Education
Selenium
Selenium is a trace mineral in the human diet. There is also little knowledge in society about the impact of this element on human health. It is definitely not as popular as magnesium or zinc, although it is equally necessary in our diet. Humanity became aware of the existence of selenium over two centuries ago, when it was isolated by the Swedish chemist Jacob Brezelius. What more do we know about him now? First of all, it is an essential component of enzymes involved in oxidation-reduction processes and cytochrome, thanks to which it protects cell membranes, and therefore the cells themselves, against oxidative stress. Hence its beneficial effect on the immune system. People suffering from any thyroid disorder have certainly come across information about its key role in the metabolism of this gland's hormones. The problem of male infertility allowed us to draw attention to the role of selenium in proper spermatogenesis, where this ingredient is necessary for the formation of sperm with proper structure and the desired motility. Less known properties of selenium include its influence on the proper functioning of the muscular system, including the heart muscle. They are so important that in regions of the world exposed to extreme deficiencies of this element, we are dealing with a specific cardiomyopathy (Keshan disease). We will also find information confirming the impact on the low birth weight of newborns whose mothers were deficient in this microelement. There are interesting reports about the effect of selenium on the nervous system, where deficiencies manifest themselves in mood declines. And finally, related to the antioxidant effect, it influences the development/inhibition of some cancer diseases, e.g. prostate, lung or colon cancer. Selenium deficiency may manifest itself through: - hair loss and brittle nails, - nervous system disorders (low mood, depression), - fatigue, - weakness of skeletal muscles and heart muscle, - weakened immunity, - thyroid abnormalities, - male fertility disorders. Where to look for selenium? The element is taken from the soil by plants, which become food for herbivorous animals. Theoretically, both animal and plant food can be its source. Foods recommended for deficiencies are most often: offal (kidneys), eggs, dairy products, sea fish, mushrooms, garlic and Brazil nuts. The latter, generally considered to be the richest source, obviously do not come from our region, and when buying them we may not be 100% sure whether they actually come from areas rich in this element. In practice, in Polish latitude, we deal with low selenium content in the soil, which results from the geographical location. The rocks from which the soil is formed in our native areas are very low in selenium. Additionally, the acidic nature of these soils makes it difficult for plants to absorb the said mineral. Supplementation may be the solution to replenish the deficiencies. The preparations available on the market include both organic forms (l-selenomethionine) and inorganic forms, e.g. sodium selenate. The daily recommended intake of selenium for adults is 55 mcg. However, supplements may contain a dose almost four times higher, up to 200 mcg. When supplementing selenium, it is worth remembering that it is a trace element for humans, which means that there is a small difference between a therapeutic and toxic dose. Therefore, despite potential deficiencies, when deciding on supplementation, it should be used very carefully, in accordance with the dictum of Paracelsus Everything is poison and nothing is poison. Only the dose makes a substance not a poison. Marta Wcześniak BIBLIOGRAPHY: Piotrowska "Content of selenium in cultivated soils of Poland", Roczniki Gleboznaczne T XXXX, No. 1, Warsaw 1984 Golonko, B. Matejczyk "Two faces of selenium, selected aspects of the biological activity of selenium" Civil and Environmental Engineering 9 (2018) Ratajczak, M. Gietka-Czemel "The role of Selenium in the human body" Advances in Medical Sciences 2016 XXXIX(12) Resolution No. 7/2021 of the Team for Dietary Supplements of 28/10/2021
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Are French fries and chips a health hazard?
