#Hep B guidelines

[drpedi07]

EASL Hepatitis B Guidelines Calculator

This EASL Guideline on Hepatitis B presents updated recommendations and knowledge for the optimal management of HBV infection.

[undead-moth]

A week ago I go to my local pharmacy and ask the pharmacist, “Do you have longer needles for vaccinations?”

“Longer needles?” She asks.

“Yeah. The CDC recommends if you’re above a certain weight you need a longer needle. Do you have them?” I ask her.

She looks a little confused, and hesitates, but says, “Yes, we do.”

I’m a little nervous by her hesitation, but determine it might be because she’s not a fluent English speaker, or because, hopefully, obviously they have longer needles, why would I even ask?

As I make my appointment online for my vaccinations, I am asked a couple dozen questions about vaccinations I’ve had, allergies I have, reactions I’ve had, etc. I am not asked my weight even though it is medically relevant.

I come in today to get three vaccinations. The new Covid vaccine, flu and Hep B.

The pharmacist is different this time so I say, “Do you have longer needles?”

“Longer needles?” he asks.

“Yes. The CDC recommends if you are above a certain weight you need a longer needle.”

“We only have two sizes. One for children and one for adults. The one for adults is an inch long. You do not need a longer needle. You are the perfect size for this,” he says, without knowing what I weigh, or caring that the CDC specifically states that I am, in fact, not the perfect size for that needle.

He argues with me some. I say, “Fine, whatever I guess, I’ll take it anyway.” I feel rude, and yet I also feel like I have a right to be upset.

I attempt to look up the post with the link to the CDC guidelines on this site that informed me I need a longer needle. Even though I have reblogged it half a dozen times and type in several different words to search for it, Tumblr does not find it.

So I go online and try to find the guidelines directly from the CDC. I can’t find CDC guidelines for Covid more recent than 2022. I click on multiple articles all the while the pharmacist is preparing needles that won’t work for me. I find several articles that state that a woman between 152-200 pounds needs a 1 inch needle. I can’t find any that then acknowledge what size needle a woman needs if she’s above 200.

Finally, as the pharmacist is swabbing down my right arm, I find an article discussing the new CDC guidelines. It states that women over 200 pounds need a 1.5 inch needle.

I say, “Yeah, I’m supposed to have a one-and-a-half-inch needle.”

He stops his ministrations and looks right at me and says, “Do you want the vaccinations or not?” like I’m being completely unreasonable for wanting to follow CDC guidelines, for expecting a pharmacy to be equipped to vaccinate a huge percentage of the population, and for not wanting to get sick or get anyone else sick.

I don’t say to him, “Actually I want vaccinations that will fucking work,” even though I really want to.

I say, “Yes. Sure.”

He promptly gives me my Hepatitis B shot in my right arm even though I told him I wanted it in my left. Then as he begins vaccinating my other arm with Covid and Flu, he explains to me, “These are the needles we have. They are the needles the CDC provided during the pandemic. They work for all adults. The only other size we have is for children and it’s smaller.”

I don’t bother explaining to him, a pharmacist, that the pandemic isn’t over. Nor do I explain to him that these guidelines are new, and didn’t exist when the CDC provided the needles he’s using.

I just accept my useless vaccines, wait the required amount of time, and leave.

Now I have to begin trying to research where I can get vaccinated with properly sized needles. I have to plan another time I can afford to stay home sick the next day. And that’s if I can even find anywhere that gives one fuck that fat people exist and get sick and make others sick too.

[elishamanning]

as for the "guideline/rule?" question: in Germany ALL vaccinations are voluntary, apart from the Measles vaccine, which you have to get in order to attend KiTa, Kindergarten, school, work in school (no matter if as teacher, dinner person, cleaning staff, whatever) or any kind of public institution, including prisons, retirement homes, hospitals (obviously), asylum seekers homes, etc. ALL OTHER vaccinations are administered voluntarily as RECOMMENDED by the StIKo = Ständige Impfkommission, the official body which is comprised of medical experts from different areas and is part of the Robert-Koch-Institut. The StIKo regularly publishes the Impfkalender (available in 20 languages) and the Epidemiologisches Bulletin with the vaccinations they recommend (there are "S"-vaccinations (standard: as in these recommendations concern the entire population/everybody who goes to see a doctor in Germany), "B" vaccinations (B as in Beruf=profession, these vaccs are recommended depending on your field of work: e.g. Hep A/B for nurses, doctors, carers; pneumococci for welders), "I" vaccinations (I as Indikation: certain people/patients are recommended to get this, e.g. pneumococci vacc for people with COPD or asthma/after splenectomy) and "R" vaccinations (R as in Reise=travelling, when you plan to go such-and-such place, you need such-and-such shot, for example yellow fever). ALL vaccinations of the "S", "I" and "B" kind and some of the "R" vaccinations* as recommended by the StIKo are covered by general insurance, which everybody is obliged to have (*with the Reiseimpfungen it depends on the insurance company, though most of the "usual ones", yellow fever, ACWY meningitis, Hep A/B, typhoid, cholera, etc. will usually be payed for by the "usual" insurances like AOK, Techniker etc. (sometimes you first have to pay for them yourself and the insurance will reimburse you later))

