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26 | null | Под прошлым рилсом напросился на добрые слова
🥰
🥰
🥰
куча лайков прилетела
Стараюсь для вас
☺️
#рилсы #запретограм | https://t.me/ibs_doc/187?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 6,200 | 0 | 1,703,153,854 | 1,730,797,658 | 10,162 | 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26 | null | НЕПОЛЕЗНЫЕ советы для начинающего (и не только) гастроэнтеролога
1. В любой непонятной ситуации назначай пробиотики. В понятной - тоже. Запор, диарея, вздутие, боли --> пробиотик!
Неважно, что научные данные говорят о низкой и непрогнозируемой эффективности бактерий в капсулах и жидкостях. Ты же как-то раз в казино дважды угадал с зеро? И в этот раз угадаешь с выбором пробиотика. Вероятность близка к 0? Но она же есть!
А если не угадаешь, просто меняй пробиотик. Один, другой, третий. Пусть пациент берёт кредит на лечение. В конце-концов, здоровье не купишь. А пробиотик можно.
2. Говори пациенту, что бактерия Helicobacter pylori есть у всех, и её лечить не надо.
А ещё лучше отправь пациента на тестирование бактерии, выяви и уже потом скажи, что её можно не лечить. Пусть немного потревожится.
А если больной будет спрашивать про рак желудка, который Helicobacter pylori может вызвать, запугай его "побочками" от лечения и смути фразой "всё равно потом опять заразитесь".
У пациента возникнет рак желудка из-за того, что не убрали Helicobacter pylori? Так это когда случится, о ваших рекомендациях не лечить уже никто не вспомнит. Дерзайте!
3. Лечи запор любыми средствами кроме слабительных.
Желчегонные, пробиотики, ферменты и спазмолитики- твои лучшие помощники в коррекции запора. СЛАБительные для тех, кто СЛАБ!
Не забудь обязательно искать ПРИЧИНУ запора в дефицитах и глистах. А на колоноскопию не отправляй: твоя пациентка уже 60 лет живёт с запором, что там можно увидеть в этой кишке?
И диета! Запрети глютен и молочку - ведь именно они виновники запора.
4. Для уточнения причин непонятных симптомов обязательно назначь анализ ХМС по Осипову.
А если пациент скажет, что доказательные гастроэнтерологи не используют этот анализ ввиду бесполезности, парируй: они просто не умеют его расшифровывать.
Сиди с умным видом, закатывай глаза и шевели губами, всем своим видом показывая, как сложно расшифровать анализ.
Не зря же ты недавно прошёл двухнедельные курсы ХМС-шифровальщика за хреннилион рублей! Нужно отбить траты. Поэтому обязательно помимо дорогущих пробиотиков назначь горсть БАДов.
5. Всегда (слышишь, всегда!) запугивай пациентов.
Лучше запугать раком.
Испуганный пациент готов потратить любые деньги, чтобы не пропустить и не допустить. Любые деньги за твою консультацию, любые средства на анализы и лекарства.
А ещё можно обещать вылечить от хронической болезни. Скажи, что только ты умеешь это делать, а остальные гастроэнтерологи - неучи и просто не умеют лечить.
Играй на желании пациента вылечиться, и можно стоимость приёма поднять до 30000 рублей.
Какие ещё советы дадим?
😂 | https://t.me/ibs_doc/188?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 6,900 | 0 | 1,703,219,652 | 1,730,797,658 | 10,157 | 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| NEUTRAL | rus | NOT SPAM | 390 | 0 | 18 | 0.988258 | 0.011742 | 0 | 29 | 54 | 17 | 8 | 118 | 34 | 91 | true |
26 | null | Время
новогодних
прошлогодних постов из запретограма
😅
Сначала я решил разобрать, пожалуй, самый популярный в России салат – оливье
Многие приверженцы «правильного питания» стараются его избегать, прежде всего из-за наличия в нем колбасы и майонеза. Но, наверняка, большинство позволяют его себе хотя бы раз в году.
😉
Так вот, возвращаясь к тематике блога.
Классический рецепт включает такие продукты:
- Вареная колбаса
- Зеленый горошек
- Яйца
- Картошка
- Соленые огурцы
- Морковь
- Майонез
Из всего этого списка относительно опасным при СРК является разве что только горошек. Учитывая, что почти всегда используется именно консервированный горошек, он безопаснее свежего, ведь небольшая часть галактоолигосахаридов выходит в окружающую жидкость, которую вы сольете.
Я рассчитал безопасную дозу любимого всеми салата, основываясь на пропорциях, указанных в одном из самых популярных рецептов, нагугленных мной. Получилось, что порция, содержащая точно безопасную для пациента с СРК дозу горошка составила около 350 г. Неплохо, правда?
Но это касается именно классического рецепта.
Если например в салат добавить лук или яблоки, как бывает в некоторых вариациях, тут уже может крыться бОльшая опасность. С их безопасными дозами вы можете ознакомиться в моих предыдущих постах, а лучше конечно совсем избегать этих продуктов (за новогодним столом и так много опасностей, и все они суммируются у нас в животе).
А что вы, кроме классических ингредиентов, добавляете в оливье? Соленые или свежие огурцы выбираете? Колбасу или язык?
😊
#разбор #запретограм #ГОС | https://t.me/ibs_doc/193?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 8,000 | 0 | 1,703,609,169 | 1,730,797,658 | 10,137 | 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| [{"ner":"России","lemma":"россия","label":"LOC","start_pos":110,"end_pos":116},{"ner":"СРК","lemma":"срк","label":"ORG","start_pos":540,"end_pos":543},{"ner":"СРК","lemma":"срк","label":"LOC","start_pos":980,"end_pos":983},{"ner":"Неплохо","lemma":"неплохой","label":"LOC","start_pos":1020,"end_pos":1027},{"ner":"350","lemma":"350","label":"NUM","start_pos":1013,"end_pos":1016}] | NEUTRAL | rus | NOT SPAM | 226 | 0 | 6 | 1 | 0 | 0 | 33 | 30 | 16 | 2 | 61 | 18 | 45 | true |
26 | null | Всем привет! Друзья, нужна ваша помощь
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Посоветуйте, пожалуйста литературу по психологической работе с подростками и консультированию подростков (частное или групповое консультирование). | https://t.me/imatrip/2084?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,100 | 0 | 1,724,516,086 | 1,730,797,658 | 10,162 | 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| null | NEUTRAL | rus | NOT SPAM | 22 | 0 | 0 | 1 | 0 | 0 | 4 | 1 | 1 | 0 | 9 | 1 | 8 | true |
26 | null | Думать — отвратительно. И чем сложнее наши думы, тем большее отвращение они вызывают.
Вообще-то ничего сверхъестественного в этом заявлении нет: нейробиологи, психологи и экономисты давно в курсе что умственные усилия связаны с эмоциональным и даже физическим дискомфортом. Но коллеги из Нидерландов, видимо, продолжали думать о человечестве слишком хорошо и провели
мета-анализ аж 170 исследований
, очевидно, в надежде, что кому-то из нас все-таки нравится думать. Так вот. Никому не нравится.
В исследованиях участвовали самые разнообразные группы людей (медики, военные, спортсмены, студенты и тд) разных возрастов, из 29 стран, выполнявшие 358 видов когнитивных задач. Они делали практически все, что только можно представить, в разных ситуациях, дома и на улице, вместе и по-отдельности: осваивали новые технологии, искали дорогу в незнакомой среде, рубились в виртуальные игры, отрабатывали удары в гольфе. И во всех (!) социальных группах и типах задачах чем больше умственные усилия прилагали участники, тем больше фрустрации, раздражения, стресса они испытывали.
Интересно, что связь между умственными усилиями и эмоциональным дискомфортом была чуть менее выраженной в азиатских странах по сравнению с Европой и Северной Америке. Школьники в Азии, как правило, тратят больше времени на школьные задания, чем их европейские или североамериканские сверстники, их мозг просто обучается выдерживать более высокие уровни умственного напряжения в раннем возрасте — считают исследователи. То есть нет никакой специфической для культуры “любви” к обучению. Есть более высокая толерантность к неприятному опыту.
В обсуждении коллеги все-таки дают человечеству шанс сохранить самоуважение и отмечают, что, несмотря на отталкивающую природу задач, требующих когнитивных усилий, люди добровольно продолжают ими заниматься. Интересно, чего это они? Вот вы, друзья, чем руководствуетесь, когда выбираете учить иностранный язык или осваивать новый трюк на скейте или практиковать навыки саморегуляции в терапии? Может быть, это то, что улучшает вашу жизнь в долгосрочной перспективе? Поддерживает ваши ценности? Делает вас таким человеком, которым вы хотели бы себя видеть? Имеет смысл?
“Люди знают, что приложение умственных усилий в конкретных видах деятельности, приведет к вознаграждению...Когда люди выбирают занятия, требующие когнитивных усилий, это не следует воспринимать как указание на то, что им нравятся умственные усилия как таковые. Люди выбирают их несмотря на усилия, а не из-за них”.
В общем давайте не рассчитывать на то, что все наши выборы будут приносить нам удовольствие в моменте. Учиться — непросто, осваивать новое — тяжело, облегчение приходит с практикой. Важно не забывать поддерживать себя во время трудностей и вознаграждать за усилия — мозг, как мы уже поняли, сам за нас это не сделает. | https://t.me/imatrip/2085?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,600 | 0 | 1,724,575,279 | 1,730,797,658 | 10,162 | 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| [{"ner":"Нидерландов","lemma":"нидерландов","label":"LOC","start_pos":288,"end_pos":299},{"ner":"Европой","lemma":"европа","label":"LOC","start_pos":1212,"end_pos":1219},{"ner":"Северной Америке","lemma":"северный америка","label":"LOC","start_pos":1222,"end_pos":1238},{"ner":"Азии","lemma":"азия","label":"LOC","start_pos":1252,"end_pos":1256},{"ner":"170","lemma":"170","label":"NUM","start_pos":382,"end_pos":385},{"ner":"29","lemma":"29","label":"NUM","start_pos":623,"end_pos":625},{"ner":"358","lemma":"358","label":"NUM","start_pos":645,"end_pos":648}] | NEUTRAL | rus | NOT SPAM | 395 | 0 | 5 | 1 | 0 | 0 | 46 | 67 | 34 | 5 | 108 | 24 | 91 | true |
26 | null | 📖
Памятка по техникам заземления
Раздаточный материал
Перевод под медицинской редакцией врача-психиатра
Инны Петрачковой
Иллюстрированная памятка кратко объясняет суть диссоциации и механизм использования техник заземления. Содержит восемь категорий техник с множеством примеров в каждой из них.
Версия для специалистов с дополнительными модулями:
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Раздаточный материал
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Информационный блок
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Инструкции
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5HT | Психообразование
#кпт_материалы #тревога_материалы #птср_материалы #па_материалы #упражнения #диссоциация #дпдр #дереализация #деперсонализация | https://t.me/imatrip/2087?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,400 | 0 | 1,724,644,338 | 1,730,797,658 | 10,137 | 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| [{"ner":"Инны Петрачковой","lemma":"инна петрачковой","label":"PER","start_pos":104,"end_pos":120},{"ner":"5","lemma":"5","label":"NUM","start_pos":409,"end_pos":410}] | NEUTRAL | rus | NOT SPAM | 63 | 0 | 1 | 0.989247 | 0.010753 | 0 | 6 | 2 | 1 | 2 | 35 | 1 | 16 | true |
26 | null | Вечерний чат
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Обсуждайте любые темы | https://t.me/magerya/11477?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 38,300 | 0 | 1,729,535,470 | 1,730,797,658 | 10,163 | 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| null | NEUTRAL | rus | NOT SPAM | 15 | 0 | 0 | 1 | 0 | 0 | 1 | 4 | 0 | 0 | 6 | 0 | 1 | true |
26 | null | 4 моих главных секрета!
1️⃣
Конечно же, любовь, забота и смирение – это самые важные лекарства для здоровья и счастья.
2️⃣
Активный образ жизни. Движение – это жизнь! Дали жизнь? Помогите её поддержать! Играйте с детьми, прыгайте, бегайте, покажите им на собственном примере все виды спорта. 2/3 мозга созданы для физической нагрузки! Активируя их, активируется и интеллект!
3️⃣
Здоровый сон. Вовремя укладывайтесь спать, это поможет укреплению нервной системы и, конечно же, гормональной! Когда ребенок спит выделяются гормоны:
мелатонин, он нужен, чтобы уставшие клетки всех органов начали восстанавливаться.
Соматотропин, он необходим для развития мышц и костей. Ведь самый интенсивный рост ребенка происходит именно во сне.
Плюс он помогает главному защитному органу ребёнка ТИМУСУ – это место, где образуются и обучаются иммунные клетки.
4️⃣
Подсказка в самом слове восПИТАНИЕ! В основе питание!
Следите за тем, что ест ваш ребёнок! Покажите сами ребенку правильные пищевые привычки.
Всех приглашаю за здоровыми привычками на главное оздоровительное безоплатное мероприятие осени – чистку
👉🏼
https://t.me/mageryachistka/582
Стартуем 24 октября!
У нас оздоравливаются семьями!
А какие секреты воспитания у вас?
Делитесь
⬇️ | https://t.me/magerya/11478?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 41,400 | 0 | 1,729,569,007 | 1,730,797,658 | 10,162 | 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| [{"ner":"24 октября","lemma":"24 октября","label":"DATE","start_pos":1138,"end_pos":1148},{"ner":"4","lemma":"4","label":"NUM","start_pos":0,"end_pos":1},{"ner":"1","lemma":"1","label":"NUM","start_pos":24,"end_pos":25},{"ner":"2","lemma":"2","label":"NUM","start_pos":119,"end_pos":120},{"ner":"2","lemma":"2","label":"NUM","start_pos":292,"end_pos":293},{"ner":"3","lemma":"3","label":"NUM","start_pos":294,"end_pos":295},{"ner":"3","lemma":"3","label":"NUM","start_pos":375,"end_pos":376},{"ner":"4","lemma":"4","label":"NUM","start_pos":843,"end_pos":844},{"ner":"582","lemma":"582","label":"NUM","start_pos":1125,"end_pos":1128}] | NEUTRAL | rus | NOT SPAM | 173 | 0 | 4 | 0.99569 | 0.00431 | 0 | 28 | 30 | 11 | 2 | 53 | 5 | 43 | true |
26 | null | Про восПИТАНИЕ детей поговорили, теперь позаботимся о новорожденных
🤱🏼
Интересное 10-ти летнее исследование было проведено
👀
🔬
В группе детей, чьи мамы употребляли
пробиотики во время беременности
, было замечено на 45% меньше проявлений аллергий, диатезов, астмы, проблем с кожей и колик.
Выявлено, что микробиота матери начинает защищать ребенка даже внутриутробно
🤰🏼
Пробиотики и симбиотики способствуют восстановлению баланса микрофлоры в кишечнике матери и положительно сказывается на составе её молока. Такой способ снизит риск колик у вашего малыша, обеспечивая ему более комфортное начало жизни
🙌🏼
Рекомендуемый способ улучшения микробиоты – принимать про(сим)биотики каждый триместр курсом по 1 месяцу: по 1 капсуле натощак и 1 капсуле после ужина.
Заказать:
👉🏼
wildberries/симбиотик
👉🏼
wildberries/пробиотик
Реклама. ООО «Жизнивек»
ИНН 2311312648 | https://t.me/magerya/11479?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 39,400 | 0 | 1,729,586,411 | 1,730,797,658 | 10,157 | 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26 | null | Осталось 2 дня
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https://t.me/mageryachistka/582 | https://t.me/magerya/11480?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 38,000 | 0 | 1,729,594,286 | 1,730,797,658 | 10,137 | 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| [{"ner":"2","lemma":"2","label":"NUM","start_pos":9,"end_pos":10},{"ner":"582","lemma":"582","label":"NUM","start_pos":70,"end_pos":73}] | NEUTRAL | other | NOT SPAM | 8 | 0 | 0 | 0.928571 | 0.071429 | 0 | 0 | 3 | 0 | 1 | 2 | 0 | 2 | true |
26 | null | Поза легавой собаки? | https://t.me/sudmednotes/9186?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 45,000 | 0 | 1,729,836,133 | 1,730,797,658 | 10,162 | 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| null | NEUTRAL | rus | NOT SPAM | 3 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 1 | true |
26 | null | 🍂
Осень
- время триллеров. Дарим 4 психологических триллера-детектива в одни руки.
Под обложкой расследования, работа криминалистов, детективов, судмедэкспертов, тонна психологии и скандинавский сеттинг. Захватят даже самого привередливого читателя.
Все, что вам нужно, быть подписанным на:
@sudmednotes
(это я)
@tomenchukav
(это автор книг)
Результаты подведем 31 октября 2024 после 20.00
Отправка приза от автора по РФ в течение 2 недель после подведения итогов | https://t.me/sudmednotes/9187?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 44,900 | 0 | 1,729,845,308 | 1,730,797,658 | 10,162 | 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| [{"ner":"РФ","lemma":"рф","label":"LOC","start_pos":418,"end_pos":420},{"ner":"31 октября","lemma":"31 октября","label":"DATE","start_pos":362,"end_pos":372},{"ner":"20.00","lemma":"20.00","label":"DATE","start_pos":384,"end_pos":389},{"ner":"4","lemma":"4","label":"NUM","start_pos":33,"end_pos":34},{"ner":"2024","lemma":"2024","label":"NUM","start_pos":373,"end_pos":377},{"ner":"00","lemma":"00","label":"NUM","start_pos":387,"end_pos":389},{"ner":"2","lemma":"2","label":"NUM","start_pos":431,"end_pos":432}] | NEUTRAL | rus | SPAM | 63 | 0 | 1 | 0.977778 | 0.022222 | 0 | 7 | 5 | 6 | 3 | 27 | 0 | 15 | true |
26 | null | Это твердая мозговая оболочка, на латинском “dura mater”.
Это внешняя оболочка головного и спинного мозга, находится над паутинной и сосудистой оболочками.
Такое название получила, потому что твердая мозговая оболочка имеет консистенцию, похожую на кожу, и очень устойчива к разрыву. | https://t.me/sudmednotes/9188?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 44,500 | 0 | 1,729,855,796 | 1,730,797,658 | 10,157 | 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| null | NEUTRAL | rus | NOT SPAM | 39 | 0 | 0 | 0.961538 | 0.038462 | 0 | 12 | 3 | 2 | 0 | 9 | 2 | 10 | true |
26 | null | Настольная книга судмедэксперта | https://t.me/sudmednotes/9189?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 45,200 | 0 | 1,729,863,215 | 1,730,797,658 | 10,137 | 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| null | NEUTRAL | rus | NOT SPAM | 3 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | true |
26 | null | Друзья
❤️
Мою книгу «Я - женщина. Все о гормонах, контрацепции, женском здоровье и многом другом» номинировали на премию «Здравомыслие»
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Это литературная премия в области медицины, задуманная для поддержки врачебной деятельности, популяризации базовых биомедицинских знаний в обществе, пропаганды здорового образа жизни и воспитания культуры здоровья.
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В попечительском совете премии есть и министр здравоохранения, и много известных врачей, научных деятелей, членов академии наук.
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Книга прошла первый этап отбора.
Ее вычитал и одобрил экспертный совет.
👩🏼💻
Сегодня последний день народного голосования.
Поддержите «мою прилесть»
😁
своим голосом
🙏🏻
❤️
Ссылка для голосования
https://crowdspace.ru/project/premiadoc2020/task/9731/solution/25747
Нужно зарегистрироваться через любую удобную для вас соц сеть или через вашу эл.почту, далее нажать кнопку «отдать голос». После дождаться, пока появится зеленое окошко "Ваш голос принят".
