Five new subtypes of type 2 diabetes

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Doctors newspaper online, 30.06.2019

    

        
        
        

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diagnosis

Researchers now suggest five subtypes of type 2 diabetes. Specific therapies should be developed for each form.

Diabetes has been largely divided into Type 1 and 2. Clarification of the shapes could improve treatment. One year ago, Swedish researchers first made a subdivision ( Lancet Diab & Endocrinol 2018; 6: 361 ). The team had analyzed data from 14,775 recently diagnosed adult diabetics. Based on diagnostic age, BMI, HbA _1c beta cell function, insulin resistance, and autoantibodies, they suggest five diabetes subgroups in adults.

This classification has already been confirmed by other researchers, and there are first suggestions for specific therapies. Affected of the first two types need insulin; they are grouped under "Severe Insulin Deficient Diabetes" (SIDD):

• Severe autoimmune diabetes (mostly LADA diabetes); Manifestation mostly in younger adults. Beta cells destroyed, no insulin production (proportion: 6-15 percent).
• Severe insulin deficiency (similar to autoimmune diabetes). Affected are usually young and slim; no autoantibodies, the immune system is not faulty (9-20 percent).

More subgroups

• "Severe insulin-resistant diabetes" (SIRD): severe insulin resistance, mostly overweight, no adequate response to insulin, high risk of nephropathy (11-17 percent). Proposed therapy with metformin or GLP-1 agonists, for kidney protection SGLT2 and ACE inhibitors.
• Moderate Obesity Diabetes (MOD): Affected are mostly severely overweight, but the metabolism is less disturbed than in patients first three groups (18-23 percent).
• Moderate age-related diabetes (MARD): Symptoms begin in comparison to the other groups at a higher age (39-47 percent).

In the last two forms, lifestyle changes have been suggested as therapy.

According to the Swedish researchers, all five forms are genetically distinct. It is therefore more a matter of different types than disease stages. In addition, the study found that many patients had not been adequately treated. Many patients of the two SIDD groups did not receive insulin on manifestation. (cis)

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Duty to prevent cancer in high radiation exposure

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Doctors newspaper online, 28.06.2019

    

        
        
        

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Health

A possible compulsory provision for increased UV exposure was on the agenda of the Federal Council on Friday. In the end, the recommendation could not prevail.

Patients who work outdoors a lot also have an increased skin cancer risk due to their intense UV exposure. The check-up is therefore particularly important to them.

© 35007 / getty images / iStock

BERLIN. The Federal Council had advised on Friday on a recommendation
    according to which employers should be obligated to compulsorily arrange appropriate check-ups for employees with higher UV exposure.

This addition should be included in the amendment to the Occupational Health Care Regulation (ArbMedVV), following a recommendation from the committee responsible for Labor, Integration and Social Policy.

However, at the Federal Council meeting, the recommendation did not find a majority. The change
    the AbrMedVV was adopted unchanged. It stays that way
    Occupational health care provision that employers make to their employees
    should.

Specifically, this is said to apply to "outdoor activities involving particularly intense exposure to natural UV radiation of regularly three hours or more per day". In addition, occupational health and safety measures should be taken to "minimize the burden of natural UV radiation."

One reason for recommending a precautionary requirement: squamous cell carcinomas, which have been occupational diseases since 2015, represented the second most frequent occupational disease and caused correspondingly high treatment costs.

However: The medical staff for such investigations is already scarce.
    According to ArbMedVV, this check-up may only be performed and certified by physicians with the area designation "occupational medicine" or the additional term "occupational medicine".

According to medical statistics of the German Medical Association in 2018 in Germany 3,519 occupational physicians work. Only 30 percent were younger than 50 years. In addition, 7450 working physicians had the additional name industrial medicine. (DAB)

We updated this post after the debate on June 28, 1919 at 4 pm

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What to do during sunstroke and heat stroke

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How to prevent a sunstroke?

Do not spend too much time in the sun. If that is unavoidable, protect your head with a light hat. Especially babies are at risk, their skull is much thinner and partially not even completely closed. Besides, you always have to drink enough, especially in the heat. As a rule of thumb, on hot days, an adult needs at least half a liter of extra water.

What is the difference to heat stroke?

