Licensed books on medicine
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Fat man reluctantly
Our body always agrees to eat more food than it actually needs. But all right, all the people would be getting fat, at least it was not so offensive. But in practice, each person will have friends who say that they eat as much as they want, they don’t count calories, they don’t play sports, and anyway, you can call them to pornography for fans of skeletons right now. Do not envy them: they usually have many other problems. Most likely, they really eat too little - simply because they have such a hectic life that they have no time to go to dinner at work, there is no caring grandmother or caring husband at home who would remind them that people sometimes have breakfast and dinner, and in general, they have constant stress, that is, physiological reactions that dull the feeling of hunger (in fact, everything is ambiguous, stress can not only suppress, but also stimulate the appetite - we will return to this). And among non-fatal people there are a lot of smokers, because every cigarette you smoke is also stressful, and it slightly increases adrenaline and cortisol, and they in turn lead to a slight rise in glucose concentration in the blood, and all this dulls the feeling of hunger 14. This effect makes it even more difficult to quit nicotine, especially in women: when people quit smoking, people usually wonder how they feel like eating all the time. Then, however, adapt and agree that the risk of gaining three extra pounds is still better than the risk of early death from lung cancer.
But often the opposite situation occurs: a person has to put tremendous conscious efforts not to gain weight. In some cases, this is due to genetic features. For example, the hormone ghrelin, which increases the feeling of hunger, can be synthesized artificially and introduced to volunteers - in this case they will begin to eat more. There are mutations in the gene encoding ghrelin that lead to an enhanced synthesis of this hormone — indeed, carriers of such mutations have a body mass index usually higher. It's a shame that reverse mutations that reduce the synthesis of ghrelin do not lead to weight loss, because there are other mechanisms that cause hunger - and this means that a weight loss medication that blocks ghrelin is unlikely to be highly effective (although similar experiments are being carried out now).
Saturation is associated with peptide YY, which is produced in the intestine. If it is administered to volunteers, then they really start to eat less. But mutations that reduce the synthesis of this peptide, lead to chronic overeating. The Pima Indians in Arizona suffer greatly from this: in their tribe two mutations are widespread that disrupt the normal production of the YY peptide, resulting in people who constantly experience hunger, and their body mass index often exceeds 45 (at a rate of up to 25 ).
There are many other molecules, the level of which affects the feeding behavior. For example, in the hypothalamus, an aguchi-related peptide is produced that enhances the feeling of hunger. It is named so because in its structure it is similar to the agouti peptide, which is produced in many animals in the hair follicles and, turning on and off from time to time, forms the color of agouti: dark hairs with yellow rings. American scientist Randy Jirtl brought a line of mice in which the agouti gene works not only in the skin and sometimes, but throughout the body and all the time - the animals turned out not only yellow, but also suffer from severe obesity, because the agouti peptide, as it turned out, causes hunger if it falls into the hypothalamus15.
The most interesting thing in Jirtla mice is that the abnormal work of the gene can be blocked by changing the diet of the mother mouse during pregnancy. If the expectant mother is fed with folic acid, choline and other vitamins for pregnant women containing methyl groups (-CH3), the cells use these methyl groups to hang them on a modified part of the gene and prevent its inadequate activation. As a result, the appearance of the offspring depends on the diet of the pregnant mouse: at different levels of methyl groups in the diet, the same mother can give birth to the young of the whole spectrum, from normal skinny mice with agouti (yellow stripes on the hairs) to hulking bright yellow fat people, - genetically, they will be as close as identical twins. These mice are one of the most famous experimental animals in epigenetics, a young science that studies how environmental conditions affect gene activity.
Epigenetics is already approaching people, including the problem of obesity. For example, in 2011, scientists from the University of Southampton published a large-scale study in which they first observed pregnant women and analyzed their dietary patterns, then studied a pattern of methylation of several genes related to metabolism in their newborns, and before the publication found 216 children who participated in this study and have grown up to the age of nine, and analyzed their body weight16. As a result, it was found that the lack of carbohydrates in the mother’s diet at very early pregnancy is associated, in particular, with an increased level of methylation of the RXRA gene (this is the receptor of the cell nucleus, that is, it is involved in regulating the activity of other genes). in turn, increases the likelihood of obesity at school age.