Можно проголосовать через телефон, но кому не удастся - попробуйте через ноутбук(так многим проще и быстрее засчитывается голос)
Очень и очень благодарна всем вам! За каждый ваш голос!
🙏🏻
❤️
Спасибо за поддержку и доверие!
#ДавайНаучпопВмассы | https://t.me/doctor_belokon/26?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 98,000 | 0 | 1,598,941,250 | 1,730,797,659 | 10,118 | 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26 | null | Последний мой пост в Инстаграм был невероятно тяжелым в эмоциональном плане.
Некоторые комментарии просто невозможно было читать. Глаза были на мокром месте.
Был один гневный комментарий от коллеги, которая тщетно пыталась отстаивать свою позицию и оправдывать свои действия в родзале.
«Вы поработайте», «написать легко, но на практике все иначе».
Я прекрасно понимаю, почему некоторые на меня так злятся.
Мы живем в условиях полуразрушенной системы здравоохранения, которая
1️⃣
не заботится должным образом, не защищает и самое главное, НЕ ОБУЧАЕТ врачей так, как это положено.
2️⃣
Есть колоссальные различия в обучении и опыте медицинских работников, усталость, депрессия и профессиональное выгорание.
Это накладывает свой отпечаток и многие просто уходят из профессии.
Остальные ощущают гнев, раздражение, злость, беспомощность, отрицают очевидные вещи, потому что привыкли работать по-старинке, не привыкли к гибкости и непрерывному процессу обучения, регулярному изменению своих подходов.
Врачи брошены системой и предоставлены сами себе.
Разнообразные пациенты, незнакомые условия, нехватка времени, хронические «недосыпы», бедность, невозможность получать адекватные НЕзаангажированные медицинские знания, незнание английского языка, незнание того, к каким источникам информации обращаться в сложных ситуациях и пр.
И знаете, что самое важное и первостепенное во всей этой истории?
Некоторые врачи просто не могут и не хотят признавать своих ошибок.
Можете ли вы поверить в то, что практикующий врач никогда не ошибался за все время своей работы?
Я никогда в это не поверю.
Потому что это невозможно.
А если вам кто-то говорит подобное - он либо лжец, либо просто не практикует.
Я нежно помню все свои ошибки, которые, к счастью, не стоили никому жизни, и из которых я извлекла уроки.
По средним подсчетам только в США ежегодно случается около 100 000 смертей по причине врачебных ошибок.
Самые лучшие клиники мира (Mayo и другие) все время проводят анализ этих случаев, поощряют врачей за признание своей ошибки, проводит разборы, не для того, чтобы наказать и публично распять, а чтоб научить на чужих ошибках, напомнить о сложных и нестандартных ситуациях, предупредить о последствиях.
«Если не говорить о проблеме госпитальной ошибки, с ней невозможно бороться» - говорит П. Проновост, доктор медицинских наук, профессор Медицинской школы Университета Джона Хопкинса, чей собственный отец умер из-за медицинской ошибки в возрасте 50 лет.
«Всякий раз, когда я набирался смелости поделиться личной ошибкой, мои коллеги с восторгом слушали. Но большинство ничего не говорили, хотя я знаю, что они так же виноваты. Культура медицины по-прежнему не позволяет нам это сделать».
Прослушайте выступления канадского врача скорой помощи доктора Брайана Голдмана на TED Talk и подумайте, хотели бы вы быть врачом? (Ссылка в следующем сообщении)
Стоит ли вам или вашим детям идти в медицинский?
Откройте видео на компьютере, там можно включить русские субтитры и смотреть с переводом.
Сдать экзамен и набрать 98% из 100% - это отличный результат.
В бейсболе игрок, который отбивает 4 подачи из 10, зовётся «легендой».
Врач не имеет права на ошибку.
Или имеет?...ведь он человек.
Если он делает свою работу супер-качественно и на 98% выполняет ее на 5+.
Но есть 1%, где он ответил неправильно:
1)недооценил серьезность ситуации
2)поставил неверный диагноз
3)выписал не ту дозу лекарства
На экзамене тебе бы все равно поставили 5.
Но когда это касается живого человека - это уже совсем другая история.
Один , всего один неправильный ответ может стоить кому-то жизни.
Один неправильный ответ приравнивается не к 98%, а к провалу.
И после нездоровый стыд, мучения и терзания.
«Зачем я вообще пошел в медицину? . . . Я не создан для такой огромной ответственности ».
Но если вы удалите из медицины всех людей, которые совершают ошибки, в ней не останется никого, кто заботился бы об пациентах, которые так сильно нуждаются в нашей помощи.
Если я собираюсь и дальше работать врачом, я должен научиться исправлять свои ошибки здоровым образом. | https://t.me/doctor_belokon/27?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 102,800 | 0 | 1,599,390,439 | 1,730,797,659 | 10,118 | 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| [{"ner":"Инстаграм","lemma":"инстаграм","label":"ORG","start_pos":21,"end_pos":30},{"ner":"США","lemma":"сша","label":"LOC","start_pos":1822,"end_pos":1825},{"ner":"П. Проновост","lemma":"п. проновост","label":"PER","start_pos":2283,"end_pos":2295},{"ner":"Медицинской школы","lemma":"медицинский школа","label":"ORG","start_pos":2332,"end_pos":2349},{"ner":"Университета Джона Хопкинса","lemma":"университет джон хопкинса","label":"ORG","start_pos":2350,"end_pos":2377},{"ner":"Брайана Голдмана","lemma":"брайан голдман","label":"PER","start_pos":2746,"end_pos":2762},{"ner":"TED Talk","lemma":"ted talk","label":"ORG","start_pos":2766,"end_pos":2774},{"ner":"00 00","lemma":"00 00","label":"DATE","start_pos":1852,"end_pos":1857},{"ner":"1","lemma":"1","label":"NUM","start_pos":475,"end_pos":476},{"ner":"2","lemma":"2","label":"NUM","start_pos":579,"end_pos":580},{"ner":"100","lemma":"100","label":"NUM","start_pos":1851,"end_pos":1854},{"ner":"000","lemma":"000","label":"NUM","start_pos":1855,"end_pos":1858},{"ner":"50","lemma":"50","label":"NUM","start_pos":2441,"end_pos":2443},{"ner":"98","lemma":"98","label":"NUM","start_pos":3008,"end_pos":3010},{"ner":"100","lemma":"100","label":"NUM","start_pos":3015,"end_pos":3018},{"ner":"4","lemma":"4","label":"NUM","start_pos":3081,"end_pos":3082},{"ner":"10","lemma":"10","label":"NUM","start_pos":3093,"end_pos":3095},{"ner":"98","lemma":"98","label":"NUM","start_pos":3228,"end_pos":3230},{"ner":"5","lemma":"5","label":"NUM","start_pos":3248,"end_pos":3249},{"ner":"1","lemma":"1","label":"NUM","start_pos":3260,"end_pos":3261},{"ner":"1","lemma":"1","label":"NUM","start_pos":3292,"end_pos":3293},{"ner":"2","lemma":"2","label":"NUM","start_pos":3326,"end_pos":3327},{"ner":"3","lemma":"3","label":"NUM","start_pos":3354,"end_pos":3355},{"ner":"5","lemma":"5","label":"NUM","start_pos":3425,"end_pos":3426},{"ner":"98","lemma":"98","label":"NUM","start_pos":3608,"end_pos":3610}] | NEGATIVE | rus | NOT SPAM | 598 | 0 | 13 | 0.996149 | 0.003851 | 0 | 64 | 96 | 56 | 16 | 146 | 38 | 128 | true |
26 | null | Я должен ПРИЗНАТЬ их, испытать здоровое сожаление, НАУЧИТЬСЯ чему-то на их основе и затем простить себя.
Это невероятно важная часть процесса.
Человек, который не чувствовал угрызений совести, не думал над своими ошибками и не признавался бы в них хотя бы сам себе - не может быть хорошим врачом.
Врачи нового поколения - те врачи, которые могут открыто говорить с другими, учиться на чужих ошибках и делиться своими, пользоваться самыми современными научными данными и совмещать теорию с практикой.
Одно без другого невозможно!
Когда нет теории - практика может стать настоящим вредительством.
А без практики теория слепа, глуха и мертва.
Важно Признавать ошибки и извлекать из них опыт.
А также любить себя за все то хорошее и невероятно нужное, что мы делаем каждый день.
Врач может ошибиться случайно.
Может растеряться, устать, неверно среагировать в критической ситуации.
Его нельзя за это казнить.
Врач тоже человек.
Преступление - делать это намеренно.
Причинять вред пациенту, отрицая очевидные вещи и доказательную медицину. | https://t.me/doctor_belokon/28?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 107,700 | 0 | 1,599,390,439 | 1,730,797,659 | 10,162 | 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| null | NEUTRAL | rus | NOT SPAM | 156 | 0 | 5 | 1 | 0 | 0 | 22 | 28 | 19 | 1 | 39 | 9 | 27 | true |
26 | null | https://www.ted.com/talks/brian_goldman_doctors_make_mistakes_can_we_talk_about_that/transcript#t-1138540
Самое лучшее выступление врача, которое я видела за последнее время.
И, конечно, глядя на него, понимаешь, какая пропасть лежит между системой здравоохранения развитых и развивающихся стран | https://t.me/doctor_belokon/29?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 118,400 | 0 | 1,599,390,512 | 1,730,797,659 | 10,162 | 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26 | null | Эфир о послеродовой депрессии | https://t.me/doctor_belokon/30?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 110,900 | 0 | 1,602,051,241 | 1,730,797,659 | 10,162 | 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| null | NEUTRAL | rus | NOT SPAM | 4 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | true |
26 | null | Часто, выбирая крем с защитой от солнечного облучения мы обращаем внимание на SPF, однако,SPF - Sun Protection Factor (солнцезащитный фактор)
- отражает лишь силу защитного действия от UVB-излучения.
Данный фактор рассчитан исходя из МЭД (минимальной эритемной дозы). А МЭД - это время, которое человек провел под открытым солнцем до первых признаков покраснения.
👆🏻
Теоретически, SPF указывает, во сколько раз дольше МЭД человек может остаться под солнцем.
❗️
Но УФ лучи спектра А тоже вредны, и в отличие от В лучей,
больше стимулируют пигментацию.
🔴
Для обозначения степени защиты от этого спектра используется индекс PPD, который расшифровывается
как Persistent Pigment Darkening (постоянное
пигментационное потемнение).
И показывает, во сколько раз солнцезащитное средство способно уменьшить дозу УФ-А излучения.
Согласно европейскому законодательству, каждый солнцезащитный крем должен иметь хотя бы самую низкую степень защиты от УФ-А, если же PPD составляет одну треть и более от SPF, то средство имеет право на соответствующую маркировку.
🧬
Помимо данных маркировок есть еще и защита от повреждения ДНК клеток
❗️
, которая обозначается как DNA PF (DNA protection factor), который как раз связан с SPF и всегда бывает больше него, например, в креме с SPF 15 он будет около 40).
Какой у вас солнцезащитный крем? | https://t.me/dr_Guvarsha/180?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 163,700 | 0 | 1,716,404,256 | 1,730,797,659 | 10,118 | 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| [{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":78,"end_pos":81},{"ner":"SPF - Sun Protection Factor","lemma":"spf - sun protection factor","label":"ORG","start_pos":90,"end_pos":117},{"ner":"UVB-излучения","lemma":"uvb-излучение","label":"ORG","start_pos":185,"end_pos":198},{"ner":"МЭД","lemma":"мэд","label":"ORG","start_pos":234,"end_pos":237},{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":381,"end_pos":384},{"ner":"МЭД","lemma":"мэд","label":"ORG","start_pos":418,"end_pos":421},{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":988,"end_pos":991},{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":1206,"end_pos":1209},{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":1259,"end_pos":1262},{"ner":"15","lemma":"15","label":"NUM","start_pos":1263,"end_pos":1265},{"ner":"40","lemma":"40","label":"NUM","start_pos":1281,"end_pos":1283}] | NEUTRAL | rus | NOT SPAM | 196 | 0 | 25 | 0.92278 | 0.07722 | 0 | 21 | 21 | 8 | 6 | 51 | 11 | 42 | true |
26 | null | С утра переставлял книги и попался «Овод».
Открыл и опять мурашки по коже….
«Овода трудно было узнать. Он пришел в бешенство и дрожал, тяжело переводя дыхание, а глаза у него искрились зеленым огнем, словно у кошки.
Монтанелли глядел на него молча. Он ничего не понимал в этом потоке неистовых упреков, но чувствовал, что дойти до такого исступления может лишь человек, доведенный до крайности. И, поняв это, он простил ему все прежние обиды.
– Успокойтесь, – сказал он. – Никто не хотел вас мучить. И, право же, я не думал сваливать свою ответственность на вас, чья ноша и без того слишком тяжела. Ни одно живое существо не упрекнет меня в этом…
– Это ложь! – крикнул Овод, сверкнув глазами. – А епископство?
Епископство? – А! Об этом вы забыли? Забыть так легко! «Если хочешь, Артур, я откажусь…» Мне приходилось решать за вас, мне – в девятнадцать лет! Если б это не было так чудовищно, я бы посмеялся над вами!
– Замолчите! – крикнул Монтанелли, хватаясь за голову, потом беспомощно опустил руки, медленно отошел к окну и, сев на подоконник, прижался лбом к решетке. Овод, дрожа всем телом, следил за ним. Монтанелли встал и подошел к Оводу. Губы у него посерели. –
Простите, пожалуйста, – сказал он, стараясь сохранить свою обычную спокойную осанку. – Я должен уйти… Я не совсем здоров. Он дрожал как в лихорадке.
Гнев Овода сразу погас.
– Padre, неужели вы не… Монтанелли подался назад.
– Только не это, – прошептал он. – Все, что хочешь, господи, только не это! Я схожу с ума…
Овод приподнялся на локте и взял его дрожащие руки в свои:
– Padre, неужели вы не догадываетесь, что я не утонул?
Руки, которые он держал в своих, вдруг похолодели. Наступило мертвое молчание. Потом Монтанелли опустился на колени и спрятал лицо на груди Овода. | https://t.me/drmyasnikov/2580?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 76,000 | 0 | 1,726,984,232 | 1,730,797,659 | 10,118 | 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| [{"ner":"Овод","lemma":"овод","label":"ORG","start_pos":36,"end_pos":40},{"ner":"Монтанелли","lemma":"монтанелли","label":"PER","start_pos":216,"end_pos":226},{"ner":"Овод","lemma":"овод","label":"PER","start_pos":669,"end_pos":673},{"ner":"Артур","lemma":"артур","label":"PER","start_pos":779,"end_pos":784},{"ner":"Монтанелли","lemma":"монтанелли","label":"PER","start_pos":938,"end_pos":948},{"ner":"Монтанелли","lemma":"монтанелли","label":"PER","start_pos":1110,"end_pos":1120},{"ner":"Оводу","lemma":"овод","label":"PER","start_pos":1139,"end_pos":1144},{"ner":"Овода","lemma":"овод","label":"PER","start_pos":1324,"end_pos":1329},{"ner":"Монтанелли","lemma":"монтанелли","label":"PER","start_pos":1367,"end_pos":1377},{"ner":"Монтанелли","lemma":"монтанелли","label":"PER","start_pos":1683,"end_pos":1693},{"ner":"Овода","lemma":"овод","label":"PER","start_pos":1738,"end_pos":1743}] | NEUTRAL | rus | NOT SPAM | 298 | 0 | 8 | 0.995134 | 0.004866 | 0 | 14 | 62 | 43 | 1 | 49 | 16 | 101 | true |
26 | null | Для скрининга депрессии часто используются стандартизированные опросники. Одним из самых распространенных является
Шкала депрессии Бека (BDI)
и
Шкала депрессии Центра эпидемиологических исследований (CES-D).
Однако в повседневной клинической практике часто используется
Патологический индекс депрессии (PHQ-9),
который представляет собой краткий и эффективный инструмент. Вот примеры вопросов из PHQ-9:
1.
Мало интереса или удовольствия от выполнения дел.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
2.
Чувство подавленности, депрессии или безнадежности.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
3.
Проблемы с засыпанием или постоянный сон.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
4.
Чувство усталости или нехватка энергии.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
5.
Потеря аппетита или переедание.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
6.
Чувство, что вы плохи или что подвели себя или свою семью.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
7.
Трудности с концентрацией на чем-то, например, при чтении газеты или просмотре телевизора.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
8.
Чрезмерная медлительность или беспокойство, заметное для других людей.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
9.
Мысли о том, что было бы лучше умереть или причинить себе вред.
- Совсем не беспокоит
- Несколько дней
- Больше половины дней
- Почти каждый день
Респонденты оценивают каждый вопрос по шкале от "Совсем не беспокоит" до "Почти каждый день". Баллы суммируются, и их общий показатель указывает на уровень депрессивных симптомов:
-
0-4:
Минимальные или отсутствующие симптомы
-
5-9:
Легкая депрессия
-
10-14:
Умеренная депрессия
-
15-19:
Умеренно тяжелая депрессия
-
20-27:
Тяжелая депрессия | https://t.me/drmyasnikov/2581?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 89,200 | 0 | 1,727,027,287 | 1,730,797,659 | 10,164 | 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| NEUTRAL | rus | NOT SPAM | 308 | 0 | 5 | 0.988764 | 0.011236 | 0 | 22 | 21 | 9 | 57 | 92 | 44 | 56 | true |
26 | null | Про борьбу с курением. Да- однозначно вредно.
Вот все страны и объявили войну с курением. Поставили задачу искоренить курение к такому-то году (каждая к своему). Исследователи посмотрели как с этим дела в 153 странах. 28 уже объявили, что готовы покончить с курением и 48- что почти готовы. (Tamil Selvan, S ∙ Yeo, XX ∙ van der Eijk, Y
Which countries are ready for a tobacco endgame? A scoping review and cluster analysis
Lancet Glob Health.
2024;)
Вот выдержка из другой статьи в Ланцет на эту тему;
В Австралии распространенность курения среди общего населения перестала уменьшаться; более одного из десяти молодых людей в возрасте 16 или 17 лет курят в Англии; и в некоторых странах наблюдается рост курения среди подростков впервые за долгое время. Глобальное снижение распространенности курения достигло плато с 2003 года, когда была принята РКТ (Рамочная конвенция Всемирной организации здравоохранения по контролю над табаком), и в 111 странах с 2005 года наблюдается значительный рост распространенности курения, что является серьезным ухудшением ситуации, учитывая, что каждый второй курильщик преждевременно умирает от заболеваний, связанных с курением. Наконец, отсутствие исполнения ослабляет РКТ. Мягкая дипломатия ВОЗ слишком мягка и неэффективна. Множество стран, серьезно нарушающих РКТ, несмотря на то что они являются подписантами, даже не подвергаются осуждению за несоблюдение своей социальной ответственности.
Как Франция может быть оценена как почти готовая покончить с курением? В 2019 году Франция была одной из шести стран мира, наряду с Чили, Турцией, Болгарией, Хорватией и Латвией, с распространенностью курения выше 33% среди лиц в возрасте 15-24 лет. В 2019 году Франция занимала второе место после Греции по распространенности курения в Западной Европе.
Ведь что делается: запрещают рекламу, ограничивают места для курения и перед фильмом вставляют наивные « демонстрируется курение табака- это вредно для вашего здоровья!»
Но по делу единственный, как они считают действенный, метод - это повышение цен на сигареты и табак ….. они растут уже напротяжении последних десятилетий. В каких-то странах очень значительно. В итоге если люди и стали где-то меньше курить, то
по итогу доходы табачных компаний и правительство от налогов табак выросли и в некоторых странах значительно
. Я спросил об этом и искусственный интеллект вот что было отвечено:
«За последние 20 лет доходы табачных компаний показали различные тенденции в зависимости от региона и конкретной компании. В общем, можно отметить, что:
несмотря на борьбу с курением и ужесточение норм, в некоторых странах, особенно в развивающихся, доходы табачных компаний продолжали расти.
