Europalainen yleislääketieteen kongressi järjestettiin Krakowassa Puolassa kesäkuussa 2018. 3 päivän kongressi keräsi yli 4000 yleislääkäriä.
Blogissa jaan matkamuistoja, ajatuksia ja oivalluksia. Olen Espoossa työskentelevä Yleislääketieteen erikoislääkäri.
Kansainvälinen yleislääketieteen yhdistys WONCA (World Organization of Family Medicine) järjestää vuosittain sekä europalaisen että kansainvälisen kongressin.
Puolasta viime aikoina kuuluneet uutiset ovat olleet huolestuttavia, maa on valumassa eurooppalaisesta yhteisöstä. Kongressimatkalle lähtiessä en tiedä mitä odottaa.
Varsovaan on lyhyt lentomatka ja lentokentällä ystävällinen mies ohjeistaa junalippua ostaessa, pian kävelemme kohti vanhaa kaupunkia. Eihän se niin vanha ole. Toisen maailmansodan jälkeen kaupunkia ei enää ollut: se rakennettiin uudestaan pommituksen jäljiltä. Asukkaista puolet menehtyi sodan aikana, iso osa juutalaisia.
Aurinko paistaa ja hyvin hoidetut puistot tarjoavat varjoa, puun alla penkillä istuu vanha mies. Hän katsoo meitä, kaksi matkalaukkua vetävää naista, ja hymyilee. Jään miettimään miten monta matkustajaa hän onkin vuosien varrella nähnyt, monta vierasta, monta vihollista. Miten maailma on muuttunut hänen eliniän aikana.
Noin 20 v sitten entisissä itäblokin maissa alkoi toisenlainen uudelleenrakennus-projekti, tällä kertaa ei korjattu taloja vaan terveyttä. Alkoi ’Eastern European Health building project’, terveydenhuollon uudelleenrakennus. Paljon tehtiin oikein, sillä puolalainen elää keskimäärin 7.5 v pidempään nyt kuin vuonna -91. Maailma on muuttunut paremmaksi.
Viime vuosikymmenten kehitys on ollut huima. WHO:n Dr Mukesh Chawla kertoo luennollaan miten maailmaan köyhyys on vähentynyt: v 1990 köyhiä maailmankansalaisia oli 37 %, v 2016 enää 9 %. Euroopalla menee hyvin. Eurooppalaisen keskimääräiset tulot ovat kolme kertaa maailman keskipalkkaa suuremmat.
Sata vuotta sitten Suomikin oli monella tavalla kehitysmaa. Silloin 1000 syntyneestä lapsesta 214 kuoli ennen 5 vuoden ikää. Nykyään luku on 3.5. Euroopassa nyt syntyvän lapsen odotettu elinikä on 10-15 v pidempi kuin muualla maailmassa, nopeinten vanhenevista kansoista 19/20 ovat Euroopassa. Lisäksi on Japani.
Vanhan iän salaisuutta on tutkittu. Ei kovin yllättäviä löydöksiä: älä tupakoi, liiku ja vältä ylipainoa. Mutta todella pitkän iän salaisuus on myös uteliaisuus ja ilo. Mitä tapahtuu ensi vuonna, mitä elämällä on vielä annettavaa? Vanha mies penkillä, joka hymyillen meitä seuraa on selvästi kiinnostunut maailman menosta. Ja hän on toisaalta nähnyt hyvin paljon.
Puolan presidentin aikeista olen huolissani, mutta jään myös miettimään, miten negatiivinen kuva minulle on piirtynyt koko maasta ja sen ihmisistä lehtikirjoitusten kautta.
Kotimaassani sote-keskustelussa ei ole pitkään aikaan tiedotettu positiivista. Silti me tuotamme maailman parasta terveyttä suhteellisen pienellä budjetilla jo nyt. Mutta jatkuva ongelmien esiin tuominen peittää tämän tosiseikan.
Voisimmeko muuttaa asiaa tarkastelemalla tulevaisuutta mielenkiinnolla ja innolla? Asenne joka tuo myös pitkää ikää.
Jos haluat nähdä graafisesti miten paljon maailma on muuttunut parempaan, kts www.gapminder.org
https://yle.fi/uutiset/3-10275959
Annika Kolster, yleislääketieteen erikoislääkäri. Terveyskeskuslääkäri, Espoon terveyskeskus- Tapiolan terveysasema
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For instance, medications for top cortisol levels are often used to deal with Cushing’s syndrome, a
uncommon explanation for excessive cortisol in the
body. These medicines work by reducing the quantity of cortisol launched by
your adrenal glands. There are checks out there to assist
detect excess cortisol in your body. If you’re experiencing unexplained stomach weight acquire, your healthcare supplier will ask about your medical historical past
in addition to your diet, lifestyle, and common health.
The more you follow flipping the change, the simpler you become at managing stress.
Stress can set off changes, including zits, dermatitis,
itching, hives, and eczema or psoriasis flares. Your mind and intestine communicate with
one another via what’s called the gut-brain axis . Stress can affect the health of your digestive
tract, resulting in constipation, diarrhea, heartburn,
nausea and vomiting, and more. The extra you practice flipping this switch from stress to relaxation, the more resilient to emphasize you
turn into. A sedentary lifestyle, then again, can ratchet up your
stress response when a stressor strikes, resulting in elevated cortisol.
Our past traumas can even cause us to stay in a state of hypervigilance .