Even if the two terms "sunstroke" and "heat stroke" are often confused in everyday life: A heat stroke is much more dangerous than a sunstroke. The heat stroke is triggered by physical overexertion in a hot environment. He often meets people in poorly ventilated areas, such as blast furnace workers or sauna visitors who do not go out in the corridors in the fresh air. Athletes who train in the heat may also suffer a heat stroke.

Heat stroke can be life-threatening

In a heat stroke, in contrast to the sunstroke, an increase in body temperature up to 40 degrees Celsius and more. That is life threatening. Great exertion combined with intense heat can disable the body's temperature regulation system, for example, sweat production fails. There is a build-up of heat.

Signs of a heat stroke are often convulsions, hallucinations and consciousness clouding. But it also happens that the person concerned is "only" completely exhausted. The pulse rate is high, blood pressure low, the skin hot and dry. Beware, this condition is often confused with fatigue or fatigue and the heat stroke is treated too late.

Bring the victim out of the heat immediately and call the ambulance. Cool your whole body with damp cloths and control your breathing and consciousness. Perform Emergency First Aid .

The heat exhaustion

There is a transitional stage between sunstroke and heat stroke, called heat exhaustion. It is caused by the loss of liquid and salts in case of insufficient drinking. Signs include dehydration and a rise in body temperature to 37 to 40 degrees Celsius. Although there are often no disturbances of consciousness during the heat exhaustion, dizziness, shortness of breath and shivering certainly already occur. The heat exhaustion is treated like a sunstroke and heat stroke.

        

    

ECJ ruling: Strict specifications for air pollutant measurements

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Doctors newspaper online, 26.06.2019

    

        
        
        

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ECJ ruling

Again and again there is a dispute over air pollutants, limit values ​​and measuring stations. The top EU judges have now passed an important verdict.

The measuring station on Gladbecker Straße in Essen. According to the ECJ, citizens have the right to have a legal check to see if the measuring stations are correctly placed.

© Jochen Tack / imageBROKER / piture alliance

LUXEMBOURG. According to a ruling of the European Court of Justice (ECJ), strict regulations apply to the measurement of air pollutants in Europe.

Exceeding limit values ​​at individual measuring points is considered a violation of EU rules, the judges said on Wednesday in Luxembourg.

Citizens can also check in court if the stations are placed correctly. The judgment should also have far-reaching consequences for Germany.

In this particular case, inhabitants of the Belgian capital, Brussels, and an environmental organization had sued Belgian authorities for drawing up a sufficient air quality plan and setting up the necessary measuring stations.

The Belgian court asked the ECJ to interpret EU law. The placement of measuring points and the scope for compliance with limit values ​​are often the subject of controversy in the debate on diesel driving bans in Germany as well.

57 cities violated nitrogen dioxide limit

In Germany pollutant levels are exceeded in many places. According to the Federal Environment Agency, in 2018 57 cities violated the EU limit value for nitrogen dioxide (see following table) .

In the past, CSU politicians repeatedly expressed doubts about the placement of the apparatus and the significance of the measured values. Federal Transport Minister Andreas Scheuer criticized, for example, that devices would be set up directly at intersections or bus stations.

The Luxembourg judges now further stated that excessive levels of particulate matter, nitrogen dioxide or other pollutants mentioned in the EU Directive on Air Quality and Clean Air for Europe at individual measuring stations were considered a violation.

Because there were health threats. Average values ​​for a larger area or an agglomeration therefore have little significance.

The EU rules also stipulate that monitoring stations should be set up to provide information about the most polluted places, the judges said.

The locations must be selected in such a way that the danger of unnoticed exceedances of limit values ​​is minimized. The interpretation of the current rules by the ECJ now applies to all EU states. (AP)

European Court of Justice

Case C-723/17

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Problems with the mother-in-law – normal?

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Self-help groups for mother-in-law victims

That this is not always so easy, you can see a thousand times in Internet forums. They read of stingy, hideous women who make the lives of their daughters-in-law hell. Of pests who interfere in all especially in the parenting . And of mothers-in-law, who are not afraid to urge the son to part with his sweetheart. There are even self-help groups in Germany that only deal with this topic. All the more surprising are the results of some representative surveys. They show that mothers-in-law are much better than their reputation. "A good two thirds of all women have a good relationship with their mothers-in-law," says psychologist Dr. med. Andrea Kettenbach from the Fern-Universität Hagen. By the way, men seem to be especially happy with their mother-in-law.