В целом, тенденции доходов табачных компаний неоднозначны и зависят от множества факторов, включая законодательство, общественное мнение и компании, которые активно адаптируют свои бизнес-модели к изменениям на рынке»
И вот заключение статьи:
«Optimism in the tobacco endgame
Alain Braillona∙ Adam Edward Langb»
«Эта устойчиво проводимая политика обеспечивает увеличение доходов для государственного бюджета и прибыли для индустрии. Снижение распространенности курения, в лучшем случае незначительное, будет лишь случайным результатом.»
Что-и тут на…и?!!!! (Можно прочитать «надули». Хотя именно на…и! | https://t.me/drmyasnikov/2582?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 97,700 | 0 | 1,727,098,766 | 1,730,797,659 | 10,162 | 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26 | null | Доброе утро! | https://t.me/drmyasnikov/2583?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 114,400 | 0 | 1,727,158,334 | 1,730,797,659 | 10,162 | 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| null | POSITIVE | rus | NOT SPAM | 2 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | true |
26 | null | Вы не представляете, как часто мне приходится говорить на приеме «это неинформативное исследование». В беспощадной отечественной гастроэнтерологии очень много бесполезных анализов, как, например, уже ставший классикой «анализ кала на дисбактериоз», или более молодой «ХМС по Осипову».
И это лишь капля в море ненужных анализов, представленных на рынке лабораторных обследований.
Врач широких взглядов, терапевт-гастроэнтеролог клиники Фомина в Твери – Ольга Сергеевна Сухарева (Ситкина)
https://t.me/doctor_sitkina
на своем канале рассказывает про ненужные анализы в терапии, развенчивает терапевтические (и не только) мифы, а также обозревает актуальные темы понятным языком.
😊
Рекомендую подписаться, чтобы не потерять классного терапевта
😉 | https://t.me/ibs_doc/180?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 5,500 | 0 | 1,702,571,445 | 1,730,797,659 | 10,121 | 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| [{"ner":"ХМС по Осипову","lemma":"хмс по осипов","label":"ORG","start_pos":268,"end_pos":282},{"ner":"Фомина","lemma":"фомин","label":"PER","start_pos":435,"end_pos":441},{"ner":"Твери","lemma":"тверь","label":"LOC","start_pos":444,"end_pos":449},{"ner":"Ольга Сергеевна Сухарева (Ситкина)\nhttps://t.me/doctor_sitkina\n","lemma":"ольга сергеевич сухарев (ситкина)\nhttps://t.me/doctor_sitkina","label":"PER","start_pos":452,"end_pos":515}] | NEUTRAL | rus | NOT SPAM | 94 | 0 | 3 | 0.992126 | 0.007874 | 0 | 13 | 11 | 4 | 0 | 27 | 8 | 26 | true |
26 | null | Сказано - сделано.
Ответы на ваши вопросы
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Мой топ бесполезных анализов:
1.
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Кал на дисбактериоз.
Наша кишечная микробиота уникальна, разнообразна и отвечает за очень многие процессы в нашем организме. По последним данным, в кишечнике живет более 20.000 видов разных микроорганизмов. Как можно оценить микрофлору по анализу, который насчитывает всего 10-20 видов бактерий?
Кстати, есть бактерии, которые живут в пристеночной слизи кишки, не выводятся наружу с калом и оценить их нельзя. Будем их игнорировать? Кроме того, высеиваются лишь те бактерии, которые лучше прижились на питательной среде в лаборатории, а не те, которые являются причиной ваших жалоб. P.S: кандида в кишке живет в норме.
PLEASE
!
2.
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Антитела IgG к вирусу Эпштейна-Барр/цитомегаловирусу/герпес вирусу.
У меня один вопрос: ЗАЧЕМ? Каждый из нас сталкивается с этими вирусами еще в детстве, а значит будут и антитела. Как они могут объяснять ваши симптомы, если данный анализ положительный у 95% населения?
3.
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ХМС по Осипову
.
Полностью отсутствует стандартизация и контроль качества за результатами. А в научной медицине всё-таки нужна структура и система, согласитесь. Поэтому любые отклонения, которые будут в данном анализе не отражают реальные изменения в кишке.
4.
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Панель пищевых аллергенов IgG.
Желудочно-кишечный дискомфорт от определённых продуктов - это пищевая непереносимость и диспепсия. Эти процессы происходят без участия иммунной системы и не вызываются ни одним из четырех типов иммунных реакций гиперчувствительности. Что же касается иммуноглобулинов класса G, то их образование - это естественный процесс здорового организма, нормальная реакция на еду. Их обнаружение значит, что человек ел данный продукт и всё :) | https://t.me/ibs_doc/181?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 6,100 | 0 | 1,702,571,445 | 1,730,797,659 | 10,121 | 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| [{"ner":"IgG","lemma":"igg","label":"ORG","start_pos":722,"end_pos":725},{"ner":"Эпштейна-Барр","lemma":"эпштейна-барр","label":"PER","start_pos":735,"end_pos":748},{"ner":"герпес вирусу","lemma":"герпес вирус","label":"PER","start_pos":766,"end_pos":779},{"ner":"Осипову","lemma":"осипов","label":"LOC","start_pos":995,"end_pos":1002},{"ner":"20.00","lemma":"20.00","label":"DATE","start_pos":250,"end_pos":255},{"ner":"10-20","lemma":"10-20","label":"DATE","start_pos":354,"end_pos":359},{"ner":"1","lemma":"1","label":"NUM","start_pos":75,"end_pos":76},{"ner":"000","lemma":"000","label":"NUM","start_pos":253,"end_pos":256},{"ner":"20","lemma":"20","label":"NUM","start_pos":357,"end_pos":359},{"ner":"2","lemma":"2","label":"NUM","start_pos":708,"end_pos":709},{"ner":"95","lemma":"95","label":"NUM","start_pos":968,"end_pos":970},{"ner":"3","lemma":"3","label":"NUM","start_pos":983,"end_pos":984},{"ner":"4","lemma":"4","label":"NUM","start_pos":1246,"end_pos":1247}] | NEUTRAL | rus | NOT SPAM | 250 | 0 | 7 | 0.984849 | 0.015152 | 0 | 26 | 31 | 14 | 12 | 72 | 12 | 52 | true |
26 | null | Дорогие подписчики,
Вчера коллега прислала такую жуткую штуку :) Звучит и правда как революционный продукт... для того, чтобы устроить революцию в животе
😡
Поскольку важно уметь разбираться в составе, вот вам задание - найдите все опасные газообразующие компоненты в этой смеси
👨💻
#разбор | https://t.me/ibs_doc/183?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 6,200 | 0 | 1,702,708,929 | 1,730,797,659 | 10,162 | 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| [{"ner":"Звучит","lemma":"звучать","label":"PER","start_pos":65,"end_pos":71}] | NEUTRAL | rus | NOT SPAM | 43 | 0 | 0 | 1 | 0 | 0 | 6 | 6 | 2 | 0 | 14 | 1 | 8 | true |
26 | null | Выкладываю рилс из инсты
#рилсы #запретограм | https://t.me/ibs_doc/184?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 6,800 | 0 | 1,702,902,302 | 1,730,797,659 | 10,165 | 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| null | NEUTRAL | rus | NOT SPAM | 6 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 4 | 0 | 1 | true |
26 | null | Поехали, следующий рилс
😁
#рилсы #запретограм | https://t.me/ibs_doc/185?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 6,700 | 0 | 1,702,971,400 | 1,730,797,659 | 10,165 | 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| null | NEUTRAL | rus | NOT SPAM | 6 | 0 | 0 | 1 | 0 | 0 | 1 | 1 | 0 | 0 | 3 | 0 | 2 | true |
26 | null | Принято много говорить о сострадании.
Но что такое
САМОсострадание
?
Как, а главное, зачем его проявлять?
Подробно рассказывает Илья Розов в своем переводе статьи Расса Хариса.
📖
Читать
#ippsy_статьи | https://t.me/imatrip/2079?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,700 | 0 | 1,723,067,360 | 1,730,797,659 | 10,118 | 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| [{"ner":"САМОсострадание","lemma":"самосострадание","label":"ORG","start_pos":51,"end_pos":66},{"ner":"Илья Розов","lemma":"илья розов","label":"PER","start_pos":128,"end_pos":138},{"ner":"Расса Хариса","lemma":"расса харис","label":"PER","start_pos":163,"end_pos":175}] | NEUTRAL | rus | NOT SPAM | 29 | 0 | 0 | 1 | 0 | 0 | 1 | 5 | 2 | 0 | 5 | 3 | 6 | true |
26 | null | Феномен резистентной к лечению депрессии до сих пор остается недостаточно изученным, поскольку может быть обусловлен множеством различных факторов, в частности фармакогенетическими вариациями и недиагностированными или нелечеными коморбидными психическими заболеваниями, требующими тщательной оценки, установления диагноза и адекватного плана терапии. Ниже представлен
перевод
статьи V. L. Voytenko et al.
Psychiatric comorbidities in treatment-resistant depression: Insights from a second-opinion consultation case series. Psychiatry Research Case Reports (2024, Jan 3; 3 (1): 100205
, посвященной анализу серии клинических случаев в рамках инновационной программы консультаций «второе мнение» и описанию наиболее распространенных сопутствующих психических состояний, которые могут возникать у пациентов на фоне резистентной к лечению депрессии. | https://t.me/imatrip/2080?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,900 | 0 | 1,723,102,957 | 1,730,797,659 | 10,118 | 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26 | null | В “Psychiatric Times” 6.06.2024 опубликована заметка с провокационным заголовком “Все ошибаются в отношении бензодиазепинов”. Автор текста – американский психиатр Дэниел Морхед, решивший прокомментировать статью в “Wall Street Journal” (26.01.2024) с заголовком, звучащим тоже довольно громко – “Опасность упования на противотревожные препараты”. Ниже перевод заметки Морхеда в “Psychiatric Times”.
Читать далее про типичную ловушку психических заболеваний и мифы о вредности бензодиазепинов. | https://t.me/imatrip/2081?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 3,000 | 0 | 1,723,273,577 | 1,730,797,659 | 10,162 | 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19 | 4 | 20 | true |
26 | null | 🔸
В
Международном Институте Гештальта
стартует новый поток
программы повышения квалификации в гештальт-терапии.
Это глубокое погружение в гештальт-терапию. Каждый модуль проведет преподаватель, специализирующийся в теме.
Программа:
✔️
Семейная терапия – Вадим Ивановский
✔️
Кризисы и травмы – Анастасия Колесникова
✔️
Работа с телесностью Руэлы Франк – Антон Савин
✔️
Бессознательное в гештальт-терапии – Федор Коноров
✔️
Особенности онлайн работы – Энн Хезер Киз
✔️
Психосоматика – Евгений Колесников
✔️
Клинический гештальт – Денис Автономов
✔️
Экзистенциальный подход – Алёна Чайковская
✔️
Работа с зависимостями – Екатерина Артеменко
ППК — это:
→ 10 модулей за учебный год
→ 11 преподавателей по узким темам
→ Каждый модуль = 3 дня теории + супервизии случаев + супервизии практики
→ Ежегодная международная конференция по представлению случаев
→ Лекции по нейробиологии.
✍️
Запись на программу и подробности
тут
. | https://t.me/imatrip/2082?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,300 | 0 | 1,724,317,322 | 1,730,797,659 | 10,162 | 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| [{"ner":"🔸","lemma":"🔸","label":"LOC","start_pos":0,"end_pos":1},{"ner":"Международном Институте Гештальта","lemma":"международный институт гештальт","label":"ORG","start_pos":4,"end_pos":37},{"ner":"Вадим Ивановский","lemma":"вадим ивановский","label":"PER","start_pos":254,"end_pos":270},{"ner":"Анастасия Колесникова","lemma":"анастасия колесников","label":"PER","start_pos":293,"end_pos":314},{"ner":"Руэлы Франк","lemma":"руэлы франк","label":"PER","start_pos":339,"end_pos":350},{"ner":"Антон Савин","lemma":"антон савин","label":"PER","start_pos":353,"end_pos":364},{"ner":"Федор Коноров","lemma":"фёдор коноров","label":"PER","start_pos":405,"end_pos":418},{"ner":"Энн Хезер Киз","lemma":"энн хезер киз","label":"PER","start_pos":450,"end_pos":463},{"ner":"Евгений Колесников","lemma":"евгений колесников","label":"PER","start_pos":483,"end_pos":501},{"ner":"Денис Автономов","lemma":"денис автономов","label":"PER","start_pos":528,"end_pos":543},{"ner":"Алёна Чайковская","lemma":"алёна чайковский","label":"PER","start_pos":573,"end_pos":589},{"ner":"Екатерина Артеменко","lemma":"екатерина артеменко","label":"PER","start_pos":618,"end_pos":637},{"ner":"10","lemma":"10","label":"NUM","start_pos":651,"end_pos":653},{"ner":"11","lemma":"11","label":"NUM","start_pos":679,"end_pos":681},{"ner":"3","lemma":"3","label":"NUM","start_pos":730,"end_pos":731}] | NEUTRAL | rus | NOT SPAM | 134 | 0 | 2 | 1 | 0 | 0 | 13 | 4 | 2 | 3 | 50 | 3 | 28 | true |
26 | null | 7 пунктов зачем принимать Аргинин
⬇️
Мы применяем эту аминокислоту на
чистке,
так как она:
1️⃣
Расширяет сосуды.
Это не только улучшает кровоток, но и снижает давление во всей системе, что является ключом к здоровью сердца и профилактике сердечно-сосудистых заболеваний.
2️⃣
Дает энергию и питание для тканей.
Благодаря эффективному кровотоку, кислород и питательные вещества доставляются в каждую клетку нашего организма.
3️⃣
Ускоряет выведение токсинов.
Аргинин помогает не только расширять сосуды в почках, улучшая их кровоснабжение, но и ускоряет вывод вредных веществ из организма, что важно во время чистки.
4️⃣
Поддерживает сексуальное здоровье.
Для мужчин аргинин улучшает эрекцию и поддерживает здоровье половой системы. А у женщин способствует повышению сексуального влечения.
5️⃣
Помогает сохранить мышцы.
Необходим для роста и поддержания мышечной массы. А там, где сильные мышцы – будут эластичные и здоровые вены. Это особенно важно для тех, у кого сидячая работа.
6️⃣
Заботится о сердце.
Предотвращает образование бляшек в артериях, развитие атеросклероза, что продлевает нашу жизнь.
7️⃣
Ускоряет снижении веса.
Сочетание аргинина с физической активностью улучшит обмен веществ, что в свою очередь помогает в борьбе с лишним весом.
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👉🏼
wildberries/аргинин
Уже пробовали Аргинин
❓
Делитесь результатами
⬇️ | https://t.me/magerya/11471?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 43,400 | 0 | 1,729,503,610 | 1,730,797,659 | 10,119 | 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| [{"ner":"Аргинин","lemma":"аргинин","label":"PER","start_pos":26,"end_pos":33},{"ner":"Аргинин","lemma":"аргинин","label":"PER","start_pos":456,"end_pos":463},{"ner":"7","lemma":"7","label":"NUM","start_pos":0,"end_pos":1},{"ner":"1","lemma":"1","label":"NUM","start_pos":91,"end_pos":92},{"ner":"2","lemma":"2","label":"NUM","start_pos":271,"end_pos":272},{"ner":"3","lemma":"3","label":"NUM","start_pos":423,"end_pos":424},{"ner":"4","lemma":"4","label":"NUM","start_pos":614,"end_pos":615},{"ner":"5","lemma":"5","label":"NUM","start_pos":787,"end_pos":788},{"ner":"6","lemma":"6","label":"NUM","start_pos":979,"end_pos":980},{"ner":"7","lemma":"7","label":"NUM","start_pos":1099,"end_pos":1100}] | NEUTRAL | rus | NOT SPAM | 187 | 0 | 2 | 0.996094 | 0.003906 | 0 | 21 | 28 | 9 | 1 | 65 | 6 | 35 | true |
26 | null | Мои хорошие, сегодня В
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👉🏼
https://t.me/clinic_magerya/123 | https://t.me/magerya/11472?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 37,300 | 0 | 1,729,507,576 | 1,730,797,659 | 10,118 | 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| [{"ner":"5","lemma":"5","label":"NUM","start_pos":112,"end_pos":113},{"ner":"123","lemma":"123","label":"NUM","start_pos":161,"end_pos":164}] | NEUTRAL | rus | NOT SPAM | 20 | 0 | 2 | 0.96875 | 0.03125 | 0 | 4 | 1 | 0 | 0 | 10 | 1 | 3 | true |
26 | null | Щитовидка — маленькая железа с большими амбициями
🏹
Она отвечает за активный обмен веществ, энергию и в целом – желание жить. Но
для качественной работы
ей нужны союзники –
тирозин, йод и цинк
.
Сегодня рассказываем о витаминах для
🦋
✅
ТИРОЗИН – основа для построения гормонов.
Из него щитовидная железа синтезирует тироксин (Т4) и трийодтиронин (Т3).
Представьте, что вы строите дом, но вдруг закончились кирпичи
🤷🏼
Что дальше?
Стройка останавливается — вот так и щитовидная: если тирозина мало, производство гормонов снижается, а значит, наступает гипотиреоз.
Появляются
усталость, сонливость, набор веса без явной причины, отеки, сухая кожа, вечно холодные руки, и даже приступы депрессии
🫥
Сомнительная перспектива, правда?
✅
ЙОД – энергия для построения гормонов
🏗️
Даже если тирозина полно, без йода ничего не получится. Если его мало, то она вынуждена разрастаться в зоб. Запустив ситуацию, мы опять встретимся с гипотиреоз, симптомы которого выше
👆🏼
Кстати, йод в обязательном порядке нужен беременным, ведь его дефицит может негативно сказаться на развитии плода. Щитовидка мамы в это время работает за двоих и для двоих
🤰🏼
В сутки должно поступать 300 мкг йода
❗️
✅
ЦИНК — это броня для щитовидной железы, особенно если есть АИТ.
Аутоиммунный тиреоидит начинается тогда, когда иммунитет вдруг решает, что собственная щитовидка – враг, и начинает её атаковать. Атака усиливается, если в организме недостаток цинка, поэтому предотвращаем дефицит заблаговременно
⏱️
Витамины для щитовидной железы:
Тирозин
👉🏼
wildberries/тирозин
Йод (йодин)
👉🏼
wildberries/йодин
Цинк
👉🏼
wildberries/цинк
Ещё больше полезной информации о витаминах и нутриентах ищите на канале "Жизнивек"
👉🏼
https://t.me/ziznivek
Реклама. ООО «Жизнивек»
ИНН 2311312648 | https://t.me/magerya/11473?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 39,900 | 0 | 1,729,514,411 | 1,730,797,659 | 10,162 | 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| [{"ner":"🦋","lemma":"🦋","label":"ORG","start_pos":232,"end_pos":233},{"ner":"ТИРОЗИН","lemma":"тирозин","label":"ORG","start_pos":236,"end_pos":243},{"ner":"Сомнительная перспектива","lemma":"сомнительный перспектива","label":"ORG","start_pos":694,"end_pos":718},{"ner":"ЦИНК","lemma":"цинк","label":"ORG","start_pos":1176,"end_pos":1180},{"ner":"АИТ","lemma":"аит","label":"ORG","start_pos":1235,"end_pos":1238},{"ner":"Йод","lemma":"йод","label":"PER","start_pos":1536,"end_pos":1539},{"ner":"Ещё","lemma":"ещё","label":"PER","start_pos":1594,"end_pos":1597},{"ner":"Жизнивек","lemma":"жизнивек","label":"ORG","start_pos":1667,"end_pos":1675},{"ner":"ООО «Жизнивек»\nИНН 2311312648","lemma":"ооо \"жизнивек\"\nинн 2311312648","label":"ORG","start_pos":1711,"end_pos":1740},{"ner":"2311312648","lemma":"2311312648","label":"DATE","start_pos":1730,"end_pos":1740},{"ner":"12648","lemma":"12648","label":"DATE","start_pos":1735,"end_pos":1740},{"ner":"4","lemma":"4","label":"NUM","start_pos":327,"end_pos":328},{"ner":"3","lemma":"3","label":"NUM","start_pos":348,"end_pos":349},{"ner":"300","lemma":"300","label":"NUM","start_pos":1158,"end_pos":1161}] | NEUTRAL | rus | NOT SPAM | 255 | 0 | 9 | 0.98913 | 0.01087 | 0 | 22 | 28 | 11 | 7 | 82 | 17 | 74 | true |
26 | null | В качественном уходе за кожей важно соблюдать комплексный и многоступенчатый уход
☝️
И ни в коем случае не забывать про
эксфолиацию.
