HealthKey

Sahara dust cloud: what health complications can it cause and what recommendations are there to protect yourself

2020-06-28T11:24:00.002+05:00

The dust cloud hit Puerto Rico this week.

On their usual journey of thousands of kilometers from North Africa, dust particles from the Sahara desert have already reached this week in southeastern Mexico and several Caribbean countries.

Every year, more than 100 million tons of Saharan dust is lifted from the desert, according to the US National Oceanic and Atmospheric Administration, and much of it reaches Europe and America.

According to Olga Mayol, an expert at the Institute of Tropical Ecosystem Studies at the University of Puerto Rico, the current cloud has the highest concentrations of dust particles observed in the region in the last half-century.

What is the phenomenon behind the "massive" dust cloud of the Sahara that traveled 10,000 km from Africa and is already affecting Mexico

From the Sahara to the Amazon: 4 fascinating impacts of desert dust that travels thousands of kilometers to reach Latin America

And although it is a common phenomenon, which even has beneficial effects on ecosystems such as that of the Amazon, this year it has added to health concerns due to respiratory problems related to the new SARS-CoV-2 coronavirus.

Upon reaching Mexican territory, the leader of the government's strategy for the pandemic, Hugo López-Gatell, asked the population of the southeast of the country on Wednesday to take precautionary measures.

The huge cloud of dust travels from North Africa to America and Europe.

"The particles are between 2.5 and 10 microns in size, which are the respirable particles. Then, they can enter through the nose and mouth when breathing and lodge in the trachea, in the bronchi, or even get smaller than 2, 5 to the terminals, bronchi, and alveoli in the lungs, "explained the epidemiologist. Dust clouds often affect people who already have chronic respiratory diseases, such as asthma, emphysema, or chronic bronchitis, which are part of Chronic Obstructive Pulmonary Disease (COPD). How our immune system works and how it fights the coronavirus And these people are more vulnerable to complications if they catch the new coronavirus. More than just dust The World Health Organization (WHO) explains that the danger of this phenomenon "lies in the content of bacteria, viruses, spores, iron, mercury and pesticides that dust presents."

In addition to sand particles from the Sahara, the cloud carries other elements present in the environments it passes through.

And it is that when the winds in the desert of North Africa lift sand, they collect pollutants when passing through deforested areas of the region, mainly from sub-Saharan countries.

"Savannas, prairies and forests": what the Sahara was like before it became one of the largest deserts on the planet

"These storms, when they are able to concentrate and reach populated areas in Europe and America, can provoke the appearance of allergies and asthmatic crises in many people," explains the WHO.

The cloud has touched Caribbean countries on its way to the southern United States,

People with respiratory problems or immunosuppression, who in turn are the most vulnerable to COVID-19, are usually the most affected.

"Cases of persistent 'flu' or allergies without apparent cause are often referred to, which may have been caused by contact with particles of biological origin present in these mists," says the WHO.

What is recommended to do?

Ideally, avoid prolonged exposure to Saharan dust, so the general recommendation is to stay indoors when these clouds are present.

The greatest care should be taken by people who have problems with the COPD group, as well as older adults, pregnant women, and children say the WHO.

Havana, Cuba, registered the presence of Saharan dust on June 24.

He recommends using facial protectors, such as face masks or a damp cloth handkerchief that completely covers the nose and mouth.

"If you have a sensation of foreign bodies in the eyes, wash them with plenty of water. It is preferable to use potable, boiled, or chlorinated water. Wash your hands before starting the procedure," she adds.

It is also important to cover water sources (wells, containers, or ponds) to avoid contamination. And moisten the floor before sweeping to prevent dust from re-suspending.

The general recommendation is to avoid exposing yourself to Saharan dust for long periods.

Coronavirus | What is dexamethasone and how it works

2020-06-21T10:10:00.000+05:00

The knowledge that the anti-inflammatory drug dexamethasone can significantly help in the treatment of Kovid-19 patients with a severe clinical picture is considered a great discovery in research aimed at effectively fighting the coronavirus. British research has shown that this steroid could save lives - the first such drug - and that it can be used immediately in treatment.

Coronavirus: Anatomy of a pandemic Coronavirus: This is not the last pandemic What kind of medicine is that? Dexamethasone is a steroid - a drug that reduces inflammation by mimicking the hormones that the body secretes in that fight. How does it work?

Coronavirus infection creates inflammation, so the body tries to fight it. But the immune system is sometimes overloaded and such a reaction can often be fatal. The reaction that is supposed to attack the infection starts to attack the cells that only the body produces. Dexamethasone calms this effect. However, this medicine can only be used for patients who are in the hospital and are connected to oxygen or respirators - patients with a severe clinical picture. The drug does not work on people with milder symptoms, because suppressing the immune system in that condition would not be helpful.

How effective is it?

According to the scientists who conducted the research, one in three deaths can be prevented among patients on respirators. For those connected to oxygen, it can prevent one in five deaths. There is no significant effect on patients who do not have difficulty breathing.

When was the research done?

The results are the conclusion of the Recovery study (Randomized Evaluation of Covid-19 therapy -), conducted by the University of Oxford. It was tested whether existing drugs used in the treatment of other diseases could be helpful against Kovid-19. About 2,100 patients received a dose of six milligrams of dexamethasone over a 10-day period. Everything about the coronavirus - in small doses A life-saving drug - a big step forward in the fight against coronavirus

Their progress was compared with a random sample of 4,300 patients who did not receive therapy. Scientists hope that dexamethasone could be used as part of a therapy that, in combination with other drugs, would further reduce mortality. It is now recommended for adults, but not for pregnant women or mothers.

How much medicine is available?

Dexamethasone is a cheap drug that already exists and is available in sufficient quantities. It was first made in 1957, and its widespread use began in 1960. Because it has been on the market for so long, the drug is not patented, which means that several different companies can produce it. This is especially good news for developing countries and the World Health Organization has praised the results of the research,

What other ailments is it used for?

The drug helps in the treatment of various diseases that accompany inflammation or swelling of the body or those conditions in which the immune system is overloaded. For example, it is used in severe forms of asthma that can cause inflammation of the airways or lungs and severe allergic reactions. Dexamethasone is also useful in autoimmune diseases such as rheumatoid arthritis or lupus when the immune system mistakenly attacks the body.

Are there any side effects?

Common side effects in the treatment of other diseases are anxiety, difficulty sleeping, weight gain, and inability to urinate. There are rare cases of changes in the eyes, blurred vision, and bleeding. However, Kovid-19 patients were given only a small dose that should reduce side effects. A study in England showed that there were no side effects among patients receiving dexamethasone therapy.

Coronavirus: When the pandemic will end and life will return to normal

2020-06-21T09:54:00.000+05:00

The whole world stopped.

Places once teeming with life became ghost towns with strict bans - from city blockades, through school closures, to travel restrictions and bans on mass gatherings.

It is an unprecedented global reaction to a disease. But when will it all end and when will we be able to return to ordinary lives? British Prime Minister Boris Johnson stated that he believes that Great Britain can "turn the tide" against the epidemic in the next 12 weeks and that the country can finally "say goodbye to the coronavirus". Coronavirus - five things you need to know Coronavirus: What are the chances that I will die if I become infected Coronavirus: How to protect yourself, However, even if the number of cases starts to decrease in the next three months, we will still be far from the end. It could be quite sometime before that tide recedes - maybe even a whole year. It is obvious that the current strategy of closing large segments of society is not sustainable in the long run, the social and economic damage would be catastrophic. Countries need an "exit strategy" - a way to lift restrictions and get everything back to normal. But the coronavirus will not go away on its own ...

If you lift the restrictions that curb the virus, then the number of cases will inevitably skyrocket. "We have a big problem in devising an exit strategy and how to get out of all this," said Mark Woolhouse, a professor of viral disease epidemiology at the University of Edinburgh.

"No country has exit strategy."

It is a huge scientific and social challenge from which there are essentially three ways out: vaccination that enough people develop immunity after becoming infected or a permanent change in our behavior/society.

Vaccines - at least another 12-18 months

The vaccine should give people immunity so that they do not get sick if they are exposed to the disease.

Immunize enough people, about 60 percent of the population, and the virus cannot cause epidemics - a concept known as collective immunity.

The first person received an experimental vaccine in the United States this week after the researchers were allowed to skip the usual rule of performing previous tests on animals.

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The search for the vaccine has been going on at an unprecedented rate, but there is no guarantee that it will be successful and will require immunization globally.

The closest estimate is that it will separate us from the vaccine for another 12-18 months if everything goes smoothly. It is a long time to wait when you face inviolable peacetime social limitations.

"Waiting for the vaccine should not be called a strategy, it is not a strategy," Professor Woolhouse told the BBC.

Natural immunity - at least two more years

The British short-term strategy is to suppress the number of cases as much as possible in order to prevent hospital overload - when you run out of beds in intensive care, the number of deaths immediately starts to jump. Once the number of cases has been suppressed, this would allow some measures to be lifted for a certain period of time - until the number of cases jumps again and a new round of restrictions has to be introduced. When that could happen is still uncertain. Britain's chief scientific adviser, Sir Patrick Valence, said that at this point, "setting absolute deadlines for anything is not possible." What to do if you experience symptoms of coronavirus Coronavirus: What if the elderly do not accept the advice The devastated sky - how the coronavirus landed planes around the world This tactic can, unintentionally, lead to collective immunity as more and more people become infected with the disease. But for that to happen, it could take years, says Professor Neil Ferguson of Imperial College London.

But the big question mark is whether that immunity would last. Other coronaviruses, which cause cold symptoms, lead to a very weak immune response, and people can become infected with the same disease several times during their lives.

Alternatives - no clear deadline

"The third option is permanent changes in our behavior that allow us to keep the rate of disease transmission low," says Professor Vulhaus. This could mean keeping some of the measures that have already been introduced. Or the introduction of strict testing and isolation of patients in order to prevent the outbreak of any epidemics. "We worked in the first attempts at early detection and contact search, and it didn't work out," adds Professor Vulhaus. Developing drugs that would successfully treat Kovida-19 infection may help with other strategies. They could be used as soon as people show any symptoms in a process called "disease control" to prevent transmission. Or that patients are treated in an ordinary hospital to make the disease less deadly and to reduce the pressure suffered by intensive care. This would allow countries to deal with more cases before they have to reintroduce blockades. Increasing the number of beds in intensive care would have a similar effect because it would then increase the capacity to cope with larger epidemics. I asked the chief British medical adviser,

Good or bad meat

2020-01-19T21:53:00.000+05:00

In the West, there are a large number of studies showing that meat in food is divided into two types, one that is good for the body and one that is harmful to the body. Most people understand the reason, but we still need some more specific data to support this view.

A study published in March 2009 confirmed what has been worrying about: eating more red meat and processed meat can increase the incidence of cardiovascular and cerebrovascular diseases and shorten lifespan. Red meat refers not only to beef but also pork and lamb. After investigating 500,000 different people, the researchers found that a group of people who ate a red meat burger every day had a mortality rate that was 30% higher than that of other people, and most of them died of heart disease and cancer. In addition, sausages, cold meats, and other processed red meats also increase mortality. Compared to red meat, people who eat white meat such as fish, chicken, turkey and other poultry have lower mortality rates.

Meat is good or bad, maternal and child health magazine article, doctor column about the benefits and disadvantages of meat to the body, all related disputes are centered around the ratio of "good fat" and "bad fat". Everyone must have heard the debate between trans fats, which are harmful to the body, and relatively healthier cis fats. In fact, there are similar disputes between omega-3 fatty acids and omega-6 fatty acids. Both of these can be obtained by ingesting fat in food. Omega-3 is an essential fatty acid in the human body and is considered a healthier fatty acid. It has the effect of lowering cholesterol and preventing cardiovascular diseases. Flaxseed oil, dried fruits such as walnuts, kiwi fruits, and greasy cold-water fish such as salmon, mackerel, and sardines all contain higher omega-3 fatty acids. Omega-3 fatty acids are mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is contained in plants such as flax, which is an omega-3 fatty acid that can be partially converted into EPA and DHA in the human body. ALA can play an anti-inflammatory role in the body and is also very healthy for the body. In general, fish oil has higher levels of EPA and DHA than plants such as flaxseed.

