Friday, July 20, 2018

Carcinogenin in our daily activity

Last week we heard about recall of valsartan, why valsartan has been recall? it's because valsartan contain NDMA, then what is NDMA? NDMA is compound that potent cause cancer or in the other name its act as carcinogen, during this time you may have heard the term carcinogen. Very often people say that certain foods contain carcinogens, so you should limit their consumption because it can cause cancer. However, do you know what is actually a carcinogen?

Carcinogens are not only contained in food alone, but in fact many things around us that contain carcinogens. For more details, see the following explanation.

What is a carcinogen?
Carcinogens are things that can cause cancer, can be in the form of chemicals, viruses, or even drugs and radiation used to treat cancer itself. In essence, things that directly cause cancer can be called a carcinogen. In general, cancer is caused by a carcinogen or a combination of the carcinogens themselves.

Carcinogens can work in many ways, directly destroying DNA in cells, causing abnormalities in normal cells, and another way of causing cell damage that causes cells to divide faster, which in turn can lead to the development of cancer.

What are the examples of carcinogens?
Carcinogens have been classified into 3 groups by The International Agency for Research on Cancer. The classification consists of agents and groups of agents, mixtures, and environmental exposures.

Agents and agency groups, The example is:
Aflatoxin, is naturally produced by certain fungi
Arsenic compounds
Asbestos
Benzene
Benzidine
Nickel compounds
Solar radiation
Powder containing asbestiform fibers
Vinyl chloride, and others.

Mixed, The example is:
Alcoholic beverages
An analgesic mixture containing phenacetin
Tobacco products
Tobacco smoke
Wood powder, and others.

Environmental exposure, Examples such as:
Aluminum production
Making or repairing shoes and boots
Processing coal with coal gasification
Coke production
Making furniture
The formation of iron and steel
Rubber industry
Exposure to sulfuric acid in the work environment, and others.
In essence, these carcinogens can be found in chemicals present in your surroundings, environmental radiation (such as from sunlight), radiation from medical devices, viruses, drugs, and lifestyle factors.

These carcinogens are not certain to cause cancer in everyone who is exposed. The ability of carcinogens in causing cancer among individuals varies, depending on the amount of exposure, the duration of exposure, the health of the exposed individual, and other factors. The susceptibility of every person exposed to carcinogens in causing cancer also depends on heredity. Heredity plays an important role as a cause of cancer. In many cases, the incidence of cancer is caused by many factors that work together.

Carcinogens in food
Be careful, certain foods that you usually eat may also contain carcinogenic compounds. Recent studies have shown that processed meats contain carcinogenic compounds, which means they can cause cancer, especially colorectal cancer and stomach cancer.

Processed meat in question is meat that has been through the process of salting, preservation, fermentation, fumigation, or other processes aimed at improving taste and storage. Examples of processed meats are bacon, ham, sausage, salami, corned beef, and so forth.

This is because processed meat has the following content:
Meat processing, such as preservation (which adds nitrate or nitrite to meat) or fumigation, can lead to the formation of carcinogenic compounds, such as N-nitroso-compound (NOC) and polycyclic aromatic hydrocarbons (PAHs).

This is exacerbated by the content of heme iron in meat, which can support the production of NOC in meat.
Cooking meat at high temperatures, such as frying or baking, can also trigger the production of carcinogenic compounds, such as heterocyclic amines (HCAs) and PAHs. HCA is formed when the creatine and amino acids in the meat react to heat generated from the cooking process. HCA is one of the agents that can cause cancer.

Therefore, you should select red meat that is still fresh and cooked itself compared to processed meat cooked in the factory. You can also process the red meat by boiling or steaming rather than frying or burning which results in higher heat. This can make the meat you eat healthier.

In addition, balance your diet by eating vegetables and fruits. Vegetables and fruits can reduce levels of DNA damage and oxidation of carcinogenic compounds, thereby reducing your risk of cancer.

nutritional scale daily body need

Intervention for Clients with Malnutrition and Obesity

Nutrition has a major role in promoting and maintaining health. Health nutrition not only contributes to the results of positive treatment but also as health care. As part of a comprehensive health assessment, including a nutritional examination to identify clients who are malnourished or at risk for developing nutritional deficits.