Энзимная пудра «Магеря косметик» – это уникальная формула на основе растительных ферментов, способствующая деликатному очищению и мягкому отшелушиванию.
Знали ли вы, что ферменты папайи известны своими способностями глубоко очищать поры и делать их менее заметными?
🍈
Как применять?
Просто смочите руки и вспеньте немного пудры, затем нанесите на влажную кожу лица и шеи с легкими массирующими движениями. Смойте теплой водой — и наслаждайтесь чистейшей кожей!
Заказать
👉🏼
wildberries/энзимная_пудра
Реклама. ООО " МаМагеря"
ИНН 2310229436 | https://t.me/magerya/11476?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 42,000 | 0 | 1,729,524,674 | 1,730,797,659 | 10,162 | 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| [{"ner":"ООО \" МаМагеря\"\nИНН 2310229436","lemma":"ооо \" мамагеря\"\nинн 2310229436","label":"ORG","start_pos":642,"end_pos":672},{"ner":"29436","lemma":"29436","label":"DATE","start_pos":667,"end_pos":672},{"ner":"23102","lemma":"23102","label":"DATE","start_pos":662,"end_pos":667}] | NEUTRAL | rus | NOT SPAM | 95 | 0 | 4 | 0.992 | 0.008 | 0 | 16 | 13 | 2 | 1 | 29 | 5 | 18 | true |
26 | null | Во время приема пищи не смотреть! Личинки бывают не только в трупах.
Кейс от подписчика. Поступил бомж,найден на улице,с диагнозом:
"Закрытая черепно-мозговая травма, ушиб головного мозга. Переохлаждение".
Обследовади, нашли субдуральную гематому. Нужно госпиализировать в хир.реанимацию, для этого как обычно "отмыть,почистить, подстричь". Перед глазами следующая картина.
Кстати, есть такое наблюдение, что как только с бомжей "снимаешь" их привычную микрофлору и фауну,они умирают. Вот и он не выжил...
Записки судмедэксперта | https://t.me/sudmednotes/9180?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 47,200 | 0 | 1,729,771,466 | 1,730,797,659 | 10,118 | 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| null | NEUTRAL | rus | NOT SPAM | 68 | 0 | 0 | 1 | 0 | 0 | 9 | 13 | 3 | 0 | 23 | 2 | 27 | true |
26 | null | Входная и выходная огнестрельная рана от выстрела в правую теменную область | https://t.me/sudmednotes/9183?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 45,200 | 0 | 1,729,797,753 | 1,730,797,659 | 10,162 | 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| null | NEUTRAL | rus | NOT SPAM | 11 | 0 | 0 | 1 | 0 | 0 | 5 | 0 | 0 | 0 | 3 | 0 | 0 | true |
26 | null | Купил билеты в кино на Венома.
До сеанса оставалось часа 4. Подумал, что как раз успею подремать. Проспали с женой и не успели в кино
Я хз, как работают будильники на айфонах, но не услышать их - нормальное явление как будто бы. | https://t.me/sudmednotes/9184?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 45,500 | 0 | 1,729,798,222 | 1,730,797,659 | 10,162 | 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| [{"ner":"Венома","lemma":"венома","label":"LOC","start_pos":23,"end_pos":29},{"ner":"4","lemma":"4","label":"NUM","start_pos":57,"end_pos":58}] | NEUTRAL | rus | NOT SPAM | 42 | 0 | 1 | 1 | 0 | 0 | 2 | 9 | 1 | 1 | 11 | 2 | 7 | true |
26 | null | Исправление тазового предлежания по методам индийского кинематографа. Меня вынесло | https://t.me/sudmednotes/9185?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 48,200 | 0 | 1,729,832,863 | 1,730,797,659 | 10,162 | 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| null | NEUTRAL | rus | NOT SPAM | 9 | 0 | 0 | 1 | 0 | 0 | 2 | 1 | 1 | 0 | 4 | 0 | 1 | true |
26 | null | Хорошие новости для ценителей кофе.
Исследовательская группа Университета Сучжоу провела анализ совместного воздействия малоподвижного образа жизни и употребления кофе на вероятность летальных исходов по различным причинам, включая сердечно-сосудистые заболевания.
В течение 13 лет наблюдения за 10 639 участниками зафиксировали 945 случаев смерти, из которых 284 были обусловлены кардиоваскулярными нарушениями.
У тех, кто регулярно потреблял более двух чашек кофе в день, риск смертности по всем причинам и от сердечно-сосудистых заболеваний снизился на 33% и 54% соответственно, по сравнению с непьющими кофе.
Кроме того, по инициативе The Washington Post один из ученых дополнительно выявил, что у малоподвижных людей, употребляющих кофе, риск смерти был на 24% меньше по сравнению с сидячими более шести часов в день людьми, избегающими этого напитка.
Важно отметить, что сидячий образ жизни по-прежнему неблагоприятен. Физическая активность оказывает положительное влияние как на продолжительность, так и на качество жизни.
Я разрешаю употребление кофе своим кардиологическим пациентам в количестве 1-2 чашек в день. Надеюсь все понимают, что пациенты с сердечно-сосудистыми заболеваниями должны находиться под регулярным наблюдением кардиолога и получать соответствующую медикаментозную терапию. Если же артериальное давление находится в пределах нормы, то умеренное потребление кофе вполне допустимо.
Максимальный порог кофе 3 чашки в день для всех - это уже лично мои наблюдения. При большем получаем повышенную тревожность, бессонницу.
PS: я также стараюсь пить не больше 2-3 чашек в день. А хобби у меня- в разных городах и странах делать красивые фото. Это фото с острова Саадият, который сам по себе чудесен, и кофе там просто замечательный
🔥 | https://t.me/DrAnshina/1180?embed=1&mode=tme | https://t.me/ | https://t.me/s/DrAnshina | 177,000 | 0 | 1,719,244,108 | 1,730,797,660 | 10,118 | 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true |
26 | null | Эфир с нутрициологом Кардаковой Марией
Все, что нужно знать о здоровом питании, БАДах, модных диетах и различных рекомендациях о питании.
Сейчас все большие «спецы» во всем, но настоящих профессионалов единицы.
Львиная часть из того, что вы читаете о питании и не только - является информационным мусором и неправдой.
Мои любимые цитаты из эфира
👇🏻
«Если бы можно было еду заменить на что-то, мы бы давно уже это сделали»
«Микробиом кишечника нужно и можно изменять с помощью питания, а не антибиотиков или добавок»
«Люди боятся нитратов в овощах и фруктах, но не боятся тех последствий, к которым может привести отказ от этих самых овощей и фруктов. Они значительно серьезнее нитратов»
«Есть ещё и другие овощи, помимо помидоров, огурцов и картошки, но люди упорно о них не знают, не помнят, не умеют есть и готовить»
«Овощи, фрукты, ягоды можно замораживать. Намного дешевле купить морозильную камеру и обеспечить себе здоровое питание круглый год, чем скупать БАДы и лечиться потом от болезней, к которым приводит несбалансированное питание.»
Об этом и многом другом смотрите в нашем совместном эфире | https://t.me/doctor_belokon/23?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 99,000 | 0 | 1,591,346,229 | 1,730,797,660 | 10,129 | 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| [{"ner":"Кардаковой Марией","lemma":"кардаковой мария","label":"LOC","start_pos":21,"end_pos":38}] | NEUTRAL | rus | NOT SPAM | 173 | 0 | 0 | 1 | 0 | 0 | 20 | 23 | 16 | 0 | 48 | 12 | 36 | true |
26 | null | https://youtu.be/uXsCngh89fI
Очень понятное и наглядное видео об экстракорпоральном оплодотворении (ЭКО)
Даже если вы не знаете английский - по видео все предельно ясно. | https://t.me/doctor_belokon/24?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 91,600 | 0 | 1,595,753,895 | 1,730,797,660 | 10,129 | 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| [{"ner":"Очень понятное и наглядное","lemma":"Очень понятное и наглядное","label":"ORG","start_pos":29,"end_pos":55},{"ner":"об экстракорпоральном оплодотворении","lemma":"об экстракорпоральном оплодотворении","label":"PER","start_pos":62,"end_pos":98},{"ner":"Даже","lemma":"Даже","label":"ORG","start_pos":105,"end_pos":109},{"ner":"предельно ясно","lemma":"предельно ясно","label":"PER","start_pos":154,"end_pos":168},{"ner":"89","lemma":"89","label":"NUM","start_pos":24,"end_pos":26}] | NEUTRAL | rus | NOT SPAM | 22 | 0 | 1 | 0.962963 | 0.037037 | 0 | 6 | 1 | 2 | 0 | 3 | 2 | 3 | true |
26 | null | https://youtu.be/_5OvgQW6FG4
А это история о каждом из нас
О первых секундах нашей жизни
О слиянии сперматозоида и яйцеклетки
О нелегком пути и сложности процесса зачатия
Считаю, что это видео должен посмотреть КАЖДЫЙ
В том числе подростки
Это удивительно, что многие женщины, которые уже сами имеют детей, не до конца понимают, как это все случается.
Посмотрите обязательно
Поделитесь информацией со своими подругами | https://t.me/doctor_belokon/25?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 103,300 | 0 | 1,595,754,182 | 1,730,797,660 | 10,129 | 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26 | null | Что для вас значит понятие «женственность»?
У каждого понятие «женственность» связано с чем-то индивидуальным.
Для меня женственность заключается в уверенности и принятии себя. Мне кажется, что настоящая женственность - это внутреннее состояние уверенной в себе женщины.
Женщины, которая знает свои сильные и слабые стороны. Женщина, которая находится в балансе с собой и знает чего хочет от жизни.
Визуальная женственность для меня проявляется в том, как выглядит девушка. Лично для меня очень важно чтобы женщина была ухоженной и чтобы она обладала хорошим чувством стиля. Не обязательно соответствовать общепринятым стандартам красоты, главное, любить себя и научиться подчеркивать свои достоинства.
Для меня женственность это НЕ ПРО вульгарность
Это про ухоженность
Это про чистую кожу , про красивые контуры лица,
Это про свежий маникюр и педикюр
И про чистые ухоженные волосы. | https://t.me/dr_Guvarsha/175?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 164,900 | 0 | 1,687,748,153 | 1,730,797,660 | 10,101 | 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| null | NEUTRAL | rus | NOT SPAM | 127 | 0 | 4 | 1 | 0 | 0 | 17 | 16 | 23 | 0 | 33 | 3 | 23 | true |
26 | null | Гранулы Фордайса – это безболезненные кожные образования светлого цвета в виде мелких прыщей. Их еще называют Себорейными кистами или кистами сальных желез.
Чаще всего эти гранулы образуются на губах.
Гранулы являются лишь косметическим дефектом и абсолютно не представляют вреда для здоровья человека. Они не заразны и являются лишь физиологической особенностью человека.
Гранулы Фордайса проявляются в виде маленьких (1-2 мм) светлых пятен, имеющих желтоватый оттенок, или папул (мелких узелков) желто-белого цвета. Они располагаются на губах, иногда в подмышечной области, ореоле соска и в интимных зонах.
Образования эти безболезненные и не причиняют дискомфорта. Они могут быть достаточно многочисленными. В случае надавливания может выделяться секрет сальных желез, имеющий желто-белый цвет и густую консистенцию. После надавливания образования могут кровить.
Не советую их давить и беспокоить данные гранулы , что бы избежать возможных осложнений
❤️ | https://t.me/dr_Guvarsha/176?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 164,100 | 0 | 1,688,305,741 | 1,730,797,660 | 10,129 | 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| [{"ner":"Гранулы Фордайса","lemma":"гранула фордайса","label":"PER","start_pos":0,"end_pos":16},{"ner":"Себорейными кистами","lemma":"себорейными кистами","label":"ORG","start_pos":112,"end_pos":131},{"ner":"Гранулы Фордайса","lemma":"гранула фордайса","label":"PER","start_pos":375,"end_pos":391},{"ner":"1","lemma":"1","label":"NUM","start_pos":422,"end_pos":423},{"ner":"2","lemma":"2","label":"NUM","start_pos":424,"end_pos":425}] | NEUTRAL | rus | NOT SPAM | 130 | 0 | 1 | 1 | 0 | 0 | 26 | 19 | 7 | 3 | 43 | 5 | 24 | true |
26 | null | Косметологи делают всех девушек на одно лицо ?
Хочу тут возразить
Качественная косметология - эта та, которую вы не заметите
Это не про «гиперобъемы»
❗️
А это про то, что вы будете выглядеть явно моложе и ухоженнее своих сверстниц
Это ухоженная кожа , с хорошим тургором тканей, без морщин и воспалений, без сухости
Это восполнение утраченных объемов , деликатно и в меру
Это очень красиво и элегантно
И ваша подруга , которая сегодня вам говорит : «зачем ты ходишь к косметологу»
Будет через десяток лет либо кусать локти
Либо платить в несколько раз больше, что бы вернуть тот облик
Который вам удалось сохранить
🥰 | https://t.me/dr_Guvarsha/177?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 158,100 | 0 | 1,688,305,742 | 1,730,797,660 | 10,129 | 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| null | NEUTRAL | rus | NOT SPAM | 104 | 0 | 2 | 1 | 0 | 0 | 6 | 12 | 15 | 3 | 23 | 8 | 16 | true |
26 | null | Почему так важно защищать кожу от солнца?
Большинство людей забывают о том, что наша кожа нуждается в защите от солнца в независимости от погоды
Разберемся, почему это важно
⤵️
Открытые участки кожи, в особенности, лицо, необходимо защищать от ультрафиолета каждый день, несмотря на сезонность.
Избыточное воздействие солнца — основная причина фотостарения кожи. В результате этого кожа теряет упругость и эластичность, покрывается преждевременными морщинами и пигментными пятнами.
Предотвратить этот процесс можно, для этого необходимо использовать крeм с SPF при каждом выходе на улицу.
⭐️
Факторы защиты (SPF):
Один из основных критериев при выборе солнцезащитного крема – это фактор защиты SPF (Sun Protection Factor). Он определяет, насколько долго кожа останется защищенной от солнечных ожогов. Важно выбирать крем с соответствующим SPF в зависимости от интенсивности солнечного излучения и типа вашей кожи.
Например, для повседневного использования достаточно крема с SPF 30, а для пляжного отдыха – с более высоким показателем SPF.
Существует 2 вида ультрафиолетовых лучей, которые оказывают негативное влияние на кожу человека – UVА и UVB-лучи.
⭐️
UVА-лучи составляют 95% от всего ультрафиолета, достигающего поверхности земли, и являются наиболее опасными для кожи. Именно они инициируют процесс разрушения коллагена и эластина, повреждая клетки дермы. С течением времени это может привести к онкологическим изменениям и ускоренному фотостарению.
UVА-лучи способны пагубно воздействовать на кожу, способствуя синтезу свободных радикалов.
⭐️
UVB-лучи составляют лишь 5% от всего ультрафиолета, достигающего земную поверхность, при этом основную их часть блокируют тучи. UVB-излучение проникает сквозь эпидермис, что не только способствует загару, но и может вызвать солнечные ожоги, приводящие к аллергическим реакциям или возникновению раковых клеток.
Обратите внимание на состав крема от загара.
Идеальный вариант – это средство с физическими и химическими фильтрами, которые защищают кожу от всех видов ультрафиолетовых лучей.
Также обратите внимание на наличие увлажняющих и питательных компонентов в составе, которые помогут поддерживать кожу в хорошем состоянии.
Срок годности:
Не забывайте проверять срок годности солнцезащитного крема. Использование просроченного продукта может быть не только неэффективным, но и опасным для кожи. | https://t.me/dr_Guvarsha/178?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 164,600 | 0 | 1,710,152,841 | 1,730,797,660 | 10,130 | 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| [{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":559,"end_pos":562},{"ner":"SPF","lemma":"spf","label":"ORG","start_pos":610,"end_pos":613},{"ner":"UVB-лучи","lemma":"uvb-луч","label":"ORG","start_pos":1146,"end_pos":1154},{"ner":"30","lemma":"30","label":"NUM","start_pos":981,"end_pos":983},{"ner":"2","lemma":"2","label":"NUM","start_pos":1053,"end_pos":1054},{"ner":"95","lemma":"95","label":"NUM","start_pos":1179,"end_pos":1181},{"ner":"5","lemma":"5","label":"NUM","start_pos":1578,"end_pos":1579}] | NEUTRAL | rus | NOT SPAM | 318 | 0 | 14 | 0.963415 | 0.036585 | 0 | 40 | 41 | 11 | 5 | 112 | 13 | 58 | true |
26 | null | Почему так важен ферритин ?
Белок ферритин — основная форма, в которой железо запасается в организме.
Определенная часть всех запасов ферритина все время циркулирует в крови, этот показатель свидетельствует об общем содержании железа.
Для чего нужен ферритин:
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поддержки общего иммунитета в активном состоянии;
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регулирования структуры нервной системы;
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обеспечения газового обмена и насыщения тканей кислородом;
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воспроизводства эритроцитов в костном мозге;
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работы мышечных тканей, образования ферментов и метаболизма холестерина.
Значение ниже нормы — меньше 10 нг/мл — отмечается при железодефицитной анемии (ЖДА).
Из-за недостатка микроэлемента не образуется достаточное количество эритроцитов и гемоглобина.
📎
Симптомы:
— Постоянная слабость и усталость
— Отсутствие энергии
— Холодные руки и ноги
— Кожа и слизистые становятся бледного оттенка
— головокружения, звездочки перед глазами, обмороки
— снижение АД
📎
При тяжелой форме анемии отмечаются следующие симптомы:
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извращение вкуса, когда человек испытывает потребность есть несъедобные предметы (мел, крахмал, золу);
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сухость кожи, выпадение волос;
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ангулярный стоматит (заеды»); | https://t.me/dr_Guvarsha/179?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 166,400 | 0 | 1,716,397,808 | 1,730,797,660 | 10,119 | 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| [{"ner":"10","lemma":"10","label":"NUM","start_pos":575,"end_pos":577}] | NEUTRAL | rus | NOT SPAM | 157 | 0 | 2 | 1 | 0 | 0 | 21 | 9 | 2 | 2 | 78 | 2 | 50 | true |
26 | null | Почему врачей перестал удовлетворять ИМТ- индекс массы тела, показатель уже 200 лет применяемый для оценки избыточного веса. ИМТ- вес в кг делится на квадрат роста в метрах.
Вот три человека. Первый- рост-173, вес 81 кг, ИМТ-27, объем талии -68 см. Второй: рост-168 см, вес-77 кг ИМТ-27. Талия- 73 см. Третий: тоже 168 см, 77 кг, ИМТ-27, но талия-93 см. И они все разные: первый цилиндрический, второй -эллипс, третий как яйцо. И риски заболеваний, несмотря на одинаковый ИМТ, у них тоже все разные.