So. There. I'm sure you wanted to know all of that. (I didn't know how to put it any shorter, sorry!)

oh yeah i know the vaccination itself is voluntary, i was just talking specifically about the policy regarding the timeline of it, specifically for those who have had covid. like is it a recommendation to wait at least 6 months (“you can get vaccinated before but you should have sufficient natural immunity until then so you can wait”) or a rule that they won’t vaccinate people who had covid within the past 6 months (“you can only get vaccinated 6 months after getting covid”), blocking people who have had it from getting the in a kinda similar way to how kids under certain ages cannot get vaccinated

if that all made sense

[catherinexxng]

for future imu students studying in unsw

Being a medical student is truly a privilege, but to be one studying abroad, is a truly satisfying and even more privileged experience, you get to be exposed to a different culture, and have your world views expanded, and some interesting stories to take home, at that ;) 

In being so, there are more steps to be taken being a twinning student compared to being in a local program. For example, you need to have a band 7.5 in your ielts and above to qualify for the twinning program. And your cert has to have a validity of 2 years until commencement of studies abroad, that means if your ielts expires 6 months before you’re to study abroad you’ll have to retake it :(  (thankfully in my case, my cert expired in August 2019, but I was still able to apply for my visa without having to retake it, my visa application counsellor helped me with it fuss-free; check below for info i.e. aecc global malaysia) 

I was initially in the undergraduate (PMS-UG) program but appealed a few months before I was supposed to start my UG studies in Dundee. I changed my mind because I can’t take the cold gloomy weather in North of Scotland. I will literally freeze to death and I love the sun too much, the way the heat and intensity strikes my skin giving that good ol loving Vit D. I knew Australia was my place. I wouldn’t last a year out North of Scotland. So I appealed to changed from the UG to G pathway. Plunging myself suddenly into the graduate program, came with a lot of confusion and uncertainty, and truly, a lot of doubts and was pretty scary. But thankfully I had my supportive family behind me. 

Tips before choosing your project: 

Choose wisely, choose one which interests you. Choose your supervisor well. Make sure you get along well with your supervisor and have one you truly are able to collaborate with and one who answers your doubts well and doesn’t ghost you, and who helps you along the way. Check for red flags when you meet them before you choose your project. I have had a friend in the same batch as me whose project was on biochemistry and nanoparticles and so he had 2 main supervisors, a bio and a chemistry supervisor. But his chemistry nanoparticle supervisor wasn’t there 90% of the time and didn’t check his dissertation before it was to be submitted, reason being he was busy. My friend had very little support and was extra stressed most of the time because of it. You don’t want this happening to you. And mind you, my friend’s project was really tough... coming from a medical background I felt as if he was doing scientist stuff. Totally incomprehensible. Choose a project which you are quite certain you’ll be able to present well later on in your research findings presentation and viva. Because you will do better if you feel like you understand your project at least to a certain degree. For me it was doing a project that had clinical value to it. 

Assessment components to note for Honours in your BMedScience degree to met the criteria to twin to unsw. 

1. Defence of research protocol (10%) 

2. Written examination (10%) 

3. Research findings in seminar (10%)

4. Dissertation (60%) 

5. Viva voce (10%) 

Components 1,3 and 5 are graded out of 10, therefore depending on your sem 3 and 5 results you can gauge how much you need to achieve in each component to make sure you meet the overall Honours result. 

The written examination paper has a total mark of 100 and are 10 questions with long-answer and short-answer questions and some are essay-style questions. As long as you master understanding the lectures in BMedSc you’ll be able to achieve flying colours. Always discuss with your lecturers your concerns before the paper, and you’ll definitely do better. 

In the Defence of research protocol component, you will basically be explaining to a panel of judges (10 or more) with a PowerPoint presentation, what your project is about and why it is of value and why you should research it. Introduction, Literature review and Methods are the bulk of your presentation. There’s Q&A at the end.

In the Research of findings in seminar component, you will be explaining, like above, in Powerpoint presentation style to a panel of 3 judges (might vary) about the results of your research. Methods, Results and Discussion are the bulk of your presentation. And there’s Q&A at the end. 

Your dissertation is a 20,000 word thesis on your project, follow all the guidelines in the BMedSc handbook.