Fried foods, especially those based on carbohydrate products, are an integral part of our diet. However, more and more research indicates that the frying process may produce acrylamide - a chemical compound that may pose a risk to human health. In this article, we will explore the health effects of acrylamide, the products in which it is present, and present medical sources that confirm this risk. Organizations such as the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) have classified acrylamide as a carcinogen. What is acrylamide? Acrylamide is a chemical compound produced in the process of thermal processing of carbohydrate products, such as potatoes, French fries, bread, as well as coffee and some cereal products. It is produced by the reaction of amino acids with sugars in the presence of high temperature. High concentrations of acrylamide can be found in burnt or heavily browned foods. Where is acrylamide found? Primarily in carbohydrate products subjected to high temperatures during frying or baking. Examples of products include: French fries, chips, potato pancakes, bread, cookies, roasted coffee. Acrylamide in research Scientific research and assessments by health institutions clearly emphasize the potential danger associated with acrylamide. If possible, it is worth limiting the consumption of heavily burnt or roasted foods to minimize the risk of exposure to this carcinogenic substance. Deep frying carbohydrate products, although providing culinary pleasure, leads to the formation of acrylamide, a substance harmful to human health. To reduce the risk, it is worth choosing less burnt and more delicately prepared foods. Marta Wcześniak Medical Sources and Research: EFSA (European Food Safety Authority). (2015). EFSA statement on the presence of acrylamide in food. Tareke, E., Rydberg, P., Karlsson, P., Eriksson, S., & Törnqvist, M. (2002). Acrylamide: a cooking carcinogen? National Cancer Institute. (2020). Acrylamide and Cancer Risk. National Toxicology Program. (2021). Report on Carcinogens, 15th Edition.
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Painkillers and health
Year by year, sales statistics of painkillers increase, according to many of them, in recent years by up to 250%! Pain is an inherent part of the human experience, and pain medications are often the first choice for relieving symptoms. However, their excessive and regular use may have adverse consequences for human health. It is worth understanding the different types of painkillers, their potential side effects and the causes of pain in order to approach the topic responsibly. Types of Painkillers: NSAIDs (non-steroidal anti-inflammatory drugs): Examples are ibuprofen, diclofenac. They have anti-inflammatory and analgesic effects by inhibiting enzymes responsible for inflammation. They may cause gastrointestinal problems. SIDE EFFECTS: May cause gastrointestinal problems, ulceration, bleeding. Paracetamol: Has an analgesic and antipyretic effect. Its excess can damage the liver. SIDE EFFECTS: Too high a dose or given for too long may damage the liver. Opioids: Strong painkillers such as morphine or oxycodone. They can lead to addiction and have a depressing effect on the respiratory system. SIDE EFFECTS: Risk of addiction, respiratory depression, drowsiness. DON'T IGNORE THE PAIN! Pain can be a signal from the body that something is wrong. Pain symptoms in the head, joints, spine or abdomen may be caused by various reasons, such as injuries, infections, chronic diseases or improper habits. Ignoring pain can worsen your condition and delay proper diagnosis. DO YOU EXPERIENCE PAIN REGULARLY? Consult a doctor - pain is intense, frequent or persistent, it is worth consulting a doctor to rule out serious health problems. ATTENTION! Don't overuse painkillers: Use medications only as directed by your doctor or as directed on the package. Adopt healthy habits - a healthy diet, regular physical activity and avoiding stress can help reduce pain; in many cases, recurrent weakness, nausea or headaches result from DEHYDRATION or lack of adequate food during the day. Remember that a healthy approach to pain involves recognizing its cause, not just masking the symptoms with painkillers. When in doubt, it is always a good idea to consult your doctor to ensure that you receive appropriate medical care. Mata Wcześniak Bibliography: American Heart Association. (2020). Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). National Institute on Drug Abuse. (2020). Opioids. Mayo Clinic. (2021). Pain Medications: Prescription pain relievers, OTC pain relievers and topical products. Harvard Health Publishing. (2019). The hazards of too much acetaminophen. Mayo Clinic. (2021). Pain Management: Pain basics. Harvard Health Publishing. (2020). When Pain Relievers Cause More Headaches.