Mother-in-Laws Are Much Better Than Their Reputation

But why is he so bad, the call of the mother-in-law? Kettenbach suspects that historical reasons play a role. "Not even a hundred years ago, after the wedding, the woman moved into the man's parents' home," she explains. The mother-in-law had been a kind of teacher to her – and a landlady who often preferred her own daughters. In addition: "If it really crashes with the mother-in-law, that really tugs at the nerves," says Felicitas Heyne. Exactly these women then bustle on the Internet and vent their anger.

problems? Causes mostly misunderstandings

The triggers for an argument are usually quite banal. "Unfortunately, women tend to read minds and interpret glances," says Heyne. From a "who looked at me but funny" or "have you heard in what tone she has said that again?" then sometimes a tangible conflict – which can emanate from both sides. This happens above all when two completely different characters meet: the cool North German mother-in-law and the talkative Rhinelander, for example. "Misunderstandings are usually only a matter of time," says Heyne. It becomes critical when the suppressed anger smolders in the air for years – until he eventually becomes a bushfire. It is better to say the same opinion, Heyne thinks. "But please factually and constructively and in no case with emotional outbursts and tears."

Four different mother-in-law types

Openness and honesty are the guarantee for harmonious cooperation? It is not always that easy, even if you try to be calm and understanding with each other. After all, they exist after all: those mothers-in-law who court their son like a jealous wife. Not infrequently, their own problems are behind this: the "empty nest syndrome", for example, the fear of loneliness when the children leave the house. Mother-in-law who behave like that are part of type two of the mother-in-law typology Andrea Kettenbach created for her doctoral thesis: lying, envious and jealous. She interviewed 34 women about her mothers-in-law, whom she then assigned to four different types. In addition to the evil guy, there is the loving, caring mother-in-law, the annoying but useful mother-in-law and the partner's defensive, but also disinterested mother.

Partner has a key role

How difficult the relationship to the mother-in-law is depends on the partner . "If he allows his mother to harass his wife, he's definitely complicit," says Heyne. She does not accept sentences such as "Do that under you". "The man has to put his mother in check when it escalates," she says. So that it does not come at all, she recommends not to screw the expectations at the beginning too high. "The mother-in-law does not have to be the best friend right away," says Heyne. That's not what you expect from a new colleague. You would rather get to know each other in peace and focus on the similarities that you have: the love of the same man, for example.

        

Trauma Surgeon Shocked About 'Motorcycle License Light'

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Doctors newspaper online, 21.06.2019

    

        
        
        

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After Scheuers Advance

Is the car license sufficient to drive motorcycles up to 100 km / h? Doctors are appalled by the proposal of the Minister of Transport.

The symbolic dream of freedom: may motorists also dream about these on small motorcycles in the future?

© lassedesignen / stock.adobe.com

BERLIN. The reactions can not be long in coming: Yesterday had [Spiegel] reported online that Federal Transport Minister Andreas Scheuer (CSU) plans that every motorist can drive motorcycles up to 100 km / h – only a few practice lessons were needed, but none Exam. Today doctors in Berlin are commenting on the amendment in a statement of the German Society for Orthopedics and Traumatology (DGOU). The Tenor of Orthopedic Surgeons: The change endangers the health of drivers.

DGOU doubts, FDP shows approval

The General Secretary of the DGOU, Prof. Dietmar Pennig, criticizes the short-sightedness of the bill: "The release of motorcycles up to 125 cc without training with examination is negligent. The drivers lack the risk assessment, which can only provide a structured education and appropriate practice. "

Since the data showed that many motorcyclists were injured, especially in spring, this proves that already experienced motorcyclists are rusty after the winter months, said the head of the DGOU section Prevention Dr. med. Christopher Spering: "So if now completely inexperienced can lead a motorcycle, this thwarted all previous preventive measures for drivers with a motorcycle license."

Even driving instructors are not enthusiastic about the idea: The Federal Association of Driving Instructors Associations (BVF) points out that already today a large part of the accidents of motorcyclists is due to driving errors. The few practice sessions are "completely inadequate," says BVF chairman Dieter Quentin according to dpa. The TÜV is also against the new regulation.

Applause, however, comes from the FDP: The proposal goes in the right direction, said traffic expert Oliver Luksic dpa. One could trust motorists with additional driving hours to control a 15 hp motorcycle "safely and responsibly".