In the viva-voce component, you’ll be talking about your dissertation with 2-3 examiners for 20 minutes and there will be Q&As.

It can all seem very challenging at first, but looking back in retrospect, I wonder why I put myself through so much anxiety with my daily struggles with all the presentations required in BMedScience and especially my negative mental self talk. If you can relate, I’m here to tell you, don’t fret it, maybe sweat some, but do what you’re supposed to do, and you’ll be a-okay! :) 

Class of Honours

First class: > 75.00%

Second class upper: 65.00% to 74.99%

Second class lower: 55.00% to 64.99%

Third class: 50.00% to 54.99%

Fail: < 50.00%

After completing research and getting your results, and achieving second upper class and above for honours, there are 3 main things on your checklist. 

1. Visa applications (online): this can take from 2 weeks and up to a month to process

2. Biometrics (immediate results and they upload it to your visa application, done at the YMCA building in KL)

3. Health check ups (done in Bangsar South and the results take about a week+ to show, and you’ll have to link these in your visa application) 

I sought the help of a visa application company for free, and you can do so too by messaging them on facebook at “AECC Global Malaysia” . The lady which helped me with my application was super sweet, her name is Ms Tan Mei Pei.   

The website for visa applications will be given via IMU. I started with visa applications on 2nd Jan with AECC’s help and was lucky to be able to finalise all of these within 2 weeks. 

By now you’d have received emails from UNSW about compliance check documents. These are health and police check documents needed to ensure you are not a health and security hazard in the clinical environment as you’ll be exposed to patients. The compliance check documents consists of certificate of good conduct from your home country (these take about a month to process so make sure you plan accordingly), vaccinations to Hep B, Diptheria, Pertussis and Tetanus, Varicella Zoster, and measles mumps rubella (MMR) and TB screening such as Interferon Gamma Release Assay (IGRA) or Tuberculin skin test are compulsory. These are independent of and separate from your visa health check. 

That is all. Good luck and all the best to you :) 

[pediadoc7-blog]

EASL Hep B Guidelines Calculator

This EASL Guideline on Hepatitis B presents updated recommendations and knowledge for the optimal management of HBV infection. To determine the EASL Hep B Guidelines Check Our Medical Calculator https://www.pediatriconcall.com/calculators/easl-hepb-guidelines

[liberalbumpkin]

The most wild thing I see on the news/social media right now is people being mad and headlines that read “scientists are now saying that natural immunity is better.” They go on to say that everyone should apologize for sticking vaccine and mask mandates down their throats etc. The thing is that scientists know as a general rule natural immunity is always better than the constructed immunity a vaccine or treatment can give you. What we also know is that being sick isn’t always good and can sometimes lead to death. Because the way that we get natural immunity (by being sick) hugely increases our risk of death and or serious side effect, constructed immunity is better for you. Think of it as homemade cookies are best, but store bought is fine. With store bought cookies you can ensure all the ingredients are good and there won’t be any allergy issues or reactions from kids at school if you bring them for an event. With homemade, you can’t guarantee any cross contamination reactions that might occur because of improperly cleaned surfaces. This is applicable for SARS CoV 2 but also still for ‘older’ diseases/infections most people forget about ie measles. The purpose is for your body to be able to fight a reaction so you don’t get sick. I think part of the reasons that people are so against vaccine mandates are for 2 reasons. #1. The government is in charge of public health and #2 there’s too much demonizing misinformation. 

#1. Public health and the government have been intertwined for much longer than people realize. As our country has gotten older and eventually gained independence this government oversight of public health has moved from municipal to provincial to federal level. Officially all the provincial governments are in charge of their own public health regulations, but they must fall within federal standards for funding to continue. because of this government stating facts and then public health following, most citizens don’t know enough about their own public health board and don’t understand how and why it works. The government is announcing public health’s standards/regulations communicates that they are in charge of the system and that they hold the power (which they hold alot). What would be nice to see would be for Health Canada to communicate their regulations (not guidelines) and then for the government to defer to them when making decisions in such a way that this process is visible and understandable. The only difference between the vaccine for SARS CoV -2 and a vaccine for say hep B or the measles is that the latter are given to school aged children or must be given before students are allowed to attend school in my province.

#2 there is so much information everywhere and the development of social media has made it more accessible. Part of the issue is that not all adults have enough biology/medical knowledge to understand what/why things are wrong and right. Another part of the issue is the accessibility of information. Sure everything is on the internet, but its not available in language the everyday person can comprehend and its very easy to misunderstand without a background in the subject. Those who take from sources don’t cite their ideas and news outlets print misleading titles which often skew the interpretation of the findings. 