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Sleep disorders and their impact on the course and control of diabetes
Diabetes is a very common disease nowadays. It is called a civilization disease or a non-communicable epidemic of the 21st century. About 3 million people suffer from the disease in Poland, and approximately 440 million in the world, which translates into 1.6 million deaths annually due to it. The disease increases mortality but also deteriorates the quality of life. Diabetes that is improperly treated and poorly controlled causes very serious complications, mainly cardiac ones - more frequent heart attacks, strokes, atherosclerosis of arterial vessels, and, as a consequence of these changes, an increase in the number of lower limb amputations, cases of kidney failure, and diabetic retinopathy. Peripheral polyneuropathy is a very painful symptom, affecting mainly the feet and significantly worsening the patient's quality of life. Currently, an individual approach to a patient with diabetes is emphasized, because each case is different. Each patient struggles with diabetes at different stages and degrees of advancement, uses different antidiabetic drugs or insulin therapy, has a different lifestyle, work pattern, ability to perform physical activity or follow an appropriate diet, which is so important in diabetes. Despite increasingly better treatment methods, modern drugs and insulins, new insulin pumps and continuous glucose monitoring (CGM) systems, good diabetes control and avoiding hyper- or hypoglycemia are still influenced by many elements of the patient's daily life. Regularity, repetition, consistency of eating, working and resting times, avoiding excessive stress, worrying, living in a hurry, as well as the ability to get good and healthy sleep are very important. The latest diabetes recommendations of the PTD emphasize the role of sleep, its duration and quality on the course of diabetes. Sleep disorders affect diabetes in two ways. On the one hand, they worsen its balance, causing morning hyperglycemia, increased insulin resistance, and certain neurological disorders that persist during the day regarding concentration, memory, and emotion. On the other hand, diabetes, especially insulin therapy or traditional, older drugs such as sulfonylurea derivatives, generate glycemic disturbances at night and impair the quality of sleep. Sleep disorders in patients with diabetes and their adverse impact on health parameters The journal Diabetologia conducted a meta-analysis on the incidence of sleep disorders in type 2 diabetes and their impact on factors such as glycemic control, micro and macrovascular complications, depression, mortality and quality of life. The authors, based on the available literature in the PubMed database, asked the extent to which the treatment of sleep disorders in patients with type 2 diabetes can improve the mentioned health factors. The review included both observational and experimental studies. The results showed that insomnia (39%), obstructive sleep apnea (55-86%), and restless legs syndrome (8-45%) occurred more often than in the general population without diabetes. Moreover, it has been shown that sleep disorders have a significantly negative impact on glycemic control and increase the percentage of glycated hemoglobin HbA1c. The reason for the increase in glycemia after a bad night's sleep is believed to be an increase in the amount of stress hormones, mainly cortisol, which causes metabolic disorders, insulin resistance, slower metabolism, difficulty maintaining optimal body weight, and additional snacking at night or in the morning. Repeated sleepless nights increase your cardiovascular risk. It has been proven that people who sleep little have higher levels of CRP (acute phase protein), which causes a greater risk of inflammation, weakened immunity, a greater risk of obesity, diabetes, hypertension, depression, and cancer. Already the first sleepless night causes memory and concentration disorders, weakened reflexes and the ability to react, anticipate, make decisions and various emotional disorders. Each additional one increases the risk and intensity of the above-mentioned disorders. Such a person may have impaired driving skills, limited assessment of the consequences of actions and reduced foresight, which may contribute to an increased risk of road accidents or accidents at work. The body returns to full balance only after three consecutive nights of sleep. Treating sleep disorders may therefore play an important role in preventing the progression of diabetes. Conventional therapies such as weight loss, education, and cognitive behavioral therapy appear to be effective in improving sleep and health outcomes in patients with diabetes. Sleeping medications should only be used in more severe cases and for short periods of time. For this purpose, you can use herbal medicines that have a relaxing and sleep-inducing effect, as well as melatonin. In conclusion, it can be stated that because the treatment of sleep disorders can prevent deterioration of diabetes control, sleep disorders should be recognized and treated in patients with diabetes in order to ultimately improve health and quality of life. Diabetes and drug therapy as factors worsening sleep quality A diabetic patient using insulin therapy, especially intensive 3-4 injections a day, and also treated with an insulin pump or older generation drugs, such as sulfonylurea derivatives, is more exposed to fluctuations in glycemia at night, which may manifest as: Hyperglycemia, i.e. too high blood glucose level >180 mg, with symptoms