NUTRITIONAL STANDARDS TO PROMOTE HEALTH

1. Diet Recommendations
Several national standards are available to evaluate planning and nutrition. The most widely accepted standard in the United States is Recommended Dietary Allowance (RDA). The RDA sets out recommendations for energy intake, protein, vitamins, and minerals for population health. For adults it takes 1800 calories / day and 0.8 g protein / kg body weight to meet basal energy needs.

RDA can be used to estimate adequate nutrient intake over time. If the client does not meet 100% of the RDA he will be malnourished. All people who meet 100% of the RDA will not experience malnutrition.

The Food and Nutrition Board (FNB), with Canadian Health involvement, has recommended that the Dietary Intake Reference (DRI) replace the RDA. The first DRI was released recommending nutritional intake relating to bone health (Food and Nutrition, 1997). The established standard of Canada, Recommended Nutrient Intake (RNI), is similar to the United States.

The role of diet and nutrition in illness has been an interesting topic for many years. The current focus is on health promotion of disease prevention. In 1995 the Dietary Guidelines for Americans were revised by the US Department of Agriculture (USDA) and the United States Department of Health and Human Services (DHHS).

The seven guidelines emphasize the importance of choosing food to maintain a healthy diet with balance, moderation. One of the most striking changes of the previous edition occurred in the heavy guidelines. For the first time, diet and physical activity are useful to maintain or increase weight.
Nutrition Recommendation for Canada (Table 64-1) is similar to Dietary Guidelines for Americans. In addition, they recommend limiting to consuming no more than four cups of coffee per day for diet and adding florida to drinking water sources to a level of 1 mg / L.

Table 64-1 Recommended Nutrition for Canada
· Sodium should be reduced
· Diet is no more than 5% of total energy
· Diet should contain no more than four cups of regular coffee per day
· Energy for the diet should be consistent with weight maintenance within the recommended range
· Diet should include essential nutrients in specific amounts of nutritional intake recommendations
· Diet should include no more than 30% of energy as fat (33 g / 1000 kcal or 39 g / 5000 kJ) not more than 10% as saturated fat (11 g / 1000 kcal or 13 g / 5000 kJ)
· Diet should provide 55% of the energy as carbohydrates (138 g / 1000 kcal or 165 g / 5000 kJ) from various sources.

2. Food Pyramid
Developed the USDA Food Guide Pyramid in 1992 to translate food recommendations into a practical graphical format (Fig. 64-2). A pyramid is chosen to communicate three key successful diets: varieties, moderation, and proportionality. The design of the pyramid of dietary buildings emphasizes on the basis of grains, fruits, and vegetables. The amount of meat, protein sources, and everyday products is added, and the intake of fats and sweets is limited. Table 64-2 shows the daily portion of each food group and explains the size of a serving.

Following this pattern produces an adequate nutritional intake if various foods are selected.
Various vegetarian dietary patterns are being adopted by many people for health, the environment, and moral reasons. In general, vegetarians are leaner than those who consume meat. Lacto-vegetarians who eat milk, cheese and milk, but avoid food, meat, fish, poultry, and eggs. The lacto-ovo-vegetarian also includes eggs. The vegetarians only eat foods that come from plants. Vegan can develop megaloblastic anemia due to vitamin B12 deficiency. All vegetarians must make sure that they get an adequate amount of calcium, iron, zinc, and vitamin D and B12. The Vegetarian Food Pyramid, supported by the Vegetarian Resource Group, can help vegetarians with daily food choices (Figure 64-3).

The third pyramid has recently been developed low-carb trends ("low-carb") diets, such as the Atkins and South Beach diet. Emphasizing the Atkins pyramid building diet on protein sources, vegetables rather than whole grains, fruits, dairy products, and nuts are added, as well as limited wheat food. Foods containing carbohydrates are the most undesirable foods, such as pasta, cakes, and white bread.