Lastly, Science changes constantly. It changes as we learn new things and as we grow in the knowledge we currently have. It often appears as contradictory, but we must progress with it. We only know so much right now and all we can do is use that information and adapt. Just because science has changed or that our interpretation on a subject is different now because we know more, doesn’t always mean that our past knowledge was wrong as long as it was based in hard scientific fact.

[acedemicsblog]

Science homework hep

Science homework hep Complete a research paper with the following guidelines and three (3) pages long: 1.     Subject:  Chemicals that prompt reproductive toxicity a. background information on the toxicant, its use, and routes of exposure; b. the process by which this toxicant causes reproductive toxicity and the concentration of exposure; c. ways exposure to the toxicant might be limited,…

[mhealthyliving]

Screen Every Pregnant Woman for Hep B: Task Force

Screen Every Pregnant Woman for Hep B: Task Force

TUESDAY, July 23, 2019 — All pregnant women should be screened early for hepatitis B, to prevent the viral infection from being passed to newborns.

So says the latest guideline from the U.S. Preventive Services Task Force.

“Clinicians can help mothers and their babies by screening all pregnant people at their first prenatal visit for hepatitis B,” said task force member Dr. John Wong.

“Screening…

[personalcjcjcj]

today i went to a hepatitis B documentary screening & discussion with dr. aaron harris, a CDC epidemiologist. something i’m always struck by when i listen to epidemiologists/ID specialists talk is how cool their work sounds. it sounds like they’re these military strategists figuring out how best to approach a problem, which, i guess, is true to almost any subspecialty in medicine, but it sounds extra novel and exciting to be doing battle against pathogens and the outbreaks they cause. i guess the treatment regimen, which is probably most often an antibiotic cocktail, wouldn’t be that exciting. but to me it seems like epi/ID is the closest you get to going to war -- a constantly evolving enemy with new weapons like antibiotic resistance or toxin production along with revisited guidelines on screening/prevention and treatment. i’m not sure how much i would want to do research, but it’s super cool to hear about developments in medical care so new that they have yet to be published. 

today i learned about how upcoming studies will show that giving hep B vaccines to mothers in their third trimester (rather than within 24h of birth) will likely increase the hep B prevention rate from 95% to even closer to 100%. i also learned about how there are certain metrics to evaluate the cost-effectiveness of certain public health interventions (i.e. if something costs less than $50,000, it is likely to be cost-effective -- thinking about it as a p value of <0.01). and also how new CDC research shows that including hep B screenings at broader health fairs (like those for diabetes or HTN) increase the # of people who get screened. all of these felt exciting to me, in a way that the trauma surgery research i’ve been hearing doesn’t. it’s not to say that trauma surgery is boring, but i think hearing about ID/epi developments brings more of a sense of awe. 

final thoughts: i don’t know if i could do it, but i always enjoy hearing about EIS officers’ projects. is ID only extra exciting here at emory because we’re right by the CDC and thus more centrally located in the ID world? i feel like i learned so much more about hep B today than i did in lecture, or at least the facts felt a lot more digested. it’s called the silent killer because it’s most commonly transmitted from mother-child at birth and asymptomatic until the patient either develops hepatocellular carcinoma or cirrhosis. was it because it was presented in the context of new emerging research? also, something we should emphasize more in the future is the health disparities amongst asian populations as well. it’s becoming increasingly apparent that east asians are essentially the only ones who do well -- and we comprise basically the entire percentage of asians in the higher spheres of society.

[thesleeping-iinsomniac]

remember when they said there’s no scientific studies to prove the link between vaccines and autism exists? well here’s 130+ scientific studies that do just that.

here you go 

“All these findings plausibly implicate Aluminum adjuvants in pediatric vaccines as causal factors contributing to increased rates of autism spectrum disorders in countries where multiple doses are almost universally administered” [9] (Section 1.2) -Journal of Toxicology

1 there you go

——

“Autistic disorder change point years are coincident with introduction of vaccines manufactured using human fetal cell lines, containing fetal and retroviral contaminants, into childhood vaccine regimens. Thus, rising autistic disorder prevalence is directly related to vaccines manufactured utilizing human fetal cells.”

Journal of Public Health and Epidemiology

2 here

——- 

Thats right btw, vaccines such as dtap contain an ingredient called MRC-5. google it and we find that it is a “human cell culture line composed of fibroblasts derived from lung tissue of a 14 week old aborted caucasian male fetus. the fetus was aborted for psychiatric reasons btw. 

so it’s great that people want to inject themselves with cells developed from a fucking aborted fetus but maybe some of us don’t want that shit in our bodies. 