of difficulty falling asleep, more frequent urination - nocturia and large amounts of urine excreted (polyuria), Hypoglycemia, i.e. too low glycemia level <70 mg/dl. It may cause waking up at night or waking up with heavy sweats, deterioration of sleep quality, problems with waking up, feeling tired, dull, and irritable during the day. To avoid these problems, you should choose the appropriate meal for dinner, especially the amount of carbohydrates in the meal, and adjust the appropriate dose of insulin depending on the glycemia before the meal, e.g. around 6:00 p.m., and basal insulin, usually administered around 10:00 p.m. Currently, with advanced devices for measuring CGM (Continuous glucose monitoring system), new insulin pumps with a hybrid system and closed loop, significant nocturnal hypo- or hyperglycemia is becoming less common, and patients have a better quality of life and avoid dangerous complications of diabetes. . To ensure comfortable sleep, remember the basic rules, such as the appropriate temperature in the bedroom (about 18 degrees Celsius), airing the room, properly selecting a sleeping pillow and mattress, and using headbands or earplugs. In the evening, it is important to turn off multimedia and avoid intense exercise late at night. It is worth remembering about fixed sleep times and avoiding shift work at night. To sum up, detecting and treating sleep disorders is not usually part of standard patient care in a diabetes office, which is often due to the time limit of such a visit, but drawing attention to this problem in the doctor's office and ensuring the patient's good sleep contributes significantly to improving diabetes control. , and sometimes to prevent it and reduce the risk of other diseases and health problems mentioned in this article. Krzysztof Chabros Diabetologist specialist Literature: Urszula Cieślik-Guerra, Sleep disorders as a risk factor for type 2 diabetes, " Fam Med Prim Care Rev11.3 (2009), pp. 574-576. Clinical recommendations for the management of patients with diabetes 2022. Position of the Polish Diabetes Association. Current Topics in Diabetes, 2022;2 (1) p. 26.
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Child and parent's cancer. How to talk to him and what to say to him?
Many people affected by cancer initially do not want to talk about it to their children to protect them from additional stress. This is understandable - trying to protect a child from the worries of the adult world is natural, but hearing a diagnosis of a disease does not only concern the sick person, but also affects the entire family. What should you tell a child if a parent, guardian or loved one is sick? When should you bring up the topic of death? Talking to a child about a parent's illness The first question that comes to mind is whether to tell the child about the disease at all. Honesty is the best policy. Regardless of age, children perfectly sense their parent's emotional states and tensions, even if we think we have masked them well. The child will notice changes in the daily routine and changes in appearance that will appear during the treatment process. When children do not know what is happening, they will invent their own story in their heads, which may be much more terrifying for a young person who is just developing than the truth. The message given to the child should vary depending on his or her age. Speak to him in a language adapted to his communication capabilities. Small children will not always be able to understand the consequences of the disease, but they will understand that, for example, their mother needs rest. The child needs to know what is happening with the caregiver. They may ask a lot of questions, such as: Does it hurt? And where is the cancer hiding? . They will probably also ask questions about how their parent's illness will directly affect them, e.g. Will I still go to school? Will I still be able to go outside? At a given moment, due to the lack of full understanding of the consequences of the disease, the child may simply ask after the conversation: What's for dinner? Older children will have a greater understanding of the situation and may have more existential questions on their part. Regardless of the child's age, remember to give him space to sort out what he has heard and to ask him what he needs. How to take care of a child depending on his age Children aged 3 to 5 years. Children under the age of 5 are generally unable to understand that we all die eventually. Children this age may expect the return of someone who has died. It often takes time and growing up for them to realize that the parent they loved will not come back. When death is very close, the child should know that the parent will die soon. It's important to tell the truth. If an expression like this is used: " Mom will go to sleep. ” and at some point the child will realize that his mother has not woken up, he may be afraid to go to sleep at night. Here are some tips that may help: messages explaining what is happening should be simple - in words understandable to the child, check whether the child understands the message, repeat and explain as long and as often as the child needs it, also name your states and emotions, e.g.: " Today I feel sad ." Children aged 6 to 8 years Children at this age are better able to understand the concept of death and that it is permanent. Some of them may imagine her as a monster or as an outsider who can come and catch them, and if they run fast enough, they can escape. A child at this age may also blame himself for his parent's illness, e.g. "Mom doesn't love me because I