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Fat man reluctantly
- A few words for fat people and fatties
In the early days of the Program, do not limit yourself to food! You wanted a chop and flavored with condensed milk and peaches endless piece of biscuit - give yourself that! It is very likely that your Organism will be stunned in the full sense of the word from such happiness and allow itself to be weak. But, as soon as he realizes that the restrictions and punishments really ended and you do not intend to humiliate and offend him anymore, your
- LARKS OF THE CONDITION, EXTRACTERS, AND OCCUPATIONAL PROTEINS, OR BEHAVIOR STEREOTYPES IN FOOD RECEPTION
LARKS OF THE CONDITION, EXTRACTERS, AND OCCUPATIONAL PROTEINS, OR BEHAVIOR STEREOTYPES IN RECEPTION
- Breastfeeding in a public place
In the XIX century, all babies were breastfed, as they had not yet invented a breast milk substitute. In those days, women often breastfed babies sitting on the porch of the house, and at the same time looked after children playing outside. Then came artificial feeding. The myth that breast-milk substitutes "outperform" it, led to the fact that in the 60-70s of the XX century, most children were fed from
- Pre-revolutionary situation: an exception to the rules
"War is a man's thing." This statement has always been taken as an axiom and, of course, not by chance: throughout the whole history of human history, this is not the most noble occupation indeed being the prerogative of men. And women have always acted as a passive victim, military booty, at best - the long-suffering Penelope or the weeping Yaroslavna. The legends of the Amazons - by the way, common
- Vizer V.A. Lectures on therapy, 2011
On the subject - almost completely cover the difficulties in the course of hospital therapy, issues of diagnosis, treatment, according to the presentation, concise and quite accessible. Allergic diseases of the lungs Diseases of the joints Reiter's disease Sjogren's disease Bronchial asthma Bronchoectatic disease Hypertensive heart disease Glomerulonephrasafasditis Esophageal hernia Destructive lung diseases
- ALLERGIC LUNG DISEASES
In recent decades there has been a significant increase in the number. patients with allergic diseases of the bronchopulmonary apparatus. Allergic lung diseases include exogenous allergic alveolitis, pulmonary eosinophilia, medicinal
- Exogenous allergic alveolites
Exogenous allergic alveolitis (synonym: hypersensitive pneumonitis, interstitial granulomatous alveolitis) is a group of diseases caused by intense and, rarely, prolonged inhalation of antigens of organic and inorganic dusts and are diffuse, unlike pulmonary eosinophilia, and alveolar and interstitial structures. The emergence of this group
1. General measures aimed at separating the patient with the source of antigen: compliance with sanitary requirements at the workplace, technological improvement of industrial and agricultural production, rational employment of patients. 2. Drug treatment. In the acute stage - prednisone 1 mg / kg per day for 1-3 days, followed by a decrease in dose
- CHRONIC EOSINOPHIL PNEUMONIA
It differs from Leffler syndrome by a longer (more than 4 weeks) and severe course, up to severe intoxication, fever, weight loss, the appearance of pleural effusion with a high content of eosinophils (Lehrer-Kindberg syndrome). A long course of pulmonary eosinophilia, as a rule, is the result of a short-term, thorough examination of the patient in order to identify its cause. In addition to the reasons
- PULMONARY EOSINOPHILIA WITH ASTMATIC SYNDROME
This group of diseases can include bronchial asthma and diseases with a leading bronchostatic syndrome, which are based on other etiological factors. These diseases include: 1. Allergic bronchopulmonary aspergillosis. 2. Tropical pulmonary eosinophilia. 3. Pulmonary eosinophilia with systemic manifestations. 4. Hyper-eosinophilic
1. Respiratory Diseases: A Guide for Physicians: In 4 volumes. Edited by N.R. Paleev. T.4. - M .: Medicine. - 1990. - pp. 22-39. 2. Silverstov V.P., Bakulin MP Allergic lesions of the lungs // Wed. med. - 1987. - №12. - P.117-122. 3. Exogenous Allergic Alveolitis, Ed. A.G. Khomenko, St.Muller, V.Schilling. - M.: Medicine, 1987. -
- BRONCHOECTATIC DISEASE
Bronchiectasis is an acquired (in some cases congenital) disease characterized by a chronic suppurative process in the irreversibly modified (expanded, deformed) and functionally defective bronchi mainly of the lower lung. ETIOLOGY AND PATHOGENESIS. Bronchiectasis is congenital in 6% of cases, being a defect of fetal development, a consequence of
- CLASSIFICATION OF BRONCHOECTASES
(A.I. Borokhov, N.R. Paleev, 1990) 1. By origin: 1.1. Primary (congenital cysts) bronchiectasis. 1.1.1. Solitary (solitary). 1.1.2. Multiple. l..l-Z. Cystic lung. 1.2. Secondary (acquired) bronchiectasis. 2. According to the form of the expansion of the bronchi: 2.1. Cylindrical. 2.2. Bagular. 2.3. Spindly. 2.4. Mixed. 3. By severity
1. Diseases of the respiratory system. A guide for physicians ed. N.R. Paleev. - M .: Medicine, 1990. - TZ, T.4. 2. Okorokov A.N. Treatment of diseases of internal organs: Practical guidance: In Zt. TI - Min.Vysh., Belmedkniga, 1997. 3. Harrison, T.R. Internal illnesses. - M .: Medicine, T.7,
- DISEASE (SYNDROME) REUTERS
Reiter's disease (Reiter's syndrome, Fissenzhe-Leroy syndrome, urethro-oculo-synovial syndrome) is an inflammatory process that develops in most cases in close chronological connection with infections of the urinary tract or intestines and manifested by the classical triad of urethritis, conjunctivitis, arthritis. Most often, young (20-40) men who have had urethritis are ill. Women, children and the elderly