(the cdc’s website has the list of ingredients) 

Vaccines literally contain toxic heavy metals and viruses and people really think that they are the answer to all diseases ….. meanwhile every single disease is on a 300% rise, 500% rise ….. does that not ring alarm bells

 ———-

 also in this very fun study in the Journal of Human and Experimental Toxicology,  we find that:

”Studies have not been conducted to determine the safety (or efficacy) of administering multiple vaccine doses in a variety of combinations as recommended by the CDC guidelines.“ 

 "In addition, younger infants were significantly more likely than older infants to be hospitalized or die after receiving vaccines.” yay

so when you ask your doctor and they say yes giving 8 vaccines to a 2 month old baby is safe .. well not according to the Journal of Human and Experimental Toxicology or has the dr not been doing their reading?

 ——— 

 Aaalso, more fun, Dr Julie Gerberding was the Director of the CDC from 2002 to 2009, and isn’t it interesting that from 2009 to present, she is the President of Merck’s Vaccine Division. 

(which is a 5 bn dollar/year operation and the supplier of the largest number of vaccines the CDC recommends.) 

P.s. How the fuck is that not a conflict of interest? 

——–

And the common argument used for vaccines is that it prevented polio, which also, as it turns out, total bs. 

The polio vaccine actually causes polio. And also causes paralysis.

here and here

Also since nobody seems to know, 95% of polio is actually symptom free. And less than all 1% of polio leads to paralysis and only 5-10% of people of that 1% die from that paralysis ……. 

so im not a ‘medical professional’ but how about ……. we study that 1% to see what is causing them to get paralysed rather than inject the whole population with neurotoxic heavy metals

There’s literally a 99% recovery rate and they have us all believing that they saved us from a ‘deadly disease’ that incidentally 99% of people naturally recover from. smh

———- 

And Hep B vaccine is associated with an increased risk of multiple sclerosis. 

-Journal of Neurology, here

———- 

Vaccination is associated with a rare autoimmune neurological condition transverse myelitis.

-Journal of Lupus

here’s the link

——

there are literally hundreds of sources and studies out there but its time we considered that maybe what we have been told to believe isn’t exactly 100%

Its about time we stopped believing that Pharmaceutical companies are doing this because they give a shit about us. 

Pharmaceutical companies are a business. 

The goal of a business is to make profit. 

For them, the profit is not in the cure, the profit is in disease. 

The natural state of the human body is health. We don’t need to inject ourselves with neurotoxic heavy metals and viruses as babies and children to protect ourselves. (because the overwhelming evidence shows that it doesn’t protect us)

Maintaining a healthy nutritious organic plant based diet with a very physically active life style, enough rest and prayer and meditation are the key to proper healthcare. And as long as that is our approach, we will remain healthy and disease-free bc as we know, health is the natural state of the human body.

[medicalreference-blog]

New Post has been published on Medical Reference. All of the diseases and ailments of the human body. How to recover from various diseases

New Post has been published on http://bit.ly/2FSHhR5

Hypoglycemia - hepatitis c - medhelp

[pozmagazine]

On June 25, federal government revised guidelines for organ transplants that will likely result in more organ donations, according to a press release from the Department of Health and Human Services (HHS) and the Public Health Service, which issued the guidance.

Notably, the update includes new criteria for identifying donors with potentially undetected HIV and hepatitis B and C viruses (HBV and HCV). Thanks in part to advances in testing and treatment, more organs can now be accepted from people who would have been classified as an increased risk donor (IRD).

More than 110,000 people are on transplant waiting lists in the United States, and, according to a report printed in the Morbidity and Mortality Weekly Report (MMWR), an increasing number of organs were going unused because they were considered to be at increased risk for HIV and hep B and C. This is in part because of the growing opioid epidemic. Not only are injection drugs a risk for the viruses, but the epidemic is also driving the number of deceased donors.

[f05erxay-blog]

cars that are good on gas and cheap on insurance

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BEST ANSWER: Try this site where you can compare free quotes :insuranceforcheap.info

SOURCES:

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[nevamwitti]

Screen Every Pregnant Woman for Hep B: Task Force

TUESDAY, July 23, 2019 (HealthDay News) — All pregnant women should be screened early for hepatitis B, to prevent the viral infection from being passed to newborns.

So says the latest guideline from the U.S. Preventive Services Task Force.

“Clinicians can help mothers and their babies by screening all pregnant people at their first prenatal visit for hepatitis B,” said task force member Dr. John Wong.

“Screening helps pregnant people get appropriate care throughout their pregnancy and helps reduce the chances of transmitting the virus to the baby,” said Wong, chief of the Division of Clinical Decision Making at Tufts Medical Center in Boston.

Hepatitis B is a viral infection of the liver that can cause liver disease and liver cancer. Babies infected with hepatitis B from their mothers have a 90% chance of having a lifelong hepatitis B infection.