Thursday, July 19, 2018

Pathophysiology of Chronic Obstructive Pulmonary Disease AKA COPD

The pathophysiology of chronic obstructive pulmonary disease (COPD) or chronic obstructive pulmonary disease is primarily a change in the airway, but there may also be changes in pulmonary parenchymal tissue and pulmonary vasculature. Most cases of COPD are caused by exposure to harmful substances, most often caused by cigarette smoke. The pathophysiologic mechanism remains unclear, but is thought to be caused by many factors.

Damage to the Respiratory Tract

Health Lung and Lung with COPD
Structural alterations of the airway are atrophy, squamous cell metaplasia, ciliary abnormalities, plain muscle cell hyperplasia, mucosal gland hyperplasia, inflammation and bronchial wall thickening. Chronic inflammation in chronic bronchitis and emphysema is characterized by an increase in the number of CD8 T-lymphocytes, neutrophils, and monocytes / macrophages.

In comparison, inflammation in asthma is characterized by elevated CD4 lymphocyte T cells, eosinophil and interleukin (IL) -4 and IL-5. However this can not be used for diagnosis, because there are conditions of asthma that develop into COPD.

Lung Parenchymal Damage

Emphysema causes damage to the distal structure of the terminal bronchioles. This structure consists of bronchioles, ductus alveoulus, and saccus alveoli which are overall called asinus. Damage to the alveoli will cause air flow disruption through two mechanisms, namely by decreasing the elasticity of the airway wall and airway narrowing. There are 3 patterns of morphologic Emphysema, namely:
1. Centracinar
Characterized by damage to the bronchioles and central parts of the acini. This type of emphysema is usually found in smokers and the upper lobe is the most severely damaged part.
2. Panacinar
Characterized by extensive damage to all parts of the acinus. This type usually causes severe damage to the lower lobe and is usually found in patients with alpha 1 antitrypsin deficiency.
3. Distal Acinar
Damage occurs in the distal structures of the airway, ductus and alveolar saccus. This type of emphysema is localized to septa fibrous or pleura and will lead to bullae formation. A ruptured apical bullae can cause spontaneous pneumothorax.

Pulmonary vascular damage
Changes in pulmonary vascular hyperplasia of intima tunica and smooth muscle due to chronic vasoconstriction of small pulmonary arteries triggered by hypoxia. [1, 2]

Reference
1. UpToDate. Chronic obstructive pulmonary disease: Definition, clinical manifestations, diagnosis, and staging. February 2017 [Cited 2017 14 March]; Available from: http://www.uptodate.com/contents/chronic-obstructive-pulmonary-disease-definition-clinical-manifestations-diagnosis-and-staging

2. MedScape. Chronic Obstructive Pulmonary Disease (COPD). March 2017 [ Cited 2017 14 March]; Available from : http://emedicine.medscape.com/article/297664

Causes and Symptoms of COPD

What Is COPD ?
Chronic obstructive pulmonary disease (COPD) is a lung inflammatory disease that develops over a long period of time. This disease prevents airflow from the lungs due to blocked swelling and mucus or phlegm, so that sufferers difficult to breathe.

Most COPD people are middle-aged people and smokers. Patients with this disease have a risk for heart disease and lung cancer.

What Causes COPD?

The etiology of chronic obstructive pulmonary disease (COPD) is damage to the airway or damage to the pulmonary parenchyma. This damage can be caused by:

COPD Causes By Smoke
Smoking is still a major cause of COPD, including second-hand smoke. World Health Organization (WHO) estimates that in 2005, 5.4 million people died from cigarette consumption. Cigarette-related deaths are expected to increase to 8.3 million deaths per year by 2030 [3].

Smoking stimulates macrophages to release the neutrophil and elastase chemotactic fators that will cause tissue destruction. A study showed that pulmonary function impairment and pulmonary structural changes in patients who smoked had occurred long before clinical symptoms of COPD emerged.

COPD Causes By Environmental Factor
COPD Causes
COPD can occur in patients who have never smoked. Environmental factors are suspected to be the cause but mechanisms are not known for sure. In countries with moderate to high income, smoking is a major cause of COPD, but in low-income countries exposure to air pollution is the cause. Risk factors originating from the environment include indoor pollution, outdoor pollution, chemicals and dust in the work environment, as well as recurrent lower respiratory tract infections at the age of the child.