Поэтому сегодня предлагают другой индекс: «»индекс округлости». О нём ниже
⏬️ | https://t.me/drmyasnikov/2575?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 73,100 | 0 | 1,726,811,716 | 1,730,797,660 | 10,101 | 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| 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| NEUTRAL | rus | SPAM | 93 | 0 | 9 | 1 | 0 | 0 | 12 | 5 | 2 | 7 | 33 | 7 | 32 | true |
26 | null | Что такое «индекс округлости тела»? И почему им предлагают заменить широко используемый индекс массы тела. Неполноценность последнего я описал постом выше.
ИОТ (или Body roundness Index-BRI) рассчитывается по формуле, учитывающей рост и окружность талии. Она не простая и рассчитывать нужно по он-лайн калькулятору. Он более точно отражает особенности мускулатуры и учитывает важнейший для здоровья показатель- окружность талии. Именно она наиболее точно отражает риски заболеваний, связанные с резистентностью к инсулину и входит в важнейшим компонентом метаболического синдрома.
Исследование показателей BRI и их связи с рисками для здоровья показали следующее:
Те, у кого B.R.I. 6,9 и выше, что указывает на самые «круглые» тела, имели наибольший риск смерти от рака, болезней сердца и других болезней.
Их общий риск смертности был почти на 50 процентов выше, чем у тех, у кого B.R.I. составлял от 4,5 до 5,5 (средние показатели людей в этом исследовании).
У людей с B.R.I. от 5,46 до 6,9 риск был на 25 процентов выше, чем у людей со средним баллом.
Но те, кто был наименее круглым, также подвергались повышенному риску смерти: Исследование показало, что люди с показателем ниже 3,41 также сталкиваются с риском смертности, который на 25 процентов выше, чем у людей со средним показателем.
Вот ссылка на многочисленные он-лайн калькуляторы: вбиваешь BRI (body roundness index) calculator в поиск, вводишь рост и окружность талии и получаешь свой показатель.
PS: в
пианиста не стрелять- сам удивляюсь…
June 5, 2024
Body Roundness Index and All-Cause Mortality Among US Adults
Xiaoqian Zhang, MD1,2;
Ning Ma, MD1,3;
Qiushi Lin, MD, PhD4;
et al | https://t.me/drmyasnikov/2576?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 103,100 | 0 | 1,726,811,757 | 1,730,797,660 | 10,129 | 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| NEUTRAL | rus | NOT SPAM | 248 | 0 | 14 | 0.887195 | 0.112805 | 0 | 24 | 24 | 13 | 12 | 69 | 13 | 49 | true |
26 | null | У нас многие проблемы от того, что в понятии многих ЗОЖ основан на слове «нельзя!» много есть- нельзя, сладкое-нельзя, жирное-нельзя, алкоголь-нельзя, курить-нельзя, сидеть-нельзя, нервничать-нельзя …. Вот секс можно, но в свете последних постановлений- предохраняться нельзя, надо увеличивать рождаемость. При этом не предохраняться- тоже нельзя- профилактика болезней.
Как в старом анекдоте:
«Принимают мужика в партию, задают ему вопросы:
— Ради партии курить бросишь?
— Ну, брошу.
— А сможешь ради партии бросить пить?
— Ну-у, ради партии смогу.
— А женщин ради партии оставишь?
Мужик задумался:
— Ну если ради партии... Только ради нее!
— А жизнь за партию родную отдашь?
— Конечно отдам, зачем такая жизнь нужна?»
То есть «нельзя» автоматически переходить в «не могу»
На самом деле ЗОЖ основан на слове «хочу»!
Хочу жить долго, хочу быть активным, хочу быть сильным, хочу быть привлекательным, хочу не болеть…
Ну а потом поделить «хочу» на «не могу». Если цифра больше единицы- всё получится! Ну а если меньше, значит хотеть надо больше! | https://t.me/drmyasnikov/2578?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 72,600 | 0 | 1,726,914,060 | 1,730,797,660 | 10,129 | 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| null | NEUTRAL | rus | NOT SPAM | 160 | 0 | 6 | 1 | 0 | 0 | 12 | 37 | 7 | 2 | 28 | 29 | 62 | true |
26 | null | Видеорубрика "Для души и тела". День рождения Доктора Мясникова – 2024
- В гостях у доктора Мясникова.
- Какого зверя подарили доктору?
- После 50 каждое последующее десятилетие лучше, чем предыдущее.
- Доктор Мясников рассказывает правду о себе.
- Какие планы у доктора на следующую десятилетку?
- Любимые упражнения доктора Мясникова. | https://t.me/drmyasnikov/2579?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 82,600 | 0 | 1,726,930,886 | 1,730,797,660 | 10,118 | 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| [{"ner":"Доктора Мясникова","lemma":"доктор мясникова","label":"PER","start_pos":46,"end_pos":63},{"ner":"Мясникова","lemma":"мясникова","label":"PER","start_pos":92,"end_pos":101},{"ner":"Мясников","lemma":"мясников","label":"PER","start_pos":210,"end_pos":218},{"ner":"Мясникова","lemma":"мясникова","label":"PER","start_pos":326,"end_pos":335},{"ner":"2024","lemma":"2024","label":"NUM","start_pos":66,"end_pos":70},{"ner":"50","lemma":"50","label":"NUM","start_pos":144,"end_pos":146}] | NEUTRAL | rus | NOT SPAM | 51 | 0 | 1 | 1 | 0 | 0 | 9 | 2 | 1 | 2 | 18 | 0 | 11 | true |
26 | null | В качестве преамбулы для следующего поста (его выложу завтра или послезавтра) хочу немного рассказать о сорбитоле.
Сорбитол – это сахарный спирт. Спирт
💧
, но не тот, который нужно пить.
Молекула сорбитола отличается от молекулы глюкозы всего лишь присоединенным атомом водорода, см. на рисунке
Так вот, этого присоединенного атома достаточно, чтобы вы стали плохо всасывать сорбитол.
И вот здесь начинаются проблемы от его свойств.
В природе сорбитол помогает растениям хранить энергию, удерживать жидкость в клетках и в том числе обеспечивают защиту листьев
🌱
и плодов
🍑
от высыхания.
Людей же сорбитол от высыхания не спасет, а, наоборот, усложнит всасывание жидкости из просвета кишечника.
Получается, что сорбитол вместе с дополнительным объемом жидкости достигнет вашей толстой кишки, где его будут ферментировать бактерии с образованием газов.
💚
С возможными последствиями вы можете ознакомиться на картинке.
Можно ли избежать последствий употребления сорбитола? Можно ли натренировать себя и переносить его лучше? Об этом завтра или послезавтра
😉
P.s. Кстати, знаете откуда такое название сорбитол? Впервые это вещество было выделено в 1872 г. из сока рябины, Sorbus aucuparia, и названо в честь нее.
P.p.s. Широко используемый консервант – сорбиновая кислота, кстати, тоже впервые была выделена из сока рябины, но химически они с сорбитолом не похожи друг на друга.
#полиолы #фрукты #интересное | https://t.me/ibs_doc/174?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 7,100 | 0 | 1,701,716,117 | 1,730,797,660 | 10,101 | 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| [{"ner":"Молекула","lemma":"молекула","label":"PER","start_pos":187,"end_pos":195},{"ner":"сорбитолом","lemma":"сорбитолом","label":"LOC","start_pos":1339,"end_pos":1349},{"ner":"1872","lemma":"1872","label":"NUM","start_pos":1144,"end_pos":1148}] | NEUTRAL | rus | NOT SPAM | 205 | 0 | 4 | 0.984791 | 0.015209 | 0 | 13 | 27 | 12 | 0 | 64 | 20 | 42 | true |
26 | null | Не секрет, что при избыточном употреблении сорбитол может вызвать диарею и привести к образованию большого объема газов.
🚽
Но можно ли «натренировать» себя и начать хорошо переносить его?
❗️
Вы точно не сможете научиться всасывать его более эффективно, так что до толстой кишки он будет добираться в том же объеме.
Тогда что можно изменить
❓
Дело в том, что далеко не все бактерии способны ферментировать сорбитол.
Умеют это делать энтеробактерии, в частности, кишечные палочки, которые есть у всех.
Так вот, их-то мы и можем «натренировать». Но стоит ли игра свеч
❓
Исследование на грызунах
🐭
показало, что чем больше масса таких бактерий в просвете кишечника, тем больше сорбитола им удастся усвоить, и тогда кишечник сможет всосать лишнюю жидкость из каловых масс.
Поэтому у грызунов с микробиотой, богатой кишечными палочками, не возникала диарея.
Но есть одно большое НО
❗️
Если бактерии усваивают больше сорбитола, то образуется больше газов…
Т.е. предположим, у вас возникает диарея от употребления, например, кураги. Теоретически, вы сможете постепенно «откормить» курагой массу кишечных палочек, если будете есть ее постоянно, и диарея, вероятно, прекратится через какое-то время, но взамен вы получите много газов.
Т.е. если вы плохо переносите сорбитол, то варианта будет два – диарея или метеоризм. (А что выберете вы? :D )
Всегда, конечно, можно ограничить употребление сорбитола. Выбор за вами.
😊
Nutrients 2021, 13(6), 2029;
https://doi.org/10.3390/nu13062029
#полиолы #фрукты #интересное | https://t.me/ibs_doc/175?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 18,800 | 0 | 1,701,764,877 | 1,730,797,660 | 10,129 | 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26 | null | Максимально полный обзор всех данных о влиянии физической активности на депрессию
(включая несколько мета анализов). I’ve read it so you don't have to.
Если коротко, то влияние аэробных нагрузок на снижение депрессивной симптоматики уже не подвергается сомнению. Если раньше это были эмпирические наблюдения профильных специалистов, то в последние годы благодаря исследованиям появилось знание о разнообразных нейрофизиологических и нейропсихологических процесах, лежащих в основе этой связи.
Но не спешите бежать извиняться перед всеми людьми, с которыми вы поругались после их заявлений в социальных сетях о том, что спортом надо заниматься и все эти ваши депрессии пройдут. Во-первых, прям так уж полностью и не пройдут, а во-вторых, нечего давать советы людям их не просивших, да еще и в столь неэкономичной форме. Давайте представим, что моего совета вы все-таки попросили и постараемся на самом поверхностном уровне разобраться в том, как оно все работает.
Итак, аэробные упражнения снижают системное воспаление. Системное воспаление — это не инфекционный, а общепатологический процесс, незаметный и длительный, специфический клеточный ответ на воздействие стрессовых факторов. Известно, что воспаление снижает передачу дофамина — основного нейромедиатора системы вознаграждений. Он отвечает за то, что мы можем принять решение действовать и получаем удовольствие от достижений. Следовательно, снижение уровня воспаления ведет к усилению нервной передачи дофамина и общему воздействию на систему вознаграждений. На уровне психики это ведет к снижению ангедонии (неспособность получать удовольствие), апатии, субъективных когнитивных нарушений. Проще говоря, нам становится проще и приятнее прилагать усилия к чему угодно.
Авторы прямо в статье прописывают следующую цепочку «Practical applications of the physical activity → inflammation → dopamine → effort framework» (мне нравится как авторы деликатно уточняют, что речь идет о practical applications, то есть надо не просто поговорить с другом, что было бы неплохо позаниматься спортом, а по-настоящему позаниматься). То есть, физическая активность → снижение воспаления → усиление передачи дофамина → позитивное влияние на систему мотивации и усилий. Каждый из этих шагов в статье подробно расписан, для желающих разобраться подробнее (или просто посмотреть лишний раз на мозг) к посту прикреплена картинка оттуда с конкретными задейтсованными зонами мозга и рецепторами.
Ну и, конечно, в статье отдельно оговаривается, что никто тут не предлагает лечиться исключительно спортом и активным образом жизни, но их наличие является важной частью системного подхода к лечению депрессии наравне с фармакотерапией и психотерапией (конечно же упоминается протокол поведенческой активации, который прекрасно согласуется со всем вышеизложенным). Авторы отмечают, что физическая активность должна сочетаться с предпочтениями человека для обеспечения долгосрочного эффекта, а вообще это недооцененный, недорогой, прекрасно масштабируемый (особенно в тех обществах, где есть фокус на поддержание психического здоровья граждан), подходящий для раннего вмешательства инструмент. Ну и в целом, знаете ли, для здоровья физического полезно, добавляют авторы.
А теперь, друзья, давайте посмотрим уже вне контекста депрессии. Мы знаем, что любой внешний продолжительный стресс усиливает системные процессы воспаления, о которых речь в статье. Войны, экономическая нестабильность, низкая предсказуемость среды. То, в чем многие живут последние годы. Даже если у вас нет депрессии (хочется пошутить «пока нет», но я не буду), но есть, например, тревога — физическая активность будет работать, за счет снижения кортизола как минимум. А там, глядишь, и мир постепенно прийдет в норму. | https://t.me/imatrip/2074?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,200 | 0 | 1,722,861,829 | 1,730,797,660 | 10,101 | 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| null | NEUTRAL | rus | NOT SPAM | 505 | 0 | 2 | 0.967742 | 0.032258 | 0 | 60 | 72 | 26 | 1 | 141 | 48 | 102 | true |
26 | null | Какая связь между пирсингом и мигренью? Для чего нужна шкала Буша-Фрэнсиса?
☑️
Ответы в
новом канале
для психиатров и неврологов.
В
канале MindCraft
публикуются
результаты последних исследований
в области психоневрологии и
шкалы и опросники
для вашей ежедневной практики, а также обсуждаются
нетипичные клинические случаи
.
Подписывайтесь, чтобы узнать:
🔹
Как
откладывание будильника
влияет на нервную систему?
🔹
Связь между пирсингом и мигренью -
клинический случай
🔹
Употребление оливкового масла
- может ли оно снизить риск смерти от деменции?
🔹
О полезной «татуировке»
🔹
Интернет-зависимость
- роль личности и семьи в её формировании
Шкалы для практикующих врачей:
🔹
Монреальская шкала оценки когнитивных функций
🔹
Опросник гипомании
🔹
Шкала Буша-Фрэнсиса | https://t.me/imatrip/2075?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,200 | 0 | 1,722,866,562 | 1,730,797,660 | 10,129 | 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| [{"ner":"Буша-Фрэнсиса","lemma":"буша-фрэнсиса","label":"PER","start_pos":61,"end_pos":74},{"ner":"MindCraft","lemma":"mindcraft","label":"ORG","start_pos":139,"end_pos":148},{"ner":"Монреальская","lemma":"монреальский","label":"PER","start_pos":671,"end_pos":683},{"ner":"Шкала Буша-Фрэнсиса","lemma":"шкала буш-фрэнсис","label":"PER","start_pos":740,"end_pos":759}] | NEUTRAL | rus | NOT SPAM | 108 | 0 | 2 | 0.993827 | 0.006173 | 0 | 12 | 8 | 2 | 0 | 46 | 1 | 23 | true |
26 | null | Шизофрения как она есть. Книга для тех, кто рядом
...Результаты многолетних трудов исследователей показали, что только совместными усилиями врача, пациента и его окружения возможно достичь максимального успеха в борьбе с шизофренией.
Ключевая из целей книги – помочь осознать этот факт близким пациента, поддержать их в стремлении быть рядом и научить, как стать полезным страдающему психическим расстройством человеку.
Но это не всё. Перед окружением пациента с шизофренией стоит немало других сложных, но разрешимых задач: осознать и принять факт наличия болезни у близкого или друга, изучить и пронаблюдать основные проявления и изменения симптомов, освоить признаки обострения болезни и процедуры оказания помощи. И при этом не забывать о себе, своей жизни.
Как это все совместить, принять, пережить и идти дальше по жизни рядом с близкими – расскажет на своих страницах эта книга.
#литература | https://t.me/imatrip/2076?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,800 | 0 | 1,722,921,178 | 1,730,797,660 | 10,129 | 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| null | NEUTRAL | rus | NOT SPAM | 130 | 0 | 1 | 1 | 0 | 0 | 11 | 22 | 9 | 0 | 43 | 7 | 23 | true |
26 | null | Привет, через неделю я неиронично ложусь в психиатрическую больницу. Серьезно обострилось депрессивное состояние, сейчас появилась возможность лечь в НИИПЗ. Надеюсь прийти в себя и отдохнуть. Планирую зарыться в книги, пить таблеточки и соблюдать больничный режим. Буду на связи, договоренности в силе.
Если кто-то хочет поддержать донатом, то можно сделать это по номеру +79964162984 альфа банк. Если у вас есть мемы на тему "админ в дурке" накидайте в комменты, пожалуйста. | https://t.me/imatrip/2077?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,700 | 0 | 1,722,928,899 | 1,730,797,660 | 10,129 | 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| [{"ner":"НИИПЗ","lemma":"ниипз","label":"ORG","start_pos":150,"end_pos":155},{"ner":"7996416298","lemma":"7996416298","label":"DATE","start_pos":373,"end_pos":383},{"ner":"16298","lemma":"16298","label":"DATE","start_pos":378,"end_pos":383}] | NEUTRAL | rus | NOT SPAM | 69 | 0 | 1 | 1 | 0 | 0 | 3 | 16 | 7 | 0 | 19 | 5 | 15 | true |
26 | null | Антидепрессант отменишь — симптомы вернутся
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Часто можно услышать мнение, что антидепрессанты, поднимая уровень серотонина, на самом деле не лечат, а лишь маскируют симптомы расстройства. Это заблуждение часто транслируют и врачи, что сподвигло написать этот пост.
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Вероятно, головной мозг
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представляется как некая бульонообразная субстанция в черепной коробке, в которой нейромедиаторы, подобно специям, влияют на вкус (проявления заболевания).
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Не все антидепрессанты увеличивают уровень нейромедиаторов, некоторые сами имитируют действие нейромедиатора, взаимодействуя с определенными подтипами рецепторов, но исходная точка влияния — рецептор.
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Каждый психотропный препарат, чтобы развилось его действие, должен способствовать изменению стимуляции принимающего рецептора: заблокировать или простимулировать.
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Это, в свою очередь, включает каскад реакций, конечной точкой которых является геном клетки
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.
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Пришедшая информация изменяет функционирование нейрона, отдавая команду о включении или выключении какого-либо гена — о начале или остановке синтеза определенного белка, соответственно.
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Вследствие экспрессии генов в нейронах происходит множество различных биологических процессов, среди которых:
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Образование новых или усиление имеющихся связей между нейронами.
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Увеличение или уменьшение обработки информации в нейронах.
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Указанные процессы оказывают влияние на поведенческие реакции, к которым относятся проявления психического расстройства.
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Еще раз: #антидепрессанты через влияние на рецепторы меняют функционирование нейронов, что проявляется в редукции психопатологических проявлений.
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Эмпирически было выяснено, что в большинстве случаев примерно 6 месяцев регулярного применения препарата с момента исчезновения всех проявлений болезни достаточно, чтобы закрепить результат.
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Психотерапия тоже влияет на геном, но снизу. Изменение поведения вынуждает нейроны изменять экспрессию необходимых генов для обеспечения нового функционирования. Не вся психотерапия одинаково полезна, но если речь о доказательных подходах, то совместное применение с антидепрессантами можно достичь лучшего эффекта, но требуется это далеко не в 100% случаев.