Another fatty acid is an omega-6 fatty acid, which is also an essential fatty acid. If the intake is reasonable, it is good for the body, but if it is ingested in large amounts, it may cause cell function disorders and increase the probability of disease. The ratio of ω-3 to ω-6 is of great significance to human health. Until the 19th to 20th centuries, the proportion of omega-6 fatty acids and omega-3 fatty acids in the human diet was between 1: 1 and 4: 1, and people with this diet had a very high incidence of heart disease. In the 20th century, with the rapid development of the industrialization of cattle farms in western countries, the incidence of heart disease is also increasing. Compared with ordinary cattle, cattle that eat corn have twice as much omega-6 fatty acids, and many researchers agree that this is one of the important reasons for the increase in the incidence of heart disease in Western countries. This aspect is not relentless in the West). Cattle raised in huge farms consume unnatural grains and corn, and they have a higher proportion of omega-6 than grass-fed cattle on traditional farms (4: 1 to 2: 1). Omega-6 to omega-3 ratios in Western diets range from about 10: 1 to 20: 1!

Here are 5 basic elements of meat selection:

1. White meat is better than red meat.
2. Lean red meat is better than fat red meat.
3. If you are used to eating fat red meat every day, try to reduce it to 2-3 times a week.
4. Beef eating grass is healthier than beef-eating cereals and corn.
5. The meat of free-range livestock is healthier than that fed on large farms.

Revive Your Boring Salads With These Original Condiments

2019-10-27T12:27:00.001+05:00

Revive your boring salads with these healthy and delicious seasonings, with ingredients from our favorite superfood brand, BareOrganics!

CHIPOTLE SEASONING WITH AVOCADO FOR SALAD
salad dressings Ingredients:

1 tablespoon of coriander, chopped

1 large avocado, past

4 tablespoons of lime juice

½ teaspoon of BareOrganics Cayenne Pepper

1 teaspoon BareOrganics Super Marine herbs powder

115g of Greek yogurt

1 chipotle pepper moistened in adobo, passed

Preparation:

Pass the avocado and chili in a blender or food processor until a smooth consistency is achieved.
Pour the mixture and all the other ingredients into a medium-sized bowl.
Mix well, add salt and pepper to taste.
Add to your favorite salads. Store leftovers in the refrigerator.
Portions: 2-3

DEA GREEN SEASONING FOR SALAD
salad dressings Ingredients:

1 teaspoon of BareOrganics Spinach powder

2 tablespoons of fresh sage, in small pieces

½ large avocado, past

2 tablespoons of lemon juice

2 tablespoons of basil, chopped

115g Greek yogurt

Preparation:

Pass the avocado and chili in a blender or food processor until a smooth consistency is achieved.
Pour the mixture and all the other ingredients into a medium-sized bowl.
Mix well, add salt and pepper to taste.
Add to your favorite salads. Store leftovers in the refrigerator.
Portions: 2-3

GREEN SEASONING FOR SALAD
salad dressings Ingredients:

60ml of extra virgin olive oil

60ml of apple vinegar

2 tablespoons of lemon juice

2 teaspoons of BareOrganics Barley Grass powder

1 teaspoon of tahini

Salt and pepper to taste

Preparation:

Combine all the ingredients and mix well in a small bowl. Serve with salads or as a sauce.
Store leftovers in the refrigerator.
Portions: 1-3

SEASONING WITH CURCUMA AND ALMONDS
salad dressings Ingredients:

2 teaspoons of BareOrganics turmeric root powder

1 (2.5cm) piece of fresh, peeled and chopped ginger

1 clove of garlic, in pieces

80ml of fresh lemon juice

3 tablespoons of natural almond butter

1 tablespoon of agave nectar

¼ teaspoon of pepper

Preparation:

Combine all the ingredients with 3 tablespoons of water in a blender and blend until a smooth consistency is obtained, for about 3 minutes.
Taste and add pepper or lemon to taste.
Portions: 6

Tired of the usual salads? Take a look at this delicious recipe for preparing vegan dishes, or these nutritious vegan recipes full of vital nutrients, and make sure you always have one of these snacks with you to satisfy your stomach cramps during the day!

A partner's behavior that can drive you to depression

2019-10-26T10:01:00.001+05:00

Most of us expect the relationship to be unconditional love, accompanied by feelings of security and security. But it doesn't always happen. A great crush can become a great affliction that can end in depression. See with us what partner behavior can help.

1. When it shows too much its dominance
The partnership should be based on a balance between the partners. As soon as one of them is more dominant and manipulates the other, it goes without saying that the other will not feel comfortable in the long run. No one wants to be controlled and underestimated in all respects.

2. Eternal critic
The long-term feeling, whether you do what you do or not like it anyway, can knock everyone's self-confidence and confidence down. Criticism is simply not the same as feedback.

3. Always tells you what to do

If your partner constantly dictates what you should and should not do, and at the same time makes it clear to you that without it you would not do anything at all, then it will not give you much confidence. Depression arises from a feeling of low self-confidence and confidence.

4. He's trying to control you
Once a man begins to determine how to handle your time, finances or friends and loved ones, it will certainly not bring you happiness. Especially when he adds the constant hunching for things not to his liking.

“Remember, depression is a power disorder. If your partner takes away the power to make your own decisions, or at least participate in joint decision making, this is the quickest way to induce depression, ”warns psychologist Susan Heitler on her blog.

5. When your husband must always be "right"

Once your husband has to be right at all times and is unable to admit his own failure or accept the opinion of another, it does not bode well. Life next to such a man is certainly not simple or happy.

6. When a partner is interested only in his own journey and goal
If you do not work as a team in a relationship and everything revolves around the plans and goals of one of the partners, it is difficult to achieve any harmony of life. And it does not have to be just big plans, but also things like what will be dinner tonight, how we spend the weekend.

7. If the partner is depressed
Depression is contagious. If one of the partners tends to see the world with dark glasses, it is very difficult not to see it over time.

8. When a man is constantly irritated

Everyone has a reason to be irritated and irritable once in a while, but once it's basically permanent, it's hard for the neighborhood to take it with a smile on your lips for a long time.

9. If the partner is offensive and related
Once you have to step around your partner and be in constant stress, so that he is not personally touched by the things you talk about or do, then you can hardly stand in the long term.

And the question is whether you should ever want to stop doing this, because such behavior is simply incompatible with a loving relationship.

10. If your partner is not actively involved in building a nice relationship
You may have a self-sufficient man at home, but if everything about your relationship is up to you, you will never be happy in the long run.

Partners should support each other, pamper themselves, help each other and enjoy joint activities. But if only one side tries to do it, then, instead of joy, she will be overcome by the weight that she has put on her shoulders.

Contraception may increase the risk of depressive conditions in young girls

2019-10-26T09:56:00.000+05:00

The discovery of hormonal contraception was a great advance. It is one of the most reliable ways to prevent unwanted conception. Like other medicines that help, however, contraceptives have some unpleasant side effects, although manufacturers try to reduce them as much as possible. Among other things, young girls may, for example, increase the risk of depressive states.

At first, many negatives were associated with the development and improvement of contraception. In connection with its use there has been talk of a possible risk of breast cancer, blood clots or weight gain.

These and many other possible negatives are repeatedly eliminated by manufacturers, but according to experts, the fact remains that some of the negatives may still be there.

For example, contraception may have a greater impact on mood and mental well-being, especially for young users, says Independent.
In recent days, experts from several major institutions (Brigham and Women's Hospital in Boston, the Center for Clinical Medicine in Groningen, the Netherlands, and the Hospital in Leiden, the Netherlands) have also come up with new information confirming this fact.

Influence on young girls
In a study published in the journal Jama Psychiatry, researchers reported that in a group of 17-year-old girls and women under 25 years of age, most of the 1,000 volunteers did not find any significant linking factor to suggest a link between oral contraceptive use and depressive symptoms.

However, this is not true of younger girls, specifically 16 years old. For those who have already used contraception at this age, scientists have found a significantly higher incidence of depressive symptoms than those who have not used it at the same age.
“Most women using contraception started her at a teenage age. However, teenagers are undergoing various emotional changes during this period, which is why many mothers are concerned about the mental state of their daughters who start contraception. That is why everything needs to be examined in detail, ”says Anouk de Wit.

"Early symptoms of depression are increasingly visible in young people and can significantly affect their quality of life," explains Hadine Joffe, co-author of the study.

"In any case, it is important that the parents of the users, the users themselves and the health care professionals be aware of the possibility of depressive symptoms that can affect the quality of life and the regularity of contraception," Wit said.

What is diabetes?

2019-10-26T09:46:00.001+05:00

Diabetes prevents the body from properly using sugar as a source of energy.

Diabetes is a chronic disease that can not be cured, but can be treated and controlled. It is caused by a lack or lack of use of a hormone called insulin.

Insulin is produced by the pancreas. It allows glucose (sugar) to enter the body's cells for use as a source of energy. In a non-diabetic person, insulin performs well and cells have the energy they need to function.

When there is a lack of insulin, or when it does not perform its function effectively, as is the case in a person with diabetes, glucose can not be used as a fuel for cells. It then accumulates in the blood and causes an increase in sugar level (hyperglycemia).

In the long run, high blood sugar causes complications, including eye, kidney, nerve, heart and blood vessel complications.

There are different types of diabetes: prediabetes, type 1 diabetes, type 2 diabetes, pregnancy diabetes and other rarer types.

Resistant depression: why antidepressants do not always work and what alternatives science offers in those cases

2019-10-12T10:27:00.000+05:00

Considered the evil of the 21st century, depression affects about 4.4% of the world's population and is the leading cause of disability, according to the World Health Organization (WHO). In a decade, between 2005 and 2015, the number of people with this disorder increased by 18.4% worldwide, according to the latest WHO report on the subject. In Brazil alone, 5.8% of the population suffers from the disease, the highest rate in the Latin American continent. Although there are several pharmacological therapies and effective psychological treatments for this disease, in a portion of those who suffer depression - between 10% and 30% - have little or no effect. These people have what is called treatment-resistant depression, also known as refractory depression. What is "smiling depression" and why is it more dangerous than the other types "This occurs when a patient, after following a treatment with two different classes of antidepressants for more than six weeks in therapeutic doses, does not present any improvement," explains psychiatrist Wagner Gattaz, coordinator of the Neurosciences Laboratory of the Institute of Psychiatry ( IPq) of the University of Sao Paulo (USP). According to the doctor, the causes are not yet fully known, just as those of depression itself are not known. On Mental Health Day, we tell you what this type of depression consists of. Individual variety One possible explanation is the great individual variability in the destination of the drug after taking it. "This variability begins in the stomach and intestine, which determine how much of the medicine will be absorbed and will pass into the bloodstream. Some people absorb more, which guarantees them a better result, and others less," he says. There are also individual differences when the medicine reaches the brain. "The goal of antidepressants is nerve connections, in which different neurotransmitters predominate, such as serotonin, norepinephrine and dopamine. But both the production of these neurotransmitters and the sensitivity of their receptors vary from person to person." Apart from that, there is individual variability in the speed with which drugs are metabolized in the liver. "What if I told you that depression also has its charm?": Wilfrido Vargas talks about a condition that has haunted him all his life about 70% of people metabolize these drugs at a normal rate. The remaining 30% can do it very quickly, without giving it time for the medicine to take effect; or slow, which causes the drug to accumulate in the body and cause a series of side effects. "We know that factors related to pharmacokinetics (the science that studies the path of medications in the human body from ingestion to excretion) and pharmacodynamics (the study of the mechanism of action of medications with their receptors) determine the differences in the response and reaction to antidepressants among people, "adds Gattaz. Antonio Geraldo da Silva, president of the Latin American Psychiatric Association (APAL) and superintendent of the Brazilian Psychiatric Association (BPA), highlights another hypothesis to explain resistance to depression treatments. "We have basically available the antidepressants' selective serotonin reuptake inhibitor ',' selective norepinephrine reuptake inhibitor ',' dual ',' dopaminergic ',' tricyclic ',' tetracyclic ',' monoamine oxidase inhibitors ',' melatoninergic 'and' lithium carbonate ', which is used as a mood stabilizer but also has antidepressant action. " "When the patient does not respond to any of them, alone or in combination, it may be because in his case the medication would need to act with some other brain substance that we do not know or identify," he explains. What may also compromise the outcome of treatment are associated with diseases, such as thyroid disorders, chronic pain and bipolar disorder, and the combined use of other medications. Treatment strategies Although resistant depression is a bit more difficult to treat, there are tools. One of them is the pharmacogenetic test, which performs a DNA analysis to see which medications are most suitable for each person and which ones they will have an intolerance. "This test increases the probability of getting the medication right, it gives us an orientation to adjust the dose," says Gattaz. It can be done by collecting saliva or oral mucosa, or a blood sample. What is dystonia and why could it be the reason you don't want to get up in the morning "Here (in Brazil) we do it through the blood. We observe the genes in the group of cytochrome P450 enzymes responsible for the metabolism of drugs in the liver, and we can identify a priori if the patient is an ultrafast or slow metabolizer," says the IPq-USP specialist, In addition, there are somatic therapies, which must be associated with drug therapies. One of them is transcranial magnetic stimulation (EMT), a non-invasive technique that stimulates the brain with magnetic waves by modulating neurotransmitters. To obtain a good result, 20 sessions are held, initially daily. "The application is done with the patient awake and from the session number ten you begin to see an improvement," says Gattaz. Another option is electroconvulsive therapy (ECT), which, through a low electrical current, induces seizures and, therefore, causes chemical changes in the brain. "This method causes depolarization of the neuronal membrane, opening channels of communication between neurons," says Silva, from ABP. The problem, however, is that this therapy is sometimes seen as a form of punishment. "However, it is safe and its therapeutic success has been highlighted by several studies," adds Silva. In ECT, the application is performed with the anaesthetized patient. They are held from 9 to 12 sessions, two or three times a week. "Some people show signs of improvement in the first session, but for the effect to be complete, all treatment must be done," says the doctor. It should be noted that both EMT and ECT are not indicated in all cases, and only the psychiatrist can assess the need individually. Another possible therapy is the use of a nasal spray of ketamine, a substance derived from anaesthetic ketamine. "It has ultra-fast action and good tolerance," says Gattaz. To get an idea, while the pills take between two and three weeks to work, this medication is effective within 24 hours after the first application. Its mechanism of action is different from traditional antidepressants. While traditional antidepressants increase pleasure-related neurotransmitters, the spray acts on glutamate, a molecule of the neural network, by stimulating areas of the brain that are linked to emotions. In the United States, this medication was approved in March this year by the Food and Drug Administration (FDA), the food and drug regulatory and regulatory body. There it is only administered under medical supervision.