Alpha1-antitrypsin (AAT) enzyme deficiency
AAT is an enzyme that serves to neutralize the effects of elastase neutrophils and protect the lung parenchyma from elastase effects. AAT deficiency is a predisposing factor in heat type Emphysema. Severe AAT deficiency will cause premature emphysema at a mean age of 53 years for non-smokers and 40 years in smokers.

Other COPD causes

Other things that can cause COPD are:
  • Hyperresponsive airway
  • Intravenous drug use
  • Immunodeficiency syndrome
  • Vasculitis syndrome
Chronic Obstructive Lung Disease Symptoms
In the early stages, COPD rarely shows any specific symptoms or signs. The symptoms of this disease only appear when there has been significant damage to the lungs, generally within years.

There are a number of symptoms of COPD that can occur and should be wary of:
  • Cough with phlegm that does not heal with mucus color phlegm colored slightly yellow or green.
  • Breathing is often short of breath, especially during physical activity.
  • Wheezing or breathing congestion and rang.
  • Limp.
  • Weight loss.
  • Chest pain.
  • The legs, ankles, or legs become swollen.
  • Lips or fingernails are blue.

Referensi

1. UpToDate. Chronic obstructive pulmonary disease: Definition, clinical manifestations, diagnosis, and staging. February 2017 [Cited 2017 14 March]; Available from: http://www.uptodate.com/contents/chronic-obstructive-pulmonary-disease-definition-clinical-manifestations-diagnosis-and-staging

2. MedScape. Chronic Obstructive Pulmonary Disease (COPD). March 2017 [ Cited 2017 14 March]; Available from : http://emedicine.medscape.com/article/297664

3. WHO. Chronic obstructive pulmonary disease (COPD). November 2016 [Cited 2017 15 March]; available from: http://www.who.int/respiratory/copd/

gastroenteritis prevention

Prevention of gastroenteritis

Here are some ways you can do to prevent the occurrence of intestinal infection:
  • Washing hands. Wash the whole hand (including the sidelines of the nail) to clean. Use soap, then rub
    your hands for about 20 seconds, and rinse with clean water. If there is no soap and water, use a cleaning wipes or hand sanitizer.
  • Always wear personal equipment. It is advisable to use your own cutlery and drinkware, such as cups, plates, spoons, and forks. Avoid wearing cutlery alternately with others. Make sure every family member has their own towels.
  • Keep the distance. If you are forced to make contact with a person infected with gastroenteritis, try to keep a distance from it. Do not touch items used by an infected person.
  • Cleaning stuff. Clean items, places, and also surfaces touched by an infected person. Objects such as table surfaces, taps, door handles, spoons, forks, and other equipment used by gastroenteritis patients living in your home can become a medium of transmission of the virus.
  • Rotavirus vaccine. This vaccine is given to prevent diarrhea due to rotavirus. There are two types of rotavirus vaccine spread in Indonesia, namely rotateq and rotarix. Rotateq is given three doses at infants aged 6-14 weeks, 4-8 weeks later, and 8 months of age. While rotarix is ​​given two doses at the age of 10 weeks and 14 weeks (6 months).

In addition to some of the above efforts, there are some things you can consider to prevent gastroenteritis. If you are traveling or in a public place, you should be careful in choosing foods and beverages that you consume. Here are some things to avoid:
  • Avoid eating raw foods, either vegetables or fruits that have been peeled or touched by the hands of others.
  • Do not eat meat that is half-baked.
  • Buy bottled water to avoid consuming contaminated water. Including when you brush your teeth, it is advisable to keep using bottled water.
  • Avoid consuming ice cubes that are not guaranteed cleanliness, because it could be the water used to make ice is contaminated by the virus.

who are at high risk of gastroenteritis

What is Gastroenteritis
Gastroenteritis is an infection of the stomach and intestines caused by several types of viruses and bacteria. This condition is also known as flu or gastric flu. Gastroenteritis can cause nausea, vomiting, diarrhea,
abdominal cramps, or indeed fever in the sufferer.

