王麗娟譯 In a small building in Marrero, Louisiana, patients in a clear capsule breathe pure oxygen.
在美國路易斯安納州馬雷羅市的一座小型建築物中,一個透明艙室中的患者正在吸著純氧。
The procedure, known as hyperbaric oxygen therapy, uses a pressurized chamber to help scuba divers overcome the bends. But Dr. Paul G. Harch offers it as aconcussiontreatment.
這項療程稱為高壓氧治療,主要是使用加壓室協助深水潛水員克服減壓症(潛水夫病)問題。但保羅.G.哈奇是用它來進行腦震盪的治療。
One patient, Rashada Parks, said that she had struggled with mood swings ever since she fell and hit her head more than three years ago.Antidepressantshadn'thelped her. But after 40 hourlong treatments, or dives, her symptoms have subsided.
病患蕾莎達.帕克斯說,3年多前她跌傷頭部後,一直為情緒陰睛不定所苦。抗憂鬱藥物對她並沒有幫助。然而在經過40小時的治療,或稱為潛水後,她的症狀減輕了。
Three studies run at a cost to American taxpayer of about $70 million have all found that the benefits of hyperbaric oxygen reported by patients may have resulted from a placebolike effect.But advocates of the treatment recently persuadedAmericanlawmakers to spend more money investigating whether the studies were flawed.
花費美國納稅人7000萬美元的3項研究均發現,病患所說的高壓氧好處可能只是類似安慰劑的效果。但這項治療的倡議者最近說服了美國國會,同意再投注一些經費去查明前述這些研究是否有瑕疵。
A growing industry has developed around concussions. An estimated 1.7 million Americans are treated every year after suffering concussions from falls, car accidents, sports injuries and other causes. While the vast majority quickly recover with rest, a small percentage of patients experience lingering effects a year or longer afterward.
Along with memory issues, symptoms can include headaches,dizzinessand vision and balance problems.
研究腦震盪的產業正在持續成長中。每年約有170萬美國人因為跌倒、車禍、運動傷害及其它原因所產生的腦震盪而接受治療。儘管絕大多數的人可在休息後復元,卻有極小比例的病患在1年或更久後,仍有揮之不去的一些症狀。除了記憶問題外,其他症狀還包括頭痛、暈眩、視力和平衡問題。
Over the last decade, the United States Defense Department has spent more than $800 million onbrain injuryresearch. And as people become more aware of the debilitating long-term consequences of repeated concussions, businesses have been chasing salable solutions.
10年來,美國國防部已花費逾8億美元從事腦損傷研究。隨著人們越來越意識到反複性腦震盪可能帶來身體衰弱的長期後果,許多公司一直在尋找具有市場價值的解決方法。
The search for ways to treat and prevent concussions has spawned screening tools, helmet sensors and brain imaging devices. But as the industry booms, medical experts are raising concerns that it is a business where belief frequently outruns fact.
在尋找治療和預防腦震盪療方之際,篩檢工具、頭盔感應器和腦成像裝置也應運而生。但隨著這項產業蓬勃發展,醫學專家也表達了他們的關切,憂心這項產業經常是信念勝於事實。
Not long ago, the field of brain injury research was small. Little attention was paid to concussion, which is also called mildtraumatic brain injury. That changed after reports showed that hundreds of thousands of American service members were returning from Iraq and Afghanistan impaired by concussions caused by battlefield blasts and accidents.
直到不久前,腦損傷領域的研究仍然不多。很少人注意到也稱為輕度創傷性腦損傷的腦震盪。但情況有了改變,因為報告顯示,從伊拉克和阿富汗返回的美國軍人有數十萬人承受戰場爆炸、意外等引起的腦震盪之苦。
In 2007, Congress allocated $600 million for research and treatment, splitting the funds between traumatic brain injury andpost-traumatic stress disorder, or PTSD.
2007年,美國國會撥款6億美元作為研究與治療之用,這些經費分別用於研究創傷性腦損傷以及簡寫為PTSD的創傷後壓力症候群。
Dr. David X. Cifu, a professor at Virginia Commonwealth University in Richmond who also works for the Veterans Affairs Department, said that the government funds spawned a research feeding frenzy. "It was a small field that got amazingly large because a lot of people were making stuff up and claiming things," Dr. Cifu said.