What does the bill suggest?

90 minutes of theory and six practical driving lessons are provided for the driver's license extension, according to Spiegel. The latter could also be completed on a traffic training course – not on the road. In addition, motorists would have to be at least 25 years old and have their driving license for five years.

Recently the importers of e-scooters had similar medical concerns : These may now not drive on sidewalks to endanger pedestrians less as orthopedists had feared. (ajo)

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Saunas are as stressful as moderate sports

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Doctors newspaper online, 15.06.2019

    

        
        
        

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Physical Exertion

The sauna visit represents a certain physical stress, report sports scientists. Quite unlike the presumed blood pressure in saunas does not drop, but it rises as in moderate sports.

In the sauna, you sweat vigorously.

© sabine hürdler / stock.adobe.com

HALL. So far it was generally accepted that a sauna visit lowers the blood pressure. It was assumed that the body vessels dilated by the heat and so the blood pressure falls.

Sports scientists at the Martin Luther University Halle-Wittenberg (MLU) have now proven otherwise in cooperation with the Medical Center Berlin (MCB).

For their study, the scientists recruited Dr. Sascha Ketelhut from the MLU 19 volunteers to check the immediate effect of sauna visits on the cardiovascular system, informs the university.

Subjects participated in a 25-minute sauna session during which blood pressure and heart rate were measured regularly ( Complement Ther Med. 2019; 44: 218-222 ).

It showed that blood pressure and heart rate rise during the sauna visit. Only some time after the sauna visit, the values ​​fell below the resting level in front of the sauna, according to the publication of the study.

Load as on the Farradergometer

For the second part of the study, the researchers put the subjects on a stationary bike and let them complete a short, simple training program.

"The subjects achieved the same blood pressure and heart rate values ​​as when they went to the sauna at a load of about 100 watts on the cycle ergometer," says Ketelhut.

This shows that a sauna visit represents a certain physical stress. For people with low blood pressure, the sports scientist can give the all-clear: "Actually, anyone can go to the sauna, which tolerates moderate physical stress without complications. After the sauna visit, however, people with low blood pressure must be careful, as this can then be lowered even further than before the start of the sauna stay. "

Similar positive effects

The Halle researcher's observation coincides with other studies, which focused mainly on the long-term consequences of sauna visits, such as demonstrating positive effects on the cardiovascular system.

In the longer term, similar positive effects were found as in sports, according to Ketelhut. However, losing weight would not help the health-promoting sweating.

The effect is very low due to the lack of muscle activity, explains the scientist. Although you lose weight in the sauna, but that's just the liquid that you sweat out and later should eat again. (ikr)

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Are you an insulin expert? | Diabetes Guide

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Sunscreen in Diabetes | Diabetes Guide

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Sunscreen: Better cream than spray

If you want to enjoy the sun longer, you should always apply a sunscreen to unclothed skin. The range of such products is now as great as the helplessness of many consumers when they stand in front of shelves with countless bottles, tubes and sprays. Eggert Stockfleth gives a small shopping guide: "You'd better reach for a cream than a spray, because when spraying something always evaporates in the air." The remedy should feel pleasant on the skin – "the best sunscreen does not help if you do not like to apply it!"

Not every sunscreen works in the same way. There are chemical and mineral sunscreen filters. Chemical filters penetrate the skin, absorb UV radiation and convert it into heat. It takes some time after application for the protective molecules to be absorbed. Mineral agents cover the skin like a protective film and reflect UV radiation. Most preparations combine chemical and physical filters.

Sunscreen should protect against UVA and UVB rays

"Always wear the sunscreen 30 minutes in advance, for example, in the holiday in the hotel before you go to the beach," advises expert Stockfleth, "even if a product with the hint acts instantly 'advertises.'

Your sunscreen should not only protect against UV-B radiation, but also contain an effective UV-A filter. Suitable products can be recognized by the circular logo with the letters "UVA". The sun protection factor (SPF) refers only to the UV-B protection. It indicates how many times longer you can safely stay in the sun with protected compared to unprotected skin. A calculation example: They correspond to the skin type 2, so your own protection time is a maximum of twenty minutes. A cream with SPF 20 expands this period to 400 minutes. The dermatologist's advice: "Choose at least SPF 30, and never use the calculated time window (it always applies for 24 hours)."