Gastroenteritis can spread through contact with people who have been contaminated with the virus. These infections are easy to use in public spaces, such as in classrooms, child care, or general care rooms.

Causes of Gastroenteritis
Overcooked foods are left too long in room temperature can also be the cause of the emergence of gastroenteritis bacteria. These infections are often characterized by nausea, vomiting, and diarrhea. This condition is often referred to as food poisoning. Gastroenteritis rarely causes complications. However, this condition can be fatal or even deadly if it occurs in infants, parents, and people who have problems with their immune system.

Here are some groups of individuals who are at high risk of gastroenteritis, including:

  • Small children. Children are more susceptible to viral infections because they do not have a strong immune system.
  • School children and living in dormitories. This infection can be transmitted easily in places where there are many people gathered at close range.
  • The elderly. The immune system in the elderly will decrease. These infections can easily be transmitted to the elderly if they live close to the person potentially spreading the germs.
  • People with weak immune systems. People with certain medical conditions, such as HIV and chemotherapy, are at higher risk of contracting infections because their immunities are attacked by the conditions they are suffering.

Diagnosis and Treatment of Gastroenteritis

Diagnosis of Gastroenteritis
Doctors may be able to detect gastroenteritis from symptoms experienced, as well as through physical examination. If necessary, the doctor may recommend a useful stool test to determine the type of organism that causes gastroenteritis. In addition to viruses, gastroenteritis can also be caused by bacteria and parasites.

Treatment of gastroenteritis
The main purpose of treatment of gastroenteritis is to prevent the occurrence of dehydration. Therefore,
patients are encouraged to drink plenty of water. If the dehydration is severe enough, the patient may need to be admitted to the hospital to get fluids through the IV.

Salt and sugar (Oralite) may be given to aid rehydration. This drug contains the electrolytes and minerals needed by the body. Although ORS can be bought freely in the market, be sure to always follow the rules of use written on the packaging. If necessary, ask your doctor or pharmacist for more information.

Antibiotic medicines are not effective against viruses. In addition, do not give aspirin to relieve symptoms of pain in patients who are under the age of 16 years. To help alleviate the symptoms of gastroenteritis, do some of the following tips at home:

  • Try to always drink more fluids. If drinking difficulties directly from the glass, use a straw. Avoid eating fruit juice because this drink can actually increase the symptoms of diarrhea experienced.
  • Consumption of foods in small amounts and easily digested, such as bananas, porridge, and fish. It aims to provide recovery time for your stomach. Stop eating if the nausea begins to feel again.
  • Use more time to rest.
  • Children and adults can consume energy drinks to replace electrolytes in the body. Oralit is also highly recommended for treating infants and children. Avoid ice cream or soft drinks because it can aggravate diarrhea in children.
  • In patients with children, gastroenteritis should be treated as early as possible because the disease contributes to mortality in children who are quite high in Indonesia. Symptoms to watch out for include easy drowsiness, lips and mouth become dry, their hands and feet also feel cold. If that happens to your child, rush to the hospital for the best treatment.

The doctor will provide fluid intake to your child with nasograstic or NG tube, which is a tube inserted through the nose to the abdomen. The fluid intake can also be administered to your child directly with intravenous therapy injected through the blood vessels.

You can also do self-care by administering fluids to infants, 15-20 minutes after they have vomiting or diarrhea. This time lag is required for the baby's stomach to rest for a moment. Breast milk can be given to a baby if he is still breastfed. In addition to breast milk, oral acid or formula can also be given if the baby can drink from the bottle.

Read Also : What is Gastroenteritis? Diagnosis and Treatment of Gastroenteritis - Gastroenteritis Prevention

Wednesday, July 18, 2018

Contains Salmonella, Hy-Vee recalls Spring Salad

The U.S. Food and Drug Administration said Wednesday the West Des Moines-based grocery chain discovered potential salmonella contamination on Monday night and pulled the product from its shelves.