Insulin increased collagen production by two- to threefold and total protein manufacturing by
twofold in cultures of lung fibroblasts. This has led to many spectators or followers wondering what’s inflicting the looks of a ‘gut’ on these athletes
and why it has elevated in current times. The abdomen distension is thought in bodybuilding circles as ”HGH Gut”,”Insulin Gut”, ”Palumboism”,
or extra popularly, ”Bodybuilder Belly”, ”Muscle Gut” or ”Bubble Intestine”.
As the above name suggests, the stomach distension seen in these bodybuilders is believed to be attributable to
insulin and human growth hormone (HGH) abuse.
A private trainer also can help you build an efficient however applicable workout
plan. Moon face has a number of causes, together with long-term
steroid use and certain health conditions. It’s also important to stay hydrated while
taking prednisone since water can help the
physique get rid of sodium, and prednisone impacts how the physique processes
sodium. In general, the beneficial daily water intake
is no less than half an oz. per pound of physique weight.
During exercises and races longer than minutes athletes benefit from consuming carbohydrate.
Most athletes rely on concentrated carbohydrate
sources within the form of gels, bars, chews, or meals like bananas,
rice balls, or peanut butter and jelly sandwiches.
This will help you higher understand your personal consuming habits and pinpoint
sure patterns you might resolve are higher than others, or vice versa!
Introducing fiber into your food plan is one particularly useful means that will help you lose weight10.
In truth, fiber helps regulate your bowel to lower bloating, helps you’re feeling full for longer, and
manages your insulin response. All of these, in flip, have an result
on your metabolism and appetite in a weight loss program in a healthy and efficient manner.
Weight gain is likely one of the most regularly reported side effects of prednisone usage9.
In common, this weight acquire in exhausting to regulate and
may depart an individual feeling helpless and with a lack of autonomy.
Additionally, a rise in urge for food and adipose tissue redistribution to the face, trunk and back could make the scenario feel
much more out of hand.
Focusing on a wholesome lifestyle might help lessen weight gain and help you
shed the extra kilos progressively. Prednisone
may cause weight acquire by rising water retention and appetite.
You may notice more fat in sure areas as a end result of redistribution. If prednisone is efficient and your well being situation is under management, it
will be simpler to eat properly and be active again. Examine with your healthcare supplier about what consuming and train plans are acceptable for you.
Prednisone may cause weight gain as a end result of it will increase fluid retention and appetite.
Researchers recorded the body weights of trial members at baseline – in addition to after 1 yr.
Outcomes indicated that weight achieve was substantially larger in persons receiving methotrexate plus prednisone (10 mg/day) than in persons receiving methotrexate plus placebo.
Nonetheless, the methotrexate plus prednisone group additionally exhibited lower DAS28 scores,
indicative of decreased disease exercise. Although the strategy utilized on this study
was a casual means of analyzing aspect effect data, it helps the idea
that prednisone and related medications trigger weight gain. That
mentioned, this examine is restricted by the demographics of Twitter customers – making
it troublesome to know whether or not these stories accurately mirror antagonistic reactions within the
basic population. Extra specifically, prednisone-mediated temper adjustments would possibly
increase your urge for food, causing you to eat extra energy than traditional whereby you acquire weight.
Prednisone is an artificial pregnane corticosteroid that
was first recognized in 1950 by the American microbiologist Arthur Nobile, and thereafter,
synthesized in 1955 by the Schering Corporation.
Indicators and signs of intertrigo depend on how extreme it’s and if there is
an an infection or not. Some folks attempt to get extra nutrients from
merchandise known as dietary supplements. One complement that’s in style with
athletes is called creatine monohydrate. You cannot definitively know what
to anticipate from tren till you inject it, as folks have totally different experiences based
on their genetics. If a person is susceptible to zits vulgaris,
trenbolone is prone to trigger additional breakouts due to its androgenic nature.
Nevertheless, there are other symptoms that may accompany this condition, together with bloating, constipation, and belly pain. In extreme circumstances, the distended stomach can put strain on the diaphragm, making it tough
to breathe. When you expertise stress, your body adapts to confront the perceived threat in a response often known as
the fight or flight response. Your heart price and blood stress improve, your physique releases more glucose to fuel your muscle tissue, and you turn into hyperaware
of your environment. Cortisol belly is sometimes called ”stress belly”
because of weight achieve within the stomach space in periods of increased
stress. You may first notice a change in your look and not another associated
signs. Palumboism and bubble guts have turn out to be part and
parcel of skilled bodybuilding.
These mechanisms in part can hypothetically contribute to the event of
belly distension in athletes and bodybuilders.
Many bodybuilders are tempted to extend their carbohydrate consumption when chopping to keep up
muscle mass. However, as insulin use has been lowered
or eliminated, their is no extra benefit to sustaining high carbohydrate consumption. In fact, chopping carbohydrates and maintaining fats may cause higher ranges of testosterone when weight-reduction plan (11), whereas
the decreased meals volume will assist maintain Muscle Intestine underneath management.
It also needs to be noted that increasing protein additional throughout these diets may help enhance visceral fat loss that was attributable to the previous insulin use.
Also, consuming out at certain restaurants or meals may be challenging when looking
to preserve a low-carb diet. For this, consider
consulting this information on low-carb meals and restaurants which might be obtainable.
Total, this research suggests that prednisone therapy is more more probably to trigger weight achieve than deflazacort amongst boys
with DMD – regardless of whether used for a short-term (12 weeks) or
long-term (52 weeks). Results indicated that weight gain-related opposed effects were extra prone to be moderate or extreme amongst prednisone customers than deflazacort users.
Researchers talked about that greater charges of weight acquire amongst prednisone customers
(in comparability to deflazacort users) is in preserving with previous
information.
References:
JBH News
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