Oral and dental health in the elderly

2019-10-12T10:15:00.000+05:00

For oral health, there is a significant impact on the quality of life, from maintaining a healthy daily functioning that includes eating, talking, socializing and even preventing pain and lack of comfort. The treatment and prevention of oral diseases in the elderly are also important to improve the general feeling and health in general. Research from recent years shows a link between oral health and chronic diseases, such as heart disease, stroke and diabetes. Adopting proper habits, maintaining a healthy diet and regular medical follow-up can help preserve teeth for a lifetime, including natural teeth, implants or artificial dentures. Dental problems in the elderly Improper oral hygiene - As a result of poor public health and limited mobility or in mind, it may be difficult to carry out the actions required to maintain oral hygiene. Periodontal disease - Periodontal disease is a contamination of the tissues supporting the teeth. Gum disease can lead to bleeding from the gums, bad odour from the mouth, the appearance of dental roots, osteoporosis and even tooth loss. Also, gum disease has an impact on chronic diseases such as heart disease, stroke and diabetes. Tooth decay - the risk of caries increases in the older generation due to the emergence of dental roots due to erosion of the gums, frequent old and incorrect restorations and dry mouth due to taking medication or after chemotherapy and radiation. Fungi - Fungi of the oral cavity can appear in people who wear partial or complete prostheses. Moreover, the continued use of antibiotics or steroids, diabetes, inhibition of the immune system, dry mouth and disorganized nutrition increase the risk of fungi in the oral cavity in the elderly. Soft tissue injuries - People who wear partial or complete prosthetic teeth may suffer injuries under artificial teeth. Most likely to talk about a wound due to friction of artificial teeth, not fixed in the mouth. Injury can occur in two basic forms: an ulcer (wound) or additional tissue growth. Oral cavity cancer - Older people (over the age of 60) have a higher risk of developing cancer in the oral cavity. The risk increases if a person smokes and/or consumes alcohol or is permanently exposed to sunlight. Possibilities for rehabilitation in case of loss of teeth Retractable dentures - dentures that mimic the natural denture and are an alternative, aesthetic and functional, for missing teeth. In general, prosthetic teeth are divided into two basic types: Complete prosthetic teeth - provides a solution to the complete loss of teeth in one or both jaws. Partial prostheses - intended to complete several missing teeth in the mouth. Prosthetic teeth over implanted teeth - when there are no teeth implanted in the jawbone, the absorption of the supporting bone begins. As a result, it is possible to create a situation where there are insufficient support and fixation of prosthetic teeth and it is difficult to fix them in the mouth without movement. The solution to this problem is the manufacture of artificial teeth supported over implanted teeth are implanted in the jawbone. Implants and permanent rehabilitation (bridges or individual crowns). Recommendations for maintaining oral health in the elderly Maintaining oral hygiene - rubbing teeth and using cleaning tools between the teeth is very important as well as in the elderly. Rub teeth twice a day with a soft brush and fluoride toothpaste. In limited mobility - an electric brush can be used. Maintenance of artificial teeth - germs stick to artificial teeth as well as teeth. Synthetic teeth should be cleaned daily. It is preferable to remove artificial teeth at night and in each case should be removed from the mouth for at least 4 hours each day. To keep the artificial teeth clean, you should rub the artificial teeth with a special brush. Dishwashing soap can be used and of course, wash the artificial teeth well afterwards. While artificial teeth are not in the mouth, they should be soaked in a sterilization solution for artificial teeth. Stopping harmful habits - Smoking exacerbates gum problems and caries. It adversely affects healing after dental procedures and the acceptance of implants. Also, smoking and alcohol consumption are factors that increase the risk of cancer in the oral cavity. Prevention of oral cancer - As is known, oral cancer is associated with life habits and therefore should refrain from smoking and drinking alcohol. Also, it was found that nutrition rich in fresh vegetables and fruits is a protective factor. In each case of a mouth injury that does not go away within two weeks - you should go to a dental examination. Cancer in the oral cavity does not cause pain in the early stages, so it is important to maintain a regular examination by the dentist at least once a year, even if there are no changes in the oral cavity. Treatment of dry mouth - It is recommended to consult the dentist and the attending physician to find out the cause of the problem. In certain cases, when dehydration is due to the use of certain drugs, the doctor replaces the drug with another drug and thus solve the problem. To alleviate dehydration, you should continue to drink enough water during the day. Alternatives to saliva, gum, or clothing can be used without sugar. Preventing and treating fungus - Keeping your oral hygiene and artificial teeth daily help a lot to prevent fungus. In the case of fungal infections in the mouth - you should go to the examination of the dentist. Treatment of fungi can be local or systemic, depending on the condition. Periodic visit to the dentist - It is recommended that the examination routinely at least once a year by the dentist. It is very important to inform the dentist of any change in the correct condition

Ice cream | Why We Shouldn't Eat The Cone Tip Why not eat the tip of the cone

2019-10-03T17:36:00.002+05:00

We should eat moderately the tip of the cone of industrial ice cream because it is a concentrate of saturated fats dangerous to health.

In the classic industrial ice cream cone, we find that at the end of the tip, it contains a delicious amount of very tasty chocolate.

Most people are willing to eat that tip of the ice cream cone because they find it especially attractive.

However, some experts point out that this tip of the cone should never be eaten. According to Bert Weckhuysen, a chemist at the University of Utrecht, you should never eat the chocolate tip of the ice cream cone because it is rich in "bad" fats.

Ice cream that never melts, possible thanks to fats
At the tip of the cones of industrial ice cream, there would be mainly saturated fats, the same that we can find in some industrial products that are sold packaged or those found in fatty meats, cheese, and butter.

The problem would be where the chocolate melts. The expert explained that there are two types of fatty acids, saturated and unsaturated.

saturated-fat-filled cone

The former, if consumed in large quantities, may pose a health risk, especially as blood cholesterol levels increase.

On the other hand, unsaturated fatty acids, unlike the former, which are solid, are presented as liquids at room temperature.

These are, for example, those found in olive oil and that have a low melting point.

Unsaturated fatty acids can be transformed into saturated fatty acids by a hydrogenation process.

It is precisely this process that is used for the production of chocolate used for cones.

Saturated fat at the tip of the cone
According to the expert, the manufacturers of ice cream cones added a lot of saturated fat on the tip of the cone, so that the chocolate remained solid.

For this reason, we would end up consuming a large amount of saturated fat contained in the tip of the cone, which could endanger our health if we consume it in large quantities.

From this point of view, even the classic ice cream cone should be eaten in moderation, like all industrial snacks.

Do you know what is the best heart rate during exercise?

2019-10-03T16:14:00.002+05:00

I often tell my friends that the proper amount of exercise for 150 minutes per week is the same as the 90 minutes of intensive exercise every week. But do you know the difference between easy exercise, moderate exercise and intensive exercise?

Exercise target heart rate The American College of Sports Medicine (ACSM) believes that the intensity of exercise is usually related to the following three factors: the percentage of the fastest heart rate, the rate of self-induction, and the amount of metabolism. It sounds a bit complicated, but we can distinguish it from a simple heart rate. Do you know your maximum heart rate?

If you are careful enough, you will find that there are many ways to help you calculate your best heart rate. Of course, I also have a formula here, you can refer to it.

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Output heart rate at the best exercise = (220 - age - quiet heart rate value) × maximum heart rate percentage + quiet state heart rate.

The right amount of exercise is equivalent to 60% of the maximum heart rate
Intensive exercise is equivalent to 80% of maximum heart rate
Super intensive exercise is equivalent to 90% of maximum heart rate
For example, a 24-year-old young man has a heart rate of 65 beats per minute in a quiet state, so his best workout heart rate can be calculated like this:
Moderate exercise (60% of the maximum) standard - (220-24-65) × 0.60 + 65 = 144 times / minute
Intensive exercise (80% of the maximum) standard - (220-24-65) × 0.80 + 65 = 170 times / minute

If you still don't figure out what's going on, or if you are not sensitive enough to the numbers, some websites can directly input your heart rate in a quiet state and automatically help you calculate the best exercise output heart rate you want to know. And the website I personally prefer to go to is
Www.runnersweb.com, you can quickly find the information I want to view.

Other formulas also have calculations of metabolic amounts. The amount of metabolism mentioned in many articles actually refers to the "metabolism". I believe that for most people, this concept is too abstract. We can understand this in another way:

Moderate exercise = 4~6 metabolic amounts

I know that you must ask again "How are the four metabolic quantities calculated? What does it mean?" The following table will very accurately label the activities of different content and the amount of metabolism to be consumed:

Metabolism: Activity content
1 Rest quietly, watch TV, read books
1.5 Dining, copywriting, diving, bathing
2 Engage in simple labour (such as doing housework), go out for a walk
3 brisk walking (4 km / h), cycling (8.85 km / h), bowling, golf, heavy chores
4 walking (4.83 km / h), cycling (12.87 km / h), tennis for two, cleaning the weeds in the backyard
5 walking (6.43 km / h), cycling (16 km / h), skating or roller skating, gardening (such as tumbling, etc.)
6 walking (8 km / h), cycling (17.7 km / h), single tennis, chopping wood, snow sweeping
7 jogging (8 km / h), cycling (19.31 km / h), playing basketball
8 running (8.85 km / h), cycling (20.92 km / h), intense basketball game
9 handball match, squash
10 running (9.65 km / h)

Where is the bottom line?
Everyone should find out their own best exercise target heart rate, and keep in mind the values shown above, and you should also know where your bottom line is, which is the minimum heart rate you should have when you exercise. On this basis, try to ask yourself to achieve this right amount of heart rate, and adhere to at least 150 minutes of moderate physical exercise every week. You can go to work by bike, or walk back home from the bus stop, even if you just dance to the grandmother in the square, "the most dazzling national style", you will save the cost of a large fitness club.

Ways to deal with spring allergy symptoms

2019-10-03T16:13:00.002+05:00

The arrival of spring allows us to take off heavy clothes and put on bright T-shirts and beautiful light clothes. This makes all the beautiful recovery seasons also bring a traditional gift to our clinics - patients who are troubled by sneezing, itching and tears. Yes, this is also a season of extreme allergy. As an allergic patient, I know the pain. Spring allergy medicine has become "allergic rhinitis", precisely the nose is inflamed; commonly known as hay fever, I have not figured out why everyone calls it "hot" because allergies usually do not cause fever. Of course, pollen is correct, because pollen is often the initiator of many allergic symptoms.