After 20 people got salmonella in Minnesota, South Dakota, Nebraska and Iowa, Midwest grocery store chain Hy-Vee Inc. has recalled its store-brand spring pasta salad.

The states are Iowa, Minnesota, Nebraska and South Dakota -- where the salmonella illnesses occurred -- and Illinois, Missouri, Kansas and Wisconsin.

The product was produced between June 1 and July 13. The packages have expiration dates between June 22 and August 3. Customers should dispose of the product or return it to a Hy-Vee store.

Symptoms of salmonella infection include diarrhea, fever and abdominal cramps, and typically present 12 to 72 hours after exposure to the bacteria. The company first learned of the potential link to the illnesses Monday night and voluntarily pulled the salad from stores.

Symptoms last four to seven days, and although most people improve without treatment, some may require hospitalization because of severe diarrhea. Hy-Vee's phone number is 1-800-772-4098. It has more than 245 stores.

5 Amazing Facts About Human Brain

The human brain is one of the most mysterious, amazing, complicated and most valuable organs. Organ that serves as the body's propulsion machine also has a lot of uniqueness. Let's see more about the following brain facts!

Read Also : How to Exercise Your Brain
Read Also : Sweating Trigger Brain more creative

The facts about the human brain you may not know

1. The brain needs a lot of blood supply
To be able to work optimally, the brain needs a lot of blood supply that should not be stopped. In fact, 30% of the blood flow from the heart will be directly channeled to the brain. This blood flow makes the brain capable of producing a reaction or an action in just 1 per 10 thousand seconds. Wow, that's quick!

2. Exercise is good for the brain
Exercise is not only good for your body and heart health, you know! Basically, exercise makes the heart work harder to pump blood. Well, as explained above, the brain needs nonstop blood intake in order to function properly.

More blood flow after your diligent exercise can help maintain brain health. Hmm .. That's why if you lack movement, the brain can be "slow" because the lack of blood that flows into the head.

More unique, the brain will learn and remember every muscle movement as you move for the sport. This then allows you to move on to the next sports sessions.

Then, when is the right time to exercise if you want to maintain brain health? Morning. Exercise in the morning can help the brain receive more blood intake so as to increase your ability to focus and concentrate work throughout the day.

3. The more eating fat, the healthier your brain
Remember, not all fats are evil and should be avoided. Good fat intake, especially omega-3 and omega-6 from fish and fruits such as avocado, works to reduce inflammation in the brain while supporting the strength of the immune system. In fact, omega-3 fatty acids are the main nutrients that help the functioning of the brain.

The composition of the brain comprises about one-quarter of fat produced by DHA, a fatty acid belonging to the Omega-3 group. DHA plays a role in supporting gray matter of the brain associated with intelligence. DHA also establishes the sensitivity of neurons that help convey information quickly and accurately.

A study shows that increased intake of omega-3 fatty acids from foods such as fish and vegetable oils may help counteract the risk of Alzheimer's. Other studies have also found that people who consume fish oil supplements are better protected from the risk of brain weakening (atrophy) than people who do not consume fish oil.

4. The brain can still function 3-5 minutes after the head is decapitated
In addition to blood, the brain's work is also supported by glucose and oxygen that comes transported in the bloodstream. Sugar and oxygen are the main fuels for the brain. That's why if you eat less or skip meals, or rarely exercise, work the brain will gradually decrease.

Permanent brain damage can occur after 3-5 minutes without oxygen or glucose intake at all. No wonder when the head of a person beheaded, the brain can still work temporarily because it has not experienced permanent damage or death function in the first few minutes.

5. Brain operation does not make the brain so stupid, but can change the personality
Facts about this brain may be a bit weird and unique. But did you know, that brain surgery, or hemisferektomi, aim to lift some of your brain? Hemisferektomi is a very rare surgery performed to overcome seizures.

Many believe that with the removal of some "portion" of the brain, the intelligence of the person can decline. This is wrong. Hemisferektomi does not cause an intelligence disorder, but it can alter a bit of your brain function after surgery. For example a change in your memory, sense of humor, or personality.

Read Also : How to Exercise Your Brain
Read Also : Sweating Trigger Brain more creative