Sunscreen: Do not bother with creaming

For creaming itself: padding, do not spill. To reach the indicated SPF, an adult needs about 40 grams of cream. When dosing, the "ninth rule" helps. Divide the surface of your body into nine areas: head including neck, each arm, both thighs, each lower leg with foot, and chest and back. Cover the outstretched middle and index finger with cream, and distribute this amount on each of the nine surfaces. As the cream wears off over time, the protection should be renewed several times a day.

If a bathing excursion or a holiday by the sea is on, definitely a "waterproof" sunscreen in your luggage. Do not take this information too literally. During bathing and subsequent drying, a part of the protective film always rubs off. Therefore, make sure to re-cream after every stay in the water. And do not stretch the bathing pleasure too much, because swimming also dries out your skin. Give her some time to regenerate.

Even in the shade, sunscreen is important

So always in the shade! Or? Caution – Trees, umbrellas and even clouds always filter only part of the sun's rays. On the safe side, you are only under a solid roof. "The time of the most intense sunlight between eleven and 15 o'clock you should not spend in the open air," recommends Dermatologist Stockfleth, "then you get 75 percent of the harmful rays not from." It is no coincidence that this time of day is used in southern European countries for a long siesta.

"The best protection is clothing," it is often said. This is not so flat, because there are big differences in textiles. A rule of thumb: The clothes should be loose, the fabric should be as densely woven and dark as possible. This always includes a headgear. Especially children and sports clothes are also available with "built-in" sunscreen. The textile sun protection factor UPF is roughly comparable to the sunscreen SPF. Textiles that have been awarded the "UV Standard 801" seal of approval protect even when wet or stretched.

Also protect the eyes from the sun in diabetes

Because UV rays can also damage your eyes, you'll need UV-filtered sunglasses on cloudless days. Especially if you suffer from diabetes-related retinal damage or cataracts. Suitable glasses have a CE mark on the inside of the bracket. If you are not sure, you can have the UV protection of your glasses checked by the optician.

As a diabetic, think about supplementing sunscreen with high quality skin care. Eggert Stockfleth advises: "Get a moisturizing lotion in the morning and in the evening after the shower." This should contain few, but high-quality ingredients. Avoid pure fatty ointments. They block air exchange and heat regulation. "Particularly beneficial for dry skin are products with urea," says Stockfleth.

The right sunscreen: pharmacists can give advice

On the other hand, you can safely do without your skin care on scents, preservatives and dyes. Let the pharmacy advise you which products are best for you. With the right sunscreen, suitable clothing and careful care, your skin is well prepared for the summer season, and you can do what is most fun in summer: go out and enjoy the best time of the year!

        

Impending Lung Damage: Automatic Respiratory System Saves Preemie Lung

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Doctors newspaper online, 11.06.2019

    

        
        
        

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Threatening lung damage

MANNHEIM. In premature babies with underdeveloped lungs, artificial respiration may be necessary. However, it often leads to acute or chronic lung damage – especially if the ventilator is working against the patient. Researchers at the Fraunhofer Institute for Manufacturing Engineering and Automation IPA at the University of Heidelberg are therefore developing a gentler process, according to a statement from the institute.

Various complications can occur with artificial respiration: Volutrauma occurs when the ventilator presses too much air into the small lung.

A barotrauma occurs when the apparatus introduces air at too high pressure, especially if the premature baby is about to exhale. To avoid both, doctors have so far helped themselves with a tube through their mouths or noses through which they ventilate, reminding the institute.

It leaves room in the trachea to allow excess air to escape. Unfortunately, this is not always particularly gentle and doctors can only respond to the rapidly changing needs of small patients manually.

Thorax monitoring is the name of the small device developed by researchers at the Fraunhofer Institute: "In principle, this is a measuring device that recognizes whether an artificially ventilated patient wants to inhale or exhale," says one of the developers, Jan Ringkamp from the Fraunhofer Institute, quoted in the message. "This allows a ventilator to adapt to the patient's needs without delay."

The system uses two antennas mounted on the patient's chest. One sends out an electromagnetic wave, the other receives it. The researchers take advantage of the fact that muscle, fat and tissue have different dielectric properties than the respiratory air in the lungs. Sounds complicated, but actually quite simple: When inhaled, the lungs fill with air and expand.

The changed proportion of air in the thorax causes the electromagnetic wave to move faster. On exhalation, on the other hand, the lungs collapse and the electromagnetic wave progresses more slowly in the tissue.

