OTIS筆試題

OTIS筆試題

　　OTIS筆試題

　　全英的

　　Please read the following two sections and complete the questions within

　　40 minutes.

　　Section 1:

　　Doctors Divided Over Heart Pills

　　A group of drugs now being marketed in the United States under a variety of brand names have been probed to reduce deaths among heart-attack survivors by more than 40% over five years. The drugs are collectively known as statins, and are currently being taken by over 10 million Americans. Doctors are currently wondering if statins will be just as effective in preventing heart attacks in people who do not necessarily fit the profile of a “high-risk” patient.

　　The people the doctors are targeting for possible prescription of statins are those whose LDL, or “bad” cholesterol, is somewhat high, or their HDL, or “good” cholesterol is a little low. Again, maybe they have diabetes, which commonly leads to cardiovascular disease, but do not yet show symptoms of the latter. A study report in the British Medical Journal concluded that statins could reduce by 30% the risk of dying from a heart attack, even among people with normal cholesterol levels and no signs of cardiovascular disease.

　　Leading pharmaceutical companies have gone so far as to petition the US Food and Drug Administration (FDA) to allow consumers to buy some low-dose statins without having to first obtain a physician’s prescription, or “over the counter”.

　　Statins work by partly blocking an enzyme, known as HMG, found in liver that turn some of the food that you eat into cholesterol. The body, in fact, needs some cholesterol to produce hormones and Vitamin D. Excess cholesterol builds up in the arteries, reducing the blood flow and increasing the danger of heart disease. By slowing down the function of the HMG enzyme, statins reduce the amount of cholesterol entering the blood stream, and force the body to draw on the cholesterol already in the arteries to make up the shortfall in its needs. Thus, there is a regular clearing out of cholesterol from the arteries. Doctors emphasize that statins work best when a person adopts a low-fat diet.

　　There are, however, certain drawbacks to statins. Apart from the fact that they are expensive-about $3 per pill, and you would presumably have to take them for the rest of your lifethey can cause liver damage or a breakdown of muscle tissue. Anyone taking statins needs to undergo periodic blood tests to check for signs of liver trouble. Most people on the pills report no complaints; those who do commonly list fatigue as the major side-effect.

　　Companies manufacturing dietary supplements became interested in statins when it was discovered that Chinese red yeast fermented on rice contains small amount of the same active ingredient found in statins. They then made a dietary supplement containing this ingredient and publicized it as a wonder drug for preventing heart attacks. The FDA banned its sale over the counter, and the two sides are still locked in a lengthy court case.

　　In the meantime, another intriguing possibility has convinced doctors that making statins more freely available may be a good thing. Research has shown that taking an aspirin a day can reduce a heart patient’s risk of suffering a heart attack. Would combining aspirin with a statin have a powerful effect in preventing heart disease? Similarly, many cardiologists are impressed by the ability of a group of drugs called ACE inhibitors to normalize high blood pressure and reduce the strain on the heart. Do they work better alone, or would a combination of ACE inhibitors and statins enhance their efficacy?

　　2

　　Please give your own opinion on the topic below within 30 minutes.

　　Some people prefer to stay in the same job for the same company, but others prefer to change jobs frequently. You should use specific reasons to compare the advantages and disadvantages of both sides.

　　(轉自華南木棉BBS)

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