Infants are routinely vaccinated for hepatitis B virus shortly after birth, but rates of maternal hepatitis B virus infection have increased by more than 5% each year since 1998, making it important to screen all pregnant women, according to the task force.

“Screening for hepatitis B in pregnant people can protect babies from lifelong chronic conditions, such as liver cancer or liver disease,” task force member Dr. Melissa Simon said in a task force news release.

“This is essential because the primary source of hepatitis B in children is transmission at birth,” explained Simon, vice chair of clinical research in the Department of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine in Chicago.

Early detection means that doctors can take steps to reduce the risk of hepatitis B transmission from mother to child.

The task force recommendation was published online July 23 in the Journal of the American Medical Association.

The task force is an independent, volunteer panel of national experts in prevention and evidence-based medicine.

More information

The U.S. Centers for Disease Control and Prevention has more on hepatitis B.

Copyright 2019 All right reserved

The post Screen Every Pregnant Woman for Hep B: Task Force appeared first on Be Healthy News.

Screen Every Pregnant Woman for Hep B: Task Force posted first on https://www.behealthynews.com

[bharatiyamedia-blog]

Sports activities betting is mistaken morally, culturally

http://tinyurl.com/y57msayx One can by no means get one’s head round to only how a lot this nation likes to ape the West. Not all of us can carry off western outfits, however what the heck, it’s cool. We might have the perfect pure coolers in our nimbu pani, jal jeera and lassi however colas are what we serve our friends to look urbane and hep. Ayurveda is a system of drugs that’s preventive and faucets pure and seasonal elements to remedy illness; our nation now touts extra allopathic hospitals with their chemical medication than Ayurvedic dispensaries. Our non secular texts, Rig Veda onwards, deplore playing. However since each different nation on the earth has embraced it for the commerce, allow us to additionally look to legalise betting in sport. Sport, to me, is an extension of our tribal roots. It’s the purest type of considered one of our most atavistic survival instincts. It’s the combat within the quintessential combat or flight. Sport is the purest type of fight left; it’s merged with and reverberates to the thrum of nationalistic fervour. Whilst India seems to be in the direction of a extra triumphant nationalist agenda underneath a authorities that guarantees to prop up a extra aggressive international coverage, will we dilute the material of nationalism by groups that characterize India as instruments for playing? I don’t suppose so. The West has a unique morality. It’s not my place to sentence or condole it; it’s not for me to applaud or respect. Simply that we, in India, have a unique outlook in the direction of morality. And, morality condemns dilution of family revenue in a sport of probability. It condemns diffusion of meagre monetary positive factors into a person’s propensity to attempt his luck. Betting on sport is basically a male pursuit—identical to alcoholism is throughout the Indian hinterland. There may be nothing mistaken with having a drink or two, however alcoholics don’t cease at that. There could also be nothing mistaken in laying a wager or two on the end result of a match, however what’s to cease compulsive playing from morphing into one other social evil? I discover the arguments in assist of legalising sport laughable. To say that one must hyperlink Aadhaar card to bets and, due to this fact, include the quantity might be flawed logic. Is it doable to test me from putting a number of bets utilizing the playing cards of my mom, father, uncle or a cousin? The Indian cricket workforce, for example, excites excessive ardour. All people, and their auntie, have a agency conviction that India will win most instances that the Males in Blue exit into area. Similar to voting patterns on this nation, which stem from emotional connects comparable to caste and faith, rooting for the house workforce will not be grounded in actuality—it’s extra about jingoism. How can betting selections be made logically? Most followers perform in a universe of notions with imperfect information concerning the skills of their stars or of the workforce. Betting will largely be emotion-driven and never based mostly on chilly cause. As a nation, do we actually want extra emotional selections to dictate the funds of a family of meagre means? The Manusmriti, has its critics for its advocacy of the varna system. I’ve no quarrel with them. However few know that the textual content served as the premise for Hindu legislation underneath our colonial rulers. As such, it has additionally seeped into the legal guidelines that proceed to control us. The Manusmriti condemns playing explicitly: “MS 9.221. Playing and betting let the king exclude from his realm; these two vices trigger the destruction of the kingdoms of princes. MS 9.222. Playing and betting quantity to open theft; the king shall all the time exert himself in suppressing each (of them).” The Rig Veda too doesn’t mince phrases: “The gambler’s spouse is left forlorn and wretched: the mom mourns the son, who wanders homeless. In fixed concern, in debt, and in search of riches, he goes by night time unto the house of others.” There may be additionally speak of the riches that will accrue to sport by income that will come from betting. I concern this can be a chimera being paraded for the gullible. Nice wealth can come from sport simply by tapping corporates seeking to enhancing model visibility. However for that, our sports activities federations must evolve a contest construction that’s vibrant and connects with the plenty. They’ve failed to take action. How will we then count on that the identical lot will do an exquisite job as soon as funds from betting begin flowing in? I concern blaming lack of cash for the state of affairs of our grass roots sport is a charade that inept sports activities directors enact to carry onto to their jobs. I wager nothing will enhance; simply the fats cats of Indian sport will get fatter. Betting on sport is morally, culturally and traditionally mistaken. I hope in one other quest to ape the West, we don’t herd on in the direction of it. Anurag Kashyap runs the NGO Shakti, which focusses on empowerment by social change Your information to the most recent cricket World Cup tales, evaluation, experiences, opinions, stay updates and scores on https://www.firstpost.com/firstcricket/series/icc-cricket-world-cup-2019.html. 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Dieta cetogénica e cancro: o que diz a ciência?