There is thus a clearly measurable difference between inhalation and exhalation, which the thorax monitoring can register and forward to the ventilator. (eb)

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How to protect yourself from the sun

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Artificial sunscreen with physical and / or chemical filters works faster: depending on the ingredients, immediately or after about 30 minutes. Between creams and sun exposure should therefore be about 30 minutes. Because the protection consumed by sweating, bathing, friction, must be re-creamed again and again.

Everyone needs a different sunscreen

Not everyone needs the same sunscreen in the same strength and preparation. "Finding the right product for the individual is a consulting-intensive task," emphasizes pharmacist Sabine Wölfer from the Kurapotheke in Bad Reichenhall. "Fair-skinned people need a higher sun protection factor than people with a darker complexion, athletes have something other than walkers, Italian tourists need to protect themselves more intensively than travelers to Ireland."

Therefore, the pharmacist recommends a certain sunscreen only when she has spoken with her client about his everyday habits and leisure interests: "I also ask for medication, as the skin is sensitive to light by some medicines." Those who take water-based medicines need a higher sun protection factor.

Dry Skin is a Warning Sign

This also applies to those diabetics who are prone to dry skin – a problem they should not, by the way, accept. For dry skin can be a sign that diabetes is not well adjusted . According to Dr. Thomas Behnke, internist and diabetologist in Neuwied am Rhein, is in a perfectly treated diabetes, the skin functionally comparable to that of a non-diabetic and neither particularly dry nor particularly sensitive to light.

Because sunscreens only protect the skin from damage when used properly, it is important to consult a pharmacy. Anyone who chooses something on their own should know the following:

• Central and northern Europeans usually have a self-protection time of 20 to 30 minutes. For red-blond, light-eyed people, it is sometimes much shorter.
• The sun protection factor says how much the self-protection time increases. With LSF 15, a self-protection time of 20 minutes is increased by 15 times 20 minutes, ie by 300 minutes. Sunburn occurs only after that, but photodamage with long-term consequences occurs after two-thirds of this period. Therefore you should not exhaust them.
• For dry skin oil-in-water lotions and creams are suitable, for oily skin lotions and water-in-oil-based creams and fat-free gel. Sprays bring less, since only a part of the sprayed reaches the skin.
• The sunscreen should protect against UVA and UVB rays.

Babies and infants should not be lightly dressed in the sun and, because of the scattered radiation, in the shade and should wear a cap. Children's skin develops its protective mechanisms from the kindergarten age. From there, you also have to cream with products that have a high sun protection factor of at least 30 and, if possible, offer a purely physical sunscreen. Physically speaking, these agents contain micropigments that reflect the sunlight and do not even let it on the skin, while chemical sunscreen is in a direct on the skin reaction with UV light. Most sunscreen products contain both.

        

Headache widespread among students

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Doctors newspaper online, 08.06.2019

    

        
        
        

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Survey

In a representative survey, more than one in four students complained of chronic headache.

DATTELN. Chronic headaches are reported to be widespread in schoolchildren and hit girls much more often than boys.

The results of the survey of the German Pediatric Pain Center at the Vestische Children and Youth Clinic in Datteln were presented on Friday.

Thus, in the representative survey, 40 percent of the more than 2000 respondents from urban areas in North Rhine-Westphalia reported chronic pain.

These are commonly defined pain that has been occurring at least once a month for at least three months. Around 33 percent of all students reported having pain at least once a week. Most commonly, it was a recurring headache.

More than one in four students (27 percent) complained of chronic headaches. Girls were affected much more often at 35 percent than boys (18 percent). Biological components – such as the onset of menstruation – and psychological and emotional factors all played a role here, said study leader Dr. med. Julia Wager.

Among all students with chronic headaches, 80 percent experienced them at least once a week. Well, every third person with a recurrent headache misses school lessons.

Fresh air, motion, distraction help

When dealing with the pain showed: 37 percent of respondents with chronic headaches had visited a doctor in the last quarter. Just over three-quarters (76 percent) said they took medication in the past three months – on average four days a month.

In about 13 percent of cases even for a week. According to the study, girls are more likely to use analgesics than boys. "The high drug consumption has surprised us and is alarming," said Wager.

It is well known that tension headache can also be helped by fresh air, movement and distraction.