Talk about the first allergen "pollen", which was first discovered in some flowering trees and then found in flowering plants. These small pollen grains enter the nasal cavity by breathing; about 5-10% of the population will respond abnormally to such small particles, and excessive secretion of chemical histamine will cause typical allergic symptoms such as sneezing, itching, and runny nose. Or it is a headache. Many people have other allergic symptoms such as asthma or eczema.

There is a way to handle it healthily, simple and free! This is to wash the nasal cavity with saline. You can inhale the saline with your nose and spit it out from the mouth or another nasal cavity. Of course, this sounds a bit disgusting, but they do clean up the small pollen grains and dust before they cause allergies. This is also very good for nasal congestion, chronic sinusitis, colds and flu, and even asthma. You can buy this suit at a pharmacy in the community. Of course, you can find a way to complete this healthy self-treatment at home. You only need a small drop bottle to ensure that you use clean cold water to ensure that no fungus or bacteria break into the nose and sinuses.

The main treatment for allergies in spring is over-the-counter antihistamines (Translator's Note: generally considered to be anti-allergic drugs). There are two generations of these drugs: the first contains diphenhydramine, also known as ketamine or chlorpheniramine. These drugs are very few but the effect can only last for a few hours.

Our side effects are symptoms of lethargy. In particular, ketamine has a very strong sleepiness effect. In fact, it is an active ingredient in many over-the-counter stabilizer tablets. For example, Tylenol contains ketamine.

Second-generation antihistamines can be effective for 24 hours and have significantly reduced the side effects of drowsiness, which of course reduces the anti-allergic effects of these drugs. General antiallergic drugs contain loratadine and cetirizine. If you have a lot of runny noses and stuffy nose, adding some decongestants such as pseudoephedrine (also known as Sudfad) can sometimes be very useful. These drugs are called D anti-allergic compounds, such as loratadine-D, but pseudoephedrine also has some auxiliary effects, it is worth mentioning that they can cause insomnia and loss of appetite. At the same time, because they are also important components of methamphetamine, they are not widely recommended, and many countries prohibit the sale of them at pharmacies. Unfortunately, as a substitute for their decongestant phenylephrine, most of the packaging is signed PE, but it has no effect. Fortunately in China, we can also buy pseudoephedrine over-the-counter.

If you have more severe tearing and itching symptoms, over-the-counter eye drops can also work, such as nasal eye net (Masuda Eye Drops). If you need more effective, the doctor can prescribe some long-term effective eye drops such as olopatadine eye drops (Pattan).

After using these methods, if you or your child still have severe hay fever symptoms, then go see a doctor. They may prescribe some prescription drugs, such as steroid nasal sprays. These are usually the last resort. They are basically very effective, but they don't work quickly. You must take it often, once or twice a day. After a few days, your symptoms will improve significantly, and the side effects are usually small. Only some of the nose is dry or nosebleed.

Those with severe symptoms of hay fever need to prescribe nasal sprays with over-the-counter and eye drops to be effective - of course, don't forget the nasal cleansing method mentioned at the beginning of the article, and I think it will last for a few weeks. It can really improve the quality of life of allergic patients to a large extent. Usually in May, when the summer is approaching, most people have already passed the most painful days of the spring.

...please refer to my other about health

Food safety: What is safe for your child?

2019-10-03T16:11:00.002+05:00

Now, food safety in China is constantly being questioned by people. Have you considered buying only organic food? Or simply start vegetarian? Perhaps many Chinese people would not consider these issues before, but many people who have emigrated abroad began to choose organic food or become a vegetarian when they weighed their own health and coexistence with nature. But can such a change really lead to a healthier and more environmentally friendly life? Here I talk about this issue from a medical and personal perspective.

Organic food china Beijing food safety Being a vegetarian or giving up most of the meat is a very important life change, but many people swear that they feel that life is healthier and more vibrant. I am a meatless person. If I can't eat meat from now on, I don't think I can do it, but I also start to reconsider because of the huge negative impact on animals caused by animals, especially cattle. I don't think that "red meat" is as unhealthy as some people describe, but our modern Western diet is indeed very unbalanced, and the chance of suffering from heart disease is much higher than that of the ancients who only eat vegetables and grains. In the past 100 years, the biggest change in human diets has been to cover more meat, while fruits, vegetables, grains and nuts have been greatly reduced. Many animals are now farmed on unnatural agro-farms, often injected with hormones for rapid growth and mechanized feeding instead of the traditional way of grazing on the grass. Studies have shown that many doctors believe that the amount of OMEGA 6 fat we are now taking from food has greatly exceeded the amount of OMEGA 3 that is very helpful for heart health. The latter is mainly derived from common plants, fish and nuts. Food. The imbalance between OMEGA 3 and 6 is considered to be the main culprit in heart disease.
That's why I admire the “Vegetarian Monday Campaign”, and their recommendation is to fast meat every Monday. The campaign began with the Johns Hopkins Public Health School and was slowly spread through word of mouth. You can get some great information through their website at beatlessmonday.com, including children's recipes, restaurant menus and more. I think this is a relatively more acceptable way to change your family's daily eating habits, and with this opportunity, you can also try to see if you can really become a vegetarian.

Organic food has also become one of our hot topics. The American Academy of Pediatrics recently published a report on children's consumption of organic foods, which is well worth reading by parents. The American Academy of Pediatrics mentioned in the report that organic foods are largely no more nutritious than traditional foods, and most children cannot benefit from eating only organic foods. This may have subverted the ideas of many people! Although organic food can be reduced

The number of pesticides in children's blood, but the Institute does not believe that this is good for health, the best research report is also vague on this point. Foods such as cereals or onions do not contain large amounts of pesticides, but apples or grapes may have higher levels of pesticides, so if possible, these two foods should be as organic as possible. The US Institute of Labor also believes that organic milk is not more nutritious than traditional milk, but in theory, it may be less harmful to antibiotics to drinking milk from antibiotic-free cows, which is quickly becoming worth worldwide. Concerns.

This report from the American Academy of Pediatrics may be reliable for some people. Don't forget that this conclusion is based on reports from the US market and US farms. I personally think that the problem of pesticide use, the use of chemical reagents and the excessive use of antibiotics, China's problems are much more serious than the United States. Therefore, it is more practical to buy organic food in China than in the United States. Before considering nutrition, avoid harmful substances first!

Antibiotic beneficial bacteria?

2019-10-03T16:10:00.002+05:00

Generally speaking, living in Beijing is basically like living in a world full of poisons. Every day, we are bombarded by the air around us and eating and drinking. Everyone tries to protect themselves and their families, but it will not Someone went to the other extreme: too clean? We take great care to protect our families from toxic substances, but is it too much protection? This is not only an academic issue, but many scientists are beginning to discover that not all fungi are harmful. In other words, bacteria are also divided into probiotics and harmful bacteria. More and more evidence tells us that newborns need to be exposed to some fungi in the first few months of life, otherwise they may develop some immune system diseases such as hay fever, eczema and allergic reactions – even in adulthood. People develop obesity. This is called "excessive hygiene."

Probiotics healthy children

For example, a very good study of 400 families last summer showed that in the first year after the child was born, the baby had a cold or ear infection and antibiotics for newborn families with dogs as pets. Use 30% lower than other non-pet families. The researchers concluded that children staying with pet dogs that are often out of the way, children may be exposed to the fungi carried by the dogs and are very beneficial to the establishment of their immune system in the first few months. But are we going to hurry to buy a dog back? Of course not - especially many children are allergic to dog hair. This study is not the first to discover this phenomenon, but it raises a very interesting topic: if children who are allergic to dog hair live with dogs in the months after birth, they will not Will it be allergic to the same dog hair?
As another example, there are more and more examples that children with caesarean sections may be more susceptible to asthma or hay fever. A new study also shows that children with caesarean sections are twice as likely to develop obesity as children in their childhood. Analysis of the possible causes is again consistent with the earlier indication of exposure to various bacterial environments: Caesarean section children do not pass through the maternal birth canal and are not exposed to bacteria that may be exposed to the product, thus not stimulating the body's important immune system response. Form immunity. Perhaps the bacteria that come into contact with the birth canal are probably the best "first meal" of the stomach that the baby has never really worked for, because those bacteria groups may contain some kind of bacteria that can control the weight of the child.

This leads to a very interesting area of research: probiotics. We all know that "antibiotics" are killing bad bacteria, but our body contains about trillions of good bacteria, which play a vital role in our daily lives. For example, there are many specific types of bacteria in our digestive system. They are responsible for the important work of decomposing the food we consume and stimulating gastrointestinal motility. Antibiotics, especially potent antibiotics, often remove the probiotics while removing germs – which is why many people have diarrhoea after taking antibiotics (many women also have vaginal yeast) Infected condition).

Fortunately, a lot of data prove that taking antibiotics and taking probiotics can greatly reduce the side effects caused by these common antibiotics - diarrhoea. An analysis of an ecological association shows that taking probiotics can reduce the likelihood of diarrhoea by 48%. Of course, there are many types of probiotics, so the study suggests that large doses (more than 5 million units a day) of Lactobacillus rhamnosus or Brassica are most effective. This study is very interesting to me. I am sure I will recommend more probiotics to my patients, especially during antibiotics.

Probiotics are also the best rehabilitative medicine for all kinds of infectious diarrhoea. Another important observation in 2010 also shows that taking probiotics will help the body recover faster. So it's time to prepare some probiotics in your family medicine cabinet!

Best way to prevent and treat diabetes

2019-10-03T16:09:00.002+05:00

Here is a very popular little test. What is the most effective way to prevent and treat diabetes? Which one would you choose?

work out
Dieting
Slimming
Avoid sweets
The answer is very surprising, not a diet, but a slimming! A 5%-10% reduction in existing body weight minimizes the risk of diabetes. In fact, every 1 kilogram of body weight can reduce the risk of diabetes by 16%. This has been well documented in some authoritative research. For example, in an article in the 2006 Focus on Diabetes, titled “Improving the Impact of Weight Loss on Diabetes in Lifestyle”, the researchers conducted an in-depth survey of a well-known public health project report, “Action to Prevent Diabetes”. The study continues to study thousands of potential patients with diabetes, and in 2002 released a report that shocked the world, saying that rigorous lifestyle habits can reduce the likelihood of potential diabetes patients into real patients by 58%; this ratio is much higher It is controlled by a drug called "meta form" every day, and the latter is only 31% effective.

But this initial survey did not specify which part of the habits to change is the most effective. Is weight loss, increased exercise or a complete diet? We found that the data results of the 2002 project report were reduced in the follow-up study in 2006, mainly in the following areas:

5% of weight loss can reduce the incidence of 58%
The second effective way is exercise. Those who achieve the goal of exercise (ie, the “appropriate” exercise goal of 150 hours per week) can reduce the risk of illness by 44%.
The third effective method is: changes in eating habits, specifically mentioning the daily intake of fat
What does this information mean for readers below 25% of the total daily calorie intake, especially for readers who have been told about potential diabetes risks? Does it mean that the primary task is to lose at least 5% of your weight? Of course, the main ways to lose weight include exercise and less fat intake, all of which are relevant. The deeper meaning of the data at the time was that if you were exercising but didn't lose weight, or if you had reduced your fat intake but still didn't lose weight, then you had to reconsider your weight loss plan.

The good news is that the study also shows that those who do all three (ie, lose more than 7% weight; exercise more than 150 minutes per week and reduce their daily fat reduction by 25%) can reduce the risk of diabetes by 80%. ! The following 2006 data clearly and clearly shows three important factors for risk reduction; the broken line indicates the probability of no weight loss: it is obvious that this is slightly improved but there is no substantial improvement:

Diabetes obesity

Diabetes risk and lifestyle changes

I think this research is very valuable, it allows people to see if their living habits are right for them. Now, the main question is – how to lose weight? Well, if I really find a way and apply for a patent, then I will make a fortune. It is extremely difficult to lose weight with solemnity, and its difficulty is comparable to quitting smoking. What we know is that dieting doesn't work that way—those who lose weight by dieting will simply come back and forth with a slight increase or decrease in the amount of weight lost. No, simple locations, we must all carefully consider our living habits, which may be much more difficult than we think; effective and sustained weight loss must include diet and regular exercise. Don't forget our golden rule: 150 minutes of exercise a week, let the heartbeat fast.