Nos últimos anos, têm surgido vários estudos que sugerem que a dieta cetógenica pode trazer potenciais benefícios no cancro. A dieta cetogénica é caracterizada pela ingestão de uma elevada quantidade de gorduras, uma quantidade baixa ou moderada de proteínas e muito baixa quantidade de hidratos de carbono.

A resposta fisiológica dada pelo aumento do metabolismo das gorduras e o metabolismo limitado dos hidratos de carbono associado a este tipo de alimentação induz um estado de cetose, com aumento da produção de corpos cetónicos, diminuição dos níveis de glicose e de insulina no sangue e manutenção do pH sanguíneo.

Dieta cetogénica: porquê o interesse em oncologia?

Na base da hipótese de prescrição da dieta cetogénica em doentes oncológicos está o facto de, independentemente da disponibilidade de oxigénio e da capacidade de o processarem, a maioria das células cancerígenas captar e converter a glicose em lactato, em vez de originar dióxido de carbono. Dado ser uma forma ineficiente para obter energia, as células usam uma estratégia compensatória, aumentando a quantidade de glicose captada que lhes permita obter mais energia e, desta forma, propagarem. Em teoria e considerando a dependência deste hidrato de carbono por parte das células cancerígenas, se se reduzir a disponibilidade do mesmo, evitar-se-á o desenvolvimento da doença. Assim e dado que a dieta cetogénica força o organismo a usar a gordura e não a glicose para obter energia, existe interesse em investigar a influência deste tipo de alimentação em oncologia.

Dieta cetogénica e cancro: o que diz a ciência?

A maioria dos trabalhos realizados foi desenvolvida com células e com animais. Todavia, um trabalho de revisão recente analisou os resultados de estudos em humanos (14), de modo a avaliar os efeitos da dieta cetogénica em doentes oncológicos.

De facto, verificou-se que os resultados podem ser promissores mas, também, que são inconsistentes. Os autores concluíram que a evidência é pouca e limitada para que sejam definidas conclusões claras e orientadoras devidamente fundamentadas pela ciência. O número de estudos existentes é reduzido e existem diferenças substanciais entre eles para que possam ser comparados. Essas diferenças assentam nas metodologias usadas; tempo de intervenção, tamanho da amostra e características da mesma, falta de grupo de controlo, composição da dieta, acesso da alimentação/nutrição, tipo de cancro, estadio, tratamento e técnicas usadas para avaliar os resultados.

Apenas dois estudos publicados entre 1988 e 2016 acerca da dieta cetogénica no tratamento do doente com cancro avaliaram a composição corporal dos participantes, os quais revelaram um aumento da massa magra com este tipo de alimentação. Apesar das limitações metodológicas desses trabalhos, esta conclusão deverá ser explorada, pois uma quantidade de massa magra elevada está associada a uma melhor resposta aos tratamentos, a uma melhor condição física, a uma melhor qualidade de vida e a uma maior sobrevivência.

Dieta cetogénica: quais os efeitos secundários?

A distribuição percentual de macronutrientes da dieta cetogénica pode causar efeitos secundários a curto prazo, como desconforto gastrintestinal (ex: obstipação), letargia e hipoglicemia. Quando ocorrem, é na fase de transição da alimentação. Podem durar entre 1 a 3 semanas, enquanto o organismo se adapta a um teor mais elevado de lípidos e mais baixo de hidratos de carbono na dieta.

Contudo, também podem surgir efeitos a longo prazo, como prejuízo do nível das gorduras no sangue, em populações suscetíveis, litíase renal e danos nos rins. O risco destes efeitos poderá ser minimizado, se o doente apenas ingerir este tipo de dieta durante a fase de tratamento. Os benefícios (por enquanto, ainda prováveis) e os efeitos secundários devem ser ponderados, de modo a avaliar se a eventual ação terapêutica da dieta cetogénica justifica os possíveis efeitos secundários.