Young people should be aware that painkillers can have side effects. "And that you can actively do something against the pain yourself," said Wager. The result also shows that it needs more prevention concepts.

According to the study, chronic headaches are favored by media consumption. Every hour that adolescents spend with media such as mobile phones, tablets, laptops, computers and even televisions increases the headache risk by seven percent, Wager reported.

The study participants use these media on average around five hours. There is a connection, but "no massive threat" through these media. The quality of sleep can also have an influence. Those who do not feel well at school or have a comparatively low level of school performance tend to be at increased risk.

Physical exercise as a protective factor

An important factor of protection is physical activity: Three-quarters of respondents do sports at least twice or three times a week. "They reduce the risk of chronic headaches by 50 percent."

In addition to headaches, children and adolescents frequently reported muscle and joint pain (20 percent) and abdominal pain (18 percent).

At the Pain Center of the Vestische Klinik in Datteln, which cooperates closely with the University of Witten / Herdecke, more than 2,000 students were interviewed online for five consecutive years as part of the federally funded project for the chap study.

The children and adolescents of the fifth to tenth grades lived in urban regions in North Rhine-Westphalia. Also around 1600 parents made statements. It was about pain, physical and mental health, school and leisure time as well as taking medication or doctor visits. (AP)

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Column: Enough sleep despite child? Does not exist!

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Blissfully sleeping super-kids? All lies!

It took me until I found out the unbelievable: Everything was lying! The dark circles of the mothers with their alleged super-children were not the result of a failed make-up, but had the same origin as mine. At some point, the werewolf broke through in them as well. Then it was wildly beleagured at the little Serafina, who apparently had her first tooth for weeks and did not want to sleep for one night. Big howls also about the otherwise so blissfully slumbering Frederik, who threatened to suffer a heart attack at every look on his cot. No, at that moment I realized with no small amount of satisfaction: Not only was my child a nocturnal alien. All children are aliens when it comes to sleep!

This insight really comforted me at a time when I had already learned to fall asleep standing upright without falling over. And not only that: at that moment, the saying of shared and half suffering was closer to me than ever. This felt solidarity again gave me a certain looseness. Educational counselor on the topic of sleeping, which I enjoyed reading my moonlight rounds, I banished completely from my apartment. I did not get much smarter though. But suddenly I had the certainty that the rhythm would come. That I just have to trust Marlene and me and our relationship. And suddenly it also worked with sleeping.

Falling asleep obstacles: Manatees and Child Raiders

Of course, there were still tons of different sleep obstacles. There was, for example, the phase in which Marlene did not want to fall asleep without first wishing everyone in the apartment a good night's sleep. Or those in which incredibly large manatees under the bed were at work. Not to mention the evil wizard in the closet. And only the child robber, who would sneak into our apartment at night, in the opinion of my daughter, to steal them.

We have always found some amicable way to deal with these difficulties. Against the robbers there was a magic spell that locked the front door. The manatee we put an apple under the bed. And the evil wizard was transformed into a lovable doddle that was too stupid to find his way out of the closet.

"Please, another five minutes!"

Even the phase in which Marlene began at night to tiptoe into my bedroom, to lie down next to me and rob me of sleep with her to-and-fro, we mastered well. We agreed: If she is afraid at night and feels alone, she can come to me – but not in my bed, but on the couch next to it.

But one day that was over too. Since she was five years old, she is the most uncomplicated sleeper there is. And I do not just say that now, because I would like to quote my blissfully sleeping super-kid. No "Please! Five minutes!". But a girl who puts on her pajamas herself, rubs her eyes at 7 pm and yawns: "I'm going to bed now, Mama, I'm tired." Not ten seconds later, and she is sleeping soundly. It's almost scary. But – how could it be otherwise – we have another problem now. No, actually it is the same. Only the time of day has changed. When I wake her up in the morning, I hear the same thing as always in the evening: "Please, five minutes!"

        

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Potentially Lethal: Energy Drinks Can Give "Angel's Wings"

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Doctors newspaper, 07.06.2019

    

        
        
        

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Potentially deadly

Energy drinks seem to be potentially fatal, as a study reveals: a liter of it can raise blood pressure in healthy volunteers and cause disturbances in cardiac electrical activity.

By Susanne Kressenstein

Energy drinks can potentially kill QT time.

