WFU

2025年6月14日 星期六

2025/6/11 中山醫院演講 / Lecture at Chung Shan Hospital on June 11, 2025

 

全方位勃起功能障礙治療


Comprehensive Treatment of Erectile Dysfunction 


#黃柏仁醫

#泌尿科醫師 #外科醫生 #疼痛科

#勃起功能障礙治療 #性功能障礙治療


#Dr. Po-Jen Huang

#Urologist #Surgeon #PainSpecialist

#ErectileDysfunctionTreatment #SexualDysfunctionTreatment








與內科李偉政主任合影
Photo with Director Li Weizheng of the Department of Internal Medicine














2025年6月8日 星期日

坐骨神經痛一定要開刀嗎?Is Surgery Always Necessary for Sciatica?

 

不開刀治療坐骨神經痛  

#黃柏仁醫師  

#超音波導引增生療法

 

Non-Surgical Treatment for Sciatica
#Dr. Po-Jen Huang
#Ultrasound-Guided Prolotherapy

 

https://www.youtube.com/shorts/AaHG4SxvTHM

https://www.youtube.com/shorts/t-bh6gkPUiU

General indications for using ultrasound in hip joint osteoarthritis

 

Detection of joint effusion

Detection of synovial thickening and hypertrophy

Assessment of cartilage lesions

Evaluation of osteophytes and bony cortex involvement

Assessment of periarticular soft-tissue abnormalities in OA (bursitis)

Therapeutic and diagnostic US-guided procedures

Follow-up of the response to local and systemic therapies

 


References: 

https://pmc.ncbi.nlm.nih.gov/articles/PMC4951794/

https://commons.wikimedia.org/wiki/File:0910_Oateoarthritis_Hip.jpg

 

超音波檢查髖關節退化性關節炎(hip osteoarthritis, OA)的一般適應症


檢測關節積液

檢測滑膜增厚和肥大

評估軟骨病變

評估骨刺和骨皮質受影響的情況

評估關節周圍軟組織異常(滑囊炎)

超音波導引下的治療和診斷操作

追蹤局部和系統治療的效果



References: 

https://pmc.ncbi.nlm.nih.gov/articles/PMC4951794/

https://commons.wikimedia.org/wiki/File:0910_Oateoarthritis_Hip.jpg

 

Severe Lumbar Nerve Compression Causing Immobility? Doctor Uses This Technique to Help Patients Regain Their Lives

  

A doctor’s thousand words

Can’t compare to a patient’s own story.

 

#DrPoJenHuang

#PainManagement #Surgery #Urology

#UltrasoundGuidedProlotherapy


https://youtu.be/8RH7EILLRUY?si=qgK_erZSQsVTzBAV

https://www.facebook.com/share/r/12LuMyJhWMf/

 

腰椎神經壓迫痛到走不動? 醫師用這招讓患者重拾生活

 

醫師的千言萬語

不如病患親自分享

 

#黃柏仁醫師

#疼痛科外科泌尿科

#超音波導引增生療法 


https://youtu.be/8RH7EILLRUY?si=qgK_erZSQsVTzBAV


https://www.facebook.com/share/r/12LuMyJhWMf/

 

2025年4月7日 星期一

“Doctor, Will I become dependent to This Medication?” — A Brief Discussion on Drug Dependence

 

In outpatient clinics, it's common to hear patients ask:"Doctor, will I become dependent on this medication?"

So, what exactly is drug dependence?

 

From a medical diagnostic standpoint:

Drug dependence falls under the category of Substance Use Disorder (SUD).

The American Psychiatric Association defines SUD as the presence of two or more of the following symptoms occurring within a 12-month period, including:

taking more substance than intended, unsuccessful efforts to cut down, significant time spent using or recovering from the substance, craving, failure to perform major role obligations, continued use despite interference with social/occupational/recreational activities, use in hazardous situations, use despite significant negative impact on health, tolerance, and withdrawal.

 

The severity of SUD varies:

According to the DSM-5, there are 11 diagnostic criteria.Depending on the number of symptoms present within a 12-month period, SUD is classified as:

1.    Mild (2–3 symptoms)

2.    Moderate (4–5 symptoms)

3.    Severe (6 or more symptoms)

The 11 diagnostic criteria are:

     1. Often taken in larger amounts or over a longer period than was intended.

     2. A persistent desire or unsuccessful efforts to cut down or control use.

     3. A great deal of time is spent in activities necessary to obtain, use, or recover from the substance’s effects.

     4. Craving or a strong desire or urge to use the substance.

     5. Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home.

     6. Continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by its effects.

     7. Important social, occupational, or recreational activities are given up or reduced because of use.

     8. Recurrent use in situations in which it is physically hazardous.

     9. Continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

     10. Tolerance.

     11. Withdrawal.

Notes:

      Criteria 10 and 11 (tolerance and withdrawal) are not counted if they result solely from appropriate use of prescribed medications.

      In this context, “substance” includes both medications and chemical substances.

 

After reading this far, you may realize:

Most medications prescribed legally by doctors do not lead to SUD.

That’s because substances more likely to cause SUD typically include:

      Caffeine, tobacco/nicotine, alcohol

      Prescription drug misuse — such as opioids, sedatives/hypnotics, and stimulants

      Marijuana

      Illicit drugs — such as stimulants (including cocaine), opioids (including heroin), hallucinogens, and inhalants

Most medications taken by the general population don’t fall into these categories, or they are used within medically appropriate guidelines.

Therefore, medications legally obtained through proper medical channels usually do not cause dependence!

 

Additional clarification:

Some patients with chronic conditions require long-term medication use.This should not be mistaken for dependence — it is simply a medical necessity.

In other words, for certain patients, these medications are as essential as food and water.It is not dependence.

After all, we don’t consider ourselves addicted to food or water just because we need them every day — right?

 

References:

UpToDate:

      Substance use disorders: Clinical assessment

      Substance use disorders in physicians

Wikipedia:

      Substance dependence (zh)

      Substance use disorder (zh)

 

Note 1:

Several studies have shown that alcohol is the most concerning substance among physicians, followed by prescription opioids.

For example, a retrospective study analyzing 3,604 physician health program (PHP) medical records reported the following “drug of choice” distribution:

      Alcohol – 25%

      Opioids – 25%

      Cannabis – 12%

      Cocaine – 11%

      Sedatives – 10%

      Amphetamines – 4%

      Inhalants – 1%

      Other – 8%

 

Note 2:

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the risk thresholds for alcohol in the U.S. are:

      Men under 65:≥5 standard drinks in a day, or >14 drinks per week on average

      Women and men over 65:≥4 standard drinks in a day, or >7 drinks per week on average

One standard drink contains ~12g of ethanol (e.g., 1.5 oz of 80-proof liquor, 5 oz of wine, or 12 oz of beer).

For gender minority populations, no formal risk thresholds have been established yet.

There is also no universally agreed definition of unhealthy use for substances other than alcohol.For some substances, any use at all (e.g., cocaine or methamphetamine) is considered unhealthy, as even occasional useincreases risks such as heart disease.