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Остались вопросы? —
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👇🏻 | https://t.me/imatrip/2078?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,600 | 0 | 1,723,013,335 | 1,730,797,660 | 10,118 | 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| [{"ner":"6","lemma":"6","label":"NUM","start_pos":1687,"end_pos":1688},{"ner":"100","lemma":"100","label":"NUM","start_pos":2163,"end_pos":2166}] | NEUTRAL | rus | NOT SPAM | 279 | 0 | 0 | 1 | 0 | 0 | 25 | 39 | 8 | 3 | 106 | 13 | 69 | true |
26 | null | Вечерний чат
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Обсуждайте любые темы | https://t.me/magerya/11459?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 40,200 | 0 | 1,729,362,660 | 1,730,797,660 | 10,101 | 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| null | NEUTRAL | rus | NOT SPAM | 15 | 0 | 0 | 1 | 0 | 0 | 1 | 4 | 0 | 0 | 6 | 0 | 1 | true |
26 | null | Продиагностируйте себя
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Это сигналы, что вашему телу не хватает витамина D:
☹️
усталость,
☹️
мышечная слабость,
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частые простуды,
☹️
подавленное настроение и даже депрессия…
Особенно важно следить за уровнем витамина D у взрослых, так как с возрастом способность организма к его синтезу снижается, а риск остеопороза увеличивается
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Как восполнить дефицит?
С помощью еды!
✅
Жирная рыба
🐟
(лосось, скумбрия, тунец)
✅
Мясо
🥩
(особенно печень)
✅
Сыр
🧀
(лучше выбирать твёрдые сорта)
Но даже если вы добавите в рацион эти продукты, получить достаточное количество витамина D исключительно из пищи довольно сложно
🤷
Оптимальное решение:
ежедневный приём витамина D. Его, кстати, еще называют гормоном радости!
👉🏼
wildberries/витаминD_капсулы
👉🏼
wildberries/витаминD_жидкий | https://t.me/magerya/11465?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 45,900 | 0 | 1,729,398,308 | 1,730,797,660 | 10,131 | 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| null | NEUTRAL | rus | NOT SPAM | 111 | 0 | 5 | 0.966667 | 0.033333 | 0 | 12 | 12 | 4 | 3 | 45 | 8 | 34 | true |
26 | null | Шоколад из кэроба
– отличный выбор для тех, кто хочет уменьшить тягу к сахару.
Кэроб стабилизирует эмоциональный фон и помогает нейронам мозга справиться с тягой. Добавьте несколько долек этого шоколада в свой рацион, и вы сможете легко наладить свое питание
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wildberries/кэроб_ассорти
Ещё больше полезной информации о витаминах и нутриентах ищите на канале "Жизнивек"
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https://t.me/ziznivek
Реклама. ООО «Жизнивек»
ИНН 2311312648 | https://t.me/magerya/11467?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 44,100 | 0 | 1,729,438,599 | 1,730,797,660 | 10,129 | 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| [{"ner":"Жизнивек","lemma":"жизнивек","label":"ORG","start_pos":372,"end_pos":380},{"ner":"ООО «Жизнивек»\nИНН 2311312648","lemma":"ооо \"жизнивек\"\nинн 2311312648","label":"ORG","start_pos":416,"end_pos":445},{"ner":"2311312648","lemma":"2311312648","label":"DATE","start_pos":435,"end_pos":445},{"ner":"12648","lemma":"12648","label":"DATE","start_pos":440,"end_pos":445}] | NEUTRAL | rus | NOT SPAM | 63 | 0 | 2 | 0.977012 | 0.022989 | 0 | 3 | 10 | 2 | 3 | 23 | 1 | 13 | true |
26 | null | Вечерний чат
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Обсуждайте любые темы | https://t.me/magerya/11468?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 42,700 | 0 | 1,729,448,708 | 1,730,797,660 | 10,129 | 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| null | NEUTRAL | rus | NOT SPAM | 15 | 0 | 0 | 1 | 0 | 0 | 1 | 4 | 0 | 0 | 6 | 0 | 1 | true |
26 | null | А вы служите своему мужу?
Что думаете на сей счет?
😃 | https://t.me/magerya/11469?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 45,400 | 0 | 1,729,479,710 | 1,730,797,660 | 10,118 | 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| null | NEUTRAL | rus | NOT SPAM | 11 | 0 | 1 | 1 | 0 | 0 | 0 | 2 | 2 | 0 | 3 | 0 | 2 | true |
26 | null | Нейросети опять чуть не убили пациента...
Так может быть в параллельной вселенной, но у нас нейросеть только облегчает жизнь врачам, но не все еще знают и понимают, как их применять в своей работе, поэтому Академия Докстарклаб решил рассказать, как нейросети могут облегчить врачам их повседневные задачи освободить время.
Представьте: у вас есть инструмент, который никогда не устает, не ошибается из-за усталости и мгновенно анализирует огромные объемы данных. Теперь это не мечта — это реальность, которая уже доступна каждому врачу.
🤖
Что умеет нейросеть?
✅
Повышает точность диагностики;
✅
Рекомендует лечение с учетом истории пациента;
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Помогает вести документацию;
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Создает контент для блога;
✅
Анализирует аудиторию.
И это только начало! Технологии позволяют врачам не только работать эффективнее, но и оставаться в курсе новейших данных. Не упустите возможность освоить этот инструмент!
ЗАРЕГИСТРИРОВАТЬСЯ НА ВЕБИНАР
На вебинаре 29 октября в 19:00 мы разберем все детали:
📌
Какие задачи можно делегировать ИИ?
📌
Как применять нейросети для работы с пациентами и научной информацией?
📌
Реальные кейсы и примеры использования ИИ от экспертов.
Регистрируйтесь и сделайте первый шаг в мир технологий будущего!
Встречаемся 29 октября в 19:00.
ЗАРЕГИСТРИРОВАТЬСЯ НА ВЕБИНАР | https://t.me/sudmednotes/9169?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 46,000 | 0 | 1,729,693,851 | 1,730,797,660 | 10,101 | 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26 | null | Только я могу случайно одним кликом удалить нахер все комментарии за 2024 год
(не первый раз такое уже)
Оставьте хоть тут огонечек в комментариях или поиграйте в медицинские слова, по принципу игры в города
🥲
Может скрасит впечатление от потерянных комментариев | https://t.me/sudmednotes/9170?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 43,400 | 0 | 1,729,697,470 | 1,730,797,660 | 10,129 | 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| [{"ner":"2024","lemma":"2024","label":"NUM","start_pos":69,"end_pos":73}] | NEUTRAL | rus | NOT SPAM | 41 | 0 | 0 | 1 | 0 | 0 | 3 | 6 | 1 | 1 | 14 | 4 | 3 | true |
26 | null | Пообщался с подписчиками
Часть 1
Записки судмедэксперта | https://t.me/sudmednotes/9179?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 43,700 | 0 | 1,729,766,723 | 1,730,797,660 | 10,118 | 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| [{"ner":"1","lemma":"1","label":"NUM","start_pos":31,"end_pos":32}] | NEUTRAL | rus | NOT SPAM | 7 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 4 | 0 | 0 | true |
26 | null | Бекстейдж со съемки. Мы с Машей не только отдыхаем, но и полезные видео для вас снимаем
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Полное видео
https://youtube.com/shorts/iPbnX4C96KI?si=ShKUG7SZZFZV-PYl
Надо запомнить: почти всегда кишечные инфекции имеют вирусную природу, а значит энтерофурил/экофурил не требуются. А если нужен антибиотик, то препарат выбора альфа-нормикс (назначается, как и все остальное, конечно врачом).
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Церукал детям до 14 лет нельзя!!! Т.к. имеется побочный эффект - гиперкинезы. У ребенка возникает состояние похожее на судороги, спазм лицевых мышц, повышение мышечного тонуса. Особенно часто бывает при передозировке.
Препарат выбора при рвоте у ребенка старше 1 месяца - ондансетрон. Для детей старше 3 лет есть латран 4 мг, детям младше сироп (но его нет в аптеке), можно растворить полтаблетки и дать.
Если тошнит, рвет, то сначала дать таблетку с небольшим количеством воды, подождать 30-40 минут, а потом выпаивать!
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Кола не должна использоваться в качестве средства для пероральной регидратации. Для детей Регидрон Био, Адиарин. Для взрослых Регидрон/Адиарин.
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Лоперамид/лопедиум/имодиум/диара нельзя при диарее! Симптом диареи (поноса) он устраняет, но никак не действует на инфекционный агент (вирус, бактерия, простейшие). Т.е. возбудитель остается в прямой кишке и там продолжает оказывать негативное воздействие на организм.
В конце концов диарея нас не сильно пугает, если адекватно проводится регидратация.Если надо остановить, то безопасным рецекадотрилом (гидрасек).
Если вы сразу начнете лечить кишечную инфекцию правильно, то поправитесь очень быстро
❤️ | https://t.me/DrAnshina/1172?embed=1&mode=tme | https://t.me/ | https://t.me/s/DrAnshina | 217,800 | 0 | 1,717,569,887 | 1,730,797,661 | 10,110 | 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био","label":"PER","start_pos":1008,"end_pos":1020},{"ner":"Адиарин","lemma":"адиарин","label":"PER","start_pos":1022,"end_pos":1029},{"ner":"Регидрон/Адиарин","lemma":"регидрон/адиарин","label":"PER","start_pos":1044,"end_pos":1060},{"ner":"🔸","lemma":"🔸","label":"LOC","start_pos":1062,"end_pos":1063},{"ner":"30-40","lemma":"30-40","label":"DATE","start_pos":883,"end_pos":888},{"ner":"4","lemma":"4","label":"NUM","start_pos":136,"end_pos":137},{"ner":"96","lemma":"96","label":"NUM","start_pos":138,"end_pos":140},{"ner":"7","lemma":"7","label":"NUM","start_pos":151,"end_pos":152},{"ner":"14","lemma":"14","label":"NUM","start_pos":408,"end_pos":410},{"ner":"1","lemma":"1","label":"NUM","start_pos":654,"end_pos":655},{"ner":"3","lemma":"3","label":"NUM","start_pos":696,"end_pos":697},{"ner":"4","lemma":"4","label":"NUM","start_pos":714,"end_pos":715},{"ner":"40","lemma":"40","label":"NUM","start_pos":886,"end_pos":888}] | NEUTRAL | rus | NOT SPAM | 214 | 0 | 3 | 0.996711 | 0.003289 | 0 | 18 | 34 | 6 | 7 | 70 | 21 | 65 | true |
26 | null | Напоминаю: температура хранения всей нашей Омега-3 от+4С до +25C.
Летом в ваших шкафах будет точно больше 25С. У нас на пляже вчера было 43С
🤦♂️
Обязательно уберите омегу в холодильник (лучше на дверцу).
Мы очень серьезно относимся к условиям хранения нашей Омега-3 не только на собственном складе и у партнеров, но и к условиям транспортировки. После того как вы ее купили следите за условиями хранения
❤️
https://t.me/DrAnshinaOmega
Отдых, когда у тебя есть свой бренд, такой
😂
с камерой в руках, то контент сними, то на завод напиши, то с сотрудниками созвон устрой.. | https://t.me/DrAnshina/1173?embed=1&mode=tme | https://t.me/ | https://t.me/s/DrAnshina | 176,300 | 0 | 1,717,658,135 | 1,730,797,661 | 10,101 | 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26 | null | Сосуды - это не водопроводные трубы, которые можно прочистить химическими средствами!!
Хорошо если эти капельницы не навредят, тогда вы потеряете только деньги и время (хотя время всегда бесценно), но я лично оказывала многократно помощь пациентам после таких инфузий. Заметила, что кардиологические пациенты особенно плохо переносят кавинтон (провоцирует аритмии) и мексидол (резко снижает давление).
Что же действительно способствует улучшению состояния сосудов?
Хоть звучит банально, но факт:
☑️
необходимо с молодости вести здоровый образ жизни
☑️
правильно питаться, контролировать свой вес, соблюдать режим потребления воды
☑️
отказаться от курения и не злоупотреблять алкоголем
☑️
крайне важна адекватная физическая активность – хотя бы утренняя зарядка + 7000 шагов в день в умеренном темпе, идеально – 10000 . Полезны плавание в бассейне.
☑️
своевременное соблюдение режима сна, а также выбор качественного матраса и подушки и поддержание оптимальной температуры в спальне (не выше 22-23°C) и ее регулярное проветривание или использование рекуператора.
☑️
лечение артериальной гипертензии, дислипидемии, сахарного диабета, гиперрукемии и др. препаратами с доказанной эффективностью!!
Да, статины действительно помогают контролировать атеросклероз!! Но не все это понимают, отказываясь их принимать!
☑️
По медицинским показаниям назначаются дезагреганты или/и антикоагулянты.
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В случаях серьезного сужения сосудов могут быть применены стентирование, шунтирование или протезирование.
Вот эти методы действительно работают, и они основаны на доказательной медицине.
Почему же все еще назначаются неэффективные средства? Этот вопрос следует адресовать врачам, которые их прописывают. | https://t.me/DrAnshina/1174?embed=1&mode=tme | https://t.me/ | https://t.me/s/DrAnshina | 205,900 | 0 | 1,718,032,390 | 1,730,797,661 | 10,101 | 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| [{"ner":"кавинтон","lemma":"кавинтон","label":"LOC","start_pos":334,"end_pos":342},{"ner":"10000","lemma":"10000","label":"DATE","start_pos":812,"end_pos":817},{"ner":"22-23","lemma":"22-23","label":"DATE","start_pos":992,"end_pos":997},{"ner":"7000","lemma":"7000","label":"NUM","start_pos":764,"end_pos":768},{"ner":"23","lemma":"23","label":"NUM","start_pos":995,"end_pos":997}] | NEUTRAL | rus | NOT SPAM | 221 | 0 | 2 | 0.996667 | 0.003333 | 0 | 24 | 30 | 9 | 6 | 70 | 20 | 64 | true |
26 | null | Коллеги
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Ваша Доктор Аньшина
🌸 | https://t.me/DrAnshina/1175?embed=1&mode=tme | https://t.me/ | https://t.me/s/DrAnshina | 180,500 | 0 | 1,718,525,715 | 1,730,797,661 | 10,101 | 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| [{"ner":"Ваша Доктор Аньшина\n🌸","lemma":"ваш доктор аньшина\n🌸","label":"PER","start_pos":213,"end_pos":234}] | POSITIVE | rus | NOT SPAM | 34 | 0 | 0 | 1 | 0 | 0 | 4 | 3 | 4 | 0 | 7 | 0 | 11 | true |
26 | null | Считаю, что задавать вопросы о том, кто сколько и от кого хочет детей, «когда собираетесь за вторым, первым, пятым, десятым» - очень некорректными и вульгарными.
Я отнесусь к ним нормально, но некоторые женщины будут поставлены в неловкое положение.
У кого-то могут быть проблемы с зачатием и вы «бьете» по больному месту своим праздным любопытством.
Некоторые женщины вообще не хотят детей, они Чайлд фри, имеют право
🤷🏼♀️
И они не хотят вам объяснять «почему». Это их мнение, они могут жить своей жизнью, делать свой выбор.
Но такой женщине придётся что-то придумывать для вас и «изворачиваться», находя оправдание для «общества».
А может у неё муж тяжело болен и они хотели бы, но не могут?
А может у женщины сложные отношения с партнером?
Таких «может» и «если» - огромное множество.
Со всех сторон это ПЛОХИЕ вопросы. Не стоит их задавать своим родственникам, друзьям, коллегам по работе. Найдите другие, более интересные темы для обсуждения. Если человек сочтёт нужным, он и сам с вами поделится этой информацией. Не лезьте к нему в спальню, в душу, в его репродуктивные органы. | https://t.me/doctor_belokon/18?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 88,400 | 0 | 1,589,741,048 | 1,730,797,661 | 10,110 | 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| [{"ner":"Чайлд","lemma":"чайлд","label":"PER","start_pos":396,"end_pos":401}] | NEUTRAL | rus | NOT SPAM | 174 | 0 | 6 | 1 | 0 | 0 | 17 | 31 | 25 | 1 | 35 | 7 | 53 | true |
26 | null | Мне нравится, что вас здесь немного. И мне с вами как-то уютно, спокойно что ли)
И ещё один большой плюс - это отсутствие комментариев и возможности интерпретировать мои слова другими людьми так, как им хочется. Во всяком случае в письменном виде и на виду у всех остальных)
Я воздерживаюсь от разговоров о COVID-19.
Но сегодня хочу поделиться с вами интересными мыслями по этому поводу.
Мыслях немного Отстранённых, не применимых к конкретному человеку, врачу, случаю, очень обобщенных, в масштабах всей планеты.
«Cегодняшняя коронавирусная болезнь, Covid-19, была названа пандемией раз в столетие.
Но это утверждение может быть ошибочно.» J.IOANNIDIS
Интересное мнение, согласны?
Нет, это не значит, что, заявив о пандемии, мы ошиблись.
Или что мы ошиблись, когда ввели карантинные меры, рассказали о важности мытья рук и социальном дистанцировании.
Что в больницах лежат актеры и никакого COVID-19 на самом деле не существует.
Что кто-то оказался дураком, а кто-то умником.
Что все это цирк и выдумки.
Совсем нет.
Это значит, что прошло время, мы подумали, получили (или не получили) новые данные и теперь усомнились в предыдущих.
Это нормально, это естественно, это все про науку.
Да, возможно COVID-19 не так страшен, как представлялось нам в самом начале, и на самом деле летальность от нового вируса ниже, чем мы предполагали ранее.
Сейчас об этом уже многие говорят и я отчасти согласна с этой фразой.
Почему? Потому что мы не знаем точно до сих пор и не знали тогда общее количество заражённых, переболевших, бессимптомных носителей, и считаем % смертности среди подтверждённых случаев у пациентов, которые, как правило, имеют тяжелое или средне-тяжелое течение COVID-19, то есть симптомных.
И Официальные данные о риске летального исхода в 3-5% могут быть ошибочны.
У нас до сих пор большая проблема в Украине сделать анализ на антитела к COVID-19.
Так же как и во многих странах есть сложности с диагностическими тестами.
И получается, что если мы не знаем общее количество зараженных людей среди населения в целом, мы не знаем реальной угрозы вируса.
В зависимости от условий и населения уровень смертности от инфекции может быть от «гораздо меньше» или «гораздо больше» чем от гриппа, например.
0,5 или 5%.
НО У НАС ПОКА НЕТ ОТВЕТОВ НА ЭТИ ВОПРОСЫ.
Наиболее ценная информация будет получена тогда, когда мы определим распространенность инфекции в СЛУЧАЙНОЙ ВЫБОРКЕ СРЕДИ ОБЩЕГО НАСЕЛЕНИЯ и будем повторять эти исследования через регулярные промежутки времени для оценки частоты новых инфекций.
Но я уверена, что уже очень скоро эти данные появятся.
Какие плюсы были в карантине?
снижение скорости передачи вируса и «разгрузка» системы здравоохранения.
У нас было время на сбор данных и работы над вакцинами/лечением.
Но каждая мера имеет свои негативные последствия.
Во-первых, люди оказались без возможности получить качественную и необходимую медицинскую помощь, имея другие болезни.
Прекрасный пример бабушки с рецидивом лейкоза был в интервью И.Шихман, где ей не могли оказать помощь в связи с бюрократией и ситуацией с COVID-19.
Остальные то болезни то никуда не делись.
И может быть (это всего лишь предположение) было бы лучше дать вирусу свободно распространяться, что нагрузило бы систему в моменте, в короткий период времени, в период «острой» фазы.
Потому как «Сглаживание» кривой эпидемии может на самом деле только усугубить ситуацию: система здравоохранения останется перегруженной на более длительный период времени и много людей с другими заболеваниями останутся без адекватной медицинской помощи.
Еще одна негативная сторона изоляции - уменьшение шансов на формирование коллективного иммунитета и распространение/усугубление других болезней: депрессии, суициды, ожирение и пр.
Вакцины или разработка эффективного лечения занимает много месяцев (или даже лет). Учитывая такие сроки, последствия долгосрочного карантина могут быть куда более серьезными, чем последствия от COVID-19.
Может быть разрушена вся социальная структура.