Dieta cetogénica: o que é importante esclarecer?

É fundamental que a investigação considere a interação desta dieta com o mecanismo de ação dos fármacos usados em quimioterapia, de modo a que possa ser avaliada a compatibilidade, antes de ser efetuada a prescrição deste tipo de alimentação.

Quanto ao contributo das proteínas na dieta cetogénica, é importante que seja mais estudado. Primeiro, porque existe uma grande variabilidade na composição corporal (quantidade de massas magra e gorda), em doentes oncológicos, o que se torna um fator influenciador. Segundo, pois importa considerar que as alterações no metabolismo provocadas pela dieta cetogénica podem influenciar as necessidades de proteína de cada indivíduo, pois os aminoácidos (constituintes básicos das proteínas) podem originar glicose no organismo, através do Ciclo de Krebs.

É, ainda, fundamental que seja estudada a influência da dieta em questão no estado nutricional, no prognóstico da doença e na saúde dos doentes em geral. A carência de conclusões devidamente sustentadas acerca dos mecanismos de ação deste tipo de alimentação, os tipos de cancro em que existe efeito, o tempo de intervenção necessário são outras questões que carecem resposta.

Dieta cetogénica: implementação e seguimento

Se a dieta cetogénica trouxer benefícios sustentados pela ciência para o tratamento do doente oncológico, deverá ser devidamente implementada e supervisionada por um nutricionista. Atualmente e devido à inconsistência dos estudos realizados e à ausência de tantas respostas, ainda não existem orientações para a aplicação deste tipo de dieta no cancro.

Antes da implementação desta dieta, deverão ser tidos em conta os resultados de análises ao sangue e à urina relativos a alterações do metabolismo dos ácidos gordos e acidúrias orgânicas, uma vez que a gordura será a principal fonte de energia. Além disso, devem ser avaliadas outras condições como: litíase renal, dislipidemias, doenças hepáticas, atraso do crescimento, refluxo gastroesofágico, défice de ingestão alimentar, obstipação, cardiomiopatia e acidose metabólica crónica. Também deverá ser efetuada uma avaliação do estado nutricional completa.

Devido à complexidade da dieta cetogénica e à potencial baixa palatabilidade da mesma, a adesão do doente depende do seu compromisso, motivação e acompanhamento durante a implementação e no decurso da mesma. A monitorização da adesão do doente é de extrema de importância, pois será determinante para se alcançar e manter um estado de cetose. Como marcadores para avaliar as alterações metabólicas desejadas, deverão ser doseadas a glicemia e os corpos cetónicos na urina e no sangue. Outros parâmetros sanguíneos (níveis séricos de eletrólitos, creatinina e testes de função hepática) poderão, também, ser usados, para determinar os efeitos hepáticos e renais da dieta.

Considerando que a dieta cetogénica inclui quantidades limitadas de fruta, vegetais, cereais e alimentos ricos em cálcio, a ingestão de micronutrientes e de fibra fica abaixo das recomendações. Embora a American Cancer Society recomende, no mínimo, 2,5 chávenas de vegetais e fruta por dia para sobreviventes de cancro, as necessidades poderão ser atingidas, pelo menos a curto prazo, através da suplementação, como recomendado pelo International Ketogenic Diet Study Group.

Em conclusão, atualmente, não existe evidência científica suficiente relativa ao efeito da dieta cetogénica no tratamento do cancro. São necessários mais estudos que respondam às questões que ainda se colocam e que ainda não permitem a implementação, devidamente fundamentada, da dieta cetogénica em doentes oncológicos.

Referências: Oliveira CLP et al. A nutritional perspective of ketogenic diet in cancer: a narrative review. J Acad Nutr Diet. 2018; 118(4): 668-88; Allen BG et al. Ketogenic diets as na adjuvant cancer therapy: History and potential mechanism. Redox Biol. 2014;2C:963-970; Breitkreutz R et al. Effects of a high-fat diet on body composition in cancer patients receiving chemotherapy: A randomized controlled study. Wien Klin Wochenschr. 2005;117(19-20):685-692; Klement RJ & Sweeney RA. Impact of a ketogenic diet intervention during radiotherapy on body composition: I. Initial clinical experience with six prospectively studied patients. BMC Res Notes. 2016; 9:143; Prado CM et al. Sarcopenia and cachexia in the era of obesity: Clinical and nutritional impact. Proc Nutr Soc. 2016;75(2):188-198; Rock CL al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243-274; Kossoff EH et al. Optimal clinical management of children receiving the ketogenic diet: Recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009;50(2):304-317. Fontes de imagens: https://ift.tt/2Eh1vE0 ; https://ift.tt/2T8VWBO

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