里奇蒙維吉尼亞聯邦大學教授,也在退伍軍人事務部任職的大衛.X.西夫博士說,政府的經費引發研究發表潮。西夫說:「它是很小的領域,卻變得大得驚人,因為許多人開始無中生有,聲稱獲致某些結果。」
Some specialists said they believed the military's approach to concussions suffered from a basic problem.
有些專家說,他們認為軍方對腦震盪的處理方式有一個根本的問題。
While agreement exists on the symptoms that define a concussion at the time when one occurs, a similar definition did not exist to describe what happens after a concussion, including how the injury's symptoms change over time.
儘管醫界對腦震盪發生時,用來界定腦震盪的那些症狀具有一致觀點,但對於用來形容腦震盪後發生的事,包括隨著時間改變,這項傷害的症狀會出現何種改變等,觀點卻並不一致。
In addition, many soldiers who are diagnosed with a mild brain injury also have PTSD, a condition with symptoms similar to those associated with a concussion.
此外,被診斷出有輕微腦損傷的許多軍人,同時也出現創傷後壓力症候群,而後者的症狀和腦震盪類似。
A few years ago, a major producer of football helmets, Riddell, announced that it was on the trail of a way to reduce injuries by using electronic impact sensors to monitor head blows.
幾年前,美式足球頭盔大生產商「里德爾」宣布,該公司正在研究利用電子碰撞感應器監控頭部撞擊,藉以達到降低傷害的目的。
The National Football League was so enthusiastic about the potential that it studied the performance of impact sensors in the Riddell helmet in eight N.F.L. games. But the league ended the experiment, saying the data produced was too crude to be of value.
美國「國家美式足球聯盟」非常熱衷這項研究的潛力,在聯盟的8場賽事中從事這項撞擊感應器功效的研究。但聯盟已對這項實驗喊停,表示感應器產生的資料過於粗糙,沒有價值。
The end of the N.F.L's field test, however, hasn't dimmed enthusiasm for sensors among coaches and parents.
聯盟的實地測試雖已結束,教練和父母對感應器的熱情並未被澆熄。
In the fall, players on several college football teams will wear mouth guards equipped with sensors made by i1 Biometrics.
今年秋天,數支大學美式足球隊將戴著配備有感應器的護口器上場,感應器由「伊爾生物識別技術」製造。
As with much in the concussion business, experts are still uncertain whether the data will result in fewer concussions or simply create statistical noise.
和腦震盪產業的多數公司一樣,專家仍不確定這些數據會帶來減少腦震盪的結果,或徒然製造一些統計上的噪音。
Medical experts say that in some ways, the search for new approaches has returned to the starting line. A concussion expert with the Mayo Clinic in Phoenix, Arizona, Dr. David W. Dodick, said he believed a cheap nutritional supplement, N-acetylcysteine, could help treat concussion symptoms, and he hoped to study it.
醫學專家說,就某些方面而言,尋找治療腦震盪新方法的研究又回到原始的起跑線上。亞歷桑那州鳳凰城梅約診所腦震盪專家,大衛.W.杜迪克說,他相信一種廉價的營養補充,亦即N-乙半胱氨酸,有助治療腦震盪症狀,他希望能做這項研究。
It would not be the first time that the supplement has been tested for that use. In 2008, the United States Defense Department began a study of it in soldiers in Iraq who had sustained a concussion. That trial showed benefits, but Dr. Dodick said that a dispute about the trial overshadowed a possible breakthrough and that N-acetylcysteine might be a valuable tool.
這將不是前述營養補充品頭一次被拿來做這項用途的實驗。2008年,美國國防部對發生腦震盪的伊拉克軍人展開這種補充品的研究。那項實驗顯示若干好處,但杜迪克指出,那項實驗引發的爭論使得這種補品可能帶來的突破遭到忽視,而N-乙半胱氨酸可能是很有價值的工具。