© Tom Eversley / stock.adobe.com

STOCKTON. In addition to a blood pressure increase, US researchers at the University of the Pacific in California have now proven another dangerous effect of energy drinks. In a study of volunteers, consumption increased the QT interval by several milliseconds ( JAHA 2019; online June 4 ).

Energy drinks contain taurine, inositol, glucuronolactone, vitamins and any amount of caffeine. Cardiovascular effects of two commercial products were investigated by the researchers in the randomized, placebo-controlled, cross-over study.

Thirty-four healthy volunteers (18-40 years old) drank 946 milliliters (32 fl.oz.) of one of these two drinks or a placebo drink (water with lime juice and cherry flavor) in one hour. After each six-day break ("wash-out") was changed until each subject had drunk each of the three variants. The energy drinks contained 304 or 320 mg of caffeine.

Electrical activity of the heart measured

In addition to blood pressure, an ECG was used to measure the electrical activity of the heart, before and after consumption, and for four hours every 30 minutes. The primary endpoint was the QT interval, reports the team led by Professor Sachin A. Shah.

Result: The QT interval was 6.0 or 7.7 milliseconds longer after consumption of the energy drinks depending on the product than after the consumption of the placebo drink. The QT interval is known to be the time between the beginning of the QRS complex and the end of the T-wave. In this interval, the de- and repolarization of the ventricles falls.

If the period is too short or too long, the life-threatening torsades de pointes arrhythmias may favor.

Parallel to the QT time extension, systolic and diastolic blood pressures increased by an average of 4.0 to 5.0 mmHg after energy drink consumption. Caffeine is probably not the cause of these effects, the researchers emphasize.

The quantities of caffeine consumed were not exorbitantly high – daily rations of up to 400 mg are considered harmless. The study authors therefore assume that another ingredient or the combination of several are the cause of the altered QT intervals and the rise in blood pressure.

High consumption questionable

The researchers are concerned about the high consumption of energy drinks. It is estimated that one in three US teenagers between the ages of twelve and 17 years of age regularly drinks in the United States. Much must therefore be treated in emergency departments and occasionally there are even deaths.

The researchers point out that the drinks are often consumed in combination with alcohol or other drugs or even with health disorders. High blood pressure or long QT syndrome should be advised against energy drinks. Page 2

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Please also read the guest commentary by Professor Stephan Martin:
Energy drinks: questionable facts are hidden

Further information on cardiology at www.kardiologie.org

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Seven Tips for Stressed Feet

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. 3 Dive into the cool

Shopping at 30 degrees. Whew! Since you want to dive his tired feet in a lukewarm cool foot bath. OK then. Additives such as rosemary oil promote blood circulation. "In every pharmacy there are also ready-to-use footbath blends that almost wake up tired feet", Dr. Katja Renner, pharmacist from Wassenberg. "They all have a caring side effect as well."

. 4 Empty veins!

In order to move the blood up against gravity, a kind of pump is necessary. Movements of the calf and thigh muscles are the driving force here: They literally squeeze out the veins. In the long run, you can keep your veins in shape through leg strength and dead weight. Whether by simply walking, cycling, climbing stairs, running or walking: All types of movement promote the muscle pump of the leg. Swimming and aqua jogging even offer an additional bonus: the cooling and massage effect of the water is enormous.

. 5 Hot-cold shower

Cardiovascular healthy people are allowed to demand even more from their vessels: Hot-cold-changing showers from the feet to the thighs strong defunct vein walls: first they expand, then they contract. "The venous training has a preventive effect," says Gerstorfer. "The veins are less susceptible to disease."

. 6 Dense with plants

Cooling gels with active ingredients from horse chestnut and red vine leaves can relieve the feeling of heaviness on the foot. "The effect comes in combination with a massage", explains Dr. med. Renner, "by stretching your legs towards the heart." Those who are prone to venous insufficiency, can take the two active ingredients as tablets. Then the preventive sealing of the vein walls is better. "But only after several weeks."

. 7 Stockings make pressure

Even stockings can exert pressure on the veins from the outside. "For lighter complaints, especially when traveling by bus or plane, the non-prescription support stockings are recommended," says dr. Katja Renner. However, if you suffer from varicose veins, "only compression stockings can prevent worse venous disease," emphasizes venous specialist Dr. med. Gerstorfer. So if your feet and legs are having problems every day, it's probably due to a vein disease. This is always a case for the doctor.

        

    

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