Do you know how much you might be overweight?

I made a simple maximum body mass index (BMI) calculation page where readers can go to this address to calculate your index, normal, over standard, obesity, and morbid obesity.

Additional reading (the following is the translator's writing part)

The cells of the human body need sugar to help them function properly. The sugar into the blood is assisted by a hormone called insulin. If the body does not secrete enough insulin or the body produces antibodies to insulin - that is, the function of insulin does not function properly, then the sugar will accumulate in the blood and cannot enter the cell for normal operation. This is the root cause of diabetes.

Diabetes is generally classified into type I and type II diabetes. Among them, type I is the insulin that the human pancreas cannot normally secrete; type II is the amount of secretion of the human pancreas or the body produces antibodies to insulin. Type II diabetes is a chronic disease that requires lifelong observation and treatment. Fortunately, it is now available.

Change lifestyle habits, self-regulation, and some drug-assisted methods to control blood sugar levels to avoid the many other complex complications that result. Clinically, type II diabetes is common, and its causes are mainly genetic, environmental and pregnancy.

What is the best milk for your child?

2019-10-03T16:07:00.000+05:00

After the child has been 12 months, what is the best milk? Breast milk is still a better choice, and full-fat milk is the second choice – but many Chinese tend to have children's formula. The safety of milk powder in China is a well-known problem, and many paediatricians and dietitians do not consider this to be the best option. Parents who are fascinated by hyped advertisements and false information can go directly to the child's doctor: What milk do you give your child? This is a great question: If my Alex is one year old, what milk will I give him? In fact, I am not sure what milk to give him, but I think I have the following options:

Local organic milk. There is a local certified organic milk (and the same brand of yoghurt) that many Beijingers and foreign settlers trust. I don't dare to be 100% sure of its security. Of course, my trust in it is the same as my trust in other things here. I know that my statement is somewhat unsatisfactory. I can only say that this choice is better than nothing.
Import UHT milk. China can now buy this kind of imported UHT milk in many places, and it has become the first choice of many people. I personally don't like their tastes very much. I really oppose the environmental impact caused by transportation costs. Also, they are mostly affordable and easy to store, so it is quite convenient.
Enhanced soy milk. I prefer the taste of soy milk compared to milk, and it is extremely simple to make soy milk myself. Pure homemade soy milk without milk has a high calcium content, so your child may need to strengthen the soy. Some imported brands are already available in some places in China, especially in hypermarkets. Don't forget that there are other bean products, such as tofu, which is also good food for calcium supplementation.
Other milk products? There is a lot of imported milk made from rice and almonds in our supermarket. Many people like goat milk, including formula goat milk. Maybe these are possible alternatives, but I personally don't like too many attempts, preferring only to use the paediatrician's recommendation.

Milk is rich in calcium and fat, but many other health foods also offer these elements, including:

Yoghurt and cheese. I insist on drinking yoghurt for anyone of any age, not only because it is easier to digest for Asian stomachs. Yoghurt is rich in many healthy bacteria called probiotics. More and more research shows that bacteria are good for whole-body health, including reducing the risk of obesity. Homemade yoghurt is also very simple. Another alternative is cheese slices, which are rich in calcium and protein, fat, cholesterol and iron.
Canned fatty fish. Salmon and sardines are rich in calcium and OMEGA3, an important component of brain development. Canned more convenient and chew fish bones!
Leafy green vegetables. Broccoli, kale, and dark, leafy green vegetables are also very good sources of calcium. But absorption efficiency is key: spinach is rich in calcium but rarely absorbed, so it is not the best choice.
Strengthen calcium food. Many boxed orange juices are supplemented with calcium, which helps to avoid the fact that many children don't like milk and prefer juices to this calcium supplement. Many grains also add calcium.
Various vitamins. In the final method, children's vitamin tablets provide all the vitamins and minerals needed for a full range of nutrients. If your child is very picky eaters, this is a good idea. For example, only 10% of teenage girls have absorbed enough calcium!

WEBSITES FOR WELLNESS: HEALTH INFORMATION IN THE DIGITAL AGE

2019-09-17T10:24:00.002+05:00

Which websites do you turn to for health information? There are thousands of healthcare sites offering advice, but a sizable portion is either trying to sell you something you don’t need or simply do not provide evidence-based recommendations. I’ve researched many websites throughout my career as a physician, and I’d like to share with you my favourite websites for health and wellness information.

General medical information

My favourite sites for everyone

www.familydoctor.org – My first stop for general health information would be the patient website of the American Academy of Family Physicians (AAFP).
www.nlm.nih.gov/medlineplus – Also good are several websites run by various U.S. government agencies, especially the National Institute of Health’s MedlinePlus database.
www.cdc.gov – I also love the United States Centers for Disease Control’s (CDC) site.
www.mayoclinic.org – Lastly, the famous Mayo Clinic website is extremely user-friendly.

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All of these sites provide well-written, straightforward articles, videos and slideshows on thousands of topics, many with an emphasis on wellness and prevention.

For the medically-minded

www.uptodate.com/patients – Those who want more detailed and technical articles can find outstanding patient handouts from the UpToDate group. The website is probably the medical world’s most esteemed source for medical information and is, by far, my most valuable website for my practice. All of United Family Healthcare hospitals subscribe to this essential database. The Pro version is expensive, but their patient handouts are free and very detailed, even though it is less user-friendly than other websites.
www.medscape.com – You can also find free doctor-level articles at the physician website Medscape which is an umbrella group of the consumer-oriented WebMD.com.
www.cochrane.org/cochrane-reviews – If you want pure evidence-based data, you can peruse the world’s top collection of meta-analyses at the Cochrane Collaboration’s website.

For medical site rankings

When you’re looking for trustworthy websites, one tip to screen out the biased sites is to use the HonSearch engine at Health on the Net (www.hon.ch). This Swiss non-governmental organization independently rates thousands of websites for trustworthy, evidence-based content, and their search results only highlight approved sites.

For parents

General

www.familydoctor.org – My favourite, parent-friendly website is still the AAFP.
www.healthychildren.org – My second choice is the American Academy of Pediatrics’ (AAP) excellent, new, a family-friendly website that focuses mostly on wellness and prevention at different ages. Their main website (www.aap.org) also has a large list of “Health Topics” that provide authoritative answers to many basic questions.

Vaccine Information

Those of you looking for vaccine information should avoid the thousands of distracting anti-vaccine websites and go straight to the trusted sources: governmental centres for prevention and disease control.

www.cdc.gov/vaccines – At the U.S. Centers for Disease Control’s website you can find the latest official schedules for vaccines for all ages, as well as valuable information on vaccine safety. The AAP and AAFP websites above also have extensive information on vaccines.
www.cdc.gov/parents – Other top sites for parents include the CDC’s special “Parents” section.
www.nlm.nih.gov/medlineplus/childrenshealth.html – MedlinePlus also has an informative section on vaccines and children’s health.

Medicines and supplements

For basic information on both prescription and over-the-counter (OTC) drugs, the Mayo Clinic’s website is a great choice, as is MedlinePlus (both links above). If you’re searching for credible information on supplements and vitamins, I trust very few websites.

http://naturaldatabase.therapeuticresearch.com – My first choice, by far, is the Natural Medicines Comprehensive Database. This website is the best source of evidence-based and unbiased data on every herb, supplement and vitamin you would ever use. There’s a small monthly fee, but they also have a huge list of free and incredibly useful articles on the front page (look for “Clinical Management Series”). You can also find much of their information for free at MedlinePlus, which licenses access to their data.
www.consumerlab.com – Once you know what OTC medicines and supplements you want, you can search for the best brands from the independent testing centre ConsumerLab. Their website is full of useful tidbits on all supplements and vitamins. There is a fee to access their detailed reports, but it’s definitely worth it for anyone interested in supplements.
www.iherb.com – When you’re ready to buy supplements, my favourite online shopping site is definitely iHerb – a one-stop-shop for supplements with a well-earned solid reputation. Many expats in China use this U.S.-based website to order not just supplements, but other natural products like Tom’s of Maine toothpaste. The prices are extremely reasonable, and items are delivered door-to-door within two weeks from the U.S. via EMS at very reasonable shipping fees and no customs hassle that we have heard of to date.

Alternative medicine

Many of us are interested in complementary treatments – such as acupuncture and traditional Chinese medicine – but it’s very difficult to find credible sources online. One trustworthy start is the U.S. government’s National Center for Complementary and Alternative Medicine at http://nccam.nih.gov. The Cochrane Database also has excellent meta-analyses of many alternative treatments. Of course, for any herbal information, the Natural Medicines database is another great resource.

Travel information

When planning your next big Asian vacation, it’s always important to quickly find out which vaccines you may need, or whether you may need pills, such as malaria prophylaxis. Before seeing your doctor, first go to the website most of us use: the CDC’s travel website at www.cdc.gov/travel. Choose your country from the pull-down menu, read their comprehensive reports discussing vaccines or medicines you may need, and your visit with the travel doctor will be much more productive and efficient.

Public health issues

Many of us have more China-specific questions about air quality, food safety and other environmental issues.

www.cfs.gov.hk – For food safety, my favourite website is the Hong Kong Centre for Food Safety. It has an enormous collection of useful bilingual reports and newsletters on food safety, most of which is just as relevant for mainland China as for Hong Kong.
www.myhealthbeijing.com – For information on air pollution as well as other expat-specific health and wellness information, especially in Beijing, I humbly recommend my own website. As China’s most popular expat health website over the past three years, I provide an easily searchable collection of hundreds of articles focusing on evidence-based tips for wellness and disease prevention. I’m very proud that my website is officially certified by the above-mentioned Health on the Net Foundation as a trustworthy source of health information.

Drink milk, should not choose normal temperature milk?

2019-09-17T10:21:00.000+05:00

Eight years ago, when I first moved to China, I had an amazing discovery in the supermarket: the small package of milk on the shelves was piled high, and the milk was stored at room temperature and had a shelf life of more than 6 months. Is it safe to do this, is milk still nutritious? Like most other Americans, our family buys fresh milk from the supermarket freezer, and immediately put it in the refrigerator after returning home. The shelf life is only about a week.

In modern society, one of our great advances in public health is pasteurization. Milk is sterilized after being extruded from cattle (or sheep and goats), mainly to kill poisonous bacteria and spores, which would otherwise cause serious damage to the human body and even death. To eliminate pathogens, it is necessary to heat the milk for a specific period - a process known as pasteurization, named after the famous 19th-century scientist Louis Pasteur. Heating not only kills pathogens but also slows down the deterioration caused by other bacteria.

Pasteurization heating technology does not eliminate all bacteria, so milk needs to be stored at low temperatures and consumed within two days of opening. The conventional pasteurization procedure is to heat at 70-75 degrees Celsius for 15 seconds - but the newer technique is to heat it at 150 degrees for 5 seconds. This kind of finished product is called ultra-high temperature (UHT) milk (also known as room temperature milk in China's domestic market). After heat treatment at such a high temperature, all harmful pathogens including spores, and enzymes that cause rancidity of milk are all killed, so milk can be stored at room temperature for several months. At the same time, the milk is directly filled after heating, thus minimizing the possibility of contamination.

But what about nutrition? High temperatures will kill vitamins and other molecules. All of the major government and nutrition websites I have visited, including the US Center for Disease Control and Prevention, the EU Food Information Council, and the New Zealand Food Safety The Authority has given the same core facts, but the expression is slightly biased. The US Centers for Disease Control and Prevention concluded that "drinking pasteurized milk will give you all the nutritional benefits of drinking milk while avoiding the risk of drinking raw milk. "At the same time, although I have read some articles that the enzymes of milk will be more damaged during the ultra-high temperature sterilization process, the US Centers for Disease Control and Prevention said: "The enzymes in the raw animal milk are good for human health. not important."

Most Europeans are sure to find it funny when I first learned about the hesitation of ultra-high temperature milk because, in most EU countries, this milk has been very popular many years ago. In China, ultra-high temperature milk is now the main product of the market, and many local brands can be seen on the supermarket shelves. As the demand for milk surges, the sales of ultra-high-temperature milk have surpassed the traditionally pasteurized milk that requires cold chain storage, because the latter is more difficult and costly in transportation and storage, especially in remote areas. in this way.
I have a lot of patients and online readers, both foreigners and Chinese. After the melamine incident in China's milk in 2008, I no longer trust China's mainstream milk brand and began to look for quality-assured milk – especially It is to ensure that children drink with confidence. Fortunately, foreign brands of ultra-high temperature milk can now be purchased on major e-commerce websites in China and can be shipped to almost anywhere in China.