Поэтому совершенно правильным является послабление карантинных мер или уже сейчас полное его отсутствие. | https://t.me/doctor_belokon/19?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 89,700 | 0 | 1,590,157,247 | 1,730,797,661 | 10,101 | 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| NEUTRAL | rus | NOT SPAM | 596 | 1 | 31 | 0.988266 | 0.011734 | 0 | 72 | 70 | 39 | 10 | 165 | 52 | 117 | true |
26 | null | Эти слова не делают дураками тех, кто вводил карантин и кто его поддерживал.
Решение нужно было принимать в моменте.
В тот моменте времени, где данных о новом вирусе еще не достаточно, где страшно и неизвестно, где ученые по всему миру строят свои математические модели распространения эпидемии, где отсутствуют точные методы тестирования, где все еще нет эффективного лечения или вакцины от COVID-19.
Как нет и сейчас.
Поэтому кричать о том, что «я же говорил, бред этот ваш карантин и вирус», “Тот дурак, а этот нас обманывал” - как минимум глупо.
После драки кулаками не машут.
И АБСОЛЮТНО НОРМАЛЬНО ЛЮБОМУ ЗДРАВОМЫСЛЯЩЕМУ, УМНОМУ, РАЦИОНАЛЬНОМУ ЧЕЛОВЕКУ ОЦЕНИВАТЬ СВОИ СЛОВА И ДЕЙСТВИЯ И МЕНЯТЬ СВОЮ ПОЗИЦИЮ С ТЕЧЕНИЕМ ВРЕМЕНИ И ПОЯВЛЕНИЕМ НОВЫХ ДАННЫХ.
ЭТО НОРМАЛЬНО.
Проблема в том, что люди не понимают ценность НАУКИ и право любого человека, в том числе врача или ученого на ошибку, на заблуждение, на изменение данных с течением времени.
ВАЖНО УМЕТЬ ОТДЕЛЯТЬ ТОЧНОСТЬ НАУЧНОГО УТВЕРЖДЕНИЯ ОТ ТОГО, кто делает это научное утверждение.
Иначе мы рискуем напасть на науку.
Мы должны быть очень осторожными здесь.
Наука - лучшее, что случилось с нами. А люди - это люди. Всегда ими были и всегда ими останутся. | https://t.me/doctor_belokon/20?embed=1&mode=tme | https://t.me/ | https://t.me/s/doctor_belokon | 96,900 | 0 | 1,590,157,247 | 1,730,797,661 | 10,101 | 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| [{"ner":"УМНОМУ","lemma":"умному","label":"ORG","start_pos":627,"end_pos":633},{"ner":"РАЦИОНАЛЬНОМУ ЧЕЛОВЕКУ ОЦЕНИВАТЬ СВОИ СЛОВА И ДЕЙСТВИЯ И","lemma":"рациональному человеку оценивать свои слова и действия и","label":"ORG","start_pos":635,"end_pos":691},{"ner":"МЕНЯТЬ СВОЮ","lemma":"менять свою","label":"ORG","start_pos":692,"end_pos":703},{"ner":"ТЕЧЕНИЕМ ВРЕМЕНИ","lemma":"течением времени","label":"ORG","start_pos":714,"end_pos":730},{"ner":"НАУКИ","lemma":"науки","label":"ORG","start_pos":819,"end_pos":824},{"ner":"ВАЖНО","lemma":"важно","label":"ORG","start_pos":947,"end_pos":952},{"ner":"УМЕТЬ","lemma":"уметь","label":"ORG","start_pos":953,"end_pos":958},{"ner":"19","lemma":"19","label":"NUM","start_pos":398,"end_pos":400}] | NEUTRAL | rus | NOT SPAM | 193 | 2 | 38 | 0.995868 | 0.004132 | 0 | 13 | 19 | 14 | 0 | 49 | 16 | 37 | true |
26 | null | Обязательные этапы ухода за лицом, которые я не советую пропускать
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Очищение: Это основной шаг, который необходим для удаления макияжа, пыли, излишков кожного сала и других загрязнений. Очищать кожу следует утром и вечером, используя подходящий для вашего типа кожи очищающий продукт.
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Тонизирование: Тонер помогает удалить остатки очищающих средств, увлажняет и освежает кожу, а также подготавливает ее к следующим этапам ухода. Тонер следует использовать после очищения кожи.
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Увлажнение: Влага играет ключевую роль в здоровье кожи. Увлажняющие продукты помогают сохранить ее увлажненной и сияющей. Используйте увлажняющий крем или сыворотку, богатые активными увлажняющими компонентами.
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Питание: Питательный крем содержит витамины и микроэлементы, которые улучшают состояние кожи, делая ее мягкой и упругой. Выбирайте крем, подходящий для вашего типа кожи, и наносите его один или два раза в день.
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Защита от солнца: Защита кожи от вредных воздействий окружающей среды, таких как ультрафиолетовые лучи, является важным шагом. Используйте солнцезащитный крем с SPF-фактором для защиты от солнечного излучения и других средств защиты в зависимости от сезона и климатических условий.
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Отшелушивание: Этот шаг помогает удалить омертвевшие клетки кожи и стимулирует ее обновление. Используйте скрабы или пилинги один-два раза в неделю для достижения гладкой и сияющей кожи.
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Макияж: Если вы используете декоративную косметику, убедитесь, что она подходит для вашего типа кожи и не вызывает раздражений. Всегда снимайте макияж перед сном, чтобы не забивать поры и позволить коже отдохнуть. | https://t.me/dr_Guvarsha/170?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 161,700 | 0 | 1,687,746,296 | 1,730,797,661 | 10,175 | 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| [{"ner":"Тонер","lemma":"тонер","label":"PER","start_pos":303,"end_pos":308},{"ner":"Влага","lemma":"влага","label":"PER","start_pos":494,"end_pos":499}] | NEUTRAL | rus | NOT SPAM | 224 | 0 | 1 | 0.996466 | 0.003534 | 0 | 21 | 46 | 11 | 5 | 82 | 2 | 41 | true |
26 | null | Я всегда рекомендую своим пациентам сдавать анализ для выяснения уровня ферритина в организме.
Почему это важно?
Помимо общего влияния дефицита железа на организм, недостаточное количество оказывает прямое воздействие на состояние кожи.
Из-за недостатка кислорода кожа становится более сухой и чувствительной, ее защитные функции ослаблены, что делает ее более уязвимой для инфекций.
Это может ухудшить ход и стать причиной обострения различных кожных заболеваний, таких как атопический и себорейный дерматит, экзема, акне, псориаз и т.д.
Ферритин является важнейшим компонентом, необходимым для нормального протекания процессов регенерации и обновления тканей, особенно кожи. Уменьшение запасов ферритина приводит к ухудшению процессов клеточного восстановления в этих тканях.
Недостаток кислорода в клетках замедляет скорость их обновления, что приводит к утолщению кожи, потере ее сияния, появлению более глубоких морщин и неровностей.
Кроме того, при анемии кожа и слизистые становятся бледными, а склеры глаз приобретают синеватый оттенок, придавая лицу уставший вид.
Железо играет важную роль в синтезе коллагена, и его недостаток может привести к преждевременному старению кожи и суставов. Кожа становится обвисшей, появляются морщины и неправильности контуров лица.
Низкий уровень железа в организме может также спровоцировать различные кожные проблемы, поверхность губ выглядит сухой и потрескавшейся;
кожа и слизистые оболочки бледные (если гемоглобин ниже 90г/л); бледный цвет внутренней части нижних век. | https://t.me/dr_Guvarsha/171?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 163,200 | 0 | 1,687,746,296 | 1,730,797,661 | 10,110 | 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| [{"ner":"Ферритин","lemma":"ферритин","label":"PER","start_pos":539,"end_pos":547},{"ner":"90","lemma":"90","label":"NUM","start_pos":1467,"end_pos":1469}] | NEUTRAL | rus | NOT SPAM | 200 | 0 | 1 | 1 | 0 | 0 | 30 | 27 | 8 | 1 | 86 | 8 | 35 | true |
26 | null | Мезотерапия или Биоревитализация. Что выбрать?
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Мезотерапия — метод введения препаратов в глубокие слои дермы, с целью улучшения качества кожи, ее внешнего вида, тонуса и тургора, а также для решения других косметологических проблем.
📎
Биоревитализация — изначально являлась частным случаем мезотерапии. Порядок выполнения процедур был такой же — отличия были в основном действующем веществе. Это метод введения в глубокие слои кожи именно гиалуроновой кислоты как основного компонента.
Сегодня многие биоревитализанты содержат помимо гиалуроновой кислоты и аминокислоты, и пептиды, и витамины, и отбеливающие элементы
Основное назначение процедуры биоревитализации заключается в восстановлении депо гиалуроновой кислоты, обеспечении глубокого увлажнения, питания и восстановления кожи, а также сохранения ее молодости.
Биоревитализация запускaет процессы ревитализации, омоложения, увлажнения кожи за счет восполнения дефицитов естественной гиалуроновой кислоты.
Мезотерапия обладает более широким спектром действия, помимо эстетического эффекта, часто используются для коррекции разных кожных патологий, таких как акне, розацеа, воспалений и пигментаций, а также активно используется для устранения целлюлита, локальных жировых отложений, стимуляции роста волос при облысении.
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Мезотерапия и биоревитализация не взаимоисключают друг друга, они являются хорошими дополняющими процедурами. | https://t.me/dr_Guvarsha/172?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 164,200 | 0 | 1,687,748,152 | 1,730,797,661 | 10,101 | 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| [{"ner":"Биоревитализация","lemma":"биоревитализация","label":"LOC","start_pos":16,"end_pos":32}] | NEUTRAL | rus | NOT SPAM | 170 | 0 | 0 | 1 | 0 | 0 | 24 | 11 | 5 | 0 | 80 | 9 | 35 | true |
26 | null | История моей одной пациентки
🤐
magic?!
✨
Как вам такое перерождение губ ?
Очень часто ко мне обращаются девушки
С осложнениями с других клиник
Осложнения могут быть
Главное уметь их исправить !
А когда отфутболивают девушек
И отказываются как либо подправить ситуацию
Это уже печально | https://t.me/dr_Guvarsha/173?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 160,800 | 0 | 1,687,748,152 | 1,730,797,661 | 10,101 | 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| null | NEGATIVE | rus | NOT SPAM | 45 | 0 | 3 | 0.983051 | 0.016949 | 0 | 3 | 7 | 4 | 1 | 10 | 4 | 5 | true |
26 | null | Кожа стянута
Шелушиться
И часто бываю прыщи …
😞
Это я слышу от каждой третьей пациентки!
🫠
Когда я задаю вопрос о домашнем уходе
Я ужасаюсь ! Потому что почти 40% людей умываются обычным мылом
🤯
Ужасаюсь, потому что мылом
Вы разрушаете воднолипидную мантию
А Гидролипидная мантия кожи – одна из составляющих эпидермального барьера кожи!
Нарушения функции и дефекты в этом барьере неизбежно провоцируют проникновение чужеродных микробов и аллергенов в кожу, активируют дегидратацию эпидермиса и вызывают сухость кожи, повышают её чувствительность к различным воздействиям окружающей среды
Используйте только профессиональный уход для кожи
Подбирайте его совместно с вашим специалистом!
❤️
А вы тоже пользовались дегтярным , хозяйственным или обычным мылом
❓
🥹 | https://t.me/dr_Guvarsha/174?embed=1&mode=tme | https://t.me/ | https://t.me/s/dr_Guvarsha | 164,800 | 0 | 1,687,748,153 | 1,730,797,661 | 10,101 | 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| [{"ner":"40","lemma":"40","label":"NUM","start_pos":159,"end_pos":161}] | NEUTRAL | rus | NOT SPAM | 111 | 0 | 4 | 1 | 0 | 0 | 12 | 17 | 7 | 2 | 35 | 7 | 13 | true |
26 | null | Вот и стал я на год взрослее! | https://t.me/drmyasnikov/2569?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 85,900 | 0 | 1,726,352,524 | 1,730,797,661 | 10,174 | 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26 | null | Пневмония
Пневмония делится по месту заболевания ей на «вне больничную» (заболели дома, на работе в отпуске-где угодно, только не в больнице!) и «больничную»- если заболел, находясь в больнице по поводу другого заболевания.
Это имеет сугубо практическое значение: разные возбудители, разное лечение, разный прогноз.
Итак- внебольничная пневмония.
В течении года (преимущественно зимой) ей заболевают 25 человек из 1 тысячи населения, причем чем ты старше- тем выше риски.
10% подлежат госпитализации, 1-5% в реанимацию.
Смертность- около 10%. При этом у людей, перенесших пневмонию шанс в течении последующего года умереть от каких-либо причин (не обязательно связанных с лёгкими-28%.
В итоге пневмония занимает 7-8 место как причина смерти людей.
Только у 38% пациентов, госпитализированных с внебольнично приобретенной пневмонией выявляют идентифицированный патоген. Из этих пациентов до 40% имеют причиной болезни вирусы, при этом Пневмококк был выявлен примерно у 15% пациентов с идентифицированной этиологией пневмонии. Все пациенты с пневмонией должны пройти тестирование на COVID-19 и грипп, когда эти вирусы распространены в обществе, потому что их диагноз может повлиять на лечение.
Основными микробами, вызывающими внебольничную пневмонию, помимо пневмококка являются стафилококк, хламидии, микоплазма, нокардия, легионелла и множества других. Это важно помнить, потому как в лечении пневмонии необходимо принимать антибиотики, покрывающие весь этот микробный спектор (азитромицин, кларитромицин, доксициклин, таваник и проч)
Факторы риска:
1 Возраст
2 Наличие хронич заболеваний
3 Курение
4 Алкоголь
5 Лекарства (снижающие кислотность желудка- типа омепразола), антипсихотики, возможно ингаляции кортикостероидов. Препараты типа Эналаприла (энап) наоборот могут снижать риски. | https://t.me/drmyasnikov/2570?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 80,000 | 0 | 1,726,559,140 | 1,730,797,661 | 10,110 | 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| NEUTRAL | rus | NOT SPAM | 233 | 0 | 3 | 0.996865 | 0.003135 | 0 | 20 | 28 | 9 | 18 | 87 | 13 | 56 | true |
26 | null | Новый мировой рекорд по нырянию в глубину с задержкой дыхания в би-ластах установил россиянин Алексей Молчанов. Он погрузился на 125 метров за 4 минуты и 32 секунды. Достижение зарегистрировано во время Чемпионата мира по фридайвингу AIDA в Аяччо на Корсике.
Молчанов побил собственный рекорд. В прошлом году он нырнул в глубину на 124 метра.
Среди женщин абсолютной победительницей стала россиянка Марианна Гиллеспи. Она завоевала первые места в трёх дисциплинах.
@ctrs2018 | https://t.me/drmyasnikov/2571?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 79,900 | 0 | 1,726,592,567 | 1,730,797,661 | 10,110 | 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| [{"ner":"Алексей Молчанов","lemma":"алексей молчанов","label":"PER","start_pos":94,"end_pos":110},{"ner":"AIDA","lemma":"aida","label":"ORG","start_pos":234,"end_pos":238},{"ner":"Аяччо","lemma":"аяччо","label":"LOC","start_pos":241,"end_pos":246},{"ner":"Корсике","lemma":"корсике","label":"LOC","start_pos":250,"end_pos":257},{"ner":"Молчанов","lemma":"молчанов","label":"PER","start_pos":259,"end_pos":267},{"ner":"Марианна Гиллеспи","lemma":"марианна гиллеспи","label":"PER","start_pos":399,"end_pos":416},{"ner":"125","lemma":"125","label":"NUM","start_pos":129,"end_pos":132},{"ner":"4","lemma":"4","label":"NUM","start_pos":143,"end_pos":144},{"ner":"32","lemma":"32","label":"NUM","start_pos":154,"end_pos":156},{"ner":"124","lemma":"124","label":"NUM","start_pos":332,"end_pos":335},{"ner":"2018","lemma":"2018","label":"NUM","start_pos":470,"end_pos":474}] | NEUTRAL | rus | NOT SPAM | 70 | 0 | 2 | 0.97561 | 0.02439 | 0 | 6 | 7 | 3 | 5 | 23 | 0 | 7 | true |
26 | null | Посмотрите, кто забрел ко мне на передачу! Алиса Тищенко- ЗМС, 7-кратная чемпионка Мира по гимнастике!
#Aliskins
🤸 | https://t.me/drmyasnikov/2572?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 77,300 | 0 | 1,726,675,652 | 1,730,797,661 | 10,101 | 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| [{"ner":"Алиса Тищенко-","lemma":"алиса тищенко-","label":"PER","start_pos":43,"end_pos":57},{"ner":"7","lemma":"7","label":"NUM","start_pos":63,"end_pos":64}] | NEUTRAL | rus | NOT SPAM | 17 | 0 | 1 | 0.958333 | 0.041667 | 0 | 1 | 2 | 2 | 0 | 3 | 0 | 4 | true |
26 | null | Сегодня ДР моего деда- Александра Леонидовича Мясникова. Вот уж кто любил жизнь! Картины, классическая музыка, женщины, литература, природа…. Да- барин, но с невероятной трудоспособностью и харизмой! На его книгах воспитывались поколения врачей, и сегодня их читаешь как захватывающий роман, а не скучное руководство! Высокий, мощный, с крупной лысой головой и неиссякаемой радостной энергией… | https://t.me/drmyasnikov/2574?embed=1&mode=tme | https://t.me/ | https://t.me/s/drmyasnikov | 82,400 | 0 | 1,726,721,540 | 1,730,797,661 | 10,101 | 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| [{"ner":"Александра Леонидовича Мясникова","lemma":"александр леонидович мясникова","label":"PER","start_pos":23,"end_pos":55},{"ner":"Да- барин","lemma":"да- барин","label":"PER","start_pos":142,"end_pos":151}] | POSITIVE | rus | NOT SPAM | 53 | 0 | 1 | 1 | 0 | 0 | 9 | 4 | 2 | 0 | 16 | 2 | 16 | true |
26 | null | Знакомьтесь, это семечка Plantago ovata (рис.1), именно его оболочку мы и употребляем в качестве источника пищевых волокон, известного как псиллиум.
В английском эта оболочка называется mucilage, что на русском значит «растительная слизь».
Из чего состоит эта оболочка?
Она представлена двумя слоями, которые смешиваются после насыщения водой:
- первый слой (L1 /розовый на рисунке 2) состоит из пектинов– хорошо растворимых линейных цепочек углеводов
- второй слой (L2 / синий на рисунке 2) состоит из «гемицеллюлозы» - 90% от всей оболочки - разветвленного длинного сахара, состоящего из ксилозы и арабинозы (обычная целлюлоза же состоит только из глюкозы), который, в отличие от хорошо растворимого первого слоя, образует гелеобразную массу, когда «набухает» за счет удержания жидкости
Прежде всего эта «гемицеллюлоза» обеспечивает псиллиум его чудесными свойствами:
- увеличение объема стула за счет того, что «растительная слизь» увеличивается в объеме в 10 и более раз
- гель-образующие свойства облегчают транзит по кишечнику
- размягчение консистенции плотного стула при запорах, и как следствие - уменьшение травматизации
- может уменьшить проявления легкой диареи – за счет повышения его вязкости
Добавлять вы его можете куда угодно: растворять в воде, соке, добавлять в каши, йогурты и т.д.
Завершу пост интересным фактом про подорожник. Эта слизь появилась у него в ходе эволюции с целью выживания – она позволила семенам сохраняться в кишечнике и распространяться животными.
Как показывают исследования, пройдя через птичку, ~83% семян Plantago ovata прорастают.
🌻
Семена других растений без защитной слизи либо перевариваются, либо не прорастают после съедения.
🐦⬛️
Возможно, при этом птички еще и лучше какают.
