than just a summer fruit
漢字の由来：蒼頡の涙―中華文化の真髄、漢字
New chemical pesticides now being used on fish farms.
lobster fishers and environmentalists have complained that AlphaMax (deltamethrin), a pesticide recently approved in Canada, has been causing the death of sea life.
Pineapple is more than just a summer fruit
You are what you eat (Opinion)
by: Hesh Goldstein
日本拉麵湯底的秘密
McDonald 炸雞+薯條 含致癌物砒霜 = 慢性中毒
愛喝含糖飲料 上班族易患糖尿病.wmv
2011-02-08
2010年亞洲最性感素食名人 方大同 和 張靚穎
2010年亞洲最性感素食名人 方大同 和 張靚穎
Little Krishna Videos
Ramayana the Epic - The legend of Rama Videos
7 Healthy Granola Bar Recipes
How to make granola bars, for a healthy homemade snack.
Famous Brazilian supermodel Gisele Bundchen condemns conventional sunscreen, calls it 'poison'
Close Look at Shoe Inserts Raises a Welter of Doubts
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