In my opinion, ultra-high temperature milk is a very good choice - especially imported ultra-high temperature milk. Also, is it better to choose to buy organic milk thistle? For children over one-year-old, this type of dairy is certainly much better than infant formula, and paediatrician groups around the world have found that formula is less nutritious than ultra-high temperature milk or traditionally pasteurized milk. The World Health Organization and the World Health Organization, as well as many organizations, recommend that breastfeeding should be done until the child reaches the age of one, and then the child is turned to full-fat milk.

I am drinking imported organic ultra-high temperature milk, which is mainly for food safety prevention. At the same time, I think that the milk that young children and family drink is 100% free of pesticides, heavy metals and growth hormone, which are produced in health. I am very reassured by the cows raised on organic farms. Considering the various food safety scandals that occur frequently here, people are worried and choose to rest assured that they are not happy.

What time does the child have to go to bed?

2019-09-17T10:16:00.003+05:00

A good night's sleep is very important to all of us, but especially for children. My son, Alex, is 17 months old and has a very regular life. He goes to bed at 8 o'clock every night and usually wakes up at 7:30 in the morning. Coupled with one or two sleep during the day, he can sleep for 12 hours a day and meet the recommended standards. But the toddler who is just a toddler in my upstairs jumps up and down every night, and most of the time I have to sleep at least 10pm. Many Chinese parents told me that their children only slept at 9:00, 10:00 or 11:00 - which was much later than my American colleagues and other paediatrician colleagues. This phenomenon may not be universal, but behind the significant differences in this sleep pattern, what are the reasons behind it, and more importantly, which way is healthier for children?

A study published in 2005 supported my personal observations, pointing out that Chinese children not only fall asleep later than American children but also get up earlier. This comparative study shows that Chinese primary school students sleep less than an hour (9.25 hours vs. 10.2 hours) than their American counterparts; what is even more worrying is that Chinese children still complain that they feel very sleepy during the day. The main problem is not when your child goes to bed: what's more important is their overall sleep length per day (including daytime naps, but most children over the age of five no longer take a nap). Sleep studies have confirmed that preschool children need 11-12 hours of sleep a day, while school-age children need at least 10 hours of sleep, and adolescents are 9-10 hours (infants need 16-18 hours, adults 7-8 hours). If your five-year-old child goes to bed at 9:30 in the evening, gets up at 6:30 in the morning, and is no longer taking a nap, then 9 hours of sleep a day is not enough for their long-term health.

Not enough to sleep at night, naturally will be sleepy during the day, which is also a major problem of lack of sleep. A series of studies published in 2013 on Chinese children showed that lack of awareness and daytime sleepiness can lead to poor student performance at school. In this study, most of the children slept from 9:00 to 9:30 pm, and almost all children got up at 7 in the morning, so many children missed half an hour to an hour of sleep every day. This doesn't look too serious, but like any debt, sleep debts have to be paid sooner or later, and it's not enough to make up for this debt by simply sleeping on weekends. The lack of awareness problems can lead to problems with attention time, enthusiasm for learning, and test scores. The researchers speculate that the anterior cortex, which is responsible for attention, creative activity, positivity, and abstract reasoning, is particularly susceptible to poor sleep. They, therefore, conclude that in Chinese society, children still have to invest a lot of time in their studies in the absence of sleep, and our findings provide a warning fable for this.

Good news can be seen from the same study: even if the school time is delayed by half an hour, it can significantly prolong the sleep time of students and improve their sleepiness during the day. The researchers conducted an intervention study at six elementary schools in Shanghai, delaying class time from 7:30 am to 8:00 or 8:30, which allowed students to sleep for nearly an hour – and more importantly, they were not very good. Complaining that I was sleepy during class. This is consistent with the results of various studies in other parts of the world, and also provides a theoretical basis for the ongoing movement in the United States. This paediatrician-led campaign initiative delayed school hours until 8:30 am. Just making this adjustment will allow the child to sleep a little longer and possibly improve their performance.

In addition to school performance, poor sleep can also increase the risk of overweight and obesity among children (and adults). In 2007, a meta-analysis of 36 studies across the globe showed a strong independent association between short sleep time and weight gain in children, and this association continued into adulthood. In Anhui Province, a study of 500 adolescent twins showed a link between lack of consciousness and weight gain. In 2010-2011, a study involving more than 4,000 children in rural areas of northeast China found that obese children were more likely to have insufficient sleep (less than seven and a half hours with a nap). Although this does not constitute a causal relationship, the connection between the two is still worrying. The cause of overweight may be a physiological factor, as studies have shown that lack of sleep can alter the hormone secretion that controls appetite. Lack of sensation leads to decreased levels of leptin secretion and increased levels of ghrelin, which increases our instinctive hunger reflex. Given that the proportion of obese children in China is growing at an alarming rate, I feel that all parents should at least consider the child's sleep problems.

I can't manage the noisy children upstairs, but in our own home, I am very happy that we let Alex develop a good sleep habit, and even if necessary, he goes to bed at 8:30 or 9:00. We can also guarantee that he gets enough to sleep every day so that he can stick to his pre-puberty. In addition, when we choose a school, it will definitely be a plus point for children to get up later.

Can the mask resist the smog?

2019-09-17T10:14:00.000+05:00

Is the protective mask really effective? Considering that China’s former Minister of Health Chen Hao and the researcher of the Environmental Planning Institute of the Ministry of Environmental Protection, Wang Jinnan and others published in the review article of the December 13 issue of The Lancet, the number of people who died early in China due to air pollution reached 350,000-500,000. The meaning of the mask is especially prominent. In the winter of 2013, serious pollution first began to invade from Harbin and has recently spread to Shanghai and eastern China. During that time, I happened to take a train from Shanghai to Beijing. I felt very confused when we galloped between the city and the country and watched them disappear in the mist.

PM2.5 N95 masks Such incidents as the masks, as well as the “end of the air” in Beijing on January 2013, have significantly increased public awareness of air pollution in China, and the discussion has proliferated. A large number of anti-pollution products in online stores are emerging; in the chat topic of the Internet and cafes, comments on the use of masks are full. Now, even in convenience stores like the 7-11, you can see a large counter with a protective mask with N95, 99% or similar eye-catching labels.

Let's take a step back from this marketing hype – is there any evidence that these masks are really effective? This issue is of paramount importance to me and my family, to hundreds of patients, and to readers who have asked me this question for years.

I usually tell everyone this way: Yes, there is evidence to prove its effectiveness - to some extent.

It has been medically confirmed that small particles (called PM2.5) of less than 2.5 microns can cause severe inflammatory reactions leading to heart disease, lung disease and cancer. Many studies have also shown encouraging results – reducing air pollution in one area can help improve the health of community members, reduce the number of emergency visits, and reduce the total number of deaths. Reducing contact with polluted air can improve health: yes, this seems to be obvious, but scientific research is often filled with hypotheses that prove to be wrong afterwards, so we need to further reflect on previous research.

Let's go back to the mask. Construction sites around the world are filled with dust, heavy metals and dangerous gases. For decades, construction workers have relied on masks made by companies like 3M, and independent lab tests have shown that these masks have a filtration efficiency of at least 95% for inhaled air. This is exactly what we mean by the term N95: the N95 mask, if it passes the official certification of the National Institute for Occupational Safety and Health (NIOSH), it has already passed through the face. test. In this test, a person wears a mask for about 15 minutes. The person wearing the mask should move in many positions. The mask is attached to a special machine to record the particle concentration inside and outside the mask. If the amount of particles in the air inside the mask exceeds 95%, the mask passes the N95 test. Many masks have received this certificate, and given this, I can be sure that these masks can greatly reduce our exposure to the most dangerous PM0.3-PM2.5 particles in air pollution.

The main problem is that we are too sloppy when we move to the next level of assumptions: by wearing these masks, you can improve your health. Yes, this sounds logical again, but so far, no research has been done on tracking these mask users – tracking them for months and years, testing their breathing and determining what improvements are being made. In the absence of sufficient data, the best data we can get from two short-term studies of the same research team, the subjects of which are pedestrians walking on the streets of Beijing. In August 2008, these researchers from Cambridge and Beijing recruited 15 young volunteers from Beijing Fuwai Hospital. These volunteers did not smoke, took any medication, and had no previous medical history. The experimental team randomly divided them into two groups and let them walk for 2 hours on the secondary road of the Second Ring Road. As we all know, the Second Ring Road is one of the many heavily congested roads in Beijing, so it is filled with various pollutants such as automobile exhaust. When wearing the 3M 8812 mask, their blood pressure improved greatly. The systolic blood pressure of the mask group was 7 mm Hg lower than that of the control group, and the increase in systolic blood pressure caused by exercise was positively correlated with the disease. The study was published in the 6th issue of Particle and Fibre Toxicology, 2009.

But as a family doctor, the team's follow-up study published in the Environmental Health Perspectives in 2012 is more informative. This time they tested people who already had heart disease. They were stable but were taking medication. This test was conducted by nearly 100 people who used the same 3M mask for more than 24 hours of a test period and did not use a mask for another test period of more than 24 hours. When wearing a mask, their heart rate variability, blood pressure, and ischemic stress markers were improved, such as an average reduction in systolic blood pressure of 3 mm Hg when wearing a mask. All of these are considered to be factors in cardiovascular disease such as myocardial infarction and stroke, so any improvement in this objective data will have a large positive impact.

Why is this so important? Because air pollution does not only cause lung problems, it also causes myocardial infarction, chest pain and stroke. I am most worried about children, as well as older people with heart disease, and the study proves that using masks in extreme pollution can prevent the onset of myocardial infarction, so it can really save lives.

This research is also flawed. They admitted that the control group did not wear a "comfort" mask, and some of the reported effects may be caused by psychological effects, because the subject may be more relaxed when wearing a mask. But these are the best studies about masks we can find right now, and of course, I won't wait for better research. I am very convinced that the underlying principles are quite powerful and proven: reducing exposure to polluted air can improve health. And we have learned from decades of construction work that N95-rated masks are specifically designed to reduce the inhalation of PM2.5, and such atmospheric particles are considered to be the most harmful of many harmful chemicals in the air. of.

Can air purifiers improve health?

2019-09-17T10:12:00.002+05:00

What is the most popular New Year gift in China this year? In addition to the new year and red envelopes, you may also be able to send an "inexhaustible gift": indoor air purifier. Undoubtedly, since last year, they have become popular in China and their sales have been blown out. I think this is a good change: including myself, many independent tests have shown that a good air purifier can greatly improve indoor air quality, reduce PM2.5 content by 80% or more, such as I am at home In the bedroom and living room, I have tested multiple brands of purifiers. But is there reliable data to prove that it does make you healthier? Of course, reducing exposure to pollution can reduce the effects of harmful health, which seems to make sense. But in the history of medicine, no shortage of common sense and traditions have later proved to be ineffective or harmful – such as bloodletting, or more modern traditions of taking multivitamins. Readers of this article, a large group of people taking multivitamins every day, think that this is "healthy", but there is strong evidence that they have no effect and may even be harmful to people. Is an air purifier an example of this?
In terms of theory and testing, a good air purifier should improve indoor pollution levels by more than 80%; this 80% boundary is also the AHAM's clean air delivery rate (Clean Air Delivery) Rate, referred to as CADR) The boundaries used in the tests, which are widely cited in the air purifier comparison chart. So, suppose you have installed a top purifier in your living room, you feel satisfied and safe, but how long can you stay in this room? Or is it possible that the purifier is too small and the room is too large, the purifier is too old, the fan speed is too slow, or is the window open? Has your original asthma and cardiovascular disease improved after installing the purifier? Understand what I mean? I want to take this topic to the next level and look for evidence that your health has improved when using these devices. I hope to be able to tell my patients and readers that in the published research, there is indeed a study that tracks the subjects for months or even years, and they and the control group (people who do not use air purifiers) For comparison, assess their health and see if there is improvement in heart disease and lung disease, cancer and mortality. Is there such a study?