😉
Ешьте псиллиум, и вы тоже будете!
https://doi.org/10.1038/s41598-020-68685-w
https://doi.org/10.1007/s00114-020-01709-7
#пищевыеволокна #интересное | https://t.me/ibs_doc/162?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 19,400 | 0 | 1,700,072,077 | 1,730,797,661 | 10,162 | 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| NEUTRAL | rus | SPAM | 259 | 1 | 3 | 0.973607 | 0.026393 | 0 | 27 | 36 | 14 | 7 | 88 | 10 | 60 | true |
26 | null | 📝
Как мы с вами знаем,
в норме
заброс жёлчи в желудок может возникать натощак после 6-8 часов голодания, во время приёмов пищи, а также во время рвоты или внедрения гастроскопа.
📝
В связи с этим не существует 100% эндоскопических критериев, которые скажут нам о патологическом дуодено-гастральном рефлюксе.
☝️
Однако, мы, эндоскописты, вправе заподозрить патологический ДГР. И он возможен не только в оперированном желудке.
✅
Один из признаков-это так называемое
Жёлчное окрашивание (bile stain)
-наложения густой жёлчи на стенках желудка. (не путаем с
«озерцом» жёлчи
в желудке-bile lake, которое бывает в норме). При этом отмыть такую жёлчь бывает непросто даже с помощью водоструйной помпы. | https://t.me/ibs_doc/168?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 7,200 | 0 | 1,700,713,466 | 1,730,797,661 | 10,101 | 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| [{"ner":"ДГР","lemma":"дгр","label":"ORG","start_pos":370,"end_pos":373},{"ner":"озерцом","lemma":"озерцо","label":"ORG","start_pos":554,"end_pos":561},{"ner":"6","lemma":"6","label":"NUM","start_pos":84,"end_pos":85},{"ner":"8","lemma":"8","label":"NUM","start_pos":86,"end_pos":87},{"ner":"100","lemma":"100","label":"NUM","start_pos":209,"end_pos":212}] | NEUTRAL | rus | NOT SPAM | 104 | 0 | 3 | 0.972973 | 0.027027 | 0 | 12 | 12 | 9 | 5 | 29 | 6 | 24 | true |
26 | null | ☄️
Смотрите, что сегодня обнаружил в перекрестке
😍
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#рекомендую #лактоза | https://t.me/ibs_doc/170?embed=1&mode=tme | https://t.me/ | https://t.me/s/ibs_doc | 7,700 | 0 | 1,700,724,973 | 1,730,797,661 | 10,101 | 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| null | NEUTRAL | rus | NOT SPAM | 11 | 0 | 0 | 1 | 0 | 0 | 0 | 3 | 0 | 0 | 3 | 1 | 5 | true |
26 | null | глухие от рождения шизофреники голосов не слышат, но видят руки, наговаривающие нехорошее на языке жестов [1]. у слепых с рождения шизофрении не бывает вовсе [2]
все по матфею: «ничто, входящее в человека извне, не может осквернить его; но что исходит из него, то оскверняет человека»
1.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632268
2.
https://bit.ly/2NmsRAR | https://t.me/imatrip/2067?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,600 | 0 | 1,722,285,279 | 1,730,797,661 | 10,174 | 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| [{"ner":"26322","lemma":"26322","label":"DATE","start_pos":333,"end_pos":338},{"ner":"1","lemma":"1","label":"NUM","start_pos":107,"end_pos":108},{"ner":"2","lemma":"2","label":"NUM","start_pos":159,"end_pos":160},{"ner":"1","lemma":"1","label":"NUM","start_pos":285,"end_pos":286},{"ner":"2","lemma":"2","label":"NUM","start_pos":341,"end_pos":342},{"ner":"2","lemma":"2","label":"NUM","start_pos":359,"end_pos":360}] | NEUTRAL | rus | NOT SPAM | 49 | 0 | 0 | 0.971429 | 0.028571 | 0 | 2 | 10 | 5 | 4 | 11 | 2 | 16 | true |
26 | null | Гэлвины казались воплощением американской мечты: отец - герой войны, мать - образцовая домохозяйка, десять сыновей и две дочери, большой дом в живописной долине. Каждый из двенадцати детей подавал большие надежды. Дональд был выдающимся спортсменом, Джон и Брайан - одаренными музыкантами, а Ричард - способным математиком. Однако со временем окружающие стали замечать, что в доме на улице Хидден-Вэлли что-то идет не так… Семья Гэлвинов хранила тайну - но их скелеты в шкафу стали достоянием всего мира и главной научной загадкой XX века, над которой десятилетиями бились генетики и психиатры. А за кадром многолетних исследований разыгрывалась настоящая трагедия: абьюз, сексуальное насилие, наркотики и даже убийство. Быть Гэлвином означало либо сходить с ума самому, либо наблюдать, как это делают близкие. Блестящее расследование Роберта Колкера - невероятная реальная история одной семьи, подарившей надежду на исцеление миллионам людей.
#литература | https://t.me/imatrip/2068?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 3,200 | 0 | 1,722,327,154 | 1,730,797,661 | 10,110 | 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| [{"ner":"Гэлвины","lemma":"гэлвины","label":"PER","start_pos":0,"end_pos":7},{"ner":"Дональд","lemma":"дональд","label":"PER","start_pos":214,"end_pos":221},{"ner":"Джон","lemma":"джон","label":"PER","start_pos":250,"end_pos":254},{"ner":"Брайан","lemma":"брайан","label":"PER","start_pos":257,"end_pos":263},{"ner":"Ричард - способным математиком","lemma":"ричард - способный математик","label":"PER","start_pos":292,"end_pos":322},{"ner":"Хидден-Вэлли","lemma":"хидден-вэлли","label":"LOC","start_pos":390,"end_pos":402},{"ner":"Гэлвинов","lemma":"гэлвинов","label":"PER","start_pos":429,"end_pos":437},{"ner":"Гэлвином","lemma":"гэлвином","label":"PER","start_pos":726,"end_pos":734},{"ner":"Роберта Колкера - невероятная","lemma":"роберт колкера - невероятный","label":"PER","start_pos":835,"end_pos":864}] | NEUTRAL | rus | NOT SPAM | 134 | 0 | 2 | 0.993827 | 0.006173 | 0 | 21 | 14 | 5 | 4 | 53 | 3 | 23 | true |
26 | null | Памятка по приёму атомоксетина | https://t.me/imatrip/2071?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,600 | 0 | 1,722,371,466 | 1,730,797,661 | 10,110 | 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| null | NEUTRAL | rus | NOT SPAM | 4 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 0 | 0 | true |
26 | null | 🫧
ВЛИЯНИЕ
СДВГ НА СЕКСУАЛЬНУЮ ЖИЗНЬ
🔞
Как известно, синдром дефицита внимания и гиперактивности (СДВГ) сопровождает человека всю жизнь и связан с рядом негативных последствий. Например, человек с СДВГ может иметь низкую самооценку, трудности с поддержанием стабильных отношений или поиском и сохранением работы. На интимной жизни СДВГ и часто сопровождающие его состояния, такие как депрессия и тревога, тоже
могут сказываться
.
В процессе сексуальной активности человек с СДВГ может:
🤦♀
испытывать трудности с удержанием внимания;
🤦♀
легко отвлекаться
🤦♀
не слушать своего партнера или не выполнять его просьбы;
🤦♀
терять вещи, такие как презервативы или лубриканты.
Человеку с СДВГ тяжело постоянно поддерживать порядок и организацию. У него может не быть энергии или желания заниматься сексом. Исследование 2020 года показало: у женщин с СДВГ снижены сексуальное желание, возбуждение, общее удовлетворение и частота оргазмов по сравнению с женщинами без СДВГ. Это может быть связано с такими симптомами, как рассеянность и неспособность сосредоточиться на своем теле во время сексуальной активности. Мужчины с СДВГ сообщали о таком же сексуальном желании, как и мужчины без СДВГ, но у них были снижены частота оргазмов, эректильная функция и общее сексуальное удовлетворение. Кроме того, люди с СДВГ могут быть гиперчувствительны. Это означает, что сексуальная активность, которая приятна партнеру без СДВГ, может быть раздражающей или неприятной для человека с СДВГ. Запахи, прикосновения и вкусы, которые часто сопровождают половой акт, могут быть отталкивающими или раздражающими для человека с СДВГ.
При СДВГ может наблюдаться гиперсексуальность, то есть необычно высокое половое влечение. Это, в свою очередь, нередко приводит к наличию нескольких партнеров или проблемному использованию порнографии, что сложностями в отношениях. По данным некоторых исследований, многие люди с гиперсексуальностью также имеют СДВГ. Некоторые люди с СДВГ могут заниматься рискованными сексуальными практиками из-за проблем с импульсивностью. Люди с СДВГ также могут иметь повышенный риск злоупотребления веществами, что может ещё больше ухудшить принятие решений и привести к сексуальному риску.
Гипосексуальность тоже связана с СДВГ. Она является противоположностью гиперсексуальности: половое влечение человека необычайно низкое, и он часто теряет всякий интерес к сексуальной активности. Гипосексуальность может быть следствием самого СДВГ или побочным эффектом лекарств, в частности, антидепрессантов, которые врачи часто прописывают людям с СДВГ. Секс ничем не отличается от других видов деятельности, которые представляют собой проблему для человека с СДВГ. Человек может испытывать трудности с концентрацией внимания во время секса, терять интерес к тому, что он делает, или отвлекаться.
Как человеку с СДВГ справляться с трудностями в сексуальной жизни?
🔺
Информация. Понимание симптомов и последствий СДВГ поможет наладить интимную жизнь.
🔺
Общение и компромиссы. Обсудите, как ваш СДВГ может влиять на близость и сексуальность. Если у вашего партнера СДВГ, принимайте во внимание его потребности наряду со своими собственными. Например, вы можете выключить яркий свет и не использовать сильно пахнущие лосьоны или духи, если ваш партнер чувствителен к свету и ароматам.
🔺
Приоритеты. Работайте над тем, чтобы быть в настоящем моменте. Избавьтесь от отвлекающих факторов и попробуйте вместе делать успокаивающие упражнения, медитировать. Назначайте свидания для секса и обсудите обязательства, которые вы можете на себя взять в процессе таких свиданий. Сделав секс приоритетом, вы сможете гарантировать, что он не будет отодвинут на второй план.
🔺
Разнообразие. Как только вы хорошо поймёте себя или своего партнера с СДВГ, вы можете начать вносить что-то новое в свою сексуальную жизнь, если вы оба этого захотите. Например, вы можете попробовать новые позы, игрушки или места.
🔺
Помощь специалиста. Если самостоятельно справиться не получается, можно обратиться к специалисту, работающему с такими запросами (часто это психолог-сексолог). | https://t.me/imatrip/2072?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 2,700 | 0 | 1,722,428,343 | 1,730,797,661 | 10,101 | 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| NEUTRAL | rus | NOT SPAM | 561 | 0 | 33 | 1 | 0 | 0 | 47 | 91 | 35 | 4 | 169 | 25 | 106 | true |
26 | null | ANIMAL BEHAVIOUR
Страна: Канада
Жанр: мультфильм, короткометражка, комедия
Продолжительность: 00:14:27
Год выпуска: 2018
Лорейн, Шерил, Тодд, Джефри и Линда пришли на очередную групповую терапевтическую сессию к доктору Клементу, автору бестселлера, посвященного методам самоконтроля. | https://t.me/imatrip/2073?embed=1&mode=tme | https://t.me/ | https://t.me/s/imatrip | 3,000 | 0 | 1,722,511,770 | 1,730,797,661 | 10,101 | 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| [{"ner":"короткометражка","lemma":"короткометражка","label":"ORG","start_pos":50,"end_pos":65},{"ner":"00:14:27","lemma":"00:14:27","label":"CARDINAL","start_pos":94,"end_pos":102},{"ner":"2018","lemma":"2018","label":"DATE","start_pos":116,"end_pos":120},{"ner":"Тодд","lemma":"Тодд","label":"ORG","start_pos":136,"end_pos":140},{"ner":"Джефри и Линда","lemma":"Джефри и Линда","label":"PER","start_pos":142,"end_pos":156},{"ner":"очередную групповую","lemma":"очередную групповую","label":"PER","start_pos":167,"end_pos":186},{"ner":"Клементу","lemma":"Клементу","label":"ORG","start_pos":220,"end_pos":228},{"ner":"14","lemma":"14","label":"NUM","start_pos":97,"end_pos":99},{"ner":"27","lemma":"27","label":"NUM","start_pos":100,"end_pos":102}] | NEUTRAL | rus | SPAM | 33 | 0 | 2 | 0.96 | 0.04 | 0 | 4 | 2 | 0 | 0 | 12 | 0 | 12 | true |
26 | null | Самый необычный анализ здоровья в моей жизни будет завтра
🤯
Пока добирался до Краснодара, получил от знакомой, которой доверяю, интересное предложение: разложить по полочкам моё здоровье и благосостояние по моей карте в китайской астрологии.
Никогда таким не занимался, решил согласиться. Тем более, там будет много про мое либидо
😁
Завтра в 11:00 выйду в эфир в Инстаграме, приходите и вы послушать!
Всех приглашаю
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присоединяйтесь | https://t.me/magerya/11454?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 40,500 | 0 | 1,729,274,848 | 1,730,797,661 | 10,174 | 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| [{"ner":"Краснодара","lemma":"краснодар","label":"LOC","start_pos":78,"end_pos":88},{"ner":"Инстаграме","lemma":"инстаграм","label":"LOC","start_pos":363,"end_pos":373},{"ner":"11:00","lemma":"11:00","label":"DATE","start_pos":342,"end_pos":347},{"ner":"00","lemma":"00","label":"NUM","start_pos":345,"end_pos":347}] | NEUTRAL | rus | NOT SPAM | 65 | 0 | 0 | 1 | 0 | 0 | 6 | 12 | 4 | 0 | 15 | 7 | 11 | true |
26 | null | Вечерний чат
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Обсуждайте любые темы | https://t.me/magerya/11455?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 39,700 | 0 | 1,729,277,114 | 1,730,797,661 | 10,163 | 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| null | NEUTRAL | rus | NOT SPAM | 15 | 0 | 0 | 1 | 0 | 0 | 1 | 4 | 0 | 0 | 6 | 0 | 1 | true |
26 | null | Нами управляют
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ПАРАЗИТЫ
Сегодня расскажу 14 признаков того, что у вас подселенцы!
Спойлер: один из пунктов — неуёмное желание сладкого
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Ваш ход
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Что думаете еще указывает на их наличие? | https://t.me/magerya/11456?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 42,800 | 0 | 1,729,310,110 | 1,730,797,661 | 10,110 | 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| [{"ner":"14","lemma":"14","label":"NUM","start_pos":43,"end_pos":45}] | NEUTRAL | rus | NOT SPAM | 32 | 0 | 1 | 1 | 0 | 0 | 2 | 4 | 4 | 2 | 7 | 2 | 6 | true |
26 | null | Я не договорил
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Ловите еще 7 признаков:
8️⃣
Странные ощущения в животе
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Необоснованный голод
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подключиться | https://t.me/magerya/11457?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 41,500 | 0 | 1,729,332,053 | 1,730,797,661 | 10,101 | 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| [{"ner":"24 октября","lemma":"24 октября","label":"DATE","start_pos":332,"end_pos":342},{"ner":"7","lemma":"7","label":"NUM","start_pos":29,"end_pos":30},{"ner":"8","lemma":"8","label":"NUM","start_pos":42,"end_pos":43},{"ner":"9","lemma":"9","label":"NUM","start_pos":73,"end_pos":74},{"ner":"1","lemma":"1","label":"NUM","start_pos":98,"end_pos":99},{"ner":"0","lemma":"0","label":"NUM","start_pos":102,"end_pos":103},{"ner":"1","lemma":"1","label":"NUM","start_pos":121,"end_pos":122},{"ner":"1","lemma":"1","label":"NUM","start_pos":125,"end_pos":126},{"ner":"1","lemma":"1","label":"NUM","start_pos":165,"end_pos":166},{"ner":"2","lemma":"2","label":"NUM","start_pos":169,"end_pos":170},{"ner":"1","lemma":"1","label":"NUM","start_pos":199,"end_pos":200},{"ner":"3","lemma":"3","label":"NUM","start_pos":203,"end_pos":204},{"ner":"1","lemma":"1","label":"NUM","start_pos":245,"end_pos":246},{"ner":"4","lemma":"4","label":"NUM","start_pos":249,"end_pos":250}] | NEUTRAL | rus | SPAM | 63 | 0 | 2 | 1 | 0 | 0 | 12 | 5 | 1 | 8 | 22 | 1 | 6 | true |
26 | null | Чай «Про лактацию»
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Травы этого сбора расслабляют протоки молочных желез, стимулируя выработку молока кормящей женщины
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Полезные минералы в составе трав облегчают работу желудочно-кишечного тракта мамы и помогают уменьшить колики новорожденного.
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Но помимо кормящих женщин, чай нормализует пищеварение, поднимает иммунитет и восстанавливает гормональный фон.
Мы создали чайный напиток, который помогает уберечь, сохранить и укрепить ваше здоровье
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Галега – маленькая, но очень гордая травка поможет улучшить лактацию кормящим мамам. Она также используется в народной медицине для лечения сахарного диабета.
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Чёрный тмин назначают при сильных болях во время месячных и ПМС (предменструальном синдроме). Также семена этого растения способны нормализовать гормональный фон после операций и родов.
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Душица в составе может похвастать соединениями, способными регулировать эффект гормона эстрогена. В результате вы получаете стабильный гормональный фон и менструальный цикл. Душица сильна в лечении беЗплодия и патологий малого таза. Ох, не зря наши предки называли её «материнкой»
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Гибискус помогает снизить уровень сахара в крови, устранив склонность к инсулинорезистентности и гестационному диабету.
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Малину все мы знаем как прекрасное противовоспалительное и омолаживающее средство.
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Скромная с виду трава манжетка – мощный лекарь, самая «женская» трава в народной медицине. Именно её заваривали наши прабабушки для благоприятного вынашивания, рождения ребёнка и восстановления после родов. К ней бежали, когда возникали проблемы «по-женски». БеЗплодие, воспаление матки, придатков и яичников, мастопатия, гормональные нарушения при климаксе, нарушения менструального цикла, угроза выкидыша, трещины и разрывы после родов – это только малая часть показаний для знакомства с манжеткой.
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wildberries/про_лактацию
Ещё больше полезной информации о витаминах и нутриентах ищите на канале "Жизнивек"
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Реклама. ООО «Жизнивек»
ИНН 2311312648 | https://t.me/magerya/11458?embed=1&mode=tme | https://t.me/ | https://t.me/s/magerya | 44,500 | 0 | 1,729,350,097 | 1,730,797,661 | 10,101 | 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| [{"ner":"Галега","lemma":"галега","label":"PER","start_pos":457,"end_pos":463},{"ner":"Гибискус","lemma":"гибискус","label":"PER","start_pos":1092,"end_pos":1100},{"ner":"Жизнивек","lemma":"жизнивек","label":"ORG","start_pos":1910,"end_pos":1918},{"ner":"ООО «Жизнивек»\nИНН 2311312648","lemma":"ооо \"жизнивек\"\nинн 2311312648","label":"ORG","start_pos":1954,"end_pos":1983},{"ner":"2311312648","lemma":"2311312648","label":"DATE","start_pos":1973,"end_pos":1983},{"ner":"12648","lemma":"12648","label":"DATE","start_pos":1978,"end_pos":1983}] | NEUTRAL | rus | NOT SPAM | 263 | 0 | 5 | 0.994334 | 0.005666 | 0 | 36 | 37 | 8 | 2 | 106 | 8 | 61 | true |
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-пшел в анус | https://t.me/sudmednotes/9161?embed=1&mode=tme | https://t.me/ | https://t.me/s/sudmednotes | 44,000 | 0 | 1,729,600,126 | 1,730,797,661 | 10,174 | 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| null | NEGATIVE | rus | NOT SPAM | 8 | 1 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | 1 | 1 | 3 | true |
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