told her I hate her and that's why she's sick ." It is important to explain to the child why the sick parent cannot play with him/her. Here are some tips that may help: inform the child, in a language he understands, what is happening to the sick person, answer all questions honestly, if you don't know the answer, say you don't know, then you can look for the answer together with your child, encourage the child to express and talk about what he or she feels, inform the child when death is imminent and allow the child to visit and be with the parent, if your child is having problems at school, explain that it is normal for school performance to drop a little when a parent is in the hospital and you are not angry with them, reassure the child that it is not their fault that a parent is sick or dying. Children aged 9 to 12 Children this age have a much better understanding of illness and death, but that doesn't mean they don't need clear information. The child will need to understand what is happening and what to expect. Here are some tips that may help: let your child spend as much time as possible with the sick person, Encourage them to express and talk about their feelings, but let your child keep their feelings to themselves if they prefer. translate and talk to the child as much as he needs it, provide information about what cancer is and what they can expect, what the treatment is like, be assured that the parent's illness is not the child's fault. Children 13+ Teenagers have an adult understanding of death, but they may not have adult coping skills. Teenagers are old enough to know that their lives will change greatly because of the illness and death of their parents, and they struggle to cope with this threat. They may cope in ways that are difficult for parents to understand, for example by refusing to talk about the illness or trying to take control. Others may adapt, try to get closer to their parents and/or try to restore order in the house. Here are some tips that may help: if interested, provide information about the parent's condition, symptoms, possible side effects of medications; what they can expect allow the teenager to spend as much time as he or she wants with the sick person; If he doesn't want to, encourage him to spend time together, but don't force him. Encourage teenagers to continue their usual involvement in school and other activities. allow your teenager to express his feelings. Remember that each child is different and their reactions may vary. However, if you have difficulty coping with a new situation, you may experience: anxiety states, which may manifest themselves, for example, in the form of reluctance to break up, problems with falling asleep, fear of getting sick, aggressive behavior, outbursts of anger, avoiding social contacts, somatic disorders, e.g. headaches, abdominal pain [4]. Despite your overload with the situation, try to talk to your child as much as possible and explain to him what is happening. Rosenheim and Reicher [1] point out four consequences resulting from an open conversation with a child: the child is allowed to express his or her own feelings caused by the situation; expresses parents' confidence in their ability to cope; helps the child modify distorted ideas about what is happening; and supports the child in realistic preparation for the new. The parent-child relationship is also important throughout the process. Philips [2] suggests that warm and supportive parenting can be a protective factor for children. Open communication between parent and child led to more effective coping and also seemed to strengthen the parent-child relationship [3]. Instead of a summary Children are incredibly resilient and with loving support they will get through this difficult time. Try to have as normal a life as possible at home and as undisturbed a daily schedule as possible. If you do not feel able to meet all the requirements, seek help from your family and friends. If you have difficulty explaining the disease, read the book "What is cancer?" by Herlofsen and Geisler, which will help explain what cancer is and how to talk to your child. If you notice that your child's condition is getting worse and you are unable to cope with it, seek professional help from a psychologist. Ida Garstecka Bibliography Rosenheim, E., & Reicher, R. (1985). iInforming children about a parent's terminal illness. Journal of Child Psychology and Psychiatry, 26 (6), 995–998. https://doi.org/10.1111/j.1469-7610.1985.tb00613.x Phillips, F. (2014). Adolescents living with a parent with advanced cancer: a review of the literature. Psycho-Oncology, 23 (12), 1323–1339. https://doi.org/10.1002/pon.3570 Kennedy, V.L., Lloyd-Williams, M. (2009) How children cope when a parent has advanced cancer. Psycho-Oncology 18 (8):886–892. https://doi.org/10.1002/pon.1455 Kornreich, D., Mannheim, H., Axelrod, D. (2009) How children cope with their parents' cancer, Post-Diploma Psychiatry 6 (2) Adams-Greenly, M., & Moynihan, R. T. (1983). Helping the children of fatally ill parents. American Journal of Orthopsychiatry, 53 (2), 219–229. https://doi.org/10.1111/j.1939-0025.1983.tb03367.x Silverman, P. R., Worden, J. W. (1992). Children's reactions in the early months after the death of a parent. American Journal of Orthopsychiatry, 62 (1), 93–104 https://doi.org/10.1037/h0079304 Warsaw Psycho-oncology Center (2016) How to talk to children and teenagers when an adult has cancer. A guide for parents and family members. Based on: Talking to children and teenagers when an adult has cancer. , MAC 5766
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