In search of the best research, I searched the Pubmed scientific database and found no strong data. Although I was disappointed, I was also surprised. A well-designed research project like this is difficult and costly to implement. But there are still a few attempts, especially for the use of high-efficiency particulate air filters (HEPA) to help children with asthma. One of them was a systematic study published in 2002. The results showed that the filter was effective but not effective in improving asthma symptoms, and the differences between the different studies were large, which increased the difficulty of summative evaluation. A more recent, well-designed study was published in the 2011 Pediatrics, which tracks 200 asthmatic children exposed to second-hand smoke in the home environment, and has half of the children's bedrooms equipped with real HEPA. The purifier, the other half got the comfort purifier, the shape is the same as the ordinary purifier, but no effective filtering device such as HEPA or activated carbon is installed. A year later, the number of children who used HEPA to see an asthma clinic decreased, which may – but not be determined – was due to a 25% reduction in PM2.5 in their room.

Other studies focus on allergies, including an interesting study in 2008. The study evaluated children with a history of allergies to animals, followed them for one year, and recorded their lung function and blood markers. One year later, there was no significant difference in lung function, anti-allergic drug use, or blood markers for HEPA air filter users, but there was a trend toward improved bronchial hyperresponsiveness in children. Another study in 1990 was even more impressive, showing that not only did indoor PM0.3 decreased by 70%, but the patient's allergy symptoms improved.

All of this suggests the health benefits of air purifiers, but for us in China and the developing world, these studies are still on the verge of the answer I want to know. In the United States, the marketing and testing of most air purifiers focus on allergies and asthma. But in developing countries, air pollution is more severe, so health risks are much more serious. We are concerned about the long-term risks of pollution to death, heart disease, lung disease and cancer. The studies I just mentioned still can't answer the more in-depth question: Can long-term use of indoor air purifiers prevent premature death, heart disease, lung disease and cancer?

The best research I have found was released in January 2013, "Indoor Air." This complex research design is very meticulous. In a random double-blind crossover design, 20 households participated, using an air purifier or a comfort purifier for more than three weeks. The family tested was in the distant First Nations community, and the main purpose was to assess whether the air purifier could improve heart and lung health. As their summary says:

“...Every household receives an electrostatic air purifier and a comfort purifier, used for one week, in random order. At the beginning and end of each week, their lung function, blood pressure and endothelial function are measured... on average Calculated, the person using the air purifier increased the forced expiratory volume by 217 ml in one second, the systolic blood pressure by 7.9 mm Hg, and the diastolic blood pressure by 4.5 mm Hg. We observed the indoor PM2.5 and Consistent reverse correlation between lung function. Overall, our findings suggest that reducing indoor PM2.5 in First Nations communities may lead to improved lung function."

The Canadian research team also previously published a similar study that tested 45 non-smokers in 20 households using a wood-fired fireplace for 7 days, comparing the health status of the subjects with or without the HEPA purifier. The endothelial function of the purifier user and the performance of inflammatory biomarkers such as C-reactive protein (CRP) have improved. Since most polluting researchers now view pollution as an inflammatory disease, the test results of such biomarkers can indeed be an accurate indicator of future health problems. This method was also used in the air pollution mask study I recently reviewed.

How do I understand these studies? First, they all affirm the information we already know: air purifiers can reduce indoor PM2.5 levels, but the results are uneven. The second is the result of looking at the health markers. I think the most encouraging finding is that even in such a short period of time (less than a month), the study of the First Nations showed an improvement in lung function. Although blood pressure improvement data is not convincing enough, a broader study may help confirm the positive conclusions they initially made.

I don't think these studies are worthy of the evidence on the board, but I really don't know if we will have more well-designed surveys like these studies in the future, because such research requires a lot of money and a large number of people, so it must be high. The amount of the project fund can be carried out. But before a better research release, we must rely on what is currently known:

· In terms of PM2.5, there is no so-called “safety” level of air pollution, which is always as low as possible.

· Deteriorating air pollution can cause death from a variety of causes, especially heart and lung diseases and cancer. Many studies have shown this, including the 2013 China Demographic Analysis.

· On the positive side, long-term improvements in PM2.5 do help reduce mortality. The best study to prove this is an ambitious epidemiological analysis of all urban populations in the United States, spanning from the 1970s to the 1990s, during which air quality in the United States generally improved. There are many reasons why people's average life expectancy has been extended, but it is estimated that 15% of the extended life comes from clean air.

· Short-term studies have also shown that reducing outdoor air pollution can help improve health. The best research I have ever seen in this area occurred in Beijing during the 2008 Olympics. A group of researchers tracked 125 healthy young doctors, tracking time before, during and after the Olympics, and found that blood pressure, heart rate and other inflammatory biomarkers were observed during the good days of air pollution improvement. Both have improved. Another encouraging study tracked pregnant women and their babies in Tongliang County, Chongqing. Studies have shown that after a local coal-fired power plant was forced to close in 2004, the results showed that the 2-year-old children had higher levels of health and muscle coordination than the control group (children born before the power plant was shut down).

Are all these enough to convince you to use an indoor purifier? For me, I have believed it a few years ago – not only because of common sense, but also because of biochemistry, it does make sense, and it also fully complies with the precautionary principle: “When an activity has an environmental or human health The threat of injury should be precautionary, even if some causality has not been fully confirmed scientifically."

Beware of the plastic products around you

2019-09-17T10:10:00.000+05:00

Alex, the son of his son, is almost a year old. He likes to put everything in his mouth, especially the bath toy. When he happily glared at the crab with fluorescent orange eyes and big eyes, I always got a little nervous. Will the plastic parts of the toy be eaten by him? This set of bath toys is produced and exported to the United States in China. The manufacturers claim that they are "safe and reliable" and the quality "reaches and exceeds" the US law. But what exactly does this mean? Does the United States have such a law? Is this my worry? Also, to what extent can my parents and other parents protect dear children from all kinds of environmental damage?

When I think of the world's dependence on chemical products and plastics, I can't help but think of what Donald Rumsfeld once called "known unknowns" - we all know that for 80,000 since the Second World War We know very little about the safety of other consumer chemicals, because there is no decree requiring human experiments on these products. The World Health Organization (WHO) stated in its 2012 report "The Scientific Status of Endocrine Disrupting Chemicals": "At present, most commercial chemicals are not tested."
The main concern is the endocrine disruptor, a compound whose molecular structure is similar to our natural hormones. Because of their similar structure, they can bind to the same receptors that bind to natural hormones, thereby altering normal endocrine activity and thus affecting all aspects of our human health. The most worrying thing is children because these endocrine disruptors can cause permanent damage during the most sensitive growth sprints, first in the mother's uterus, and then in the puberty phase. The most notorious example is diethylstilbestrol (DES), which was used by many pregnant women after World War II to prevent pregnancy complications. However, people gradually found that the baby girl born to the mother who took the drug suffered from a rare vaginal cancer, and DES was banned as a carcinogen, but even now, the group of "DES daughters" still continue to encounter Reproductive health problems, and the problems are not only their own but also their daughters, which means that some endocrine disruptors can permanently change our genes and affect future generations. This is the modern warning fable that I am most worried about and the focus of WHO's attention: our children, our descendants.

The prestigious JAMA Pediatrics published a review of endocrine disruptors in 2012, basically agreeing with WHO's evaluation of this chemical, even though it is related to human research. Hard data is not very powerful, but it is enough to cause concern and concludes that “as a preventive measure, there are ways to reduce exposure of women and children during pregnancy to endocrine-disrupting chemicals”.

Click image to enlarge it.

What worries me is that although compounds like DES have been banned, there are still a large number of endocrine disruptors widely used in various daily necessities. The most commonly mentioned compounds include bisphenol A (BPA), Polyvinyl chloride (PVC) and phthalate. Bisphenol A can be used to make shatterproof plastics. It has been used in the manufacture of plastic (milk) bottles, sucker cups for young children, and food and beverage (milk powder) cans for the inner coating since the 1960s. Polyvinyl chloride is a common material in transparent or translucent articles such as cling film, plastic soapboxes and tubing at home. Phthalates are the most common plasticizers and are very common in toys, cosmetics, and food packaging. They can cause harm to children and are associated with infertility, obesity, cancer and neurodevelopmental disorders such as behavioural abnormalities and low IQ. For bisphenol A, the standards of the international community and China are now very uniform. The EU, the United States, Canada, and China have banned the production of food containers (such as milk bottles) for infants and young children. As for phthalates, China’s quality standards have lagged behind. In February 2011, the EU has listed three common phthalates directly into the chemical “elimination list” in children’s products. The use of phthalate esters in toys, which is subject to strict control, and the determination of phthalate plasticizers in polyvinyl chloride plastics for national standard toys and children's products issued in 2008. Detailed regulations were made but no limits were imposed on their content. In the past two years, the quality inspection department has detected excessive phthalates in children's shoes and children's toys exported. In Taiwan, in 2010, a female worker who had been engaged in plastic film for many years and had long-term exposure to plasticizers was diagnosed with cryptorchidism. The attending doctor suspected that it was related to long-term exposure to higher concentrations of phthalates; In Hong Kong, a study conducted by the Baptist University in 2010 found that more than 90% of the phthalic acid diesters in the 200 Hong Kong blood samples examined exceeded the standard.

It should be pointed out that the main problem of these research and "consensus" statements is that almost all research is animal experiments rather than human experiments, so no one can play a ticket saying that the damage caused in animals will inevitably also appear in people. Body. The mice and monkeys in the lab are not human, and we do know that a large proportion of the drugs have achieved excellent results in mice, but they fail in the next phase of human experiments. Therefore, I need to admit that all medical concerns about modern social chemicals are not conclusive, and I hope that we will get more solid data in the future.

Some researchers have experimented with reducing this uncertainty by helping researchers remove all sources of plastic products in the home environment, such as plastic containers and prepackaged foods, and then monitor BPA and neighbours in their urine. The concentration of phthalate by-products. The research in these studies is striking and deeply disturbing. One of the most famous studies was conducted in the San Francisco Bay Area on January 2010. The researchers were from research institutes such as the Silent Spring Institute and the American Breast Cancer Research Fund. They removed all BPA and phthalate products from a total of 20 people in five households, and as a result, their concentrations in the urine did drop significantly. However, a similar experiment in 2013 showed a completely unexpected result: the experimental group showed a significant increase in the level of ortho-dimethylate. The researchers then examined the various food sources of the participants and found that the phthalate concentration of the meal was surprisingly high (21,400 ng/g) in its “relatively healthy” prepackaged food. Higher concentrations of phthalates are also present in perfumes such as dairy products and paprika (the former being more than 440 ng/g and the latter being 700 ng/g). The researchers speculate that this may be because the phthalates in the packaging material migrated into the food.

Hong Kong Centre Food Safety Plastics Packaging

Parents can find helpful advice on several consumer group websites and blogs. I prefer the "Soft Landing" blog, where you can find a very useful guide to buying security products. Also, the Hong Kong Food Safety Centre is very useful, not only provides a guide to the use of disposable plastic containers but also downloads a PDF version of the guidelines for the safe use of food packaging and containers. Similar recommendations were provided by the Pediatric Environmental Health Task Force. Here are some of the most recommended recommendations I have summarized:

1. Try to buy products that do not contain BPA, phthalates, and PVC. A detailed list can be found on the “Soft Landing” blog, especially to avoid baby products containing such ingredients.

2. Replace all plastic food containers with glass.

3. Refer to the plastic coding system guidelines to avoid products marked 3, 6 and 7 on the mark, using the products marked 1, 2, 4, 5, the latter material is more stable, better heat resistance, acid resistance, oil resistance, etc. characteristic.

4. Consider buying organic foods to reduce the risk of exposure to pesticides.

5. If you need to use plastic food film, use only PE (polyethene) film; avoid food contact with plastic film as much as possible; try not to heat the microwave in the microwave after wrapping the film.

6. In particular, do not let the film touch the surface of the liquid, and neither hot and cold liquids can be used.

7. Use a vacuum cleaner with a high-performance HEPA filter to regularly clean the carpet and floor in your home to reduce indoor dust damage.

8. The food packaged from the restaurant should be placed in a glass container as soon as possible after returning home. Never use a takeaway plastic box to heat the food, and do not eat the food directly.

As for Alex's bath toys? The “Soft Landing” blog included it in safer bath toys, and the manufacturer wrote to me several times to prove that these products “are free of BPA, phthalates and PVC”. So I will let him continue to lick the toy.

Drinking or not drinking formula, this is a problem

2019-09-17T10:04:00.000+05:00

As a general practitioner working in China, I often come into contact with worried parents. One of the questions that they most often ask me is what kind of milk powder should be used after the child is one year old. Which kind of milk powder is best for picky eaters? Is there any milk powder that is most beneficial to your child's physical and mental development? And my answer is: Why do you have to let the full-year-old children drink formula? Even further, why do you have to drink milk?

Although breast milk is always the best food for all 0-1-year-olds, mothers may not be able to achieve full breastfeeding for a variety of reasons, so infant formula has become the choice of tens of millions of parents around the world. As for infant formula for children over 1-year-old, it is another matter. Infant formula is an invention of the infant formula brand in recent years, with the aim of making more money from the pockets of parents who are highly loyal to the brand. They usually advertise baby milk powder "more nutritious than milk", "designed for picky babies" and contain nutrients that support the immune system. No mainstream pediatric or family medicine group, including WHO, supports the use of infant formula as the first choice for any healthy child. For all children over the age of one year, the best choice for calcium and fat and other nutrients is always breast milk. WHO now recommends that mothers breastfeed their babies until they are two years old, followed by milk, and breast milk and milk. At this time, it should not be the main food for children, and its proportion in its balanced diet should be smaller and smaller.

The biggest dissatisfaction of paediatricians and nutritionists with infant formula is that they usually contain more sugar than milk and often add extra flavours such as vanilla extract. In 2010, there was even a chocolate-flavoured infant formula market that quickly exited the market after encountering numerous bad reviews. For example, in Enfagrow's ready-to-drink formula, every 100 grams of this formula contains 7 grams of sugar, while 100 grams of whole milk contains only 5 grams of sugar. Maybe it doesn't look like much, but the extra sugar is still not to be accumulated.

In modern society, the biggest threat to health is diabetes and obesity, while refined sugars and carbohydrates contribute a lot to these two major illnesses. So, with so many healthy foods to choose from, why take the risk of making your child fall in love with sweets and like sweet formula? Infant formula also claims to contain many other special nutrients that are also good for health – but other sources of nutrition, such as vegetables and meat, are far better than milk powder. Wendy Swanson, a Seattle paediatrician and mother of two children, wrote in her blog: "I will never recommend this type of formula, and I have communicated with me. The dozens of paediatricians, pediatric digestives, nutritionists, and childhood obesity experts are also not recommended. See Chapters 1 and 2. These milk powders are harmful to children... Children under the age of 1 do not need it at all. The formula, unless in very few cases, their paediatrician recommends a special formula."

When I was in California, I found that only a few parents let children over the age of 1 drink formula. However, in Beijing, I found that a large proportion of parents did not let their children drink fresh milk but instead drink formula milk, and among these parents, there are many Chinese. In China's online stores, you can see more types of a formula than the United States. Why is this so? Are the little babies in China who are picky eaters not like to drink milk?

As a doctor who has lived in China for six years, my answer to this question is clear: most Chinese people simply do not trust domestic dairy brands. To be honest, it is difficult for me to blame them, because everyone clearly remembers the melamine scandal that occurred in domestically produced milk powder in 2008, killing 6 children and treating 300,000 children. Although the incident has passed for 5 years, I can't find a parent or a doctor here. Whether they are Chinese or foreigners, they can make a ticket saying that a certain domestic dairy product brand can be 100% assured and absolutely safe for children. I can't judge whether the distrust of the local dairy company is reasonable, but if the parents decide not to let their baby be a mouse, I certainly understand it. But I also need to emphasize that the brand of dairy products is not completely reliable, and well-known brands such as Abbott, Corcoran, and Nestle have recalled products due to quality problems.

Therefore, we have to face this unique Chinese phenomenon: parents do not trust the local milk, but they have to let their little baby get the calcium and fat-rich in milk. Do they have other options?

As a parent of a baby, I have discussed with my wife many times what our child Alex should eat after he is full. The following are the foods that I recommend to replace infant formula:

Native organic milk: In Beijing, a small number of organically certified milk (and yoghurt) has been favoured by many foreigners and natives. However, I am not sure that it is 100% safe.

Imported high-temperature sterilized milk: Now in China's supermarkets and online stores, you can buy a lot of high-temperature sterilized milk from Australia, Germany, France, which is also the first choice for many people. I personally don't like the taste of this type of milk, and because of its long-distance transportation, I am extremely dissatisfied with the environmental impact of them. But they are very cost-effective and have a long shelf life, so they are quite convenient.

Strengthening Soymilk: Compared to milk, I prefer the taste of soy milk, and homemade soy milk is very easy. Home-made pure soy milk is not as rich in calcium as milk, so your little baby at home needs to drink soy milk. Imported soy milk is now available in many parts of China, especially in high-end supermarkets. In addition, other soy products are also a good source of calcium, such as tofu. In addition, in the supermarket where I live, there are various imported rice milk and almond milk. Still, others like goat milk. Maybe they are all possible alternatives, but I don't have much research on this, and I would rather insist on the recommendation of most paediatricians.

Yoghurt and cheese: I think yoghurt is better than milk for people of all ages, not least because yoghurt is easier to digest for most Asians. Yoghurt also contains a lot of probiotics, and more and more studies have shown that probiotics are good for health. One of the benefits is to reduce the possibility of obesity. It is easy to make yogurt at home. Another great option is a piece of cheese, which is rich in calcium, protein, fat, cholesterol and iron.

Canned fish: Salmon and sardines are rich in calcium and Omega 3, which is critical for brain development. Canned fish is actually better because you can even chew the fish bones and eat it!

Green vegetables: broccoli, kale and dark green vegetables are rich in calcium. But bioavailability is the key: spinach is rich in calcium, but only a small fraction can be absorbed, so it is not a particularly good choice.

Calcium-fortified foods: Many boxed orange juices are supplemented with calcium, which is especially useful for children who do not like to drink milk and prefer to drink the juice. There are also many portions of cereal added with calcium.

Multivitamins: Children's vitamins provide the vitamins and minerals needed daily, but this is the last resort choice. For children who are extremely picky eaters or other children with certain diseases, it is best to ask a paediatrician before taking it. opinion.

The most important thing is the balance and variety of food – to ensure that the children's plates are colourful and what kind of food is available.

Perhaps a few years later, the research institute can finally complete a comparative study on infant formula and milk to assess the effects and effects of formula on the health and development of young children. If these studies show that formula is really beneficial, and that WHO, the American Academy of Pediatricians, and the American Academy of Family Physicians explicitly recommend infant formula, then I will consider changing the perception of it. But at least for now, in the absence of relevant research and recommendations from professional organizations, I simply don't recommend infant formula as a food for children over 1-year-old – even in China.

I am testing air for Beijing.

2019-09-11T12:40:00.003+05:00

As a foreigner, I feel that I have a certain degree of freedom to do something weird. One of my favourite weird activities is to go to the streets, suburbs and mountains of Beijing to measure the level of air pollution there. I came to Beijing the year before the 2008 Beijing Olympics, and since then, I have been interested in air pollution (or is it fascinated?). Sometimes, I also borrow a handheld particle monitor from an air purifier brand team. It should be noted that this handheld monitor measures the index of PM0.3 in the air. This kind of particle is more common than PM10. It is smaller than PM2.5, but it can also be used as reference data for air pollution.

On weekends, my wife and I would drive around Beijing. I used one hand to drive the car. I used the other hand to extend the tiny nozzle of the particle detector out of the window and let it smell the air like a dog. Sometimes, I will ride a bicycle through the streets of Beijing, stop from time to time, then take out this large device from the bag, monitor the level of particles in the air, and record it in the notebook. People passing by will be very polite to avoid contact with me. But this is not necessary, because I usually wear air-proof masks and bicycle helmets; as early as a few years ago, both of them were rare on the streets of Beijing (unfortunately, helmets are still rare).

During these adventures, I recorded many details about air pollution, and this data really surprised me. From 2009 to 2011, I conducted three, one-week tests every time in Beijing. I have found that air quality has remained almost constant. One of the most disappointing discoveries was the air condition in the beautiful mountains of the Jingxi Gunsan Temple. My expectation is of course that the air in the mountains is cleaner than the "yellow fog" in Beijing. Isn’t the mountain scenic spot a place away from troubles? Unfortunately, the air pollution values there are no different from the values in Beijing's urban area and are equally disappointingly high - according to news reports, one of the reasons may be the burning of fallen leaves. After the official website, zx.bjmemc.com.cn went online at the end of last year, I will also go to see the air quality map above. Based on my observations over the past few months, I noticed that the official data is the same as my current measurement: the PM2.5 level of the suburban air monitoring station is almost the same as that of the urban area, but in the windy or sunny weather, the suburban air Quality is usually better. Throughout the year, especially on hot summer days, people still like to go out and climb, but we don't expect the sky there to be bluer.

In addition, I also spent a lot of “geeks” to monitor PM2.5 data in various shopping malls and streets in Beijing. One surprising finding is that the PM2.5 level of a bustling street is not much different from a secluded alley. I often read in the paper that there is a peak of pollution in a section within 150 meters from a busy street. This situation has been confirmed in London studies, but in Beijing, from the loop to the tree-lined avenue on the bank of the canal, I Air quality has never been found to increase by more than 10%. I guess this is because my handheld monitor only measures PM0.3, a pollutant, and if you add carbon monoxide, nitrogen dioxide and other pollutant data that is more common in urban main roads, the result may not be the case. In addition, a study by the Swiss Tropical and Public Health Institute in Los Angeles County, California found that people living within 75 meters of busy streets have major diseases such as adult heart disease and childhood asthma. The incidence rate is much higher. So, I think this general rule still applies: avoid strenuous exercise, cycling or walking on busy streets.

And if you have to go to or along these main streets, be sure to consider wearing a regular N95 respirator. In Beijing, the University of Edinburgh and the Union Medical University conducted research. They recruited 15 healthy young people to participate in the trial in August 2008. The subjects were between 8 am and 10 am, along the second. The loop and other busy streets walk for two hours and monitor their breathing, heart rate and blood pressure. You can imagine their image: carrying a huge bag, various antennas stretched out, and wearing a mask! But the good news is that when they wear a mask (3M N95 respirator), their blood pressure and heart rate variability are reduced. This study can be said to provide the most powerful evidence at the moment that a suitable N95 mask will indeed protect you.

Another monitoring that I was very disappointed during the monitoring period was that in the case of very serious pollution (ie, when the air quality index exceeded 300), the indoor air was almost as dangerous as the outdoor air in most shops and restaurants. I found that indoor air pollution is usually 50%-80% of outdoor. In Xi'an, Xi'an Jiaotong University and other units in the three offices and outdoor sampling in 2008, the results show that indoor and outdoor particulate matter concentration has the same trend, the ratio of PM2.5 to outdoor in three rooms were 79.7%, 50.1%, 83.0%. But keep in mind that this is an environment where the air quality index is over 300, so indoor air is also very unhealthy. What surprised me the most was that one day I went to the most famous imported bookstore in Beijing and found that the indoor air there was even worse than the outdoors! It seems that literature can't escape reality. I think the reason for this may be indoor smoking, and some research reports support my guess about smoking indoor air. Fortunately, the bookstore completely banned indoor smoking shortly thereafter. In China, every move of a company is not a trivial matter. I very much hope that other companies can follow it as an example.

Also on that day (that was a terrible day, the air quality index exceeded 400, reaching a "very dangerous" level), I found that the PM2.5 level in a store and building in the "Green Zone" was safe. of. The Sanlitun Village shopping mall is particularly serious, and the air in each store is very bad. Those open doors and open-air corridors inflicted on my lungs and also violated the health of shop employees.

On this day, I think the best place is my own home, especially the bedroom. For most adults, a lot of time is spent indoors, and in our lives, one-third of the time is sleeping; therefore, installing air purifiers in the bedroom to protect the family is a matter of course. It is. Turn on the purifier, close the door, and go to sleep. Hey! In this case, in China, one-third of the time is free from pollution. My life is not based on imagination; when I purchased the air purifier, I personally compared the performance of multiple brand products. Close the bedroom door and open a purifier. After two hours, the indoor PM2.5 level is reduced by 95%-99% compared with the outdoor. This is still the result of the mute setting; for many other machines, this is not an easy task. I am now used to their buzz and see it as white noise that is relaxed and protected.

This is an adventure that a person is addicted to in Beijing. Although a lot of my data will be worrying, I still think that these solid data will give people some peace of mind. At least, I now know how bad the situation is, and I know how much I can improve.